The surgery.

The morning of checkout from our fancy 5-star hotel (a total luxury I won’t forget anytime soon), we packed everything up and went around the city for some last minute purchases and sightseeing. The time after surgery is so unknown that we don’t want to bank on what shape I’ll be in. We went to the largest Krishna shrine in Chennai, the Arthasarathy Temple, which is the oldest structure in the city.

There was a tour guide (who I’ll admit totally hustled me for his tip) that explained Hinduism so comprehensively that I felt for the first time I finally understood a glimpse of it. Rotating around the temple we were greeted by a few of the locals, one of whom asked where we were from and proceeded to proudly proclaim her son-in-law was finishing his pHd in Indiana and called him over. Poor guy, he looked so abashed. Before leaving, there was a “wish tree” that people would tie strings to, cradles for prayed-for children, or just touched and asked for positive outcomes. Sam and I held hands and laid our other on the tree, both wishing for a good outcome the following morning. The anxiety followed me around like a cloud. We left, went back to the hotel, grabbed our bags and headed to the hospital. It’s a nice, private suite, with my hospital bed, a bed for Sam, a couch, and a desk, with a closet and fridge and solo bathroom. As soon as I arrive I’m greeted by the angel Devi, who speaks the best English and is a fantastic nurse besides.

The next morning I wake up at 5am to start prepping for surgery; they want me in OR by 5:30 for that holding pattern that everyone who’s had surgery is familiar with. They go to put in an epidural, and he doesn’t get it. I repeat, HE DOESN’T GET IT. I let him try again and again, because what’s my alternative? Everyone is starting to panic. The Tamil and Hindu being spoken around me starts to become frenzied. He’s talking to me through it though, and finally, after the 7th or so attempt, he gets it, and my relief is the color of saffron. He tells me that I had scar tissue on my back at the normal insertion points, and had I had epidurals many times before? Never, I said. Turns out all those car accidents proper fucked me, and I was suddenly giddy that I couldn’t ever have kids because LORD.

I wake up around 2 or 3 in the afternoon. I wasn’t brought back until noon, and it was because the doctor had never seen what I have before and was taking his time investigating it. The knee pain I’ve had for half my life, which he termed patellar femural dysplagia, is a congenital defect in my tibial bones. If you look at any goofy skeleton cartoon, you’ll know the piece I’m talking about; the valley between the two bulbs at the distal end of the femur and proximal end of the tibia. Basically, the “crack” part that makes bones look like butts. In real anatomy, you’d see that it’s a deep groove, and our kneecaps track within that groove. It’s a hinge, basically. Well, My bone doesn’t look like a butt. It’s flat...shallow...and consequently didn’t provide my kneecap anywhere to glide within. So my kneecap has been sliding around in my joint since puberty, which is why this pain began when I was 15 (growth spurt) and didn’t fade. Gradually, my body built up a massive mound of fibrous tissue to keep the kneecap attached to the lateral/outside part of my knee, but when my ortho Dr. Donaldson did a lateral release, he undid that lifetime of work and made the issue that much worse.

My surgeon, Dr. Venkat, looked me in the eye and told me that I was right. That he was wrong. It wasn’t an overexaggerated rendition of pain, it wasn’t the chemicals in my brain being wonky, it was that my knee was in a permanent state of dislocation because it never had an actual track. As my buddy Tony put, like a golf ball on a flat tee - easy on, easy off. Afterwards, Dr. Venkat reevaluated my xrays and saw the minor indications of my condition, and was shocked. I gave him an education, he kept repeating. The only corrective surgeries for this kind of condition are in Europe, where they essentially saw at the bone to make a track for the patella, but I’ll likely come back here to do the lesser surgery he initially suggested for my left knee on my right. He’ll cut the head of the tibia at an angle, slide it over a centimeter or two, and add another tubercle attachment for my kneecap with some stem cell injections to help repair any damaged cartilage.

