I've been studying Jesus' conversation with his disciples in Acts 1, just before he left this earth. They ask Jesus if The Kingdom is going to be restored to Israel, since the suffering of the Messiah is done? That seems to be the order in OT prophesy. Jesus gives his followers a new responsibility and a gift to go along with the duty. The responsibility was to be witnesses of what they had seen and heard. The gift was a permanent presence of the Holy Spirit. This gift would provide the power, the ability to carry out the responsibility.
I have made evangelism so much more complicated than what Jesus sketches out. What have I personally seen and heard from Jesus? Jesus took a skinny, diminutive wall flower and gave him the power to talk to others about God. I have personally been placed at the right place at the right time with the right word for individuals. I have felt the presence of God so powerful it pasted me to the floor. I have watched some influence tenderize stubborn attitudes and encourage the fearful. Often this influence manifested after prayer to God through Jesus.
Folks can certainly argue about whether these effects are just "psychological" or "spiritual." Either explanation leans toward the supernatural by the way. How can you measure love in a test tube or as electrical impulses. Can you determine for sure which came first, the electricity or the feeling? What about when the electrode is not attached? What causes the electricity to arise then? Why are these feelings, which cripple at times, an evolutionary step forward?
I know, maybe they are not and will be dropped in another million years. Since neither you nor I have any idea what will be in a million years, my guess could be just as accurate as yours. My guess is that God will have put an end to this corrupted existence by then and brought about the next age, where folks previously corrupted by sin, like me, will be made new through trust in Jesus the God man. Don't you hope I'm right?
Thursday, September 26, 2013
Thursday, April 25, 2013
2 weeks out
I arrived home after 3 days in the hospital. I brought home 30 staples, 9 stitches, a wheeled walker, a bedside commode and 80 oxycodone. The stitches were to allow the intersection of my new vertical slice and my horizontal scar from 27 years previous. I also brought home my 27 year old screw from my first Hauser Procedure.
My first few nights I slept on a very cushy couch which had proved great for napping. Too low as the anesthesia wore off. Way too difficult to climb off from. I switched to a firmer, scratcher, higher couch which worked fine.
During the first week my thinking was fairly fogged from anesthesia and regular high doses of painkillers. With flashes of awakening nerves gave notice around the new knee that they were back on the job. My second night home, after all had gone to bed, my whole leg tensed into a capital "L" shape for 3/4ers of a second while I yelped and relaxed.
I brought a sheet of exercises home, stick figures moving branch legs to taunt me. I called the new knee "my 5000 lb leg." It took me 10 days before it lost enough weight for me to lift it without assistance. Talk about frustration.
Two weeks out I can walk with a cane for short distances. I can climb stairs, though sleeping in my own bed is not as comfortable as the couch. I can shower with a chair. My thinking is growing clearer as I ease back on the meds.
Discouragement is a threat. My expectations are growing more realistic. All along I have asked God to guide me down His path to healing. He has helped my body a long way in two weeks, but its easy to lose sight of how major a surgery I had. I had carried a bunch of pain for months prior to the operation. I wanted to wake up with the pain just a couple of weeks from being gone. Today that looks more like a year. I'll keep you posted.
My first few nights I slept on a very cushy couch which had proved great for napping. Too low as the anesthesia wore off. Way too difficult to climb off from. I switched to a firmer, scratcher, higher couch which worked fine.
During the first week my thinking was fairly fogged from anesthesia and regular high doses of painkillers. With flashes of awakening nerves gave notice around the new knee that they were back on the job. My second night home, after all had gone to bed, my whole leg tensed into a capital "L" shape for 3/4ers of a second while I yelped and relaxed.
I brought a sheet of exercises home, stick figures moving branch legs to taunt me. I called the new knee "my 5000 lb leg." It took me 10 days before it lost enough weight for me to lift it without assistance. Talk about frustration.
Two weeks out I can walk with a cane for short distances. I can climb stairs, though sleeping in my own bed is not as comfortable as the couch. I can shower with a chair. My thinking is growing clearer as I ease back on the meds.
Discouragement is a threat. My expectations are growing more realistic. All along I have asked God to guide me down His path to healing. He has helped my body a long way in two weeks, but its easy to lose sight of how major a surgery I had. I had carried a bunch of pain for months prior to the operation. I wanted to wake up with the pain just a couple of weeks from being gone. Today that looks more like a year. I'll keep you posted.
Wednesday, April 17, 2013
What They Found . . . Blocks CAN leak
"H&E stained sections demonstrate synovial tissue lined fibrofatty tissue with polypoid and somewhat villiform synovial proliferation. . . Some dystrophic calcific material deposits are noticed in the synovium. Zones of golden brown hemosiderin pigment are noticed in the synovium."
