Tomorrow, a few moments after 10 AM, Dr. Darren Friedman, MD (young and recently out of residency, like Taj .. which hopefully is a good thing) will pick up a scalpel and make a four-inch incision from the bottom of my kneecap to the top of my tibia, and with that simple action, will singlehandedly place me on the lengthy and painful path towards a strong right knee. ACL reconstruction surgery is an odd sensation, primarily because you don't particularly notice the lack of an ACL in your day-to-day life of going to work, drinking beer, and watching TiVo. It only slides itself into your consciousness every week or two, when you get up from laying on the floor, or step out of the shower, or turn quickly to get onto a subway car. It is only then you remember that your knee simply isn't all there. So, tomorrow, I will walk into a hospital with a seemingly decent knee, and exit with a swollen, painful knee. You expect to leave a hospital feeling better than when you walked in; that is not the case with orthopedic surgery.
The decision to have another knee surgery as a 33-year-old was much more difficult than the first two times. I originally tore the ACL again three years ago, and at the time, looked at my life with reality: I was in the twilight of my athletic years, wasn't excessively active outside of the gym, and was told if I avoided activities involving pivoting and frequent extertion, I would be able to manage. At the time, having just moved to New York, that seemed fine. ACLs aren't required for picking up and consuming a beer. It was like if your car had no bumper: Sure, you can pay to have it fixed. Insurance will even pick up the tab. But do you really need a bumper? Only if you are planning on hitting something again. And with due diligence, you can avoid that.
The problem is more that it is always there, in the back of your mind: You aren't 100%. Every time someone asked me to play basketball, or go skiing, I had to point to my knee and say "i can't". Then the one time I said "i can", my knee gave out on me, again, keeping me off my feet for a week. Was I really ready to say goodbye to real physical activity for the rest of my life at this age? Am I really going to live the rest of my life on the couch or jogging on a treadmill?
Maybe. But at least if I finally do decide to get off the couch and shoot some hoops, I'll know I have everything I need to do that.
I don't remember much for my past two surgeries. Part of that is intentional: As any of you who have had surgery know, they now use anaesthesia with amnesic qualities, so you don't remember anything, even if you are conscious at the time. This is somewhat unsettling: One minute, you are sitting in a prep room, and (in your mind) the very next second you are in a bed in the recovery room with your knee numb and bandaged. And it is actually four hours later. But it is also kind of awesome: You are able to time travel to the point after your surgery without having to experience any of it. LIke you walk into a room with a bad knee, then turn around and open the door, and your knee is fine again.
That was ten years ago. These days, there are other options. Technically, they can give you what's called regional anaesthesia: a spinal nerve block (to numb your entire lower half) or sciatic-femoral nerve block (to target just the injured leg), although I don't know if the hospital I'm going to (NYU Downtown Hospital) allows this. This option is better than general anaesthesia, which knocks out your entire body and comes with some lame side effects (last time I puked for a number of hours after, which is common). I've requested regional, and while I'm not sure how I'll handle being paralyzed below the waist for a few hours, anyone i've asked who has had it done when pregnant says it is a great thing. The problem is that they won't really allow you to be awake for it, instead putting you in what's known as "twilight sleep", which basically means you are conscious, but don't remember any of it. Which is a bit weird to me. They literally turn off the part of you that is aware of consciousness but you aren't unconscious. I guess it is like sleep walking. I'm going to ask to be as aware of the procedure as I can, mostly because I don't like drugs (or people) fucking with my consciousness. It's a control thing. But there probably isn't an option. And last two times I had no problems with it. Although, I have read that they've recently discovered very precise anaesthesia that can literally only turn off the pain nerves that need to be turned off, and not the ones that control movement, pressure, etc. As it stands now, they just turn off everything. But in about five years or so, you'll be able to have a full surgery fully awake and alert, but pain-free. I look forward to this option. But all in all, all options are better than the days of the Civil War, when you got a shot of whiskey and a towel while someone sawed your leg. So I won't complain.
I hope I still get the morphine drip, afterwards, which is to this day the best physical and mental experience I have ever had. Precisely, it brings total and complete happiness to your entire being every time you press the button.
After that, I go home. For some reason, the pain afterwards isn't too bad. You can pretty much put weight on it in a week. Before that, you sit on the couch and watch TV and NetFlix and have people bring you delicious fast food, because, you know, you're sick. And blog. Lots of blogs.
Get ready.