Fix My Knee

Psst. Looking for me?

2004-05-14T22:13:00.000-04:00

I started a tri blog. You can find it here: http://nicetri.blogspot.com. Training schedules will be predominant (I expect there'll be some whining, too), and I'll throw in general life updates as well.

Long Time No See

2004-04-29T09:14:00.001-04:00

Hi.

It's been a while.

This might be the last Fix My Knee post... at least for now.

A few things to update. First, I had an appointment scheduled with Dr. Nestor at the beginning of April that I missed. Forgot. Totally slipped my mind. Terrible, right? Nope, I think it's pretty freakin' great, actually. Because I'm not preoccupied with my knee anymore! I don't have pain at all, and only a little stiffness sometimes. I'm completely active again - this week I did yoga on Sunday (with David!), a spinning class Tuesday, weights yesterday, and this morning I jogged a little. (Jogging's a little harder, and my knee is sometimes a little hurty.)

I did reschedule the appointment with Dr. Nestor, and saw him two weeks ago. Pretty much nothing to report... He's happy with my progress, and I can return to regularly scheduled programming now. He did mention that I could stop wearing the brace except for new activities, which I thought was a little funny because I haven't worn it since December. Shh.

But before that: I'm going to do a triathlon! I signed up last weekend with Team In Training, run by the Leukemia and Lymphoma Society. Training starts mid-May, and the race is on September 26th. It's Olympic distance, which means .9 mile swim, 25 mile bike, and 6.2 mile run. I'm so psyched. I'm also going to be fundraising, so watch your mailboxes for those letters.

I'll probably start a training blog, and when I do, will post the URL here. For now, though, it appears Fix My Knee is on hiatus. Thanks everyone for reading, I couldn't have done it without you.

Whew!

2004-03-04T10:37:00.000-05:00

Things to report... Cara, the girl we met in the last entry, is fine!

"It turns out that the anatomy of my knees is such that my kneecaps - -
both of them - - have a born desire to dislocate (ask me about my Q
angle, if you’re curious), and the bang I gave my right knee at 15 was
what gave that kneecap the path to dislocate at whim. The doc pretty much
dislocated my “good” left kneecap as a demo while I was lying there on
the table, much to my shock."

Hm. More things that can go wrong with the knees, which as Candace pointed out to me a while ago, are way behind in evolutionary terms. I received another email from Cara last week, and from the It's A Small World department, she has the same physical therapists as I do!

Speaking of PT, I squeezed 3 more visits out of my insurance company. Pretty unnecessary at this point, but still useful for information. Melissa said I'd be OK to start jogging, and so far David & I have gone once. I lasted for less than a mile before my knee started hurting. That's a question for Dr. Nestor when I see him in April: How much should I push through the pain?

I'm thinking about doing my first triathlon in June. At some point this might turn into a training blog!

Happy Day-After Valentine's Day! And, Hi Cara!

2004-02-15T17:25:00.000-05:00

On Thursday night after tutoring, David & I were riding the 6-train home. At one of the downtown-ish stops a girl got on the train, and as the train started moving she twisted her knee - hard. It was like déjà vu! Several people asked if she was OK, and she said she'd dislocated her knee, and that it hadn't happened in years. We got off with her at the next stop (Astor Place), which has a Kmart conveniently located right off the station. She bought an ice pack and an Ace brace, and we packed her into a cab and sent her home (to Park Slope, of all places).

Today she called to thank us, and I gave her the link to this blog. As I was giving her the info, David was mouthing, "Tell her yours was the meniscus, too!" Because, yeah, this site was soooo depressing! Anyway, hi Cara! It really, really isn't that bad. I'm 4 1/2 months post-op and I went to the gym today, did a full workout, and even swam a little! And really, who cares if you can't run in the park when it's -4°C.

Denied

2004-02-06T12:28:00.000-05:00

Well, it finally happened: My insurance company is denying coverage for further visits to physical therapy. I called them this morning and I have to file an appeal. I'm putting that together today. I've also been warned that the appeal can take up to 3 weeks to be resolved, and during that time while I may opt to pay out-of-pocket, I might not be reimbursed.

Dr. Nestor's office will fax me a letter of medical necessity, and I've already called my primary care physician for another referral. Besides a whiny letter about not yet having my quad back yet, I'm not sure what else to include in the appeal.

My last covered visit is tonight. I'll talk to Melissa then about what I should do, both about the appeal and about ongoing therapy, and perhaps she can give me a regime to tide me over until I can (hopefully) resume treatment.

Wish me luck!

Virtual Knee Surgery

2004-02-04T16:21:00.000-05:00

A co-worker just sent me this excellent Flash movie! Check it out!

4 Month Anniversary!

2004-02-03T11:05:00.000-05:00

It's been exactly four months since surgery. I feel fantastic. Rehab is going swimmingly (literally - I started swimming!).

The weekend in Toronto was awesome. On Saturday morning my cousin Katherine & I went swimming, and she taught me how to do a proper front stroke (she's a lifeguard and swim instructor). Sunday morning I woke up early to work out in the hotel gym - I ran on the treadmill, then did wall slides, lunges, and leg press. Not a complete session, but pretty good for having squeezed it in.

Yesterday morning I saw Dr. Nestor. He is very happy with my leg at this point, even my quad. I bit the bullet and asked him about my left knee, which also has a torn ACL. He checked the MRI results (from two years ago, when that knee was bothering me) and did a clinical exam of my knee. He is recommending that I have the left knee repaired as well. I'm going to think about it, and if I do decide to go for it, I'll schedule surgery for late-Fall (so I can at least enjoy the summer!). Rehab for my left knee will be easier, as without the meniscal repair I'll be allowed to weight-bear immediately following surgery. My mom already offered to come again, even!

I see Dr. Nestor again in April. I'll continue rehab until then, and after that I'll likely be on my own again! I'm already planning to train for a triathlon or two this summer - that will also help me get in shape for the second surgery, if I decide to have it.

Happy Birthday Mom!

2004-02-02T13:40:00.000-05:00

Lazy Week

2004-01-28T22:33:00.000-05:00

I'm tired.

I just called PT to cancel tomorrow morning's 8am appointment. Work has been super-busy lately, and I have volunteer tutoring tomorrow night that I'll need to leave by 5:30 for - and right now I can't fathom a 12+ hour day.

I have aspirations of at least jogging a little bit at the hotel this weekend, but we'll see. David called me on my lunge-promise today. Hi, David! See, I do mention you!

When I was looking up the number to cancel my appointment, I found pictures of my therapists, Melissa and Alison. They rock!

Bad Hair Day

2004-01-27T09:38:00.000-05:00

I woke up at 7 this morning to get to an 8:40 PT appointment, that was CANCELLED because the gym was closed due to a water main break on 8th Ave.

Of course, today was the day I decided not to blowdry my hair before PT because the amount of sweating I do necessitates a shower after my appt anyway, so I can blow it dry then. Except when my appointment is CANCELLED. It's good that I at least decided to shower before I left the apartment this morning.

Right. I know, this entry is only tangentially related to my knee.

Aside from the hair thing, the cancellation means I'm going to have a pretty sedentary week. I'll only have one PT appt (Thursday morning, if the water is fixed by then), and I had to cancel yoga because I'm going to Toronto this weekend for my mom's 60th birthday. I'll have to work in some lunges at home tonight to make up for it.

Jogging

2004-01-21T22:21:00.000-05:00

My warmup at PT now consists of 3 minutes walking, 10 minutes (!) jogging, then another 3 minutes walking. When I first start jogging (at 5.5 mph) I find my gait is a little awkward, and I'm pretty sure I'm favouring my right leg. It gets comfortable after a few minutes.

The other night I had a really weird experience. I woke up to feed Memphis and walking back to bed, my knee *hurt* - there was a sharp pain on the inside of my knee. I went back to sleep, and when I woke up, it was fine.

Saturday I started yoga. The instructor, Jill (who's actually a Jillian too!) is really great. It's a type of yoga that I've never practiced before (and I must confess I don't remember what it's called), but it's very similar to Hatha (which I've done lots). I was surprised at how flexible I am now - my knee bends without any problems. It's still tender to kneel, so for kneeling poses like Child's Pose I had to put a pillow under my knees. It went very well, and I'm looking forward to working with Jill more.

Speaking of flexibility... I can now get my heel to my butt without help! At PT I use the strap to pull my foot forward, and I can even grab the top of my foot and pull it further. It's kind of surreal.

PT today:

Walk/Jog: 3/10/3 min. warm-up
Leg Raises: 6lbs, 2x15 each way
Hamstring Curls: 75lbs, 2x15
Hack Squat: 2x15 (just the bar, no added weight)
Wall Slides: 2x15 with 12lb weights
Quad Lowering: 2x15
Balance: UFO-thingy with ball throwing (2x15)
Wobble Squats: 2x15
Reverse Lunges: 2x15 (with each leg)
Shuffle: 6 (back-and-forth counts as 1)
Grapevine: 6
Side jumps: 3x30 seconds
Jogging up: 3x30 seconds
Hopscotch (new!): Standing with feet shoulder-width apart, I jump forward (feet together) then forward again (feet shoulder-width). Then I spin around, sort of, so that I'm facing the other way and my left foot is where my right foot was (and vice-versa). 3x30 seconds. This one's pretty fun, but also a little dizzying.

On The Brace

2004-01-14T17:18:00.000-05:00

In my last appointment, Dr. Nestor told me that I'd soon start a jogging program, as well as more lateral movements, in PT. He ALSO said that I'd start these activities while wearing the brace.

I haven't been wearing the brace.

I did mention to Melissa that I'd been instructed to wear the brace, at least initially, for running and shuffling/mobility exercises. When we started these activities, neither of us brought it up. In fact, while I've followed every other one of Dr. Nestor's protocols religiously, this is the one thing I'm consciously ignoring. I haven't had any instability, and Alison did say my form and stride were good when I was running yesterday. My knee doesn't hurt after the exercises, either, so I don't think I'm straining anything.

But that's all speculation. I certainly don't have a PhD in orthopedics.

Today I found a link to this article, and any traces of doubt I had about my braceless self were alleviated.

"The AAOS believes that after ACL reconstruction, there may be a role for rehabilitation braces used in the early post-surgical phase, but functional braces used later during recovery appear to provide no added protection to the knee following a well-performed reconstruction.

Types of braces other than prophylactic knee braces have different structural designs and have been developed to help treat specific problems stemming from injury or disease.

Rehabilitative knee braces have been designed to provide a compromise between protection and motion. There is some evidence that use of these braces in the initial post surgical period may improve early functional outcomes. The majority of scientific studies show no difference in final outcomes of anterior cruciate reconstructed knees, whether a brace is worn or not. The overall long-term outcome in all studies reviewed was good. Thus, it does not appear that a brace is needed to support or protect a reconstruction in a well-done surgical procedure. Questions remain as to whether a brace would be useful to support the knee in patients with anterior cruciate ligament reconstruction in special cases (e.g. weakened tissue, collagen disorders, suboptimal fixation). Since studies to date indicate that these braces neither improve nor degrade the long-term results of anterior cruciate ligament surgery, they should remain in the armamentarium of the orthopaedic surgeon for discretionary use."

Almost forgot...

2004-01-13T22:59:00.000-05:00

I also did reverse lunges today! I was wondering over the weekend when I was going to start lunges, and then Alison noticed today that I haven't been doing them yet! Did 2 sets of 15 (no weight), and will probably add forward lunges next week.

Since all the new stuff this morning I haven't experienced any new pain or discomfort. I'm pretty happy about that.

Leaps and Bounds

2004-01-13T11:01:00.000-05:00

Kind of literally, actually.

Today's PT went something like this:

Elliptical: 10 min. warm-up
Leg Raises: 5lbs, 2x15 each way
Hamstring Curls: 75lbs, 2x15
Hack Squat: 2x15 (just the bar, no added weight)
Wall Slides: 2x15 with 10lb weights
Quad Lowering: 2x15
Balance: UFO-thingy with ball throwing (2x15)
Wobble Squats: 2x15
Shuffle: 6 (back-and-forth counts as 1)
Grapevine: 6
Side jumps: 3x30seconds
Jogging up: 3x30seconds
And...
JOGGING! Real, honest-to-god, jogging on the treadmill. Intervals (1 min walk, 2 mins jog) for 10 minutes. Aw yeah. I've been advised to pay attention to my knee over the next couple of days (my next appointment is Friday). We want to avoid any patellar tendonitis, so if it's uncomfortable, we might postpone more jogging for a while.

