Stage 5: The Surgery — Lindsey Bauer

On Friday October 13, 2017 at 0400 my alarm went off signaling that the big day has come. My surgical date. I felt like I never went to sleep. I jumped out of bed and made my way into the bathroom to shower for the last time for 3 days (yea, I know grrrrooosss). After changing and brushing my teeth, Mom and I drove down to Manhattan and arrived at the Surgicare of Manhattan as scheduled for 0615. Oddly enough as we drove down to Surgicare, it didn't even feel as if I was driving to the have surgery. It felt as if I was driving to the airport, but this time the early flight wasn’t to a vacation destination.

Side note: I just want to say thank you to my brother's friend, Matt, for lending us his car. My mother unfortunately can not drive a manual transmission so, my car was unfortunately not an option for her to drive us to the city. Matt you're a life saver! Thanks!

My surgical appointment began with checking in with the welcoming, yet calming lady at thefront desk staff. I was pretty taken back by how awake and chipper she was this early in the morning. I never understood how morning people are filled with such enthusiasm before the sun rises. After filling out the basic surgery paper work, Joe, the Breg rep, went over the instructions for my CPM (Continuous Passive Motion) machine and informed us that he already dropped my knee brace off to the OR. Joe was awesome. He carried the CPM machine to the car for my mom and even helped her find the nearest parking garage. I watched them leave the waiting room and waited for my name to be called.

“Lindsey!?” My name was called by one of the OR nurses who lead me into the pre op area. I followed the nurse down the hallway passing several empty chairs behind curtains until we finally made it to mine. She asked me the standard pre op questions: confirmed my name, date of birth, allergies, past medical history, procedure, etc. She placed my identification bracelet around my left wrist, gave me my gown, the sweeeeet (sarcasm) hospital socks, you know the kind with rubber grips on the bottom??, and showed me where the bathroom was so I could give a urine sample. Then the waiting began.

Sitting in my chair for 5 minutes felt like an hour because my nerves started to run. Thankfully, my mom finally came back from dropping the car off at the parking garage. I was beyond relieved to see her. Having your mom by your side is the best company to have before you have surgery. My mom knew exactly what to say to keep me calm.

As we waited, we were greeted by many faces. I met my anesthesiologist, Dr. Riegler, who was awesome and quite funny. I informed him of my previous anesthesia horror stories and he smiled and replied simply “I smell a challenge. Challenge accepted.” I loved the humor and confidence already,

Side note: If you ever have any surgery, make sure you always communicate your concerns and previous experiences with the anesthesiologist. Obviously, the first time you really don't know what to expect, but just be up front and honest. Unfortunately, I do not do well with anesthesia, but Dr. Riegler did a fantastic job considering my previous experiences.

Dr. Nicolas and Shannon, one of his newer but awesome PAs, came by, said hello, introduced themselves to my mom, signed my knee, confirmed the procedure, smiled, and said they'd see me in a few.

As we waited, Rocco, one of my orthopedic preceptors in PA school, came by to check on me as well. He asked, “ How are you doing? Are you ready? This is going to be good!!” Of course I replied with, “Yeaaaa, ready as ever but, nervous! Ha Ha.” “ You'll be fine!!!! You're in good hands!” he said. I knew he was right. What better people could you have around you? My Mom, Rocco, one of the longest practicing orthopedic PAs I know, and of course, Dr. Nicholas, one of the best orthopedic surgeons in the country! Now that’s what you call the “A Team!” You’re probably wondering why my preceptor from PA school is greeting me before surgery right? Well, prior to my surgery, I did a lot a research on ACL reconstruction. I consulted and reached out to several surgeons, one of them being Dr. Nicholas. Both Dr. Nicolas and Rocco were my orthopedic rotation preceptors. Luckily Rocco, and Dr. Nicholas remembered me from 2009 and got me scheduled right away for my appointment.

Side note: Let me tell you how grateful I am to have picked this rotation. Rocco and Dr. Nicholas were my two favorite preceptors. They taught me how to suture, work the OR, how to be efficient in a busy office (which translated well to the ER setting I currently work in), taught me a crap load of orthopedics, and how to have a good patient- provider relationship. 4 weeks ago I met with Dr. Nicholas and Rocco in their office for my initial consult. We discussed my concerns and scheduled the OR date. The two friendly and warm faces greeted me in my room like my rotation was yesterday. That patient-provider relationship was now with me. We went over my options as to what kind of graft I was going to have. Initially we agreed on the patellar tendon route, but I expressed my concerns and we agreed to do the allograft route. I think that makes Dr. Nicholas an amazing surgeon. He listens to his patients, he listens to their concerns, and he involves the patient into the decision making, but still helps guide them to the best decision for the patient. The anterior cruciate ligament reconstruction with a quadruple hamstring allograft was scheduled. The surgery date was set and I knew Dr. Nicholas and Rocco were going to be the best team for the job.

