Friday, June 9, 2017

I'm struggling ... and I blame Mike Fisher

At this point in my surgery "career," I feel like I can identify and describe all of the emotional stages of post op recovery. I'm pretty sure these specific stages are not published anywhere, nor is there scientific evidence to support them - so don't quote me in your next rehabilitation paper.  However, I have predictably experienced these stages after each and every one of my 9 knee surgeries. In addition, I have witnessed others experiencing similar emotions after surgery. Let's call this a subjective qualitative post: "The stages of post op recovery."

The first stage is survival. As soon as you gain consciousness in the recovery room, your goal is to just stay alive. Your body has been through severe trauma and you are relying on your medical team to give you the most effective cocktail of drugs to prevent you from experiencing agonizing pain. It's a difficult phase; however, your brain shuts down all thought processes and goes straight into flight or fight mode. You don't worry that you just flashed everyone your lady parts. You don't give a damn that you just peed the bed. It doesn't bother you one bit that you just told the Physiotherapist to F$%# off. You are strictly in survival mode. It's primal, it's dirty, and it can be horrendous.

Survival mode lasts anywhere from a few hours to a few days. Once your body has recovered from the shock of being cut open, your brain switches back on, the endorphins start pumping, and you start to reflect. "Wow, I got through that. I did it!" Enter the "Elation" phase of recovery. In the elation phase, you are so fricken happy you survived that you feel like hoisting your surgery trophy (they really should present you with a victory token) in the air and shouting, "I did it!!!" The drugs are still free flowing and you excitedly post an update on social media bragging about your survival. You begin texting everyone you know, exaggerating events to add to dramatic effect and your feelings of achievement, "Doing great. I almost died, but I made it!"

For me, the Elation stage of recovery was prolonged due to the travel back to Canada. My Mom, Ev, and I were all concerned about the trip from Philly to Saskatoon. It was evident that my knee was not bending enough to fit behind the seat in the plane, and so we had to be creative with my seating and positioning during both flights. I was quite concerned that I wouldn't be able to fit on the plane and would be stuck in Philly forever. It wasn't particularly comfortable, there were a few tears - but we made it. Once I settled in on my Mom's couch at Candle Lake, elation kicked into high gear. "I did it! I'm a survivor! I am awesome! I can do anything!" I happily sipped my Timmy's steeped tea, enjoyed my view of the lake, and prepared to settle in for 6 more weeks of recovery.

Predictably, the elation stage of recovery soon deflated into the stage I like to call, "When reality punches you in the gut." For me, this occurred in the middle of particularly frustrating episode of Dr. Phil. "OMG. I am stuck in this brace that locks my leg straight out in front of me for 6 more weeks. OMG. I am on crutches with no weight bearing for 6 more weeks. OMG. I still can't bathe myself nor can I put on my own underwear." Ugh. The "when reality punches you in the gut" phase hits, it literally feels like...well, like someone has punched you in the gut. It's difficult to catch your breath and panic ensues, usually followed by a severe case of self pity. Although this phase of recovery only lasted a few days for me this time, it was significant. My Physiotherapist with Penn Med explained my recovery protocol prior to leaving Philly. As he outlined the dates at which I should be achieving specific goals (i.e. 90 degree knee flexion at 3 weeks), I nodded, confidently thinking, "pfff, 90 degrees. No problem. I'm not a rookie. I'll probably bend to 110 degrees just to show them." When Penn Med physio questioned, "Does this all make sense?" I responded, "This ain't my first rodeo." Yep. I actually said that, like a cocky little shit who thought she was above Autologous Chondrocyte Implantation and meniscus transplant surgery. No biggie. Reality punched me in the gut when I met with my Physio in Canada and realized that at 3 weeks post surgery, my knee was stubbornly stuck at 35 degrees flexion. My Physio calmly and kindly explained that we needed to step up the exercise to ensure that my knee didn't get too far behind the expectations. All I heard was, "You are failing physio. You are a failure." I don't fail (well...there was that one time that I dropped out of that weather class in University. Who knew weather could be so complex? And to be fair, I did drop out before I could fail) Anyway, I went home and forced my knee into 36 degree flexion, crying in pain and feeling incredibly sorry for myself the entire time.

Luckily, phase 4 of recovery was right on the horizon. I call this phase the "F#$% YOU!" stage of recovery. This phase is defined by irrational anger. Instead of focusing on the fact that my knee is not bending, I am stuck in a straight legged brace for 5 more weeks, and am still struggling to put on my own underwear, I have decided to focus my anger on random people and events. Cue Mike Fisher, captain of the Nashville Predators. As we watched Nashville smash Pittsburgh in game 4, I suddenly became enraged with Mike Fisher.

"How did Mike Fisher get a trade to Nashville?" I questioned Ev as we watched the game, "So he was able to just request which team he wanted a trade to? Just because he was with Carrie Underwood they agreed to trade him to Nashville? And now his life is just perfect. Un#$%#ing believable."

I heard the angry words spit out of my angry little mouth and realized that what I was saying was absolutely ridiculous; however, I couldn't stop. I slammed Mike Fisher throughout the entire game. Evan, wide-eyed, glanced at my Mom and Step-Dad and commented, "Ya! I hate Mike Fisher too!" Good answer. Oh my poor family (Ironically, I am actually cheering for Nashville. And Mike Fisher seems like a good dude).

Mike Fisher is mocking me, "Haha, Kirstie can't bend her knee!"

