Category Archives: Random
Flipping Coins to Decide on Surgery — My Little Torn Meniscus
The coin flipped through the air — heads meant I would go in for the surgery, tails meant I would not. The coin landed on heads.
“Damn,” I thought. Maybe, I’ll do best two out of three. I flipped it again. Heads. “Damnit.” I thought maybe I should flip it one more time, just to be sure. The quarter made that high-pitched zipping sound after it left my hand, cutting its way through the air. It hit its apex and then descended into my palm. Heads. “DAMNIT!”
I brushed my teeth, put my shorts on, and headed to the hospital. I had just flipped a coin to help me decide if I would have surgery on my meniscus. It’s hard to say if that was a good choice, since I’m still recovering, but I’ll know in a few weeks. I mean, I’m not dead, so there’s at least that.
My knees aren’t in the best shape. This is my good one:
And the good news about my good knee is that it belongs to my good (dominant: right) leg. The bad news about my bad knee is that it belongs to my bad left leg. Right now, this is my bad knee on my bad leg:
Over the last 15 years, my left leg has been through some shit. It all started in 2000 when I dropped into a half-pipe and traveled up the wall for the first hit: 3-2-1 lift-off. I dropped my shoulder and head to start the rotation — the trick to be performed was a backflip-180. As I made my way around, I was expecting my skis to meet with the hard snow of the half-pipe’s wall within the second, but the sound and feeling didn’t come. What?
And finally, I crashed hard on the tails of my skis in the bottom of the pipe. The impact from the crash was so powerful that I broke my left leg’s tibia and fibula clean through.
BAM! POW! WHAM!
The surgery for that was, well, gnarly. The results left me with a titanium rod extending knee-to-ankle, and three screw (two in ankle, one in knee area) implants. This is the nicest video I could find of the procedure, which still gives me the chills, even though it’s just drawings/cartoons:
And if you’re really looking for some bloody stuff, you can watch this one:
A year after that surgery, I was playing soccer for my high school team. The season had just started, and we were in our second or third game. I was blazing down the right wing with the ball and a defender came in cleats up from a frontal/side angle. He smashed right into my shin guard and missed the ball, from what I recall. But for what he missed in ball, he made up for by fracturing my shin.
One might say that that kind of damage/trauma to a leg leaves a lasting impression. Physically, I had a shin that protruded near the site of the break, and it would change colors (get black and blue-ish) when I ran around for a long time. Naturally, I kept skiing and playing soccer, because it takes more than broken legs to stop this guy!
Fast forward about 10 years to February of 2015. I skied about 15 days, and everything was just dandy for my knees — at least I thought so. Then, in March, I was playing an indoor soccer game (super important playoff game, obviously) on a hard court.
It was late in the second half and I was backpedaling to get in a good offensive position, when, all of a sudden, my left leg just kinda gave out.
It felt weak and uncontrollable, like someone kicked all the mojo out of it. There were only two minutes left in the game, so I kept playing with my newly acquired hobble-run.
We lost the game, and afterward, I remember thinking that my leg felt weird, maybe a little shocked; I was also limping around like a feeble old man. When I got home, I got a good look at my knee; it was completely swollen. “Shit,” I thought. “Did I tear something? Shit! Shit! Shit!” I started icing it, took Alleve, grabbed a shower and went to bed.
The next day, I tried to get out of bed and couldn’t put weight on it; I wanted to cry.
I probably did. I had been in this position twice in my life already, with the same leg — “always this goddamned left leg,” I said, likely in a more impressive combination of four-letter words. But I tried to stay hopeful. I had my brother get me a pair of crutches from Craigslist and I set up a doctor appointment.
After getting a MRI, it was clear: my meniscus was torn.
The physician recommended that I do physical therapy for 4-6 weeks before thinking about surgery, because for a meniscus, it’s usually not something that is “repaired.” More often, he told me, the torn/frayed part of the meniscus is scooped out, which is analogous to removing a hangnail that bothers you. (One little difference between a hangnail and a frayed meniscus is that fixing one requires some clippers, and fixing the other one requires anesthesia, and, uh, knives and shit.)