A lot of terms to look up. I will ask the doctors Friday when the staples come out. Best I can make out, a benign tumor had grown in the synovium and was taken out along with the end of the upper leg bone.
A good tip femoral nerve blocks can leak. My nurses and I found this out the hard way. Wednesday afternoon my gown and blanket lay damp over the IV. After several hours, the next shift of nurses decided to cut the flow of the block and call in the anesthesiologist.
The better part of an hour later, the A' on duty examined the site, declared it leaking, noted that can happen and recommended leaving the block off until morning, when it could be replaced.
I didn't make it til morning. Burning, crushing pain overwhelmed the normal pain meds by change of shift. The PA with the morphine needle fought off the pain dragon. One more needle as the block rebuilt its wall. The site leaked right up until the block was removed Friday morning.
A lot of terms to look up. I will ask the doctors Friday when the staples come out. Best I can make out, a benign tumor had grown in the synovium and was taken out along with the end of the upper leg bone.
A good tip femoral nerve blocks can leak. My nurses and I found this out the hard way. Wednesday afternoon my gown and blanket lay damp over the IV. After several hours, the next shift of nurses decided to cut the flow of the block and call in the anesthesiologist.
The better part of an hour later, the A' on duty examined the site, declared it leaking, noted that can happen and recommended leaving the block off until morning, when it could be replaced.
I didn't make it til morning. Burning, crushing pain overwhelmed the normal pain meds by change of shift. The PA with the morphine needle fought off the pain dragon. One more needle as the block rebuilt its wall. The site leaked right up until the block was removed Friday morning.
Monday, April 15, 2013
Surgery
I was out of it this past week, but I'm sitting in the porch in the sun. Tuesday, April 9th at 8am I rolled stupidly into surgery on the right knee. The knee lay mangled and marked for revision. Even with the Smith and Nephew custom cutting guides, Dr. Joel McClurg took three hours to finish the revision.
He held 2 concerns going in. One, finding the screw from my Hauser procedure of 25+ years earlier. It's metal obscured its location on the MRI. He probed the general area seeking a metal on metal "ting." Once found he was able to unscrew it back through the bone as designed!
Concern Two, how worn down was this guy's patella? He removed 14 mm of "cauliflower looking" material from the base. The button still fit flush on the bottom. Some extra holes needed to be made in the remaining hard bone to enable gluing.
At 12:30pm I was parked in room 203 to begin recovery.
He held 2 concerns going in. One, finding the screw from my Hauser procedure of 25+ years earlier. It's metal obscured its location on the MRI. He probed the general area seeking a metal on metal "ting." Once found he was able to unscrew it back through the bone as designed!
Concern Two, how worn down was this guy's patella? He removed 14 mm of "cauliflower looking" material from the base. The button still fit flush on the bottom. Some extra holes needed to be made in the remaining hard bone to enable gluing.
At 12:30pm I was parked in room 203 to begin recovery.
Monday, March 25, 2013
Joint Camp
Part of the presurgery at Guthrie is a session called Joint Camp. My camp took place March 22. My wife and I walked in the hospital at 7:45am to begin. One of the main goals of the session was to gather all the background needed for surgery ahead of time. The nurse who I am likely to see after surgery taped on EKG leads and ran a tape. She did an intake of my medical history.
After that we were taken to a conference room where we met the other "campers." Four of us are facing joint repair. The first camper I met is 6 years older and will have both knees resurfaced the day before my single surgery. The next camper was a mid-sixties woman and the last a late 50s gentleman who will get his hip replaced.
The two facts I gained from the physical therapist were one, the cutting of the ends of my leg bones will mean the loss of the pressure receptor feedback. This could make the joint feel strange until my brain releans. The second regards a nerve block. For recent shoulder surgery I had a nerve injection. Not fun. In this case an IV would be inserted to drip anesthesia on the femoral nerve until its time for me to be discharged. This will allow me to do PT with less pain.
After that we were taken to a conference room where we met the other "campers." Four of us are facing joint repair. The first camper I met is 6 years older and will have both knees resurfaced the day before my single surgery. The next camper was a mid-sixties woman and the last a late 50s gentleman who will get his hip replaced.
The two facts I gained from the physical therapist were one, the cutting of the ends of my leg bones will mean the loss of the pressure receptor feedback. This could make the joint feel strange until my brain releans. The second regards a nerve block. For recent shoulder surgery I had a nerve injection. Not fun. In this case an IV would be inserted to drip anesthesia on the femoral nerve until its time for me to be discharged. This will allow me to do PT with less pain.
