This morning there was a holiday party in my office. I went to the room, but it was fairly crowded. All I saw when looking at the crowd was a bunch of people who might knock me down. I panicked a little. When I got back to my office I was a little upset. I've been doing so well and I just wasn't expecting to encounter so much fear. It really shook my confidence.
And now it is snowing enough to lay down a slippery layer outside. If I fall, I don't know what would happen. I don't have normal balance, so I may not be able to recover. I can't get up from sitting on the ground without something to grab onto, to pull myself up. If I fell on the sidewalk, how long would I have to sit there until someone came along to help me?
I don't want to be so fearful. I'm having a rough day, but it's all inside my head.
Thursday, December 16, 2010
Wednesday, December 15, 2010
MRI
Last night I went to get a 3.0 Tesla MRI, which is basically a very powerful MRI screening that can produce high quality imagery. Here's an article about the very one that I went to at the Hopkins Outpatient Center.
It takes a while and isn't the most pleasant experience. For 35 minutes you have to hold very still in a very cold room. It's really loud, even with the earplugs and thick headset, so you can't fall asleep. That being said, you aren't trapped in a tiny tube so I didn't get claustrophobic. The tube is big and your head and arms are outside of it.
I am very excited because this is my first MRI since the surgery and I have an appointment with Dr. Trice tomorrow where I will find out what it shows him. I feel like I am doing pretty well, but I would like the reality check.
It takes a while and isn't the most pleasant experience. For 35 minutes you have to hold very still in a very cold room. It's really loud, even with the earplugs and thick headset, so you can't fall asleep. That being said, you aren't trapped in a tiny tube so I didn't get claustrophobic. The tube is big and your head and arms are outside of it.
I am very excited because this is my first MRI since the surgery and I have an appointment with Dr. Trice tomorrow where I will find out what it shows him. I feel like I am doing pretty well, but I would like the reality check.
Tuesday, December 7, 2010
8 1/2 Months out
I was looking for a specific post for someone and ended up reading some of my own blog. I'm glad I wrote it, since I think a few people may have found it helpful, but also because I would have forgotten a lot of this.
I saw my massage therapist (MT) again this weekend as my shoulder and upper back have continued to give me problems. It seems like the discomfort starts to build up over about a month before it becomes very bad. It makes sleep difficult because no position is really that comfortable. I'm going to start seeing him for 30 minutes every 2 weeks now to try to stay ahead of the building discomfort.
While I was there, I had him go over my knee to break up scar tissue. It's pretty unpleasant and difficult to do an adequate job on yourself. My MT suggested using a topical analgesic, such as Biofreeze, to dull the pain while using quick, short strokes to break up the scar tissue. It's a good suggestion and helps dull some of the aches too.
The knee gets stiff still and often I will feel pressure in it until I get a good pop out of it. (It's audible, so sometimes it catches people off-guard, which is highly entertaining.) I think that is due to the brace though since it pushes things out of a normal position. I've been walking up to 2 miles at a time, and the increase in distance may be one of the factors that have helped the knee feel smoother lately. Well, sometimes anyway. I am still quite aware of the knee but my limp has gotten noticeably better in the last few weeks. It's almost gone.
I added a new link on the right to the Chester ACI Rehabilitation Guide For Femoral and Tibial Articular Cartilage Repair, that someone shared on the knee geeks forum. It's a great find! It covers both the surgery and the rehab in one document. I was reminded again by reading that document that Dr. Trice is keeping me on a very slow path. Perhaps ACI is easier for some others? But then again, I don't seem to have any complications so it can be harder for others too. Anyway, it's a good reminder to mention to any readers that I was really bad off before, so don't get too scared. My experience might be on the more painful side.
I saw my massage therapist (MT) again this weekend as my shoulder and upper back have continued to give me problems. It seems like the discomfort starts to build up over about a month before it becomes very bad. It makes sleep difficult because no position is really that comfortable. I'm going to start seeing him for 30 minutes every 2 weeks now to try to stay ahead of the building discomfort.
While I was there, I had him go over my knee to break up scar tissue. It's pretty unpleasant and difficult to do an adequate job on yourself. My MT suggested using a topical analgesic, such as Biofreeze, to dull the pain while using quick, short strokes to break up the scar tissue. It's a good suggestion and helps dull some of the aches too.
The knee gets stiff still and often I will feel pressure in it until I get a good pop out of it. (It's audible, so sometimes it catches people off-guard, which is highly entertaining.) I think that is due to the brace though since it pushes things out of a normal position. I've been walking up to 2 miles at a time, and the increase in distance may be one of the factors that have helped the knee feel smoother lately. Well, sometimes anyway. I am still quite aware of the knee but my limp has gotten noticeably better in the last few weeks. It's almost gone.
I added a new link on the right to the Chester ACI Rehabilitation Guide For Femoral and Tibial Articular Cartilage Repair, that someone shared on the knee geeks forum. It's a great find! It covers both the surgery and the rehab in one document. I was reminded again by reading that document that Dr. Trice is keeping me on a very slow path. Perhaps ACI is easier for some others? But then again, I don't seem to have any complications so it can be harder for others too. Anyway, it's a good reminder to mention to any readers that I was really bad off before, so don't get too scared. My experience might be on the more painful side.