I stopped playing soccer for a couple months and switched to running. Eventually, the pain I felt while traveling up and down stairs subsided and I could run a few miles pain free. A couple more months and I was playing soccer again, mostly without pain. Then one day, I kicked the ball in a weird way and it hurt so much I had to stop playing. Again, I stopped soccer and turned only to running. In June, I decided to schedule my surgery for September so I could enjoy some sweat-like-you’re-gonna-water-California’s-plants summer runs and the great outdoors.
Well, as it turns out, time turns (with the hands on the clock, duh), and it was September, and my surgery was in five days. To be certain about the decision for surgery, I went out to play soccer and gave it a good romping. To my dismay, I could elicit no pain. This is when I started to freak out and think, “Maybe I don’t need the surgery? Maybe I can just keep using it like this? This is fine. I like using it like this. Nothing to see here, folks.” This couldn’t be true — where had the pain gone?
To add to my predicament, I knew I would be skiing this winter, and had no idea how my knee would react to skiing and more specifically, skiing moguls (my favorite). To guarantee that I would be skiing pain-free this season, I had to decide if I would:
- A) use the lack of pain I felt while playing soccer as a predictor for what I would feel while skiing and not get surgery (but risk making the tear worse), OR,
- B) just get the surgery and settle with the fact that I’d have less meniscus to help protect my knee from arthritis in the future, but probably prevent future tearing, and probably be pain-free.
By the way, these options suck.
I slept on it, and the next day (Wednesday), I played soccer again. I hammered on it with lateral movement, twists and turns, but I couldn’t get much pain out of it. And that made my decision even more difficult. I was hoping that two days of soccer would bring some real pain to it. But instead, I felt like the 14-year-old boy I once was.
Surgery was scheduled for Friday, and I had all of Thursday to decide.
I called my doctor and my old physical therapist — one said to do it, and the other said not to. Perfect.
So, I slept on it again. And when I woke up on Friday, I was really hoping to have a definitive answer, but I didn’t have one. I was standing in the kitchen when I decided I’d flip a coin. I walked into my room to grab a quarter. And then…
…The coin flipped through the air and landed on heads.
I woke up in the post-operation room and I looked down at my leg; it was all bandaged up. Time had passed, and events had occurred while my consciousness was away. Now that it had returned, I took stock of the situation and was relieved that it was over. A nurse came by and I stated: “thirsty,” for which I was awarded a small styrofoam cup of ice chips.
It was time to go home.
- I don’t recommend flipping coins to determine whether you are going to do a surgery or not. You should be certain about your decision. In the end, if I really did’t want to get the surgery, I wouldn’t have shown up at the hospital. I think my brain calculated the odds and determined I was more likely to be pain-free this ski season if I went with the surgery. But, it really felt like a bet. And I hate betting.
- A meniscectomy (the procedure) is a quick recovery compared to other things, like tearing/repairing your labrum (https://sweet-as-tandy.com/2014/07/30/what-its-like-to-have-surgery-on-your-labrum/). If the procedure involves scooping, and not stitching, you shouldn’t need crutches, and you’ll walk out of the hospital the same day of your surgery. Your knee will be swollen though (GET SWOLL, YO).
- Your throat can hurt post-operation. Oh, you didn’t know? That’s usually because they stick a endotracheal tube (https://en.wikipedia.org/wiki/General_anaesthesia) down that guy.
What It’s Like to Have Surgery On Your Labrum
Shoulder surgery is kind of like getting drilled in the face with a wine opener. The only major differences are 1) the location of the drilling, and, 2) in the event of drilling your face, you’d probably die, but in the case of your shoulder, you will want to die.
OK, it’s not that bad, but it can be if you don’t have strong enough pain medication (more on that later).
I’ll break this down into a few sections for readability, which should allow you read whatever you care about (assuming you care about something).
Background of the Injury
I’m skiing with my dad and a few of our French friends in Zermatt; you can’t see much, especially not the Matterhorn. We are in shin/knee-deep powder and I come to a stop, but become slightly unbalanced and am barely standing, with the majority of my weight resting on my pole. My friend sees this and pushes me over. Annoyed, I stand back up and realize that I’m not going to push him over because he is ready for it, standing on two skis — he is also 200-220 lbs and about 6’4. So I decide to pick him up, because that’s obviously the better idea.
I wrap my arms around his legs at a very awkward angle and pull with all of my might. (Imagine standing on skis or rollerblades, rotating your torso 90 degrees to the right, and then lifting lots of weight.) What might happen is your shoulder will make a popping sound and have a minor dislocation. You might then say something like, “dang, my shoulder feels weird. I wonder if I dislocated it.” And that was me. With anterior and posterior tears to my labrum, I skied the following day with one pole; I probably should have put it in a sling.