Be It Resolved

2004-01-08T10:53:00.000-05:00

"Let us resolve differently. Let us resolve in ways we have yet to imagine. Small but insanely potent. Pinchable but wildly deep. Frugal but wonderfully expensive.

"This is the year you make small but omnipotent differences. This is the year you pay for the person behind you at the toll booth, just for the hell of it, because you can, because you have no good reason not to, because, really, what cost genuine acts of sporadic kindness?

"This is the year you celebrate the success of others and be happy for their happiness and work to reduce envy into a tiny shriveled green raisin stuffed way, way back in the corner of the pantry of your worldview. Possible?

"This is the year you do one thing that absolutely that terrifies you but which you know, deep down, is good and vital for your soul. The year you vow to break your own traditions. When you swear to sin, deeply and profoundly, against your own preconceived sanctimony.

"Maybe that means dissolving, like fog in the sun, a cold batch of your bitter religious training. Maybe that means jumping off the high cliff of your most naughty inhibitions. Maybe that means nothing more than no longer living for the sake of someone else's perception of who you're supposed to be. Maybe it's cutting your hair. Joining a protest. Protesting a join. Winking instead of sneering. Swallowing instead of spitting.

"This is the year you open your mind, just a little, broaden your media world, just a little, vary your sources and question the spoon-fed truths and the force-fed fabrications. It is the year we take more personal responsibility. For our actions. For our posturing. For our gluttony and violence and intolerances. Our god cannot beat their god. There is no superior race. We are all immigrants. The clenched fist is not the new American symbol.

"After all, this is all any new year offers: an opportunity. It's nothing more than a number on a calendar, and it is nothing more than a chance to review the recent past and preview the near future and see what we can tweak and reevaluate and hopefully explode into a million tiny glistening revelations.

"Because this is the year of the follow through, the year you stop telling yourself you're really and truly gonna do that thing you always said you were gonna do and instead stop thinking so much about it and just stand up and put on your pants and make the necessary calls and take a deep breath and get the hell off the couch of self-doubt and do it."

Mark Morford

Shuffling

2004-01-06T14:28:00.000-05:00

New today: Shuffling. And grapevining. Shuffling and grapevining. Coming soon: Jogging (!).

Next week I start yoga. I found someone on craigslist who lives near me, and is taking one-on-one students at a really low rate to get hours for her certification. It's been almost four months since I've practiced, save the occasional downward dog avec brace. I'm looking forward to it. Except the getting up at 7am part.

2003 In Review

2003-12-31T14:22:00.000-05:00

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.

Jumping into 2004

2003-12-31T11:59:00.000-05:00

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!

Kickin' My Own Ass

2003-12-30T11:27:00.000-05:00

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!)

A+

2003-12-17T13:11:00.000-05:00

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

9 1/2 Weeks

2003-12-09T14:29:00.000-05:00

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!

Brace for Snow

2003-12-06T22:56:00.000-05:00

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.

Christopher

2003-12-04T12:05:00.000-05:00

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?

Massaging my Patella

2003-12-04T12:01:00.000-05:00

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.

It's all about the physical therapy

2003-12-01T20:42:00.000-05:00

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.

Leaps and Bounds

2003-11-25T13:17:00.000-05:00

Quick update from PT yesterday...

Flex: 125°+! Dig my bad self, yo.
Leg Raises: 2lbs on my ankle
Hamstring Curls: 45lbs
Leg Press: 75lbs

Also did 10 minutes warmup then 40 minutes post-PT on the bike. Rock and roll.

Go Christine!

2003-11-24T15:59:00.000-05:00

I just received email from Christine, who at 13 days post-op is already at 150°! That's hardcore. Way to go, lady!

Yesterday I went for an actual walk. It was great! We probably walked about a mile. It was an absolutely gorgeous day here - in the 60s and sunny. My knee was a little sore and quite swollen last night, but it was so great to go outside and go for a walk.

Have PT tonight and Wednesday after work. I'm planning to stay and do cardio & upper body workouts after my sessions. Also, I'm going to get Melissa to measure my flexion. I've been having David help me out at home, and I'm hoping I'm past 120° by now. I'm probably starting some new stuff in PT tonight, like for balance I'll be not only standing on the half-cylindar, but tossing & catching a ball while balancing.

Today I read some interesting posts on the ACL board about depression. I'm far from depressed right now, but I was pretty bummed in the few weeks following surgery. I don't think I even realized the extent of it until recently I sent a link to this blog to a couple of friends I haven't heard from in a while. Both wrote back, "Wow! You've been through hell!" Hm. I guess the first week or two really sucked, but overall I feel great now.

Day 48

2003-11-20T16:47:00.000-05:00

Wow, it's been almost seven weeks since surgery. People keep telling me it seems like it went so fast. Not to me. That first week felt like a year.

A few updates. The new PT clinic is awesome. Melissa is awesome. Alison (one of the sports medicine assistants) is awesome. It's a high-energy place, and I have no regrets about switching. This morning was my second appointment there. We added hamstring curl with weights (30lbs) and leg press (62.5lbs). Melissa also put weight (1lb I think) on my ankle for the leg raises. And I'm now going fast enough on the bike to consistently break a sweat, which is such a great feeling. We tried walking down some stairs, and that tires me out and makes my leg hurt pretty quickly. I'll keep practicing at home, with the brace on. Before I left today, Alison cut me a compression sleeve to wear under the brace, which may help with the hives.

I saw my PCP today to get the PT referral. Had a physical, all systems go. Also got a flu shot. Oh, and I asked him about the potential brace allergy. He hooked me up with some Allegra, so I'll see how that works out over the next couple of days.

This week I've been taking the subway to work and cabs home. Tonight I'm meeting D after work, so we'll probably take the subway home together. I'm really happy to be returning to regularly scheduled programming in my life. I've even found myself forgetting a couple of times that I have to be careful - like, on Monday night, I started running for a cab. Oops. (Fortunately I realized very quickly that I can't run yet!) I'm still quite tired, but not having any after-work activities like tap dancing or kickboxing gives me plenty of time to go to bed early.

Allergic?

2003-11-19T14:58:00.000-05:00

I think I might be allergic to the new brace. No, I'm not being cute. The past couple of mornings I woke up with hives all around my knee, localized to where the brace sits. Coincidence? I've never had an allergic reaction to a cream or fabric, and the brace doesn't seem to be made out of anything that radical, but who knows. I posted the problem to Bob's ACL WWWBoard and received an interesting response - it seems someone else had a similar problem with the Breg X2K.

I have an appointment with Dr. Nestor again on December 17. I'm going to try to stick it out with this brace until then, because if I do change I'll likely need another Rx anyway.

Hoops

2003-11-18T13:49:00.000-05:00

I started PT today at Pro-Fit in the Equinox gym on Greenwich Avenue. My therapist is Melissa, and she rocks. She did an evaluation (said my extension is good, gait is good, and again I made it to about 108° in unassisted heel slides), then started me with exercises. I have a bunch of new stuff to do now, which is fantastic. I started with the bike (10 min.) and leg raises, which I guess will be part of my repertoire through eternity. We moved on to:

Wall Slides: I lean against an exercise ball against the wall, then slide down, keeping my back straight, in a modified squat position (2 x 15)

Standing Hamstring Curls (using a small weight) (2 x 15)

Balance: I stand on a half-cylindar with my right foot and balance (3 x 30 sec.)

Step Ups: I step up with my right leg and down with my left leg (2 x 15)

After I finished these excercises she massaged the scar area, and stretched my leg for extension and flexion, as well as my hamstring. She said the flexion is fine, right where it should be.

In addition to PT, my insurance company is graciously providing me with many hoops through which I must jump! Switching clinics was not as cut-and-dried as I'd expected it to be. First of all, unrelated to insurance but still annoying, when I arrived at Pro-Fit this morning, Dr. Nestor's office still hadn't faxed the Rx for treatment. I called them and they were able to send it before my appointment officially started. Next problem: I need a new referral from my Primary Care Physician. Referrals are a pain in the ass. When I initially injured my knee back in September, I had to go to a doctor to get a referral to my OS. My PCP is on the Upper West Side, and since I was pretty immobilized at the time, I found a different doc in my neighborhood, who basically looked at my knee and told me to go see my OS. When I started PT at Park Sports, I don't know what they did for a referral, but somehow Oxford approved the visits and I did receive a letter with the name of my PCP as the referring physician.

Now, Pro-Fit needs a referral for their clinic. I called my PCP, who I haven't seen in over two years, to get the referral. His office said they couldn't give it to me without him seeing me. I understand that's standard, but without the referral today I'll be responsible for the full cost of this morning's appointment. Argh. They'll hopefully fax the referral today anyway, and I have an appointment to see the PCP on Thursday. Who is, of course, inconveniently located on the UWS.

Also, this morning, Melissa told me that I should plan to come twice a week, because she's pretty sure my insurance will run out before we've completed as much treatment as she'd like. I guess ninety visits is the absolute maximum, and they can deny coverage before that is reached. I went to Park Sports 17 times, and so far I've been to Pro-Fit once, for a grand total of 18 visits. That's $270 in co-pays, plus the initial home visit ($130).

Running total spent on PT: $400

Subway

2003-11-17T21:30:00.000-05:00

This morning I rode the subway for the first time since September 21. For anyone reading this who doesn't live in NY, that's a LONG time to go without riding the subway in this city. It's good to be back.

I Go A-Walkin'

2003-11-17T13:17:00.000-05:00

Notice a theme here?

On Saturday morning I walked to PT, for one last session with Lena. It was a good one. I spent about 10 minutes on the treadmill and 10 minutes on the bike. Then went through the usual battery of exercises, and when it came time for flexion, she first put heat on my knee. It really helped. I made it to 113° on the heel slides. Lena told me I could put moisturizer on the incision spot (it was extremely dry, but I wasn't sure whether it'd be safe to moisturize it), and showed me how to push the skin together so it separates from the scar tissue. This will help me avoid having a "pulling" sensation around the scar when I bend my knee. Overall it was a good session.

However, I decided I'm going to try Pro-Fit. I stopped by on Friday to speak with a therapist and check out their facilities. I was sold. I spoke with a really nice woman named Allison (I think) who is one of the sports medicine assistants. The real selling point for me is that the clinic is located inside the Equinox gym on Greenwich Ave., and I'll have access to the gym facilities for an hour before and an hour after each appointment. And, that particular Equinox has a pool! So I'll be able to resume my regular upper-body training, and once I can start swimming, I won't have to pay for a separate facility.

I also checked my insurance over the weekend, and it provides for 90 PT visits per condition per lifetime, which is excellent coverage and more than adequate (I will be going 3x/week for six months total).

I've emailed Christine a few more times, and she's even reading this journal now (Hi Christine!). It's been great to compare notes with her. She's already past 100° - awesome, eh? - and is walking around. We're planning to meet up when I'm home at Christmas, and I'm really looking forward to it!

I can walk... veeerrrrry slllowwwlllyy

2003-11-14T13:23:00.000-05:00

I've spent the past day and a half walking around, slowly but surely. I have to say, I was pretty efficient on those crutches after six weeks! But since I ditched them on Wednesday night, I haven't looked back. The leg is shaky, especially in the evening, and it swells up A LOT. But I'm moving carefully and so happy not to have those damn crutches.

Yesterday was my first PT visit since weight bearing. I WALKED there (woo hoo!) and Svetlana and Boris were both quite surprised that I was allowed full weight bearing right away. Anyway, I started, as usual, with the bike, and rode for 10 minutes at 10-12 mph. Then I did the leg press with my legs on separate pedals, which was very exciting. We lowered the weight to 50lbs each, and it was really challenging for my right leg. No quad, remember? I asked Svetlana to talk to me about stairs, and she said it's best to go one at a time on the way down, at least for a week, but that it'd be OK to walk up stairs in the usual fashion. We didn't do much else - the usual leg raises, and a bit of manual manipulation, most of which I could do myself using a yoga strap (or with David's help).