So here I am, sitting unhappily at the F&%# you phase of recovery. This is a tough phase, as your irrational anger can most definitely push visitors away. I consciously try to utter positive statements like, "It's coming along" and "It's getting there," when friends and family inquire about my recovery...but let's be honest, I am not going anywhere for a while. My Physiotherapist is now manually bending my knee (NOOO KELLY CLARKSON!) and the CPM (AKA Constant Pain Maker) has finally arrived from Winnipeg (the CPM is like gold in Western Canada!) I thought I could progress without it, but it's apparent that it is necessary for my recovery.

manual bending: like a very slow full body wax
I'm looking forward to the "Insolent toddler phase" of recovery, which, according to my calculations should arrive in approximately 3 weeks time. If you recall from my last major surgery experience, at 6 weeks post op I became defiant, refusing help from others, hoarding food, and asserting that I could do everything by myself. Click here for a real treat. Oh goody, can't wait for that one! haha. When I say "haha," I'm not actually laughing, by the way.

Ok, Friends. Thanks for listening. I will get through this. Eventually my knee will just have to bend. Right? Thanks for all the encouraging texts, emails, phone calls, and visits - the visits have had a miraculous effect on my mood. It's difficult to be angry when you are at Grandma's house, eating her incredible tarts and chatting with Baba while crunching on her fabulous pickles. My buddies are also super distractors from my icky mood. Last weekend they put sunglasses on my face and gently placed me in the boat like the guy in "Weekend at Bernie's." I think it was fun. Me and my unbendy knee feel loved!

Cheers to Mike Fisher. Go Preds!

Here's a pic of me on the boat! Wheeeee!

My friends took me to the beach. What a great day!


Friday, May 26, 2017

Surgery #9: When American Healthcare slapped me in my polite Canadian face

You know that saying about the best laid plans, right?

I felt like I was an expert surgical patient the morning of my surgery. I was cool. I was calm. I was prepared with an arsenal of post-surgery weapons, including digestive cookies for nausea, a metal-free hair tie,  a list of questions for my Anesthetist, and a host of meditation techniques to calm my nerves and ease my pain post surgery. I had essentially been preparing for this surgery for a year, exercising both physically and mentally, as well as undergoing surgeries #7 and #8 which were prerequisites to this cartilage implantation surgery

So when the nice lady behind the Registration desk at the University of Pennsylvania Hospital informed me that I was at the wrong hospital, I felt a bit...well...panicked.

As my mom, Ev, and I hopped in another uber to take us to the Pennsylvania Hospital (no "University"), I looked anxiously at my watch. It was 9am - the exact time that I was scheduled to check in. The Uber driver informed us that we were about 40 blocks away from my Pennsylvania Hospital. He also informed us that traffic was not flowing on this Monday morning. I attempted to remain calm in the backseat; however, the drive was anything but relaxing. The streets of Philadelphia were out of control. It was UPENN graduation, so we dodged thousands of joyful grads in their caps and gowns and waited patiently for proud parents to cross the street. I felt like screaming, "Congratulations on such an impressive achievement... but get the F&*$ out of our way!" Like a video game, our route was foiled with obstacle after obstacle including garbage trucks, front-end loaders, and blocked streets. The three of us remained silent, anxiously watching the time tick. Thinking, "what's the worst that could happen?" it dawned on me that they could cancel or postpone my surgery. Yikes.

We finally arrived almost an hour and a half late to Pennsylvania Hospital. At that point I was in full blown panic mode. They quickly whisked me away to prepare for my surgery. Unlike my last surgeries at the surgery centre, where they carefully hung my clothing in my fabulous PennMed garment bag and delivered a nice dose of Versed to calm my nerves and make me forget, they carelessly threw my clothes in a plastic bag and instructed me to climb up into a stretcher. Off I went, panicked and choking back tears. This was not the plan. Where's my Versed?!

Once I was rolled onto the surgery floor, I was "stored" in the pre-op room, where the Anesthetists prepare their patients and patients meet with their Surgeon to discuss the surgery. I met with my surgeon who informed me that it would take at least 5 hours to transplant a new meniscus and implant my cartilage into my lesions. 5 hours? No one mentioned a 5 hour surgery! Again, I felt unprepared..and..where the eff is my Versed? I met with my Anesthetist, a quiet, elderly looking man, who probably had 40 years experience under his belt. I requested a post surgical nerve block, an injection that numbs the knee for hours to help ease pain after surgery. Trying to regain control, I took charge of the conversation, asserting, "How many nerve blocks have you performed?" The Anesthetist kinda glared at me and huffed, "It's not rocket science." Perhaps I pissed off my old guy because when I woke up 6 hours later, I was in excruciating pain, and it was apparent that the nerve block did not work. Shit sticks. I had lost control again.

The next 24 hours were rough. I was admitted to a private room with a fantastic nurse who shared my name. Kirsten tried everything to get my pain under control. I was injected with Dilaudid, Percocet, Gabapentin, and muscle relaxants - you name it, I got it. Nothing eased my pain. Mom and Ev took turns holding my hand and helping me breathe through the tears. When pain became intolerable, I began snapping my fingers, which is a strange pain reaction, but indicated to my "team" that things were bad. They finally decided to equip me with a PCA, a device that delivers Dilaudid on demand, with a push of a button. I pushed my little button all night long and finally was able to settle down for a few hours. There was a cot in my room, so thankfully, my Mom stayed the night and Ev went back to the condo to stay with the pets.

