What the surgeons do not always talk about or want to know about it TO ... Personal experience after the plastic of the PCD and meniscus

“The best operation is the one that was avoided” - Nikolai Pirogov. But it so happens that either he “ran” for too long, or couldn’t “run” / “escape” in principle. It was in such a situation that I got a little over a year ago, when, in the literal sense of the word, I crawled over to the surgeon with a request to get rid of the constant pain in my knee. For almost 12 years I was treated conservatively. Successfully, almost in nothing did not limit myself - you can get used to everything. But the old sore caught me off guard and did not give me a better chance to choose. Operation after 3 days and ...

Next, I must make a mandatory remark. Everything written further is subjective, my personal opinion and my situation. In medicine, there are almost no identical cases. All, even the most standard, diseases are highly individual. That is why I will often use the words: “almost”, “probably”, “most likely”, “often”, “happens”, etc. Then why am I writing about this? I had no choice, but if he has one? From my own experience, the stories of acquaintances and those who went this way with me in clinics, I made a clear conclusion for myself - there are almost no operations without complications. Probably can not be in principle. But the trouble is that the doctors (surgeons) do not talk about it, and if they do, they do it in passing. Yes, they can talk for hours about the methods of the operation, about the history, statistics, about the details. But a minimum of complications and side effects, and if they say, only about the main or mandatory, or about those that are found in more than 60% of patients. But there are other 40%. All this against the background of terrible stress and pain, which has a stronger effect on the understanding of what is happening. As was rightly noted in one of the articles on geektimes, the quotation: "Like most surgeons, they lost interest immediately after the operation was deemed successful." As a result, the patient often faces complications not only immediately after surgery, but often later, having already forgotten about the illness.

The surgery itself, as it turns out, is not such a large percentage in the success of recovery. No, at the hands of the surgeon, of course, everything depends on 99%. But there is still anesthesia / anesthesia, rehabilitation, medication courses, exercise therapy, physiotherapy, diet / day and much more. Are there any complaints about buttons? No - then this is not quite to the surgeon. This article is not about surgery and not even about medicine in the scientific sense of the word. And about the fact that I want doctors to open their mouths more often and explain more to the patient all the possible risks and complications. This, perhaps, is not particularly important for them, the masters of this jewelry business. This is important for us - the patients, because we want to know what awaits us not only during the operation, but also before and after. And there will be various problems: I repeat - there are practically no operations without complications. But first things first.
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I have never been a professional athlete, but all my childhood was spent at the stadium, where we all kicked the ball into the improvised goal from the briefcases. School years, students - I could not live without a game. He played several times a week: for the student team in football, for the amateur - in hockey. Despite the old equipment or even its partial absence, I managed to get rid of bruises or small microtraumas. Until then, until I got to sharply swollen right knee. At that time, diagnostics on MRI, which we are used to, was not yet common. Maximum x-rays, examination and words of the regional traumatologist of the "before the wedding will heal." Next was a partially self-made orthosis hinged. I actively played another 2.5 years. Then the orthosis stopped helping. Thanks to good people, I was able to agree on a consultation with a doctor of a professional club, where I was diagnosed with PKS rupture, and even with round eyes I was surprised how I could play all this time. In Russia, then, arthoroscopy was not done, but only the full opening of the joint, and naturally, I had no money for Germany as a student. Then the decision was a conservative treatment. Yes, I had to finish with sports, but I lived a normal life for a long time until one rainy evening the problem returned. Repeated conservative treatment (on which I insisted) did not help, and as it turned out later, it could not help.

Now, in 2016, arthroscopy is the gold standard for meniscus surgery or knee joint plastic surgery. Not at all what it was in 2003. Now this is a minimally invasive procedure, a minimum of stitches. And the prices are not particularly biting. I will not dwell on the question of the choice of the clinic and the surgeon - this is not so important in this narrative, and especially individually. Everyone I met with talked about the same thing - everything will pass relatively easily, in 3-4 days I will go home, in 3-4 weeks I will walk, even with crutches. After 3-4 months - swim and run. In six months I will be as good as new, and in a year, I can “play the piano, although I didn’t know how before.” Important! Now a year has passed since the 1st operation. In fact, I do already run, play ping-pong and even swim. I go to the fitness club. But then I did not even guess and did not understand how thorny this path was. How often you have to step over pain and fear, survive complications and get side effects. This is exactly what I was not particularly warned about (or did not focus attention). As it turned out, there are many little things that I would like to know BEFORE, not AFTER.

