2 Steps Back

It's been a little while since I've written. I have been so busy trying to get back to normal but my knee does not want to come along for the ride!

Since I wrote, I've unpacked from the Bahamas and been on a business trip to Boston. I had such a good time seeing the city! I even walked for about 2 and a half hours after the sessions were over which made me feel like a real able-bodied person. Beacon Hill was rough - I was at a snails pace, but I did it!

Unfortunately, though, I had a big fall in a restaurant on my last night. We were walking back to our table. The floor was slippery and my shoes didn't hold me. As I skidded on my bad leg, my knee gave out and I landed in a heap with my legs under my butt.

This could have been the most embarrassing moment of my year, but I was in too much pain to care what the table of 12 on one side of me or the full bar on the other side thought. It took me two or three minutes to compose myself on the floor and make sure that my leg was willing to let me stand up. My knee swoll up and it took me about 25 minutes to calm myself down from the pain and fear that I'd hurt something that couldn't easily be fixed. I did finish dinner and returned to the hotel room for a giant pack of ice. Thanks so much to my friends who consoled me and ran down the street in heels to a pharmacy to get some ibuprofen!

My physical therapist says that he doesn't think that I permanently hurt anything and I feel the same way. I have a doctor's appointment in a week to verify this. I'm still in more pain than last week - it still feels swollen and angry. I might say the same for myself. I need to get back to my physical lifestyle or check out weight watchers, but perhaps this can be discussed at another time!

Must Read for Soccer Girls

I just read this very interesting NYTimes article about ACL and injuries in general and female athletes. I was so fortunate during my competitive playing years that I never suffered a major injury and missed very few games in spite of averaging probably 40-70 games a year for my competitive years from about age 12 to 18.

Today, I'm recovering from the major surgery as a woman over 30. I've played well over 1,000 soccer games in my life I'm sure. And how did I tear my knee to shreds? Skiing. Harrumph! It would have been more worth it in a soccer game!!! I will be so mad if that day skiing takes me from the sport I love!

The article is right...there are tradeoffs if you decide to return to something like soccer. You could face surgery again, further damage, or just not be the same. Do I want to just return to being active while leaving soccer out of the equation? No way! I can't imagine losing the ability to compete or the social outlet with other people who love to play and try to win. I love the feeling of a perfectly kicked ball coming off your foot. If I get that feeling once a year that's worth a hundred hours of play. But, then again, what if I can't be a shadow of who I was before my injury years before I expected to ratchet things back in my 40s or 50s or after kids? Will that be okay? Will it be the same?

So many questions that only time will bring answers for...

There's another dynamic in the article. The "is it worth it for girls to compete and make these sacrifices of health and wellness" tone. To me and to many women I have played with (my indoor team this winter had five of twelve women who had gone through ACL surgeries as adults) it is worth it. But for someone on the outside looking in, I could see how it seems crazy as youth or adults.

Surgery + 8 Weeks: Good Cop - Bad Cop

I refer to my two primary physical therapists as "Good Cop" and "Bad Cop". This has nothing to do with their abilities (both outstanding) or personalities (both cool), but there is a distinct difference between their methods. You know with BC that you're going to be pushed to the brink on most days and with GC the process is more conservative. I think they both do a great job and it's a good combination to have the two working together.

Yesterday was a prime Good Cop vs. Bad Cop encounter. GC walked me in and got me going with the usual Exercise Bike for 10 minutes and I followed with the normal stretches. Then, I asked him what was next. I was scheduled with BC and he checked with him. No surprise that I then was given the sentence of 10 minutes with the leg hang. I laid on my belly on the table with a (heavy) heating pad on the leg and a weight on the ankle. Everything from just above the knee down was hanging off the table. GC told me there would be no Quad Stim to accompany this therapy. I was so thanking the heavens that it was a GC day!

Two minutes later, BC came by to let me know that I was not getting off that easy. He attached the Quad Stim, and proceeded to ramp up the voltage to the usual excruciating muscle cramp. 10 seconds on - 30 seconds off. Not only did I get added discomfort, I got to start my time over!

When the buzzer went off "Time's Up!", GC started to walk over to release me from the weights and wires and all that good stuff. I'm usually unable to do much more than a very feeble army crawl at this point anyway. Unfortunately, though, BC spoke from across the room, "Hold up!" I got to wait an extra minute till he finished with the other patient and slowly came over. My 10-minute easy leg hang had turned into another torturous session with extra minutes added on!

