Surgical vs 'Good' Leg [5 weeks, 1 Day Post-Op]

I was just thinking about how at the end of February I was hitting all the resorts in Salt Lake City with my snowboard, and here it is, almost 3 months later, and I've been through injury, surgery, and what they say is the hardest part of re-hab. I can't wait to hit the slopes again... among other activities I'm itching to get back to!

So in my continued efforts to get back to 100% (or better!) I returned to PT today assuming I'd have pretty much the same routine as normal: Ultrasound (locally @ incision), a few painless exercises and stretching, and eventually 'ice' by rubbing ice directly on my knee until it's numb! I was right on everything, but then I got a little more in the way of exercises.

At 26 Days Post-Op (just 10 days ago) I mentioned some 'upcoming milestones'...

One goal is to get back to a 'normal range of motion' , which is from zero to 130-135 degrees. Drew told me that I am within a few degrees of that as of today (Yay!) but that my 'good' leg is closer to 160, so I definitely have some more work to do!!

Another ongoing goal is to normalize my gait. Today I was told I have all the PARTS of walking normally, I just need to piece it all together in one fluid motion. I like to compare this to learning to golf -- it's not easy to do everything right at once! While I may be able to control my walk enough to appear not to have a limp, it is still a very conscious effort (hence my previous post, 'Could the limp be gone?!' not stating that it was gone!). Drew would watch me walk and of course compare- What was my 'good' leg doing that my surgical leg was not? [Answer: My surgical leg is slightly bent through the whole stride; I'm never completely straightening it out.]

My goal to walk smoothly comes back to another goal I was perspicacious enough to realize over a week ago- being able to trust my surgical leg as I balance on it and at the same time go between straight and slightly bent. I brought this up to Drew today and he had me 'practice' doing this very motion. There were some new twinges of pain as I did it, and my leg was shaking (oh, how sad the weakness is!), but it was good to be forced, because I hadn't challenged myself at home just yet. I had to stop a few times and do the same motion with my 'good' leg, just to remember how it's supposed to look and feel!

And so the battle of Surgical vs 'Good' Leg continues.... As for the other milestones I'd set:

• I'm happy to say I can go up stairs without favoring my surgical leg
• I can balance on my surgical leg when it's straight (as well as slightly bent) without pain or feeling like i'm going to tip over (it's going between the two that's tough!)
• I can go down stairs with one foot per stair (though I favor my surgical leg VERY much when doing so)
• I continue to massage around the incision to get the skin to move freely over the knee cap (and I've also been using Mederma to hopefully reduce visibility of the scar... eventually)

Pic as of today (you can ignore the waffle imprint- that's from using my ThermoComp icing machine...)

And, since I may not post again before the Memorial Holiday - I hope everyone has a safe and fun weekend, and I'll try not to do anything dumb to mess up all my hard work on my knee!!

Cheers!

Could the Limp Be Gone?!? [4.5 Weeks Post-Op]

I've had my set-backs in recovery, and in my last blog at 4 weeks post-op I talked about my continued pain when attempting to walk, and how it's likely due to a case of tendonitis. This pain was forcing me to limp, even when I really focused on evening out my stride.

While I'm still at PT 3 times per week, we've been taking it easy for about a week and a half, doing ultrasound in the area of my patellar tendon and locally icing directly on the skin. I knew patience (and a positive attitude!) would be a must as I overcame this hurdle.

I must say I'm having a bit of writer's block to describe just how I've come to ask myself... Could the limp really be gone? It comes down to this- up through this morning (I think!), I still couldn't seem to stop favoring my surgical leg. However, this afternoon I was on the phone and decided to take a short walk down the street and back. I was walking with control, but the pain was minimal if anything, and I realized I could walk normally!

Perhaps it helps that I was just doing PT at home and stretching. Or maybe it's that I was distracted with conversation. But this little triumph had me excited, so I had to share!

Meanwhile tomorrow is my 5 week follow-up with Dr. Shapiro. I'm looking forward to getting his opinion on my progress, and moving on from here!!

Walking the Runway [27 Days Post-Op]

Today I returned to work, and while it was nice to get back to a 'normal' routine and see some familiar faces, it was a short distraction before I headed to PT in the early evening.