It still begins with collecting tests for admission to the hospital. Depending on the requirements, the complications here relate mostly to the wallet. If you do not use the free clinic (and they do not all the tests and procedures), so in general the amount can be decent. This is important, because the cost of the operation and hospital stay is already known before passing the tests, but these additional costs were an unpleasant surprise. The night before the operation and preparation for it are not the most pleasant procedures, but obviously not the worst.

But then comes the first thing to think about - anesthesia / anesthesia. A conversation with the anesthesiologist the day before the operation is mostly information for him (type of anesthesia, choice of drugs, doses, etc.) so that everything goes safely. Yes, he will tell you about what will be going on and how, what “can go wrong”. But again, not in full. They do not always tell what is possible and impossible on this day or the next day. Figuratively speaking, 99% of operations with this type of anesthesia (in my case - spinal) goes well. But somehow I do not want to get into this negative 1%. The same spinal column gives complications (and not even at the injection site) immediately after the procedure or far after. And it is not always clear that the illness that occurred in 3-4 months is a consequence of anesthesia, how to react to it and how to deal with it. I was lucky, both operations from the position of anesthesia were almost good. Although I still remember with a shudder how on the 2nd operation it was difficult to breathe on the operating table (anesthesia in the back was 1 time lower, and the second time higher). But in fact, for a month or two there were slight dizziness and neurological pain for no apparent reason. And after 6 months there were problems with vision. Is there a connection with anesthesia - no doctor can answer neither yes nor no, but the fact that after 2 spinal anesthesia there is a drop in immunity and an imbalance of the functions of the body is a fact, even though I cannot prove it.

The second is the pain after. The operation of the PKS plastic itself went well. The process took about 1.5 hours. In theory, the worst is over. In theory. In fact, when the spinal column departed, pain came. But not “bad” pain, but “good” pain is a sign that this is the first step to recovery. But because it was “good,” this did not negate the fact that the knee was bursting open and it ached several days in a row 24 hours a day. Yes, the nurses of the hospital worked perfectly: they did all the necessary procedures and injections. I am very grateful to them for this. And from the third day, when the bandages were removed and a special orthosis was put on (also an expensive pleasure), it was ALREADY to begin to do some light exercises. The pain from the seams was added to the pain inside the knee (the orthosis was attached next to the seam and pressed on it). On the 5th day I was already at home. But at home, of course, there are no drugs that are pricked in the hospital under the supervision of doctors. You say, how could you want without pain? I will answer - I understood that it will be and that it is necessary to go through it. But, I wanted to know or hear about this from the doctors of pre-hospital.

The third is the compensator. This is a very important point that is often forgotten. And because of this, I got a second arthroscopic operation on the other leg. It's funny, but few people think about such things before. And I do not mean inconvenience. In fact, for a month I was one-legged on crutches. Accordingly, the functions of the right foot were distributed between two hands and a healthy left foot. But again, this was not always the case, and the load on a healthy leg increased several times. No, the knee, where the PKS was healed and in perfect order, but the lifestyle that changed for the time of crutches strongly “patted” both the healthy leg, arms and back. As a result, on a healthy leg with not the most difficult movements, I got a meniscus gap. Most likely, I seized the trauma of youth. But, if I did not have to live on one leg, perhaps this would not have happened. In fact, compensator is not only a problem of traumatology. According to the stories of my friends, I can say that a similar problem exists in those who performed the surgery, for example, in front of them or underwent chemotherapy. No, compensator is again not a contraindication against the operation and not the main factor in the decision. You say that this is all so clear and logical that I am stupid. I agree. But! I was lucky that I had never walked on crutches before and had no idea about these problems. And it is logical if this problem is “on someone else’s experience.” But when everything falls upside down, it hurts and the brain is still blunt, then such problems creep into the foreground and greatly interfere. Even slightly changing worldview. For example, I realized how inconvenient cities are for people with disabilities ...

