3 weeks after 2nd surgery

So tomorrow marks 3 weeks from my 2nd surgery on my right knee.

I was at the doctors this past Wednesday (March 26th).  He said everything looks good, on my scar anyways and they took out the stitches and put on the white tape.  I guess I have no nerves back there or something because I didn't even feel the stitches coming out, and that is probably why I didn't feel anything after surgery.  Anyways, the only problem that I have now is to get my leg to go straight and bend the whole way back.  Currently it won't lock out to at least 180 degrees and is way less than that and it is only bending back to about 90 degrees and I need to get it back to 140 degrees like my left leg.  So I am currently doing therapy and won't be able to go back to work until I go back and see him on April 23rd, so hopefully by then my knee will be less swollen (which it isn't really swollen) and I can straighten it and bend it back for he most part.

So here is the final results from my surgery and testing of the stuff they took out, understand what you can:

Narrative

FINAL DIAGNOSIS:
BONE AND SOFT TISSUE, RIGHT KNEE, EXCISION
SYNOVIAL CHONDROMATOSIS, CLINICALLY RECURRENT.
GG/acs

ACS/ACS


Pathologist: Karen Schoedel, M.D.
** Report Electronically Signed Out **
By Pathologist: Karen Schoedel, M.D.
3/13/2014 08:28

My signature is attestation that I have personally reviewed the submitted
material(s) and the final diagnosis reflects that evaluation.
_______________________________________________________________
GROSS DESCRIPTION:
The specimen is received fresh labeled with the patient's name, initials BMM,
medical record number and "1 synovial chondromatosis right knee". It consists
of an irregular piece of white-tan hard, smooth lobulated cartilaginous
tissue, measuring 3.2 x 2.8 x 2.3 cm. The cut surface reveals white-pink, firm
to soft tissue with diffuse bone. The specimen also consists of 2 detached
pieces of tan-pink, cauterized, firm fibromembranous tissue, measuring 1.9 x
1.8 x 0.6 cm and 2.0 x 0.9 x 0.8 cm. Representative sections are submitted as
follows:
ADC - bony/cartilaginous mass following complex decalcification
B - soft tissue.
Formalin Exposure Time: 7 hours 0 minutes
Decal Cassettes Formalin Exposure Time: 31 hours 0 minutes.

Grossed by: Leigha Watson, PA student
Reviewed by: Kara Balatincz, PA (ASCP)

LRW//LRW/LRW



MICROSCOPIC:
Microscopic examination substantiates the above diagnosis.

The following statement applies to all immunohistochemistry, insitu
hybridization (ISH & FISH), molecular anatomic pathology, and
immunofluorescence testing:

The testing was developed and its performance characteristics determined by
the University of Pittsburgh, Department of Pathology, as required by the CLIA
'88 regulations. The testing has not been cleared or approved for the
specific use by the U.S. Food and Drug Administration, but the FDA has
determined such approval is not necessary for clinical use. Tissue fixation
ranges from a minimum of 6 to a maximum of 96 hours. Immunohistochemical
stains (where applicable) are performed with appropriate positive and negative
control reactions. Immunohistochemistry assays have not been validated on
decalcified tissues. Results should be interpreted with caution given the
raised possibility of false negativity on decalcified specimens.

ESTROGEN/PROGESTERONE RECEPTORS (ER/PR) TEST DETAILS: Although the use of
ER/PR is primarily for differential diagnostic purposes rather than
therapeutic ones, we utilize the therapeutic criteria for positive and
negative immunohistochemical results below: The test for the presence of
hormone receptor protein is performed by the immunoperoxidase method according
to the ASCO-CAP Guidelines. A positive Estrogen or Progesterone receptor
tumor shows nuclear immunostaining in greater than or equal to 1% of the tumor
cells (i.e. and H-score of 1 or higher). The ER and PR Histologic Score
(H-Score, or HS) is calculated as the sum of intensity of staining times the
proportion of cells staining and has a dynamic range of 0 to 300. The
semiquantitation immunostaining raw data used to calculate the H-score is also
shown above in the report. Generally, the H-score correlates to percentage of
positive cells.
Estrogen receptor antibody SP1, an IVD, is performed using the IVIEW detection
on the Benchmark XT (Ventana, Tucson, AZ). Progesterone receptor antibody 1E2,
an IVD, is performed using the IVIEW detection on the Benchmark XT, (Ventana,
Tucson, AZ).

