Fix My Knee

Stop me with the end-of-year blogging! Inspired by Wendy's latest entry at Pound, here's a brief recap of 2003:

January: Whined about old job. Started Spanish lessons at Berlitz.

February: Shacked up with D!

March: Whined about old job.

April: Started tap dancing! Found fabulous new job! Went to Paris where I consumed multiple pains-au-chocolat and learned how to say "corkscrew" in French. April was a banner month in '03.

May: Went to Canada for Sirrah's thesis defense. She rocked. We partied.

June: It rained. Then it rained some more. I turned 29 the day Harry Potter 5 was released. We went to Barnes & Noble for the spectacle. D took me to Daniel for my birthday: Best meal I've ever had.

July: Saw a Leonard Cohen tribute in Prospect Park. Then headed off to Barcelona (and outlying areas) with BFF Sara. Rendez-vous with Aaron & Linley.

August: Went to Maritime Canada with Sunny. Spent a couple of days in Halifax and PEI. Ate lots of lobster. Went here. Celebrated 2 year anniversary with D.

September: D turned 35! Tee hee! Had a fight with a branch in Prospect Park. The branch won.

October: Knee surgery. Post-op physical therapy. Leg bending. Spent a good amount of time with my friends Ben & Jerry. See archives.

November: Ditched the crutches. See archives.

December: Celebrated an uneventful Christmas in Canada. Realized I'm boring. Made New Year's resolution to talk less about knee.

This morning at PT I started jumping. Not a lot, and not high. I stand sideways with one foot on a step, then jump so the other foot is on the step and the first foot is on the floor (on the other side). It's a pretty common exercise I remember from doing step aerobics. I did three sets of 30 seconds each of those.

Next I stood facing the step, and jogged up and down (leading with my right/ACL leg). Three sets of 30 seconds there, too. Melissa is off for a couple of days and the clinic was quite busy. I had a different therapist, Robin, do my stretching. It, um, hurt. But, my heel hit my butt on two out of three bends, which is pretty rockin'.

Yesterday's entry was kind of pissy, eh? Well, not everything that came out of this surgery was bad. No, really. David and I are closer than ever. We spent a lot of time together right after surgery, and a lot of that was time where I needed him more than I would have otherwise. In our case that's a good thing, because sometimes I'm too independent for my own good. I also spent a lot of time with my mom. More time, in fact, than we've spent together over the past seven or eight years. And it was so good. A few people have asked me if her staying with us for 10 days was too long. You know what? It wasn't. I'd do it again in a heartbeat. Only next time I'd get a better bed for her to sleep on - the couch can't have been all that comfortable. A side effect of her staying with us is that she and David got to know each other better, and they like each other! Or else they both put up a really good front for my benefit. That works.

Happy New Year! I hope everyone reading this blog (all two of you)takes good care of their knees in 2004!

Last night at PT Alison pushed my heel to my butt. I wanted it to get there before January 1, which meant I had two sessions in which to do it. When I told her that was my goal, she took no prisoners. It hurt, but woo hoo!

I don't know if anyone is still reading this blog... Maybe Candace (hi Candace!) and David when I tell him I've updated it. Anyhoo, Merry Christmas and Happy New Year and all that.

I was home over the holidays and realized that I've become quite boring in the past few months. All I have to talk about is my knee, and surgery, and the suckiness of knee surgery. But hey, that's been what I've been doing this year. Before that was kickboxing, and tap dancing, and lots of yoga and weight training. There was running, and a plan to do a triathlon in the Spring or early Summer. Now there's rehab, and range of motion, and ACL lingo (I'm almost 3 months post-op autopatellar graft with meniscal repair). There are titanium screws and atrophy. There's stiffness and swelling. There's a brace that gave me hives. There's ice, lots of ice. There's also been some self-pity, and even some questioning of friendships. It isn't chronic, and I'll be back to full activity within a couple of months, but this surgery and rehab are definitely the most difficult things I've ever had to deal with personally.

'Tis the season for introspection, I guess.

Per the good doctor Nestor, I'll start a running program in January. I'm also going to join the Y in Park Slope, and start swimming. I'll do PT 2x/week, Tuesday & Thursday mornings, and hit the Y at least once over the weekend.

As for Fix My Knee, I'll try to update weekly or so, mostly for my own record of PT milestones.

From yesterday, 12/29:

Elliptical: 10 min. warm-up
Leg Raises: 5lbs, 2x15 each way
Hamstring Curls: 75lbs, 2 x 15
Leg Press: 95lbs, 2 x 15
Wall Slides: 2 x 15 with 8lb weights
Quad Lowering: I stand on the step with my right foot and lower gradually until my left foot almost touches the ground, then raise back up. 2 x 15
Balance: Standing on a UFO-shaped air pillow, 3 x 30 seconds (this is *hard* - I'll add the ball throwing when I can just stand for more than 10 seconds)
Squats: Standing on a teeter-totter type apparatus, I balance in the middle, then squat. 2x15
Retro Treadmill: 10 min. (backwards)

+ stretching and range of motion (heel to butt!)

No really, he said it.

I saw Dr. Nestor this morning. He said the scar looks great and my knee is "solid." He was very pleased. I told him I'm at about 130° degrees, and he said I'd probably get 5-10° more, and that his wife (who apparently has also had the surgery - aww!) still complains that she can't fully bend her knee. I'm confident that once I start yoga again I'll get more flexion. I asked him about activities - he said I'll probably start running in PT in the new year, and that I could cross-country ski on flat terrain, wearing the brace. (He also said I should wear the brace when I start running, which I don't think Melissa is going to be crazy about.)