I was shocked when they removed my PCA the next morning, just as my pain was becoming controlled. My new nurse, Andrea, informed me that the PCA delayed my discharge and I had to be discharged by 6pm that evening. Say Wha??? That was the moment that the American Healthcare system slapped me in my unknowing polite little Canadian face. As I struggled, once again, to get my pain under control with injection after injection of medications, Mom and Ev met with the billing agent and a member of the Orthopedic Team who explained that my 5 hour surgery was coded as an "Outpatient procedure," which included a maximum of 24 hours in hospital, if needed. Anything extra was billed. An extra night in the hospital could cost up to $10,000. The medical team agreed to prepare a case for me, stating that I was in "intractable pain," however, they could not guarantee that my insurance would cover the cost. Frustrated and upset, I decided to go home, and requested that my Nurse numb me up with meds, so that I could transfer into an Uber and get back to our condo. I was very scared, as my pain was still a 10 out of 10. Again, I felt like I had lost control.

Surprisingly, the transfer home was better than I expected. Mom and Ev were so calm and cool, and I had a really great porter who helped me into my Uber without increasing my pain. I made it home, got into bed, and got absolutely baked on prescription pain meds for the next 3 days.

My memories of Wednesday, Thursday, and Friday are mostly a blur, to be honest. I required assistance to do everything, including going to the bathroom and getting dressed. Evan informed me that at one point while assisting me to the bathroom I questioned, "Why are we here?" Unsure of how deep and profound I was going with this, Ev responded, "Like on Earth? Like in Philadelphia?" and I responded, "No, like why are we in the bathroom?" I didn't really realize how stoned I was until my television began switching languages mid program. I turned to my Mom and asked, "Why is the TV switching languages?" I could tell by her concerned look that it was time to sober up from this "trip."

So that brings us today. It's been 12 days since my surgery. My pain is under control and I've drastically reduced the amount of medication I am taking. My Television is no longer switching languages, I can follow the plot of a 30 minute sitcom, I can go to the bathroom by myself, and I am orientated to place. Haha! The five of us (Dundee and Biloxi too!) are still in our little dark 800 square foot condo in downtown Philadelphia. We fly back to Canada on Sunday. My surgeon reports that my surgery went well and I now have the daunting responsibility of ensuring that my knee does not bear my weight for 8 weeks. I've been here before and I know that I can do it. I spend my days on a machine called a Continuous Passive Motion (CPM - AKA Constant Pain Maker), which slowly bends my knee, increasing it's flexion each day. It's uncomfortable and was, initially, quite painful, but it gives me a purpose to my day. My Physical Therapist has also provided me with a list of exercises to get my knee flexion (bend) to 90 degrees as soon as possible. I'm nervous about flying home, and fitting behind the seat, as I can only currently bend my knee to 30 degrees.

Overall, the surgery experience and post op was not as I had planned. But now that my pain is under control and I'm gaining independence (today I put on my underwear ALL. BY. MYSELF! #winning). I feel pretty upbeat, positive, and motivated to ensure that this surgery is a success. I'm relieved that the surgery portion of the experience is over. My Mom and Ev have been so awesome. If I so much as adjust my pillow in the night, my Mom immediately becomes alert and ready, "What do you need sweetie?" Although Evan is still working full time, he takes the time to arrange garbage bags, stools, and footrests to shower me every few days. I'm so lucky to have such a fantastic support system. I'm prepared for the fact that flying home on Sunday will be challenging. It's going to be a stressful day for Ev, Mom, Dundee, and Biloxi (#lindsaycircus). I hope that my pain is controlled and I'm relatively comfortable during the 2 flights back to Saskatoon. I can't wait to see my family and friends and settle in at Candle Lake for the summer.

Cheers Friends! I'm comin' for you Timmies - start steeping the tea!

Is there a knee under there or they did they remove that?
The view from my couch. If you look up...way up...you can see sky.

Resume the position on the CPM - Constant Pain Machine


Off to my Dr appointment - doing our best with an office chair on wheels and a cutting board

This guy is really stinking up our condo, but he's such a good buddy


The animals are restless and have resorted to staring competitions.


I reached 30 degrees! Whoohoo!


The Lindsay Circus on the road.











Saturday, April 29, 2017

Relax!

"Relax!"

That is the single worst thing that you could say to someone who is NOT relaxed. However, I often find myself commanding my body to relax, "Relax. Stop worrying. Relax!"

Our bodies are not Siri. Despite the incredible feats that our body can accomplish, it does not always respond on command. By ordering our body to "Relax!" our sympathetic nervous system doesn't just comply, inhibiting the "danger! danger!" signals to our adrenal glands. Our adrenal glands don't simply stop producing the stress hormone, cortisol. Our breathing doesn't just automatically slow it's rate. We simply cannot control our reaction to stress by commanding it to "RELAX!"

I've been working with my Pain Psychologist to identify and challenge negative thinking patterns and behaviour that is affecting me. It's called Cognitive Behavioural Therapy, which has helped to change the way I think and feel about situations, and as a result, has helped me to chill out and experience less pain.  It works! It's taken a lot of homework and practice, but I'm feeling much more equipped to deal with stress and anxiety, specifically as it relates to my condition and pain.

But...I still have challenging days where negative thoughts spin out of control and my strategies just aren't as effective. Cue Easter Break 2017. I had 10 days off of work. Although I had a few appointments throughout the week, the majority of my schedule was wide open. Lots of time to "relax."

I found myself laying by the pool, book in hand, listening to the waves crash in the distance. "Relax. This is nice."

I found myself sipping my tea on the couch, cuddled up with my cat, watching celebrity interviews on the Today show. "Relax. You enjoy this."

I found myself exercising in the pool, stretching my muscles and feeling my body move effortlessly in the water. "Relax. This feels good."

