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Surgery: Fear, anguish and pain

*Writing this post on the hospital bed*

Surgery Day:

So with my surgery scheduled for mid-noon, fasting had to start from 5am. The hospital gave me the option of either admitting myself the night before or the day of the surgery. Given the close proximity to home I decided not to stay the extra night which meant admitting myself at 7am of the day of surgery. When I walked in at 7am Dr Tai was already in and working away on his computer.

I had in advance requested for a single room but all the single rooms were fully occupied so that meant I had to share a double room while I awaited a vacancy – It seems like patients who patron the Ara Damansara Medical Centre share the same preference for single rooms.. What was interesting for me thought was that my roommate for half the day turned out to be a 19 year old national rugby player. It was his second surgery with Dr Tai this year and his first one happened last year on his left knee, also due to a meniscus tear… He told me that this time round he had unfortunately torn his ACL in his right knee and that it would be a real shame if his career had to be cut short due injuries so I hope he has a speedy recovery.

Moving on, Dr Tai came by at 8am and needed me to sign a consent form. The form basically was seeking consent to perform a knee arthroscopy and fix any meniscus damage. He also added a line that he would fix any other injuries should the arthroscopy allow. This to me suggested he was still leaning towards a meniscus tear oppose to a cartilage tear as suggested by the radiologist report.I was made to take an antiseptic bath at about 10 am and by 12pm I was wheeled down to the operation theatre. I was introduced to Dr Wong the aesthetician and I was informed I would be going under a general aesthetic. I enquired if that meant I would be vomiting post-surgery and he replied the days of vomiting are long gone. Again I had to sign a consent form and I was then put under. Said my Bismillah and then poooooof, I was unconscious and poooooooooof, few hours went by just like that

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I remember waking up at 5pm and everything was a blur. A nurse came to attend to me and I told the nurse my knee was hurting. She replied short “of course” as I just had my knee operated on. She told me that she would put me on some painkillers and I then got wheeled into my single room which had now become available. While I was being wheeled, I was told that the operation was completed at 4.10pm which confirmed the fact that I was in the surgery room for about 3 hours.. Anyway, remember about how they say ‘days of vomiting being long gone’? Ahah, guess who started vomiting just about half an hour into being conscious..

So yes, Dr Tai came by at about 7pm to provide an update of the whole thing. He said he had cleaned my meniscus but that was not the problem. Indeed I had a grade 4 tear to my cartilage, it wasn’t a big tear but unfortunately the tear was at the load bearing portion of my knee. This meant he was required to perform a microfracture surgery that works by creating tiny fractures in the underlying bone – this causes new cartilage to develop but they are never as strong as the original.

Guys, I think everything still sounded okay to me but what Dr Tai had to share next left my heart feeling heavy. He said as a consequence of my injury, I can no longer play any sport that requires running or jumping. Dr Tai then said but if I insist on playing sports, then there were two options. The first is to have a knee cartilage transplant and the second was to have a knee replacement. In both cases it would be an open surgery and they were complicated procedures. I looked at my wife Nur and her facial expression reflected what I felt inside. While all prior pain was physical, this time it was emotional pain. Despite having my family and in laws drop by later at night, lingering in the back of my mind was the decline in quality of life I had to accept.

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Being positive was a struggle.

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When BIL writes…

*Disclaimer: I am not a medical doctor and the information I relay is purely based on memory. I may have gotten some of the facts wrong but it’s based on what I understood and remember. This post is not intended to promote or demote any doctor or medical centre and purely reflects my own experience and assessment.*

Dear loyal readers of dianadiadia,

This is not Nadia but instead it’s Bazil, brother in law to Nadia. I am not a blogger but I wanted to share my experience as I was not going to start my own blog so this is me menumpang blog Nadia.

I have been unfortunate to have damaged my knee to the extent where surgery is my only option. When the diagnosis was shared with me, I was overwhelmed by a sense of fear and anxiety. Naturally I turned to the internet to better understand what ordeal I had gotten myself into and thankfully for the internet, there were plenty of information out there for my apprehension to digest on. There were however very little information that was Malaysia centric and every case was unique in nature, so I thought I would contribute to the world by sharing my experience.

What I felt intriguing about my injury was the nature I injured myself and how it was not until almost a week later did I realise I had a problem. Now, let’s go through the timeline:

  • Friday, 19 June: It was Friday night futsal and I was running for the ball when I felt my right knee go limp. I wasn’t in pain but I was struggling to run and decided to hobble off to the side-line and rest it out.

Couple years back something similar happened when I was jogging up a hill and after a couple days I was back to normal so I didn’t think too much of this incident.

  •  Wednesday, 24 June: I had a long meeting where I seated for the entire 2 hours. When the meeting adjourned and I stood up, I felt a sharp pain in my knee and I struggled to put any pressure on knee. I tried to walk it off but any attempt to straighten my knee the sharp pain returned. I knew this was not normal so I hobbled my way to the GP that was in the same building.

The GP said there was slight bruising and told me to come back in two weeks’ time. If I was still in pain then she would refer me to a specialist. She gave me some ibuprofen tablets and a knee guard and send me packing.

