8 Months Out

Yes, I know I posted the last post a little past the 7 month mark, but I was talking about an appointment that happened at about 7 months out. However, today actually does mark 8 months since my surgery.

Tomorrow is Thanksgiving and I am hosting. Since cooking is a hobby of mine, it will be nice to be able to stand in the kitchen again. Last year I did very little because it hurt too much. It is good to have something to be thankful for regarding the knee.

My knee is doing pretty well. I can still feel it most of the time. It aches and sometimes feels very hot, but never any sharp pain. Icing still feels good. I can go for walks now, so I accompany my husband as he walks the dogs. I used to be the one that walked them most of the time, but it's been almost 2 years since I've been able to do that. It's funny that I still remember my reaction to the first OS when he said I needed MFX and would spend 4 weeks on crutches afterward. I was shocked by that length of time. Now, that reaction seems kind of cute and innocent in retrospect. I suppose I have become a more patient person.

My shoulder has been bothering me. I think it is related to the remnants of my limp. It doesn't hurt exactly, but then again my standards for defining something as painful are not what they used to be. It just makes it hard to get comfortable. I have leftover pain relief goop from seeing the pain management doctor before my surgery, so I am using that. I don't want to take Tylenol too often since it can be rough on the liver. I'll see my massage therapist again soon too. A sports massage therapist is definitely the way to go when healing. It's such a more practical approach versus a traditional massage therapist.

There was one other interesting thing that happened in my last appointment with Dr. Trice. He seemed unusually happy to see me in the office, but I think I figured out why. When he came in for the consultation he introduced a nurse practitioner that was sitting in on his meetings with patients. Clearly she was not an orthopedic nurse because he was explaining to her what a MFX is, though I suppose she could have just been too polite to correct him! I am guessing that she was following various doctors within Johns Hopkins to understand their jobs better.

After I asked my questions of Dr. Trice and he answered them, he told me to tell this nurse how long I had been dealing with my knee. "Almost 2 years." I said. He told me to describe my condition before the ACI. I don't get asked that very often by someone who actually wants the full answer. I obliged, saying " I was in pain every day whether I was walking or not. With daily prescription pain medication, I could work in the office only about 2 days a week and work from home the rest of the time. The floors there just hurt and the times when I would uncontrollably scream from the pain were embarrassing. Without pain medication, I could barely get off the couch."

About here I realized Dr. Trice was showing me off. He told me to get up and walk across the room. I did so. He asked about my current pain level. I said it really didn't hurt, just aches, so perhaps a 1 (on the trusty 1-10 scale that you get asked about all the time). The nurse's eyes were huge and all she could say was "Wow." It's a lot to comprehend, which is why I usually tone down my descriptions of the experience in casual conversation. I believe Dr. Trice was happy to see me because I am a good example of the impact his work can have on someone's life, and that seems to be what he wanted to show her. It's kind of nice to be thought of as a success story, even if I'm not out of the woods yet.

Doctor's Guidance at 7 Months Out

I posted this on the knee geeks forum because I found Dr. Trice's guidance to be interesting and thought others might too. I can't really say it any better than I did there, but it is an update so I'll add it to my story.

I am doing very well. The knee aches and pops a lot, but there is very little pain. The popping is probably due to the unloader brace shifting things around. There are some "crazy nerve spikes," as I call them, which feel like a quick shot of tissue based pain and are usually around the scar. Not bad at all!

My latest doctor appointment was very interesting and I thought I would share the experience. I have seen on here that at 7 months most ACI patients are permitted to run and such other activities, but my doctor has restricted these for me. Going into the latest appointment, he let me swim (aqua arthritis class only), use the recumbent bike, and walk up to one mile on even surfaces. That's it. No elliptical, no walking the dogs, nothing even close to running. Needless to say, I felt pretty restricted.

So I went into the appointment wanting to understand the reasons for my severe activity restrictions. He said that there were a few. The first two were that my defect was very large (I don't know exact measurements but I think it was about 2.5 x 3 cm on medial femoral condyle) and that I had been in more pain before the surgery than most of his patients (I'll admit I was pretty bad off).

However he said the strongest reason was the previous microfracture and that he had other patients with ACI after microfracture who were doing well at 7 months and then weren't at 9-10 months and he doesn't really know why. So, he wants to be cautious. I guess I thought I was mostly out of the woods as long as I didn't do anything stupid. Apparently he sees a lot more forest before me.

He did however loosen the restrictions a little bit saying I can walk up to 3 miles and I can sign up for a slightly more vigorous swimming class as long as I am very very careful. The elliptical and walking the dogs are still off limit.

This appointment was about 2 weeks ago and a little after 7 months out. Now I am creeping up on the 8 month mark and continuing to be cautious and optimistic. I just can't wait to get these woods behind  me.