May 31, 2011

A busy active weekend, although much less than a typical Memorial Day that I would have spent hiking some crazy trail in Yosemite if my knee was totally fine.
Instead, I took my daughters window shopping and it was a fun time with fewer people in the shops than I expected.
I walked a lot and my knee was doing fairly well, especially since I had also been quite active the two previous days.
Pain is gone in my knee but some stiffness remains.
My flexion is much improved and my extension too, yet this morning when I settled on the floor mat I am now using instead of my daughter's bed, my left knee was still sticking up.
It looks as if the inflammation is totally gone since my two knees look very much alike, the area that was still showing a little bit of swelling (where the major incision has been made for surgery) is now looking good.
So I wonder if what is keeping me away from full mobility is only the remaining scars tissues.
I have physical therapy tomorrow as well as a massage appointment and I hope that both will increase my progress.
I am torn between moments of great hope and fear.
Returning under the knife is still a possibility today while yesterday I believed it was out of question.
The last four months have been hard on my family and I wish for a full recovery and a sunny summer.

May 28, 2011

Friday was not as good as the three previous days and I was disappointed to show up for physical therapy. I had hoped for a much more significant improvement since Tuesday, Wednesday and Thursday had been great days.
But after two hours doing my exercises and being checked by my PT, I felt better. Progress is definitely on its way.
Yesterday was a busy day with long walk through the lovely Old Town Clovis before and after a lovely dinner with my husband. The weather is totally awesome here and it was really nice to walk through familiar streets without much effort.
Everyone at home (kids and parents alike) was exhausted after a long and busy week and we all were in bed shortly after 11:00 p.m.
I slept well and wasn't as sore as I usually am when I wake up. I biked for 25 minutes and then did a big grocery shopping trip.
After lunch, I finished my leg exercises and walked the mile-loop around our local lake.
I was fine the whole time so I guess this is real progress.
Because of Memorial Day, I don't have physical therapy on Monday but I will take advantage of the long weekend and walk more.
My leg slides are getting easier and smoother. But most of all, my gait is faster and so much more similar to my regular stride.
If only I could skip another surgery and go away with my family this summer!

May 25, 2011

It is perhaps too early to claim success but I am positive that the cortisone shot I got on Monday is working.
Today I cleaned my house almost entirely with my regular heavy vacuum cleaner, dusting under every piece of furniture.
My knee was totally fine although I didn't dare to push too much.
I did my exercises earlier this morning and will do more before picking up my kids at school this afternoon.
I have physical therapy on Friday and I can't wait to measure the progress of my extension and flexion.
It is an exciting time as I am now walking toward a prompter recovery.
It has been a long winter but although a little bit of rain is expecting in the valley and even snow above 8000 feet, I am reaching the end of the tunnel.
I can't wait for the long walks on the beaches of Maine and the biking on the six miles path near our cabin there.

May 23, 2011

I saw my surgeon, Dr. Simonian today. As always, he is a great gentleman, caring and professional.
He presented me with two options regarding the inflammation and arthrofibrosis of my knee. His goal is mine: put me back where I was before my accident. Since there is a definite progress, he skipped the surgery and instead opted for a cortisone shot which should finish the job started with the medication he prescribed early May for five days.
He is not sure that it will be enough but considering the immediate relief I felt after I started the medicine, he believes it is worth giving the cortisone a try.
I should experience some soreness and icing the knee is key. Good thing I brought my icing machine with me today. Good thing that the weather is mild in the valley. The ice won't melt.
So I keep my fingers crossed and hope for a serious improvement in the next two to three days.
Meanwhile I am chilling at Starbucks before returning home after school pick up.

May 22, 2011

The week and weekend flew by so quickly that I didn't take the time to update my blog.
Good news, perhaps!
Tuesday, Wednesday and Thursday were pretty good days and Friday was definitely good since my extension has regained a lot of motion.
My physical therapist is cautious and kept reminding me that the most important thing is the progress. A flexion at 130 degrees when it was only 100 is great. I still have a way to go since my right knee is a 140 but he is right to insist that improvement is key.
Some strength exercices are still hard to accomplish without pain but I am better at anything else. Walking is easier, smoother and it feels good to wear dresses and skirts again with small heels.
I have an appointment tomorrow morning with the surgeon to check the inflammation and the arthrofibrosis that had developed after surgery.
I hope I can avoid another surgery!
Tonight looks great. I spent a lovely weekend with my two younger kids since my husband is away with one of our oldest one.
We have been busy and I hope tomorrow will be great news for me.
I biked 30 minutes and did my stretching exercises. I feel better and better and can't wait for good news.
Wish me luck!