Focus continues to be on evening out my gait. I keep thinking it's mental; that I am just not trusting my leg. However some pains can not be ignored (even after popping a Vicodin pre-PT) and just when I feel I'm improving, I get the same pain (more shooting than general) in the area of my patellar tendon, and my body goes back to the exaggerated limp.

Also, today I was given so many directions to correct my stride as I walked the imaginary red carpet for my trainers: "Let your leg straighten out before swinging it forward." "Bend your knee more." "Pull your surgical leg forward more quickly before you step on it." "Go faster." "Hold your shoulders way back..." My head was spinning and frustrations were mounting as I couldn't seem to do what they were asking. Walking the runway was neither glamorous nor fun. I really was (and am) at a loss.

What scares me is that the two people working with me at PT can't seem to figure out how explain the intermittent pain I'm getting and one of them mentioned the possibility of tendonitis today, which, honestly, has me a little freaked out. With overuse being the primary cause of tendonitis, even hoping I don't have it, I wonder if 'powering through' the pain in hopes of a speedy recovery may actually be hindering my recovery??

Tomorrow I will be 4 weeks post-op, and while I knew it was far fetched (even my surgeon uncle said so), I remember Drew telling me I would be running around 4 weeks. I can only hope that statement was made as incentive, and that it doesn't mean that I'm doing something wrong.

I have my 5 week follow up with the Doctor in 1 week (though I did see him briefly today as he made a random visit to the PT area) and hope to have this settled by then, or at VERY least, be able to get some answers as to where I am in comparison to his other patients at this point, and how I can stay (or get) on track.

"The Wall" or "1 Limp Forward, 2 Limps Back" [22 Days Post-Op]

Pre-injury I had a half-marathon in mind as one of my next physical undertakings. I'll probably do one, eventually, but clearly my focus is elsewhere now. However, I feel like I'm hitting that 'wall' that runners speak of in full marathons (when they hit the unbelievable distance of 18-20 miles and just can't seem to keep going); but this time, it's not running, it's walking.

Since I'm a big fan of trying to keep positive, I drove to PT today with my music cranked, windows down, and saying to myself, "Today will be great!" Monday was a tough PT for me (summary: on the verge of tears the whole time with various frustrations; and oh yeah, the pain!) but Tuesday I felt like I was starting to get trust back in my walk, and didn't seem to be limping as much. I thought I'd walk into PT today and wow them with my improvement!

I posted before, and it was to describe the troubles I'm having in getting a normal gait. I know this is all part of the process of recovery, but as of today (Wednesday) the task seems daunting again. My trainer spent 1.5 hours with me today trying to problem solve, and I must say, his actions and conversations make me think I have him stumped. First, it seemed I was having trouble with extension. However a few exercises later it became clear that I have no additional pain, nor problem, in getting my surgical leg completely straight. Then, it was a backwards-skateboarding sort of motion on the treadmill, which didn't seem to loosen me up any more or get rid of the pain I was feeling. If this particular pain is normal, Drew did not verbalize that!

We did an ultrasound to send waves of heat deep into my knee to help break up scar tissue and "promote healing", and I was told I may feel less pain immediately after treatment. Honestly, I didn't feel a difference (...and they said I was on a 'high' setting!). Then, when icing, instead of putting a cold pack on my leg (which is typical), we took a block of ice and rubbed it directly on my knee near my incision, and kept the cold localized in the area I feel a 'twisting pain' when trying to walk. Once done with these treatments, I tried walking again, and with a numb knee and my poor walking habits, I still couldn't seem to shake the pain.

So, I wish I was writing to say, Hey, more improvement today! But in actuality, I must say this post is more of a release of my frustrations in my lack of improvement. I know it's a tough road ahead, and I'm not giving up, but knowing walking is my next 'big thing' to overcome makes the frustrations mount as I go in to PT and can't find hint of improvement. Additionally, the incision seems to be stuck in place (skin doesn't move freely over top of the knee/cap area, so there must be scar tissue to break up) and even after going through ~5 minutes of torture/manipulation by Drew today, he didn't get it to loosen any more. How am I supposed to manipulate it at home and see improvement, when there's no way I can inflict that much pain on myself??

