Dear Regular Readers,
Welcome to another edition of our weekly newsletter and I hope it finds you all in excellent health and fine spirits.
Without further ado, here is the concluding part of my knee story.
I left my wife in the hospital waiting for my son to come out of the operating theatre and I jumped straight into a taxi to take me to another hospital for my knee operation. On the way to the hospital my knee was beginning to feel very warm to the touch and it was starting to cause me some pain and discomfort, it was painfully itchy which I knew was the result of the staphylococcus infection which I had most likely picked up through the last aspiration and hydrocortisone injections the doctor had administered in to my knee. I can remember that the roads were quite busy and the taxi driver spending quite a lot of time stopping and starting his taxi and I was worried that I might be late for my operation, but fortunately I managed to get there just as the doctor had finished sharpening his scalpel.
Once through the main hospital entrance doors I made my way quickly to the reception desk and announced my arrival; I was told the room number by the receptionist and I promptly made my way to sit down and wait for the doctor to call out my name. No sooner had I sat down my name was called out and I went into the doctor’s room; there was a slot of urgency in the doctor’s voice and in his general body language as he told me to quickly follow him to the room where he would perform the operation. The room was not really an operating theatre as such but more of a training room for junior doctors and nurses. When I went in to the room there were other doctors and some nurses present, both senior and junior; I was instructed to jump up on to the examination table by the doctor and roll up my trouser leg. The doctor looked again at the area that he would be operating on and then he instructed a young junior doctor, under the supervision of a more senior doctor, to prepare the area that he would operate on. The junior doctor placed lots of disposable tissues around the knee and he placed a kind of kidney tray underneath it which I assumed at the time was to catch all the septic fluid that would come oozing out as soon as the doctor made his incision with his scalpel. I was then approached by the operating doctor and he told me that he would begin by sterilizing the area surrounding the knee and then injecting some medication into the regional area to numb it before proceeding with the operation; I was told to relax and wait for about 10 minutes for the medication to take effect.
So there I was in this side room come operating theatre stretched out horizontally on an examination table doubling up as an operating table with lots of seasoned and fresh junior medical professional faces surrounding me waiting for the operating doctor to come in and perform an operation on my knee What happened from thereon is still very clear in my mind, before the doctor carried out the operation he explained to his eager observers the approach he was going to take and asked if anybody had any questions, which nobody had. He then made his incision into the infected bursa and as soon as the scalpel entered in to the bursa infected fluid (puss) shot out with some real pressure behind it and it just started to ooze out and it didn’t seem to want to stop. Once the majority of puss had flowed out of the incision the doctor had made in the bursa he then started to gently press the knee to help to force the remainder of the infected puss to drain out. After he was confident that he’d managed to drain the bursa of all the puss he then inserted some gauze directly in to the incision to soak up whatever puss was remaining. After inserting the gauze in to the incision the doctor put in a few stitches to close up the point of entry and he then passed the job of bandaging up the area over to one of the young observing doctors.
The young doctor that bandaged me up told me that he was surprised at how much puss had been drained from the infected bursa and he mentioned that it was highly likely that more puss would come out, so he told me to return back to the hospital the following day for the bandages to be removed and to have new bandages put on. I was also told that I would need to have a course of antibiotics for the next 4/5 days and for speed related purposes they would be intravenously introduced into my body as the staphylococcus infection in my blood was quite high. At this point I asked the doctor what the chances were of my primary problem (bursitis) being cured through the bursa having been infected opened up and drained and I was told that if the bursa is able to fuse together after being drained and if it heals properly then it would solve my bursitis problem. After hearing this it made me feel very hopeful and just for the hell of it I threw a quick prayer upstairs to see if the big guy up there was listening; I tend to do this at times like this just in case he is within earshot of what’s going on.