May 18, 2011

After a tough Monday, I spent a great Tuesday with a lovely Italian dinner with my husband. I walked and climbed stairs and was fine. I didn't feel any warmth on my knee cap and the scar that was still itching once in a while has stopped.
This week is final week at my kids' high school. School starts at 8:30 and ends at noon so today instead of driving back home I stayed in town. My college daughter is staying with us for a few days so we went window shopping together, something a French woman always loves. I hadn't done it since a while and wasn't sure my legs would bear the three hours. But actually I was quite fine. We stopped for coffee mid morning but were up the rest of the time.
My knee has lost a lot of stiffness, and my gait is definitely better.
For Mother's Day, I received a gift certificate for a beauty treatment and I booked an appointment for a pedicure. My feet deserve a treat and a thank you. The last months have been tough on my entire body and I am looking forward to a slow pace morning at the beauty salon. I will pick a nice color for my nails to give me a boost.
I am feeling more confident today than I was on Monday and who knows maybe I will really skip the surgery I am dreading and just move on with more challenging physical therapy before complete healing.
Speaking of physical therapy remains me that I have only biked ten minutes early morning and did my leg exercises.
Off I am for fifty leg slides and hamstring stretches!
Anyway, I heard there is a chance Tioga Pass remains closed this year. It seems impossible but the rain we've got yesterday and the day before was more snow for the mountains.
Last year, I had to wait for Labor Day to climb my beloved Clouds Rest.
Perhaps there are some hiking gods after all.

May 16, 2011

Physical therapy at 8:00 a.m. today and although I was optimistic on Friday, my knee is again too stiff. Arrrggghhh!!!!
In exactly a week from today I will see Dr. Simonian, my surgeon.
I have no idea of the verdict!
Meanwhile, I am taking morning and evening Iboprufen, biking, doing my leg exercises and hoping for the best.
This is a busy week at home with finals for two of my kids, a trip to the East Coast for my husband and one of my daughters, a couple of meetings for me.
I will of course do my work-out and hope for the best but today I feel a little down.
If only I could avoid another surgery!

May 15, 2011

I had physical therapy on Friday and I was elated to learn that my extension, so bad when I saw the surgeon on May 2, had improved a lot.
The extension of the knee is measured from 0 being the best (no space between the back of the knee and the surface where the leg is extended) to whatever space there is.
On May 2, my extension was 7 with some pressure on the knee. It was 5 without any pressure and 3 with little pressure on Friday. Okay, my right knee extension is a perfect 0. Yet, I was really excited.
I have been taking some morning and evening Iboprufen to fight the inflammation and I hope that the combo medicine/exercise will finally pay off.
I went to Berkeley on Saturday to move my daughter out of the campus until she moves in her new apartment. We walked through town to get coffee and then drove to San Francisco for lunch (our traditional family dim sum). We took an after lunch walk at Embarcadero and the Pier. I walked well although there is still a slight limp which nobody but me can notice.
The weather being cool, I brought my ice machine in the car and it was nice to cool off my knee after the walks. But there was no feeling of warmth or swelling in my knee. My calves and thighs though were aching and I can't wait to get them back!
I have physical therapy tomorrow and hope to record new progress.

May 12, 2011

Yesterday my physical therapist measured my knee and the flexion has reached 128 degrees. When I saw the surgeon on May 2, it was a mere 121.
So the medicine has definitely done its job. The question now is how much inflammation there is compared to the scarring tissues. If it is only scarring tissues, a surgical procedure can be necessary and will solve the issue.
On the other side, nothing but medicine will reduce the inflammation.
So when I see the surgeon again on May 23, he will get another Xray of my knee and see what's left of the inflammation and arthrofibrosis.
My two goals are the same since post-surgery: mobility of the knee that leads to a better gait and building my left leg muscle mass.
I used the treadmill for the fist time yesterday and it felt okay although awkward to walk quite slowly.
The other exercises have been readjusted to avoid too much strain on the knee as long as the inflammation is still there.
Massages are recommended to drain fluids and the relief is obvious.
The young woman who does deep tissue massage and all kinds of massages essentially for athletes does a great job.
She is strong although only 5'5 and her hands do marvel.
Since my ski adventure, I keep meeting health professionals who know more than I do about human body.
I thought I was paying attention to mine and in some ways I have but I am discovering muscles and areas of my body I ignored until now. My masseuse found areas of stress I didn't suspect and also some that were painful but I had ignored.
I still miss my knee very much although it is now from the exterior looking like my other knee. Only one scar is visible and only because I know it is there.
My quadriceps is still weak but both therapist and masseuse reassure me that it will come back.
Since the week after surgery, I have felt that my muscle strength should have returned sooner if I had been able to extend my knee.
No way to walk naturally with a crooked knee.
So now that it is much better, I hope I won't need to return under the knife.
Summer is just poking its nose in the foothills and I love having dinner outside. I avoid thinking of long hikes and shoot for more humble goals.
I suppose I had been spoiled until my accident. So many painless years were indecent perhaps. I have learned that bodies break and that it takes time to heal.

