knee update 

I don't think this first skin graft has "taken" at all. It moves around too much to stick, if you can envision that.
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AWESOME! 

I have just the best friends and co-workers in the world. My boss Julie Sprinkel, the Practice Manager at DSI, found me an oven and a dishwasher for my new house. Then the next day my FORMER boss Mike Minnich from NetGain Information Systems just up and GAVE me his washer and dryer. Those items, along with the refrigerator I bought last week mean that I now have all the important appliances. I'm just flippin amazed by my friends!
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ouch 

It's not feeling so great since yesterday when they removed the vacuum. Dr. Garg did some work on the still-deep lower wound and it really hurt, i think there is some left over pain from that work. and the super-fragile graft he applied yesterday can't possibly be staying in one spot, it's right on the moving part of my knee......
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yesterday 

Well I decided to start blogging here about my recovery from my knee injury because so many people have been asking me about it. Often!

Some history is in order first:

Our company Christmas party (I work at DSI, a GI practice with several offices in the Dayton area) was on the 2nd of December at Kettering Skateworld. The theme was "70s" so disco and roller boogie were completely appropriate! I donned my favorite caftan, boots and hip wig and I think that I looked like Mrs. Roper but better! I was in a funk that week, so I was determined to have fun that night.

Dinner was great and after that I managed to get the folks at the party to sing "I'd like to teach the world to sing" in the style of the Coke commercial (Thanks for the words Shannon Simpson!) and it was not only hilarious but it was just plain fun. When it came time to put the skates on I was the FIRST person grabbing skates off the rack, I didn't even wait for the Skateworld employees to hand me the skates, I just went back into the skate storage area and grabbed some. When i was 17 I worked at a USA skating rink and I considered myself a good skater back then. That fact that this was 20+ years later didn't worry me for some reason. Like I said I was in the need to enjoy myself.

For about ten minutes everything went just fine. I remembered how to move (my muscles in my legs were clearly out of practice) and I got around the rink carefully a few times. I tried going a little faster but decided against it after nearly losing my balance a few times. Some time on about my tenth revolution around the rink I slowed down too much and got wobbly. If you are a skater you know that often it's easier to stay up if you are going a little faster, a lot like riding a bicycle. I lost my balance and went right down on my left knee. It hurt! I was afraid to get up but a couple lovely people helped me, so after I untied my skates I managed to get up and hobble off the rink. The knee bore weight so I didn't think it was broken and I got some ice at the concession counter and sat for probably a half hour or so with the ice on my knee.

When the pain subsided a bit I decided to drive home to Springfield. It was my left knee after all, i didn't really need it to drive. But that was an excruciating drive. I barely remember it as a haze of pain. At home I put my knee up on pillos and packed it with ice, thinking the swelling would go down by the next morning and all would be well.

I didn't sleep well and at about 3am I asked my partner if he could take me to the hospital because the pain had become insufferable, but it was the middle of the night and our 5-year-old daughter was sleeping. She needed to go to school the next day so we decided I could suffer through a couple more hours and as soon as her daycare opened we took her in and my partner took me to the ER. They x-rayed it and put ice on it, shot me full of pain medicine and sent me home after 7 hours, telling me it wasn't probably broken (maybe cracked) but not much else.

Right about this time, Chloe came home from pre-school with a sore throat and a fever. I was incapacitated and now my daughter had strep! I took her to the pediatrician on the crutches the ER gave me. That was an adventure. By the end of the day Chloe was more comfortable and sleeping but my knee had developed an alarming amount of swelling. The edema was bad enough that the skin on my knee blistered up over an area about the size of a bandaid or two. With all the changes of ACE bandages, the blister ended up open that day, and at the same time I noticed that I had strep throat also!