When I got home from PT, I took off the new brace, and my leg was really red and irritated in a couple of places, especially where the pads grip the sides of my knee. I theorized that the brace is maybe too tight and needs to be adjusted. This morning before work I went back to HSS to talk to Rolando in the Brace Shop about the fit. He checked me out and said that a larger brace would be too loose, and that it's tight because of the swelling. He advised me to keep it off at home when I'm just hanging out, and keep my knee iced and elevated to alleviate some of the swelling. Okey-doke.

While I was at HSS, I decided to swing by the physical therapy clinic they have on-site. At first I wandered into the spinal rehab clinic, and spoke to a therapist there, who walked me over to the sports rehab center. On the way we talked about my therapy, and he said if I'm not happy with what I'm doing, I should definitely shop around and not wait. When I spoke with the sports therapist, he was more neutral. I did get a chance to glance around the clinic at HSS (it's really big and nice), and I grabbed an updated list of HSS-affiliated PT clinics (the one Denise had given me was from last year). There's one at the Equinox on Greenwich Ave. that's run by a guy who used to work at HSS; I'm going to stop by there after work today to speak with a therapist.

Update from Christine

2003-11-13T14:04:00.001-05:00

My Toronto ACL friend called me last night when she was home from the hospital. It seems everything went well, and it wasn't even as bad as she expected. Luckily the optional meniscal repair didn't need to happen, it was fine, so she just had the ACL reconstruction. She sounded to be in good spirits. She has her first physio appointment today, and we'll probably speak after that.

Speaking of which, I have my first walking PT appointment today! Whee! I can't WAIT to walk in there, crutch-free! I've decided to stick it out at Park Sports for a few more visits, to see if things improve now that I can weight bear. It is, after all, ridiculously convenient.

Figleaf

2003-11-13T14:04:00.000-05:00

I forgot to mention this, but when I was waiting for Rick to develop the x-rays yesterday, I noticed that the gonad protectors are Figleaf brand.

Hilare.

I Can Walk!

2003-11-12T18:37:00.000-05:00

This morning I had my follow-up visit with Dr. Nestor. David came along for the ride. We arrived at HSS at 10am, just in time for my scheduled x-rays. A very nice technician named Rick x-rayed my knee in a few different positions. (I was happy to have the chance to bend my knee and warm it up before seeing the doctor.) After the x-rays we moved to Dr. Nestor's waiting area. While we were sitting in the waiting room, I peeked at the x-rays. I have screws! Two of 'em, and they look kind of big - maybe an inch long. It was cool and very Six Million Dollar.

We saw Dr. Nestor at around 11:45. He took off the steri-strips (yay!) and took out two more sutures. He said it's healing nicely. Then he did the "Show me what you've got" routine and I bent to over 105°! He pushed it a little and said he'd give me 108° for today. Then he did some tests (moved my knee sideways, up and down), declared it to be "rock solid," and said I could now fully weight bear! I can walk! He also said I had no quad left. Win some, lose some. I'm also allowed to push the flexion - no more limits there - and should get to the maximum of 130°-140° soon.

We looked at the x-rays together, and he said everything was fabulous. I asked him about the patella (which had the middle third removed for the graft), and he said eventually that will regenerate. The body is very sci-fi. I also asked him what the screws are made of: Titanium. I have titanium screws in my knee! Isn't that cool?

I brought an extensive list of questions, and went through them with him. He had lots of time today, and seemed very happy with my progress. He said the six week guideline of no weight bearing is because often people cheat, and he could see that I'd been religious about protecting the knee, which is fine.

Can I get a smaller brace, or have a brace adjustment? YES! See below.

Can I sleep without the brace? YES!

Can I take a bath?? Not yet, until the scabs fall off.

What should I expect from physical therapy? Can I have a list of other clinics? I got a new list from Denise (see below). I'm going to stick with Park Sports for the next couple of weeks, to see if my therapy steps up a bit now that I can walk.

What's up with the knee-popping? As soon as I mentioned this, he knew exactly what I was talking about. Fortunately my knee even cooperated and popped in his office. He said it's scar tissue, and will decrease as the tissue heals.

What about the fall down the stairs? At this question, D noticed that Dr. Nestor looked a little sheepish. (He hadn't called me back after I left the message at his office.) He said he'd worried about that kind of thing, but it was clear I hadn't done any additional damage.

What's the protocol from here on out? Is there a limit for flexion? Strength? Balance? No limits now - I can safely push the flexion in my knee. Or, my physical therapist can.

After all my questions were answered, he gave me instructions to see Denise to make a follow-up appointment (Dec. 17) and get a prescription for a new brace. Woo hoo! She also gave me the list of HSS-approved PT clinics, so I may check out some other facilities later this week. Unfortunately there's nothing really close to either work or home (except the clinic I go to now).

After seeing Denise I made my way to the Brace Shop on the second floor. A very nice man, Rolando, fitted me for the Breg X2K, the women's model. This brace is hardcore and sporty. It's what NFL players are issued (the Giants team doctor works at HSS, so that's where their players are sent). I actually like it! And, I could walk right away! I was worried that with the loss of muscle in my quad I'd be wobbly, but my leg supports me pretty well. A new question arose at the brace fitting: Can I wear the brace over yoga pants or tights? Rolando deferred to Dr. Nestor on that one, so I'll give him a call about it.

I spent the rest of the afternoon at the office. It's very exciting to walk around, carry things, and open doors for myself. I do notice stiffness sets in pretty quickly, and I may keep an ice pack in the freezer at work. I'm also exhausted, but I'm sure that's emotional as much as anything. I can walk!

Christine

2003-11-11T09:52:00.000-05:00

Yesterday I spoke with some co-workers who've done PT, and asked them about their experiences. I definitely need to shop around. One guy is currently going to a clinic for his shoulder, and the clinic he goes to doesn't charge him the co-pay. (I've already spent over $200 on that, plus the initial visit that was $130.) His clinic is located at Bally's gyms, so he also has access to their equipment during his visits.

I also did a web search for ACL rehab, and found Bob's ACL WWWBoard. People's experiences vary greatly, and much of the variation is dependent on the orthopedic surgeon (OS). While reading through the messages, I came across one from a woman named Christine who is scheduled for ACL reconstruction today (November 11). Her posting described some of the preparations she'd taken, and she mentioned that she's scared, especially of the pain. I wrote back to her privately because I was also totally freaking out the night before surgery, and it really would have helped me to talk to someone who'd recently had the same procedure. We spoke on the phone last night. Christine lives in Toronto! She tore her ACL skiing two years ago, did rehab for about a year in the hopes of strengthening it enough to avoid surgery, but continued to have instability. She is in the OR as I write this for ACL reconstruction and meniscal repair on her right leg, and I'm sure she's kicking ass. We're going to speak again later this week.

In speaking with Christine I found out a few differences between the procedures in NY and Toronto. Christine has an overnight stay in the hospital. When she went in for pre-op counselling, she spoke with another woman who'd just had the surgery. Apparently she'll have access to morphine overnight, but will be sent home with nothing stronger than Tylenol-3. I seriously don't know what I would have done without the Percocet, and I encouraged her to ask her surgeon whether a stronger painkiller would be available. (Pain management is critical. Trust me.)

On the same board on which I met Christine, I found a posting entitled, "How long before you walked?" I posted a question in this thread describing my surgery, and the muscle loss since, and received the following response:

"I also had ACL Recon and meniscus repair. When I was cleared to walk with out the crutches, it was 3 more weeks before I could go without using at least 1 all the time. I had a lot of muscle atrophy too. Just don't overdue it because you will experience an increase in the swelling as you try to go off the crutches. Good luck. Just remember that ice is your friend!"

Tomorrow is my visit with Dr. Nestor. I'm nervous. I have lots of questions for him.

- When can I safely sleep without the brace?
- Can I PLEASE remove the steri-strips? [The original post-op strips are still on my knee, with the original post-op dried blood. Yuck.]
- What protocol should I be following? What can I expect to be able to do in 1 week? 2 weeks? 4 weeks?
- What's up with this popping in my knee? [New! My knee now pops, around the kneecap, during flexion exercises. It's not painful but it's slightly uncomfortable and weird, and Svetlana didn't know what causes it.]

Physical Therapy Redux

2003-11-10T10:21:00.000-05:00

Had PT on Saturday morning. Lena was back! She'd been on vacation, and she also started a new job at a hospital (also doing PT). I asked her about the new job, and she told me it's very different from Park Sports. For one, there's much more documentation for each patient. She also said it's much less stressful, in that she sees about 10 patients a day there, whereas at my clinic, there are sometimes four or five of us to a single therapist.

I'd had a few misgivings about the clinic, but I'll start with a description before I get into those.

The PT clinic I go to is two large-ish rooms, plus a few smaller rooms with tables (that I think are primarily used for electrical stim and ice). The front room has a treadmill, a recumbent stationary bike (my best friend), an arm cycle, and a few other apparati. It's fairly spacious. The second room has a Cybex multi-weight contraption, the leg press, a stretching table (the elevated, padded bench-type table that I use for heel slides and other stretches), and a stainless-steel table with a couple of chairs, on which most of the hand therapy seems to be done. The back rooms have regular exam-room type tables. When I started going to this clinic I did most of my exercises back there.

The clinic charges $100 per visit. I pay $15 for the co-pay, and my insurance covers the rest. My sessions have evolved into a pretty standard routine:

- 15-20 minutes stationary bike
- Leg press (3 sets of 10 @ 60lbs)
- Resistance band work
- Leg lifts (quads and side)
- Heel slides
- Manual manipulation (where I lie on my stomach and the therapist manually bends my heel toward my butt)

On Saturday I was at the clinic for 75 minutes. Of those, I spent about 5-8 with Lena. This doesn't seem quite right, considering the equipment I need for rehab could all be found in a regular gym, and a personal trainer at $100/hr would be with me for the whole hour. Of course, a personal trainer has different training and creds than a physical therapist. Here's the thing, though: On Saturday morning, Lena was the ONLY person working in the clinic. The phone was ringing off the hook, she was assessing a new client with carpal tunnel, and there were at least two other people there (besides me). I'm not unhappy with the therapists themselves, but I really want to walk! And if there's anything I can do to build up my muscles, I want to know about it. This could be how all PT clinics are, but I think I might shop around after I see Dr. Nestor on Wednesday (in two days!!!).

Speaking of building up muscles, I left the brace off all day yesterday (I was just sitting around the house anyway). Previously I've always blamed the brace for the apparent skinniness of my right leg (because the brace does compress it, and I'm usually comparing right after I take the brace off). But, ack. My right leg is WAY smaller than my left one! It's crazy! I took a few sample measurements along both legs, and it's up to an inch smaller in some places. I know, it's the A-word. I hate that word.

Weekend Summary: Days 37 & 38
Flex: 110°+
Crutching: 19 short/6 long (about a mile)
Arecibo: $12
NYC Taxi: $0

Recent Purchases

2003-11-07T13:53:00.000-05:00

I don't want to turn this blog into a big lecture on ACL surgery preparation, but I just bought a fancy new backpack (in Chili), and I love it oh-so-much. Just before surgery I picked up a $20 streetcorner backpack. It sucked. One of the shoulder straps constantly slips. Plus it's unbalanced and heavy, and I blame it* for the stair incident. Happy Five Weeks, Brace!

Another item I recently bought is Dr. Scott's Knee Book. This book rocks! It has diagrams of All Things Knee, and describes common problems and their solutions. It even has diagrams of rehab exercises. One of ACL patients quoted in the book said, "What I wasn't prepared for was the amount of pain that was involved in getting back flexibility in terms of bending and straightening my knee. It's not easy--you have to make a commitment to therapy." Sound familiar?

*Also blamed for the stair incident: A bright pink plastic bag that D brought up from the basement the weekend before I fell, and left on the landing. It is an old bag from a shoe store called "Selby's" that apparently used to be on Fifth Avenue (not sure if it was in Manhattan or Brooklyn). It has the most hilarious image of a bending shoe with a heel, and the text is in Bookman! Very retro. I happened to be staring wonderingly at the Selby's bag when I fell last week, hence the blame.

Weird Body Stuff

2003-11-07T10:13:00.000-05:00

Since surgery, I've noticed a few interesting (some cool, some not so cool) changes in my body. I'm talking about unexpected things - not the knee-swelling, although that is kind of interesting.

