Wednesday, December 23, 2009

Two OS Visits

Before I describe my recent OS visits – yes, plural; seeing two surgeons reminds me of that “famous” JCVD quote and movie trailer line: “There are two of them. Double the Van Dammage” – I wanted to share my bike riding adventures. A few weeks ago, I bought a friend’s old mountain bike. Other than a few bike outings on vacation, I haven’t ridden one since my sophomore year in high school; i.e., when I got my driver’s license and no longer needed a bike for transportation.

First, it really blows biking outdoors in the cold. And by cold, I mean anything under 50 degrees. The wind whipped my face worse than Vic Morrow cracked Kunta Kinte (not sure why that analogy popped into my head; it just did.) Pedaling faster to get home quicker just makes things worse. Yeah, I realize I’m a moron. But at the time, that logic made sense. Also, I’m a sh*tty bike rider. Just brutal. I need bumpers on the side of the trail, like those bowling lanes for little kids.

Bikes have changed dramatically from the ones I rode as a kid. My first bike was a New York Giants dirt bike bought at Sears (my dad got a steep work discount). With a massive banana seat and tires fatter than contestants from the Biggest Loser, that thing outweighed a tank. I remember getting trapped underneath the bike after a wreck, unable to lift that beast off me. Too bad they didn't make the LifeCall for that thing. You know, I've fallen and I can't get up? Anyway, I’m pretty sure the Army now uses its frame for body armor in Iraq.

Remember being fearless on your bike as a kid? It was like the Dukes of Hazard on two wheels. We would rocket over creeks off homemade ramps and launch ourselves down outdoor stairways. Now? I avoided even the 2cm crack in the middle of the paved trail. That twig smaller than my 4-year old’s foot? Too big to ride over. Yes, age and injuries have transformed me into a mega-p*ssy. It’s gotten so bad that just watching the X-Games freaks me out.

Ok. I met with 2 surgeons last week. I had my regularly scheduled check-up with Turgeon on Friday, and then I met with a new OS just to get a fresh set of eyes to check out my knee. For the most part, their evaluations were similar. Here’s what each had to say.

When I met with Turgeon, my big concern – other than the usual, how is the knee healing – was the twinge of pain on the inside part of my knee. As I blogged about earlier, my google-educated diagnosis suggested a possible medial meniscus tear.

Turgeon doesn’t think my meniscus is torn. He didn’t rule it out, but after performing a variety of bends and twists he doesn’t think there’s anything seriously wrong. He also thought the knee looked pretty good, and suggested it was time to step up my activities. He told me to start pushing the envelope and scale back if my knee starts to hurt. In fact, he told me – gulp – that it was ok to start jogging, though I need to use baby-steps. For instance, he told me to slowly increase my treadmill walking until the pace reached a point where I had to start a slow jog. He suggested I maintain the jogging pace for short periods – 10, 20, 30 seconds – before reverting back to my walking speed.

Turgeon, however, is a bit concerned with how the osteotomy is healing. The x-rays reveal the bone hasn’t filled in yet. He wants to keep the screws in my shin until July. Normally, he removes the hardware between 12-18 months. In my case, if the bone had looked ok, he would remove the screws now because they’re protruding. But he wants to keep them in for a bit longer.

But the main takeaway is that the knee looks and feels solid. The crepitus is normal. I’ve got full range of motion and full extension. No pain in the ACI-repaired areas. I need to build up my quad strength, however, which should come with time and after some more intense rehab. That will be the challenge with pushing things – how far can I go without aggravating the knee?

He told me that as I push the knee, I’ll also learn whether the meniscus is torn. He cautioned that the MRI – last taken 2 months before I started feeling the pain – is an imperfect tool to detect meniscus tears. If the pain persists, he mentioned undergoing an MR arthrogram. Basically, the doctor sticks a needle into my knee and injects some type of dye. The fluid then seeps into the knee joint and shows any “contrasts,” or possible tears, etc. The pictures might also reveal any deformities with the ACI graft. This procedure is not without risks, however. A number of lawsuits allege that one of the substances in the dye – gadolinium – causes a number of harmful side effects. Plus, sticking a needle into your knee joint can’t be enjoyable. Unless you’re Bubbles, I guess.

