Knee Surgery Results

To follow previous posts on what happened with my knee click here for the first one and here for the second one.

I had surgery yesterday afternoon and the Doctor did not find anything wrong with my meniscus. Instead, he found other problems...

1. The ACL (Anterior Cruciate Ligament) had been stretched, but not torn. Because of the stretch, the some chords had separated so he repaired and tightened the ligament.

2. The Femur's Condyle (I believe) had been torn as well so he repaired that also.

3. Also, there is a slight crack in the cartilage underneath the knee cap and he repaired that as well.

I understood him to say that the femur and knee cap had slight cracks in them, but after researching here, I think it was the cartilage tears that he was talking about because he did say something about cartilage damage (I'll blame the misunderstanding on the drugs from surgery...smile:).

The final result is that the knee is fixed! I will be on crutches for two weeks without putting pressure on my leg (that will make leading worship in church and a Quinceañera ceremony next week interesting). The actual cost of surgery was $1600 usdollars ($20,527 pesos). We have already spent $370 usdollars on previous doctor visits, blood tests, medicine, and travel expenses. I go in for a follow-up visit next Tuesday where the Doctor will explain a little more in detail of what he did. I really like this doctor and have a high respect for him and his work. He told us that he will not be charging us for rehabilitation after surgery (Praise the Lord!). So, the continuing costs will be a minimal (travel and meds--if needed).

Thank you so much for your prayers and for those of you who have helped financially. If you haven't had a chance to help and would like to, you can see how here.

Blessings to you all!

Knee Injury Update

Click here to see the first post.

We went to the 2nd opinion Dr. last night for my follow-up visit. After doing a little research on the internet and seeing the two different Doctors, I've learned a lot about knee injuries and the many different areas where a knee can be damaged. Again, he said the ligaments are good (collaterals and cruciate). The swelling is down and there is less pain (probably due to the anti-inflamatory and pain killer he put me on???lol). He did not rule out the meniscus (which was the first Dr.'s diagnosis), but said I should rest some more before doing anything else to let the Medial Collateral Ligament heal completely (the first Dr. did not mention anything about that ligament, but the 2nd Dr. did a more thorough exam and found that it was damaged a little--as if I had stretched an elastic band too much). Apparently, this is nothing serious, it just needs about four weeks to heal itself.

What I conclude is:

1. Medial Collateral Ligament: The 2nd Dr. is right about it needing to heal itself. I give this a 100% chance of being right.

2. Medial Meniscus Tear: The 1st Dr. is probably right about this and the need for repair with arthroscopic surgery. I think what I've researched supports what he says even though his diagnosis was not as thorough as the 2nd Doctor's, I give this about a 99% chance of being right. Especially for this statement and others that I found in the link above: "Weight bearing and rotation at the time of injury tend to cause meniscal injuries." Remember that I landed on my leg fully extended and it rotated.

3. Anterior Cruciate Ligament: Niether Doctor said this was what was wrong. However, that's what they said 20 years ago about my right knee and once they looked at it through arthroscopic surgery 9 months after my injury, they immediately found that it was torn. I found this in my research..."The most common mechanism for ligamentous knee injuries is an inward, medial force usually accompanied by some external rotation and flexion (as when being tackled in football). In such cases, the medial collateral ligament is usually injured first, followed by the anterior cruciate ligament, then the medial meniscus." This is similar to what happened to me. I would give this a 5% chance just because of my past experience with the missed diagnosis of my right knee.

4. Posterior Cruciate Ligament: The 2nd Dr. rose concern about this because of 1--pain in the back of the knee when I extend it and 2--the way I fell on it, hyperextending and twisting. He gave me a pass to have an MRI done to see if this is a possibility. However, it is a very uncommon injury and usually occurs with blunt force like a car accident or Football. I researched this here. I would say there's a 1% chance of it being this.

The Plan...

• I give more weight to the first doctor's diagnosis because his specialty is the knee. The 2nd doctor's specialty is the back, but does work on knees; it worked well to have him as a second opinion and would explain a little bit of his doubt as to what could be wrong.
• I will not have the MRI done because of it's cost and the two doctors contradicted themselves on the quality of what can be seen in them. The first doctor said you can see ligaments, but many times the parts of the meniscus is hidden.
• Monday morning I'll go to town to get my blood tested in preparation for surgery.
• That afternoon, I'll call the first Doctor and let him know the results. As well as asking him some more questions. An important question I have is if he'll not just work on the meniscus, but look around and see if there is anything else that is damaged (ie: ACL, PCL, etc.).
• If he says he needs to see me one more time, I'll go. If not, we'll set a date for surgery...hopefully this next week!

