Wednesday, January 29, 2014

A SeaSpray's Heart Regarding Surgical Date Change, Appointments, Recalcitrance and Appointment Follow Through

2014 Wall Calendar, Keepers Of the Light

My knee replacement surgery was rescheduled to March 3rd.  I'm relieved.  And I didn't change it.  The doctor wasn't going to be able to do it that day.  But the scheduler suggested the day before, the 10th.  I had to also clear the date with our sons since they will be at the hospital too that day.

But ...still ...that wasn't doable for me.

Why not you ask?

Well's the thing ...I was already getting a bit squirrelly about it.  One for a silly reason ..that I'm not sure I should admit to.  And I really don't believe.  Okay ..I will - tell you about that.  But first the second reason being that I just did not FEEL it in my spirit and I also had things I wanted to do first.  The most important being to schedule a couple of other appointments that believe me I have stalled on doing Stalled with a capital "S" kind of stalling and 2 years and 2 months.  The other appointment - I just want a second opinion on something that had been ruled out in the past ..but since I am having surgery (yes- I really am), I just want to be cleared 100% in this area.  Okay ...maybe only GOD himself can give 100% clearance for surgery ...but I want to go into it with the most informed information available.  As a matter of fact ...I WOULD rather do the knee surgery ...just yank my knee out and put in the bionic one and let me work through the pain to walking normally again versus having this test.  I probably should've expressed my concern to the doctor when it first came up ...or at least 2 yrs later when I went back to see him to schedule said test.  Actually he suggested it in 2009 technically I've put this off for 4 years and 8 months.  And I confess I became concerned because of a friend's experience with the test ...but also ...just the idea of it is unnerving.  And then in reading a little about it on line ...I get confused when reading articles that state such tests can cause problems that aren't there because they can lead to more invasive testing that isn't necessary but could cause problems. Of course if it comes back with a good report ...which I really DO expect (I k-n-o-w - I am a walking contradiction.  Blame the Gemini twins in me ;), and I really don't believe in astrology either, btw.)  If you are a medical person reading this, you may already know what test I am avoiding.  I will get into it in another post.  Suffice it to know that said test is scheduled for February 10th at 1pm.  I did have it scheduled for the 3rd, but it turns out Mr SeaSpray in a relatively new job, has to fill in for another employee that week.  Of course give me an inch ...

And my second appointment involves another direction that I really don't want to go in but for my own peace of mind with this second opinion I have that set for the 14th.  I am optimistic about this new specialist I will meet.  I confess ...I had a difficult time choosing between two of them in this specialty.  And even though I know online reviews can be flawed ..I still read them.  One of my docs recommended this one.  But also in the same hospital is another one who is WORLD renowned and also works out of a prestigious NY hospital.  I didn't think to ask my doctor about the latter one.  I suppose I could ask my new dentist who probably knows both of them, but I am keeping this appt on the 14th.  It feels good knowing my operating ortho doc replaced both of of my dentist's hips and he had such good things to say about him.  I guess word of mouth ruled in my deciding to just go to the the recommended specialist. 

I have to tell you that my recalcitrance regarding the reconstructive uro surgery and now knee surgery and certain tests is not indicative of the person I've been for most of my life.  God as my witness ...I have always been the person who believes in biting the bullet and doing what you have to do.  Furthermore ...medically speaking ...I know ...that I know...that I know ...that it is important to do these things early, so that if anything is wrong (God forbid), it is caught when physicians can treat their patients more effectively...even saving the patient's life because of early intervention.   It's just common sense really.

And obviously ...I really don't believe my avoiding these tests is life threatening or I would have done them.  But ...beginning with the uro issues in 2006 resolved ...except for some follow-up testing ...I really did have serious concern about being a high risk surgical patient and is exactly why I resisted.  I knew that there is inherent risk in all surgeries ... but I really internalized these concerns because of my issues.  I also became fearful instead of relying on my faith which would've kept me focused in a positive way.  But I also did not have that green light in my spirit.  I do not regret my urological choices and here I am  ...a uro patient who ended up NOT needing the reconstructive surgery.  But then I became the patient avoiding knee replacements.  Again ...I know there are risks and I have some of the same concerns ...but I am more optimistic about this and don't feel as consumed with fear ...or fatalistic about the surgeries.  And while knee replacements aren't a day at the beach op after the uro would've been a real biatch.  But that wasn't what scared me.  It truly was about the risks if post-op went south and other concerns.

I guess I am also more at ease ..not at ease ...but more at ease because I know of so many people that had successful knee replacements.  I didn't know anyone that went through the reconstructive uro surgery.  Never mind with the same risk factors.  The operating ortho doc was so matter of fact like it was as natural as breathing and no big deal and that after 3 months of rehab with the first replacement I would go back into the OR and have the second one done and be done with it.  He did say that I'm not a good candidate for bilateral knee replacements, but I didn't want to go that route anyway.  And I absolutely ...100% am determined I will work/walk through the pain and do whatever I have to to get to walking normally again.  I DO have that in me.  I was the same way with both c-sections post-op.