To think back on the recent physical pain and mental frustrations I have gone through gets me worked up all over again, and it really is turning into a [negative] vicious cycle. I know I can overcome it, it's just a matter of how.

Just over 3 weeks out, I am still proud of how far I've come and the pain I've tolerated, but I am ready to conquer that next step... this time, without a limp...

Learning to Walk Again [18 Days Post-Op]

In my second visit to PT (which was 3 days post-op) I was already being challenged to put weight on my surgical leg and try to 'walk' across the PT room. I remember thinking how ridiculous that was, because I was so unsure of my leg (and myself) and it must have looked like a baby deer teetering close to disaster with each step. Even Eric's mom, Sandy, said something to the tune of, "Does this remind you of learning to walk?" and of course, I have no recollection of that, but I'm sure I looked quite similar in technique!

So now I am closing in on 3 weeks post-op, and in yesterday's PT I again felt the pains of the forced bending (not sure what degree we got to but I hope it was 120!) and the frustrations of the most simple uses of my leg, which just aren't coming naturally. However, I have been improving every day (some days more than others!) and I'm now being told to work on 'walking'.

I have officially eliminated the use of crutches (even when going on somewhat uneven terrain) and have been walking in a controlled, slow and short-strided manner. I realize this is not how I want my gait to look when I'm done rehab-ing, but as they say... Baby Steps!

When asked to walk by my trainer yesterday, I made a conscious effort to stand upright (instead of look at my feet) and just walk evenly. Drew called me out on it immediately, telling me to speed up (I was going frightfully slow) and to stop trying to 'control' my stride. I followed directions (like the 'perfect princess' I said I'd be in PT) but there was an über-uncomfortable feeling below my kneecap, and at the times when walking requires balancing on the surgical leg at the sensitive position between completely straight and just bent, I felt like Bambi again.

"Let's put you on the treadmill," Drew said. Wha?! Didn't I just prove I'm not even ready to walk 'normally' yet? But sure enough, I climbed on and Drew took the belt speed up to what is probably a normal walking pace... but I looked like a pirate trying to speed-walk on my brand new peg-leg! Oh, and of course there was the return of the aforementioned pain below the kneecap (in the area of the patellar tendon).

This limping pirate look may have brought Drew back to reality, as I just couldn't seem to go with the 'flow' of the treadmill. So, for 5+ minutes I instead stood with my right leg off to the side of the treadmill belt, and at a much slower belt speed, would put down my left foot and 'walk' with my left leg. (I looked like I was skateboarding now) This allowed me to gradually put more weight on the leg as I got more comfortable, and my new task was to work on taking longer strides and stop avoiding straightening my leg all the way before 'pushing off' and lifting the leg up again.

Unfortunately, I do not have a treadmill or stationary bike at my disposal, so I am unable to work on such activities (and range-of-motion exercises) at home. This didn't stop me from going out today (Saturday) in the lovely noon-day sun and walking ~5 blocks. I tried to follow all of the tips and directions that Drew had given me, but in the end I know it still looked 'controlled' if not limping, because I had a friendly passer-by ask, "Are you OK?"

I compare this attempt at walking to learning to golf. There are so many things to remember when you learn to swing a club: head down, legs slightly bent, grip a certain way, twist your body a certain way, backswing so your arms do or don't bend too much... you get the idea. It's just a little overwhelming to try to remember it all and follow it all to a T. Same goes with this whole 'walking' bit. No matter that I've walked plenty in my lifetime, when it no longer comes 'naturally' it's truly an effort to make walking an effortless motion!

So, while I know I still have a ways to go before strangers aren't concerned for my well-being due to my unconventional walking style, I am making improvement, and that is all I can ask for now!

And because pictures are fun:

Day 16 post-op: I 'cleaned up' the incision area before re-taping. Looks good w/ the exception of the zig-zaggy part at the lower kneecap Day 18 post-op: OK, not a flattering pic at all, but for the sake of comparison, this is a pic with legs in the air, slightly bent and completely relaxed. Note the swelling still obvious to the sides of the knee and lower thigh/knee area. Also, major muscle mass difference in the thighs (lower portion of picture) which I hope to reclaim when this is all over!!