May 10, 2011

My knee is definitely better looking now that I have finished the Methylprednisolone (what a mouth full!). My husband and I drove the kids to school together and we had breakfast at Mimi's cafe.
I wore the dress my daughter gave me for Mother's Day and although it is not a very short dress,the hem is just above the knees. I was a little self conscious but I only noticed people looking at my dress and not at my...knee!
I have physical therapy tomorrow and I am impatient to get a feedback from my PT. I'd like him to measure my progress since I am sure the flexion is far better. The extension could be better but has improved. The overall appearance of my knee is good so I am hoping for faster results now.
As a matter of fact, I have returned to a more normal range of movements.
I vacuumed my room today and was able to bend to get dust under my bed. I can squat much lower than I did last week. I also do some exercises on a mat and stand up easily when I am finished.
I feel some stretching pain at night. It wakes me up several times but I fall right back to sleep. It didn't happen as long as I was taking the medicine but returned last night.
The weather couldn't be more gorgeous here and although I miss my daily walks, I am full of hope for a great summer away from home.

May 8th, 2011

Finished my medicine on Mother's Day.
My knee doesn't feel as still and the flexion is definitely easier. I'm not so sure that the extension is much better although it could be. Biking gets easier too when I start.
Yesterday afternoon, I walked around the lake but I had to skip the last few hundred feet since my kneecap was getting red and warm. My knee felt tight and was hurting.
But the discomfort and pain went away quickly so this is better than before. I slept well and this also a good sign.
I was much celebrated by my four kids and husband and it put me in a great mood.
I biked for 30 minutes, did my leg work-out, iced my knee while checking my e-mail and working on a story I started last week.
I have physical therapy on Wednesday and I hope to see an improvement with the help of the anti-inflammatory medicine.
I miss my knee and I can't wait to be myself again.

May 6th, 2011

I am now more than half way through my medicine and I think my knee is losing some of its stiffness.
I am aching from other parts of my body like below the hips, the calves and my left quadriceps is still weak and tight.
I went to physical therapy this morning and my program had been revised. Most exercises related to strength have been cut to spare the knee.
I am still biking on the up right bike, using the elliptical and doing my table exercises with ankle weight.
At the physical exam, my PT found my knee softer which I think is true.
I bought a pair of shorts to encourage my work-out. My legs are not what they used to be and it is sad to realize that the results of a lifetime of physical activities can be wiped out in a few months.
But I know that it works also in the other side so I will now concentrate on more leg work to make sure I look okay in my new pair of shorts.

May 4th, 2011

I took my first whole day of medicine yesterday, secretly hoping for an overnight miracle.
Of course, it didn't happen that way although I spent a good night which could be a sign of improvement.
I biked for 20 minutes and did 50 leg slides to keep the knee mobile.
I canceled my weekly massage therapy, not because I didn't like it or think it can be dangerous but because I lost the blind trust I put in my physical therapist and will wait until my next session on Friday to discuss the following weeks.
It is hard to realize that weeks of hard work aren't providing the expected results. Even harder since I have asked questions that should have triggered more research or a second opinion.
I am not discouraged since I want more than ever my knee back. But I will definitely be a less obedient patient and a more demanding one.
The weather has turned almost summer like here in the Sierra foothills and the mountains are blue in the distance, a call I have to resist but is getting more urgent as months go by.
I can't know for sure when I will be myself again and although my condition is not life threatening compared to very serious illnesses, I am worried and also sad to realize that nobody ever knows anything for sure.

