You’ve gotta be fucking kidding me!
I didn’t even get back home before it broke...
This Substack is about life in Việt Nam from the viewpoint of a 10-year expat who spent his first 60 years in a low-context culture.
In previous ‘stacks, I’ve talked about how difficult it can be to find decent health care providers in Việt Nam unless you’re in one of the larger cities. More recently, I’ve written extensively about the US-centric nightmare disguised as my right knee.
As an expat living in Việt Nam, I have the luxury of being able to fly to the US for medical treatment by simply charging a trans-Pacific round trip to one of my credit cards and paid for over time at usurious interest rates. With everything that’s happened to me health care-wise over the past 10 years, I’ve been thinking recently of how different it would be if I were native Vietnamese with similar issues and no credit cards.
We’ll leave that thought experiment for possibly another time.
The sentence that pretty much sums up my past eight days is:
If it wasn’t for bad luck, I wouldn’t have any luck at all.1
After spending a month in LA for my sixth knee surgery and related recovery/physical therapy, I was very happy to finally arrive back home on Saturday, the 17th. As anyone who’s read more than a couple of my musings would know, I was especially excited to see my daughter H and get a few of her wonderful hugs.
Unfortunately, I didn’t get the first until the 19th.
Drum roll, please…
What the hell???
Two-plus weeks after surgery, the knee was pretty good at walking up to a kilometer (~0.6 miles), though standing for long periods was difficult and painful. Because of this, I requested wheelchair service for my flights home, mainly to keep from having to stand in queue for two hours or more at Việt Nam Immigration.
My flight from the US connected in Taipei very early Saturday morning. As I walked from the wheelchair toward the men’s room, I turned left. Something I’d never thought about before that moment is that a walking left turn requires rotating the right knee a bit. As my knee rotated, the newly-installed hardware blew out (up?) with a POP much louder (and at a lower frequency) than the joint-pop you get if you pull a finger steadily. The pop of the finger, NOT the fart some clowns2 bless you with after asking you to “pull my finger.”
With the POP came a LOT of pain.
Instantly.
Minimum 8/10.
I sat down.
There was obviously something very wrong with my knee. One of my first thoughts after “It fucking broke!” was, “Why couldn’t this have happened yesterday while I was still in LA? Now I’ll probably have to turn around and fly back as soon as I get home.”
There’s US$2500+ down the toilet, just for airfare and AirBnb.
Then, “Can I walk on it? If I can, will it make it worse? I need to see Dr Phat as soon as possible.”
Testing it gingerly, I found that I could walk on it, though slowly and very painfully.
I wished I hadn’t packed the knee brace in my checked luggage, but then why wouldn’t I? I’d thought my knee was fixed.
After a few minutes to re-group and catch my breath, I made it to the departure gate. Fortunately, the flight to Saigon wasn’t very full, so I had a whole row of three seats to myself. In spite of having plenty of room, it was a VERY UNCOMFORTABLE four hours, constantly shifting, trying to find a position where the knee hurt less. There isn’t one.
Once I got to my hotel, I called FV Hospital, and made an appointment for 9:30 Monday morning with Dr. Phat, Chief of Orthopedics. There was no way I was traveling any further without knowing exactly what was going on.
I spent 90% of the next two days in the hotel, in bed, making hundreds of fruitless attempts to find a body position that gave a bit of pain relief. The best I found dropped the pain level from a continuous 8+/10 all the way down to a continuous 6/10. If I was very lucky, I could put together two consecutive hours of sleep before the pain jolted me awake.
I arrived at the hospital early Monday morning and waited for Dr. Phat. He examined my knee and agreed that something had moved that wasn’t supposed to.
He sent me for x-rays.
Dr. Paiement (the LA surgeon) had sent me home with a copy of the “Operative Report”, a written play-by-play of the three hour-15 minute procedure. I gave it and the follow-up visit x-rays to Dr. Phat.
Now what?
Once he’d glanced at both, I asked him if he could fix me. He said that because they used Stryker hardware, he could not. Stryker stopped selling their hardware in SE Asia about 14 years ago, so he cannot get the parts he would need. He also said that there is no telling how much my knee is torn up inside because of the wire-looking piece continuously impacting the meat. Bottom line — I would be much better off flying back to the US for the repair.