Problem: I was not relaxed. My jaw was clenched. My fingers were chewed until they were raw (stress causes me to forgo food for fingers). My stomach churned with nerves. My tried and tested meditation techniques were only providing temporary relief from anxiety. I was sucking back a daily vodka paralyzer, which only made my head ache. Boo. People attempt to emulate my environment with sound machines and heat lamps, and here I was, in a tropical paradise, cocktail in hand, and unable to relax! RELAX DAMMIT!

On Wednesday, I met with an Orthopedic Surgeon on island who is new to me. I can't recall his name, but I do know that he is Finnish. I required this Surgeon's signature to authorize my cartilage implantation surgery at the University of Pennsylvania Hospital, which is scheduled for May 15. Over the past 4 years, I've had dozens of appointments with at least 8 different Orthopedic Surgeons. Each of these specialists agree that my condition is severe and rare, and the majority of these specialists state that there is no treatment for this condition. This is why I sought out a Surgeon who researches my condition at a University known for its medical advancements. He believes that this upcoming surgery could result in very positive results for me. I'm putting my trust in this person who has presented me with a few decades of research and a history of positive results with respect to my rare condition. If I can't trust him, who can I trust?

So it shouldn't have surprised me or gotten under my skin when the Finnish Doc kindly agreed to sign off on my surgery, but then expressed skepticism with regards to a positive surgery outcome.

Instead of spewing out the numbers, the research, and the evidence that support my upcoming surgery, I sat in silence. I felt my shoulders rise defensively to my ears. My heart fell. And there it was. Doubt.

I listened intently for 10 minutes as he expressed his apprehension regarding the surgery. Instead of breaking down and crying in the Orthopedic Surgeon's office (my MO),  I composed myself, straightened my back, and spoke in a calm, confident voice, "Do you have any alternative solutions for me?"

Taken aback he responded, "No."

"Okay then. Thank you for your time. I am a strong person. I am educated. I am very aware of what this surgery entails. It was nice to meet you." This man was not going to see my tears.

Surprisingly, the Surgeon nodded and responded, "I can see that. I wish you all the best."

I took my signed paper and exited the hospital in the middle of a massive thunderstorm. Fitting. I then sat in my car and... well, I cried. Ugh. Good times. RELAX!

I've been enthusiastically explaining this surgery for the past year, "It's incredible. They are harvesting my cartilage in a lab! They will implant it back in my knee. Isn't technology and modern medicine amazing?" The reality is, I'm just not so sure. I want to be sure. The research is convincing. The science side of my brain tells me that this surgery makes sense. However, I've underwent 8 surgeries, and although many of them have provided temporary relief, I have yet to experience more than a year of reprieve. Am I doing this because I believe in it? Or am I doing this because I have no choice?

So I have some doubt. Instead of bottling up that doubt and facing the world with a brave face and enthusiasm for modern medicine,  I decided to tell people. I met with my island besties on Thursday for a really fantastic pre-birthday celebration at the Kimpton Spa. I sipped champagne, soaked in the waterfall hot tub with perfectly pedicured toes and admitted to my friends that I am afraid. They listened. They reassured me. And I felt better. I began to relax.

I messaged with my Canadian buddies. I told them about my appointment and we chatted back and forth. They called the Finnish surgeon bad names. And I felt better. A little more relaxed.


I'm calling it: Best Pina Colada on island at the Kimpton

Spectacular spa day with my island girls

My new wine glass, "Ship Happens." These girls know what I like!

The next day, my 38th birthday, Ev and I hopped on plane for a quick 45 minute flight to Jamaica (Confession: I drank the complimentary in-flight rum punch at 7:00AM) and settled in at Strawberry Hill, our own beautiful cottage nestled 3100 feet above sea level in the Blue Mountains. Immediately noting that there was no TV and the only sounds were the cool mountain breeze blowing through our cottage, the chirping of birds, and the occasional distant sound of honking (the road up the mountain is so narrow that you must honk when you are driving to warn oncoming traffic!), I was initially concerned that there wasn't enough action to distract me from my anxiety. I was so wrong. It was wonderful. Ev and I spent hours drinking Red Stripes on our mountain deck (because Jamaica!), watching and feeling the clouds pass directly in front of us, listening to Bob Marley's greatest hits (because Jamaica!), and just hanging out. We indulged in spa treatments, amazing meals and cocktails, and soaked in the serenity and peace. At night, our little cottage echoed with the sound of the rain on the roof and the wind blowing through our louvered wooden windows. Our four poster bed was heated and I don't think I've ever slept so soundly. It was just awesome. Although I have a severe dislike for the word, "romantic" (If you have to state that something is romantic, is it really romantic??), I will say that the weekend was "mystical." Yes, that's the word. Mystical. We discussed my fears about my upcoming surgery - but it didn't consume my thoughts or our conversation. We just thoroughly enjoyed each other's company,  and I submitted 100% to relaxation. Caveat: Do not go to strawberry Hill with someone you don't like. You will be spending a lot of time together. We observed a bird-watching couple arguing mountainside and pondered the possibility of them starring in the next Dateline Murder Mystery (the husband is always guilty, by the way). Ensure that your travel partner is your best buddy for this particular getaway.

Despite the mystique of Strawberry Hill, the experience didn't magically wipe away all my worries and fears, but I feel better about things. I am afraid. I have doubt. But I've made a decision to have this surgery. I am committed. The surgery is booked. My cartilage is growing in a Boston lab as we speak. It is the right decision because it is the decision that I have made.

One Love!

The view from our mountain cottage

My birthday dinner - 38 isn't so bad!

just flexin'

My knees are soaking up the freedom!

Jammin' 




A Biloxi Mama and her little Biloxi kittens. The resort is looking after these guys in return for pest control!

So I ordered the complimentary rum punch on the 7am flight. It was my birthday!

