Microfracture Surgery

It is not the first time I have had surgery, and it is certainly not the first time that I have had knee surgery (the fourth to be exact).  However, knee surgery is in a category by itself.  In many ways it is one of the most difficult kinds of surgeries that I know of.  It is more difficult than heart surgery.  Yes, you read that correctly.  Before you start calling me crazy, think about it a little bit.  First, I am talking about my own circumstances, as that is all I know.  When I had my open heart surgery, I (like most heart patients) was told to get up and walk around.  There is a fear that if you lie flat for too long you are at a greater risk for pneumonia.  Knee surgery?  Forget it.  I was told and am presently being told to stay off my fee, or more specifically, my foot.  You see for the next 6 wks I cannot not any weight on my right leg.  No weight AT ALL.  People have had this surgery done - NBA players Jason Kidd and Chris Webber and Olympic Skier Bode Miller.

I challenge you to do this for 24 hrs.  Take a shower and put no weight on one of your legs.  Try walking around on crutches and carrying a cup of coffee at the same time.  Well, let's just say it doesn't really work.  Now with heart surgery, I could not really carry heavy things, but I could at least bring a cup of coffee from the kitchen to the living room.

So back to the knee... microfracture surgery is a procedure where tiny holes are drilled into the bone closest to where cartilage is missing from the knee.  The goal is for the bone marrow to drain out of the hole and form a blood clot.  This clot along with your own stem cells is supposed to create new cartilage. Yes, I said your OWN STEM CELLS PEOPLE so do not go running around crazy bent out of shape about the stem cell thing - it is an amazing scientific achievement developed by Dr. Richard Steadman who is a knee surgeon in the Southwest. 

So after 6 weeks of not being able to put any weight on my leg, things should be sorted out (we hope...) However it will be a while before I know anything, months in fact.  5 weeks to go, and I am sure that there will be ups and downs. The downs happen when I (or the crutches slip) and fear runs through my entire body and I start to wonder if I have just messed everything up.  Or when I am lying still with the hip to ankle Bledsoe brace on my leg and I turn on my side and hear a small crunch in my knee and start to wonder if the clot is dissolving.  It is not a stress-free recovery.  We will see happens several months from now.


Well, Then, where do I begin?

I started this blog years ago, after a stroke.  Yes, I know.  You might be tired of that word.  I myself have started to grow tired of it, and I suppose 4 years later that is a good thing.  I actually never thought that I would shy away from the word.  For so long after the stroke, it became my central identifier.  And yet now it is merely a small part of who I am and it by no means defines me.

Since 2006, I have taken an active stance in speaking out about stroke and heart disease awareness.  In the beginning, I did it for myself.  Then, as time went on, I did it for people I knew who had suffered a stroke.  Some went on with their lives, and some people's lives were taken by stroke and heart disease. Now I am truly passionate about raising awareness, and it has become noticed.  Recently, I was contacted by Harvard Pilgrim Healthcare to participate in a program they started call "Well, Then."  This is a community of individuals who share ideas about being and living well.  Topics range from healthy eating to living with diabetes to (yes, you guessed it!) living with heart disease.

When Harvard Pilgrim approached me, I was intrigued.  They asked me to write a series of pieces and post some videos over a two month period and explained that I would be compensated for my work. Another venue to raise my voice, to share my story, and to quite possibly make a difference.  I thought about it.  I thought about it a while. I knew that I had a lot going on and with the upcoming holidays, some travel plans, and a pending knee operation, I wondered whether I could commit to the task. However, I kept thinking back to my own experiences with stroke and heart disease.  I did not know all of the warning signs of stroke and heart disease prior to my own experiences.  I did not know that heart disease was the nation's number one killer and stroke number three.

If I did know the signs and the symptoms, would it have been any different? Maybe, maybe not.  But if I am able to reach just one more person and make a difference, then in the end it is all worth it after all.

 


In the Moment

Sunset

Very soon, there will not be enough space on forms for me to fill out the number of surgeries that I have had.  I am not yet 40.