Anyway ...I am glad for the extra time because I am going to get both of these appointments out of the way, am believing for good reports and then I will be so RELIEVED to be past them.  I will squeeze a mammo appointment (pun intended:) in asap - hopefully before them ..just to get that out of the way too.  I had the gyne appt in November.  Oh and I have to write the post about that experience.  Aside from where the assistant and I busted out loud laughing for all to hear.  :)  And get a dental checkup out of the way as well.

I also have to go to the recommended knee replacement class, get the PAT done and also my yearly physical.  And all of these things will culminate in my PCP giving clearance for the knee surgery.  I guess the buck stops with him. Included in my surgical packet is the orthopedic office request for surgical clearance from my PCP and so I have to have all test results forwarded to him.  The only thing I'm not doing ...I guess is a uro test ...which ironically was a huge concern for me because of what my ortho doc up here told me. He said, "If you get an infection post-op ...then I would automatically put you on 2 years of prophylactic antibiotics and if the infection got in the knee then the knee would have to come out."  I definitely wanted to do the retro-cysto dye test prior to surgery after hearing that insure my ureter was wide open.  But I had good results with the renal scan last summer ..and this March 17th will be the THREE YEAR anniversary of when the last ureteral stent was removed and I have not had any relapses ...Thank you God ...and urodoc!  :)  Is there a part of this dot every "I" and cross every "T" SeaSpray that still wants to do the test because it's ultimate proof?  Admittedly ...yes.   But logically seems it is not necessary.  This is because with past relapses in which the ureter totally constricted ...I never went past 18 months without a relapse.  So ..on March 17th ...I will have gone TWICE that amount of time without a relapse.  YAY!!!!  :)

Ha ha!  Well this was quite the circuitous route to get to the rest of the reasons I am glad surgery has been rescheduled for March 3rd.  It gives me more time to work out in the pool at the Y.  And more time to keep losing weight.  One doctor scared me in the fall ...stating that I should lose more weight or I'll have a "rough" time in rehab.  He is the only one that said that and it wasn't the operating ortho doc.   I came home feeling like giving up that day, but the next day I began losing weight. It is why I cancelled the November 5th surgery date. But then I did yo-yo ...although I have to say I did pretty well maintaining (for the most part), despite the holidays. I know I have to be mindful to eat as healthy as possible and not fall into the temptation of skimping, but focus on quality nutrition and no crash dieting. I still want to lose more weight, but build stamina for the OR and post-op and rehab.  Admittedly this frigid weather  has not been motivational for swimming at the Y, but I know I have to go beyond my physical feelings and focus on the warm swimming area and warm water - hopefully warm.  Sometimes it can be cooler.

 So this is my mission over the next 5 1/2 weeks.

And then finally ...I have this incredible NESTING instinct.  I want everything in my life that needs to be done be done and out of the way.  Cleaning, organizing, paperwork ...even  ...the dreaded ...T-A-X-E-S.  Anyone who has followed my blog knows how much I l-o-a-t-h-e doing the taxes and always procrastinate until a few days before the April deadline.  I want them DONE!  BEFORE surgery.  And pictures ...I want to organize pictures and put some in frames.  I have so many to go through!   And clothes and so many things.  It's like I'm seeing with new eyes.  I just see all these loose ends I want to tie up.  And then I will feel better about  the surgery and I won't have to worry about them when I come home and will only need to focus on doing what I have to do in rehab.

Oh and speaking of rehab ..the operating ortho doc said if PT clears me that I will not be going into a rehab facility, but straight home after a 3 day stay at the hospital.  I had serious reservations about that.  Also a friend of mine ...a nurse had her hip done and came right home.  She said knowing what she knows now ...she would've "fought like a cat" to go into a rehab and not straight home.  My understanding is that knees are more difficult to recuperate from. I also will be alone at home since everyone works. Mr SeaSpray could probably take the first week off, but we'd miss the salary. But the ortho doc said that people only spend 2 hrs a day rehabbing, but have a higher risk of infection there vs going home.  So ...while I am apprehensive about going straight home ...I sure as heck don't want an increased risk of an acquired infection.

And I contacted a new physical therapy office because they are a lot closer to our home.  But I feel guilty abut not going to the PT guy who helped me with both meniscal repairs, etc., and I've known him since 1996.  I also know he is good. And I have a good rapport with him.  Although I spoke with this new guy on the phone a few years back about something else and we talked for about 15 minutes beyond the reason I called him and also had a good rapport. And I know someone who raved about him and HER son is also a physical therapist.   However a nurse I know said the latter guy is nice, but she feels he only has one modality whereas the guy I have always gone to does so much more with the patients.  I will decide this week.  Okay ...I am leaning toward staying with the one I have the history with ...but gee this new PT guy's facility is so much closer to home. 

And now that this post is so darned long that I will discuss my "rationale" for surgical dates based on numbers for another post.  :)

I have to say even though this post is so long, it's been cathartic to write and my plans are more concrete in my not enough time in the day brain now. 

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