First of all, the marble. A few weeks ago I mentioned here that I had the sensation that something was poking into my leg just above and to the right of my knee. Initially I thought the brace was on crooked, but adjustments didn't work. When we unwrapped the bandage to look at my leg in that spot, nothing was there - except swelling that was localized, about the size and shape of a marble. The marble grew more pronounced over the following week or so, and by now it's mostly subsided.

Next, the lumpy thigh. About three weeks after surgery I noticed that my right thigh was really lumpy - in fact, it was like one of the muscles along the inside of my thigh had sort of curled up two inches above my knee. So while my left leg is nice and smooth, the right one has this lump. I asked Svetlana about it and she explained that when there's an injury, muscles seize up to protect the injured area. She said it was just like getting a knot in your shoulder, and told me I could apply heat therapy to help the muscle relax. So while I'm still a little grossed out at my lumpy thigh, I think the body is really amazing.

Lastly, for now at least, the baby finger of my right hand is numb. This phenomenon started about three weeks after surgery. It's numb from about the pad of my hand, all along the right side, up through my baby finger - but only the right side of my baby finger. So if I pressed the right edge of my right hand in an ink pad, that would pretty much map out the numb area. I asked Boris about the numbness, since he's the hand guy at the clinic. He said it's just that I'm pressing on a nerve in my hand when I use the crutches, and that the feeling will come back. If I was going to be on crutches much longer, I might be advised to change to some that use my forearm to take the pressure off my hand. But I'm hoping not to be on them too much longer.

And there were a few more little things that would fall into the category of Weird Body Stuff. Like, percocet makes me fart. Really.

Day 35 Recap:
Flex: 108° (Had PT after 4 hours at work... Bad idea. My knee was stiff and my quad was noticeably weaker.)
Crutching: 5 short blocks
Arecibo: $25
NYC Taxi: $20
Days to Dr. Nestor: 6

Day 33

2003-11-04T22:31:00.000-05:00

Flex: 110°+
Crutching: 10 short blocks
Arecibo: $0
NYC Taxi: $0
Days to Dr. Nestor: 8
Oh, and weight: 147 (Not to turn this into Bridget Jones's Knee Diary, but I've lost 8lbs since surgery. Um, yay? I'd really recommend Weight Watchers over knee surgery.)

Last night I had drinks with a friend from Waterloo, and on our way out of the bar a guy stopped me and asked what I'd done to my leg. I told him the deal - the Reader's Digest version of course - and he told me he needs meniscal repair sometime soon. I assured him that was cake - I had arthroscopy to repair torn meniscus about three years ago, and it was literally a walk in the park. I had a cane that I barely used, and I think I went back to work on the third day after surgery.

Not much new to report from PT today. I did meet a guy who's scheduled for ACL repair on November 14th - I gave him the address of this blog, so if you're reading this, hi! And good luck - you'll totally kick ass. (He's already doing PT in preparation for the surgery, so I'd consider that an edge... Plus no meniscal problems to speak of.)

Oh, and the brace-free honeymoon is over: Svetlana was not keen on the idea of me sleeping without the brace. So, OK, I had my three nights of freedom.

Day 31: One Month!

2003-11-03T11:50:00.000-05:00

Today The Brace and I are celebrating our one month anniversary. It's been an intense first month: We've spent almost every waking and sleeping moment together. To celebrate we're having some time away - in fact, Saturday night was the first time I've slept without The Brace since October 3rd. Even though she's been a great source of protection and support, and I need her around in the short-term, I'm thinking we might break up sometime before Christmas. Maybe even by Thanksgiving.

Canadianisms

2003-11-03T11:13:00.000-05:00

I forgot to include in the "Stuff is Funny" entry the new Candianisms I've learned recently.

Ace Bandages: You know those stretchy bandages you wrap around an injury to support it - usually for a sprain? Well, in Canada they're "tensor bandages." Ace is the brand, I guess, like Kleenex, so that's what they're called here in the US of A. When we were at the post-op doctor visit, my mom asked Dr. Nestor if I needed to put the tensor bandage back on. He looked at her blankly. She recovered quickly, "I mean, the Ace bandage."

Physical Therapy: In Canada it's called "physiotherapy," or "physio" for short. I think I said that a few times at first, and probably people just thought I was speaking quickly, but then I realized that it's PT here. Always two words. My mom confirmed that it was called "physical therapy" when she lived in Florida, too.

Day 29

2003-11-02T14:32:00.000-05:00

First of all, a shout-out to Wil, my kickboxing coach, who just emailed me that he's reading the blog. Can't wait to get back in your camp!

Flex: 110°
Crutching: 2 long blocks, 2 short blocks, plus the market
Arecibo: $20
NYC Taxi: $18

Had PT on Saturday morning at 8am. I was a little late, but arrived just as Boris was getting there, so that was fine. This was my first PT since the stairs incident, so I was interested to see if there would be any setback. I started on the bike and did 15 minutes, with full rotations (seat at 10). OK there. I stretched my hamstring them moved on to the leg press and did the usual 3x10 @ 60lbs there. Good. All systems go. Did a few other exercises with resistance bands, then moved to the table so Boris could do his thang. After a few heel slides (85° on my own) I flipped over, and he manually bent my knee. We stopped the first couple of times at around 95°, then he stopped at 100° and I was fine. He moved through 105° to approx. 110°, which was my highest yet, and puts me on-track to be at 120° when I see Dr. Nestor on the 12th. David calls it the "Degree-A-Day" program.

Vicki met me at PT and was hung over enough that she wasn't moving much faster than me on the crutches. We had coffee, then I had breakfast with David & Andrew, then Andrew most graciously chauffeured us to the Green Market. It was the most fabulous day ever - the high was 77°F, and it was incredibly sunny. I hadn't been to the market in over a month and was so very excited to be there.

One thing about being on crutches is I am hyper-sensitive to other people with canes or crutches or even a slight limp. On Friday night on our way to the party we ran into Femur Reconstruction Guy again - he was trick-or-treating with his daughter. He'll be allowed to weight-bear around when I am, but then, he's been on crutches since April. Good luck, Femur Guy! Our waitress at brunch was limping from a fall she'd had the night before, and told me she could use the crutches. At the market one of the fish ladies commiserated with my disabled state - she'd also had femur reconstruction a few years ago, and had been off her feet for seven months. Another guy at the market told me he'd had ACL repair about 20 years ago, and assured me I'd be fine.

The thing is, it *is* interesting. The brace itself is interesting. How someone navigates NYC on crutches is interesting. I appreciate it when people talk to me about the brace or the crutches, and I don't even mind the gawking as long as it's accompanied with a smile.

In the evening we ordered up a car to go to the Lower East Side for Vicki's gallery opening. It was so much fun. She is a fabulous artist - if you're in NY, check out the exhibit through the end of November at UZI N.Y. GALLERY on Avenue C. At my insistence we went a few doors down to Lava Gina for another drink, and being out for the first time in over a month was way fun. (Incidentally Lava Gina is a brace-friendly establishment - lots of comfy seating.) Even though I'm a cheap drunk right now, I was careful not to get too tipsy, as tipsy and crutches do not go well together. Thanks for a fun night, D!

Day 28: Hallowe'en

2003-11-02T14:10:00.000-05:00

Hallowe'en is my most favourite day of the year. This year was no exception, as I trumped even myself in the costume department: I dressed up as Ski Accident Barbie. It was fabulous. I donned a white turtleneck, long blonde wig, pale pink hat and scarf (with hearts!), and a very authentic-looking "Ski Accident Barbie (Includes Crutches)" sign. I made David a matching "Ski Instructor Ken (First Aid Kit Included!)" sign, and he wore a white turtleneck and baby blue hat and scarf with snowflakes.

I wore the costume to work and it was a big hit. I also made my most fabulous graveyard brownies ever, two batches, and took one to work and one to the party we went to in the evening. I have a few pictures, will post more when I have them.

Pre-Hallowe'en Scare

2003-11-01T13:33:00.000-05:00

On Day 27, Thursday Oct. 30th, I was on my way down the stairs to go to work, when I lost my balance and took a tumble. That's right: I fell down some stairs. Yikes. Or as my brother commented, "Shit. What'd you do that for?" Good question.

First of all, I'm OK, and as far as I can tell no further damage was done. I lost my balance and fell forward, hit my right foot on the floor, and bounced over. I think I flipped over on my head and shoulders, went down about six steps, and ended up on my butt on the landing of the third floor apartment. Thank God for landings. I was shocked, and pretty freaked out. I evaluated the situation and found all limbs to be intact and nothing particularly painful, then I did what anyone in that situation would have done: I cried. I also yelled out to see if anyone was home in the building - in hindsight I'm not sure exactly what they could have done, but it seemed like having someone else there would have been helpful. Nobody was home. I thumped back up the stairs to my apartment and parked myself on the couch. I was still shaking and freaked out. I phoned the car service to tell them I no longer needed the car, and left David a message at work that went something like, "Hi, it's me. I fell down the stairs . Can you please call me back?"

David called back within 10 minutes. He was probably more freaked out that me at that point. I assured him I'd be fine, that I was going to take a painkiller and go back to bed. We hung up, and he called back almost immediately to tell me he was coming home. I told him that really, really wasn't necessary, but he insisted, and came home for a few very comforting hours before he had to go back into the city for a meeting.

About half an hour after the fall I took off the brace and tried some flexion exercises. I seemed to be able to bend as much as usual, so I was pretty sure then I'd be OK. Fortunately I was wearing the brace, which I wear so much that I think it is going to fuse to my leg.

When I told my mom about the mishap she suggested I call Dr. Nestor just to let him know it had happened, so I left him a message.

The Moral of the Story

"A little learning is a dangerous thing; drink deep, or taste not the Pierian spring: there shallow draughts intoxicate the brain, and drinking largely sobers us again." Alexander Pope (1688-1744) - An Essay on Criticism

The previous day (Wednesday, Day 26) had been fabulous, and as a result I was not paying as much attention as I should have been. I was also a little tired and sore from the crutching around. I was lucky. And in case I thought this blog was getting a little boring ("look how far I can bend my knee!"), this oughta spice it up a little.

Happy Hallowe'en!

2003-10-31T14:35:00.000-05:00

Yesterday was a scary day, just in time for Hallowe'en. I will write more about that, and reveal my most excellent costume, this weekend.

Until then... Boo!

This Just In

2003-10-30T09:18:00.000-05:00

I received the first statement from my insurance company, from Hot Italian Guy (the anesthesiologist): $2040.00. (It's all covered by insurance, I just thought the amount was interesting.)

Day 26

2003-10-29T17:03:00.000-05:00

Vital stats:

Flexion: 105°
Extension: Almost 0°, needs some work
Bike: Full rotations w/seat at 10, even sped things up a bit
Crutching: Lots (whew!)
Car services: 0

I can't believe it's been 26 days since surgery. Time flies when you're on crutches! (Speaking of which, on Saturday when we went out for breakfast - successfully! - we ran into another guy on crutches. He'd been on since APRIL - femur reconstruction. He was good on those bad boys - taking stairs two at a time.)

Today David stayed home and came to PT with me, then we went out for lunch and ran some errands. Yesterday when I bought a scone, the bakery guy asked me if I wanted a bag with handles. I told him no thanks, but I could use a manservant to schlep my stuff. To which he replied, yeah, couldn't we all. I agreed and said I'd wanted one before the crutches. Well, today I had one! Yay D!

So. Blockage. We crutched from our place to PT (six short blocks), then to the 2nd St. Cafe (two long blocks plus two short blocks), then to Rite Aid (three short blocks), then to D'Ag's (one short block), then home (two long blocks). Total distance about a mile. Whee! I was beat when we got home, and sweating by the time I made it up the stairs. Took a brace-free nap this afternoon which was simply divine.

Hallowe'en Costume

2003-10-29T09:40:00.000-05:00

If I didn't already have the best Hallowe'en costume in the works, I could go as a porn flick: Everything is tight, or stiff, or has something strapped on.

Ba-dum bum.

98°

2003-10-27T12:58:00.000-05:00

Nope, not the band... The angle! Had a good weekend in terms of at-home exercises, and a great session this morning with Svetlana. The two other people at the clinic when I was there were also ACL repairs. Laura is at her six month anniversary, which was very inspiring. She injured her ACL skiing in Jackson Hole in March, and had the surgery there (ACL and meniscal repair, plus she fractured a bone - ouch). She told me she was walking with a slight limp two months after surgery, and she looks great now.