I am not complaining, these kinds of things happen, and for the most part there is little that I could have done in my past to have prevented any of these surgeries.  

My tonsils?  Well, they just got too big and by the age of 6 the doctor wanted them out.

At 19 a disc in my back degenerated so badly that my right leg was starting to go numb and give out.  I am not sure that I could have changed that.

Three knee surgeries happened due to a stupid skiing accident on a day when I did not even want to go skiing.  I suppose I could have changed this - I could have not gone skiing that day.  I could have taken a different trail down the mountain (I'm sorry, HILL, as we were skiing in Massachusetts...), and there are dozens of other little decisions that could have been made to stop the incident from occurring, but none the less, it happened.  And life goes on.

A hole in my heart... born with it.  Congenital heart defects happen, and I do not know of any ways to stop them.  Many people have asked me, "Well, how did you find out about it?"  A simple one word response:  "I had a stroke."  And I could not have stopped the stroke, because it had to do with the heart defect.

And now I am pretty fired up, because I get to have another knee surgery.

You almost have to laugh at all of this.  Almost.  Because if you didn't you would sit down in a corner and cry because the entire situation is pretty pathetic.  However, I am not the kind of person to sit in the corner and cry.  I am not the kind of person to sit in the corner and complain.  I would rather be in the middle of it all, changing things for the better, and making a conscious decision to live my life in the moment, and know that for that moment, it is going to be alright. 

 


Frequent Patient Card

I should be used to it by now... the waiting, the anticipation, the news, the no news, the anxiety, and perhaps most prominent of all, the frustration.  Yes, after all of my numerous visits, countless tests, blood draws, scans, xrays, MRIs, I still hold out hope that the next time it will be different.  But more often than not, I am disappointed.

I am a repeat customer at my hospital.  If any one of my doctors spent time reading over my chart, they would see that I am an excellent client - good for them, bad for me.  Three knee surgeries, stroke, open-heart surgery, pneumonia, all within in the past 6 years.  Pretty good stuff, right, and for someone who has not even reached the age of 40.  And lucky me, I managed to do something to my knee again, two days ago.

Not just a little something, but something so painful that I am unable to put weight down on my leg. So painful that it keeps me up at night, and so painful that just looking at stairs causes panic.  You might say, well I am a klutz or I need to take better care of myself.  That is the irony of it all - low blood pressure, no smoking, and a fitness instructor, so stuff like this should just not happen.

But let's get back to the doctors, and my frequent "shopping" card at my hospital.  It takes very little for a doctor to look at my chart and see that when I am calling and asking a question, I am not trying to be difficult, but simply looking for a response.  I do not think that it is too much to ask that I receive a response in 24 hours.  So when I called my orthopedic doctor a while back and left a message that I was in a considerable amount of pain and it would be helpful to have the results, I was less than thrilled when I had not heard anything by the next day.  I called back almost 48 hours later and was told that in order to find out my MRI results I would have to speak to radiology, and my orthopedic doctor would be given another message but that he was really busy (yes, I am aware of this, the first time I met with him I waited in the office for 2 1/2 hours...)  Radiology told me they would not give me the results as my doctor needed to give them to me, and so I was being bounced around like a ping-pong ball.  Oh, as far as my pain goes, they told me to increase the Advil and I could come in for a cortisone shot.  Um, no thanks.  I have had one of those (2 in fact) and they don't work.  Neither, for that matter, does the Advil... And I informed them that I really looked forward to coming in and waiting to be seen.  It just rocks.

I suddenly was reminded of 2006 and the preparation for my heart surgery.  I was not given direct answers, and often the answer that most people agreed upon was a run around response.  So, I consider myself an "expert" in the medical system, and I am continually disappointed.  There should be some kind of points card for frequent visitors (patients) at hospitals.  You know, those of us who unfortunately are more familiar with some aspects of the medical care system than our own doctors are.

I know that my circumstances are by no means unique.  Sadly, my situation (the lack of response, apathy, and wait time) probably happens to most people.  Why is it that when a doctor treats patient with respect that it is cause for celebration?  Or when a patient is seen within 5-10 minutes of the scheduled appointment it is considered "on time"?  Yes, there are many other variables at play here, and I am well aware of these (patients can be late too etc), but as a frequent patient I think that expectations and outcomes should be higher. 