How I Got to Surgery
The decision or path to surgery was not direct. For the first couple weeks after the injury, I had a lot of pain with overhead and behind-the-back motion. And at first, I was hoping my shoulder would just heal itself, like Wolverine. But after minimal improvements in those first weeks, I scheduled an appointment with my general doctor. He said to take it easy and come back in 2 weeks if there were no improvements.
I came back, then I got an Xray. Then I did PT. Then it still hurt. Then I went back to my Dr. Then I got referred to a specialist. Then the specialist said I should get an arthrogram MRI. Then I got the MRI. Then I went back to the specialist and he told me that my labrum was torn. Then I was sad.
By the time I decided I would get the surgery, it was June; 4 months has passed since I first injured myself. I had good range of motion again, but still couldn’t bench press or do anything overhead without pain. So I decided to go for it.
I showed up at the hospital 2 hours before surgery. The asked me to fast — no food or drink after 12 am the night before. Wondering why you fast? It’s because they don’t want you to throw up food and react poorly to the anesthesia. You don’t want complications when you’re knocked out, apparently.
Before they put me to bed, I noticed there were at least seven people in the operating room with me. The nerve block had already been administered by then, in addition to some form of valium. One of the last things I remember was the burning sting of the anesthesia coursing through my veins. And then I lost consciousness.
Post-Operation — At the Hospital (sucks)
Two hours later, I’m awake in the post-op room. People ask me how I am. I’m fine, except incredibly thirsty. I can also see that I am now in a sling. My vitals machine kept going off because of my shallow breathing. I said it was bullshit because I was sitting there intentionally taking deep breaths the whole time, just trying to get the machine to stop. (Of course I know better than the machine when I’m still wrecked from anesthesia.)
Once deemed ready to move to the next stage, they send me to the nurse room. In short: all of the nurses sucked, but they were nice. I was able to retrieve my clothes, and needed to put my shirt back on. A couple nurses tried to help me get my shirt back on, but in the process, my arm fell out of the sling and was hanging in the middle of space. So here I am standing in the middle of the nurse’s room with my shirt off and my arm dead between my arms. Fantastic.
When the Nerve Block Wears Off (Day 1)
I got home and started eating cookies, because I could. Around 9 p.m., the nerve block was wearing off, and I started to take my prescribed oxycodone. Around 1:30 a.m. I laid down in my bed.
And then I started to cry. The pain was unbelievable and continued to worsen. I had already taken more than the prescribed dosage of my painkillers, and based on the recommendations, should not have taken another pill for an hour or two. Around 2 a.m. I couldn’t take it any more. This was the kind of pain that will make you feel helpless. And once you start to feel helpless, you may begin to panic. I just wanted it all to end. I was damn near ready to go to the hospital for morphine or another nerve block, or jump out my goddamned window (I preferred the first two ideas).
I called my dad who was 3,000 miles away since there was a good chance he’d still be up. While being distracted by my father and pacing around my apartment, his girlfriend called my doctor and asked questions about my pain medication, and before I knew it, my doctor was calling me at 2:30 in the morning. (I could not believe it.)
Collectively, we decided that I could take another pill. I did and then slept in our la-z-boy chair that first night. Laying down was, in a word: impossible. In two words: damned terrible.
When You Need to Travel (Day 2)
I slept for about 5 hours before waking up in pain, and I immediately popped another pill. I needed to solve this pain problem. Around 10 a.m., I called my doctor and he just told me to come in as soon as possible. I left my apartment and could barely walk. I slowly struggled my way through the streets of Manhattan for a block or two before hailing a cab. Little did I know that this was about to be the most painful cab ride of my life.
All told, me and the cabbie rode 70 blocks together. Except I was the only one who cried the whole way. You don’t realize how bad NYC’s street conditions are until you experience something like this. I now have a lot of respect for people who drive and have back problems.
I pulled myself together and made it to the doctor’s office. He had me move my arm around a little bit, and again, immediate tears.
For the record, I don’t just cry for Argentina every day; it really just hurts if your painkillers aren’t doing the job.