Hobbled back to office wore the knee guard and the sharp pain was back. I could not stand up with this knee guard on. So I called the GP and told her of this and she said I better see the specialist. She recommended I visit Kuala Lumpur Sports Medical Centre (“KLSMC”) as they were good with futsal injuries.

 

1GP’s medication

  • Friday, 26 June: I had my appointment to meet the orthopaedic consultant, Dr. Reza Ng. He inspected my knee asking if I felt any pain each time he put pressure on the knee but to be honest, other than Wedneday’s episode I felt fine. He recommended I carry out an MRI and X-ray to ensure there was no meniscus tear.

The great selling point of KLSMC I must say is they are as good as a hospital without the long wait. I had to head down to level 2 and within 10mins wait; I was getting my X-ray done. The MRI scan took just over half an hour and within 15 mins of completing my scan I was back in the consultant’s room.

Dr Reza Ng looked at my scan and said it looks like I have a slight meniscus tear and I also have a cartilage lesion. Dr Reza suggested that they remove the liquid that has built up in my knee due to the bruising and to also inject me with Hyaluronic Acid. He suggested a follow up in two week’s time to asses my meniscus. Dear readers, based on my reading, a meniscus can heal it depending on where the tear is. The outer rims of our meniscus have blood supply therefore it is able to self-regenerate where as if the tear is elsewhere surgery would be required.

After my injection I was in tremendous pain. I could not stand up let alone walk. They had to put me on a Knee Continuous Passive Motion (CPM) Machine to help straighten my knee and to ease my suffering. Dr Reza at this point said my condition looks bad and I should get a surgery done within the next one week.

2Prepping my knee for injection with an ice pack

3On the CPM

  • Saturday, 27 June: I’ve never gone under the knife and the thought of surgery scared me. I had spent the previous night reading up on meniscus tear and what the surgery entails. I thought it would be best for me to get a second opinion and I turned to my mother’s orthopaedic doctor Dr. Tai Cheh Chin of Subang Jaya Medical Centre (“SJMC”). Now SJMC is a full fledge hospital and like all hospitals it was busy and hectic. I registered at 11am and only met with Dr Tai at 3.30pm…

Okay, so I had made the mistake of taking pain killers on the same day so when I met with Dr Tai, I was in near perfect condition. He ran his test on my knee and I felt no pain. When he asked if I was confident in my knee, I said 100%. He inspected my MRI scan and he said while the MRI scan showed some lesion but at the same time we need to be aware that it’s possible that it may be a false positive. An MRI scan is reliant on the patient being still during the scan, any slight movement could trigger markers creating a false positive where there is something shown on the scan and there is nothing in reality. He also said based on the pain I’ve had, I most likely have had a meniscus tear and I should wait two weeks. Dr Tai also told me to lay off the pain killers as it could be masking my symptoms.

  • Sunday 28 June: No pain killers for today and guess what….I was struggling to walk!!! I called up my good sister in law Nadia and told her to buy me some crutches on her way to my place for board meeting with the team including her kakak. This was clearly not a good sign 🙁

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Thanks for the crutches SIL

  • Monday 29 June: I had my follow up appointment with Dr Reza and he shared with me the radiologist report. It said I have a grade 4 cartilage lesion and suspected meniscus tear. This is bad news and the fact I was struggling to walk only confirmed this. He suggested I go in for surgery on Thursday and shared how he would be fixing me. First there would be cartilage shaving followed with drilling into my bone to release my stem cell from my bone marrow. This will be followed with harvesting stem cell from my blood cell and then injecting back into my knee to promote the growth of a new cartilage. KLSMC is really at the forefront of sport medicine. There are not many other medical centre in Malaysia that will carry out this procedure.

Scary stuff and I wanted my second opinion again. So I called Dr Tai and booked at appointment for 5pm. Again being a hospital and due to Dr Tai’s popularity, I had to wait a good 3.5 hours before I got meet with Dr Tai. He read my report and said seeing how I was in pain he agreed with the report but maintain that until he does arthroscopy, he would be ready to judge the extend of the damage. He explained to me the surgery procedure which was very similar to Dr Reza’s but one difference in terms of procedure is he instead of harvesting stem cells from the blood, he will instead harvest platelet rich plasma from my blood and inject it in my knee to assist the stem cells from my bone marrow to grow into cartilage.

While Dr Reza was the modern doctor with the latest procedures, Dr Tai was the conservative doctor with the more generic procedure. I deliberated for some time what would be my best option and I took into consideration the following factors:

  1. My age: I am just 28 yrs old and should avoid taking risk as I have my whole future ahead of me.
  2. Location: KLSMC is located in Damansara Heights while Dr Tai is located at both SJMC and Ara Medical Centre which is located next to my parents’ house.
  3. Reference: A close family friend of ours Dr Vijay knew of Dr Tai and had good things to share of Dr Tai.

So I made the call that I will proceed with Dr Tai to operate on me. Today is Thursday 2 July 2015 and I am due for surgery tomorrow at Ara Damansara Specialist Centre. I hope to share with the readers out there bout my experience as well as my road to recovery. Wish me luck!

 

6Radiologist report: Grade 4 cartilage lesion and a suspected meniscus tear

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Grade 4 doesn’t look good….

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