Knee Surgery – Meniscus Flap Tear

Knee Surgery September 11, 2019 (© 2019 F. P. Dorchak)

On September 11th, 2019, I had knee surgery to remove a meniscus flap tear and clean up a ton of scar tissue. I’d been at home on crutches until September 15th. But the docs have these Sequential Compression Devices (SCDs) that inflate and deflate once per minute, and I’m to wear those for two weeks after the surgery, which means I take them off September 25. I’m to wear them at all times I’m not upright or moving, which includes sleeping. They help prevent blood clots, but no definitive studies have been done.

I’m writing this post to put some information out there I never found. Maybe I was wording my searches improperly, but I just wanted people in my situation or similar to be aware of a few things no one told me, or I’d been given contradictory information. You can do a search for the more encyclopedic aspects of this post that I’m not going to cover (sorry!). It would take too much time, and I don’t have a lot of that right now, given trying to get daily stuff done and do physical therapy three times a day, at an hour to and hour and half or so a shot. I haven’t written a word in my novel since Sept 11th because of this.

First off: you will hear contradictory info from EVERYONE. And I mean EVERYONE, from well-meaning and expert medical team to Physical Therapists (PT; also may mean “physical therapy”). It doesn’t mean the info is incorrect, it just means it contradicts. So, it could be incorrect, correct, or just “humanized” by humans who can’t quite remember all the finer details. Even from the PT and medical literature. Just do your due diligence and err conservatively. Do too much or too little, whatever the case may be, to get back on track.

Ask tons of questions–and RECORD THEM. Yes, ask your medical and PT providers if they mind if you record them. The good ones won’t care. The conspiracy theoried or not-quite-good ones will be taken aback and decline. Again, doesn’t mean they’re bad folk, some people are just wary. If can’t record…write this shit down.

Background

When I was 18 years old, I was running a two-mile run at a track meet, when a hairline tear in my meniscus caused me to drop out before the first bend. I don’t recall doctors doing anything about it, and have been since been told that back then there really was nothing that could be done. For nearly 40 years it had zero affect on everything I’d done…running, marital arts, road and mountain biking, hiking, heavy-rope jump roping, weight lifting (squats!), swimming, you name it. Then, about two years ago, I was doing routine leg extensions, nothing heavy, excellent form, and felt and heard a POP!

Well, that can’t be good I thought to myself.

Fluid soon surfaced around my knee joint. Couldn’t even drain it with a large-gauge needle. Continued to workout and live with it, but it became more and more of an issue, until this past year when my knee began randomly buckling. Earlier this year I had Synvisc/cortisone injections into it with no correction.

My opposite hip has gotten far worse this year, requiring a replacement (which I’m getting next month). Since things were so negatively progressing, and I’m not yet anywhere near 80 (okay, maybe to 20-year-olds I am!), I decided might as well correct both, so did the knee first (it’s smaller surgery, quicker recovery). I’m not Olympiad fit, but I’m pretty damned fit, and both of these injuries have extremely impacted my fitness life, not to mention life in general. I haven’t hiked in two weeks (surgery notwithstanding), because my last hike caused extreme pain in my hip. I used to have a resting heart rate in the 40s, for crying out loud! No more running for me. Used to be able to do both front and side spits!

Mens sana in corpore sano: “a healthy mind in a healthy body”…this is how I’ve tried to live my entire life. Ever since I’d learned the “a sound mind in a healthy body,” I’ve done my best to epitomize it. I wasn’t stupid about my health or fitness training…and still take it quite seriously. Sure, perhaps once or thrice over some 40 years of training I did something stupid…but not enough to impact me and permanently bring me down. Just to make me extra sore for two weeks, maybe. I always did proper form and used proper amounts of weights—which to some would very much look stupidly heavy to one not a gym rat. But I know my body and my ability.

But, still, you lift, you run, you do marital arts, you bike…doesn’t matter. If you are physically fit, chances are you WILL get injured at some point. Maybe not in your 20s…or your 30s, but, dammit, your 40s and 50s sneak up real quickly. And I hate to put stuff like this “in your heads,” but look at me. I had a good run of things until I hit 57, then I tore my subscapularis. Yes, I was using heavy weight, but it was heavy weight I’d been using for years. I was smart about it. Proper form. Thing is as you age, your body changes, and who-knows-what-else has become a weak link in there you don’t even feel, but something will happen and you’ll be forever changed. I no longer lift heavy. I’ve learned. Adapted. I just wish I’d really understood in my youth what would come from all my heavy lifting, because though my original answer to my wife’s question of if-I-knew-then-what-I-know-now-would-I-have-changed-my-workout-routines-answer-of-“No,” would now be a “Yes.” Sure, I’d still weight train, but not like the beast I’d been (in college, at an off-campus gym, bunch of us would always gather around the other during heavy-heavy lifting, like cheat-deads or squats, and YELL at each other. Yes. Loudly. Yeah, there was lots of testosterone in them days!).