Hearts and Tarts

Lily has been working with the American Heart Association to educate individuals on the signs and symptoms of stroke since her personal experience in 2006.  An avid member of the fitness industry who still teaches four classes a week, Lily had just finished instructing a step aerobics class when she suffered from a stroke.  After four days in the hospital, doctors discovered a previously undiagnosed congenital heart defect, an ASD, an atrial septal defect.  As she considered her options and made the difficult decision to undergo open-heart surgery to have the hole closed, Lily realized the importance of education and research around stroke awareness.  Following a full recovery, she contacted the AHA and has been a dedicated advocate ever since, including a recent appearance on Capitol Hill to speak to members of Congress about funding, education and research.

Health and fitness have always been a large part of Lily’s life, and her work in this industry included managing health clubs and working in the Bahamas and Mexico for Club Med before she entered into academic administration as the Assistant Director of the Harvard Business School’s Global Initiative.  For the past 7½ years, Lily has worked at MIT where she served as an advisor for the Chair of the Faculty in the President’s Office prior to her current role as the Manager for External Affairs at the Harvard – MIT Division of Health Sciences and Technology.

In her free time, Lily runs two blogs.  The Queen of Hearts, focusing on health and fitness, is a light-hearted, but inspirational space about life and love.  The Queen of Tarts, centering around her passion for food, shares recipes, stories and tales from a culinary queen.  With a Master’s in Intercultural Relations and fluency in three languages, Lily is also an ardent traveler and photographer, and currently lives in Boston’s South End.

When she’s not working, teaching or writing, Lily can be found baking in the South End, exploring new cultures, and most importantly, using her voice as a resource to help others suffering from stroke or heart disease have rich lives full of laughter.


Unwelcome House Guests

You probably do not know me.  In fact to you, I might very well be a stranger.  But I am sure that you have met my close friends:  heart disease and stroke.  You might even know them better than I do, for I have only had the most intimate of relationships with them since 2006.

I met heart disease years ago, but not on a first name basis.  Heart Disease wanted to meet my grandfathers first and become close friends with them before truly stepping through the doors to my own life.  When I was a small child I remember tracing the long scar on my maternal grandfather’s chest with my fingers asking him to tell me the story behind the scar over and over again.  Such a big scar, and such little fingers trying to understand the depth of what lay behind the incision.

In the sixth grade, heart disease decided to visit again.  This time, to my paternal grandfather.  The visit was such a surprise that we did not have time to plan… heart disease just came in, and when it left, it decided to take my grandfather from us.  However, at that point in time, I still had small hands, and there were no scars to trace with my fingers, we only had pain left behind.

Stroke then decided to stop by, and visited my maternal grandfather.  Twice.  The second visit devastated us all – however, it devastated my grandfather the most, as it left him incapacitated and bedridden for 14 years and eventually too sick to keep fighting.

I suppose my family gained popularity and status in certain circles, because both heart disease and stroke decided to visit me in July 2006.  Stroke made a surprise visit on July 21, 2006 and stayed for a while.  I later learned that heart disease (congenital heart defect to be specific) had actually stopped by on November 20, 1972 the day I was born.  However, it did not decide to make itself heard until stroke showed up.  I guess it was an attention thing…

The funny thing with stroke and heart disease is that they are the kinds of guests that never really leave.  They are always around, lurking in a corner, down a dark alley, and just waiting for the window to be left open just the tiniest amount so that they can come back.  Heart disease is the nation’s number 1 uninvited guest – stroke is number 3. 

You might not know me, but I am quite certain that you have met heart disease and/or stroke before.  They sometimes come without letting you know in advance of their travel plans.  They are not the kinds of friends or guests that you want to have in your home or in your family or friends’ homes.  They do not say please or thank you, and when they leave, it is not quietly and often a path of destruction is a reminder of their visit.