HER2 IMMUNOHISTOCHEMISTRY TEST DETAILS: 4B5 antibody clone is used as part of
FDA approved Pathway on the Benchmark XT (Ventana, Tucson, AZ) and interpreted
as follows: Score 0 (negative) = No staining is observed or membrane staining
is observed in less than 10% of the tumor cells. Score 1+ (negative) = A
faint/barely perceptible membrane staining is detected in more than 10% of the
tumor cells. The cells are only stained in part of their membrane. Score 2+
(equivocal) = A weak to moderate complete membrane staining is observed in
more than 10% of the tumor cells. This score requires reflex testing by FISH.
Score 3+ (positive) = A strong complete membrane staining is observed in more
than 30% of the tumor cells.

This laboratory is certified under the Clinical Laboratory Improvement
Amendments of 1988 ("CLIA") as qualified to perform high-complexity clinical
testing. Pursuant to the requirements of CLIA, ASR's used in this laboratory
have been established and verified for accuracy and precision. Additional
information about this type of test is available upon request.
PATIENT HISTORY:
Chief Complaint/Surgery Pre-op Diagnosis: RECURRENT SYNOVIAL CHONDROMATOSIS
RIGHT KNEE
Surgery Post-op Diagnosis: RECURRENT SYNOVIAL CHONDROMATOSIS RIGHT KNEE
Surgical Procedure: ARTHROTOMY KNEE
Reason previous hospitalization/surgery = right knee scope

HISTO TISSUE SUMMARY/SLIDES REVIEWED:
Part 1: SYNOVIAL CHONDROMATOSIS RIGHT KNEE
Taken: 3/10/2014 08:52 Received: 3/10/2014 11:43
Stain/cnt Block
H&E x 1 B
DC x 1 ADC
H&E x 1 ADC





TC1

Component Results

There is no component information for this result.

General Information

Collected:03/10/2014 8:52 AM
Resulted:03/13/2014 8:28 AM
Ordered By:Kurt R Weiss, MD
Result Status:Final result

This test result has been released by an automatic process.

Finally, here is some pictures of my knee:

2 Weeks after 2nd Surgery

So today is 2 weeks after having my surgery for the 2nd time, I haven't posted up any pictures of my newest scar with stitches so I will put those up with this post.

I still got no pain back there, just mainly soreness, hard to sometimes fall asleep because of the soreness but its way better than it was last year.  I go to the doctors again on Wednesday so we will see what he all says.

These are pictures for a few days after the surgery.

Days after the surgery

So I had surgery on Monday March 10th, 2014.  I had to be there by 5:00 am and surgery started at about 7:30.  Got there, went back to my pre-surgery room, got IV's and whatnot, they also gave me a patch behind the ear to help with nausea after the surgery with the anesthesia.  So it was a little after 7:00, my parents and my wife, Kayla, were there, they came to get me and drugged me up with some relaxing stuff, and that stuff was awesome, I have never been high before but I am sure that is about what it feels like haha.  We got back to the freezing cold room, I was still laying on the bed, and they still had time before the surgery started so they started showing me stuff around the room which was kinda amusing and kept me calm.  Then they gave me the oxygen mask and I was out until I woke up in the recovery room.

When I woke up I had no pain, no IV injected pain meds or anything.  Got wheeled up to my room, they gave me 2 pain killers, and my parents and Kayla got up to my room.  Then I took one more pain killer around 8:00pm and then only have taken tylonell extra strength since then with some aspirin for blood thinners but that is it.  I then got released on that Tuesday (a day before I was supposed to be released), went back to Johnstown for the night, then headed back to York on Wednesday where I am now at.

So the Doctor said that everything looks good now.  They cut me open like they did before, right over the old scar (which I think is why I didn't really feel any pain except for an ache every here and there).  He took everything out that involves the synovial chondromatosis, he said that the one piece was about the size of a ping pong ball behind my knee and he has no idea how I was even walking on it because my knee couldn't even bend or extend.  He also got the rest of the little pieces.  He took an X-ray before they took me out of surgery to make sure that he got everything which it looks like he did from what he says.  Right from I woke up in recovery, I could see that my knee was a lot straighter than it was before I had surgery.