So, no more brace except for possibly hazardous activities (walking in snow and ice qualifies). Also have good news on the itching front - it seems the Rx from the dermatologist has done the trick. Probably not wearing the brace helps too.

PT update:

Elliptical: 10 min. warm-up
Leg Raises: 3lbs, 2x15 each way
Hamstring Curls: 45lbs, 2 x 15
Leg Press: 95lbs, 2 x 15
Wall Slides: 2 x 15 with 8lb weights
Step-ups: 2 sets of 15 - these have improved drastically
Balance: 2 x 15 ball catches, now standing on this half-football shaped thing that's a little more wobbly than the cylindar
Retro Treadmill: 10 min. (backwards)

+ stretching and range of motion

It's hard to believe, but surgery was 9 1/2 weeks ago! The time is split up in my head: The first 6 weeks of crutches, and the 3 1/2 weeks since. Each chunk of time on its own seemed like an eternity.

Went to see a dermatologist today about the hives, and other general itching I usually have this time of year. She gave me a prescription and recommendations for an oatmeal bath and a moisturizer, and said that she wouldn't conclude that the itching around the brace was necessarily a reaction to the brace (especially since there wasn't much itching, and I don't have a history of skin reactions).

Nothing new to report from PT this morning. I've been approved by my insurance company for 8 more visits. I plan to go 3x/week until Christmas, then maybe reduce to 2x/week in January. At that point I'll probably join a gym as well and do more strength training on my own. I'm ready to get this leg back into shape!

Even if you're not in this part of the planet you've probably heard about the ol' Noreaster that blew in yesterday. It dropped several inches of snow over the past two days. Yesterday morning when I got off the subway on my way to work the snow was just starting, and it's barely taken a breather since.

I went outside at lunchtime yesterday sans brace. It doesn't fit under most of my pants, and changing my clothes all the time is just a pain in the ass. The sidewalks were really slippery. I was careful, and ran my errands without incident, but decided then and there to play it safe when there's snow. David even called me in the afternoon to warn me about slippery sidewalks. (He knows I'm tired of wearing the brace all the time.)

Had PT after work yesterday. I increased the ankle weight to 2.5lbs, and hamstring curls to 55lbs. We added one exercise: I stand facing a wall that has a resistance band at knee level. With the band wrapped around my leg at knee level, I bend and straighten my leg. The band provides resistance when I'm straightening, and that'll help my quad. Two sets of 15 of those.

The patellar resistance sucks. One of the therapists told me yesterday that I'll feel it more when my quad gets tired. I noticed it going up a flight of stairs yesterday. Speaking of stairs, I'm getting better at descending, but it's still choppy.

Christine just sent me this really wonderful story about her 5-year-old son, Christopher:

"I wanted to tell you a cute story about my son: Christopher.

He has been seeing me icing my knee all the time and wanting to help to make me feel better and recover faster.

Yesterday when he arrived home from school, both of his coat pockets were totally wet. I asked him what happened Christopher? How come your pockets are all wet?

He said, oh look in the pocket mommy I brought you some ice for your knee :)

He was so cute, when they had their afternoon break and they were outside he collected ice for my knee...of course he did not realize it melted."

Isn't that so great?

Most of the discomfort I have these days is around my kneecap (aka, my patella). The graft to reconstruct the ACL came from my patellar tendon. The surgeon cuts the middle third of the tendon out to create the new ACL. As the patella heals (unlike the ACL, the patella does self-heal), lots of scar tissue builds up. The scar tissue can block the movement of my knee, or make it feel like it's "sticking." It's uncomfortable at best. Mostly this happens when I'm doing something that involves a lot of bending and straightening of my leg, like hamstring curls.

Allison worked with me today and showed me how to massage the patella to loosen it and break up the scar tissue. Under normal circumstances the patella moves around quite a lot (we can see this on my left leg). The movement on my right leg is much more limited, so the goal is to increase that movement.

The spots near the top and bottom of my incision are particularly tender these days. Allison told me that's because small pieces of bone are removed from those spots to create the bone plugs used in the ACL recon. Interesting. Massaging those spots will also help them feel better, so there will be lots of knee massaging at home. Very romantic.

We increased the leg press to 85lbs today, added 5lb hand weights during the wall slides, and added a set of ball catches. During flexion Allison told me I'm limited not by the joint flexibility but by pain. In other words, I'm a wimp. So another thing to be doing more of at home is bending the goddamn thing. I think David likes helping with that, in a twisted and sadistic way. Also romantic.

In addition to the usual routine, we mixed things up a bit today.

For balancing, I stood on the half-cylindar, threw a 5lb ball against a trampoline that's leaning against the wall, and caught it. The catching is the hard part, of course. Did 2 sets of 15 of those.

Then onto the treadmill! Allison set it to a 15° incline, and I walked backwards, kind of squatting down, taking long steps. This exercise builds the quads. It was harder than it looked. I did the full 10 minutes, and I was sweating afterwards. So my whole session went:

Bike: 10 min. warm-up
Leg Raises: 2lbs, 2x15 each way
Hamstring Curls: 45lbs, 2 sets of 15
Leg Press: 75lbs, 2 sets of 15
Step-ups: 2 sets of 15 (going over, leading up with my right leg and down with my left)
Balance: 2 sets of 15 ball catches
Retro Treadmill: 10 min. (backwards)

Then stretches: calf, hamstring, and the dreaded extension and flexion. Allison thinks it's okay for me to do yoga, to the point where it hurts. She said it will help my balance and strength, but noted that I will tire quite quickly, especially during poses where I'm relying on my right leg.