Wednesday, November 24, 2010
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.
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.
Wednesday, November 17, 2010
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.
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.
Tuesday, September 28, 2010
Six Months out
So I sincerely doubt any of my family or friends are reading this anymore, but I am trying to keep putting in updates periodically for others who might be going through the same surgery and stumble across this blog. I just passed the six month mark and had an appointment with Dr. Trice, so it's a good time to take inventory of my progress.
Overall, I am doing pretty darn well. I am in much better shape than before the surgery. My knee aches sometimes, but ice and Tylenol seem to calm it down. I just reduced PT to once a week and I am in an Aqua Arthritis class twice a week. I can do straight leg raises with 2 pound weights and side leg raises with 5-7 pound weights. I still have a limp, but it is less pronounced unless I am tired. I can get through a typical day at the office with no unusual fatigue (though Mondays are still Mondays, you know?) but I do get quite fatigued if I do something unusual such as driving a long distance to and from an all-day meeting. I am definitely optimistic about my recovery, but still aware that caution is required. I'm not out of the woods yet.
I have a few new instructions from Dr. Trice as well. He approved walking outside for exercise, starting with 1/4 mile at a time for one week, then 1/2 mile at a time for a week, and so on up to one mile. So in just a few weeks I will be allowed to walk with my husband and dogs for a whole mile at a time! He said to then stay at that level for about 3 months. I am planning on trying to do one thing each day, either walking outside, PT, swimming class, or the treadmill.
Dr. Trice also said he wanted me to continue wearing my unloader brace for another 6 months (whatever, it's not that uncomfortable) and that I can now do short arc exercises (GR1 - it's just a video showing the exercise). A short arc is basically straightening the leg from a horizontal and slightly bent position while it's unsupported. It was not something that I was allowed to do before as it is apparently pretty rough on the knee. I did them in PT and was shocked by how weak I was! It was a reminder that I still have a way to go.
I have come a long way, but there is still more work to be done. I'll keep updating periodically just to note progress at various milestones. Cheers!
Overall, I am doing pretty darn well. I am in much better shape than before the surgery. My knee aches sometimes, but ice and Tylenol seem to calm it down. I just reduced PT to once a week and I am in an Aqua Arthritis class twice a week. I can do straight leg raises with 2 pound weights and side leg raises with 5-7 pound weights. I still have a limp, but it is less pronounced unless I am tired. I can get through a typical day at the office with no unusual fatigue (though Mondays are still Mondays, you know?) but I do get quite fatigued if I do something unusual such as driving a long distance to and from an all-day meeting. I am definitely optimistic about my recovery, but still aware that caution is required. I'm not out of the woods yet.
I have a few new instructions from Dr. Trice as well. He approved walking outside for exercise, starting with 1/4 mile at a time for one week, then 1/2 mile at a time for a week, and so on up to one mile. So in just a few weeks I will be allowed to walk with my husband and dogs for a whole mile at a time! He said to then stay at that level for about 3 months. I am planning on trying to do one thing each day, either walking outside, PT, swimming class, or the treadmill.
Dr. Trice also said he wanted me to continue wearing my unloader brace for another 6 months (whatever, it's not that uncomfortable) and that I can now do short arc exercises (GR1 - it's just a video showing the exercise). A short arc is basically straightening the leg from a horizontal and slightly bent position while it's unsupported. It was not something that I was allowed to do before as it is apparently pretty rough on the knee. I did them in PT and was shocked by how weak I was! It was a reminder that I still have a way to go.
I have come a long way, but there is still more work to be done. I'll keep updating periodically just to note progress at various milestones. Cheers!
Tuesday, September 7, 2010
I can't believe I am still learning
I thought I had pretty much figured out all that I needed to know, but then this weekend happened. I have been having so much trouble with all my muscles aching and my back just all knotted up. It has been hard to get up in the morning. So, finally, I asked my PT for a recommendation for a massage therapist.
Lesson Learned: I should have gotten a massage a long time ago!
It is highly important to have the right type of massage therapist who knows how to actually heal the muscles, not just help you relax. Sports massage therapists seem to be the ticket. Anyway, a wonderful woman named Brandy took her magnificent elbows to the arch around my left shoulder blade. It was one huge knot from both the cane and how I have been compensating for my limp. I didn't even realize until she was done that I had been restricting the motion of my left arm. She freed it.
The next day I was sore, as expected. It has made a huge difference though and I wish I had done this months ago. I am finally starting to feel closer to normal.
Lesson Learned: I should have gotten a massage a long time ago!
It is highly important to have the right type of massage therapist who knows how to actually heal the muscles, not just help you relax. Sports massage therapists seem to be the ticket. Anyway, a wonderful woman named Brandy took her magnificent elbows to the arch around my left shoulder blade. It was one huge knot from both the cane and how I have been compensating for my limp. I didn't even realize until she was done that I had been restricting the motion of my left arm. She freed it.
The next day I was sore, as expected. It has made a huge difference though and I wish I had done this months ago. I am finally starting to feel closer to normal.
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