Fear and Loathing in Central Texas

For two weeks, recovery couldn’t have gone any smoother or better after an ACL reconstruction procedure. Both physical therapist and surgeon were confident after my first few therapy sessions that I would be back to hiking trails in under three months and running soon after that. But then inexplicably, trouble; the pain was going the wrong way, and my patellar graft harvest wound started bleeding spontaneously. Just a trickle at first, ending with a baseball-sized blood blister bursting. Knee joint fluid draws proved negative, so head-scratching ensued within the medical and therapy team in my corner.

The surgeon called an audible on the Saturday after the fluid draw to perform exploratory surgery on Monday. He called me back within twenty minutes and expressed a bad gut feeling and that we should do it the next morning, a Sunday. He managed to form a crew and found a surgery center. He calmly explained that it would be a quick look around, maybe 25 minutes to ferret out the culprit. I arrived with nothing but the clothes I had on, expecting like everyone else that I would crutch it out of the OR and be heading home in a few hours, answers in hand.

And this is where it all becomes a nightmare; the surgeon found a staph infection inside my knee joint. He had to scrape away all the infected tissue, under constant irrigation. In his words, he had to be "aggressive" because he was paranoid and didn't want any recurrence. I awoke over two hours later, not knowing anything other than extreme pain. A nurse informed me that I had blown through every Fentanyl packet in the OR and they had to steal some from another OR to get me through my procedure. Post-op, I was infused with a drug that keeps the brain from forming memories for humanitarian reasons. My recollection is reduced to a man, chattering endlessly between doses of IV analgesics, pulsed into me at the maximum allowable rate. But the pain overcame these intervals, and he was doing his best to distract me until my next dose. I don't recall his name, but I owe him the deepest of thanks.

The bad trip continued; for a week I lay in a hospital room, barely conscious, my knee under constant compression and ice, my brain swimming in the cocktail of oxy, two types of Dilaudid and Flexeril, combined with IV antibiotics every 8 hours to battle the MSSA that had invaded my surgically repaired knee joint.

After the blur of a week, the staff transferred me to a rehab hospital where the strange trip rambled on. CRPS symptoms engulfed my leg, which was horrifying, the potential result making my ACL rupture seem like a paper cut. A pain management doctor added Gaba Pentin to the recipe of pharmaceutics raging havoc on my organs, and later a psychoactive drug to mitigate spells of uncontrollable crying and deep depression and anger. When I had arrived at the rehabilitation hospital, I had been laying on my back, with rare spurts of being vertical, for three weeks. Total body atrophy had already left me unable to get out of bed unassisted, and I was incapable of self-care. And I was in a facility that seemed more concerned, save for a few of the staff members, to checking boxes to keep the insurance money flowing in. It's the lowest I have been in my life, by far.

I spent 17 days in the hospitals. The saving grace was my wife and daughter were there 24/7. The moral support kept me from the bottom, and my wife corrected several pending medical errors, at times resulting to stern actions to prevent me from being overdosed, missing antibiotic IV's, or treated like a shell of a human. I am sad and fear for those in similar conditions that are unable to advocate for themselves nor have an advocate on their side.

I received PT and OT multiple times daily. Not all of it was bad, but it wasn't at all the type of care that I am accustomed to as a lifelong athlete. It was also strange to be doing therapy with elderly patients just trying to get out of a wheelchair or clothe themselves. I have a newfound respect for those living with a disability; until this stay, I hadn't had any direct exposure. I progressed from being lifeless in bed to be able to sit up for a while and somewhat able to ambulate on crutches or a walker. The doctor in charge, psychiatrist, and a few other senior medical staff members agreed that the environment in that hospital wasn't sufficient for me past a certain point, and I was there. They pushed for an early release, and I got it. I left on July 18, 2018. 17 days. A nightmare most of the time, interspersed with tiny victories.

So I have been home for ten days; caring for me and getting me to PT and doctor's appointments has been more than a full-time job for my wife, and my daughter has lost a significant portion of her summer. But we carry on, day by day, hour by hour. I have a LOT of help from my friends, something I could never have never predicted. The outpouring of support by friends both near and far, some relationships spanning 30 years, has been unbelievable and life-changing. Estranged from my parents for the majority of my life, I often complained of "having to do things for myself, by myself." I will never utter those words again.

The days roll into each other, waking well before 6 a.m. due to bed pressure pains from sitting or laying most of the time, to embark on the slow process of getting ready for the day. My wife has to feed me, get the dogs fed and out, and get a five-year-old up and ready. It's an hour drive at least to an appointment, and there are three IV infusions per day that dominate the schedule. We persist. Friends have continued with fantastic support; food drops, fabricating ramps, assembling at home therapy tools, and babysitting me so my wife and daughter can salvage a few days summer that every 5-year old deserves. Hard work produces small gains daily; I had to adjust my thinking from an athlete, athletic goals are not in the realm of possibility at the moment. Brushing my teeth on my feet, shaving, sitting more than laying, getting up more than a handful of times in a day are the new milestones. I have learned to accept them as steps forward.

When I landed in the rehabilitation hospital, buried deep in overwhelming sadness, an old motocross friend texted me a true story that has firmly planted itself in my psyche. I visualize the main character in this story when the pain comes when the effort doesn't seem to match the result, or when the negative feelings creep in:

"A good friend of mine was a mid-pack SX racer in the late 90s. One day while training on his mountain bike, he hit his head so hard he almost died. Had to learn to talk and walk all over again. One morning during his recovery, he walked outside his house and found a big rock; he carried it ONE step and went back inside. The next day, two steps. Then three. He got to the point where he was running 10 miles to get to the rock! Another friend saw this and suggested he become a Navy SEAL. My friend was the honor man of his BUD/S class and has been in the teams for almost 20 years. He credits his injury for being the defining event that taught him about his true capacity and put him on his path."

It's morning here. And I'm going to give it my all to move that rock, even if it's by the smallest of steps.

Seiji Ishii