My plan of care anxiety relieved - Joe Theismann and Vampires

I had surgery on my blown knee this past Wednesday. Let me say that I was happy with the progression of my care. Friday, I hurt the knee. I was able to get in and see my primary care physician with-in 40 minutes and have a plan of attack sketched out that afternoon.
I got an appointment with an orthopedic surgeon for Monday and had the surgery scheduled for Wednesday morning.
I'm not sure how other folks insurance companies and health care options work, but I could not believe how well my schedule moved forward.

While I'm super happy with my case progression, I learned how much of a wuss I am. Now post-op, I know that there was not much to worry about from the actual procedure. I had way more anxiety due to my wild imagination than anything else. In general, there are two things that I can't stand seeing on TV - knee injuries and neck injuries. Can't stand them. It's hard not to feel the injury on myself! I have turn away, try to change the channel right away and control the nausea. The knee injuries - I'm not sure why I have that issue, but I remember seeing Joe Theisman's football game where his leg was shattered. It was too much for me. As for the neck - I've always been afraid of vampires. As a kid, I couldn't sleep with my neck exposed to the air. It was too creepy.

Anyhow, wussiness aside - this is what my days looked like from day of injury to immediately post-op.

Friday-Monday - I actually didn't have too much pain. The original injury was more of a shock than painful. The dislocation of my patella was fricking painful, but again, that was the initial injury. The bruising around my knee was disgusting. Otherwise, I was sitting on my couch or my bed with my leg up in the air. I've never had any other knee injury, and don't wish one again, but a severed patella tendon is weird. Your quadricep flexes and pulls on the patellar tendon, which in turn pulls on the shin, which pulls and controls your lower leg. With out that connection, my leg was a ton of dead weight. I could stand straight up with my legs locked, but nothing else. It was awkward.

Monday - Met with the orthopod. Before we even saw him, he was able to see my x-rays and read my history and physical and scheduled my procedure for Wednesday morning. He did a couple tests on my leg and gave a very detailed picture of the surgery. It was during this description that my choice to be a pharmacist and not a nurse or physician was validated. And of course, the detailed description made me want to puke.

Tuesday - Waited around a lot. I had periods of anxiousness just thinkng about the surgery. I'm sure my BP was up there.

Wednesday - Day of surgery. The procedure was scheduled for 10:45. I was due into the outpatient surgery center at 8:30. My prep was promptly started at 9:00. Line placement was the worst. The nurse couldn't get a line placed on the first try. It was line in the hand. Unfortunately the nurse had to describe everything she was doing and I realized that the thought of a piece of metal sliding through my blood vessels was added to my list of anxiety creators. Todd Smith, the orthopod came in and again described exactly what he was going to do. I had to cut him short and explain to him that my anxiety was running high. Checking my blood pressure showed a systolic of 150's and diastolic of 100's. Wow.
A little fentanyl and versed and I was happy and anxiety free.
After that, I don't remember much.
The anesthesia was a combination of a femoral nerve block plus general anesthesia. The nerve block places medication at a specific nerve that would block any sensation at the location of the surgery. It helps keep the amount of narcotics and sedation that is given to the patient and quickens the recovery from anesthesia. It also provides some pain control for about 18 hours post procedure.
I remember slowly waking up in the PACU (post anesthesia care unit). I was transferred to a chair and then sent home.
All in all - one hour prep, one and a half hour surgery and one and a half hours in recovery.

That wacky patella

See the bottom right hand pic. Your patella isn't supposed to be that high! The tendon that anchors it down is torn. Owwy.

Knee me

At least there is no arthritis or mini-breaks. This is 12-15 years of bad patellar tendonitis. Mini-tears and periods of inflammation make it a perfect spot for a tear.

Combine that plus a quadricep firing hard to prevent a fall backwards and you get a tear. I felt bad for my kids. They didn't quite know how to handle seeing daddy all hurt. Also, I've been rolling with the kids regularly - Gracies Bullyproof JiuJitsu program. AWESOME stuff. It actually has such great basics that it can help anyone in the Jits game.