Fourth - rehabilitation (postoperative pill courses, etc.). I was warned in advance about rehabilitation. Yes, it is often necessary, and in my case it is even critical. Accordingly, these dates were included in the hospital and vacation. But what will be included in this course, I learned only after the fact. Yes, during this time I was put on my feet, in fact, they taught me to walk anew. But as time has shown, this was not enough. It took a second course of rehabilitation. And this is again money, nerves, sick leave ... Yes, this item is not directly related to the unsaid, but in fact, I'm not the first who could not recover in standard terms. And if so, then when planning time and money, it would also be desirable to take into account the TO. And another important point. In my case, the knees are operated, and the muscles fly. In the sense that one is curing, and the other is kolich. Yes, this is a side effect is always with PKS, but with other operations other organs may suffer, for example, located nearby.

Fifth, there are no easy operations. Yes, after the 1st rehabilitation course, a torn meniscus on the other leg came up. Having already passed a certain path, it was decided not to suffer and operate on the second leg. Moreover, at that time I considered the experience rather positive. After talking with the same surgeons (the details do not matter) for some reason in my head it happened that after the plastic of the PCD, arthroscopy on the meniscus is a trifle. Yes, and the conversation with the doctor took no longer 2 hours, but 30 minutes. It was already clear a lot, and it would not be much to dig and drill. And home on the third day, and without an orthosis, and without complications - such as how to treat a tooth. That was my key mistake. I emphasize - mine. I did not ask the right questions. For some reason I thought that the meniscus is a trifle after PKS. Yes, and my doctor, who has already performed a thousand operations on the meniscus, did not consider this something awful. If I knew BEFORE what I know now, I would still have performed the second operation, but later. Would give the body more time to recover and compensate. But it turned out what happened. The operation was again successful. Yes, everything went much easier. I went on the 2nd day and nothing hurt. But at 4-5 days the side effects began. Not critical, but taking into account the surgical intervention, causing almost panic. It seems that this circle of hell has again passed, and at the exit, if not better, then even worse. No, there are no complaints to the doctor - on the 5th day I asked all these questions and received answers to them. After a while, almost everything went away. The key word is almost. And as it has now become clear that this is “almost” - for the rest. Although I make every effort so that it passes.

Sixth, relapse or late complication. That year has passed. I would rate my condition by the knees at 70-75% of the norm. I make up the rest already in the gym. The funny thing is that now the knees - this is the most healthy part of the body. In the sense of the joints themselves. Yes, you need to continue to pump muscles, continue to do yoga, stretching, etc. But just recently, one complication came out after PCD plastics. Not fatal, the probability of surgery is very small. So far, only injections and physiotherapy. I do not want to go into details, according to the surgeon, such complications were in the history of modern medicine (arthroscopy) in 3 cases (re-operated on 1). I am the 4th. Of course, this is difficult to predict before, taking into account how many such operations are now done daily. But from the moment this bastard got out, a couple of days passed before the consultation, which added gray hair to me. The problem has been removed. I hope it will not happen again ... And I also read it myself: that my knees will ache in bad weather, that the crunch will remain, the problems with full flexion will not disappear either. A whole pot and glued together are two different pots. This is important to understand, since it is still very difficult to achieve miraculous healing at 100% or complete disappearance of the problem. The main thing - it does not hurt and practically does not interfere with leading a habitual way of life.

Once again I want to emphasize. The story is private. I was very lucky that excellent doctors and excellent medical staff of the hospital worked with me. But even their magic hands and care can not help the features of the body. Yes, I had no choice: I could not do the surgery. But, if someone has a question about surgery, try to gather more information about it. Information, not even about the procedure itself (they will tell you about it from time to time), namely, what is hidden and what doctors often talk about so often. Complications and side effects are almost always present. They may be more or less pronounced, but they will. And it is better to be prepared for them in advance. If not physically, then at least psychologically. This will help you not only to make a decision, but to calmly relate to unexpected situations after surgery and, perhaps, to return to a normal lifestyle more quickly.