Two people on the journey to recovery

Registration

The names have been changed but the stories are real: it was a chance meeting at the reception desk that brought Hans and Peter together. Their own experiences had sharpened their gaze. “Pain?” “Yeah, you too?” “Yeah.”

Between colleagues and fellow sufferers, there wasn’t much more to be said. “Playing sport?” “Yeah, during training, you?” “During a match.” There was just enough time left to share the last important piece of information: “I got injured playing football” – “For me it was playing handball.”

Then the two men were finished registering and staff promptly took care of everything – afterwards, both Hans and Peter stressed how friendly and unbureaucratic the whole process was. It took just a few minutes for Hans‘ suspicion that he had a hernia to be proved correct and he was welcomed into Andreas Schlüter’s consultation room. Peter was worried about major damage to his right knee and was seen by Dr. Karsten Reichmann.

Examination and diagnosis

Karsten Reichmann was at the game on Saturday when Peter carried out a counterattack, jumping up to throw the ball. “When I landed, my right knee overextended.” Reichmann manually examined Peter’s knee while they were still in the sports hall and shared his concerns, which he then confirmed during his monthly consultation. But Reichmann wanted to be completely certain. Whilst he was still examining Peter, the friendly administration staff organised an MRI – for tomorrow morning.

Images in hand, Peter had his next appointment with Dr. Reichmann the very same Tuesday morning – Dr. Reichmann strongly believes in treating his patients in a swift and timely manner. “The quicker the examination and treatment, the greater the success. And that means patients can get back to going to work and playing sport all the faster.”

The MRI confirmed the suspected diagnosis: torn anterior cruciate ligament, torn lateral collateral ligament and medial collateral ligament, damage to the medial and lateral meniscus, bone bruising. “Major damage” had turned out to be complete damage. But it was complete damage that could be repaired. “See you tomorrow,” Karsten Reichmann told his patient, “for the operation.”

Around the same time on the very same Monday, Andreas Schlüter also completed the initial physical examination. Hans’ suspicion had been right. Four years ago, he’d had a hernia on his right-hand side, now it was on his left, and it’s an injury which requires surgery. If the bowel is trapped in the hernia, it can be life-threatening. As such, “time” is also a crucial factor for Andreas Schlüter when considering treatment. “We don’t want it to come to emergency surgery.” After a thorough examination and an in-depth discussion with the patient, there’s a little more room for manoeuvre with this injury. If the patient has a business appointment, or any other important arrangement, surgery can be postponed under certain conditions.

In the meantime, clinical staff have also arranged an MRI scan, so Hans can rule out an inflammation of the pubis. After an examination on Thursday, it was confirmed that there was no inflammation present. “That’s lucky,” said Hans, having had his share of bad luck, and he could make his way back home for the meantime - his surgery was scheduled for Monday.

The operation

Peter was admitted to surgery in the Zentralklinik on Tuesday morning, a clinic affiliated with Dr. Reichmann and Mr. Schlüter’s practice. Anaesthesia staff informed him at length and prepared him for his anaesthesia. Then off he went into the operating theatre, where Dr. Reichmann, an operating assistant, anaesthetist and three operating theatre nurses were ready to perform the procedure.

Karsten Reichmann is a specialist in knee injuries and he has sat in on many colleagues both during and after his studies. He is proficient in all common, and even more seldom used, surgical techniques, such as posterior cruciate ligament reconstruction and cartilage transplantation. He had done the preparations for Peter’s surgery the evening before, just like he does for every operation. The plan for the procedure was in place and both the appropriate instruments and necessary screws and pins were ready to be used. Dr. Reichmann and his entire team knew what needed to be done. In this sense, there’s no difference between small and largescale operations, surgical procedures which are easier or more complex; every case calls for thorough preparation and high levels of concentration.

Andreas Schlüter performs around 200 hernia operations per year. He is more than proficient in various surgical techniques – open or laparoscopic, using the Lichtenstein repair or the TAPP technique. He had already discussed the most gentle and most promising methods with the patient, as well as clarifying whether it is appropriate to operate on the hernia using mesh made from matter foreign to the patient’s body, or whether the opening will be closed using connective tissue.

In Hans‘ case, both doctor and patient agreed upon open surgery using mesh. Hans was also well prepared for his procedure, just like his fellow sufferer for his knee operation. But this isn’t all completely new to him due to his previous injury. “Schlüter performed the operation so well back then that going back to him didn’t come into the question.”

Hans was wheeled into the operating theatre where Andreas Schlüter, an anaesthetist, operating assistant, two operating theatre nurses and a nurse specialising in anaesthesia were waiting, each with vast amounts of experience. Every patient is unique – this isn’t a routine process.

Post-operation

Both operations were successful and Hans and Peter were taken directly onto the ward where they’ll receive round the clock care from the nurses and doctors. Hans has a rather large appetite and enjoys pretzels and coffee before the usual evening meal. Karsten Reichmann and Andreas Schlüter look after their patients personally, explaining the procedures and how they went.

Hans‘ hernia was covered with mesh. Andreas Schlüter levelled and removed the omega-shaped bulge above the hernia, in turn eliminating the risk that the bowel could get trapped, as well as the source of the patient’s pain and his restricted capacity to physically function.

Meanwhile, Peter learned that his torn cruciate ligament had been replaced by a ligament from his own body. Karsten Reichmann had mended the lateral collateral ligament and medial collateral ligament, the damaged menisci had been smoothed down and stitched up and one piece had to be removed.

By this time, both doctor and patient were practically greeting each other like old friends. “That’s the advantage of being treated in such a practice and clinic,“ both Hans and Peter pointed out. “Doctors know their patients, treating and caring for the same patient from the first consultation to the very last.”

Hans and Peter were free of their drainage tubes the day after the operation. Both the “completely damaged” patient, and the hernia patient, were able to be discharged, but only after being properly prepared by their doctors. “The operation is only the halfway point on the journey to success,” both Karsten Reichmann and Andreas Schlüter are aware of that fact. The other half depends on the willingness of the patient to work in harmony with the subsequent rehabilitation process.

After being discharged

Hans and Peter tentatively performed the first physiotherapeutic exercises in the clinic. Doctors and nurses didn’t just examine the patients in bed, rather they gave them advice on how to walk properly, for example. It goes without saying that both patients received in-depth information about what they should do, what they can do and what they will do in the following weeks, all in collaboration with physiotherapists. Naturally, Karsten Reichmann and Andreas Schlüter liaised with the therapists on request in order to discuss further methods of treatment and recovery.

In this vein, both doctors continue to support their patients. Hans and Peter have long since had their staples and stiches removed. Hans had to remain inactive for four weeks, but in the meantime, he could carry out his pre-arranged physiotherapeutic exercises. After three more weeks, he can perform his first sprinting exercises and try out his ball skills once again. When the season enters into its decisive stage, he’ll be confident that he can back up his teammates on the pitch. Not least thanks to the help and skill of Andreas Schlüter.

After having his completely damaged ligament repaired, it’ll take a little while longer for Peter before he’s able to play the contact sport of handball once again. Nevertheless, he was already on an exercise bike three weeks after surgery, having begun to work on his mobility just one day after his operation. He started to work on training specific muscles a few weeks later and after four months he went on a long and rather demanding run for the first time after his operation. He is constantly supported on his way to recovery by check-ups from Karsten Reichmann. His goal is within touching distance – restore the movement and muscles that Peter put into play before each counterattack. And in the interest of telling the whole story: when he got injured, the ball was in the goal.