Turgeon didn't suggest I get MR arthrogram. He knows I’m an information junkie, and wanted to share this possibility now so I can educate myself in advance. Of course, I hope the pain goes away, making the possibility of further testing a moot point.

Turgeon also told me that he’ll probably check out the graft site when he removes the screws. He could clean up any overgrowth or remove extra scar tissue, though, at this point, he doesn’t think that’ll be necessary. He used a bioglide sealant – not periosteum – to cover the graft, which has a better track record; less than 5% of patients with bioglide sealants experience overgrowth.

The following Tuesday I met with Dr. Joseph Berman in Arlington, Texas, about 30 minutes away from my house. Berman, I think, does the most ACIs in DFW, and works out of a specialized facility; it was even larger than Turgeon’s old offices at the Texas Sports Medicine Group. I brought all of Turgeon’s visitation notes and the two surgical reports, as well as both MRI pictures and the technician reports. I felt like a fledgling author delivering a rough draft of his novel to a publisher. Berman took his own x-rays while I was there.

I was very impressed with Berman and his staff. I sensed he felt a tad uncomfortable serving as a second opinion, not wanting to play Monday Morning QB-surgeon and question Turgeon’s actions. However, I think he realized that I was a pretty-educated patient and had a number of specific questions for him to answer, which made his job a bit easier.

Like Turgeon, Berman did not think I tore my meniscus. So much for my google MD. Also like Turgeon, he thinks my recovery is going well. He suggested that the pain on the inside part of my knee, along with the quivering sensation my knee experiences when doing single-leg squats, might be from my lack of core strength. My right quad is still noticeably smaller and weaker than my good leg. Berman thinks that with continued rehab my knee will strengthen and some of these issues will disappear. Berman does not suggest I start jogging yet. He told me he counsels ACI patients to wait 14-16 months before attempting impact activities. But he says biking, even mountain biking, is fine.

Like Turgeon, Berman is concerned with my osteotomy, though he offers a dramatically different solution. He would remove the screws now and do a bone graft to fill in the tibia. If the bone hasn’t filled in by now, he says, it probably won’t. A bone graft is a pretty serious – and painful – procedure, and the recovery lasts 3+ months.

We also spoke, somewhat at length, about the ACI process in general. He told me that the Israeli surgeon who pioneered MACI is a friend of his. I informed Berman of the CBS Today feature piece on Dara Torres’s ACI knee surgery (in my earlier post, “Celebrity Knee Surgery,” I noted that the press release announcing her surgery was vaguely worded; it didn’t specify which procedure Dara was having. I speculated it was ACI, and it turns out that's what she had.) If I was Berman, I would find a way to turn Dara’s very public ACI surgery into a marketing effort, assuming that’s ethical. It’s like rainmaking for doctors. Anyway, here’s a link to the CBS story on Torres:

http://www.cbsnews.com/stories/2009/12/14/earlyshow/health/main5977298.shtml

I also told Berman about my blog, and gave him the link. Not sure if he’ll check it out, or if he’ll enjoy my sense of humor. I also spoke with one of his nurses about my blog and my recovery experiences. I had mentioned I had swapped messages with one of Berman’s recent ACI patients (and blog follower), Char. Hopefully the info I passed along helps.

So, where do things stand now? Interestingly, the pain on the inside part of my knee has disappeared over the past few weeks. The leg actually feels ok right now, though I still think something’s amiss with my meniscus. I’ll probably try speed walking, and might even progress to a point where I jog a few steps. But I plan on waiting at least another month or so before I begin jogging. I also plan on regularly doing weighted leg raises again -- something I stopped doing -- especially the ones lying sideways to build up my abductor and adductor muscles. I think that might be the best and least painful way to build up my inner quad strength. And I wonder if the increased strength might eliminate the meniscus pain.

I next meet with Turgeon around Spring Break, unless the pain in my inner knee re-appears. We take x-rays every visit, and, if the bone does not appear to be healing, I’ll ask Turgeon’s opinion on how to address the problem. I want to avoid a bone graft, if possible. I really don’t want to endure another crippling surgery, especially now that I’m somewhat normal again.

In the meantime, happy holidays.

