Ciao, Dr. S! [20 Weeks Post-Op]

From the title, I'm sure you can guess... My good man, Dr. Jeffrey Shapiro gave me the final farewell yesterday in my follow-up visit! He admitted that I came out of the gate a little slower than most, but that I've made up ground since then and am right on track. I had often looked forward to my visits with Dr. S to get such confirmation, but at the same time I'm grateful that I had a (mostly) smooth road to recovery and that I'm nearly back to normal!! This must be what Drew felt like when I ended things with him, and PT... *sigh*

Despite halting doctor and PT appointments, I'm not done yet! PT (at home) will be ongoing, as I hope to stick with doing things on my own at least 3 times a week until I can work my way back into sports. For instance, today I strapped on my soccer/UF cleats for the first time and got a taste of the field. Unfortunately tomorrow's soccer practice was cancelled, but I will be doing a workout and eventually heading up to the driving range to dust off the 'ol golf clubs too! Knowing the doctor doesn't need to see me again gives me that 16-yr-old-with-a-set-of-car-keys feeling of freedom again!

But I must share... Yesterday's 'closure' with Dr. S did end on a bit of a personal sour note. My good friend Wendy was in one of his OTHER exam rooms, getting the news that she'd torn her ACL (just like me- playing flag football!). So, as much as I would have liked to avoid my injury, I am almost glad I have the experience (and blog!) under my belt to help reassure her that she'll come through it just fine!! [You can do it, Wendy!]

The gorgeous bouquet I received from Miss Wendy... just for helping! Aww, shucks!

Things I'm looking forward to: Golfing this weekend, Yoga class starting in 2 weeks, and hopefully dusting off the frisbee one of these weekends for some good 'ol fashioned pick-up games!

My First 1-Mile Run [2 Months Post-Op]

Since my last PT visit, I hadn't made much time to get in quality exercise for my knee over the weekend. I blame being preoccupied, but a little of it was laziness. Over the weekend there was a lot of walking and standing, and the 'ol knee held up well. Occasionally an ache would find it's way around my knee, but nothing too painful. Either way, I was looking forward to today, since my last PT visit was finally a break from the monotonous routine I'd been doing.

Today's surprise was the 'timed 1-mile run'. As an ex-cross country runner and being an athlete in general, I know I used to be able to easily run 1 mile. Plus, I've done previous sessions of run-walk intervals in PT, covering more than 1 mile, but today's challenge was to do 1 mile running, and at a decent pace. So, once I'd done an 8 minute warm up on the elliptical and stretched a little, I headed for the treadmill. Drew was not over my shoulder during the run, so I didn't burn myself out on it, but I did make sure to turn up the pace from previous PT runs (from 6.0 to 6.5). I finished in ~9:30, and for my first mile back after knee surgery, I am OK with that! (Plus, I know I could have gone faster if I had to, but I still had a full slate of PT ahead of me!).

The run left me whipped, but as usual, I felt really good about it once I was done! I did a handful of other exercises (including shuffling side-to-side between cones; also pushing off side-to-side in a speed skater fashion on a slip board) which had me working on sideways movements and adding in a little squat motion as well. It's good to know I'm getting to a point where it's not all about the range of motion in a straight line!

While I did have to go down in weight on the one-leg press today by ~10#, I was fine with exhausting my leg muscles to the point where they were shaking throughout that exercise, and others. Lunging is still difficult to put the weight evenly through my surgical leg, but practice makes perfect, right?

Next Monday (just shy of 10 weeks post-op) I'll see the Doctor again and make sure I'm on track!

I haven't posted pics in a while, but then again not much is changing. Swelling seems minimal, the incision is healing up nicely, and the definition in my legs is coming back, little by little. The only thing I might ask about is the dark spot that still remains on the back of my knee where I had dark bruising after surgery. I am sure it's normal, but just out of curiosity.

"Rumping" [6 weeks, 4 days Post-Op]

When I left you, dear reader, I had told you of my first attempt at running. I have since undergone yet another PT session (which included about 10 minutes of 2-minute intervals of speed-walking and then 'running') ... but I wouldn't call it running. It's more of a cross between limping and running... which my good friend Jesse so cleverly coined "Rumping".