You do not have to think twice about my story or feel pity or remorse– I have started to move beyond these visits, and beyond the fear of a potential “next” visit.  I celebrate my life, with a new husband who recognized my signs of stroke. But think about yourself, your friends, and your family.  Understand the importance of limiting the impact of these unwelcome guests.  Support the American Heart and American Stroke Associations. 


Oh the places we'll go! Part 3

Honeymoon... Africa. Why not.  And we were deep into the bush of Selous.  Deep into southern Tanzania surrounded by some of the most pristine beauty I have every seen in my life.  People gasp, their eyes widen with delight, and they often oohhh and ahhh in delight after hearing about our adventures.  Yes, it was THAT amazing.  Yes, we DID see the animals.  And actually, yes, the "tent" that we stayed in was exceptionally beautiful, while being both luxurious and rustic at the same time.  But all the while, our surroundings reminded us of where we were, and we were able to stay in the moment.

We always knew that we were being watched, and that added an element of mystery (and often unease) to the trip...

Hippo-in-water 

We learned that we could easily become fodder at any given moment...

Lion

Being still and quiet often had its advantages...

Single-ele

Saddle-back-stork
 

The definition of beauty defied imagination...

Women-on-beach-2
 
And we were able to say that we went off into the sunset...

Lake-sunset
 


Oh the places We'll Go Part 2

Selous
 

Selous... Southern Tanzania.  It was winter, and as the sun warmed our skin and the ground below, our feet crunched on the fallen leaves, and gave us the impression on fall in New England.

We were greeted by warm smiles and cool face towels.

We were met morning, noon, and night with exceptional views of the lake.

Table

We were offered live entertainment at a moments notice...

Giraffes 

And were introduced to the locals...

Crocs

And this was only on day one!  

After sundowners and dinner we were escorted back to our tent by an Askari under a clear dark sky and we searched for the Southern Cross all the while peering into the night for what might come out.  We looked out into the night, waiting and listening for what might come... waiting for the next day.
  


Oh the places we'll go! Part 1

It was the first of many things.  The first time in several years that we had gotten away for a substantial period of time, the first time to East Africa, the first time on safari, and perhaps the most important - the first holiday as a married couple.  I started the planning with Zanzibar and worked my way from there.  It sounded exotic, and like a place that I might like.  I knew few people who had ever traveled to the island renowned for its spices and once ruled by the Sultan of Oman.  From Zanzibar, the sensible place to go (we quickly found out) was Tanzania.  We also learned rather fast from an amazing British Travel Company that we should go south.  

South? I asked?  But what about the migration?  The wildebeest?  The Serengeti?  

Do not worry, I was told, go South, go to Selous.

Selous?  What the hell and where the hell is Selous?  

Oh, it is wonderful.  It has the largest population of wild dogs and it is about 55,000 sq km (the largest game park in all of Africa).

Well, that was all fine and good, and lovely that it was the largest game park in all of the African Continent, but that also meant that there was a diminished chance of seeing the lions, the rhinos, the BIG FIVE!  

But, I was told... there were wild dogs.

I spent some time looking at the camp where we would be staying and quickly decided if nothing else, we would have some lovely lie-downs, and I would be in Africa, on safari, in style.  We were going to stay in a proper tent that zipped up and down and an outdoor shower, and since it was located on a lake, I would see crocodiles.  

OK - and then, then we would get to Zanzibar.  The Spice Island.  Beach, sun, and more beach.  I started to get excited, I started to plan, and to pack.  The list of shots was long...meningitis, tentanus (mine had run out), Hep A, Yellow Fever, Typhoid, and of course the malaria pills.  But none of this mattered.  We were looking forward to the adventure of a lifetime.

It did not hit me until we were on the 12-seater airplane flying from Dar es Salaam to the middle of the Tanzanian Bush.  

DSCN0884
 

The little plane lifted off and left the city behind.  The 30 minute flight took us over lush green fields, hills, valleys, and the like and as we flew further south, the landscape started to change.  Since it is winter in sub-saharan Africa, the landscape had hues of pale greens, yellows, and browns.

Desk
 

and so it began...