Tuesday, December 8, 2009

11-Month Update -- Setback

I suffered my first real setback about 2-3 weeks ago. It might be a reoccurrence of an earlier problem. There’s a sharp twinge of pain on the inside part of my knee, right where the knee forms a “V” when it bends. I think this is what doctors call, “the joint line.” The pain appears to be below the patella, suggesting it’s unrelated to the ACI surgery (at least that’s what I hope). My symptoms are consistent with a medial meniscus tear. (I earned my M.D. at Google University). The 6-month MRI suggested I tore the posterior horn of my medial meniscus, which, I learned, is the most common place to tear cartilage. Turgeon thought the actual MRI pictures were inconclusive, and the 2nd MRI report didn’t note the meniscus tear. Then again, the MRI guys also thought they were looking for a torn ACL…

The pain prevented me from doing my knee exercises for a few weeks; the rehab kept aggravating the pain. That’s troubling. But what’s worse is that the pain started flaring up during normal activities. This is the first time I’ve ever experienced daily knee pain, and I’m seriously concerned. I never had constant pain before my surgery, and I’m worried that the surgery made my knee worse. The doubts about my decision to undergo ACI – the ones I tried to bury months ago – have re-emerged. I now think about my knee pretty much every time I walk or climb stairs. Over the past 2-3 days, the pain has disappeared, and I recently did some shuttle leg press with minimal bend and weight with no ill after-effects. Hopefully the pain is unrelated to the ACI repairs, hopefully the pain doesn’t suggest anything serious, but if it’s a meniscus tear, hopefully it can be fixed rather easily, or as easy as arthroscopic surgery can be. That’s a lot of hoping…

My next doctor’s appointment is this week. Hopefully (there’s that word again) I’ll get some insight into the cause of my knee pain, as well as a possible solution. I already scheduled an appointment with another ACI doctor for the following week. I want a second set of eyes to examine my knee, not just about the possible meniscus tear, but also to evaluate my progress from the ACI surgery.

The possible meniscus tear poses a new dilemma. I had wanted the OS to check out the status of my cloned cartilage and “clean up” any overgrowth at the same time he removed my screws, and I had planned on waiting until next year to have the screws removed. However, if I tore my meniscus I’ll probably need to get scoped fairly soon, which means I have to decide now whether to get the screws removed, too. Frankly, I don’t think I have a choice. I don’t want to undergo two separate surgeries and two separate recovery periods. I want to handle my rehabs at the same time, if possible, even if it’s earlier than I had planned. This will jack with stuff I had planned to do in 2010.

Anyway, I should have some interesting details to share next week after my two doctor’s visits.

Ok, because this latest posting is a bit morose, I decided to share my adventures dressing up as Santa 5 years ago. This story was re-worked from the original email I sent to some buddies. Enjoy.

I made 4 Santa visits. The first 3 stops were to little kids: 1 ½ - 3 years old. Those were fun trips, even the visit to the kid who was scared sh*tless of Santa. I read a few Xmas stories, gave them some gifts, and told corny North Pole jokes. Good times.

The last stop was a different story: a 7 yr-old boy and his 10-yr old sister. When I saw their ages on my checklist, I assumed the older sister no longer believed in Santa, but was just playing along so she didn’t ruin it for her brother. As it was, I was skeptical that the 7-yr old (first grader) still believed in Santa. Well, those were 15 of Santa’s most uncomfortable minutes.

I first made a couple of “I’m checking my naughty/nice list” jokes and then gave the kids the gifts their parents stashed outside. After they opened them, dead silence. Crickets chirping. I had no idea what to do. At one point, I almost asked their parents, “How ‘bout throwing Santa a bone here….” The kids didn’t seem real interested in listening to Xmas stories, and I’m not sure what the rules say about letting a 10-yr old girl sit on my lap. So I started asking them some dorky questions about school and what they like to do, the kind of questions aunts and uncles ask during family reunions. It turns out the boy is artsy. He bragged about the pot he made in art class and the poems he’s writing in English class. I almost asked if he painted the pot fuchsia. I immediately checked Santa’s rules for helping little kids come out of the closet. Not that there’s anything wrong with that.