The pain was extreme, dearhearts, and the next day was even worse. But now I’m technically on day 2 (48 hours out of surgery) and already I’m seeing the light at the end of the tunnel. I’m sure I’m in for plennnnnty of discomfort in the upcoming weeks, but I’m not yelling out in pain or weeping yet, and that’s a great way to start the day!

The decision.

It’s our first evening in Chennai, technically. We arrived in the wee hours this morning. I am awake from jet lag and 2 cups of chai with dinner and pain and anxiety. I’m sure you read this and think I’m anxious about having surgery, but really it’s because getting a total knee replacement was suddenly not my only option.

The doctor ordered a 3T (Tesla) MRI, which shows the density of cartilage in a joint with nifty color coding. Clue: red is BAD. I had these two spots with a ton of red...all red, actually...but overall, my knee was okay. The doctor was dumbfounded. Yes, I had moderate damage, and in those points they could feel severe, but overall, my joint was not in need of replacement. He suggested stem cell injections for the potholes, and a tibia surgery that would split the bone and spread it a few centimeters to add another contact point that would help stabilize my kneecap. That alternative surgery was only a grand cheaper than a total knee replacement, and while my doctor insisted I could feel a reduction in pain two days post-op, I wasn’t so confident. We got into a discussion about cytokines, pain pathways, and the inability of the brain to utilize this information and determine the extent of the issue.

Some background: I had endometriosis since shortly after I started menstruating, probably around 14. I remember my pain was never like other women described, but I figured I just conceptualized my discomfort differently. After I was in a car accident at 19, I attributed my pelvic pain to back pain from that collision, but really, it was this. It didn’t come to a head until I was 26. TWENTY FUCKING SIX. Twelve years and I did it. I broke bones and didn’t shed a tear. I put my body through physical hell for most of my late teens and early twenties, out of the desperate need to live and keep going. With a bum knee since I was 15, endometriosis for the that and then some, it’s no surprise that my brain perceives pain differently.

So when a surgeon that I respect and has been so patient with me tells me that I should not proceed in the plan I’ve been working toward and meticulously laid out to cure said pain, arguably after a remarkable lack of sleep, I broke down. People, I broke down like I was watching the opening sequence to Up on my surgeon’s forehead. I had to make a hard decision; the main pro on the lesser treatment was objective approach as the less intense option. If I were a doctor, I’d encourage the same. But the risks of it not shutting down that pain pathway were too high. Sam and I talked about it for hours and I spoke to some friends and family, deciding that after all this planning and struggle, the lesser option with no guaranteed success was not for me. It takes an average of 6 months to see results with stem cells, and it didn’t account for the issues on the underside of my kneecap that could just reinjure the cartilage.

I sat in the dark and looked deep into myself. It’s the closest to praying that I come, because who needs to speak with words to whatever it is inside each of us? The quiet sense of surety filled me. Acting with my heart has never led me astray, and I know in my heart that this is what is best for me, the future I’ve worked so hard for, and the man I get to spend it with. Pain has been snuffing out my soul slowly and surely for the last two years and when I have the choice to eradicate it as best I know how, I cannot take a lesser choice.

Day 1 in Chennai

I enter the tarmac, and the smell of must hits me. You know the smell...it’s towels that were left on the couch too long after a shower, or your house with the water cooler only after it’s been closed up like a drum for a week at the peak of summer. It’s not bad; far from it, it makes my amygdala light up like a nostalgic summer camper (which I never was) and bring back warm fuzzies of my aunt’s house and beach trips. We arrived at the airport at 12:30am and it took about an hour to go through immigration, customs, and grab the luggage. As soon as we walked outside there were hundreds AND I MEAN HUNDREDS of men lined up to try and get our fare as taxi drivers. Holy crap. Right away some dude tried to grab my luggage to my “waiting car”, and luckily I’m paranoid and also knew that we had a car from the hotel waiting, so I was able to find him and make that grabby sumbitch carry my luggage to the car. Because I’m not a douche, I tipped him $2USD, which converts to roughly $160 rupees, and that’s a high reward from grabassery behavior but such is life. I tipped the actual driver only $100 rupees, and considering a standard tip is 10-20 rupees (approx. 15-20 cents USD) I’m just handin’ out hundreds like a baller. I’ll only ever be rich enough to sprawl out on a 5-star-hotel comforter surrounded by imposing-looking currency, and that’s in India, and Imma take advantage.

