Still Dancing With My Demons

I have found that information is the best way to educate my mind when I’m left with unanswered questions. Today is no different, actually Thursday was no different, as it was Thursday, yes that I had yet another bomb dropped in my lap by my friendly VA doctors. It was good news to hear that there is now a solution, but bad news because of what the solution involves when it comes to the repair and pain relief in my knee. Anyone who visits this blog regularly over the last several years will have read about my knee, my challenges with the VA, playing the waiting game, and in many ways, dancing with my demons, or at least entertaining them on a dark rainy night.

I really was blindsided as I was led to believe that I merely had ligament problems once again, but no, these two doctors took a very blunt and honest approach with me, thank you, and explained and showed me just how fucked my knee really is. First of all, bone to bone contact because of deterioration of the cartilage is a rather challenging pain to explain. As well, that same space being approximately 100% covered with arthritis. I’ve always said ignorance is bliss because it allows one to disconnect from something and become very indifferent to ones grief. So be it, not everyone has had a broken knee to include broken femur in two places, broken tibia, destroyed ligaments and muscles, and so forth. I get the precious innocence of ignorance to my personal hell. I give these doctors credit, it was like they were in my head reading my thoughts and knowing my daily challenges. It was cool but also some freaky voodoo shit was going down too, I think. It was almost nice hearing my own personal words coming out of someone else’s mouth right there in person. Anyway, below is the best description I could find about the corrective surgery. I have spent the last two days reading, trust me, but I think this might just be my answer. However, I will put this out there for y’all, if you know a better answer, please pass it on. So, here it is.

Originally written here.

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Knee osteotomy is commonly used to realign your knee structure if you have arthritic damage on only one side of your knee. The goal is to shift your body weight off the damaged area to the other side of your knee, where the cartilage is still healthy. When surgeons remove a wedge of your shinbone from underneath the healthy side of your knee, the shinbone and thighbone can bend away from the damaged cartilage.

Imagine the hinges on a door. When the door is shut, the hinges are flush against the wall. As the door swings open, one side of the door remains pressed against the wall as space opens up on the other side. Removing just a small wedge of bone can “swing” your knee open, pressing the healthy tissue together as space opens up between the thighbone and shinbone on the damaged side so that the arthritic surfaces do not rub against each other.

Osteotomy is also used as an alternative treatment to total knee replacement in younger and active patients. Because prosthetic knees may wear out over time, an osteotomy procedure can enable younger, active osteoarthritis patients to continue using the healthy portion of their knee. The procedure can delay the need for a total knee replacement for up to ten years.

Surgery

Depending on where osteoarthritis has damaged your cartilage, an osteotomy removes a wedge of bone from different areas of your shinbone. The most common type of osteotomy performed on arthritic knees is a high tibial osteotomy, which addresses cartilage damage on the inside (medial) portion of your knee.

The following surgery section provides details about the high tibial osteotomy procedure that apply in general to most other osteotomy procedures. The procedure usually takes one to one-and-a-half hours to perform.

During a high tibial osteotomy, surgeons remove a wedge of bone from the outside of your knee, which causes your leg to bend slightly inward. It is like realigning a bowlegged knee to a knock-kneed position. Your weight is transferred to the outside (lateral) portion of your knee where the cartilage is still healthy.

Surgery
After anesthesia is administered, which may be regional, or general, the surgical team sterilizes the leg with antibacterial solution.Surgeons map out the exact size of the bone wedge they will remove, either using an X-ray, CT scan, or 3D computer modeling.A four- to five-inch incision is made down the front and outside of your knee, starting below the kneecap and extending below the top of your shinbone.Guide wires are drilled into the top of your shinbone (tibia plateau) from the outside (lateral side) of your knee. The wires usually outline a triangle form in your shinbone.A standard oscillating saw is run along the guide wires, removing most of the bone wedge from underneath the outside of your knee, below the healthy cartilage. The cartilage surface on the top of the outside (lateral side) of your shinbone is left intact.The top of your shinbone is then lowered on the outside and attached with surgical staples or screws, depending on the size of the wedge that was removed.The layers of tissue in your knee are stitched together, usually with absorbable sutures.