Dealing with the daughter was equally nerve-racking. Very nice girl, but she was exceptionally quiet. I struggled to use her Hillary Duff CD gift as a conversation bridge. I even heard myself say, “Santa likes Hillary Duff, too. She’s a fine entertainer.” I was using Kramer’s “Mr. Movie Phone” voice, the episode in which he finally told the caller, “why don’t you just me the name of the movie…” Painful moments.

After a few pictures with Santa by the Xmas tree, I asked the kids if there’s anything else they wanted to ask Santa. The boy said, “You’re not the real Santa, are you? You’re just one of his helpers dressed up like Santa.” Totally out of the blue. Dad was videotaping the whole episode. I’m sure in a few years when they show that tape at their family reunion, some drunk cousin is gonna bust out, “Check out the look on Santa’s face!!” I was completely frozen. I desperately looked at the mom for some help, the second time that night I wanted the parents to throw Santa a bone. Thankfully, the mom said, “Santa, Brandon knows there are many Santa helpers.” So I picked up that train of thought and told the kids, “Yes. Santa’s really busy at the North Pole right now. There’s just no way he can check on ALL the kids in the world, so he asks helpers like me to visit certain kids to see if they’ve been naughty or nice. And after my visit here, I can safely report back that Brandon and Megan are nice kids, deserving of really neat gifts.” I think that answer helped avert disaster. If the kids didn’t buy it, I was ready to pull of my fake beard and say, “Look, kids. I’m just a gov’t worker, trying to make the world a better place.”

Wednesday, November 25, 2009

iPhone rant

While I continue to play Monday Morning Knee Quarterback, I wanted to share a recent observation.

As I was leaving a Dallas Mavs game with my 7-year old son, I noticed a group of twenty-something guys and girls hanging around the main lobby area. The guys wore slacks and fitted, striped button-down shirts (I’m also pretty sure they leased BMWs, lived in 600-square foot apartments and racked up $30,000 in credit card debt, like most Dallas Chachis). The girls wore pant suits, so I don’t think they were hookers. Anyway, they looked like they were trying to figure out where to go next. Yet this group wasn’t laughing out loud or goofing around, the kind of behavior you’d expect from people this age. In fact, they didn’t seem to be having fun at all, or even socializing with each other. Something didn’t look right.

And then it hit me – all of them were texting. These people were more into their phones than their friends. At the risk of sounding like an old foagy – oh, these young whipper-snappers and their portable internets – what’s the point of going out with your friends if you’re not going to pay any attention to them? That makes no sense.

Like rats following the Pied Piper, one member of the group eventually signaled that it was time to leave, and everybody filed out of the arena. Of course, three-fourths of them continued pecking away on their phones, which made walking difficult. Actually, they looked like they were waddling. People probably thought they had dumped in their trousers. But seriously, I’m not sure what shocked me more: that people would ignore their friends like this, or that friends would tolerate this behavior? To paraphrase the immortal George Costanza, would it be so wrong of me to smack the iPhone out their hand? I say no.

Anyway, this scene reminded me of similar ones 10-15 years ago when cell phones first appeared. Back then, people spent the entire night talking on their cell phones, not to the friends they were out with. With the ubiquity of smart phones, I fear society is about to repeat this annoying behavior. Those who don’t learn from history are doomed to repeat it. I don’t think people had cell phones and texting in mind when they uttered this phrase, but it fits. So let’s take a little stroll back in time.

(Wait a second. Before I examine this troubling trend -- ubiquity. Impressed? Ever since I saw “ubiquitous” on my Word-A-Day Calendar three years ago, I have to use that word at least 3x/week. Even if I can’t pronounce it correctly. Ubiquitous).

Back in the ‘80s, cell phones were larger than Kim Kardashian’s ass. Seriously, have you seen non-airbrushed pictures of her rear end? It’s got more craters than the Moon’s Sea of Tranquility. (Thank you, thank you. I’ll be here all week.) Back then, cell phones were more flash than substance, just like Kardashian’s butt.