I will thank them both when this is all over because they've been great in helping me, but I won't soon forget who's good cop and who's bad cop.

Surgery + 7 Weeks and a Day: Peaks and Valleys

Things have been good for the most part this week.

Somehow my PT seems to last more than 2.5 hours but not be nearly as painful and actually almost feels like a workout. Things I'm doing...bike, walking backwards on treadmill, some stair-like motions, balancing on one leg with actions, weights (3 or 4 machines per session - I'm @ 145 lbs for leg press w/ both and 70 with one and given my history of wimpiness this feels like a lot), the normal stretches, calf raises including on one leg, and practicing walking. I haven't returned to the "torture chair" in a week but do have two things I really dislike...therapist pulling and pushing the leg straight (kind of massage with a medieval torture theme) and prone hang off a table with the added benefit of quad stimulator at the same time. Today the full 10 minutes was unbearable and I give myself kudos for not screaming.

Through all this though, I realize that the PT and value of the trainers is worth every blessed insurance penny they get paid. They do great work and push me much harder than I would be able to push myself. This brings me to a big concern. I haven't gotten an answer back yet as to whether my insurance benefits have been extended for physical therapy. Given the fact that I'm not jogging yet, I'm really concerned with my progress if I'm left to my own devices.

The other bummer is that outdoor soccer season is starting. Well, I should probably revise the term "bummer". I'm really happy my friends that do get to play, but I am going to be a green-eyed monster. I've spent countless hours this winter working on the board of directors of my local adult soccer association to get our organization ready to have spring, summer, and fall leagues. It's ironic that during my first term on the board I'm not likely to play in a single game. I plan to practice some sports photography as my back-up hobby while I'm out, but will miss the exhileration of kicking the ball just right where it feels perfect coming off my foot and the general camaraderie of playing with different people which always keeps it interesting.

Alas, I guess it could be worse. Spring seems to have arrived (finally) and after a long Michigan winter this is a time where it's very hard not to feel a sense of wonder and happiness.

Surgery + 8 Days: Wisdom Inside Dark Chocolate

I found today's inspiration inside the Dove Dark Chocolate my friend Gerri gave me. Here's the wrapper:


What a great reason to eat chocolate!! Anyway, I would say today was a very good day.

Therapy was quite challenging and we made it on time in spite of six more inches of snow we were blessed with overnight. I swear that it has snowed 90% of the days I've had 7 a.m. therapy and with salt supplies running out in Michigan the roads have not cooperated. Today wasn't too bad, though.

I did the electrode stimulation for my quad for 15 minutes, "NuStep" modified sitting stairmaster for 10 minutes, range of motion exercises, calf stretch, standing work with exercise tubing, ankle pumps, and the newly introduced modified squat - a whopping 55 pounds with both legs and 30 with the knee alone - but not bad for 8 days post surgery. My therapist says I'm on track but he would like my leg to be straighter - this is painful! If you look at your leg, straight is actually a bit inverted and I'm not there yet. I do have 90 degrees range of motion - something I thought would be impossible last week.

I had a really good day of work today, too. Chloe was decidedly hands off. She must have tired herself out yesterday. I'm making my first non-therapy venture out of the house tonight for a board meeting for the soccer association. Tomorrow it's my big debut at work. Probably good so I don't get too used to working at home. It will be so exciting to wear something that isn't pajamas or sweat pants!!!

Surgery + 5 & 6 Days

I've finally got cabin fever which means it must be time to take the next step and start getting out of the house! Sunday was a long day. I've still been staying on the couch as much as possible trying to focus on staying elevated. I did PT exercises twice on Sunday (I had done them three times on Saturday). I think I'm at about 45 degrees on ROM although when I sit up and let gravity do the trick, I can go much closer to 90 degrees.

Today (Monday morning) was welcomed with a 90 minute PT session. They say I need to focus on straightening the leg as much as possible "so they don't have to torture me in a month or so". Amen to no torture! Jeff thought I had somehow deserted him in the waiting room. There was 20 minutes of electrodes stimulating my quad muscle, calf stretch, two range of motion exercises, 8 minutes on a sitting stairmaster, leg lifts, modified squat, and 20 minutes of ice with electrodes to reduce knee swelling.

The one thing still holding me back is pain management. I've pretty much given up the prescription painkiller except at night where it's not strong enough to keep from waking me up in pain. This is complicated from muscle cramps I'm getting during the night - probably from the PT. I'm going to keep struggling with that.