Breathtaking scenery


Ev's showing me how to "wine"

Cheers!

My new buddy. Apty named "Whitey"

The lights of Kingston from 3100 feet




Sunday, April 16, 2017

The Moment We Became Adults

Happy Easter! Easter, to me, is synonymous with family. My family has had a difficult year. We lost my Dad's Father, my "Gido," to cancer in October. Easter has always been a big family celebration in my Dad's family, and this will be my Baba's first Easter without my Gido. I'm sure it will be a difficult day for her. Almost a month ago, we lost my Mom's brother, my Uncle Neil, to cancer. Uncle Neil was far too young and vibrant to leave this Earth. My heart is just so heavy for everyone who is hurting, including my Mom, my Grandma, my Aunts and Uncles, and especially his immediate family: my 4 young Cousins and my beautiful Aunty Colleen who lost an incredible Father and Husband. I know that I can't take their pain away but I wish that I could teleport myself back to Canada so that I could be there to support my family. I've said it before, the biggest sacrifice I've made moving to a tropical island is being present for the ones I love when they need me the most. I love my family so much and I just hope that they know that despite being so far away, I think about them all the time.

Easter, on the island, however, is apparently synonymous with camping. I discovered this a few weeks ago when I was listening to the car radio. You heard me correctly: CAR RADIO. After 2 years of burning CD's (like it's 1999) for the Japanese radio that refused to tune into a station above 75 FM, and constantly indicated via GPS that I was floating in the ocean around Japan, I got a functional car radio installed! WhooHOOOO! Grand Cayman, to my surprise, has 5 FM stations that I choose to listen to which include the hits, rock, Caribbean soca, and some old school 90's music. Not bad for a an island with 60,000 people! As I was driving to the east end of the island one day, a commercial came on for our local grocery store: "It's almost Easter and you know what that means!" (eggs? Bunny? Jesus?) "....Camping!" (Camping?) Yes, the Easter weekend is the "May Long" of Cayman, where the locals pitch their tents on the beach and grill, party, and celebrate the Easter long weekend
for 4 entire days.

My Japanese GPS: It took 2 1/2 years but I made it to Japan!


Cayman Campground

Seeing the plethora of tents, BBQ's, and cases of beer, I immediately had flashbacks to the May long weekend in Canada. The May long weekend (typically the third weekend in May) is the biggest party weekend of the year because it is the official start to summer! (I believe it's also the Queen's birthday - Thank you Queen Victoria!) After hibernating for months through the frigid winter, everyone packs up their tents, trailers, and cabin supplies and heads out to the lake to enjoy a weekend of campfires, wiener roasts, and PARTY. In Saskatchewan, it's very seldom that the lake has actually completely thawed for the May long weekend, so we often gaze out at the frozen lake, anticipating all the fun water activities to come.

As a teenager, the May Long was THE MOST IMPORTANT PARTY WEEKEND EVER. Now I am NOT admitting to anything, but many teens prepared for May long in April, arranging a "pull" (someone who was at least 19 years old who could legally purchase booze). One year, some people I know managed to line up someone's brother's cousin's friend who took their $800, promising to return with the booze that was neatly listed on a piece of paper (Rockaberry Coolers and Strawberry Angel!) The pull ran with the cash and left 10 very sad (and broke) teenagers sobbing like babies. Sober babies. If anyone did actually make it to the lake with the pulled alcohol, the weekend was spent running through the campgrounds of Candle Lake,  dodging Conservation Officers and RCMP. You were a true survivor if you made it through the May Long without a ticket (known as a "one eighty" - $180 fine) for underage drinking or open alcohol. Looking back, the May Long was not actually a good time. My friends and I often spent the weekend, cold, dirty, shoeless (why the hell were we shoeless?) and miserable, wandering the campgrounds with a severe case of FOMO, searching for the best May Long party, racked with the fear of returning to school on Tuesday, only to realize that THE PARTY OF THE YEAR was missed or shut down by a responsible adults. Responsible adults were always ruining the May Long fun. To solidify the agony of the May Long, Mother Nature occasionally threw a wrench in our camping plans by delivering a heavy snowfall during our initiation to summer weekend.

A Canadian Classic: You will wake up with a headache. Guaranteed. 

Don't grow up, Kirstie! It's a trap!
At age 17, when Evan and I became a couple, I introduced him to epic May Long, and, together, we shared in the misery excitement. As we matured, the May Long morphed into a "Rick's Lounge" weekend, where we (Gasp!) partied legally at the local lounge. Despite our mature approach to partying, somehow the night always resulted in wandering, cold, miserable, and shoeless (Why? Why?) through the bushes, searching for an "afterparty."

When we turned 25 years old, we purchased our first house - a lakefront cabin at Candle Lake (when I say "WE purchased," I mean "Evan purchased"), and Evan and I had our own place to party on the May Long. Unfortunately, our first May Long in our new home took a terrible turn and nosedived us into the depths of despair known as adulthood.

It was 2am on the Saturday night of May Long 2005, and Ev and I had settled into bed after a night of campfire wobbly pops with our buddies. Suddenly, we were awakened by the flashing lights of a police car projected on our ceiling. We could hear shouting, the sounds of breaking glass, and the rustle of bushes in our yard. Ev quickly jumped out of bed, grabbed his golf club and headed outside to survey the situation (or beat someone with his golf club...the jury is still out). I watched in horror from my window as half a dozen frantic teenagers abandoned their bottles of beer in MY yard, and hid from the police under MY deck (technically, all of these things belonged to Evan, but you get the point). Donning only his bright blue Bart Simpson boxers, and shoes! (He was wearing shoes?) Ev waved his golf club at the drunk teens and bellowed, "HEY! GET OUT OF MY YARD!" I shuddered from my window. My boyfriend, the super cool Evan Lindsay, had a "Dad" voice. Terrified, the teens abandoned our yard and fled the scene. Terrified, I climbed back into bed and snuggled under my covers. At that moment it occurred to me: We are no longer the careless teens running from the law. We are the adults ruining May Long fun. We are the fun inhibitors. That moment marked our graduation from our carefree childhood days into the realm of responsibility and adulthood. That is the moment when Evan and I officially became (shudder)...adults.