Day Of Surgery

At most medical centers, you will go to “patient admissions” to check in for your outpatient arthroscopic surgery.

After you have checked in to the hospital or clinic, you will go to a holding area where the final preparations are made. The paperwork is completed and your knee area may be shaved (this is not always necessary). You will wear a hospital gown and remove all of your jewelry.

You will meet the anesthesiologist or anesthetist (a nurse who has done graduate training to provide anesthesia under the supervision of an anesthesiologist). Then, you will walk or ride on a stretcher to the operating room. Most patients are not sedated until they go into the operating room.

Here are some important steps to remember for the day of your surgery:You will probably be told not to eat or drink anything after midnight on the night before your surgery. This will reduce the risk of vomiting while you are under general anesthesia.Wear a loose pair of shorts or sweatpants that will fit comfortably over your knee bandage when you leave the hospital.Take it easy. Keeping a good frame of mind can help ease any nerves or anxiety about undergoing surgery. Distractions such as reading, watching television, chatting with visitors, or talking on the telephone can also help.

Recovery Room

Following a knee osteotomy, you usually stay in the recovery room for at least two hours while the anesthetic wears off.

This procedure typically causes significant pain. You will be given adequate pain medicine, either orally or through an IV (intravenous) line, as well as instructions for what to do over the next couple of days.

Your knee will be bandaged and may have ice on it. You may have significant pain early on and you should take the pain medicine as directed. Remember that it is easier to keep pain suppressed than it is to treat pain once it becomes present, so ask the nurse for medication when you feel pain coming on.

You should try to move your feet and ankles while you are in the recovery room to improve circulation.

Your temperature, blood pressure, and heart rate will be monitored by a nurse, who, with the assistance of the doctor, will determine when you are ready to leave the hospital or, if necessary, be admitted for an overnight stay. Most patients remain in the hospital for two to four days following an osteotomy.

Post-Op In Hospital

After knee osteotomy, you usually are taken to a hospital room where nurses, anesthesiologists, and physicians can regularly monitor your recovery. Most patients spend two to four days recovering in the hospital.

As soon as possible after surgery is completed, you will begin doing continuous passive motion exercises while in bed. Your leg will be flexed and extended to keep the knee joint from becoming stiff.

This may be done using a continuous passive motion (CPM) machine. The CPM is attached to your bed and then your leg is placed in it. When turned on, it takes your leg through a continuous range of motion.

There will likely be pain, and you can expect to be given pain medication as needed. Ice also helps control pain and swelling.

For two or three days after surgery, you may experience night sweats and a fever of up to 101. Your physician may suggest acetaminophen, coughing, and deep breathing to get over this. This is common and should not alarm you. The incision usually starts to close within six days and the bandage can be removed. Physicians commonly fit you with a knee brace that may allow a limited range of movement and helps push your knee into the correct position. For a high tibial osteotomy, the knee brace pushes your knee inward, making you slightly more knock-kneed. Please note that some surgeons will cast your knee for 4 to 6 weeks to ensure that the osteotemy heals.

You may be able to put some weight on your knee, but physicians usually prescribe crutches for at least six weeks. You will be given a prescription for pain medication and usually schedule a follow-up visit sometime around six weeks after surgery.

Rehabilitation

Most patients can begin physical therapy around six to eight weeks after surgery. Unlike other surgical treatments for arthritis, osteotomy relies on bone healing before more vigorous, weight bearing exercises in the gym can begin. In the best scenario, people respond to strengthening exercises and stop wearing the brace after the first three to six months of therapy.

Light exercise is one of the most effective ways to relieve arthritis pain by stimulating circulation and strengthening the muscles, ligaments, and tendons around your knee. Strong muscles take pressure off the bones so there is less grinding in the knee joint during activities. In conjunction with a healthy diet, exercise can also help you lose weight, which takes stress off your arthritic knee.