My leg raises (the quad sets) were strong today. Svetlana told me I should leave the brace locked at 0° until I can weight bear, but that it's OK to set it at an angle when I'm sitting. That will make work a heck of a lot easier. I see Dr. Nestor again on November 12, and he'll hopefully approve weight-bearing - at which point PT will get a lot more interesting. Today after PT I opted to crutch home instead of calling a car service - it's raining a little but very pleasant outside, and crutching around is a good way to use up the excess energy I have these days.

Four more days 'til Hallowe'en! David & I came up with the absolute best costumes on the weekend, I'll post pictures at the end of the week. And, I decorated my crutches with rubber bats, spiders, and skeletons. Very festive indeed.

Boris

2003-10-24T16:53:00.000-04:00

New physical therapist today! Boris! I've met Boris before, seen him around the clinic, but never worked with him.

I should note that my PT has progressed to the point where I often spend the first 30-40 minutes doing my own thing at the clinic - about 20 minutes on the bike, then I sit on the table for a few minutes to do the regular bend, then the leg press (still 50lbs). So, that's how I started today. Big news on the bike: I did a complete rotation! Woo hoo! One step closer to adding some cardio to my "workout." There was cheating involved, though: I set the seat one notch further back, so the maximum bend wasn't quite as far as it would have been at the previous setting. Still. (The cheating was sanction by Boris, he told me to do it just to get the rotation.) I went around a few times, forwards and backwards, particularly slowly when I approached and hit maximum flexion with my right leg.

When I reached the end of my own routine, Boris came over for the manipulation part. I started with heel slides and actually hit 90° (that was a little surprising since it was without help, I guess I'd loosened up a little with the previous exercises). After a few of those I flipped over onto my stomach and Boris pushed my heel up until my knee was at about 95°. He also explained that this exercise would be more difficult because my hip was straight, which meant that my quad would tighten up more quickly.

I asked him a few questions about timing. He said I'm on-track for being three weeks post-op (yay!). I asked him how long it would take me to walk after I'm allowed to weight-bear, and he said a few weeks, depending on how much strength is in my ankle and hip. He also stressed that I have to have complete extension - like, when I'm extending my leg, the back of my knee needs to touch the table. If there's even a degree or two of flexion, I'll limp. Good to know.

Tomorrow morning D & I are going to try that trip to Dizzy's again... Wish us luck!

The Lighter Side

2003-10-24T13:21:00.000-04:00

Just before surgery, I Googled "ACL repair" and came up with a bunch of sites on the topic. Some were published and maintained by hospitals or schools, with diagrams and technical details about the surgery. Others were personal accounts - written by people who'd had one or both knee operated on, with prep lists and ideas of what to expect before, during, and after the surgery. These personal sites freaked me out. I started my blog for a couple of reasons, not the least of which was to find the more optimistic side of this procedure.

And, even though it hasn't been the funnest thing I've ever done, a lot of funny moments have resulted. Like David taunting me with my crutches just a few days after surgery, then standing on his right leg and jumping up and down and saying, "Wish you could do this, eh?" That cracked me up. And when Mom was here, her leaning *across* my legs (that were propped up on the coffee table) to pick something up on the other side of me. (I caught her before she really leaned, and we had a good laugh about the incident.)

I've said it before and I'll say it again: Stuff is funny. Listing my religion as "chocolate" on the patient information form was funny. The woman beside me in pre-op was funny. She was having double-knee replacement surgery (OK, not so funny). One of her pre-op questions was which knee was worse. The nurse explained to her that whichever knee she felt was worse would be replaced first during the surgery, in case anything went wrong and they had to stop: At least she'd have the worst knee done, and she could come back for the second one. Well. This woman could. Not. Decide. She hemmed and hawed and went on and on about the right knee being more painful but the left knee being more stiff or vice versa and back and forth, for probably 10 minutes, until the nurse gave up and told her the doctor was going to ask her the same question, so she should decide. Then another nurse came in to talk to her, or maybe it was the surgeon's fellow, and asked her again which knee was worse. Same debate. It continued for another good ten minutes, while David & I listened on and rolled our eyes wholeheartedly. When the first nurse came in to ask my pre-op questions the first thing I said to her was, "Right knee, please." We all cracked up. When the double-knee woman's surgeon finally came in to talk to her (they still hadn't resolved the "which knee" conundrum) and asked her that fateful question, I heard her husband say, "We can't go through this again." I don't know what they decided, maybe they flipped a coin.

Waiting five hours for the opthamologist after surgery is kinda funny in hindsight (no pun intended). Crying while hooked up to oxygen and getting snot all over the tubes is funny in a pathetic sort of way.

When I could finally haul my own leg onto the bucket to go to the bathroom, the Huggies commercial song "I'm a Big Girl Now" popped into my head. That was freaking hilarious.

It's funny that I'm incredibly proud that I can put on my own sock and shoe.

Even The Brace is now funny. When I wear pants over it I look like the Michelin Man - dudes, that's funny. Yesterday, trying to sit at my desk with a too-short ethernet cable and my leg up on another chair was pretty damn funny.

One thing that's not so funny is daytime TV. Shut up, Dr. Phil.

Bored

2003-10-22T17:03:00.000-04:00

I'm tired of the "ACL Repair" game. Can we stop now?

Signed,
Gillian "Ready to Walk Already" Gutenberg

Notify

2003-10-22T12:41:00.000-04:00

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Days 18 & 19

2003-10-22T12:33:00.000-04:00

Yesterday it was 18 days since surgery. I had my third shower in over two weeks, and went to work for a few hours. It was really great. My coworkers rock, and were very accomodating and understanding about my limited mobility. I flipped over a recycling bin to rest my leg on under my desk and was OK like that.

Today is Day 19. I had PT this morning at 9am with Svetlana. I started with about 30 minutes on the bike - still back and forth, but I came incredibly close to a full rotation. Interestingly, today going backwards was easier than going forwards. The opposite has been true the past two times. She measured me at 90° on the bike, and I probably pushed a few degrees past that. After the bike I do a standing hamstring stretch, with my right leg propped up on a stool. That feels great. Next, to the bench for the regular flexion.

I mentioned to Svetlana this morning that my flexion is blocked at home by my leg hitting the desk I sit on. She said she'd show me another position I could use to increase flexibility. She had me lie on my stomach, and she pushed my foot toward my butt to bend my knee. It hurt, a lot. It's really interesting that 90° isn't just 90° - it's relatively easy for me to get there on the bike, but when it comes to heel slides, for example, I only make it to about 75° before it hurts. Anyway, Svetlana means business, and while I was on my stomach she continued to push my foot forward until I was at 95°. Woo hoo!

But. Not so fast with the celebration. Next came the quad sets. While lying on my back, with my left knee bent so my foot is flat on the table, Svetlana instructed me to tightly flex my quadricep, pull my kneecap up, push my heel forward to get my leg *really* straight, then raise my leg. When lowering my leg, I need to concentrate on keeping my knee as straight as possible. She watched me do this a few times, and noted that I'm probably losing 10° every time I raise my leg - that is, my knee bends slightly on the raise. This is not good. She said I should be doing this exercise at least 10-15 times, three times per day, and that being able to raise my leg keeping it completely straight is one of the indicators that I am ready to have flexion in the brace.

I did a set of 12 of these raises, and my quad was burning at the end. It requires intense concentration, because it's really easy to relax a little bit and let my knee bend slightly. I tried it a couple of times with my left leg just to see which muscles I use, and I was surprised at how easy it was with a leg that already works!

After the quad sets, I did the usual set of side lifts, then moved on to the leg press (three sets of 10 at 50lbs). Then I did a few calf and hamstring stretches with a strap, then ice (I love ice). I'm planning to do at least three more sessions at home today, and on Friday I'll be working to get a full rotation on the bike.

Leg Press

2003-10-20T18:51:00.000-04:00

Svetlana was my physical therapist again this morning. I started with 20 minutes on the bike. The first time she measured my flexion, I was already at 90°. Wahoo! She told me I can safely go for another 15°. David came with me, and was probably underwhelmed at the intensity with which I "rode" the bike. I only move my left leg forward until my right leg is at about 90°, then I move it back until I hit the same angle.

After the bike, I moved to the table and did the usual flexion exercise. Then Svetlana suggested I try the leg press. While she went to check my chart to see whether I'm ready for that, David & I exchanged the same panicked looks that Mom & I had exchanged when she'd suggested I get on the bike. But I've never done that before!

Deep breath. Svetlana adjusted the seat on the leg press so that when I sat down, my resting position would be at approx. 90°. She set the weight to 40lbs, and had me sit with both feet on the same pedal. She instructed me to push primarily with my left leg, then resist on the ecentric with my right leg. It went surprisingly well!

I talked to Svetlana today about setting my brace to have some degree of flexion during the day. She said four weeks is the usual timeline for that, which means my leg has to be locked straight until the end of next week. I'd been planning to wait until I could bend to return to work to sit comfortably at my desk, but now I'm planning to return at least a couple days a week and just prop my leg up on another chair when I'm at my desk. Should be OK.

I also asked her about how long I needed to sleep wearing the brace, and she said it really varies depending on the surgeon. I get the impression that Dr. Nestor is pretty conservative, which I respect, so that means it's probably going to be a few more weeks. Unfortunately, sleeping is becoming increasingly difficult. My back is really stiff. I wake up a lot, and don't have the luxury of turning over and going back to sleep.

A Shower and A Breakthrough

2003-10-20T12:08:00.000-04:00

The weekend went smoothly. My mobility is way up, I made lunch (veggie burgers in the toaster oven) on Saturday, and even baked brownies (from a mix) on Sunday. I miss cooking a lot.

Mom left Saturday morning. Her help was invaluable, and our kitchen has never been so clean! Thanks Mom. So much.

Saturday morning I took my first shower! In two weeks! Dr. Nestor said a shower would be OK, he just didn't want the incisions (still covered with steri-strips) to be soaked. Logistically the shower went something like this: I used one crutch and the sink to suspend myself long enough to hop into the tub with my good leg, then swung my right leg in as well. I stood with my left side toward the shower, which left my back against the wall for support. David stood outside the shower with his arm available for me to grab onto for balance. It was the best shower ever. Getting out of the tub was a little more challenging - I had to sit on the edge and swing my legs over, then stand up.

Saturday both D & I crashed. We were exhausted. He'd had a busy week at work, and I'd made it to 90° the day before. No small feat, that. I did a few rounds of exercises on Saturday, and again on Sunday. Sunday I tried something new, which resulted in a breakthrough of sorts: While sitting on the desk for the flexion exercise, I did shoulder presses and bicep curls using a body bar that D brought home on Friday. That totally distracted me from the pain in my knee, and I was able to bend it further (on my own) than I had previously. We're estimating I got to 90° here on Sunday, which rocks. I'm sitting on a desk for these exercises and we measure by how close my calf gets to the bottom of the drawer on the front of the desk. I hit the drawer for the first time on Sunday, and even held it for a few seconds (without screaming hysterically).

Svetlana

2003-10-17T17:15:00.000-04:00

Lena was off this afternoon so my physical therapist was Svetlana, the woman who had come to our apartment for the initial visit.

She asked me what I usually start with, and I told her the flexion exercise. She asked if I'd been on the bike yet. Nope, no bike. That's fine, she said, your surgery was two weeks ago? You can go on the bike. What did your surgeon say? she asked. I told her: He said my flexion isn't good enough. OK, she said, it was at 76 last time right? (I was impressed at this point that she'd read my chart.) She pointed to the bike and told me to see how far you I could get.

I was freaked out. I think Mom was freaked out too. I protested: "But I've never done the bike before..." Svetlana was all business. "It's fine," she said, and instructed me to use my left leg to push the pedals forward and then backward as far as I could.

It rocked. I was so much more comfortable (the bike is the kind with the seat back), and felt so much more in control. She measured the angle of my knee when I'd pushed it to the limit. 80°! Score! After 5-10 minutes on the bike, she had me move to the table. Time for the manual pushing. She told me she was going to get me to 90°. Today. Right now. I freaked. Then breathed. She had me put both hands on the right side of my body, and instructed me to keep my right hip down. Then she pushed. Oh dear God it hurt. I think I squeaked, and tried to breathe. She held the stretch for a count of seven, then released it. Then she did it a couple more times. Finally, she held the goneometer at 90° and pushed my knee to meet it.