“Everything looks fine,” he said. And then he prescribed me a stronger dosage of painkillers. This new dosage did the job.
Watching Time Melt (Days 3-30)
The more pills you pop, the faster the seconds will slip away from you. That’s a good thing if you have undergone shoulder surgery, especially on your dominant side. My first check-in came one week later, when my stitches were removed. That was also the first day I got to take a shower, and I was elated to do so.
With all your spare time, what can you do? Well, I wanted to exercise, but pretty much everything was out. I was only allowed to walk. In the third week, I started walking the stairs of my apartment’s building. On the fourth week, I began riding a stationary bike. You can probably start riding a stationary bike as soon as there is no risk of having sweat get into an open wound and risk any sort of complications or infection. I played it safe and waited till week four, though.
Throughout the time after your surgery, your mood should look about like this (X-axis = time, Y-axis = scale of 1-10. Blue is your shoulder pain. Red is your mood.):
As you can see, you are basically going to act like a moody, drugged teenager on day one.
During this time period, you should also remember to ice. I was provided with this shoulder pack that made me feel like a superhero of sorts.
Below are some of your available activities during this first month of gloom:
Around the thirtieth day, or so, I tried out my ping pong skills. I probably shouldn’t have done this, but I could not resist. Consequently, my right shoulder was pretty sore the next day from being jostled around.
Things You Will Learn That You Took For Granted
- Having two usable hands.
- If you had surgery on your dominant side, your dominant hand.
- All of the things that you have [insert your age – 4] years of practice doing with your dominant hand. Two examples: 1) brushing your teeth, 2) wiping your ass.
- Putting on deodorant.
- Washing your left arm.
- Tying your shoes.
Tying your friends up.
- Tying anything.
- Cooking (This didn’t affect me, I just assume it would affect others. I hate cooking.).
- Insurance — the medical claims submitted for all-things-shoulder-related totaled $29,578!!
- Friends/Family — They are what kept me going in the first few days when it was the worst.
- Prior to surgery, go through your house and think about all of the things that require two hands to operate; find a substitute for them. (Can opening, bottle opening, cooking in general, laundry, etc.)
- Have your shoulder surgery in a place with a warm climate (avoid hot if you can). This will allow you to only have to wear t-shirts/sandals all the damn time, which makes a huge difference. I cannot imagine trying to “bundle up.”
- Buy a pair of Vans slip ons. (Or old-person velcro shoes.)
- Double-check that you have friends or family before doing the surgery. If you don’t, save up a lot of money so you can pay someone to do everything for you.
Inject me with Ink and Then Give me an MRI
There’s nothing quite like having a 4-inch needle stuck into your shoulder, and then having dye injected shortly thereafter. Actually, there is something like this, and it’s called an arthrogram MRI. And actually, there’s another thing just like this too; it’s often referred to as “owwwwwwwwwwwww (actual medical name).”
Before we get to “procedures,” let me describe the environment of the 21st-century imaging facility and waiting room. I arrive at the packed lobby; it’s 10 a.m. I glide (stumble) over to the check-in counter, and say that I’m here for an appointment. “What for?” the receptionist replied.
“For the pain I’m having on my left ass-cheek,” I said.
Just kidding; I didn’t say that, but I should have. Instead I told the truth, that I was up in this hot mess of a hell-hole for an MRI. While I was getting processed, I overheard some real gems. The man to my right was complaining about computers and Obamacare. The man to my left had a tracheostomy and sounded a bit like Darth Vader. The woman behind me had a Nokia phone with the volume set to “Level 10: Deafening.”
I finished my paperwork and sat down right under the TV. Rachel Ray was on. The worst part was that the TV was being watched.
Carrying on, I sat in the first waiting room for 20 minutes, and then in some other random waiting room for another 10 minutes, and then in some dressing room for another 15 minutes, which is where I got to put on this haute couture:
I crossed my legs because that was the regal thing to do, and that dressing room was my palace, goddamnit. Then finally, some guy knocks on the door and escorts me to the Table of Terror (TOT), the origin of the arthrogram injection(s).
Once at the TOT, a doctor starts telling me how great this is all going to be. And I know that’s impossible, because I completely fucking hate needles. “Let’s just get it over with,” I say.