Swollen right knee.

IMG00147.jpg

Grrrrrr. Popped the knee today. Dislocated patella and torn patellar tendon. We'll see what the ortho doc says Wednesday!

...FVGC efficientization of my armbars.

After taking the day off, President's Day and all, I realized that I was able to get to FVGC to roll for the noon class. It was fun getting back there. I know that this is not going to be a regular thing.
First 30 minutes was practicing take downs with the Judo instructor. We practiced 3 different take downs.
A hip throw - I don't have any examples. Penny Thomas does a the kind we were working on in the last BJJ legends.
Ohsotogari - a leg sweep.
Ukiwaza - a sweep from front - a variation can also be done from behind
Ohuchigari- almost the Ohsotogari - but using more of the hip and thigh to block the opponent and taking them off balance.
The next 30 minutes was drilling some things for the Blue Belt testing. Arm bars - Americana, Straight Arm bar from mount and from guard. We also practiced Triangles from guard.
Bill learned a couple things to make the straight arm bar set up more efficient.
1) Arm bar from mount. This tip was really helpful for me. When I get into the arm bar: Collect/secure arm, transition from mount to seated modified mount (right leg up): transition weight to free arm on opponent head or chest, pivot hips and swinging my leg over the head of the opponent while keeping control of arm - my transition sometimes ends up where my rear lands quite a bit a way from my opponents shoulder. leads to some wasted motion on my part to maintain control or an ineffective armbar if I can't resecure the elbow and arm. TIP from Bill: When transitioning to seated modified mount. My right knee is up while I'm sitting on my left knee/butt cheek. My left lower leg is positioned parallel and right up against my opponents back/neck/head. The tip is, with my right knee up - lean forward towards that right knee. Usually my shin ends up being straight up and down. Instead consciously lean that right leg/knee forward using my weight on the opponent. This sucks my hips/rear closer to my opponent and even shifts them up on their side. THEN work the transition. Butt to shoulder connection!
2) Straight Armbar from Guard. When I was at the club 1.5 years ago. The armbar from guard was a 4 step affair. Control wrist with cross grip, control back of head with c-hook, use head grip, and a posting foot on hip or floor to swing and pivot to the side, swing other leg to hook shoulder. Pinch legs together, hip up. The "new" version for me is similar to this clip. But the FVGC version doesn't use the step that secures the opponent tricep. a) secure wrist. no cross grip needed. use same side hand. b) on side of secure wrist, post foot on hip of opponent. Your hip and thigh effectively block any motion of the opponent's shoulder. c) with posted foot, get hips up and hang opposite leg on opponents shoulder. Chop down like setting up a triangle. This already puts pressure on the arm with hip up and leg weight bearing down. d) Swing posted leg around opponents head. Knees tight and hips extended.

I finished up my time rolling with some guys. One of them with some good wrestling experience and about 75 pounds on me. His takedowns on me seemed effortless. At least I flew around like a rag doll. I was happy for the little wins, good neck protection, able to create space to reguard or prevent mount. I'll tell you that the first time he got side control on me - his weight up on me and his toes and shoulder pinned against my cheek, neck and face. It was tough not to feel totally claustrophobic! Forget not feeling it. I definitely felt it! But a little frame here and a little shrimp there. I was safe. I did get him in a damn good lapel choke from my half guard - no tap. While I was working the choke and working to reguard - he was finally able to tap me with a weird choke/cross face thingy - I'm on my side, head up. He worked a forearm/elbow against my neck and pressured my head against my opposite shoulder. It was uncomfortable and I thought I was fine until I started losing my vision a bit. I asked him to put me in that position again to see if it was just uncomfortableness versus a submission. I almost went black again. I think it was my broad shoulder that did me in. I was able to pass his guard and protect from a couple armbars and Americana's. All in all it was a fun time.