I’m not telling you all this to brag…but to let you know I’ve been there.

I’ve been…and still am…a gym rat. I never entertained thoughts of failure or injury into my work outs. Never. I knew (and know) my capabilities…knew how far I could realistically push myself. And I tell you this because as careful as I was, I was still smacked down with two surgeries from my antics, if you will: shoulder and knee. Both are fitness injuries that would never have otherwise occurred. Never. Only because I was a runner and a lifter. Period. My surgeon calmly rattled off how lifter injuries are inherent to the effort. How that if you lift, these are your likely stats from the 40s on up, and though I can no longer remember them, they floored me. “It’s just a matter of time,” he said, and this guy is a sports-specialist who did a Fellowship study under the globally #1 renowned hip replacement guru Dr. Steadman Philippon, at his Institute in Vail. I believe the stats were along the lines of once you hit your 60s there’s some 40-60% you’ll tear something serious enough for surgery.

My arthritic hip, however, appears genetic. My dad and at least one sibling have hip issues, with my dad having had a hip replacement of his own.

Surgery Prep

Find prehab exercises and DO them. Religiously.

I did this for some four months before my shoulder surgery and it made a freaking difference. My excellent health also was a factor. Just by getting “opened up” you automatically lose something like 20% of your physical “capability.” Then you add to this whatever it is that the surgery is doing to you. So, if you’re sedentary, you’re at a far more diminished capacity than someone who works out.

Someone who works out in an activity that involves pain and body stress also far better tolerates surgical pain than the sedentary individual. This was why I was told I didn’t feel any pain (not an ounce!) during my shoulder surgery last year. Not even a scooch. Okay, cool. Thanks, fitness. And this year, except for the second day (my knee’s surgery pack swelling really hit me, no ice while sleeping, once after all the surgery meds wore off), I’ve also felt zero pain in my knee. No pain meds. One more to go…hope the trend continues.

Ever since I’d learned about my hip being a total-replacement candidate some ten years ago, I’ve been doing specific gym training to mitigate that—that one machine that has a roller on a pivot, called the Rotary Hip machine, where I exercise all four directions of my legs. It takes some 10-15 minutes, but I want those specifics muscles strong come hip replacement time. Those movements were the PT I was given way back, when first diagnosed.

For the shoulder, go to a PT and ask for a regime. It involves working out what I call the “tiny, no-seeum muscles” of the shoulders. You only need some five pounds or less to work them out, doing 15 reps of each exercise, everyday, first thing in the morning. Shit works, man. I swear by it. Still do em. I showed these to a guy (my age) at the gym who’d been having bench press problems, and he started doing them once/week, and they helped him with his bench. Even if you’re not a gym rat, and are an average person, I still advise doing these, because so many people tear their shoulders out doing things like lifting-and-removing luggage on planes. A family member did exactly that and had to have surgery.

And…if you have Short-Term Disability (STD) at your work, TAKE it.

Take TWO WEEKS.

You’ll think I’m crazy, but heck, man, everyone needs a break, and you need to REST and RECUPERATE. I actually had two weeks all in the bag for the knee—and cancelled it. Cause everyone told me it’s no big deal, I’ll be up and running in three days.

Well, not exactly. Or the medical staff post-hab is different and they don’t all require the same post-hab mechanics.

My surgeon, who specializes in SPORTS-RELATED medicine, prescribes rehab. Apparently, not all docs do. But I want it…I want to get back to where I was and keep fit…but also…apparently not all docs prescribe SCDs. I don’t know enough about the Deep Vein Thrombosis (DVT), but I know enough to follow medical advice. And it’s such a “small thing” to yield big returns…like helping to allow one to keep breathing.

Remember I said to “err conservatively”?

So, if you get those things, you’ll have to wear them for TWO WEEKS every time you’re NOT on your feet or moving…which includes while you sleep. When you’re on your feet and moving, you’re already forcing the blood to keep moving. I was told I didn’t need to use them when standing or moving. Yes, they’re annoying as hell after a spell, but it’s only two weeks, and we gym rats all know and have done “forced reps,” so just deal with it. Everything’s temporary.

You’ll also be prescribed PT, which you’ll have to do 2-3xs a DAY. This takes time! My PT, which I have to do 3xs a day is between 45 and 75 minutes per session. That’s 3.25 hours a day of PT. Yeah. And that doesn’t count the extra icing you’re supposed to do for a while early on, 15 – 20 minutes a clip.

Take the STD.