(Hold on a second. After I typed this blog post, I stumbled across a bunch of recent photos of Kardashian, including her Halloween “Princess Jasmine” costume. She looks lean and fantastic. The pictures didn’t show her booty, however. And with photo-shopping you can never tell how legit the pictures are. But I reserve the right to re-examine my previous comments about her rear…)

Gordon Gekko sat aboard his yacht and whispered into his cell phone, “Blue Horeshoe loves Andicott Steel.” (Maybe the scene didn’t play out EXACTLY like that, but this description works better for my blog post, and I’m not above bending the facts to fit my needs). Yuppies immediately sprinted from the movie theatre to buy their own phone, hoping to capture Gekko’s aura. Pretty soon, upscale clubs were full of douchebags walking around with suitcase-sized devices to their ears, pretending to be brokers. They really weren’t buying and selling stocks, of course. They just wanted people to think they were important. Their only accomplishment, however, was ignoring their companions. And looking like douchebags. Eventually the phones shrank in size (I don’t hold much hope for Kardashian’s butt) and cost, allowing the masses to buy cell phones, too. Poor manners were no longer limited to the sweater-vest and wine bar crowd.

Now, God forbid I morph into the Miss Manners of social etiquette, but proper usage of cell phones required a steep learning curve, made worse once people with IQs under 75 could afford them. At first, people talked non-stop on their cell phones, no matter where they were or whom they were with. Kids’ school functions. Restaurants. Sporting events. Who can forget the TV shots of people chirping away on the phone, oblivious to the game? But probably the worst experience, in my opinion, was grabbing a hung-over brunch at IHOP or Denny’s, and being forced to suffer through the cell phone conversation of a very loud redneck who just had to call Cooter and brag about the 5-point buck he just bagged, or the hot chick he just nailed who turned out to be his second-cousin. In my best Nancy Kerrigan voice, WHHHYYYY can’t I just eat my pancakes in quiet?

Folks didn’t care who they ignored or who they offended. Basically, they talked on their cell phones because they could and because they thought it made them look important. They were dead wrong; they just didn’t realize it. By using cell phones incessantly, the less affluent played catch-up with the douchebag-yuppies they openly mocked but secretly envied.

Let me share my cell phone epiphany. Back in the late 1990s I went to Happy Hour at a Tex-Mex place with a group of acquaintances. What can be happier than a Corona and chips/salsa? Nothing, I say. Well, I remember talking about sports and chicks – that’s pretty much the only thing guys talk about – and casually asked the guy a few seats down to pass the chips. I immediately resumed debating the virtues of Latinas vs. Asian women, truly the LeBron vs. Kobe debate of women. 5, 10 seconds elapsed before I realized the guy hadn’t passed the chips. I looked up and the bastard’s chatting away on his cell phone. I made eye-contact and gave him the look that says, “Hey buddy. Pass the chips already.” You know the look.

He appeared a bit dumfounded at my annoyance, and then he gave me a condescending look that says, “Um, can’t you see I’m a super-important guy on my cell phone?” You know that look, too. Then he spun around in his chair and turned his back to me. Apparently, a call in the middle of Happy Hour was so important that he couldn’t use his free hand to slide the chips down 3 feet.

15-20 minutes later – by this point I had calmed down enough such that I no longer wanted to dump the pico de gallo on him – I casually asked him who he was talking to (he didn’t realize that I was ticked off at him). He said, “Oh, a buddy got stuck working late and he was complaining about how he had to stick around until his boss left.” Somehow, speaking on a cell phone transformed this call into something so important that he couldn’t pass the f*cking chips and salsa. Bastard.

The common thread here? People ignored their companions. The phones gave them an inflated sense of self-importance. Their conversations – or, just the ability to hold a conversation – took precedence over the people standing next to them.

Grown-ups respond to new toys just like kids – they play with them non-stop until the novelty factor wears off. Just like Pac-man got old after the 12,063 time, cell phones did, too, and people eventually integrated them in a socially acceptable way. Everybody was much happier, especially the Verizon technicians who kept switching off cell phone towers because they thought it was funny to randomly drop calls. F*ckers.

Unfortunately, the smart phone crowd discarded the lessons learned during cell phone misuse. Maybe the current generation using smart phones never had to learn cell phone etiquette. Maybe people today just don’t care. Or maybe, just maybe, in the Facebook and Twitter era people like their friends a little bit less. Seriously, how many times have you looked across the table and saw a companion texting away instead of actually, you know, listening to what you were saying? If you’d rather text somebody else than talk with your companion, why go out with them in the first place? If your companion is so boring that you’d rather text somebody, just say so. You probably don't care about hurting his feelings.