Stretching

In the first few weeks of rehabilitation, your physical therapist usually helps you stretch the muscles in the hamstrings, quadriceps, and calves while flexing and extending your knee to restore a full, pain-free range of motion.

Aerobic Exercise

When pain has decreased, physicians generally recommend at least 30 minutes a day of low-impact exercise a day for patients with arthritis. You should try to cut back on activities that put a pounding on your knees, like running and strenuous weight lifting.

Cross-training exercise programs are commonly prescribed when you have arthritis. Depending on your preferences, your workouts may vary each day between cycling, cross-country skiing machines, elliptical training machines, swimming, and other low-impact cardiovascular exercises. Walking is usually better for arthritic knees than running, and many patients prefer swimming in a warm pool, which takes your body weight off your knees and makes movement easier.

Strengthening

Strength training usually focuses on moving light weights through a complete, controlled range of motion. You should generally avoid trying to lift as much as possible with your quadriceps and hamstrings. Your physical therapist typically teaches you to move slowly through the entire movement, like bending and straightening your knee, with enough resistance to work your muscles without stressing the bones in your knee.

Once your physical therapist has taught you a proper exercise program, it is important to find time each day to perform the prescribed exercises.

Recovery at Home

You will likely feel pain or discomfort for the first week at home after an osteotomy, and you will be given a combination of pain medications as needed. A prescription-strength painkiller is usually prescribed and should be taken as directed on the bottle.

Swelling in your leg usually decreases over a span of three to six months after surgery. There may be some minor bleeding for a few days, but by the time you are released from the hospital, most bleeding should have stopped. If you notice an increase in swelling or bleeding, you should call your physician.

Physicians generally recommend that you avoid putting stress on your knee until the bones have healed. Putting weight on your knee too early may damage the bone surface and prolong healing time.

Here is what you can expect and how you can cope after an osteotomy:Icing your knee for 20 or 30 minutes a few times a day during the first week after an osteotomy will help reduce pain. Ice therapy may need to intermittently continue for a few months if pain bothers you.As much as possible, you should keep your knee elevated above heart level to reduce swelling and pain. It often helps to sleep with pillows under your ankle.Immobilize your knee in the prescribed, hinged knee brace for about six weeks. You may remove the brace for brief periods to perform passive motion exercises with the aid of a physical therapist or a CPM machine. Range of motion exercises are important for healing. Regaining full extension is just as important as bending your knee.Your leg may appear slightly bent after the surgery as it heals into its new alignment.Most patients have to keep the incision dry for seven to ten days. Your physician can recommend a surgical supply store that sells plastic shower bags. Wait until you can stand comfortably for 10 or 15 minutes at a time before you take a shower.Crutches or a cane may be needed for between six and ten weeks, depending on the pain. It is difficult to describe the amount of pain any given patient will experience.Six weeks after surgery, your physician usually gives you a check-up. X-rays can determine how your bones are healing and whether you are ready to begin rehabilitation.You may have to take between six weeks and six months off from work, depending on how much you rely on your knee to perform your job.

Prevention

After rehabilitation, preventing osteoarthritis is a process of slowing the progression and spread of the disease. Because patients remain at risk for continued pain in their knees after treatment, it is important they are proactive about managing their conditions.

A fall or torque to the leg during the first two months after surgery may jeopardize the healing of your bones. You should exercise extreme caution during all activities, including walking, until your physician determines that your bones have healed.

Maintaining aerobic cardiovascular fitness has been an effective method for preventing the progression of osteoarthritis. Light, daily exercise is much better for an arthritic knee than occasional, heavy exercise.

When you have arthritis in your knees, it is especially important to avoid suffering any serious knee injuries, like torn ligaments or fractured bones, because arthritis can complicate knee injury treatment. You should avoid high-impact or repetitive stress sports, like football and distance running, that commonly cause severe knee injuries. Depending on the severity of your arthritis, your physician may also recommend limiting your participation in sports that involve sprinting, twisting, or jumping.