The operating doctor then reappeared to inform me that a nurse would now administer my first course of antibiotics intravenously and that it would take about an hour; he told me I had to return to the hospital the following day, which was Saturday, to have a further course of antibiotics pumped into my veins and also to have the bandages changed. He also put me on a course of antibiotic tablets to be taken 3 times a day. I asked the doctor if I should ice the newly operated on area and he told me it would not do any harm, but to make sure I only did it for 15~20 minutes with one hour rest periods in between. I remained laid out flat on the examination table until every drop of antibiotic had dripped from the bottle and into my bloodstream which took about 40 minutes. I then made my way to the payment area to settle my bill which came to 60,000 yen (about 400.00GBP), and to collect my antibiotics prescription. As it was a Friday and still early afternoon I decided to return back to my office to do some work, but beforehand I dropped into the pharmacy to pick up my meds.
Once back at work I went straight to the trusty little company refrigerator and pulled out my well used bag of frozen edamame (Japanese beans) and with the aid of a bandage I strapped the bag to my leg, removing it every 20 minutes or so for an hour and then back on for 20 minutes, repeating this process until finishing time. My knee felt good, very good, it was painful and felt very sore but it was the kind of pain and soreness that you feel when you know things just feel right and you’re on the way to recovery. Clearly, I was not out of the woods yet, if the bursa was unable to fuse back together after being cut to release the sceptic matter then I would basically be back to square 1 which would mean another more involved operation to remove the bursa completely. There was no shower for me that night at home; I just had something to eat, took my antibiotic pill and rested up in readiness for the following day’s return to the hospital to have the bandage changed and to receive my 2nd antibiotics fix.
I woke up in the morning with little to no pain coming from the knee and as it didn’t particularly feel sore I took this as a very positive sign; when I looked down at the bandage covering my knee it was a little bit stained and it felt quite weighty, so I assumed this was because of the volume of puss that had drained out and been soaked up by the bandage during sleeping. After a strip wash, eating some breakfast and popping an antibiotic pill into my mouth I went off to the hospital as planned and as usual when I got there I went through the usual routine of reporting my arrival to the receptionist and then being told to sit down and wait for my turn. I am not sure if it was because it was a Saturday or whether I was seen to be a patient that needed some urgent care and attention, but almost as soon as I sat down my name was called out and into the room, in which I had had the operation, I went.
The first thing the doctor did when I entered the room was have me jump up on to the examination table so he could remove the puss soaked bandage, sterilize the area and then replace it with a fresh one. At that time, I couldn’t really see how things looked with my knee, but the doctor reassured me that thus far all looked well and he commented that it seemed reasonable to think that the bursa was going to fuse together and heal by itself, which if it did it would solve the primary bursitis problem I had been suffering with for over a year and I would be a very happy man indeed. With a fresh bandage on a nurse then appeared and I was then hooked up to an IV drip and for the next 40 minutes I sat back and watched the slow flow of antibiotics enter into my bloodstream; at times trying to read a book I had taken with me to kill the time, but if you’ve ever sat down with a syringe in your arm hooked up to a portable IV unit you’ll know that this is not so easy to do given the limited amount of movement you have and the fear that you may dislodge the syringe somehow. With the last drop of antibiotics having just nicely filtered through into my veins the nurse reappeared and I was unhooked from the IV drip; I was then told to press down on the entry point of the syringe after it had been withdrawn to reduce any possibility of bruising. After which, the nurse then told me to return to the hospital the day after tomorrow, which was a Monday, to receive the same treatment and with that in mind off I went to settle my medical care bill for that day and then I jumped in to a taxi and made my way back to the office to resume work (I work on Saturdays).
Monday came and off I went to the hospital for another bandage change and my dose of intravenously administered antibiotics. After the treatment I was told to attend hospital again the following day to have yet further antibiotics pumped into me and also to see my usual doctor (the doctor that performed the operation) to have the stitches removed and to have the knee evaluated. In the meantime, I was taking the antibiotic tablets and still icing my knee at intervals during the day at work and when I got home in the evenings. The following day, I went back to the hospital for my second to last intravenous dose of antibiotics and my consultation with my usual doctor. With a body full of antibiotics I made my way over to sit and wait for my turn to see my doctor. I had to wait for quite some time before I was called in to the doctor’s surgery because it was just very busy. When I did finally get in to see the doctor he asked me how my knee felt and then proceeded to remove the bandage and take a look at the freshly operated upon knee. With the bandage removed I could now see my knee in all its full glory; apart from still being very swollen, it was no longer warm to the touch and it looked less angry that it had previously, it felt like it was on the mend. The doctor seemed happy with progress so far and he proceeded to remove the stitches (about 6 of them) and he then pulled out the gauze that he had initially pushed in to the knee to allow the puss to drain out from the infected bursa, warning me first that it may be somewhat painful, which it was a bit. Looking at the knee as it was, the doctor told me that all the signs pointed to the fact that the bursa had fused back together and so he felt that no more fluid would build up in the knee which literally was music to my ears. He then personally changed the dressing and enquired as to how many antibiotics tablets I had remaining and after informing him he then gave me a further 2 week supply. He told me that I did not need any further IV fed antibiotics treatment, but that I needed to return to hospital the following day to have another blood test to check to make sure that the antibiotics had killed all the staphylococcus infection.