No Pain, No Gain [3-4 Days Post Surgery]

Time to bust my butt. I already talked of my first Physical Therapy visit, which was no cake-walk, but also was understanding my mental limitations when it came to rehab. Between that Wednesday afternoon and now (Saturday afternoon) I have learned even more about my abilities (physical and mental) as well as had some mini-accomplishments, including getting outside (today is GORGEOUS!) and taking my first shower! (I am not sure who is more excited about that last one - me or my caretakers, Eric and Sandy! hehe)

Let me give you a quick insight into how things are going here at home. My go-to spot is the living room couch. I have not ventured upstairs to the master bedroom, so I've made this my spot 24/7. I have slept surprisingly well! Within reach I have my crutches, some snacks, puzzles, the laptop, my camera (of course!), water and meds. The coffee table has been moved so the room is open in the middle, and I use this open space to do my PT at home; as shown here:
[Laying on my belly, I am using my non-surgical leg to try to bend my surgical leg to regain range of motion]

Also nearby is the ThermoCompression Unit, which is a machine which cycles 43 degree distilled water/alcohol mixture through a cuff which velcros around my surgical leg. In addition to the cold mixture, it also pumps air into the cuff (alternating, slowly making the cuff more and more tight around my knee). This is similar to the Game Ready unit the same company provides, but I do not have to continuously add ice to it to keep it cool. Here is a pic of me while icing/compressing using the ThermoCompression Unit:

[I try to do this 20-30 minutes each hour when possible. Control unit seen on the TV tray table]

So, that's really my daily grind. Yesterday (4/17, 3 days post-surgery) was my second PT visit, and while I understand, "No Pain, No Gain" , I also would never wish this upon anyone else. (I have also admitted that I am happy girls can get away with more tears in situations like this, because the 2nd PT was quite more difficult and as tough as I thought I was, I donated my share of tears...) Here was the routine:

(A) In seated position with legs in front of me: 15 Electric Shocks via 2 electrode pads (roughly 2"x3") placed on surgical thigh to force muscles to contract for 10 seconds (then rest for 50 seconds).

(B) Lying on back, keeping surgical leg straight, lift heel off ground and lift ~2' from ground. 3 sets of 10 (I had some assistance from Drew on first set because my brain was having a hard time telling the muscles to work.

(C) Lying on stomach, Drew forced my surgical leg to bend to ~75 degrees. This was by far the most painful thing, done 3 times. I was crying and moaning the whole time, and I felt bad for anyone else who had to witness it!

(D) Without crutches, I had to walk ~80'. This was truly learning to walk again. Drew had to walk backwards in front of me, with his hands out so I could use them for balance. This was not as awful as the forced leg bend, but since walking forced me to put weight on my surgical leg and try to get muscles to fire and work, this was the second most difficult task.

(E) My walking destination was an exercise machine which puts you in a sitting position with your legs in front of you, slightly lowered. Each foot is on an independent pedal/step, and as I extended my right leg, it would force my left (surgical) leg to bend, and for 10 minute

s I did this back and forth pushing to work on range of motion in my surgical leg.

(F) Walk (with 10% help from crutches) to where I iced my leg for 10 minutes using the aforementioned 'game ready' machine.

This may be one of the few times I have to pat myself on the back for pushing through the pain and working towards the greater goal of getting my leg back to normal! *pat, pat* But I can't discredit the encouragement of Sandy (who watched the torture occur), as well as all the kind words that you all continue to give me. Thank You!

And, after that windy entry, I'll breeze through the last few points...

I TOOK A SHOWER!! hehe Thanks to a little pre-planning, including a removable shower head, this was the basic set-up that allowed me to clean up!

[To avoid falling, I had the aid of a little stool. I am allowed to get the incision area wet, but am avoiding it as best I can to keep the tape on which will help the scar heal better!]

Some pics of the wound- Here is 3 days post surgery:

And here is 4 days post surgery (today) which has shown the very first signs of any bruising, on the inside of the knee (tho it is yellow, and not black-and-blue):

And finally, I can not discount how GORGEOUS the weather is today (low 70's I've heard!), and what great encouragement that is to want to get outside! So, to continue to work on my walking, I took to the streets (ok, just our sidewalk...) and practiced!

I might be slow, but this is just the beginning of my comeback! Yippee!! ;)