Side note: for those of you who are unfamiliar with the terms mentioned above. An autograft is a graft that the surgeon takes from the patient’s own body. An allograft is a taken from a cadaver. A cadaver is a person who has passed away and kind of enough to donate their body to people in need.

Finally the OR nurse arrived and escorted me to my operating room. I looked at my mom with last minute hesitation, gave her a hug and a kiss, and told her I’d see her in a few hours. Mom reassured me, smiled, and walked through the exit door. It was just me and the scrub nurse now.

As we walked past the scrub station, I saw Dr. Nicholas prepping for my surgery. “ You ready?!” He said. I responded enthusiastically, “ Heck yea! Let’s do this!!” With two thumbs up! “That’s what I like to see and hear! The recovery all starts here!” I knew this was going to be good! This is why I trusted and liked this man. He's extremely positive and enthusiastic. You can always tell that he is totally used to working on athletes.

The OR nurse and I walked through double doors entering the cold sterile room. The familiar clean smell of the OR brought me back to memories of assisting in the OR. We were welcomed by the scrub nurse and Dr. Riegler who were both masked. The OR table was set up just for me. Dr. Riegler placed a 22 gauged IV in my right antecubital, administered fentanyl, placed the non-room rebreather over my face, asked me to breathe in and out, and finally started to admitted the propofol. I felt tired but, attempted to hold conversation. Then lights out.

Seconds passed (which was really an hour) and I woke up in the recovery room with my mom by my side. The familiar large, black, bulky, black knee brace was fixed on my numb right leg. The nerve block made my entire leg from my hip down feel painless, for now. This is the part where you wean off of anesthesia. I don’t want to scare anyone who has never had surgery before, however, I figured I’d share my experiences with you.

As stated before, I am one of the few people who does not have good reactions to anesthesia. I became depressed, apologized to every staff member in the surgical center, my mom, and started to cry. Then depression phase finally passed, thankfully. This was abruptly followed by overwhelming feeling of happiness and euphoria. My Mom told me each time Dr. Nicholas came by to check on me, I made everyone laugh. I was shouting, “I love you Dr. Nicholas! You're awesome!!” As per my mom, he responded with, “I like that!!” LMAO. I don't remember saying this at all, but at least I can say I was happy. After all I did in fact have an awesome surgeon and he didn't seem to too upset about it. HAHA! Followed by the overwhelming feeling of joy, the hell phase took over like a black cloud. The intense, sharp, dull ache, and pressure sensation of a vice grip clamping to my skull began. Here comes the migraines. Each wave of pain was accompanied by nausea and vomiting that lasted for 3 hours. I don't know if any of you saw my Facebook post, but all I can say is I don’t know what I would have done without my mom. Not only was my mom being a mom, but she was a nurse extender. She wiped tears and vomit off my face every other second as . She kept the nurses up to date every time my blood pressure shot up! Especially when it hit 190/109. Yup, that was my BP and higher. The spins continued and the intermittent nuclear bomb going off in my head persisted. Finally, after 3 hours, my symptoms faded.

Side note: I know 3 hours feels like a long time, but my last anesthesia experience almost had me staying overnight at the hospital. So gold star and two thumbs up for Dr. Riegler!!

Finally, I was stable and moved to another recovery room. This where my nurs offered me a warmed corn bread muffin and orange juice that literally tasted like heaven in my mouth. Eating was the best part of the entire morning because I couldn't eat anything after dinner the previous day. Yay for food!!! Finally, my mom and I were allowed to drive home and the surgery was over.

Side Note: Surgicare of Manhattan is awesome!! If you ever need surgery, this place is where it's at! The staff and nurses are amazing and so attentive. You can really tell these people love where they work and have an amazing team!! Also, like I said before, the corn bread muffins are bomb. 5 Star review for sure!!

My first post op PT was scheduled for Monday at 0900 . . . 3 days after surgery. I couldn't wait to go! Let the recovery begin and on to Stage 6: The Long Haul!!

Jake offering me his toy when I got home from Surgicare.