The next day I woke up with a raging infection in my throat, and as if that weren't enough, my knee was disgustingly infected as well, in the area where the blister had lain open. I made an appointment to see my GP, Kevin Macy. He's awesome by the way. Dr. Kevin was kind of busy when i got there, so I saw his partner Mr. Muir. He's awesome too by the way. When Dr. Muir heard that I had strep he took a culture of course, then started talking to me about the antibiotics I should have .... I had to interrupt him and say "well hang on I'm pretty sure my knee is infected too". He took one look at it and kind of freaked out. He went to go get Dr. Kevin and they stood over me looking at my knee with a kind of morbid fascination... I'll admit it was technicolor, that's for sure .... and they shot me up in the hip with a strong antibiotic and gave me a prescription for two more antibiotics. The strep in my throat was gone pretty much immediately. The knee looked a lot better after a few days also. But after 10 days of antibiotics, Dr. Kevin told me to keep taking them for another 7. After 17 days, the infection looked gone but just as soon as I stopped the meds it came right back.

Dr. Kevin knew there was something he couldn't see going on and he was concerned about infection getting into the joint (he had sent me to an orthopedist right at the start who said it was NOT infected in the joint ... but you never know) so he referred me to the Springfield Regional Wound Care Center. That led me to Dr. Tarsem Garg who is the awesome-est of all. Dr. Garg uncovered the mystery of the injury in all it's semi-gross detail by performing surgery on January 15th. Underneath the skin of my knee (but on top of the bursa) there had been a really large hematoma. A massive blood blister basically but under the skin and fat. That big pocket of blood had become infected with strep and died. Dead cells are bad to have anywhere in your body when they are in large numbers! They harbored the infection for that whole time, about 45 days, until Dr. Garg cleaned it out.

After surgery, I went on wound vac tharapy, which I find both fascinating and amazingly effective. Don't balk at it if you ever have to use a wound vac, it works! It made the healing process just zoom. By yesterday, the 22nd of February, only 5 weeks or so after surgery, the tissues were re-knitted together and all of the wound bed tissue was re-created by the combination of the vacuuum and my own healing power. It would have taken more like 5 months without the vacuum. I call that crazy awesome.

Knowing that I would need them when the wound bed was all filled in, a couple of weeks ago the clinic sumbitted a request to Anthem to cover skin grafts by a company called "Oasis" who create them using cultured pig tissue. It's what the doc wanted to use because it's less expensive than other grafts and he felt that would work best for my knee. But Anthem would not cover it, calling it "experimental" in spite of the fact that it's been around for 30 years and works for like 90% of patients who get themse grafts. Each application of these grafts retails for about $750 and they want you to get them in increments of 12. I did the math and that's $9000! I knew I couldn't afford it but I wanted my knee to get better.

So yesterday I went in and Dr. Garg gave me a different brand of graft called Apligraft because there was a slightly better chance that Anthem would cover it. It's cultured human skin tissue and it's super thin. It doesn't work quite as well (it's super fragile like tissue paper, which on a knee doesn't stick well because of the constant movement) and they were still pretty sure that Anthem wouldn't cover it but I went ahead and got the graft. I was FINALLY able to go without the vacuum. What a relief! It had been hanging on me like a heavy purse (or fanny pack if I wore it the other way - very stylish!) since January 15th so I was really ready to be done with that, even though it worked really well.

They warned me that grafts almost never "take" on the first try but I have decided to be optimistic. Why not? What else can go wrong?

Julie Spenkel, my boss at DSI, has been the MOST understanding and caring person throughout this mess. I know that she felt responsible in some small way because she had planned the party where the injury first occured, but of course my falling on my knee is not Julie's fault. I keep trying to tell her that withi limited success, so if you are reading this and if you know Julie you should tell her, too.

I'll keep my blog updated with the rest of my recovery. I've kept a careful photo journal of all of this mess but I've decided not to post it here because most of the photos are pretty graphic. Many are downright disgusting. Some of you might be squeamish. But if you are interested in the photos before and after surgery and during the wound vac healing, let me know and I'll send you the link to a slideshow I'm creating. It's not for the weak of stomach!

Love to all,

Jane
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Sharepoint is fun 

It's dorky I know, but i am really looking forward to launching the new DSI/DECL SharePoint 2010 server. It's a big project and a change in internal corporate paradigm. My favorite kind of project! Got a book about 3" thick on Server 2008 R2 and another book about 2" thick just about SP 2010 so i am all set for some late night reading.

of course the new file server comes first ..... and tha parts aren't even ordered yet!
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