We get to the hotel, check in, room is EPIC (and also musty). I shower under a waterfall showerhead, slip on my terrycloth robe and try to defrag after 22 hours en route from LAX to Chennai. I succeed and sleep for a momentous three hours, at which point I spring up like a Hun daisy (thanks Mushu, you have a quote for every occasion). I go down to breakfast, which is also amazing. This hotel officially makes the most magical cheesy eggs I’ve ever had in my life and YOU BETCHA I’m going down an hour early so my food can settle and I can get seconds tomorrow.

People are constantly looking at me. I worried it was because I was dressed improperly (my calves are showing), but I realize it’s because I’m white. And how many times have I noticed with disdain that people in any given place are staring at a Punjabi in a turban, or a Muslim woman wearing a burqa? And here I am on the receiving end, the end clearly demarked “other”, and I am self-conscious and paranoid and fidgety and GRATEFUL. Grateful that I can take this trip at a point in my life when I am acutely aware of my priviledge as a white American and am shoved against the glass; not only do I see an entire society of those who are unable to rise above their station, which I have already done at 30, but I am found wanting by many onlookers. I am grateful to be lacking, know that I am lacking, understand why I am lacking, and try anyway. Because that’s the immigrant’s tale in America, and even after one day, I think it’s really important that most Americans experience this feeling. We’d be a lot nicer of a country if we did.

After breakfast we went to the hospital and met with the surgeon, at which point I had x-rays done and went to another place to have a 3T MRI. That’s right, 3T stands for 3 Tesla, and shows cartilidge damage severity by accumulations of water (which indicates swelling in le cartilidge which is 80% water) - something never made possible to me in the US. I waited a total of 30 minutes, had the MRI for 20 minutes, and picked up my results (including color-mapped readouts, scans, and report) within two hours. While we waited, Sam and I picked up some adroid phones for $90 and Sim cards at ANOTHER location (because they can’t be sold at the same place) which required legit passport photos that we had to walk around the corner to get and were done way more professionally than ours in the states, haha. Got said Sim card and purchased 10 gigs of prepaid data for $20 (HOLLA), then picked up the results and went back to the doc. I’ll talk more about that second fateful visit when I’m stuck in bed post-op, but I’ll tell you a few things right now that I saw driving around the city.

A ganesh painted onto a tree, his trunk melding into the roots. Colorful shrines on every corner (literally), including in the parking lot of the hospital. The tiniest horse I’ve seen that wasn’t a donkey or pony hauling a two wheeled carriage/rickshaw piled high with hay. So many colors. Vendors in every nook and cranny of each street. SO MANY TREES. Almost the entire city is shaded by their leaves. Not as much poverty as I expected. Massive demolition with new construction going up in its place for the poor. Didn’t smell as bad as I’d been warned to expect. So much beauty.

Basically, I feel like the first few days are a page right out of the Darjeeling Limited and I’m not about about it.

on the glory of frequent and unsolicited conversations

I haven't written in a very long time. This blog has served its purpose, which was to grant me an outlet when I needed it most. I am a verbal/written processor; I rarely am able to come to terms with feelings or situations unless I'm able to express it somehow. Now that I'm married, my poor bastard husband hears it all on the frontline and has kept me sane through this intense nursing program (that is now finished! I am a RN, BSN and the world is beautiful).

