My second knee surgery has been scheduled for January 8th

So I got a very bad diagnosis from Dr. Michael C. Kupfer, and Dr. Evan Bachner today. The report on my left knee said the following:

1. Chronic tear of the anterior cruciate ligament. Prominent anterior tibial drawer sign.
2. Degenerative maceration of the anterior and posterior horns of the lateral meniscus. Horizontal cleavage tear posterior horn medial meniscus.
3. Marked degenerative changes in this patent with near-complete absence of of articular cartilage over both the lateral femoral condyle and lateral tibial plateau, marked thinning of the articular cartilage over the medial femoral condyle and medial tibial plateau. There are associated large marginal osteophytes.
4. Moderate sized effusion with thickened plicae seen in the suprapatellar joint space, both medial and lateral in position, as well as infrapatellar thickened plicae.
5. Two discrete loose bodies having marrow signal are seen posterior to the lateral femoral condyle. The first is 0.9 x 0.4cm. The second is 0.8 X 0.5cm.

The loose bodies with marrow signal is the most scarry element, worse than the ACL. They are obviously bone chips. This may mean my bones are leaking. These are the primary malefactors causing me a shitload of pain right now. Try walking around with a couple of bone chips floating around in the soft tissues of your knee. It hurts like a sonofabitch. I'm talking about sharp, jagged, knifing pain. Take a little too long of a step and BANG! It feels like somebody just stabbed you in the knee with a steak knife.

Dr. Bachner scheduled arthroscopic surgery for Firday, January 8th 2010. He is not going to attempt to reconnect the ACL. He's going to leave it snapped. The rest will be cleaned up as much as possible.

Frankly, I am really bummed out about this. I am still suffering post-surgical pain from my last procedure. Now this one will be much more elaborate than the first, which means more pain, and it will not result in a repaired ACL. I am going to be walking around with a busted ACL for the rest of my life, until the day I die. It seems rather heinous to go through that much pain, just to continue walking around with a busted ACL for the rest of my life.

But wait! There is more. I have been strongly counseled to get Gastric Bipass surgery. Both my primary care physician and my Orthopedic surgeon believe it is imperative that I take 80 to 100 pounds of weight off my knees. Otherwise, it will be the wheelchair for David. They want me to get real skinny. You can't carry my weigh on a busted ACL.

But wait! There is still more. Dr. Bachner emphasized the fact that I am still staring down the gun barrel at knee replacement surgery. Problems as profound as my left knee do not get resolved any other way. He just won't do it now, because I am "too young" and too overweight. He'll do it in 7 or 8 years when my weight is at 180.

So, pain is the forecast: Surgical pain, post operative pain, rehab pain. Oh yes, I almost forgot: I won't be able eat normally for the rest of my life either, so there will be hunger pains.

So I just had my second in a series of three injections of euflexxa

I have bad knees. The MRI performed by Dr. Robert C. Howard indicated that I have severe osteoarthrosis, a small tear the anterior horn lateral meniscus of my right knee, complete loss of hyaline cartilage posterior to the patella, a large subcortical cyst involving the medial tibial plateau and beneath the medial tibial spine. Both Menisci demostrate degenerative signal within.

Dr, Evan Bachner concured and decided I should be treated with euflexxa. Euflexxa is essentially pure hyaluronic acid injected into the joints. The purpose is to lubricate and inflate the cartilage... however much there is left of it. You have to take a series of three injections spaced exactly 1 week appart. You can repeat this every three months. Eventually, I will need knee joint replacement surgery, but not now, not at my age.

I really felt the right knee as the harpoon went in. Hurt like a sonofabitch. There are two injections. The first is Lidocaine to numb up the knee. The second is euflexxa. Euflexxa is a thick substance, and cannot be injected with a thin needle. They stick it in with a harpoon needle. They have to pierce the cartilage to inject it. Piercing cartilage with a harpoon needle is a painful proposition. This is the reason for the Lidocaine.

Unfortunately, the doc shoots me with the Lidocaine and then immediately follows with the euflexxa. He doesn't give me even 60 seconds for the Lidocaine to take effect. The consequence is that the knee is still very sensitive during the second injection. That hurts like an SOB. I think I am going to suggest a 60 second pause next time.

Still this is doing me some great good. The past two days (Tuesday Wednesday) I actually got to the point where I was forgetting about my knees and just walking normally again. Also, my times on the elliptical motion machine increased pretty dramatically. I actually did a pure 30 minute workout again.

Dr. Bachner was surprised by this. He says it usually takes a full week or two after the 3rd injection to begin feeling the effects. I can look forward to better things.