Wednesday, March 20, 2013
Paperwork
Yesterday I went in to fill out my presurgery paperwork with Christine Doak P,A, She mentioned a nerve block possibility during the operation. I had one for my left shoulder and it was not a pleasant experience. She explained that leg blocks work different. For the arm block the nerve in my neck was pierced with a needle and a novacaine like chemical injected. As it wore off, my arm buzzed and my neck throbbed for a solid day. Hard to sleep when that's going on!
When the leg nerve is blocked, they put in a tiny catheter which drips number on the nerve. This sounded better than the needle.
When the leg nerve is blocked, they put in a tiny catheter which drips number on the nerve. This sounded better than the needle.
A deeper understanding of knee replacement
I recently emailed Dr McClurg some questions. On 3/14 I went on to talk with him abut the upcoming surgery. I asked about .ligament retaining surgery. In his opinion the jury is still out on its value. Dr. McClurg elated that leaving the ACL and PCL add complexity to rebalancing the joint. During surgery, he will make adjustments on the two outside tendons of the joint to keep even tension throughout the bending and straightening of the knee, thereby realigning my upper and lower leg. If the two inside ligaments are left in, they also would need to be accounted for. Years of damage have thrown them all off. Now the complexity of realignment has increased 16x!
He also bright up a patient who came to him who had retained the PCL. This person had fallen on some stairs and torn the ligament. The joint was rolling because it was designed to have a who,e PCL for support.
I also asked him about my high riding patella, or Patella Alta. cpuld he repair that during surgery?
"To a limited degree." He replied. "The length of the patellar tendon is already set. We canut in more material to raise the joint line a bit so that the patella is more likely to rest in the groove. However if we have to do a revision, which at your age is likely, we would have less to work with the next time."
I asked if I would be shorter.
"No."
I'm having the Smith and Nephew Visionaire one off cutting guides done. They were not able to fashion the guide for the tibia. The screw in their from the Hauser Procedure decades before through too much of a shadow on the MRI. I will be able to keep the screw after surgery.
Dr. Joel McClurg answered my questions patiently and from a solid knowledge base. I feel as confident and informed as I can.
He also bright up a patient who came to him who had retained the PCL. This person had fallen on some stairs and torn the ligament. The joint was rolling because it was designed to have a who,e PCL for support.
I also asked him about my high riding patella, or Patella Alta. cpuld he repair that during surgery?
"To a limited degree." He replied. "The length of the patellar tendon is already set. We canut in more material to raise the joint line a bit so that the patella is more likely to rest in the groove. However if we have to do a revision, which at your age is likely, we would have less to work with the next time."
I asked if I would be shorter.
"No."
I'm having the Smith and Nephew Visionaire one off cutting guides done. They were not able to fashion the guide for the tibia. The screw in their from the Hauser Procedure decades before through too much of a shadow on the MRI. I will be able to keep the screw after surgery.
Dr. Joel McClurg answered my questions patiently and from a solid knowledge base. I feel as confident and informed as I can.
Thursday, February 21, 2013
Bow-legged Day
Mike the MRI Guy made cheese for 10 years before he started as a tech. "A friend of mine got me into it. He was going to X-ray school and said I should go with him. I applied for MRI school just to see if I could get in. Only two out of 150 make it. A couple weeks later I got a letter in the mail saying I made it."
We cruised through the intake form, while we rode the lift up the outside of the semi that housed the machine. He had me lay down on the narrow tray and strapped my right leg secure in a precise position. He put the headphones on me and stepped to the control section of the trailer. With tiny jerks and roaring buzzes, my knee passed under the gaze of the magnetic eye. After 30 minutes he released me with a worried look.
"You must have a metal screw in your knee that's throwing a shadow. Does the doctor know about that?"
"Yes. I told him."
"Well, I hope they don't send it back." He led me off for the full leg x-rays with a warning not to move.
Once in x-ray, the tech had me change into hospital pants, while she taped up the quarters. When I returned from the changing room, she began to tape the coins to different parts of my leg.
"This procedure is so new that the company hasn't sent us the markers yet, but the coins work fine. Now climb that stool and set your foot on that line. I'm going to take 3 pictures of your leg. If you move, or even shift your during one we have to start over." No pressure? By picture 3 I feel like my leg is vibrating. The tech is happy with them anyway. I'm not. My leg has started to bow. I arrived at 7am and I left at 8:20am.