Today I gave the run/walk intervals another try. I was advised by Drew to go to a track (meaning level surfaces and a nice padded course) but since there was a soccer game going on in Berkley's track infield, I refused to run around the game and provide entertainment for the ~100 people there. So, I went outside of my trainer's wishes, and hit the streets (very carefully, might I add). First, it was taking my walk from a slow, to normal, to eventually quick pace. Then, once I felt comfy, I tried running again. It felt just as awkward as the first two times, but if nothing else, it felt good to be out, trying, and breaking a sweat!

I believe the reason I can't shake the limp while running is I am (1) still having a hard time mentally trusting my surgical leg, (2) my muscle mass in my surgical quad is substantially less than my non-surgical and (3) when I do run, I am not letting my surgical leg extend out all the way, therefore I'm running shorter strides on that leg versus my 'good' leg. This overcompensation caused a little pain in my 'good' leg's hip towards the end of the run, but nothing I feel when walking or going about my day-to-day.

Otherwise I feel I am reaching a point where I actually sometimes FORGET about my 'bum' knee! It is a wonderful thing. The more I find myself putting it out-of-mind, the more I realize I am getting back to that 'normal' lifestyle I so desire. In the coming week I'll still be seeing my trainer 3x, but after that we've decided I'm ready to go to 2x / week. This can only mean one thing... PROGRESS!! :)

A Monumental Week [7 Days Post-Op]

Tomorrow is my 4th Physical Therapy and my first post-op appointment with Dr. Jeff Shapiro- I promise to get an entry up about that tomorrow... But, first things first: Here we are, 7 days post-op!!

If you would have told me this week would go by so quickly, I wouldn't have believed you. But trials and tribulations aside, there have been some definite improvements that have me keeping a positive mind in my eventual recovery!

• I can bend beyond 90 degrees and straighten to zero degrees
• I can bear all of my body weight on my surgical leg (veeery carefully)
• I can walk (albeit slowly and quite hobble-ish) without aid of crutches or a brace
• I can get up and down stairs without assistance
• I can drive
• I can bathe (woo hoo!)

Of course, there are many milestones including:

• Going up and down stairs w/o having to take them one at a time
• Walking w/o a limp
• Regain balance (on both and) in my surgical leg
• Regaining entire range of motion
• Running
• Returning to sports (this is KEY for my sanity!!)
• Getting back to 'normal' !

I understand this will take 6-12 months, and I'm not planning on being a hero and getting out there too early. However, I hope I can continue with physical torture... I mean therapy (!) with vigor until I'm where I am capable of being, both physically and mentally! Of course I wouldn't be able to do it without a strong network of support, so again, thank you to everyone for all your help and kindness.

And because everyone likes photos (or, is it starting to gross you out?!)... some Day 7 post-op pics, for reference:
Increased yellowing and bruising, primarily on the inside of the knee and a little down the shin.
Bruising has also come about on the back of the knee:

I don't seem to have any trouble straightening to Zero degrees, and there has been no change in the incision area, as I have not removed the tape nor gotten it wet. Bending the knee continues to be a challenge, and I can get it to about 100 degrees but not without pain.

Until tomorrow...

Bruising, Driving, Pain and Ditching the Crutches [6 Days Post Surgery]

I have heard of people getting bruising all the way down their shin and around their knee (seems normal since there was a saw, a drill and 2 screws in the mix of the procedure) but I hadn't seen too much of that on myself until recently.

Since pictures are worth 1000 words, here are some shots which show a little of the bruising, as well as my improvement in getting my knee to bend at home. [Remember, the Day 6 goal was 90 degrees per my Physical Therapist, Drew...] The swelling and tightness within the knee was what was keeping me from bending any further:

4 Days Post-Op:

5 Days Post Op:

6 Days Post-Op:

Now, granted, the pic above of 90 degrees was taken after PT, but to my credit, I did try at home that morning, and got to ~85 degrees and was delighted! As you can see here, on my way to PT I was able to get myself into the car and also crack a smile. Clearly I did not know what was waiting for me behind PT #3...

I arrived in my immobilizer and on crutches, and made my way so I could unwrap everything as I sat on one of the padded PT tables.


