Day 840: Surgery Part II

What labels define you? Human, husband, engineer, painter, writer, philosopher? Some labels are absolute. The arrival of my first child made me a parent. There was no ‘sort of’ about it. It was a biological absolute. But some defining labels are applicable only by degree or based on some subjective or undefined secondary criteria. At what point do people who run become "runners"? If you can survive a misstep that leads you into the deep end of a swimming pool, are you therefore a “swimmer”? Or do you need to swim by choice on a regular basis? Sometimes there are measurable criteria that can warrant a label. Crossing the English Channel without a boat, for instance. That would certainly qualify you as a "swimmer". Not to mention a bit compulsively ambitious. If the label describes your primary means of employment, then surely that’s what you are, at least for the moment. But what if it’s just a hobby? Lots of people take pictures. And yet clearly they're not all "photographers". Most people know how to ride a bike. But that does not make them all “cyclists”. I began considering this label idea a few weeks ago when a co-worker found out that I play guitar. “Oh, you’re a guitar player,” she naturally concluded. I responded by clarifying the extent to which I felt the label was appropriate. “Well yes, I play a little bit.” The fact is, I’ve played a little bit for the last 25 years but I'm still not sure that makes me a “guitar player”.

This morning I revived a label I was more than happy to be rid of for a while. “Are you the patient?”, I was asked. “Yes”, I answered somewhat reluctantly, “I am the patient”. This is one of those absolute labels. It is something you either are or you are not. Yesterday I filled out all the pre-surgery forms and liability releases for a second time and went through all the preparatory rituals, and invisible shudders, and second guessing, and today I was once again a “patient”. After two years of struggling to recover from knee injury and surgery I finally decided that it was time to go under the knife again with the hope of resolving at least some of what was still not quite right with my knee. And so this morning I shaved the offended leg, got hooked up to the IV line, and climbed up onto the table once again.

I was in the same operating room with the same surgical staff as the first surgery. I woke up in the same recovery bed and I was wheel-chaired into the same elevator that led down to the same valet parked car as before. Now I'm lying in the same fold-out bed in the same San Francisco loft with the ferret hazards, the blood red walls, and the giant stuffed and mounted zebra head. The same crutches, ready once again at the side of the bed. The hum of the same ice-machine and the mildly nauseous mind numbing post-surgery anesthesia hangover, both present and accounted for. Thankfully, even on days like today, there is a strange comfort in the familiar.

" Right now I'm having amnesia and deja-vu at the same time.
It’s like I've forgotten this before. " - Steven Wright

A few things are different this time though. Most notably, so far the pain level is quite tolerable. That said, my knee is still entirely numb from the local anesthetic so I’m enjoying my condition with guarded enthusiasm. The nurse pulled out the “it’ll get worse before it gets better” card to properly set my expectations of the next couple of days. On the official surgical scoresheet, this second procedure was listed as a "Major Debridement and Chondroplasty".
Major - Involving multiple areas or surfaces
Debridement - Removal of foreign matter or dead tissue from a wound
Chondroplasty - Surgical repair of cartilage
Meniscectomy was a late add to the agenda as yet more meniscus damage was found once they got inside my knee.

Although this procedure was considerably less traumatic than the original surgery, the decision to venture into the surgical fun house again was far more difficult the second time. Surgery was the obvious - the only - reasonable choice in the first round. But this time I already had a relatively functional knee. Day to day tasks were no longer a problem. Only the more aggressive activities were still an issue. Mountain biking, hiking, soccer - all caused varying degrees of pain. Still, with as good as my knee was doing I didn’t exactly expect the doctor to open it up and find he had accidentally dropped his car keys in there last time or anything. The symptoms were just not that drastic. So then how exactly does one justify the risk and expense of a second surgery? How much of our original selves should we expect to recover after a catastrophic injury? At what point do we become too greedy for improvement? These are questions I knew I couldn’t successfully analyze, so I just didn’t.

My post-op appointment is tomorrow morning - bandage changes, physical therapy, and a post-op evaluation including the review of a new set of amazingly clear endoscope photos (a deeply intriguing yet slightly stomach-churning part of the post-op proceedings). After that, I return home and start local physical therapy all over again. This has been a long road that just got longer at the end. It’s a bit like arriving at what you think is the top of a long climb only to find that the actual summit was hidden from view and is still just a little further up the trail.

Time for one final push to the top.