Thank you for your prayers, I'll post again about this after Monday.

DECEMBER UPDATE

MERRY CHRISTMAS and HAPPY NEW YEAR!!!

We are finally getting settled in here in Cofradía. Things are going well and we were so excited to see a number of new faces in the church as well as youth when we came back. It’s starting to get cold...it’s been down to 53 degrees already at night. The coldest I’ve seen it is 41 F.

Thank you so much for your prayers as we travelled. We did not have any mishaps except the need to change a tire on our utility trailer. I found a free one on the craigslist in Tucson, so we were able to get our spare back before crossing the border.

Crossing the border was very simple. We did not get charged for anything we had in the trailer or the truck and we got two green lights so we didn’t have to unload anything to show them what we had. What a blessing! Many times, they’ll ask you to unload everything! We made it back after 2900 miles of driving over 15 days. Depending on the roads, we drove 45 mph to 60 mph all the way down.

Are you going to be visiting in Mexico? If you have plans to come to either Mazatlán, Puerto Vallarta, or Guadalajara, let us know. We are within 4 hours of all three of those cities with Mazatlán being the closest (3 hours). We’d love to show you around Cofradía so you can get a taste of this Mexican countryside!

Follow these links for more..
Knee Injury—Our first time back with the students at youth group, I hurt my knee playing volleyball.
Arial View of New Church—A photo of the new church building taken this fall from the air.
EL RETO 2009 Final Week—The biggest youth event of the year.
From Washington to Cofradía—Follow our trip down and meet the people we visited.
Cofradía Parade (Nov. 20th)—First week back to school for Rebecka and already involved.
Marriage Conference with Doug and Jan Taylor—See pictures of some couples.
December Newsletter Hardcopy—This is a quarterly newsletter we send to those who do not have email.
Facebook—if you’re on Facebook, I’d love to get in touch with you!

This month, would you please pray for...

• Knee Injury Complete healing. Wisdom for the Doctors if surgery is needed. Financing.
• Youth Volleyball and Speed Soccer Tournaments We’ll have our annual Christmas Tournaments right after Christmas. This is a great event that brings youth together and draws in students who normally don’t come to church.

Thank you very much for your prayers and continued support.
See how to partner with us and donate here.

Blessings,
Steve, Geña, Rebecka and Emma Rose Silberman
Missionaries to Mexico
SKYPE: “srsilberman”

Marriage Conference with the Taylors

Once again Doug and Jan Taylor came to do a more than excellent marriage conference.

They have a great way of taking simple concepts and applying them to our marriages. The youth were invited to attend this time and the Taylors did a great job relating to them as well. The couples were blessed with this conference; their strong marriages bring a strong foundation to the church body. Here are a few pictures of some of the couples.

Getting ready for prayer.

Geña and I praying for Feliciano and Toña.

Luis and Mari. Luis is one of my Youth Interns.

Salo and Amalia.

Hugo and Norma

November 20th Parade in Cofradía

November 20th is a Holiday in Mexico celebrating the Mexican Revolution and they always have a parade that the school kids and land owners participate in. Here are a couple picks, see more on Facebook.

From Washington to Cofradía 2009

November 1st we started our 14 day journey to Cofradía. After hearing Josh McDowell speak at CMC in the morning, we went home to finish packing had have lunch as our friend Fabian Gomez came to visit one last time.

As we said our good-bye's and prayed for safe travels, we continued to pray for our truck and trailer for no mishaps all the way to our destination. We drove anywhere from 45 - 60 mph all the way to Cofradía.

Our first night we stayed with our friends Jack and Dana Harroun in Vancouver, WA.

It's been about 7 years since we've seen them and we had a great time. In the morning, my former Youth Pastor Ron McClung came to visit us at the Harroun's house.

I haven't seen him I think since I've been working as a missionary for almost 14 years. It was great to catch up. We took off from Vancouver and crossed the bridge to Portland, OR to visit another friend I haven't seen since college, Sheila (Hollimon) Oliver and her husband Joe and daughter Elizabeth. Great to see them too!!

That night we made it to Central Point, OR and stayed at a hotel. After having already paid for a room, we forgot that we had our dog with us. So, I went back in to see if it was ok and the clerk showed me the sign right behind her that said "$25 fee for pets". Bummer, that's about 6 mochas at Starbucks!

