{"id":93,"date":"2004-07-13T02:45:51","date_gmt":"2004-07-13T02:45:51","guid":{"rendered":"http:\/\/localhost:8888\/marcos_test\/?p=93"},"modified":"2025-10-02T09:23:56","modified_gmt":"2025-10-02T17:23:56","slug":"arthroscopic-surgery-and-the-picc","status":"publish","type":"post","link":"https:\/\/www.marcoscarpio.com\/wordpress\/2004\/07\/13\/arthroscopic-surgery-and-the-picc\/","title":{"rendered":"Arthroscopic Surgery and the PICC"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\">The symptom was innocuous: a sudden fever after I ate a bad piece of &#8220;<strong>bao<\/strong>&#8216; &#8211; &#8220;<strong>siopao<\/strong>&#8221; as we call it back in Manila.  My body reacted by trying to eliminate it from my system when I took a brief shower. I was sure that I didn&#8217;t get rid of all of it.  The fever fluctuated between highs and lows even as I attempted to manage it by taking only <strong>Tylenol<\/strong> every four hours.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">On the 4th day, I felt significantly better and tried to return to my routine by doing some yard work and light household chores.  They weren&#8217;t back-breaking work, but <u>it was all the bacteria needed<\/u> to strike back at me at the end of the day.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The following morning, not only did I have the fever back, but I also had <strong>severe pain in the top portion of my right knee<\/strong>.  There was no swelling, but merely touching the area elicited very sharp pain, and <u>walking was extremely painful<\/u>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">After the sixth day, I gave up all hopes of self-medication as the fever shot up to record highs, and walking was now excruciatingly painful.  We called the <a href=\"https:\/\/kaiserpermanente,org\" target=\"_blank\" rel=\"noreferrer noopener\">hospital<\/a> and were immediately scheduled for an appointment for the following day.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">At the hospital, <strong>blood<\/strong>, <strong>urine<\/strong>, and <strong>synovial fluid<\/strong> samples were taken, as well as X-rays of my chest and the right knee.  The fluid drained from my right knee didn&#8217;t look too good (<strong>yellow-orange in color<\/strong>), and I was wheeled directly to the ER.  There, further blood and synovial fluid samples were taken, and I was put on IV.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">An <strong><a href=\"https:\/\/www.expertinstitute.com\/experts\/dr-guenther-olaf-knoblich-52743\/\" target=\"_blank\" rel=\"noreferrer noopener\">orthopaedic surgeon<\/a><\/strong> was brought in and talked to me briefly about my kidney operation of 1981, when my right kidney was removed due to <strong>hydronephrosis<\/strong> and <strong>pyelonephritis<\/strong>.  <u>He suspected that I had a urinary tract infection and that it had caused the fever and the severe pain in my right knee<\/u>.  He tapped my remaining left kidney to elicit pain as well as the area above my bladder.  I told him that there was no pain in either place.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The surgeon returned to explain to me that he had to perform an &#8217;emergency&#8217; <strong>arthroscopic surgery<\/strong> on my right knee to get rid of all the &#8220;bugs&#8221; and infection in there.  Worse, he will have to open up the knee (arthrotomy) in case the disease is much severe than he thought, to eliminate the possibility of the infection, doing more damage to my still-intact knee.  <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The knee X-rays revealed <u>no ligament or meniscus damage<\/u>; however, <u>allowing the infection to remain in the knee for an extended period can cause severe damage to healthy tissues<\/u> in a relatively short amount of time.