So I had the nurse and the physical therapist come today, nurse said everything looks good, she showed Kayla how to do the dressing and the ace bandage on my leg.  The physical therapist showed me some exercises, she is gonna call the doctor to see what else I can do.  The nurse is done and doesn't need to come back anymore unless I call, and the physical therapist will be back on Saturday.

My next knee appointment with Dr. Weiss in Pittsburgh is on Wednesday March 26th.

From now to then, Kayla and the pups (Ellie and Hannah) will be taking care of me!

Here is some pictures, I will get some pictures up of my scars and surgery marks when I get a chance to take pictures of them.

Pre-surgery:

After surgery:

Patch behind the ear for my nausea:

On my way home from the hospital:

Came across my doctors Story

Came across my doctors story of how and why he started doing this, pretty interesting read:

http://www.upmc.com/Services/orthopaedics/patients/Pages/kurt-weiss.aspx

Patient Stories - Dr. Weiss Testimonial

From patient to practice: The story of Kurt Weiss*

Kurt Weiss wasn’t planning on going to the doctor’s that week. Like most teenagers, he had other things on his mind. Then at football practice, his leg started to hurt him terribly.

“My mother threatened to cancel my mountain climbing trip with friends if I didn’t go,” he explains. “So to humor her, I went.”

It was a good thing he did. After being diagnosed with sarcoma, Kurt was sent immediately to Mark Goodman, MD, who at that time was the only orthopaedic oncologist in western Pennsylvania. By the age of 15, Kurt received his last rites when his cancer spread to his lungs for the third time.

Then, in 1990, Kurt participated in a clinical trial that saved his life. Developed by researchers at the MD Anderson Cancer Center, the immune-based method was designed to destroy drug-resistant bone tumor cells. The trial worked, and with the help of Dr. Goodman, Kurt Weiss began the long road to recovery.

Unfortunately, fixing Kurt’s leg was no easy task. He developed repeated infections, and finally, Kurt and Dr. Goodman decided together that an amputation was necessary.

“Then, during finals week at Notre Dame, my leg was hemorrhaging every day,” remembers Kurt. “I called Dr. Goodman. He said, ‘Kurt, if I have to come up there and carry you to your tests, you’re going to finish your finals before we get this done.’ ”

Not only did Kurt finish his finals; he also made it to the 1996 Orange Bowl, where he marched as president of the Notre Dame band. After the amputation, he also marched, although he was able to do it even better than before.

“That experience really had a profound effect on me,” explains Kurt. “I had thought I wanted to be an engineer, like my dad and my uncles and my sister. But I really became interested in the pathologic aspects of my disease. And more than that, I admired the people like Dr. Goodman who were looking after me. I wanted to be like them when I grew up.”

And grow up, he did. In 2003, he earned his medical degree and won a Howard Hughes Research Scholars Award to do research on metastic bone tumors at the National Institutes of Health (NIH). Eventually, he joined Dr. Goodman’s practice at UPMC.

Now known as Kurt Weiss, MD, he is one of only a handful of surgeons who specialize in sarcoma. Dr. Weiss is also one of the very few physician-scientists searching for a cure for this disease, and the only one who is also a former sarcoma patient. Part of the orthopaedic surgery team at UPMC, he still spends at least two days in the lab, studying the science behind the disease and looking for the answer that will stop it for good.

At the same time, his colleagues — Dr. Goodman and Dr. McGough — are beginning a clinical research study of artificial limbs that actually hook onto a patient’s real bones, and look and act just like real limbs. Hoping to be a part of the 15-institution study, Dr. Weiss, who owes his life to a clinical trial, was one of the first to sign up.

*Adapted from the Shadyside Voice article entitled “I can help you. This is what I do.”

Well Monday is the big day!!

Five more days

So I will be having surgery on Monday March 10th.  I am ready for it because I can barely walk and my knee hurts like heck.

I already had blood work done, and now all I have left to do is the pre-surgery testing stuff this Friday.  Then it is off to surgery on Monday in Pittsburgh.

They will just be doing the back of my right knee, cutting me open I am assuming to the way they did it before.  They are not going to repair my meniscus as far as I know because of how it is torn, it isn't worth fixing.

Well I will update after I am done with surgery.

Here is some final pictures of my knee before surgery.