Happy Easter Everyone!
To my family: I miss you and love you so much. I will see you soon.

Saturday, April 8, 2017

Things you should not say to people on crutches

Crutches are an interesting mobility aide. For most people, crutches symbolize a temporary disability. Many of us have been on crutches at one point or another - whether it was a broken ankle in high school or a knee replacement at age 65, many can relate to the crutches, and assume that the person on crutches is in the process of being "fixed."

When we see someone in a wheelchair, on the other hand, we may sympathize, wondering if the person was in a tragic accident and unable to walk again. When we see a woman with a bald head peeking out from beneath a scarf, we may sympathize, wondering if she is undergoing cancer treatments. It's human nature. Certain aides or accessories cue our brains to experience more sympathy, to view a situation as more serious than another.

Now I'm not inferring that no one has sympathy for people on crutches; however, based on 5 years of consistent crutching experience, I will say that there is often a different reaction to a person on crutches verses other visible injuries/ailments. My situation is unique, in that, I have a degenerative cartilage disease. I don't mind explaining this to people, but I do notice that when they ask, "What happened?" many are surprised and slightly uncomfortable with my response. People appear to struggle to process the information about my condition. It's not expected. They would prefer to hear that I tore my ACL in a skiing accident because that makes sense to them. They can relate to that injury. Everyone knows someone who tore their ACL! It confuses people when I use 1 crutch one week, 2 crutches the next, and no crutches the following week. They don't understand that my pain varies from day-to-day. They expect to see progress. They expect to see recovery in a neat and linear way consistent with the average person who is recovering from a knee injury. So I think that sometimes people say and do inappropriate things because they just don't understand my disease and my explanation does not match their expectations.

I've noticed quite a few list-type articles out there: "10 things NOT to say to a pregnant woman," "5 things NOT to say to someone with depression," "7 things you should NEVER say to someone who has just gotten divorced," etc. So, I thought I'd add to the mix and create my own list. Behold:

Things You Should NOT Say To People On Crutches

1. "What did you do to yourself now?"

As I crutched across the school yard, sweat dripping down my face, pain radiating down my knee, I looked up as a fellow "professional," hands placed sternly on her hips bellowed, "And what did you do to yourself now?" I clenched my teeth as my inside voice replied, "Oh I just acquired a rare cartilage disease you dumb &*%$" Being a professional in my place of work, I filtered my inappropriate thoughts, smiled through my gritted teeth, and replied, "Just had another knee surgery." 

Why would one assume that I "did this to myself"? Given that I've been on and off crutches for the entire time I've worked on island, do people assume that I am injuring myself every weekend at international beer pong tournaments? (How badass would that be?) Anyway, don't say it. Just don't.

Crutches need support too sometimes


2. God will heal you

Now don't get me wrong. I'm pro God. If God wants to heal me, I'm all for it! I really do appreciate it when people say that they are praying for me. Regardless of your religious beliefs, when someone states that they are praying for you, it indicates that they are thinking about you, hoping and wishing for the best. It's a lovely gesture that I greatly appreciate. But I'm afraid God ain't putting my cartilage back together. Dr Carey from the Penn Cartilage Centre is putting my cartilage back together. When I explain to you that I have a specialized surgeon who is planning my treatment, please don't diminish my trust in the medical system by saying, "Don't worry, God will heal you."

3. That doesn't look fun!

Picture this: a sweaty woman, donning 2 large knee braces, leaning on a crutch, and painfully rolling a suitcase across a gravel path. Yelling, "That doesn't look like fun!" from across the gravel road is NOT helpful. Please help me. Please take 3 minutes out of your day and give me a hand. Some days I may not need your help. Some days I am stubborn and want to prove something to myself. If you ask, I will reply, "Thanks for asking but I got this today." Some days I will thankfully hand over my goods and direct you to my destination. It sure doesn't hurt to offer!

My crutches have many useful purposes, from bottle opener...
...to a microphone! This crutch knows how to party


4. I know exactly how you feel. This one time....

Okay. I want to be clear about this one. I think that it's human nature to try to relate to someone when he/she isn't well. It's a technique that we've incorporated to help us form connections with others: "Oh the same thing happened to a friend of mine and he's all better now," etc. I get it. I also understand that people want to help, and sometimes that involves sharing articles they've read on the internet about stem cell treatment, miracle cartilage gel, etc. The gesture is nice. However, this can quickly turn into a long-ass boring story about "you." I thought you were trying to empathize with me, but now I've been leaning on my crutch in the hot sun for 10 minutes listening to a long ass story about the one time that you broke your ankle. One acquaintance skipped the empathy all together and commented, "My knees are killing me too!"  A simple, "I was on crutches too and I know that it's not fun. Hope you feel better," would totally suffice!


5. When are you getting off the "sticks"?

This is another interesting human response. When someone is sick, whether it be suffering from a cold or recovering from brain surgery, we just want to hear that they are "getting better." It's uncomfortable when we ask someone, "How are you feeling?" and the response is, "Actually, I'm not feeling better." What do we do with that information? Often, especially if it's not someone I'm particularly close to, I will respond, "coming along," regardless if I just discovered that I will require another surgery due to my degenerating cartilage. 