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">So, that same day, very late at night, I was wheeled into the operating room (OR) for either a quick arthroscopic surgery or a much longer, open-knee surgery.  Inside the OR, I was probably awake for only five minutes and quietly prayed for the best.<\/p>\n\n\n\n<figure data-wp-context=\"{&quot;imageId&quot;:&quot;6a19dc272537a&quot;}\" data-wp-interactive=\"core\/image\" data-wp-key=\"6a19dc272537a\" class=\"wp-block-image size-large wp-lightbox-container\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"481\" data-wp-class--hide=\"state.isContentHidden\" data-wp-class--show=\"state.isContentVisible\" data-wp-init=\"callbacks.setButtonStyles\" data-wp-on--click=\"actions.showLightbox\" data-wp-on--load=\"callbacks.setButtonStyles\" data-wp-on--pointerdown=\"actions.preloadImage\" data-wp-on--pointerenter=\"actions.preloadImageWithDelay\" data-wp-on--pointerleave=\"actions.cancelPreload\" data-wp-on-window--resize=\"callbacks.setButtonStyles\" src=\"https:\/\/www.marcoscarpio.com\/wordpress\/wp-content\/uploads\/2004\/07\/shutterstock_1203850114-scaled-1-1024x481.jpg\" alt=\"Advanced surgical procedures had made previously long. invasive surgeries like arthroscopy routine, and with high success rates.\" class=\"wp-image-3384\" title=\"Advanced surgical procedures had made previously long. invasive surgeries like arthroscopy routine, and with high success rates.\" srcset=\"https:\/\/www.marcoscarpio.com\/wordpress\/wp-content\/uploads\/2004\/07\/shutterstock_1203850114-scaled-1-1024x481.jpg 1024w, https:\/\/www.marcoscarpio.com\/wordpress\/wp-content\/uploads\/2004\/07\/shutterstock_1203850114-scaled-1-300x141.jpg 300w, https:\/\/www.marcoscarpio.com\/wordpress\/wp-content\/uploads\/2004\/07\/shutterstock_1203850114-scaled-1-768x361.jpg 768w, https:\/\/www.marcoscarpio.com\/wordpress\/wp-content\/uploads\/2004\/07\/shutterstock_1203850114-scaled-1-1536x722.jpg 1536w, https:\/\/www.marcoscarpio.com\/wordpress\/wp-content\/uploads\/2004\/07\/shutterstock_1203850114-scaled-1-350x165.jpg 350w, https:\/\/www.marcoscarpio.com\/wordpress\/wp-content\/uploads\/2004\/07\/shutterstock_1203850114-scaled-1.jpg 2000w\" sizes=\"auto, (max-width: 767px) 89vw, (max-width: 1000px) 54vw, (max-width: 1071px) 543px, 580px\" \/><button\n\t\t\tclass=\"lightbox-trigger\"\n\t\t\ttype=\"button\"\n\t\t\taria-haspopup=\"dialog\"\n\t\t\tdata-wp-bind--aria-label=\"state.thisImage.triggerButtonAriaLabel\"\n\t\t\tdata-wp-init=\"callbacks.initTriggerButton\"\n\t\t\tdata-wp-on--click=\"actions.showLightbox\"\n\t\t\tdata-wp-style--right=\"state.thisImage.buttonRight\"\n\t\t\tdata-wp-style--top=\"state.thisImage.buttonTop\"\n\t\t>\n\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" fill=\"none\" viewBox=\"0 0 12 12\">\n\t\t\t\t<path fill=\"#fff\" d=\"M2 0a2 2 0 0 0-2 2v2h1.5V2a.5.5 0 0 1 .5-.5h2V0H2Zm2 10.5H2a.5.5 0 0 1-.5-.5V8H0v2a2 2 0 0 0 2 2h2v-1.5ZM8 12v-1.5h2a.5.5 0 0 0 .5-.5V8H12v2a2 2 0 0 1-2 2H8Zm2-12a2 2 0 0 1 2 2v2h-1.5V2a.5.5 0 0 0-.5-.5H8V0h2Z\" \/>\n\t\t\t<\/svg>\n\t\t<\/button><figcaption class=\"wp-element-caption\">A photo of the &#8216;basic&#8217; process in knee arthroscopic surgery and post-op scars. (Photo credit: Advanced Surgery Center, Omaha, NE)<\/figcaption><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">It was way past midnight when I woke up to find myself in the recovery room, with my right foot heavily wrapped in an elastic bandage and a much thicker foam wrap secured by <strong>Velcro straps<\/strong> to immobilize the area from the top of my knee down to my ankle.  There was also a <strong>MediVac<\/strong> (drain) coming out of my right knee via a rubber tube.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>After the second day<\/strong> at the hospital, the drain was removed.  <strong>The following day<\/strong>, all the straps and bandages were removed.  I was glad to find only <u>three (3) slits<\/u> on my knee (two at the bottom and one on top): ONLY arthroscopic surgery was done, and my knee was not opened up.  Still, without the pain-killing medication (<strong>Vicodin<\/strong>), moving the knee -mainly sideways &#8211; elicited severe pain that rang up my entire CNS (central nervous system).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Throughout this ordeal, a wide array of antibiotics was administered on an 8-hour cycle via IV.  At the same time, the doctors awaited the results of the <strong>blood culture and sensitivity<\/strong> (C\/S) test to determine the best antibiotic for the specific bacteria causing the infection.  <u>My right knee was still swollen like an overripe papaya<\/u>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>On the fourth day<\/strong>, the most effective antibiotic had been identified, and the doctors informed me that a PICC line would need to be inserted <u>so that I could administer the antibiotic at home<\/u>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>On day five<\/strong>, the <strong>PICC (Peripherally Inserted Central Catheter)<\/strong> line was inserted following a 45-minute outpatient department (OPD) procedure.  It was a very slender piece of plastic tubing inserted through a vein in my right arm (the nurse informed me that this route was shorter) that was <u>initially guided by a thin wire<\/u>.<\/p>\n\n\n\n<figure data-wp-context=\"{&quot;imageId&quot;:&quot;6a19dc2725c1f&quot;}\" data-wp-interactive=\"core\/image\" data-wp-key=\"6a19dc2725c1f\" class=\"wp-block-image size-large wp-lightbox-container\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"814\" data-wp-class--hide=\"state.isContentHidden\" data-wp-class--show=\"state.isContentVisible\" data-wp-init=\"callbacks.setButtonStyles\" data-wp-on--click=\"actions.showLightbox\" data-wp-on--load=\"callbacks.setButtonStyles\" data-wp-on--pointerdown=\"actions.preloadImage\" data-wp-on--pointerenter=\"actions.preloadImageWithDelay\" data-wp-on--pointerleave=\"actions.cancelPreload\" data-wp-on-window--resize=\"callbacks.setButtonStyles\" src=\"https:\/\/www.marcoscarpio.com\/wordpress\/wp-content\/uploads\/2004\/07\/adobestock_507404519-1024x814.jpeg\" alt=\"Insertion of a PICC line is done at a hospital's out-patient department (OPD). And it takes less than a minute to remove it. \" class=\"wp-image-3385\" title=\"Insertion of a PICC line is done at a hospital's out-patient department (OPD). And, it takes less than a minute to remove it. \" srcset=\"https:\/\/www.marcoscarpio.com\/wordpress\/wp-content\/uploads\/2004\/07\/adobestock_507404519-1024x814.jpeg 1024w, https:\/\/www.marcoscarpio.com\/wordpress\/wp-content\/uploads\/2004\/07\/adobestock_507404519-300x239.jpeg 300w, https:\/\/www.marcoscarpio.com\/wordpress\/wp-content\/uploads\/2004\/07\/adobestock_507404519-768x611.jpeg 768w, https:\/\/www.marcoscarpio.com\/wordpress\/wp-content\/uploads\/2004\/07\/adobestock_507404519-350x278.jpeg 350w, https:\/\/www.marcoscarpio.com\/wordpress\/wp-content\/uploads\/2004\/07\/adobestock_507404519.jpeg 1200w\" sizes=\"auto, (max-width: 767px) 89vw, (max-width: 1000px) 54vw, (max-width: 1071px) 543px, 580px\" \/><button\n\t\t\tclass=\"lightbox-trigger\"\n\t\t\ttype=\"button\"\n\t\t\taria-haspopup=\"dialog\"\n\t\t\tdata-wp-bind--aria-label=\"state.thisImage.triggerButtonAriaLabel\"\n\t\t\tdata-wp-init=\"callbacks.initTriggerButton\"\n\t\t\tdata-wp-on--click=\"actions.showLightbox\"\n\t\t\tdata-wp-style--right=\"state.thisImage.buttonRight\"\n\t\t\tdata-wp-style--top=\"state.thisImage.buttonTop\"\n\t\t>\n\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" fill=\"none\" viewBox=\"0 0 12 12\">\n\t\t\t\t<path