Are you really gonna want to work from home and manage all this? Maybe you do, if you really live for your work, but it sucks up my day and kills any fiction writing I’d do before work. Then we’re dealing with contractor bids and such from half a dozen different entities to do some exterior damage correction on our house, then repaint, just living life and dealing with all that comes up throughout your days, well, your days gets filled pretty quickly.

Take the STD, if you have it. I will be taking it for my hip R&R.

Knee Surgery

When the surgeon went in, he found a lot of scar tissue and that the tear had rubbed off a section of cartilage…but the rest of kneecap and meniscus were good. Had I known that cartilage would have been rubbed off, I would have done the surgery far earlier…but there’s just no way of knowing this. ASK QUESTIONS! Everybody’s different. No one ever mentioned this…or if they did, it wasn’t impressed upon me enough. I don’t know. And the thing about meniscus tears is that they have a very thin top portion of it that receives a blood supply—and it is only that thin section that can be repaired. If the tear goes through that thin upper portion into the rest of the meniscus (like mine) that does not have that blood supply, you cannot repair the tear. It has to be removed. Or trimmed. It interferes with legs stability (I never felt any pain). So he trimmed away the damaged portion and cleaned up my scar tissue. My Physical Therapist feels I can make a full recovery and not have to worry about the missing cartilage—or needing Synvisc shots for the rest of my life–given I have the bulk of my meniscus and my fitness. Whew.

Adapt or Die

Get preventive as you age!

As I mentioned above, find those little PT exercises to bolster any weak areas you may have as you age…but most importantly, do some resistance training. Do something. Get out and move. Do calisthenics, Tai Chi. Walk. It was initially weird that I wasn’t moving mountains of iron in the gym after my shoulder surgery, but I got used to it. I’d had my day. I’d had fun lifting. I’ve always been fascinated by moving heavy weight. Those days are gone at 58 years of age, and I’m good with that! Some folks are doing that high-impact shit at places I won’t name, and I’m telling you:

DON’T!!!

It doesn’t take a genius to figure this out: you keep ramming your body against and into stuff, and something’s GONNA give. Break.

Look at all these military folk—special forces people—being medically retired or released because of destroyed joints. These were fit twenty-year-olds forced to the extremes of their physical limits, and for a while were freaking bad-ass. But if they were lucky enough to grow older, they developed joint (and other) issues. And they were trained by the best to be bad ass. Also think football. Not just the the never-talked-about head injury epidemic, but all that body and joint damage.

And another example: when I was big into Marital Arts in my 20s, I was friends with the #2 Kansas full-contact karate champ, also in his 20s. He told me one morning that his body creaked and ached until he did all his stretches first thing. If often wonder how he is these days. I’ve seen him repetitively deflect hard sticks smacked into his bare forearms without a tear or a flinch.

Why go looking for something like this when lives aren’t actually at stake except for your own?

Sure it feels fun—I’ve done it, the explosive, powerful, plyometric movements that make you feel like a freaking superhero, but geez, none of us are superheros. We’re human. Do something else that doesn’t require constantly pounding and smacking your body all to hell. Good God, the arthritis that is coming for ALL those gym rats as they age…I just can’t bear to think about it.

Take it from guy who required two surgeries because of his fitness antics when he wasn’t even trying to be “stupid” in the gym…think and reevaluate your fitness regimes. It’s never too late. You may think it won’t happen to you…and you may be one-in-a-million. But you may not. And after this third surgery in just over a year, I’m really hoping I don’t have to ever go in again.

To borrow a phrase from The Lost Boys, when you’re 20, you’ll never die and you’ll never grow old…

But if you’re lucky, you will grow older. Please plan for that, and stop the madness.

Mindset is Everything

One last thing (I added this after I posted because I forgot about it, sorry!): your mindset is EVERYTHING.

I’ll say it again, because it’s that important:

YOUR MINDSET IS EVERYTHING

If you feel you decay as you get older, you will grow old in far worse shape mentally, physically, emotionally, and spiritually than others who do not hold that mindset.

If you feel that when you get cut into, you’ll never be the same, you’ll prove yourself correct.

But…if you believe in yourself, your recuperative powers, and never being held down by anything, include temporary stops to the Surgery Store, you will blow people away with your rehabilitation and recuperation.

If you believe in yourself and the goodness of your life and direction, you will be that person that others will look at, like, damn, really? He’s 60?

We all grow physically older, but that doesn’t mean we should start planting ourselves in the ground before we actually get there. I know a guy who still works out in his 80s. And he’s no freaking pushover. He’s a retired neurologist.

Keep moving until you can’t any longer. Adapt. have fun. Be radiant. Let yourself and others know you still have a powerful, positive energy about yourself…and it will carry over into everything about you, including you recuperation from all of the above. Your outlook on Life.

Let nothing get in the way of your life.

Everything is temporary.

Your mindset is everything.

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