Because osteoarthritis has multiple causes and may be related to genetic factors, no simple prevention tactic will help everyone avoid increased arthritic pain. To prevent the spread of arthritis, physicians generally recommend that you take the following precautions:Avoid anything that makes pain last for over an hour or two.Perform controlled range of motion activities that do not overload the joint.Avoid heavy impact on the knees during everyday and athletic activities.Gently strengthen the muscles in your thigh and lower leg to help protect the bones and cartilage in your knee.Non-contact activities are a great way to keeping joints and bones healthy and maintain fitness over time. Exercise also helps promote weight loss, which can take stress off your knees.

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Posted From Scorpion Sting’s Motorola Droid Maxx!

Fences Make Me A Great Neighbor

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Not the way you remember hearing the old saying? It’s my twist because it makes more sense to me, plus I could really give a shit if I have good neighbors or not. Mine know I don’t want them in or around my yard. For the newbies reading here today, my house sits on 11.93 acres of land somewhere way outside the city of Houston. Now, we live in what’s called an “acreage neighborhood” where all the homes sit on a few acres. Just so happens that when I bought my “lot” that I bought the two lots available to the left and the one lot available to the right. Why? Because I wanted my neighbors to have to put some work into it when they would choose to be nosey. After almost 10 years I would say the experimental theory has been a success because I barely know my neighbors, just the damn way I like it. Within the almost 12 acres there is a roughly 4 acre pond which was dug so I could build up where my house would be built, as well as level out what would become my yard. Also, there is 3ish acres of a densely wooded area which butts up to a feeder creek off of the San Jacinto river. Everything else is mowed as my yard and has a wooden fence around it.

Well, after the storm last night I found a tree had fallen on a section of my wooden fence way in the backyard. This explained why the breaker for the electric circuit had been tripped. Yes, it’s a partially electrified fence. Why? To keep the criiters, varmints, and the neighbors dogs from digging under the fence and getting into my yard. Don’t worry, out in this area its only putting out about 2000 volts. But, the tree seems to have damaged the line by completing the circuit, hence tripping the breaker. At least the mystery is solved, I figured I would find a dead animal of sorts out in the back, not a tree on the fence. Since I located this so late in the afternoon all I really felt like doing was exactly what I did, take a picture of it, well, actually about a dozen. Why? I needed them to show to the insurance company to show the damage. The adjustor will be out Monday morning to make a report so I can’t touch it until afterwards. If it were endangering life or property then I can, but its just a fence so I was told to wait. Waiting is not something I am good at, especially when there is so much work to do. Meanwhile, the neighbor on that side figured out I was back there and decided he wanted to have a 30 minute chat about absolutely nothing, in fact I don’t even remember as I sit here writing this.

When I tell my wife what had happened and what went on with the insurance she went off on one of her tangents and wants me to look into having the tree removed by someone and the fence repaired by someone. She didn’t ask when I would be taking care of it, she wanted to know when someone else was going to do it. There will be nobody else doing any of it because I want to do it. Plus, I have the kids to help me out, so it will be fine. On top of that, I finally got my favorite tool on the planet running again after it died on me back in March, I thought it was really dead, but it runs like a screaming chainsaw banshee now. So I’m good to go. Y’all were aware that every man has his favorite tool? My dad’s is a 50 year old flathead screwdriver, my son’s is an old roofing hammer, mine is, well, mine is the fine machine pictured below, its probably the most useful and versatile tool I have ever owned. Next week I put it to the test, next week I will see if bringing it back to life was worth it, next week the chips will fly. Fuck calling a tree removal company, fuck someone else fixing my fence, I will do it my way. My wife knows this already, she was just trying to be cute and see if she could ruffle a few feathers. The adventure never ends in our marriage, but that is life as well, shit happens, we could cry about it or take care of it. Some of us know the right answer, the others call a tree removal company.