We made our way to Lincoln, CA to visit Geña's sister for the night. We spent most of our time with her niece Nayeli because everyone else had to work late.

The next morning we headed to Tracy, CA to stay the night with Geña's brother Luis.

Rebecka and Emma have lots of fun with their cousin Giselle.

The next day we continued on towards Bakersfield, CA and stayed with another niece of Geña's at a Dairy Farm in Buttonwillow, CA. Can you say flies? WOW!

That evening we went to dinner at Geña's cousin's restaurant "El Huichol" in Bakersfield and invited along our friend Pastor Gerardo Osuna and his family. That was a lot of fun.

The next day after breakfast we headed out to have lunch with a friend from elementary school, Pastor Brandon Beard, in Santa Clarita, CA.

We continued on to stay the night with our friend Francisco Jimenez and his family in Oxnard, CA.

After breakfast at IHOP, we took off to visit one of Geña's friends from Santa Fe (the next town after Cofradía) who lives in Norwalk, CA and had lunch with them.

That evening we headed out to Geña's other sister's house in Perris, CA and stayed with her for three nights.

We attended church with her and Geña's mother who lives nearby came to visit as well. Then on Monday I had to run some errands for our truck and repack some things we accumulated on the way down. Then, on Tuesday morning we headed out to Tucson, AZ to visit with Bob and Dorothy Micher and stay with them two nights.

That gave us a day to do our last minute stateside shopping and rest a tiny bit before crossing the border the next day. We crossed the border without any problems at all. We didn't have to pay duty on anything and we got a green light at both check points. That was great because if you get a red light, many times they'll ask you to unload everything you have to make sure that you're not carrying anything you're not supposed to.

We spent the night in Obregón, Sonora and the next day continued on to stay with Doug and Jan Taylor in Mazatlán, Sinaloa. By Saturday, November 14, we were in Cofradía...finally. We had a great time in Washington speaking, visiting, and seeing family. We also had a great trip as we travelled and visited family and friends on the way to Mexico. Thank you to all of you for taking the time to visit with us either at breakfast, lunch, over coffee, or opening up your homes. May the Lord Bless you!!

December Newsletter

Click here to see our latest newsletter.

Arial View of the New Church in Cofradía

Youth Summer Camp

The report for our youth's summer camp is up on Amber's blog. Click here to see what happened...

Knee Injury

It was my first time back to the youth group with the Students. We normally have about an hour to hang out, play games, and talk. We were playing volleyball and I jumped up to hit the ball, fully extending my left leg. When I came down the leg was still fully extended and it twisted out of place, then right back into it's place. That hurt! It started to swell up minutes later so I had someone get some ice for me. After about 20 minutes, I started to feel light-headed, so I had Brad Pembleton who was visiting us, take me home. I rested the leg, put ice on it, and elevated it for a while. It continued to swell.

My first chance to see a Dr. was the following Friday. Great Doctor. He tested my knee twisting it around trying to bend it ways it shouldn't bend and found where the pain is (go figure). He immediately called it a Medial Meniscus Tear and wouldn't know how severe it was until he was able to look at it with an arthroscope.

I began to do some research on the internet and found a couple of sites about Knee Injuries and Meniscus Tears that supported what he had explained to me. I had pretty good confidence this guy knew what he was talking about. It is his specialty.

Twenty years ago when I blew out my right knee, I never got a "second opinion" and when the Dr. finally did the arthroscopic surgery, he found out that it wasn't just a sprain but an ACL tear, much more serious! I waited 9 months to have that surgery because of the original diagnosis.

So, I decided that I would have a "second opinion" this time and we went to see him last night. Great Doctor also. He took out of my knee over 50ml of water to take some of the pressure away--one reason I was unable to bend it very well. He found that the medial collateral ligament was slightly damaged, but nothing serious. He hesitated to say that it was the meniscus and asked me to come back in two weeks after taking some pain and anti inflammatory medication.

Is the first Dr. that good to know that it is the Meniscus and there is no need for a second visit, but surgery is needed to find out more?

Is the second Dr. taking wise precautions in case surgery is unneeded?

If I go with the first Dr., I could probably have surgery next Monday which would give great time for healing before all the Christmas and New Years events.

If I go with the second Dr. and later suggests that I need surgery, that's pushing surgery back to the first week of January...that's possibly another two months on crutches!