May 3rd, 2011

I used to trust my body more than my mind.
If I had a bad cold, I still exercised but with moderation.
If I didn't trust a steep incline when hiking, I let my legs find their own way and they never failed me.
I have always respected the limits of my body although I love the feeling of effort and the reward that accompanies it.
So after the ski accident that led to the reconstruction of my ACL and partial reconstruction of my MCL, I trusted my body to recover.
Since I had never had any physical injury and never had surgery before I also had to trust a surgeon and a team of physical therapists.
And I did.
When I saw the surgeon six weeks ago, I told of my worry related to the poor extension of my injured left knee. He reassured me and said it was too early in the recovery process to worry. He prescribed six more weeks of therapy which I followed with diligence and faith.
On top of the two weekly sessions, I biked at home as often as I could, did my exercises with regularity.
I kept telling my physical therapist of my knee that could not fully extend and thus blocked my gait. My PT said it was okay and gave me complimentary exercises to help the mobility.
I suffered through some but never complained.
My goal remained the same: WALK.
I had noticed how my knee and even my big toe became red after being on my feet for a little while. It was also warm under my touch. I was told it was nothing.
I told of my quadriceps that was stretched to the point of discomfort if not pain. My PT said he wasn't concerned with my muscle issues at that point.
I told of being woken up with heaviness and stiffness every night.
I asked if scarring tissues could create this effect.
No, no, he told me.
I asked if ultra sound therapy would be appropriate for me and he said that since I had no evident and significative pain, it was not necessary. Most patients who came with ACL reconstruction had ultra sound treatment at the physical therapy facility I attend.
Everything I asked or told was dismissed and instead I was urged to move the knee and to relax.
The reason behind my issue started to shift toward me, the patient, who was afraid of putting weight, who had taken a bad habit after surgery and wasn't able to correct it.
As if because I was able to perform every exercise with enthusiasm and will, I was not one of the patients who needed much attention.
A weekly massage session was recommended in addition to the twice a week therapy.
I did everything but didn't see the expected results.
I knew something was not right.
Ater all, I know the benefits of hard training and how they show day after day. There was improvement with my knee but not enough compared to the amount of work I was putting in it.
So I tuned back to my body to tell me it was not right.
Again I was in charge.
When I met the surgeon yesterday morning, I knew my body wasn't lying to me.
The set of X rays confirmed that I still have significant inflammation and arthrofibrosis.
In three words: I was right.
The surgeon, soft-spoken and caring as always, prescribed strong inflammatory medicine for five days, promising results.
By then, of course, my level of blind trust had significantly decreased and I asked what would happen if the treatment didn't bring the expected results.
Worst case scenario: opening the knee again to get rid of the scarring tissues obstructing the knee mobility.
A mix of disappointment, anger, worry and relief washed over me.
I was right and my issues had a simple name: inflammation. That was the good news.
The bad news is that the treatment and eventually the cleaning of the knee will delay the already long recovery.
I was angry at the physical therapist for having missed the inflammation and for having convinced me that the reason behind my limited mobility was me and not my knee.
I went to therapy and worked as usual since the surgeon had not required less work out. I felt pain on the elliptical and when I did the stork exercises (standing on the injured leg, slightly bent with maximum weight on the heel). Other than that I was doing fine.
My PT when I was finished told me that since we knew what was the reason behind my stiffness, urged me to spare my knee if in pain.
Funny that only three days earlier he urged me to move that knee and to work on it as much as possible.
I asked about the weekly massage and was told that it doesn't hurt. But does it help?
Today I started my first dose of anti-inflammatory medicine and beg pharmaceutical forces to do their job.
My next physical therapy session is on Friday. By then, I should see an improvement in my knee if the medicine works.
The next surgeon appointment is in three weeks.
I won't wait that long if my knee is not moving as much as I wish.
Morality: challenge authority, take charge of your body. After all this is my knee we are talking about.
And my knee was a big part of my life.
And I intend to keep it that way.

May 1st, 2011

A few months ago, I was getting tired of a mile-loop my husband and I walked at least once a day. Although it is a nice path that wraps around a pretty lake, it is an easy walk for the fast walker I used to be. I was complaining to my husband that it was flat and short and that I needed more to my work-out. And I did in fact walked much more than that loop.
But after I fell skiing, I hadn't walked the loop at all. And over the last months of recovery, sudden nostalgia for the lake hit me randomly. I would have done anything to walk the loop again and again and again.
And finally today I did!
Gorgeous weather, pristine lake, and a terrain I had forgotten about.
The loop is actually not flat at all now that I am still in recovery. It climbs up and down and there is even a small bridge to cross the creek that overflows in the winter. Water is not rushing anymore but there is too much water to walk without the makeshift bridge.
The good news is that I walked across the log just fine, the one-mile-loop is still too easy for me as a cardio-workout.
The bad news is that I will have to walk the loop many times if I want to improve my gait and speed.
Until I get tired of it, I'm afraid.