The following day, I returned to the hospital for 09:00 sharp for the blood test, I had it and then waited with baited breath and fingers crossed to see the doctor. It was early in the morning and usually the hospital is a hive of activity and movement at that time, but not on this particular day so it was not long before I was called in to see the doctor. The doctor showed me the results of my blood test and thankfully I was pretty much back to normal; he told me that he was very pleased and also very surprised at the same time with the outcome as he had never expected the turn of events that had taken place. He asked to see the knee; he removed the bandage and commented that all looked well and that the swelling was going down nicely; he told me that it would take about a further 2 weeks before the knee would be back to looking normal and that I should continue to take the antibiotics: he added that I should return to the hospital as soon as possible if I felt any pain or the area began to swell again. I reassured him that I indeed would and I commented that I had never stopped praying all the way through my ordeal and that I believed that my prayers had been answered and that some sort of divine intervention had taken place. Upon hearing this, it put a relieved sort of smile on his face and I also believe he gave a quiet sigh of relief as I believed, and still to this day believe that the result of my staphylococcus infection was the product of the very last aspiration and hydrocortisone injection that he had carried out: he had withdrawn the syringe a couple of times during the aspiration and also during the time that he was injecting hydrocortisone which perhaps in hindsight he also thought that that was the result of the infection. Anyway, he wished me well and that was that.
So 7 months have now passed and where am I now with my knee? Well, the doctor was (almost) right, it took about a month for the swelling to go down and for knee to look normal again; it felt a bit odd at first bending it as I had refrained from doing so for over a year, but gradually it has become easier as time as passed. The only thing I have noticed is an annoying clicking sound when I do bend my knee that was not present before the bursa problem came about but I can live with that; the clicking sound is not as loud as it first was, so it may disappear in time. The most important thing for me is that I now have no fluid filled sac hanging down from my knee, all the fluid has disappeared and there is no swelling at all. All I have to remind me of my prepatellar bursa issue is a small scar from having the operation and as that is quickly disappearing it won’t be too much longer before it’ll look as though there was never any problem at all. Of course, I never kneel directly on the floor with my left knee, I’m actually too scared to because of the fear of having the problem erupt again, so when I need to kneel down I always pop on my knee pads and even then I put hardly any weight on my left knee, it’s the right knee that takes most of the weight.
I have attached some before (see images 4887 and 4888) and after (see images 6809 and 6811) pictures of my knee just as a reminder to myself and anybody else out there that has been following this story how much effort and time has been put into overcoming a problem that at first seemed like it could only be cured by surgical removal rather than cut and natural repair. If I had not contracted the staphylococcus bacterial problem there would never have been any need for the bursa to repair itself and I would have had to have had my bursa removed (sooner or later) to solve my problem. If you are unfortunate enough to have the same problem as I had or you have the misfortune to get injured and end up with the same problem I had then of course I would never advocate that you infect your knee with staphylococcus bacteria in order to avoid removal of your bursa because it doesn’t make good sense for a start and it’s way too risky. In my case, it happened this way and I believe it was always going to happen this way because of some intervention from up in the beyond somewhere; I believe it had already been written that all the protection I needed from things going wrong was wrapped up in this divine intervention and the miracle that came from it.
I’ll be back next week with something completely different, so until then enjoy the weekend ahead and for those of you in Japan I hope you have a good Golden Week holiday.