Recently, I've been surprised on how many people feel safe talking to me. I had so little time in the nursing program that I didn't go to a lot of places and have these opportunities. Two weeks ago or so, I was filling up the mini with gas and a nice young black guy was at the pump next to me, his lady in the car. He was washing his windows and I needed to wash mine too; when he was done, he gave me the wiper, then we started talking about cars. He came over and followed behind me with a paper towel as I washed the windows, making sure there weren't any water lines. He had tattoos everywhere, including his neck and face, and was articulate and considerate. We talked about our moms, and suddenly he said, "You know, you're one of the chillest white women I've ever met." I laughed, we shook hands, I waved bye to his lady (who smiled and waved back), and parted ways.

A few days later, I had a long conversation about the nature of cyclical, systemic poverty with an older black guy at the laundromat who drove a neon green caddy. We spoke for over a half hour, and it was so awesome to learn his perspective. Same for the homeless elderly white lady with an amputated leg. She gave me this open testimony about her history with abusive men, drugs and alcohol, and her nonexistent relationship with her children. It was amazing. And I feel so privileged that something in my nature enables people, literal strangers, to give the gift of their stories to me.

Because at the end of the day, we are our story.

We leave for India next Wednesday, and I'm going to try and write as often as I can while I'm there. I may start a new blog for it, and if I do it'll link it through here.

Make your story a good one, loves. That's all I hope for you.

.

I'm profoundly depressed right now, for a lot of very valid reasons. Normally I'd need to write a post to see the validity, but luckily I married the right person, and he validates my stress and anxiety when I share them with him. But that sharing occurs often, and I feel like a wholly burdensome partner, so I'm trying to get it out here and not weigh him down any further.

I don't have the energy to describe all of the factors that are leading to this point. A big reason my coping ability is so low is the intense, prolonged knee pain I've been in for the last 18 months. I don't have it in me to deal with manufactured in-law drama, school drama besides getting there and back and finishing my million assignments on-time, maintain a house, and still be a good person. So I'm withdrawing into myself, bit by bit, and becoming more apathetic than I've ever been. It's a hard place to be. I put all my emotional energy into my nursing and then into my marriage, and there's nothing else left.

December 15 is my last day of my BSN, and I can't wait. Next semester it's just residency and an online class, and taking (AND PASSING!) my NCLEX. Then working. Contuining with my Masters, although with how I'm feeling right now, I don't know if I'll continue anytime soon, or even at APU.

I'm living an emotionally devastated life, and I don't know how to change it, except to keep putting one foot in front of the other. And it's killing me.

powerlessness.

The weather outside reflects my mood. My father keeps saying that it's earthquake weather, and it keeps echoing inside my head and rumbling out of my eyes...my core is shaking. I am under such immense stress that I feel myself tearing. Shearing. Pulling and pushing and under no control of the turmoil.
It is, to say the least, exhausting.
That's what has been so enduring lately - the lack of rest. I feel dead, all day every day. Life has become the process of putting one foot in front of the other and putting out the fire under my step. My dream after marriage is just sleeping.
There are issues with the house we're buying. Not with the actual house, not with the financing, not with anything that you would expect for their to be issues with. Nope, we were on our shit and all of that is totally handled. The issue is the sellers.
They had four goddamn repairs to do that were minor as all getout. Replace the wood under one eaves. Put a plate over the pilot light of the water heater, add a strap to it, and add a drainage pipe. It would take a shitty handyman about 4 hours to fix it, but they've waited until the absolute last day. And the tenants are still in there. Not only is my real estate agent not putting pressure on them, she's saying that I...YES ME...told the tenants they should be out by 5/11. Monday. When Sam has to be out of his apartment by Saturday, 5/9. Why would I tell them a date I never even had as an option in my brain?! As a matter of fact, I told them the 7th. As a second matter of fact, it's not my responsibility for their vacancy.
So for 2 days, we'll have to have all of his stuff in a Uhaul parked against my parent's garage and hoping we don't get robbed. 
Well Erin, that's not so bad. Why are you freaking out, you may be thinking. Well, because I have a very amazing group of friends that are willing to help me throughout the day of Saturday to move us, get us unloaded and partially unpacked. If we're delayed and don't get our keys until Monday, we'll be alone. And that means we'll be unloading alone. And that means that I'll be in so much physical pain that I may actually not leave bed and say FuckItAll to LIFE. Which I can't afford to do. Not with the school program I'm in. Not with my marriage commencing via wedding in 15 days.
So, like most humans, the fear of pain is motivating me and making me fiercely aggressive. I am gearing up to fracture and could care less what the fallout is.
By fracture, I mean: scream, cry, roar. I'm already doing it extensively. I can't bear the thought of going home, taking care of the dog I'm dogsitting, hear the shit my parents will dole out like candy, do laundry, pack my life, and ultimately have NO CONTROL over whether I will have the home I've worked hard for by Saturday.
Someday soon, it'll be better. I just wish I could exert some type of action to make it so.