The one thing I've missed today - first day home alone is company. This was especially apparent as I knocked over a full glass of water about 5 minutes after Jeff left for work for the day. It was so nice of Mom to come and visit for five days and do way more helping out than she should have - I owe you big time, Mom! Other friends, Sue, Joanne, Skeeter, Jason, Connor, all have helped to brighten my days with visits. I also had two bundles of energy visit last night - Jen's twins Jadyn and Jordan - they were fun and brought yummy chocolate chip cookies. The two giant care packages from my work and our soccer team/Jeff's work have been so amazing and all the warm thoughts, cards, e-mails, etc have been so great. And, of course, the biggest helpers have been the residents of the house - Jeff who has been chauffeur, nurse, and jack of all trades and Bethany who took off work Wednesday to help me out and is always so handy. THANKS SO MUCH!

No Pain No Gain

One of the unfortunate side effects of PT is the pain that comes with it. I know I'm making progress just in 24 hours of exercises. It's already easier to do PT today than yesterday. Heel slides are currently my nemesis. I had about 125 degrees Range of Motion (ROM) pre-surgery. I would be surprised if I was at 40 degrees today. I need to get to 90 degrees ASAP!

Anyway, the PAIN part! All of the focus on strengthening the quad/upper leg is that those muscles feel used!!! Unfortunately, during the night the accompaniment to tired muscles appeared - cramps! Not only do leg cramps hurt a lot, but when you also are scared of an out of control tightening leg making your knee hurt more, there is pain and nerves attached. I probably got up in pain five or six times, but made it through. I'm anticipating a few more of these nights as I make progress, but am still so glad to have aggressive physical therapy to get me back on the road more quickly.

Other big news - I got a hsower - yippee! I would definitely recommend that if you have knee surgery, you buy some sort of chair for your shower before surgery. We hadn't done that so made a quick trip to the store first thing this morning - it was definitely necessary. I feel so much better now that I know I can refresh and renew with a shower every day. I know some doctors make you wait to shower until after your stitches are removed - I'm so glad I'm not in that boat!

Surgery At Last

The day for surgery finally arrived. I would say I was more nervous on Monday, the day before, than on Tuesday when I went "under the knife". We pulled out the couch in the recovery room (aka my living room) before we left to go to the Ambulatory Surgery Center. We arrived early (a rare occurence for me) and when we went into the brand new facility I could tell that at least Jeff would be comfortable. The waiting room was posh as far as I was concerned with a couple computer terminals, tables, and a lot of space.

I was immediately taken into the surgery prep area, given a bag for all of my stuff along with a gown and socks to change into. The nurse got my IV in and double-checked that I was me and went through some pre-surgery questions. I briefly saw my doctor and his resident as he walked out of his previous surgery. He initialed my right leg and that was the last I saw him for the day. The resident went over the gameplan and then I met the anesthesiologist and her resident. She asked if I wanted general anesthesia or a spinal - definitely general! She also told me that when I woke up I would have the option of a spinal block if the pain was severe when I awoke. This puts anesthetic in your femoral artery to basically numb your leg. She said about 20% of patients have severe pain and can use the block but they don't like to do it until after the surgery because it only lasts for 8 to 12 hours.

The resident gave Jeff a prescription for post-surgery painkillers and he gave me a sedative to keep me calm. Then it was time to say goodbye to Jeff and head into the surgery. I was pretty relaxed (with the prescription). I remember being wheeled in, confirming my name and why I was there and that's all, they put me under.

I awoke in the surgery room (I think) and I was in A LOT of pain. It's all pretty fuzzy but I know my leg hurt much worse than I expected. I was rolled into the recovery room. The nurse immediately increased the pain medicine in my IV. I was shaking, moaning, and having trouble communicating. The pain medicine was helping a little and I'm not sure how long this was going on, but they made the decision that the spinal block made sense and I was all for that!

The anesthesiologist and her resident used an ultrasound to find my artery and the nerves around the patella. They were great about getting the injection in around my groin and it only took a few minutes before I was much more comfortable!

Mercifully, they waited till I had calmed down to bring Jeff back. He had been updated by my doctor right after surgery - he said that the MCL was healing well and did not need any fixes in the surgery. They replaced the ACL and cleaned up the meniscus as expected. They are still concerned with some damage on the outside of my knee - something about bone spurs. I'll find out more about that when I get to speak with him on Friday.

Jeff waited with me in the recovery room for 20 or 30 minutes and then I was released to go. Jeff warmed up the car and I got wheeled out. Everything went smoothly and we were on to the next stage - recovery!!