We cruised through the intake form, while we rode the lift up the outside of the semi that housed the machine. He had me lay down on the narrow tray and strapped my right leg secure in a precise position. He put the headphones on me and stepped to the control section of the trailer. With tiny jerks and roaring buzzes, my knee passed under the gaze of the magnetic eye. After 30 minutes he released me with a worried look.
"You must have a metal screw in your knee that's throwing a shadow. Does the doctor know about that?"
"Yes. I told him."
"Well, I hope they don't send it back." He led me off for the full leg x-rays with a warning not to move.
Once in x-ray, the tech had me change into hospital pants, while she taped up the quarters. When I returned from the changing room, she began to tape the coins to different parts of my leg.
"This procedure is so new that the company hasn't sent us the markers yet, but the coins work fine. Now climb that stool and set your foot on that line. I'm going to take 3 pictures of your leg. If you move, or even shift your during one we have to start over." No pressure? By picture 3 I feel like my leg is vibrating. The tech is happy with them anyway. I'm not. My leg has started to bow. I arrived at 7am and I left at 8:20am.
Wednesday, February 20, 2013
Total knee Replacement
On April 9 th I will have a total knee replacement of my right knee. This installment is written on the night before my full-leg MRI. I am getting this MRI, so that my measurements can be sent out to create custom cutting guides for my right knee. These guides mean no measurements will need to be taken once my leg is opened up.
I would like to acquaint you with how I reached this point. I am a 48 year old male who has had multiple knee surgeries over the last 30 years. When I was 17 and chasing a friend, I stepped in a hole in the yard. My left leg stopped and my knee popped out and came back, a subluxation. Weeks later I was playing tennis in gym and the knee subluxed again. The pop was so loud my gym teacher could hear it a couple courts away. That fall I went to see my first orthopedic surgeon. He told me that my kneecap was riding high on the outside of the knee joint. He said that my muscles were pulling it like a bone string, patellar tracking syndrome. He gave me exercises to do, straight leg lifts. He then scheduled me for arthroscopic surgery on my left knee in about a months time. He went into the knee took out several pieces of floating cartilage and tried to clean up the joint.
By the next fall I was back to see him again. My knee had subluxed another four times. The exercises failed. The plan was to disconnect the bottom of my patellar tendon move it over on the tibia and screw it back in, the Hauser procedure. This worked. After months of rehab and almost a year of recovery my knee was better than new.
My rights knee also had patellar tracking syndrome, and subluxed several times. I went to see the surgeon and this time we cut right to the Hauser Procedure. Another success. The knee felt very strong.
For the next 20 years I played hours and hours of basketball,volleyball lifted weights, ran and enjoyed life. About seven years ago my knees started aching and swelling. Getting up after sitting was extremely painful. A new surgeon scoped both knees twice, removing much damaged cartilage, bone spurs and about 3/4s of an inch of height. He then moved me Euflexxa injections into the joint. No relief. 18 months ago I took my first cortisone injections. After 4 series they stopped providing relief, so here I am.
I would like to acquaint you with how I reached this point. I am a 48 year old male who has had multiple knee surgeries over the last 30 years. When I was 17 and chasing a friend, I stepped in a hole in the yard. My left leg stopped and my knee popped out and came back, a subluxation. Weeks later I was playing tennis in gym and the knee subluxed again. The pop was so loud my gym teacher could hear it a couple courts away. That fall I went to see my first orthopedic surgeon. He told me that my kneecap was riding high on the outside of the knee joint. He said that my muscles were pulling it like a bone string, patellar tracking syndrome. He gave me exercises to do, straight leg lifts. He then scheduled me for arthroscopic surgery on my left knee in about a months time. He went into the knee took out several pieces of floating cartilage and tried to clean up the joint.
By the next fall I was back to see him again. My knee had subluxed another four times. The exercises failed. The plan was to disconnect the bottom of my patellar tendon move it over on the tibia and screw it back in, the Hauser procedure. This worked. After months of rehab and almost a year of recovery my knee was better than new.
My rights knee also had patellar tracking syndrome, and subluxed several times. I went to see the surgeon and this time we cut right to the Hauser Procedure. Another success. The knee felt very strong.
For the next 20 years I played hours and hours of basketball,volleyball lifted weights, ran and enjoyed life. About seven years ago my knees started aching and swelling. Getting up after sitting was extremely painful. A new surgeon scoped both knees twice, removing much damaged cartilage, bone spurs and about 3/4s of an inch of height. He then moved me Euflexxa injections into the joint. No relief. 18 months ago I took my first cortisone injections. After 4 series they stopped providing relief, so here I am.
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