The Joys of Being Awake For Orthopedic Procedures

Back in September, I talked about the hope of being able to undergo a stem cell procedure that had a good chance of repairing some of the damage to my knee.  On Monday, I had the procedure done.  It’s too early to tell if it worked, or how much better things will be, but the procedure itself was enough of an experience I thought you might all enjoy the tale.

But first, I will be talking about a medical procedure, and I will share details.  If you get squiggy about such things, you may want to skip that part.

Last time, I did mention I would be looking into the VA covering it.  Turns out, they don’t, since it isn’t FDA approved yet.  Because the procedure is using my body fluids/material, it can be done without FDA approval, but until they can do a double blind study, the FDA won’t sign off on it.  Given what I am about to share, I would hope the FDA would perhaps find an alternative way to approve this. ¹

I went into this knowing what was going to happen, because the doctor didn’t want to sugar coat it.  The two big things to know are that first, I’m awake for all of this.  Half an hour before, I took a Xanax and a Tramadol, which is a nice effort, but the combo had no discernible effect on me (no loopiness or anything).  The second is that stem cells can’t tolerate local anesthetic (it’s toxic to them), so when they harvest bone marrow and fat cells, they can’t numb the harvest site.

Begin Squiddgy Bit

It started out simply enough, a 60 cc blood draw to recover platelets. ²  Then into the paper shorts, a quick stop to void the bladder, and then I climbed up on a surgical table and laid face down for the next 45 minutes.  My lower back and hips got painted with betadyne, complete with me joking that I didn’t know a Trump tan was part of the package.  Then I got a bunch of needle sticks to numb my backside (remember, only the harvest site has to be clear of anesthetic, not the path to it), before the doctor made a small incision and tunneled down to the tip of my left pelvis.

Turns out, the tips of your pelvis play host to a stem cell reservoir, so there is a ton of stem cells there to harvest.  As such, the doctor began to tunnel into the tip of my left pelvis.

And by ‘tunnel’, I mean ‘drive a spike into it’.

I’ve never had a Rockwell test done on my bones before, but I can’t find much to recommend it, even if, if my doctor is to be believed, I’d score pretty high on it.  The doctor had to use the heavy mallet (which he’s never had to pull out before), had to switch to the other hip (because he couldn’t get through the first one), and told me he felt comfortable forgoing his afternoon workout.  He has done over 200 of these procedures and claims that was the hardest he ever had to work to get into the marrow.

Also, I’ve met a lot of orthopedic surgeons, and I’d never qualify any of them as ‘weak’.  They start out at, “Hell yeah, I lift!”, and end somewhere around ‘Offensive lineman’.

Allusions to badassery aside, I was awake during all this, under very mild local anesthetic (and none in the bones), and now my lower back feels like it went 10 rounds with a jackhammer and did not come out victorious.

Also, if you’ve never had a surgery done while you’re awake, it’s hard to describe what it feels like, but the pain nerves inside the body don’t fire the same way the ones on your skin do, or the brain interprets them differently, I’m not sure which.  So having a spike drive into your bone doesn’t hurt the same way it would if it drove through your skin.  It’s not a sharp pain, more like an intense pressure.  It’s nothing to sneeze at, you’ll still be clenching down on something, and the pain will wash over you, but it certainly has a different… flavor to it.

And the marrow extraction was unique as well.  I now know what it feels like to have some of your innards sucked out through a straw, and again, I honestly can’t recommend the experience.

After all that, I hardly noticed it when he harvested the fat cells.

While they were cleaning up my back and patching the holes they made in me, the marrow and fat and platelets got filtered and spun and combined, then loaded into a big ass needle ³, which was then driven into my knee and the whole mess was injected.

End Squiddgy Bit

So my knee hurts from the needle, and it feels very full, which is uncomfortable.  I got two holes in my back, and a pelvis that’s taken a pounding, and not in a way that is an innuendo for some sexy fun time.  In short, I’m sore.  I have some Vicodin, and I took two yesterday, (one after the procedure was done, and one a bit before bed, so I could sleep).  I also have 90+ hours of sick time I have to burn before the new year or I lose it, so I’m home taking it easy for the next two weeks.

But it’s done.  I start physical therapy on Friday, and I have to avoid anti-inflammatory meds for the next 4 weeks, but by spring, I should be noticing some effects, so I guess I’ll check in again then.

Image by jacobms

1. Because I don’t know how many people suffering osteoarthritis in the knee would be willing to undergo this and wind up with a knee full of saline instead of stem cells.  I’d want a whole lot of money as compensation.  And at least have study procedures done under general anesthetic, because being awake for it was no picnic.
2. No biggie, I give blood all the time
3. yes, that’s a technical term, I’m betting the gauge on that thing was in the single digits