That's right, I hit 90° today. Doesn't mean it's going to get back there all by itself, but at least now I know how it feels (it hurts) and that nothing breaks when it gets there.

I did some more new stuff during the session, including heel slides. Then the usual quad and side raises, then ice.

I probably accomplished more in that 45 minute session than in any of the previous (longer) sessions. Thanks Svetlana.

The Brace

2003-10-16T15:59:00.000-04:00

Google comes through again. Here's The Brace, in all her glory. Eventually I'll have a picture of me all decked out in this baby, but for now you'll have to enjoy it on this fine model.

Speaking of models, I have become obsessed with knees in fashion photography. In the October Marie Clare, which I bought as part of the first-injury stockpile, there's a particularly leggy model in a short, short minidress with no tights. I covet her knees. I think they are incredibly beautiful. Ditto when I see people walking outside with shorts (or even tights) on. Mom, I think your knees are gorgeous. Take good care of them.

Pain

2003-10-16T15:36:00.000-04:00

Yesterday at PT, as I was forcing the flexion of my leg for the upteenth time and had tears streaming down my face, another girl comment to me, "Isn't it weird to be crying about pain you're inflicting on yourself?"

Since visiting Dr. Nestor yesterday, we've increased the intensity of the flexion exercises drastically. "Ow, OK, that hurts," doesn't cut it anymore as a surrender. Now we push the bend and hold the leg until I really cannot stand it - usually this means I'm sobbing and gasping for breath. Now, I say "we," but even though my mom is there, I'm doing this all myself. I'm now able to hoist myself up on the desk (which we've covered with my yoga mat and a sheet), keeping my right leg straight, and hook my left foot under my right ankle for support. Once I've scooted back until the backs of my knees are just ahead of the edge of the desk, I start lowering my left foot. Once my foot is all the way down - that is, it's far enough that gravity won't pull it any further - I move my left foot to the front of my right leg and start pushing it further. This is the hard part. The first few degrees are OK, but then it starts to hurt. My quad continues to involuntarily tense up, and despite my best efforts to relax it often feels like there's a fist, or a baseball, just above my knee.

It's impossible for me to know the angle I've made it to, so I rely on Mom guesstimating that it's further than last time. After I've held it for, well, as long as I can possibly stand it (remember I'm pushing my leg myself, with my other leg), I release my left leg and let my right leg dangle. Then I hook my left leg back behind my right and gradually raise it back up until it's nearly straight.

Moving up through a particular range of motion there makes my knee ache to the point that my teeth hurt. The best way I could describe it to Mom was that it's like wacking your funnybone, only the ache doesn't go away in a minute or two. It's there and kind of moving around throughout the movement.

We've done two sets of exercises today. Bending my knee has become my mission. Between sets I rest, eat something, and psyche myself up for the next set. Self-inflicted pain, indeed.

D-

2003-10-15T21:50:00.000-04:00

This morning I had the first appointment with Dr. Nestor since surgery. I brought the whole entourage (D & Shirley). (To fit three of us in the car, Mom sat in the backseat with my leg across her lap.)

First the nurse, Mindy, removed the ace bandage and the dressing. Then Dr. Nestor came in and removed the sutures. The larger of the two felt kind of neat coming out as it pulled through my skin. He checked my extension (how straight I could get my leg) and said it was good. Then he said, "OK, let's see what you've got," and instructed me to loop my left leg behind my right leg and lower it down, to see how the degree of flexion.

His comments: "Bottom of the class. D-. You're going to be sent to the principal's office." He pulled out his goniometer, the same plastic device that Lena uses to measure the angle of my knee. "50 degrees. That's not good enough." I saw David and my mom exchange looks. "You need to work on this five to 10 times a day. This is your job. You need to be spending hours every day working to get this flexion."

His point was abundantly clear.

Aside from that, I was instructed to continue to wear the brace, and that in a couple of weeks the physical therapist could set it to have a 90° flexion (which will allow me to sit at my desk). I'm also allowed to shower now - whee! I will see Dr. Nestor again in four weeks.

We left the office feeling somewhat defeated. We'd been doing exercises at home, twice a day, but obviously hadn't been pushing hard enough. I was scared. Dr. Nestor had pushed on my leg when I'd had it bent at his office and when I'd nearly screamed in pain, he'd said, "Breathe through the pain."

Right.

We went from his office to my office, just to say hi - it was so, so great to see everyone. Mom & I stayed there for about an hour, then we stopped at Old Navy to look for brace-compatible clothing. Mission accomplished - we picked up a couple pairs of belted twill pants, and some long-sleeved t-shirts. (I learned when I broke my foot in university that sweaters do not fare particularly well with crutch use.)

We returned home around 2pm, ate lunch, then did the first set of flexion exercises. I was so scared. I think Mom was scared too, but she rocks more than anything and stuck it out. It hurt a lot. I cried a lot. We pushed it hard, and held it down. When I brought my right leg back up, supported of course by my left leg, my whole knee ached. It's unbelievably difficult to relax my quad during these exercises. I've started trying different approaches, and I'm finding that massaging it with my thumbs while I'm trying to push my right leg down (with my left leg) is the most effective. After that set I was exhausted (that seems to happen a lot lately!) and we both slept for about an hour. I left the brace off for that time and it was deliciously wonderful.

When we woke up we did the flexion exercise again - a little shorter this time, because we had PT at 6:15 tonight.

At PT, Lena asked how the visit to the doctor had gone, and I told her. She had me start with the flexion exercise (of course), and the first time she measured I was only at 67°. Urf. So, I tried harder. Again and again. The next time she measured it was 75°, and the last time I made it to 76°. Nobody could have told me it would be this hard to bend my knee. I can hardly believe that only a month ago I could do a pigeon pose. The rest of my exercises went well - I don't have any difficulty working my quads (with leg lifts and side leg lifts). My next appointment is Friday at 3pm. I am determined to get to 80° during that session, and will work to be at 90° for Monday.

My cousin sent a great ACL site tonight, with diagrams of rehab exercises. Note that I have not been instructed to do the Heel Slides pictured here - my equivalent exercise (the "flexion exercise") has me sitting on the edge of a table with my right leg straight and my left foot hooked behind my right heel, supporting it. To bend my knee I lower my left leg and my right leg follows passively.

The Knee Index

2003-10-14T13:21:00.000-04:00

Number of times a day I could raise my right leg the day after surgery: 0
Number of times I could raise it 10 days after surgery: 90
Circumference of my right knee, in centimeters, five days after surgery: 42
Circumference of my left knee: 37
Number of painkillers I took 10 days after surgery: 3
Number of painkillers I took one day after surgery: 12
Number of Percoset I have been prescribed since surgery: 80
Number remaining: 7
Number of stairs between my apartment and the sidewalk: 67
Degrees of flexion in my knee the day after surgery: 0
Degrees of flexion in my knee 10 days after surgery: 75

Voluntary Outing Numero Uno

2003-10-14T11:48:00.000-04:00

The weather here over the past week or so has been simply fabulous - ranging from the mid 60s to the low 70s and very sunny. Since we didn't have any PT or other knee-related outings scheduled for today, I suggested that Mom & I take a breakfast trip to Dizzy's.

We headed out around 10:15. Made it down the stairs sans problème, then began the journey of three short blocks followed by one long block. Total distance about 1/4 mile.

We made it to the corner of 7th St. That's it. One block and change. It was much warmer out than I'd anticipated, and I fatigued very quickly. Shirley helped me hoist my leg onto a ledge so I could rest for a minute, and then we headed back. I was dreading going back up the stairs at home! When I got to the first landing my back was drenched in sweat and I felt slightly faint, so Mom went upstairs and got me an apple. (Gimme fuel, gimme fire...) That helped. A lot. I still needed to rest on the other landings but made it up in one piece and now I'm chillin'. Shirley's going to toast up a waffle and hook me up with some yogurt, and I'm going to get whatever work done I can today.

I wonder if Dizzy's delivers...

Day 10

2003-10-13T19:11:00.000-04:00

For the record: Shirley = Mom. (I also call her Memphis' Grammy, but that is frowned upon.)

I had physical therapy at 9:15 this morning. David came along to check out the facilities. Mom walked to the clinic because I take up the whole back seat of the car. We're going to have to figure out something for Wednesday morning, when both of them are planning to come to the doctor with me.

We explained to Lena the whole swollen-foot saga this morning, and she was pretty unfazed by it. We like Lena, even if she did wrap my leg too tightly. This morning we started with the flexion exercises, and again she measured the angle. I clocked in at a rather disappointing 75° - not as much improvement as I'd expected to see. She also explained how the angle is measured - by drawing a line from the ankle bone to the knee for one arm of the angle, and from the knee to a particular bone that's sort of at the thigh, below the hip. Looking just at my knee, it really appears that I'm at 90°. I'm noticing that I can get a lot further now before the initial discomfort begins. This morning Lena was really emphatic about relaxing my quad. It tenses involuntarily, as a protection I'm sure, and I'm not quite sure how to relax it.

Everything else went well at PT, but for whatever reason coming back up the stairs to our apartment really tuckered me out today. By the time I was at our landing I was exhausted, and barely made it to the couch. Mom says I turn white when I hit the wall like that. I managed to eke out some work from home today, and while I'm not sure exactly how much I contributed, I did feel like I was getting caught up, and it was nice to have interaction with other people. Around 2pm I faded - I went to lay down and slept solidly for almost 2 hours.

My knee is a little achy tonight. We did a set of exercises without incident. Hoping to get to 90° before PT on Wednesday.

Day 9. I Love Today

2003-10-12T13:15:00.000-04:00

Today is the first time I've had that thought since surgery. Yay!

I'm almost caught up, so let's just finish up last night.

Yesterday when I woke up my foot was still swollen. Rats. I stayed in bed most of the day, with my foot elevated and packages of frozen peas wrapped around it. It was still puffy into the evening. Around 8pm Mom made dinner and we started watching "The Others." At a critical plot moment near the end of the movie, I realized my foot was freezing. I alerted Shirley and she whisked me into the bedroom where she completely unwrapped the ace bandage. Fortunately my leg looked fine - the swelling there had completely subsided (except right around my knee) - only my foot was still huge. She massaged it gently and re-wrapped the bandage much more loosely. I managed to make it through the rest of the flick, then fell asleep almost immediately.

This morning my foot had almost returned to normal. It was warm and happy. There is still a little puffiness around my heel, but it's about a million times better. Yay Shirley! We'd really wanted to trust that the PT knew exactly how tightly to wrap the bandage, but clearly it was too tight for me. The set of exercises this morning was the best I've done yet - D estimated my leg was bent to about 80°, and I did a complete set of everything else. Now football's on, Mom's making Thanksgiving dinner (today is Canadian Thanksgiving, dontcha know), and I'm pretty darn content.

My Cabbage Patch Doll Foot

2003-10-11T19:01:00.000-04:00

On Thursday, my right foot was swollen. I called my mom in to have a look at it, and she found a big dimple beside my heel that she thought was quite hilarious. She was giggling and carrying on about the cute dimple on my foot, and called David in to look at it. D looked at my foot and said, "Should we be worried about this?"

It was pretty swollen. Shirley guessed it was because I'd had it down quite a bit on Wednesday, with going out to PT. I'd also been able to sit on the couch for longer, and when I'm on the couch my leg is straight out on the coffee table and thus below my heart. (It should be noted here that I'd previously argued that having my foot on the coffee table counted as "elevated," whereas Shirley said it needed to be higher than my heart.) Mom was calm about the whole thing and just said we'd keep it up and ask Lena about it when we went to PT on Friday.

Friday morning I had my first visitors! A couple of girls from work made the trek to Brooklyn and brought cupcakes from Cupcake Cafe and chocolate bread from Balthazar. It was really, really good to see people. After they left my mom & I got me washed up, and at 1:30 we headed out to the clinic for another round of PT.

Lena said it wasn't great that my foot was swollen and I lost the elevation argument: My foot needed to be above my heart whenever possible. We went through the usual exercise regime, and she iced both my knee and my foot before I left.