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Why So Serious All The Time?

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Recently I received an e-mail which asked “How can you continuously besmirch our Lord the savior Jesus Christ?” and that wasn’t all she asked. She asked allot of questions about why I hate everyone and everything. I don’t think I have been asked such specific questions so I wanted to share so I could explore out-loud what I am thinking. Usually I get asked “why?” allot or I get told, in simple terms, “to go to hell” for the most part. People are so judgemental of what others have to say. Granted, I do write about a few sensitive subjects on occasion, like race, adoption, smoking and cooking, sheeple, fucktards, religion, atheists, Christians and Christianity, Jesus and God, the Devil, strippers, alcohol and drinking, disabilities, and so forth, so pick something from “A” to “Z” and I have probably written about it.. I don’t expect everyone or anyone to share in on my personal opinion, if you do then you do and if you don’t then so be it, no hard feelings either way on my part. The only qualifications I have to have my opinions is the simple fact that I’m a human being sharing this planet with many others so I get to see allot from my point of view. So, back to why I’m writing this post.

“How can you continuously besmirch our Lord the savior Jesus Christ?” That’s an accusation and a question all rolled up in one. To be honest, besmirch was a new word to me, not one previously in my limited redneck vocabulary, so I had to look it up to see what it means. Here’s what I found. the definition of besmirch (biˈsmərCH): to damage the reputation of (someone or something) in the opinion of others or to make dirty; to soil. Now the term continuously: uninterrupted in time, sequence, substance, or extent. Now, I’ve looked back in review, over the general contents included in my blog. Guess what I found. Nothing, in my opinion, that would suggest a continuous or even a partial besmirching of anything, in fact there isn’t one single thing that has space on my blog that gets continuous commitment. Now, if you want to talk about what I have had to say about the freaks in The Westboro Baptist Church that’s a different story, I mean, come on, is it normal for a group of people claiming to be Christians doing God’s work to have their website address as “godhatesfags”. Perhaps I’m the only person on the planet that doesn’t think that’s normal. Now, if that is Christian bashing then some of y’all need to check to make sure you are praying to the right idol. So, I’m at a loss with the concerns that I’m besmirching Jesus Christ anywhere ever here on my blog or in person. Just because I don’t believe in God or Jesus doesn’t mean I hate them or that I wish to damage their reputation. When I talk about Christianity in general it is because the “news” is on the radio, the papers, on the internet somewhere, and occasionally the information comes home from church with my wife. Still doesn’t make me a Christian hater. A better description would be a person who chose not to be sucked into Christian conformity.

So, what am I trying to get at here? Not sure, but I hope to have that figured out before we are done here. All I know is that I am a human being just trying to live my life the best way I know how. That’s all I have to offer, no more, no less. I return now with fresh thoughts after an extended lunch hour. I suppose I understand the judgemental nature of the human animal, we tend to judge and assume what we don’t know simply because we have never learned to do it any other way. Meaning? People tend to pick one point and focus on it with such fury that they become blinded by everything else, like the truth for example. I’m comfortable with myself within my own skin, with my thoughts, my actions, my life, and what I write about right here. I don’t hate anyone that I know of, with the exception of my ex-wife who is the queen of evil cunts. Other than my personal thoughts about her, I have no problems with people. I do, however, reserve the right to have an opinion or three about daily observations that I witness on a day-to-day basis. It’s just that damn simple. If, for whatever reason, you or someone you know, falls into the subject, topic, or category I happen to be discussing and you feel it’s like I’m pouring salt into your open wound then that is all on you because all I am doing is talking, I didn’t make what I’m talking a part of your life, you did. So, there you have it. Did it answer all of your questions? I hope not because I wasn’t trying to answer anyone’s questions. Look, I’m just here doing my thing, just living my life, and trying not to be so serious all the time. You should try it sometimes, it’s nice.