(Exaggerated Al Gore sigh). Look, there are plenty of good reasons to text somebody or surf the web while out with others. I understand. Just don’t be one of those obnoxious pr*cks who texts while somebody else is talking to you.

And now I’ll step down from my soap box.

Two final thoughts: I’ve never read the Twilight books and don’t plan on seeing the movies. But the pasty Vampire guy? The James Dean lookalike? Robert Pattinson (I just looked up his name). He reminds me of those 90210 actors, guys who are 40 but play high schoolers. Except that without the sideburns and schlocky-ness, he seems creepy. If Pattinson ever appeared on 90210, he definitely would've date-raped Kelly. By the way, I loved watching 90210 and Melrose in college. I’d hit the bars immediately afterward with a happy face. Those shows always seemed to put me in a good mood. It's hard to top quarter beer nights after those shows.

And finally, Happy Thanksgiving. Remember, the mash potatoes make-or-break the meal…

Saturday, November 7, 2009

10-Month Update

Man, I never thought January and February would end. Shower seats. Toilet seat risers. 23 hours in bed. Sleepless nights. And now it’s November. You know what? I actually miss my toilet seat riser. Crapping that high is kind of empowering. Like driving an SUV. Alright, let’s check out how the knee’s doing today.

Walking around? No problem.

Stairs? Not completely normal, but no real issues. Sometimes I catch myself concentrating on my form, especially that first step.

Bending and squatting? Done cautiously, but capable. 1-legged squats are difficult once the knee bends beyond 60 degrees. At that point, the leg starts to quiver like a guy in the electric chair. The knee feels like it’s struggling to hold it together, like the First Wives Club at a Mathew McConaughey flick.

Surfing? Nope. Crossing my fingers I’ll be able to surf in Maui in May.

Lumberjacking? Not yet, but my chainsaw and flannel shirts are ready.

Kneeling and crawling? Difficult, but possible. It’s uncomfortable, not so much on the actual knee, but on the bone wedge when it brushes against the ground.

Running or jogging? No.

Pain? Not really, though I experience occasional twinges of discomfort on the inside part of my knee. The outside of my knee sometimes feels compressed, like an oversized object trying to squeeze through a smaller hole. (I’ve got several X-rated jokes ready to go, but decided to hold off). Also, the screws in my shin and the bone wedge from the osteotomy are sensitive.

10 months out, I still don’t know whether the surgery was “worth it.” It’s too early to tell. Keep in mind that my knee wasn’t in shambles at the time of the surgery, so I never experienced the debilitating moments some ACI patients suffered through. I decided to go under the knife before my knee rotted away. I’ll probably evaluate this decision every few months for the rest of my life. For my sanity, let’s hope I eventually reach the stage where I conclude the past 10 months – or however many months pass – was worth it.

Thursday, October 29, 2009

MRI, Part II and a Little Road Rage

A lot has happened over the past few weeks. Not with my knee, of course. More same old, same old there. But I do have a new update to share – my 2nd MRI. I’ve also got a classic car accident story. Minor fender bender; nobody got hurt. The lady who hit me, however, sped off. Don’t worry, I channeled my inner Bo and Luke Duke and chased her down. More on that later. In the meantime, grab a Coke and a snack, and settle in for a mammoth, 3,000-word entry to make up for my sporadic postings.

This was my 2nd MRI. The first one took place at the 6-month mark, and the technician wrote up a report focusing on my perfectly intact ACL, not my ACI. F’ing moron. Excuse me – Dr. F’ing Moron. I can’t believe that guy is a legit doctor. He probably got an on-line diploma from The University of Phoenix. That’s a pock mark against MDs.

Anyway, fast-forward three months. As I blogged about earlier, I felt kinda dirty when my OS ordered another MRI so soon after the last one. From my non-expert opinion, it didn’t seem as though it was justified. Nothing new had happened to my knee over the past 3 months. But since the MRI cost me $0, I wasn’t complaining.