First, sitting upright with legs extended in front of me, I did 45 reps of using a belt around my surgical foot to pull the heel towards my butt, causing my leg to bend, then using my leg to push back out to straight. This is an easy way to 'warm up' the joint, as shown here during my at-home PT:Next, it was extend and bend time. I was lying on my back with legs extended as Drew massaged the lower thigh and knee-cap area. It was a cross between being painful and a relief. This manipulation lasted about 30 seconds, before he stood up (I was laying around his waist level) and he then leaned into my knee, forcing my leg to straighten as much as possible. In my opinion, I thought he was trying to bend my knee backwards, and this surprise pain caused me to flop around a bit. But it was nothing compared to PT#2's forced bend. I was then asked to flip over on my stomach, and got further massage on the back of my knee. In my few visits I knew this to be the prelude to a very painful forced bend, so already I was getting anxious. He did distract me though, by massaging the bruised area on the back of my knee (pictured below) which hurt a bit, but not terribly. Then, the moment I'd been dreading.

I am not sure where he places his hands, as I get into a foggy mentality at that point. But needless to say, he pushes my knee to bend beyond comfortable (or even uncomfortable) limits, into the screaming, gasping, never-felt-pain-like-this-before range. This is not meant to scare anyone, but I would not have wanted to watch this being done to myself or anyone else. Even though I was in an open PT area with other recovering people around me, I had no ability to limit the noises and cries coming out of my mouth. I actually cried/yelled, "STOP-STOP-STOP-STOP-STOP!!!" as he continued to bend my knee. Eventually, he did stop (this forced motion probably took all of 15-20 seconds, but felt like an eternity). My only saving grace was that instead of doing this 3 times, as he had done on Friday, he only did it once.

Drew told me he bent it to 95-100 degrees. I'm all for working towards a successful recovery, but be HONEST with me, man! If you're expecting more than 90, don't tell me 90! 5-10 degrees may not SEEM like a big difference, but trust me, I could feel every little degree (and the people around me could HEAR it!). There was an older man on the next table over who tried to make me feel better saying he's been through the same thing, but unless I heard his cries of pain, words didn't offer much consolation at that point. What I needed were Kleenex and more Vicodin....

PT carried on in challenging fashion, as I was forced to walk the ~80ft to a bike in the corner w/out brace or crutches, and it was all about being able to put full weight on the surgical leg, which I didn't think I could do w/out it giving out from under me. I had to trust Drew. I had to trust the guy who just put me in the most pain of this whole experience. Talk about a wild inner monologue.

I made it to the bike, where I used the force of my right leg to work on range of motion (ROM) for my surgical leg. Slowly I worked my leg forward and backward around the 'U' made by the lower portion of the pedal revolution, until I could finally make a full revolution with just a little pain.

After that it was more walking, some balancing, some marching in place and finally, icing my knee at the end. I was exhausted and in pain, but at least it was all over.

I went to leave, immobilizer on my leg and crutches under my armpits. As I said goodbye to Drew he looked at me with wild eyes and said, "What are you doing?!" and he motioned to an assistant, "Take those crutches away from her! No more crutches!" I became protective of my supportive crutches and responded, "OK, OK! I won't use them! But I'll carry them myself!" and hobbled my way to my car, where my crutches still sit.... So it's official, I've ditched the crutches!

There are no 'goals' for Wednesday PT, and Drew did say he promised not to beat up on me too badly every time, but perhaps every other time. I don't know what that means, but I did admit to him that if it is necessary for recovery, he can do whatever he wants (what was I THINKING?!). Maybe next time I'll bring a flask.... !

For further comparison to previous days, here are some shots from Day 6 Post-Op:

Doctor Says... [27 Days Pre-Surgery]

I had spent numerous hours online doing research, as well as talking to teammates and friends who’ve undergone ACL reconstruction. As I sent out emails I received overwhelming support (even if it did start out, “Man, that SUCKS!...”) and I also learned that many people I knew, who were athletic and active, had undergone a surgery for this very injury. All of this helped me put this all into perspective. I will get through this!! I am trying not to play it down as if it’s not a big deal, because it is! For this girl (who’s never had a broken bone or stitches, remember…) this is a major surgery on a major joint. That doesn’t mean I am going to let it own me.

