Arrival at this page from previous parts of my medical journey allows the reader to skip the first couple of paragraphs otherwise, my story includes several chronic ilnesses centered upon being an Auto-immune person with Hypothyroidism, Coeliacs Disease, Pernicious Anaemia, Gout, Aortic Annuerism, Angina, Axonal Neuropathy, Arthritic Knees and a Lumbar Spinal Cord Defect.

Fortunately, all but the latter two are under control as a result of being continually monitored by several consultants at my NHS Hospital. Even so, the Annuerism continues to grow omminously reachng 5.2 centimeters in June '09, so it remains a threat to my well-being in an uncertain future. Axonal Neuropathy causes me numb feet from toe to ankle but I am assured, apart from the inconvenience, it's essentially a benign conditiion due to damage probably caused by the P.A.

The crooked Knees have been awaiting treatment for over two years while key consultants had an "After-You-George" series of investigations to establish if I can be safely anaethetised complicated by Annuerism and Obesity plus the fitness of my Nervous System to undertake epidurals and nerve blocks. They even decided I would need a high dependency bed for recovery.

As ever, the Lumbar Spine Defect prevents me from walking any useful distance over 50 metres without significant pain in lower back, buttocks, hips, front pelvic muscles and upper thigh. Pushing through the pain results in vice-like, cramps relieved only by sitting or squatting. This takes a minute or two to dissipate giving me another fifty metres but the effect after a couple of hours of this yo-yo between pain and relief is very exhausting.

Thus it became a mission born out of desperation to break into this circle of despair created by crooked knees and inability to mobilise due to the spinal issue. Eventually I persuaded the knee surgeon to proceed with the worst knee and I therfeore found myself on the operating slab during the second week of Jan '09. The anaesthetist was the key person now, as to whether he could satisfactorily perform the epidural and nerve block as the strictly preferred alternative to a General Anaesthetic, which he says is risky for me anyway. No such luck! After 35 minutes of poking me with his needles and apologising for not so small scratches, he could not reach the spinal cord cavity to squirt his stuff. His assistant was assuring me it would be OK, whilst mopping my brow and urging me to just bend over a bit more please? Not easy with my big tummy.

Now the moment of truth! The job can't be done so he suggests abandonment. I should Coco! I inform him in no uncertain terms, I dont care how he does it, just find a bloody way of proceeding because unless he did, they would have to drag me kicking and screaming from the theatre. If you recall Patrick McGoohan telling Rock Hudson to blast his way through the ice pack enroute to "Ice Station Zebra" you'll have some idea of the tension thereabouts?

He agreed! The nurse warned me there would be a cool sensation in my hand and the next thing I knew would be waking in recovery. True to her word, I awoke in a world of tubes and pipes sporting a new left knee. The next four hours were a mixture of waking, dozing, acute pains in the knee and bladder before they fixed these duel problems with painkillers and catheter respectively.

And so it proceeded! Vital signs, pain control, relieved visitors, (relieved bladder to - phew!), surgeon expressing satisfaction, starting physiotherapy, out of bed, start walking, all before the end of day two. On the third day, loads of swelling, ice packs, more walking, navigating stairs and a declaration that, depending upon the bloods, I can go home as soon as the medications arrive from pharmacy. Wow! Tuesday morning to Thursday afternoon, job done! Its like a production line!

Now it gets complicated! After a three hour wait the ward doctor declares I can't leave due to renal malfunction detected by blood test. Shoot! Have to wait another whole day while they investigate and resolve. Well, whats best for me, so no worries there then? Following day its "Home James, and dont spare the horses"!

I have to say what surprised me was the speed of mechanical recovery and flexing of the joint. to 120 degrees in less than a week, it was so good, the physiotherapist discharged me after one session with her words ringing in my ears, "Dont neglect the exercises!". Of course the muscular and soft tissue trials and tribulations are a very different kettle of fish!

Six weeks later, I meet the consultant again, virtually free of internal joint pain and getting the best from constant exercising and riding my bike. He immediately declares total satisfaction and wants to get on with the second knee as soon as possible because, "this waiting list nonsense has gone on long enough". After all this time he is now in overdrive and within a few days my second knee is scheduled for the end of April, just 8 weeks from being discharged from knee #1.

So it transpired, I fetch up at the same place to repeat the process but unfortunately the procedure was cancelled ten minutes before I was due in theatre as a result of a critical backlog of trauma cases requiring two elective theatres being requisitioned for the sick and needy. Tough on me but I depart with a promise of being rescheduled within 4 weeks.

So now its the last week in May and here we go again. First on the list and ready for the slab. Make you laugh, I had to walk to the operating theatre, operating gown flapping away! Must be a shortage of porters. No silly nonsense this time trying to give me an epidoodle! Straight in with the knockout drops and I wake in recovery with another new knee, with no high dependency bed on standby either.

Back on the ward things seem a lot different. First off, no drain in the wound" Second, my bladder works, tickety boo! Thank goodness for that! Now for the bad news! The wound is bleeding lots. and they keep piling on the bandages. I wake at 4am the following morning in a sea of blood. not dissimilar to that gory scene in "The Godfather" but the only thing missing is the horse's head!

The night nurse, an epitimy of calm, redressed the wound but it turns out the leakage occurred as a result of the steri-strips letting go due to excess swelling. This remained undiscovered for another 12 hours. So in the late afternoon of day 2, the surgeon was summoned 'tout de suite' and immediately stapled me up with 21 shiney new clips. I counted them going in.

Next day was down to physiotherapy, as before and the day after that found me tackling the stairs again so with no renal malfunction this time around I am discharged to the comfort of my own home. Everything goes swimmingly, discharged by the physios straight awayl. Then, completely out of left field I get this fat lower leg with oodles of wierd internal pain, so I visit the GP at 4.30 pm on the Tujesday exactly 3 wks after the operation and at 5.30 pm I'm back in hospital with suspected Deep Vein Thrombosis (DVT). What I don't need right now is DVT.

More blood tests and an ultrasound scan proved to be thankfully negative so its back home and off to the GP whom I persuade to treat it as an infection. He agrees that antibiotics would be OK, just in case, and would do no harm anyway. One week later he does diagnose a dodgy leg infection, cellulitis. This takes four weeks of strong antibiotics to shift and proved to be a real setback regarding exercising and pain control.

Despite the setback, 6 weeks from the operation the consultant's registrar declares complete satisfaction with their handiwork and dismisses me to be seen in clinic 12 months hence. Thus the knees are done and its now a straight fight between me and these damn muscles, tendons ligaments and soft tissues to get both new joint working purfek again

You'll have gathered that walking remains an elusive luxury due to the continuing spinal defect but at least the knees respond well to their daily cycling excursion and as this part of the story folds, I have just had my third lumber MRI to try and determine the root cause of that sorry state of affairs. Mind you, I refuse to be depressed by these goings on, continuing these website attempts to document my life in hobbies so my har-won experience can be shared with fellow enthusiasts.

Go to the next page for a gruesome MRI Scan of my spine here or just go back to previous page.

The Medical Story (Continued)

Breaking into The Circle of Despair caused by Arthritic Knees and a Lumbar Spinal Cord Defect.

Ramon Alban


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