So when someone asks, "How much longer do you need the crutches?" I'm unsure of how to respond. The truth is, I will probably need then off and on for my entire life, but no one wants to hear that. That's not an expected response and it's typically followed by awkward silence. So my reply is typically, "Any day now." Unfortunately, I feel like people are disappointed, when 2 months later, they see me back on the crutches. And that's when I hear, "What did you do to yourself now?" (See  #1) It's a vicious cycle!

My crutches can jump at Batabano


So now that I've disclosed all the things NOT to say to people on crutches, let's end on a positive note. So many students, friends, colleagues, and strangers step up and say and do some very helpful things/gestures when I am on crutches. These caring gestures/words restore my faith in humanity and often make my day. Here are just a few examples of the awesome acts of "CaymanKind" thoughtfulness that I've experienced on crutches:

"Miss, that looks like it hurts. I feel sad for you." (5 year old student with a language delay)

"You always keep going with a smile on your face. That must not be easy for you some days." (co-worker)

"Whoa! Stop. I'll carry that for you. Where are we going?" (security guard at school parking lot)

"Hang in there. I can see that you're in pain today." (co-worker)

"You need a hug!" (7 year old student with a language delay)

"Let this woman to the front of the line." (stranger in a long line at the police station)

"Do!" (5 year old severely language delayed student as he independently brought a chair for me to sit down and motioned, "sit" with the word, "Do!" This was such an incredible gesture of compassion from a little boy who has shown remarkable progress)

"I got it!" (Uttered by each and every one of my office-mates as I pack up my materials to leave for the day. My office-mates ROCK!)

"Miss, come with me. I can help you in the office where you can sit." (Bank Teller who noticed me waiting in line)

"We're your island family. If you need anything, we are here for you." (My island besties)

My crutches can even SCUBA (with the help of good friends!)






Sunday, March 12, 2017

Bonding over emesis: Another surgery in the books!

Well surgery #8 has come and gone, and compared to previous experiences,  I will chalk it up to a success.

After undergoing 7 previous knee surgeries, I went into 8 like a professional patient (or terrorist), negotiating my demands with the surgical staff as soon as I entered the surgery centre in Philadelphia.

"Ok, listen. We can do the Percocet but no Fentanyl this time. Last time I suffered convulsions and we do not want that happening again."

"Fine. I will take the general anesthetic, but you need to use the mouthpiece instead of the oxygen mask. You know I get claustrophobic under there."

"Where's my Versed? Did someone forget my Versed? You guys know that I get anxiety and need that Versed."

Ok. I wasn't actually that demanding - I definitely made requests politely as any nice Canadian would - but I did go in with my list of "optimal surgery strategies." Oh my god. They must hate the Type A controlling patient from the Cayman Islands! 

I exited the surgery centre the very afternoon after my surgery, feeling pretty badass and ready to conquer the famous Philly "Rocky" steps. My pain was minimal and I was on an anesthetic high. 

About 24 hours later, nausea rocked my world, and continued to rock my world for 3 days. Let's call it the "post surgery beach body diet." Aside: I have so much sympathy for people who suffer from nausea for long periods of time due to pregnancy or chemo treatments, for example. That must be so awful.

I met with my Orthopaedic Surgeon, the Cartilage Repair Specialist, 4 days after my surgery. My surgeon is a good guy and a total cartilage nerd. He LOVES cartilage. He loves to talk about cartilage, he loves to photograph cartilage (I now have an album of deteriorating cartilage pics), he loves to repair shitty cartilage - cartilage is his JAM. Given the fact that I have a rare cartilage condition, we are a match made in heaven and I am extremely lucky to have him as my surgeon. But....it's taken me a while to warm to my brilliant cartilage buddy. I have no particular reason, really. He listens. He explains things very well. He takes a lot of time with me. He emails back immediately if I send a question. He has good bedside manner. He's a likeable guy. But...he finds cartilage sooo enthralling that he smiles the whole time whilst discussing it- even when delivering bad news. It irked me. I felt like he saw me as a surgical challenge and was actually excited about my shitty knees (the dramatic side of me pictured a villain from a Disney movie rubbing his hands together, "Yes! This deteriorating cartilage is mine. All MINE!") I yearned for a bit of sympathy - maybe a frown -  to accompany, "Your knees are worse than expected." 

Luckily, we turned a corner on surgery #8. As I sat in his examination room, 4 days after surgery, listening to him describe the details of the next surgery - the cartilage implantation (smiling!), I felt that horrible familiar feeling of excess salivation and stomach roll. I quickly pushed my surgeon to the side and puked in the sink directly behind him. In that moment, something wonderful happened - he stopped smiling. I mean, he didn't hold my hair back or soothe me with a rendition of Frozen's, "Let it go!" But I felt like he saw me as a person who...well...puked. 

Although my Surgeon opted to exit the room for pukefest '17, upon his return, instead of continuing with the discussion of the next exciting surgery (happy face!), he commented, "You really are struggling with nausea. That's awful. We will try and solve that issue for you for the next surgery." EMPATHY! Thank you. Thank you. Thank you. I am more than just a challenging case, you know. There is a nauseated person attached to these scarred up knees! So now I feel like we can work together on this. It was a "me" issue and now I am over it. Yes. Let it go, indeed. 

