The Final Cut

I came up with the title for this post and then realized that it is the name of a Pink Floyd album/song as well as a movie. Not to be interpreted as a sign that I am spiraling into depression, it simply refers to the fact that I am having one (actually two, keep reading) last surgery to close out 2013.

Celebrating the start of 2011 in Vientiane, Laos, before my body started falling apart!

Yes, it's true, I go under the knife once again today, the very last day of the year. Despite my & my various doctors' best efforts, my knees are a constant source of pain & discomfort and are severely limiting my ability to do the things I love (e.g. biking, going for long walks). I became aware of the problem about three months into my hip rehab (I had surgery to repair a torn labrum on 1/15/13) and it steadily grew worse as my level of physical activity progressed. Iontophoresis didn't diminish the pain so my doctor, Andrea Herzka, recommended a series of three Synvisc injections which I started just before my 39th birthday in July. Unfortunately, those didn't help either, and having exhausted the number of physical therapy visits allowed by insurance, I was left with few options. At that point Dr Herzka ordered MRIs of both knees, and when we finally viewed them together in late September, it was very obvious why I was/am in so much pain. The cartilage under both kneecaps has deteriorated significantly which is causing friction in the joints. This is accompanied by a grotesque grinding sound which can be clearly heard when I climb stairs or crouch down. For some people the Synvisc injections provide enough of a "false cartilage" buffer to reduce the pain significantly. Sadly, my knees only felt worse after this treatment! Dr Herzka said I needed surgery and so here we are today.

Greg & I rode our bikes to the top of Mount Tabor on New Years Day 2013. I don't think I'll be doing that tomorrow!

Considering I also had sinus surgery (to correct a deviated septum on 4/23/13), I was quite reluctant to go through another surgery this year. I asked Dr Herzka if there were any other alternatives and she referred me to a chiropractor, Phillip Snell, who specializes in sports medicine (and was still covered by my insurance). I saw him a handful of times over the past two months and he definitely has the knowledge & skills to help me. But we ran into the same obstacle as with physical therapy; the pain in my knees is too intense to make any progress with the other musculoskeletal issues I have.

Recovering from sinus surgery. It was not fun.

Bearing in mind that I reached the out-of-pocket maximum for my health insurance plan mid-way through the year, and all of those numbers will be reset to a higher deductible & out-of-pocket maximum on January 1st, it made the most sense to schedule the surgery in 2013. It was a bit of a challenge to get everything lined up in a fairly short amount of time, but OHSU's Center for Health & Healing was able to squeeze me in on today's surgery rotation even though they're only using one outpatient operating room.

Heading out to catch the bus to physical therapy after my hip surgery.

It was also a tough decision whether or not to have both knees operated on the same day. While the recovery time for this surgery, called bilateral arthroscopic chondroplasty, is relatively short (5+ weeks) compared to my hip (6 months), it will certainly be a bit harder to get around with two banged up knees. I figure I have been in pain for so long it can't feel that much worse and hopefully I'll be in much better shape sooner than later!

I almost passed out from the pain during the first round of Synvisc injections!

Greg jokingly says I should win the "Patient of the Year" award at OHSU (mainly because they've gotten so much money from us & our insurance company). It is a bit disconcerting when so many people in a medical building call you by your first name in passing! But I am certainly thankful that my health issues, albeit when considered cumulatively have been challenging, are nowhere near as serious as so many of my friends & family have gone through this year or are currently battling.

I do enjoy the view from OHSU's Center for Health & Healing!

I'll close out this post by wishing all of you a very Happy New Year! Hopefully I will come up with some meaningful resolutions as I spend the first week post-op recuperating at home. I know what one of them will be: try to get through 2014 without any surgeries!!!