I napped (with my foot on a pillow) when we got home, and Shirley went to the grocery store to fetch bags of peas to ice my swollen appendage. Later that night Andrew came over (whee! another visitor!) and we all ate pizza and ice cream - me with my foot propped up on two big couch pillows on the coffee table.

When I went to bed, I suddenly had this feeling that something was jutting into my leg just above my knee. I thought perhaps The Brace was on a little bit crooked, but what it really felt like was a marble or a knuckle pushing into my leg. I called my mom in to have a look, and we undid The Brace completely, but nothing - I could still feel it. So she unwrapped the ace bandage enough to see my skin, and there really was nothing there - but the sensation was about where one of the small arthroscopy insicisons was, so that's all it was. Some healing going on I suppose, and bruising.

I managed to fall asleep, and fortunately I haven't felt it since.

ACL

2003-10-11T18:41:00.000-04:00

I Googled "Anterior Crucient Ligament" and found that I'd been misprouncing and misspelling it this whole time - it's really the Anterior Cruciate Ligament. I also found a nifty page that answers basic questions about ACL injuries and repair.

For the record: I had a partial tear (not a complete rupture, which given my activity level probably would have needed surgery before now). The tissue that was used to repair the ACL was taken from my own patella.

In addition to the ACL repair, I had my meniscus repaired. Another page on the same site describes the meniscus and its functions. This part of the surgery means that I won't be able to weight bear for 6 weeks (normally the ACL repair rehabilitation allows for weight-bearing almost immediately).

Shopping

2003-10-11T15:14:00.000-04:00

I was just doing some online shopping, and I'm trying to imagine what will fit over The Brace, or how it will look under an A-line Gap skirt. This sucks.

It's Been One Week

2003-10-11T13:32:00.000-04:00

Look at that! It's Saturday, October 11. One week of crutches down, five to go. It seems like surgery was a year ago. While I can see I've made progress, there is clearly a long way to go.

Back to post-op. I had been instructed in the hospital to start my exercises the day after surgery. Quite diligently, on Saturday afternoon, David & I attempted the first round. It was not a roaring success. The first exercise was to lie down, with my left (good) leg bent at a 90° angle (so my foot was flat on the bed), with my other leg straight (of course), and lift my right leg up to the height of my left knee. Cake, right? Nope. I could not budge that leg. It took all my strength and energy just to flex my quadricep, and despite every ounce of willpower I couldn't lift the leg. It was exhausting and frustrating. We tried a few times throughout the day but on Saturday it just wasn't happening. It was to the point where I had to do raises with my left leg just to remember which muscles I should be using! Sunday, joy of joys, I was able to raise my leg a few times. That was exhilirating. By Monday I could do a set of 10.

On Monday I called my doctor's office to get a list of physical therapists in my area. Fortunately there is one just a few blocks away. I called them to set up an appointment for Tuesday. Still dreading the stairs, I inquired about having a therapist come here for the first visit. The service was available, but would not be covered by my insurance. I opted to spend the $130. (During this phone call I noticed one interesting side effect of the painkillers: When I read my Oxford ID number to the PT clinic, I kept mixing up the order of the numbers. It was akin to having a reading disorder.)

On Tuesday (Day 4) at 3:30pm Svetlana came over. My doctor's office had faxed the rehab script to the PT clinic, and she went over the booklet I'd been given at the hospital. We did the prescribed exercises, and she gave me a few extras, including side leg lifts. It was so, so nice to lie on my side after having been on my back for four days. My hip was already getting tight, and the exercises felt really good. The last exercise (with the brace off) had me sitting on the edge of the bed while she held my right leg. The idea was that she'd lower my heel gradually to practice bending my knee. Oh my God. That was entirely frustrating - we could only go about 25° before the pain was unbearable. So we stopped, and I was left with strict instructions to continue that stretch several times a day until I could increase the range of motion.

I have a new ligament. It is tight, and I need to stretch it out gradually to get the range of motion. The risk is that if I wait too long to stretch it and increase the range of motion, it will heal and be much more difficult to stretch at all.

My mom arrived Tuesday night. Prior to surgery she'd told me to let her know if I needed/wanted her to come. I said I would, as I still wasn't sure what I'd be able to do on my own. When we had arrived home from the hospital on Friday night, I'd called her and tearfully admitted that I wanted her here. The brace alone had given me some idea of how little I'd be able to do myself, and how much I'd be leaning on David, and I wanted to make sure he didn't wear out. She had immediately agreed, and found a train ticket (flying was prohibitively expensive). By the time she arrived on Tuesday I was looking pretty scary, I hadn't bathed for 4 days, and while I had splashed water on my face and made liberal use of facial wipes, you can really only get so clean without soapy water. (Dr. Nestor had given David strict orders after the surgery that I was not to shower until he saw me the following week, as any water would increase the risk of infection.)

So. Shirley arrived and temporarily relieved David of his orderly duties. He went to work on Wednesday, happy to rejoin the land of the walking. Mom & I halfheartedly went through my exercises in the morning, then she washed my hair. That undertaking involved me lying on plastic sheets with my head hanging off the bed, while she shampooed my hair over a bucket of water. It was actually quite efficient. Then she gave me me a sponge-bath of sorts, and I was wonderfully clean.

Wednesday afternoon was my first outing since surgery. I had an appointment for physical therapy (at the clinic, this time) at 4:30pm. Shirley helped me get dressed in David's sweat pants and a tank top, and let me get a head-start on the stairs before she called the car service (I know, to go five lousy blocks). (Coincidentally the driver was the same one who'd driven me to the hospital on Friday.)

Svetlana was away, so I had Lena as my therapist. I loved her, and so did my mom. She pushed a little harder this time with the exercises, especially with the flexion. I think we made it to about 45°. She also removed the ACE bandage for the first time, and measured my knee. On average it was 4-5cm bigger than the left knee. It kind of looked like a knobby horse's knee. The stitches from the arthroscopy were visible, but the incision from the patella graft was covered with steri-strips (which I had been instructed not to touch before seeing Dr. Nestor).

Lena gently massaged the skin around the incisions to increase the circulation. It felt great. She told us to make sure massaging always pushed up the leg, so that it wouldn't end up in my foot and would have a chance to reciruculate in the lymphatic system. After the massage she left me with electronic stimulation things attached to my knee, and a big ice pack.

We were at the clinic for about 90 minutes. After that, and climbing back up the stairs, I was exhausted and fell asleep almost immediately.

Post-Op

2003-10-10T22:10:00.000-04:00

The first night after surgery I woke up every 2 hours and took a percoset. This was recommended by the doctors, who made it clear that I was not to be heroic and suffer through the pain. Good advice! David actually woke up with me the first couple of nights to give me the pills. Despite the drugs, it hurt. By Saturday, the day after surgery, I was slightly more comfortable.

We had logistic issues to work out. One was getting my leg out of bed. I didn't have the strength to move it, nor did I even know how to get the leverage to do so. David figured out a way to gently move my leg while I pivoted my hips to get it out of bed, while I stood with my good leg (God bless my good leg!), and he lowered the straight leg down. He holds my calf with one hand, and my thigh with the other, from the opposite side. It's a bit awkward, but gives him the best leverage.

Then, of course, the bathroom. I don't know how I did it the Friday night after surgery, but the adrenaline wasn't flowing as much after a dozen or so percosets, so we had to figure something else out. The solution ended up being an overturned bucket that I could rest my heel on while sitting on the toilet. At first I couldn't even raise my leg enough to place it on the bucket, so D had to do that too. (As if the Ben & Jerry's wasn't enough, he had to put my leg onto a bucket so I could pee. Wow, right?) My slightly bruised dignity aside, we managed. That morning, D went out again to buy fresh challah bread, and came home and served me breakfast of French toast with strawberries and bacon, in bed. It was fabulous to say the least. (He also warned me not to get used to it, that tomorrow morning I'd be served yogurt and a frozen waffle.)

I slept most of Saturday. At one point we tried to move me to the sofa, and that worked briefly, but I got uncomfortable really fast and had to move back into bed. I really don't remember much about the first couple of days except that people phoned, many bouquets of flowers were delivered, and I cried a lot.

The Stairs

2003-10-10T16:32:00.000-04:00

The car ride home from the hospital was less than enjoyable, but we made it. Then I had to face, for the first time, the stairs.

We live in a fourth floor walk up. It's five, really, if you count the stoop. Yikes. I honestly don't know how I made it up those stairs, but I did. David's mom was there, and David stood behind me in case I toppled over, and I made it. As I was going up the first flight (outside) our downstairs neighbour Juan came home. That lucky devil has the ground floor apartment. He asked what had happened and I squeaked out "ACL" then turned around so I wouldn't burst into tears (again).

So. Up the stairs. Willpower is a crazy thing. I found myself feeling fortunate that I'd had crutches before, when I broke my left foot in university. I felt pretty comfortable balancing on them, although that was a little different because back then I could bend my leg. This time? Not so much.

I beelined for the bedroom, making a quick stop on the way in the bathroom. Another feat I have no idea how I managed. Try it. Sit on the toilet with one leg straight out in front of you. Great. Now get into that position without bending your leg. See? Not so easy. Anyway. Made it into bed, sent David out for drugs, and tried not to think about my knee.

It hurt. A lot. I had the Cryo/Cuff on it to keep it cool, and that did help, but it was surprisingly painful. I think I'd commented earlier (at the hospital) to David that as the anesthesia was wearing off, it wasn't as painful as I thought it would be. Well, now it was worse. We're talking 8-9 on a scale of 10, with 10 being the worst pain you can imagine.

Let's not dwell. David came back loaded down with prescription drugs, yummy chocolate-cranberry bread, and he even brought over my close friends Ben & Jerry. Have I mentioned David rocks? It's worth mentioning again and again - David rocks.

Hey. Something's Wrong With My Eye

2003-10-10T12:08:00.000-04:00

I was in and out for the first half hour or so. I vaguely remember my Italian guy being there at first, and then another guy checking things. There were nurses around, and other people recovering from various other surgeries. And... my eye. My right eye hurt. I couldn't open it. It burned, and felt like there was sand in it. It was watering like crazy. My legs were still asleep, which was kind of interesting, but MY EYE HURT! I tried to talk but that was weird; I couldn't quite do it. Somehow I got the attention of the guy who was monitoring me (Danny), and told him my eye hurt, and that if that was normal it was OK, but I just wanted to know if it was normal. He gave me a piece of gauze to wipe the tears, and told me he'd call my anesthesiologist. Yay, Italian guy!

An hour passed. No Italian guy. Nobody, in fact. So then I started feeling sorry for myself. It was around 1:30 (I could see the clock), and nobody was paying attention to me, and my eye hurt, and my legs were waking up (I could wiggle my toes), and I was scared. So I started crying. Well, I still had the oxygen tubes in my nose, so that made crying gross, because the oxygen tubes got all snotty. One of the nurses noticed that I was a wreck, and I heard her say, "That girl is in a lot of pain, between her eye and her leg. I'm going to give her some morphine." Yay! Morphine! Danny offered me a sandwich (tuna or turkey) so I could have a Percoset as well. I ate the turkey sandwich, drank some apple juice, and gratefully accepted the drugs.

Around 2:30 the nurse who had given me the morphine came over and told me her name was Betty (I was very excited to have my own Nurse Betty), and asked if anyone had come with me. I told her my boyfriend was in the waiting room, and she went to get David, who came in a few minutes later. He looked hilarious - he had to wear a yellow hospital thing over his clothes. I was so, so happy to see him. He kissed me and it was seriously the best thing ever. I asked him to tell them about my eye again, because it still hurt like a bitch and was watering a lot. He talked to someone, maybe Betty, and told me he could see someone was on the phone "opening up a can of whoop ass" about an opthamologist. The next little while was hazy - I mostly kept my eyes closed to keep them from watering. At one point Nurse Betty tried putting some artificial tears in, but that didn't help much, so they kept trying to get the eye doc.

At 4pm the physical therapist came over. She showed David the book with the exercises (since I still couldn't see properly). He asked her for a better pair of crutches - we still had the crappy wooden ones from two weeks ago at the ER that we'd had to drill holes in to get to the right height. She hooked us up with a fancy metal pair.