fill=\"#fff\" d=\"M2 0a2 2 0 0 0-2 2v2h1.5V2a.5.5 0 0 1 .5-.5h2V0H2Zm2 10.5H2a.5.5 0 0 1-.5-.5V8H0v2a2 2 0 0 0 2 2h2v-1.5ZM8 12v-1.5h2a.5.5 0 0 0 .5-.5V8H12v2a2 2 0 0 1-2 2H8Zm2-12a2 2 0 0 1 2 2v2h-1.5V2a.5.5 0 0 0-.5-.5H8V0h2Z\" \/>\n\t\t\t<\/svg>\n\t\t<\/button><figcaption class=\"wp-element-caption\">Photo of a PICC (Peripherally Inserted Central Catheter) line procedure (Photo credit: Roswell Park Comprehensive Cancer Center, Buffalo, New York)<\/figcaption><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">The tube snaked all the way up to a large vein (<strong>subclavian vein<\/strong>) situated very near the heart. <u>The main idea was to deliver the antibiotic rapidly to my bloodstream while diluting it at the same time in the area where plenty of blood rushes by, for a more extended period than a <strong>drip IV<\/strong><u> (which is usually effective for only four (4) days)<\/u>.<\/u><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">As a standard procedure, an X-ray was taken to ensure the PICC line was in place; otherwise, the entire procedure would have to be redone.  I was also informed that <u>the PICC line will remain in my body for two weeks<\/u>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">That done, I was out of the hospital after a few more hours of briefing &#8212; all related to the arthroscopic surgery on my knee and the PICC line they had embedded in my body, as well as how to administer the drugs at home.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">For now, I&#8217;m simply looking for better days ahead &#8212;<em>&nbsp;to <\/em>return to my daily routine.  But this time around, I will be more thankful for each day that passes.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Simply being healthy is, indeed, a feeling of already being wealthy<\/strong>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">&#8212;links:<br><a href=\"http:\/\/www.arthroscopy.com\">www.arthroscopy.com<\/a><br><a href=\"http:\/\/www.thefurrymonkey.co.uk\/picc.htm\">www.thefurrymonkey.co.uk\/picc.htm<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>EPILOGUE<\/strong>:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/www.marcoscarpio.com\/wordpress\/2004\/08\/18\/rehabilitation-after-arthroscopic-surgery\/\" target=\"_blank\" rel=\"noreferrer noopener\">After the successful surgical procedure<\/a>, <u>all necessary medications and supplies (required for administering antibiotics at home), as well as durable medical equipment (DME)<\/u>, were delivered by a third-party provider.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n","protected":false},"excerpt":{"rendered":"<p>The symptom was innocuous: a sudden fever after I ate a bad piece of &#8220;bao&#8216; &#8211; &#8220;siopao&#8221; as we call it back in Manila. My body reacted by trying to eliminate it from my system when I took a brief shower. I was sure that I didn&#8217;t get rid of all of it. The fever &hellip; <\/p>\n<p class=\"link-more\"><a href=\"https:\/\/www.marcoscarpio.com\/wordpress\/2004\/07\/13\/arthroscopic-surgery-and-the-picc\/\" class=\"more-link\">Continue reading<span class=\"screen-reader-text\"> &#8220;Arthroscopic Surgery and the PICC&#8221;<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":3405,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[8],"tags":[],"class_list":["post-93","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-whats-new"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.7 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Arthroscopic Surgery and the PICC - Baclaran Para\u00f1aque Rizal<\/title>\n<meta name=\"description\" content=\"Whenever you have a fever that doesn&#039;t subside in a few days, it&#039;s wise to consult your doctor. 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