So, today I met with Dr. Shapiro again, and my dad came along to hear the discussions on my options. (I must admit, bringing anyone, especially my dad, along seemed like a very 1st grade thing to do, but it was nice to have someone there to distract me while waiting, and chime in with questions I might not have thought of…)

Enter Dr. Shapiro, stage left: “[To me:] Hi Again. [to Papa John:] Nice to meet you. [To me:] Your ACL is completely torn. There doesn’t seem to be any damage to your meniscus or other tendons or ligaments, so that is good. There’s some bone bruising, but that will go away in a few weeks.” Dr. Shapiro sees a manila folder I brought with me and says, “So, what questions do you have for me?”

I was surprised, as I figured he’d dive right into my options, what he recommends and how to go about it. But he didn’t have to make any small talk because he remembered I said I was in any sport I could get my hands on, and knew I’d want to get right back to it. And so I began, “Well, from what I’ve found online….”

Dr. Shapiro and I agreed on the procedure Uncle Jimmy had mentioned to me- the patellar tendon graft. Since this was the surgery Dr. Shapiro does 110 out of his 150 yearly ACL reconstructions, I was confident that I would not need a second opinion or need to search for someone with more experience. He answered all of my questions (Yes, I’ll start rehab the next day… Yes, I can shower soon after… I can return to work in a week [Nah, let’s make it 2 to be safe, I said…]…) From there, he asked when I would like to do the surgery, and if I had anything coming up that I wanted to do before having surgery. I got a little smirk on my face and said, “Well, [Detroit] Tiger’s opening day is April 10… If I have surgery right away can I be well enough for that?” He immediately said no, because there’d be too much walking. That decided it for us- the surgery would be Tuesday, April 14, 2009…. “See you then!” he said.

We checked out and proceeded downstairs in the same building to set up some Physical Therapy prior to the surgery to (1) straighten out my leg all the way, (2) strengthen my leg/knee to help with recovery and (3) to get to know the trainer and the facility to be sure I like it! I ended up getting an appointment with Drew, who would become my physical trainer, to do a baseline and get some exercises from him to do at home. At first meeting I wasn’t sure what to think, but I figure it’ll take a few more sessions before I’ll understand his process and how he’ll be helping me through what’s going to be my biggest physical accomplishment to date. We set up a few upcoming appointments and I was on my way. With PT and Surgery scheduled, I still don’t think an understanding has completely sunk in of what I am going to be going though!

Official Results [33 Days Pre-Surgery]

Thursday was finally here! Today I am leaving straight after work to head for Chicago and carry on the third year of our traditional St Pat’s Day celebration! Erica was flying in from Philly, and I’d be driving to Jordan’s apartment and we’d eventually be with Jen, Eric and Meagan too. It was bittersweet though- wanting to know so badly about my knee but also wanting to ignore it and be excited for my upcoming weekend!

I checked my cell phone around 930am and noticed I had a voice mail from Aunt Judy’s number. Turns out Uncle Jimmy had given me a call and before they ran off to Puerto Rico, I was to return the call. My heart was beating out of my chest as I dialed him, because who knows what he’d seen in those images?!

“So, what’d you do?” Jimmy said after we’d exchanged pleasantries… He may have meant “tell me exactly how it happened” but his emphasis on ‘do’ gave that hint of “How’d THIS happen?” I bucked up for it, told him my sob story (or, lack thereof) and he hit me with the news. “Well, from the images I was so privileged to see… you tore your ACL.”

Don’t cry. You’re at work, you’re 26, and you knew this might be a torn ACL. But no matter my inner monologue to my tear ducts, they welled up anyhow. Sports are my life outside of this cubicle I’m stuck in!

Jimmy and I discussed my options, how long I’d be out of work, and I said I’d try to get the official MRI report to him as soon as I could. I didn’t get it to him before he left for vacation, but I did have it faxed to me 15 minutes before I hit the road to Chicago- and it was just as we’d suspected…

To quote the MRI report: “The anterior cruciate ligament is blown out. There is grossly altered signal in its place…”

Needless to say, I had the next 4.5 hours to spend with myself and deal with the reality of my injury. I was jittery and nervous, for some reason. I think there may have even been an onset of a cold sweat. But I let the road sooth my jitters, and luckily it was a sunny and gorgeous evening, and I was on my way to spend time with people I knew I could lean on for support with the recent news!