Finally I was relocated to another area to wait for the opthamologist. After another half hour or so of waiting, I told David I just wanted to go home. It had been 4 1/2 hours since I'd first mentioned my eye, and I thought it probably wasn't a big deal if nobody had come to check it out, so I thought we should get moving with the other stuff. We'd been in the hospital for 11 hours and we were both exhausted. So he found the physical therapist, who had to show me how to use the crutches before I could get dressed. We practised using them on a little set of stairs they had at the hospital, and I was OK'd by her. Then we had to get someone else to come and fit me with the Cryo/Cuff. The Cryo/Cuff is a fancy way to keep my knee cold - it really also deserves its own entry or at least description.

David helped me get dressed (it was not trivial), and then, after 5 hours of waiting, Dr. Seiff the opthamolgist showed up! Joy! He was worth the wait. He was completely sweet, and apologized profusely for the wait. He put a drop in my eye, and I could see! He told me he'd just numbed it, and he thought I probably had a small scratch on my eye. Then he did this cool thing where he put yellow dye in my eye, and shone a blue light on it. The yellow dye pooled in the scratch, and the blue light made the scratch show up green. David looked through the blue lens and sure enough, he could see the scratch. All of this made me really happy. Dr. Seiff told me I couldn't have the numbing stuff because it isn't good for your eyes, but he prescribed an antibiotic drop as a precaution and told me it would heal within a day.

My question, then, was how did my eye get scratched during an operation on my knee? There are a couple of possible explanations. When you're under anesthesia, your blink reflex doesn't work. So I might have rubbed my eyes when I woke up, and scratched it then. Or, my eyes might have been taped shut during surgery (they do this sometimes so that the eyes don't dry out), and were possibly irritated when the tape was removed. At any rate, I could see again!

The nurses gave us a prescription for vicodin and percoset, and I asked for another percoset before we left because I didn't know how soon we'd be able to get the Rx filled. We called a car service and waited about half an hour, and by 6:30 I was in the car and on the FDR back to Brooklyn.

Day 0: The Fix

2003-10-10T11:37:00.000-04:00

On Friday, October 3 we had to be at the hospital by 6am. I had been instructed not to eat or drink past midnight the night before surgery, and to shower before coming to the hospital. I was also to wear loose clothing, and to leave all my jewelry at home. We woke up at 4:30am. I showered and dressed in David's sweats and a tank top and sweat shirt. We called our favourite car service (Arecibo, for those of you in the Park Slope area), and within 5 minutes there was a car at the door. It was a quick ride to the Hospital for Special Surgery, since there was no traffic that early. We were checked in and in the waiting area by 5:40am.

Shortly after 6 we were summoned into the pre-op area. I had to put on the fancy hospital gown, and fill out a patient information form. It was early, we were giddy, and the form included such giggle-inducing questions as, "Why are you here today?" We answered the question, "Do you have someone available for emotional support?" with David, my boyfriend, and Memphis, my cat. For religion I wrote "chocolate." It was probably the best part of the day. The woman on the other side of the curtain from me was having double knee replacement surgery, and at one point her husband commented that we seemed to be having an inordinate amount of fun.

[The woman on the other side of the curtain deserves her own entry at a later date.]

I had lots of pre-surgery visitors who generally asked the same questions. The first nurse who came in went over the patient info form, confirmed that I was having my right knee operated on, and asked various questions about my health in general. She also informed me that she'd worked hard all week, and since it was Friday, it was Mean Day, so she was going to be mean to me. She was awesome. Really great bedside. We laughed a lot (which was no mean feat, as I was on the verge of tears that entire morning). The surgeon's fellow came in and autographed my right knee (his initials are JM). He told me he'd be holding the clamps for Dr. Nestor during the surgery. I told him not to slip, and to make sure no Junior Mints ended up in my knee. He seemed to find that really funny. Another nurse came in and asked some questions about my current mobility - at the time, I could bend my knee completely, but not get it straight.

Then the anesthesiologist came in. He was hot. Like, really hot. And Italian. Last time I had surgery the anesthesiologist was hot, too. What's up with that? We went over anesthesia options: general, epidural, or spinal. At HSS they do spinal 99% of the time. He said I'd still be asleep, even before I had the needle to anesthesize my legs, and that the main difference between spinal and general would be that I'd wake up before my legs. I opted for the spinal, and confirmed that it'd be OK for me to leave in my belly ring (it would, but it would have to be covered for the surgery).

Dr. Nestor visited before the surgery too. We had a few questions for him. He explained again how the procedure would go, and told David he'd come out to the waiting room after the surgery to tell him how it went. The first nurse (the pseudo-mean one) came back and inserted the IV. She taped up my belly ring, and then realized that we needed to do a pregnancy test. So we did that, waited about 10 minutes for the results (negative), then I kissed D goodbye and my nice Scottish nurse wheeled me into the OR.

Once in the operating room, another nurse and the anesthesiologist lifted me onto the operating table. He said to the nurse, "I'm going to need you to sit her up," and I said, "It's OK, I can sit up myself." Ha ha. Then he started swapping stuff in the IV, and said, "This takes effect pretty quickly. Some people are surprised at how quickly it works."

Um, yeah.

Then I woke up.

I was still in the OR when I opened my eyes. It felt like I was breaking through a curtain, and I remember having some kind of dream about Taco Bell. The Scottish nurse said, "There she is! Everything went very well. He was able to repair your meniscus." I was wheeled into the recovery room. I remember seeing the clock: 12pm.

What Happened? Part 2

2003-10-09T23:06:00.000-04:00

I'm back in bed, laptop and cat at my side, for more quality time with The Brace. I just heard David tell his Dad on the phone, "There probably will be some atrophy, but that's what the physical therapy should help." Ack. Freaking out again.

Back to October 1 at my doctor's office. After discussing the options, we both agreed that the ACL repair was the way to go. Without fixing it I'd be at higher risk for future injuries, and I'm a pretty active girl. I'd done research on the ACL repair surgery and had some idea of what it would entail, and the prospect was not so appealing. The doctor and his staff were incredibly understanding. The surgery was immediately scheduled for that Friday - yes, October 3, two days from when I was receiving this news. I panicked, then paid my co-pay, weepily called David to tell him the news, then hobbled off for the pre-surgery bloodwork.

From the doctor's office (at the Hospital for Special Surgery) I called work to let them know I wouldn't be in that day. I was a mess. Every time I thought about the upcoming weeks and months I would burst into tears. When I left the dr.'s I met David at his office. We decided to buy a new bed to replace his ailing 10-year-old mattress. Within about 20 minutes at Sleepy's we'd ordered a new king-sized pillowtop for delivery that evening. We picked up a set of sheets and I went home to wait for the bed to be delivered.

Thursday, October 2 (day -1)

I went to work. The day went slowly, and I tried to wrap things up as I knew I wouldn't be in at all the following week. My co-workers were incredibly understanding. One had had the ACL repair surgery a few years ago and had already told me it would "suck," and given me some details and what to expect. Someone from the hospital called me at 3pm to pre-register me for surgery, and at 5pm someone else called to tell me I was to be there first thing Friday morning, at 6am. I left work then to run last-minute errands, which included buying a wireless router, getting a pedicure, and purchasing a freezer-full of meals for D & I for the week.

[Incidentally, while running the aforementioned errands, I learned some things. One, that the people who shop at Best Buy are nicer and more helpful than the people who work there. Two, that hopping into a Chinese nail place on crutches and asking for a pedicure confuses the hell out of them. And three, that the people who work at Whole Foods are nicer and more helpful than the people who shop there.]

Tune in tomorrow for Day 0! Find out how your eye - yes, your eye - can get screwed up when you have surgery on your knee. Also explore why the anesthesiology profession seems to attract so many attractive people.

What Happened? Part 1

2003-10-09T12:24:00.001-04:00

It has been 6 days since my ACL and meniscus repair surgery. I finally have a laptop with a fancy wireless internet connection (thanks to David & Garth), and if you didn't know any better and you saw me lying here in this mammoth king-sized bed with the FOP at my side that I've turned into quite the lady of leisure.

But there is, of course, lurking beneath the fluffy goose-down duvet... The Brace.

The Brace and I are spending a lot of time together. We didn't really get along at first... She's stubborn, and doesn't always go with me the way I try to go. I'm stubborn too, so there was conflict. Lately, though, we're working things out. I can haul her out of bed, and raise her up. It takes some persuading but she usually ends up where I need her to be.

How did The Brace and I end up in such close quarters?

Several years ago, in 1996, I was on an Ultimate Frisbee team in Ottawa. I'm not much for team sports, and until very recently (ah the irony) I hated running, passionately, but Ultimate is a fun game and a great way to meet people. Plus you get to drink beer! On the field, after the game! That's my kind of sport. I actually remember my Ultimate career-ending moment, when a pivot turn wrenched my right knee. It swelled up and my aunt, with whom I was living at the time, insisted that I see a doctor the next day. X-rays came back negative, and I was able to walk and not seriously debilitated, so I underwent a brief regime of physical therapy and resumed regular activities.

Some other stuff involving my left foot and my left knee happened in the interim, but they're not so relevant right now.

In January 2000 I was planning a move from California to New York. A few weeks before the move I was babysitting for friends, and knelt on their parquet floor. Something happened that wasn't very nice. I started experiencing sharp pains in my right knee. It was worse when I carried heavy objects on that side, and sometimes it was OK. As soon as I arrived in NY in March 2000, I made an appointment with an orthopedic surgeon. He ordered an MRI of my knee, and found torn meniscus, as well as irritation behind the kneecap. He also informed me that the MRI showed a torn anterior cruciate ligament (ACL), which was not causing this particular pain but was, he explained, responsible for the general instability I sometimes had in my knee. The ACL is a stabilizing ligament. It keeps your knee from moving laterally (side-to-side). When it's torn or otherwise weakened, you can have the sensation of your knee "giving out." That was my experience - it happened occasionally when I was doing something like jumping jacks (ah yes, lateral movements), but didn't affect me much in my daily activities.

The recommended surgical option was to have arthroscopy to repair the meniscus and *hopefully* relieve some of the kneecap irritation. I scheduled the surgery, my mom flew down to help out, and it went incredibly well - I was back at work within a couple of days, and the pain had been completely alleviated. Back to regularly scheduled programming - I resumed working out, strengthened my quads and hamstrings, and while I still experienced the occasional instability, everything was kosher.

Until now. On September 22, 2003, David & I went to Prospect Park to meet some people we'd met on craigslist to play touch football. We were barely warming up, just tossing the ball around, when I stepped on a branch. My right knee twisted and "gave out," as it is apt to do. Usually I walk a little and it feels better right away, but not this time. I couldn't put any weight on it, and I couldn't straighten it out. David suggested we go to the hospital, which I brushed off as silly, but then realized I really couldn't walk. One of the people we were with had a car, so I hopped to the street and he gave us a lift the few blocks to the hospital.

We found a wheelchair (I know, it's pathetically hilarious) and D wheeled me into the ER. I wasn't upset or worried, it just felt like something was out of place and maybe it'd take a little while but that it would adjust. I filled out all the forms and waited for about 2 hours to see a doctor. He bent it and asked me a few questions, then ordered a set of x-rays to make sure there wasn't a bone chip. The x-rays came back negative, and he sent me home with a brace to keep my leg straight-ish, painkillers, crutches, and an order to see my orthopedic surgeon.

Within a couple of days I saw Dr. Nestor once again. He examined me and discussed possible diagnoses, which he would be able to confirm after an MRI. If there was a meniscal tear, he might be able to repair it with arthroscopy. If it was a severe tear, or on the outside of the meniscus, he'd recommend having the ACL repair to increase stability in the knee. Of course there was the possibility that there was no tear, and it was simply a bad sprain that I'd work through.

No such luck.

On October 1 I went in for the results of the MRI. I learned that I had a bucket handle tear of the meniscus. It was pretty messed up. The good doctor listed my options and discussed them with me. He answered all my questions, and we decided that I would have the ACL repair and he would try to repair the meniscus. Because of the extent of the tear there existed the possibility that he would have to remove the meniscus entirely. That freaked me out. Dr. Nestor explained that I wouldn't notice its absence for the next 20-30 years, but that not having meniscus would put me at a higher risk for osteoarthritis, and I'd probably need knee replacement at some point. Whee!

Stay tuned... frequent updates over the next few days.