First up, local anesthesia to the shoulder area, which kinda hurts. Next, a little more anesthesia, and then, El Doctor sticks the 4-inch needle in my shoulder, which is basically brushing up against my joint. I am recoiling. The Dr. asks if it hurts. I say, “yes Mr. President.” And he hits me with some more Local A. Then he stabs me with the needle again. Whammy, I can’t feel it now.
There are other people in the room; they probably think I’m crazy at this point, but one of them is working an x-ray machine. The x-ray machine is used to get the needle properly placed at the glenohumeral joint (I Googled that). From what I can tell, the needle placement looks great, and I’m ready for the ink! Coach (the Dr.) tells me that I’m going to feel some pressure when he injects the contrast dye. I take a look at the size of the injection tube — not too bad– and I noticed that the ink was clear. For some reason, I was expecting blue — not sure why.
I look at my shoulder, and there’s a needle hanging out of it (awesome). At that moment, I wonder why anyone would ever do heroin. Then Coach goes for it and pumps me full of lead. It is hard to describe the feeling. I suspect it feels pretty shitty without the local anesthesia. I would describe it as an immense amount of pressure that you want to escape, but can’t go anywhere. It’s like a balloon being inflated, but it doesn’t have anywhere to go. And that was that (except for the part where I turned into Captain America).
From the TOT, I was on my merry way to the Magnetic Resonance Imaging machine, a.k.a, I was on my way back to the future. I was passed off to some sweet gal from God-knows-where (because I suck at picking out accents, even when people have a strong one, like she did) hits me with the details:
- Don’t move.
- Don’t move.
- It’s kinda loud.
- Don’t move.
- It’s only 35 minutes.
I acknowledge that I understand her and stand there awkwardly in my sexy blue gown, waiting for the next orders. She hands me some ear plugs, and I decide to put them in my ears. Next, she has me lay down on narrow gangplank, and then she walks to the other room. Then, the gangplank starts moving into the narrow tube of the MRI machine. “Claustrophobia, here I come,” I thought. Moments later, the machine starts clicking, and zinging, and banging, and making all sorts of noises, so many that I started thinking the whole damn Chinese National Ping Pong Team had an exclusive reservation to play their sport, right inside my head. I closed my eyes.
“PING! PING! PING! PING! PING! ZZZZZN! ZZZZZN! ZZZZZN! ZZZZZN! PING! BANG! CLICK! CLICK! CLICK!”
When the sounds finally stopped, the MRI was complete, and thirty-five minutes had elapsed.
And in that glorious silence, it became clear to me after remaining physically still for those many musical minutes that The Chinese National Ping Pong Team is actually a well-versed team of terrorizing torturers. (And I will probably think twice before playing ping pong again.)
After I left the imaging center, I walked right over to the Union Square market and got a brownie — just like the other 6-year-olds do after leaving the doctor’s office. I am twenty-seven years old.
P.S. Skip to 1:28 of this video if you want to see what the procedure is like: https://www.youtube.com/watch?v=jPg_6bvpZfw
Day 4, Lost in a Sea of “Bad” Food
Dearest Isabella, Our ship capsized over the Atlantic very near the Titanic and it was quite frigid in the water. I can only say that I survived by eating others in the life raft.
I arrived at work yesterday and found a mysterious brown bag sitting on my desk, motionless. I resolved to investigate this paper parcel in an effort to fully realize the contents within. What I found was most disturbing. Please see Exhibit A:
By now, you must understand my overwhelming consternation that was coursing through the veins of my living self.
What devilish soul would impart such a gift upon me. They must know that I am not allowed even a morsel of this catastrophic carbohydrate to enter my mouth. And yet they did it anyway. Cruel (and most unusual!).
Yet I will have you know that I was not led into temptation by the flour-filled flavorful snack of the demon gods. I stood steady on my ground and passed the bag to another traveler, and perhaps their own temptations led them to damnation. I cannot say for sure. But darling Isabel, I must go to bed now.
Sir Alexander of Paleo (King of the 20 Kingdoms of Kingdoms of the North and South and East and West, 5th Lord to the Second Brother of Charles, and 19th Cousin to the Lady Mary)
Things In New York That You Stop Taking Photos Of
During my first year in New York City (moved out in October, 2009), I took quite a few photos of things that were, at the time, novel. Novelty photos are great because they unveil subject matter that excites an individual. I think we should always feel excited about our environment, and if you are not, it may be indicative that you need to change your life-clothes. Here are some of my gems.