Upon returning to the hotel, I emailed Dr. Paiement and sent him photos. He replied that I needed to get back to LA ASAP. He also said to move around only as necessary and use crutches when I do have to move.
{I’ll spare you the numerous colorful expletives that’ve passed through my mind}
I’m already flying back with H on 1 July and I have to make ANOTHER trip now???
Two more trips, or one?
Initially, H was willing to move our trip up and go with me to LA, hanging out for a couple weeks before we traveled to see family/friends. She has a HUGE heart and wanted to do whatever was best for me. After discussing it a bit further, we both realized this wasn’t our best option. The biggest obstacle was where she would stay Monday night when I will have to stay over in the hospital. She’s 13, so there’s no way she’s staying in the AirBnb or a hotel by herself, even if it weren’t the second night of her first trip to the US.
My friend L, whom she’s known for at least six years, lives just outside LA and graciously picks me up at LAX before each surgery. He said he’d offer to put H up at his place and show her some of the LA sights while I’m hospital-bound, but his roommate likes her weed and he didn’t feel he could ask her to take a night off. Thanks, I agree and appreciate the thought.
My sister said H is welcome to stay with them in Ohio while I’m in the hospital and I could then fly up a week or so later after the surgeon cleared me for travel. H liked this idea. Unfortunately, it also won’t work because she would have to take two flights unaccompanied; I can’t wait the extra days it would take to fly there with her and then return. She’s a more savvy traveler than many adults I know, but even with an airline escort through the airports, it’s not something either she or I were willing to consider.
As much as I would love to have her along, I’m going solo.
If everything goes according to plan (and why would it?), I’ll be back home by 15 June, giving me time to unpack and then repack for our Daddy/Daughter trip.
Why go back to the same surgeon?
Yeah, it sounds a bit daft to head back to the same place that did the last surgery, seeing how well it turned out. At this point, I don’t feel I have a choice:
Two very experienced orthopaedic surgeons told me to get it fixed as soon as possible.
The pain is making me crazy.
Time is of the essence. Every day I delay, the knee is most likely getting more and more torn up inside.
If I return to Cedars, I can have surgery on 26 May. Finding another surgeon with a high level of experience with knee revisions AND who’s willing to take the case without examining me in-person AND who can get me into the OR rapido is a chore I’m just not up to in my current state (pain, immobility, and limited budget).
It’s my uneducated opinion3 that this was equipment failure, not pilot error.
Now what?
By the time this publishes, I will have spent the entire five days of my “visit” home either in my office or my bedroom, with an occasional trip to the kitchen. Not once did I leave the house, though I did get daily fresh air via my open balcony door. Sleep was fitful at best, non-existent at worst.
Saturday morning, I flew to Saigon for my Sunday flights to LA. Because I requested a wheelchair, Vietnam Airlines picked me up at the gate in Dalat their custom van
and delivered me to the rear starboard door of the aircraft.
In Saigon, they took me off the same way.
As this publishes, I will be on my way back to the airport and my second trans-Pacific flight in 8 days via Starlux Airlines4. Upon arrival in LA Sunday evening, I will return to the AirBnb that I checked out of only 10 days prior. I will try to sleep.
Monday, I will report to the Emergency Room at Cedars-Sinai as early as I can, most likely before 7 a.m. Doing so apparently allows me to bypass some of the bureaucracy and gets me into the OR more quickly. Since I had an EKG and other pre-op tests only five weeks ago, they’re not needed this time.
Pre-surgery questions
Before they put me under, I’m going to ask if they can weld the post this time so it never moves even ¼ mm.
Or, better yet, install a YKK zipper instead of stitches for easier access next time.
Wish me luck.
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Hi, Steve from Foxcroft.
Or is it wishful thinking?
Starlux was the least expensive on short notice. I flew them for last month’s surgery trip and they compare favorably with Korean, Cathay Pacific, and others. Their food, however, is the worst — but the US$400 I’m saving will buy a meal or three to compensate.
Ain’t that a bitch! So sorry for your continued troubles and string of bad luck. I’ll think about you the next time I’m burning the incense.
Thank you, David. I can’t think of anything that would make me happier than for this to be my last surgery on this knee.