tempered.

I ruminated on the year that had just passed by. It was, like it is for everyone, the beginning and the end of so many things, but there were more than the average notable occurrences. Most importantly, it was the last year I would ever be single (at least I hope). Really, who goes into marriage assuming that it’ll someday end? Not me. And not Sam, thankfully. We met in February and intend on walking through this life together. As a part of that, it was also the last year I would spend New Year’s Eve alone. It was the last year that I would feel lost from my path; nursing school has begun and as the culmination of four years of work, it feels like a big part of me that has been waiting to bloom has finally started to. It was the first year I lived without the fearsome pain of endometriosis, and had to live for 365 day the reality of never having a period, ovarian cysts, terrifying bleeding, suffocating pain, or the possibility (however slight) of giving birth to my own offspring.

It’s an odd thing, accepting that bit. It’s easy to accept something when you have the capability, and a little harder to swallow when it has been forcefully taken from you…more so when you yourself is the one who did the taking, to survive and thrive.

I realize I haven’t blogged in quite some time, and as I was talking to my friend Kathleen today, I realized why that was. Simply, it’s Sam. Blogging began as a way for me to expel my deepest self with force and words. I was unable to do it in regular life, primarily because I was too busy, or often because it was too much for me to reasonably expect my friends to listen to as I processed my life and feelings. Life is not easy, and I am poor, but instead of therapists or making my friends hate me, I turned to this venue. Writing it made it true. 

And now, honestly, I tell everything – EVERY SINGLE THING, that poor bastard – to Sam. He is in every way the best thing to happen to me. Also, the idea of spare time to write these days is a mirage, and I think that if I am going to devote a certain time of day to writing, it needs to be creatively, not just regurgitating the same things I’ve already verbally worked out with Sam or another friend.

I’ve decided a few things though. 2015 will be a big year that much is certain. Sam and I will be moving into our own place with a spare bedroom for our loves who need a place to land for a while. We will be getting married in May (the date isn’t known by many because we’re eloping and don’t want to cause a fuss), I’ll be completing my B.S in Nursing at the end of the year and beginning my preceptorship in anticipation of the NCLEX, and I’ve mentally committed myself to volunteering in a nursing home, ideally with hospice patients who don’t have their own family to sit with them.

I just watched a documentary called Serving Life, about inmates volunteering in Angola penitentiary’s hospice program, and what the warden said has stayed with me: it’s about taking care of each other in this life. I’ll dig your grave, and someone else is going to dig mine.

I’ll hold your hand and dig that grave for you, because I am capable of doing so, and not everyone is.  

There was a lot more that happened in 2014. Mental health advocacy for friends, cosigning on a car for a friend, refinancing my own, getting different health insurance (saving me thousands every year – THANKS OBAMA!), two knee surgeries, not missing a single day of nursing school despite those surgeries and still managing a 3.8 GPA, loving not only my life-partner but his family, road trips, tears, fears, and everything in between.

My best friend told me today that I am mellower these days. That Sam has calmed me down. Truly, I think that I am now tempered…that the fire of these last few years has done its job. I felt my blows. I hardened, and sharpened, and am formed in the best shape so as to slice.

So as to slice.