I've been back on the island now for about 10 days and recovery is going well - there's always good days and bad days, but overall, it's been positive. A huge part of the success is the presence of my Mom. It's so nice having her company, as I find quiet alone time difficult, my head spinning with worries about my job and the upcoming challenges that the next surgery brings. I have this terrible habit of telling myself that I am not healing fast enough (I know. Ridiculous), and both Mom and Evan have been so supportive and reassuring that I am doing great. Mom has also been feeding, watering, and cheering me on during my physio exercises. Although she leaves the island on Wednesday, I still have a week to work on my strength and endurance so that I can return to work in the best shape possible. 

In all the flurry of post surgery activity, something terrible happened in our house. We forgot Dundee's Birthday. It completely slipped our minds. Oops. I awoke on Thursday to a Facebook memory of Dundee's birthday a year ago. Damn. I quickly looked at the date and realized that we had missed his birthday by a week! Luckily, Dundee hasn't had access to a calendar and as far as we know, did not suspect a thing. So we celebrated Dundee's 7th birthday on Friday with birthday hats, friends, and lots of pats. Have you ever seen such a big puppy smile? 

Cheers Friends!

One happy pooch!

Another Penn Medicine garment bag. Luckily they've started a punch card for me. One more surgery and I get a free shirt!

But how awesome is that pedicure? Perfection.

During my appointments Evan plays. With everything. He even froze his arm with anesthetic spray.


Oh good! Ev caught the post barf on camera! Ahh..the memories.

Just organizing my cartilage photo album (these are my intra-operative surgery photos). Someday I can show my awesome cartilage just how far it has come! ;)


Dundee and I do physio together every morning!


Dundee hugging his new birthday toy - exhausted from his party!



Sunday, February 19, 2017

Training for #8

I have a small, brightly coloured Mead notebook that I keep around the house. If you peek inside, you will see (in my neat "teacher" printing) items such as:
  • Maintain weight. Protein!
  • Sleep goal: 8 hours a night
  • Meditation goal: 3 times a day
  • Gym 2-3 times a week: range of motion, stretching, upper body strength, core stability
  • Water exercise 2 times a week: range of motion, increase heart rate, stretch
  • Ice and heat for pain

At first glance, you might assume that I am training for something - perhaps a marathon or race of some sort. I guess I am in training, but not for something that most people train for. I am in training for my 8th knee surgery which takes place next week in Philadelphia.

Time to overhead squat the crutches!
I don't think that the majority of the population undergo regular surgeries once or twice a year like I do. On the other hand, I am aware of the fact that some are withstanding much more serious and life-threatening procedures than mine. But I would assume that most people go into surgery having no idea what to expect - there are so many unknowns. What happens before I fall asleep? Will I wake up? How will I feel when I wake up? Although each experience is different for me, I have 7 past surgeries to reflect upon - each experience has had its positives and each experience definitely has had its challenges. So I'm doing what any type-A control freak would do: I am using my past experiences to train and prepare for this surgery as best as I can so that I am in a position to succeed. But...and this is a huge but that I have spent hours discussing and analyzing with my Pain Psychologist:  I am prepared for the fact that obstacles will arise that I cannot control... and that is OK. (Haha, my $100/hr sessions are paying off!)

I hear friends saying, "You are so brave," but I don't necessarily feel brave. I feel like I am just living my life as best as I can with this shitty disease. To be honest, I am scared. As prepared as I am for this surgery and as strong as I presently feel physically and mentally, I am still fearful. Some of my fears are rational. I am afraid of the 10/10 pain that consistently hits me 2-3 hours post surgery. That pain is scary and, despite undergoing 7 surgeries, no Anesthetist, Surgeon, or Nurse has yet to determine how to control that pain for me during that period of time. I am also afraid of drug interactions. I've had a few bad ones that have caused me to shake and twitch uncontrollably. Kinda terrifying.

Some of my fears, however, are irrational. I had a nightmare that my surgery was on a Carnival Cruise Ship. My Ortho greeted me in a Captain's hat and said, "Welcome aboard, what joint are we doing today?" Perhaps you recall my post about our disastrous cruise on the "unfun" ship? Another irrational fear is the fear that my Anesthetist will have an "off" day and miscalculate my anesthetic, placing me into a lifelong coma (I mean, haven't you ever been daydreaming when you go to make minute rice and mistakingly add 2 cups of water instead of the prescribed 2/3 Cup of water? Does this ever happen to Anesthetists in the operating room??)

Ev and I head to Philadelphia on Wednesday, I meet with my Surgeon on Thursday - the brilliant cartilage man who is much too joyful when he delivers bad news - and I undergo surgery on Friday. This surgery is another "clean-up" operation to prepare my knee for upcoming cartilage implantation surgery. My Mom is meeting us there (my mom and Evan are a huge part of my successful recovery plan - thanks Team!) and we will spend a week in Philadelphia before we all fly back to the island for my rehabilitation. It sounds so simple when I write it all down! I am fully aware that the next month will test me, but I feel confident that I have a solid plan in place.

Note the stupid smile. Can you say "high as a kite?"

Stupid smile again! I am obviously drugged and think that I am going to the spa for a facial. 

In the meantime, Ev and I have been partaking in some fantastic island activities in an effort to relax and distract. Last night we did the Bioluminescence tour, which entails paddling a kayak to a bay at night where glowing plankton reside. It was a beautiful star-filled night sky and the ocean glowed liked tiny diamonds when you ran your paddle through the water (kinda like the scene in Life of Pi!) Today I have a pedicure at the swanky new Kimpton Hotel Spa (I will opt for a soothing toe hue to ensure that my Anesthetist is NOT distracted) :)

This week I have felt incredibly grateful that I live in such a beautiful place that promotes relaxation and serenity. I am also grateful for wine.

Cheers Friends!

Photo cred to Cayman Kayaks