Well, it turned out to be a complete waste of time. Maybe that’s karma’s response to health care waste. Of course, I’m not too concerned about adding a few thousand dollars of wasteful medical spending to our current gazillion dollar deficit; I’m only concerned about wasting my time. Unfortunately, I will never get back the 30 or so minutes spent lying inside a metallic tube, struggling to hear crappy music over a ton of static. Not even the free cookie the diagnostic center offers made the trip worthwhile.

A week after the MRI, I reviewed the results with my OS. You know how sometimes you walk into a doctor’s office and the morose vibe swallows the room? Cranky and sickly people hovering about? Maybe a few injured old people? Man, hurt old folks are the worst. Anyway, you can almost sense that any news delivered won’t be good.

That’s how I felt walking into Dr. T’s office. During every visit, I exchange brief pleasantries with Dr. T before my examination, usually in the waiting lobby or on the brief walk to the patient room. This time was no different, except Dr. T was distracted. Very distracted. I barely got a nod. He also seemed rushed, perhaps even a bit irritated.

When Dr. T entered my room, his speech was rapid, his attention diverted. He even grumbled a bit. His demeanor reminded me of a blackjack gambler who excitedly doubles-down on an 11 against a dealer’s 6, only to watch the dealer miraculously pull out a 21. Worst, as the gambler slumps away with up his last 3 chips, the dealer cheerfully wishes you good luck, when she's really being condescending. Frankly, I think the gambler would be justified in shoving an automatic shuffler down the dealer’s throat. Ok, that’s a bit violent. I wouldn’t do that, even after my 14th Vodka Cranberry, my personal favorite Vegas drink. I admit this drink is a bit girly, but it’s decent-tasting, doesn’t leave me bloated (which 14 beers would do, assuming I didn’t barf after my 8th one), and usually I don’t wake up the next morning thinking I’m in Kabul. Ok, back to my doctor’s visit.

Dr. T’s attitude was strikingly different from my last visit when we rejoiced over the results from the MRI at the 6-month mark. At that visit, Dr. T dished out high-fives as frequently as Amy Winehouse pops pills. Of course, I’m taking Dr. T’s word that my MRI looked good. The garbled grid of images always confuses me. I can’t tell if I’m looking at my knee from the right or left side, top or bottom. Hell, it could a sonogram and I wouldn’t know the difference.

I didn’t learn anything new from MRI #2. It basically said everything looked exactly the same as it did 3 months ago. The lazy MRI technician probably wanted to write, “ditto.”

There was one interesting piece of information. Unlike the previous report, this one did not identify any meniscus tear. Apparently it magically healed over the past 3 months. I have no explanation how. Oh, wait, that’s not true. The logical explanation is that the MRI technician is an effing moron. The second report noted “increased signal” in both the medial and lateral meniscus. There was no edema (basically, swelling) or any defects noted. Indeed, the articular cartilage “appears well-preserved.” The MRI revealed some cartilage thinning along the lateral patella facet. There was no mention of the trochlear groove, the other spot fixed.

Frankly, I expected Dr. T to be generally happy with this report. From my perspective, it confirmed the earlier, “good results” from the previous MRI that led to all those awkward high-fives. But he was nonchalant, even dismissive. Even after I prodded him about how the graft looked, he simply said everything looks fine. I got nothing from him. Nothing.

Dr. T’s mood wasn’t the only aspect of the visit that bothered me. He also gave me conflicting advice. At the last visit, he said he wouldn’t take out the screws from the osteotomy until 15-18 months because the tibia was healing slowly. This time, he said he’d take them out before year-end. He didn’t explain what had changed.

Also at the last visit, Dr. T encouraged me to ramp up my quad-strengthening activities. Specifically, he told me to start doing step-ups, slowly increasing the amount of reps, height of the platform, and the weight in each hand as my leg got stronger. Well, I took his advice. Yet, instead of congratulating me when I told him I had progressed to 2-foot step-ups with 20lb dumbbells, he chastised me for being too aggressive, and warned me that I was placing too much force on my patella-femoral joint. Huh? I was dumbfounded. After I listed all of the exercises I had been doing, Dr. T told me to focus on the shuttle leg press. This was the first time I left my appointment discouraged not by the progress of my knee, but by my OS.

So, how does my knee feel now? Tough to say. The knee goes through odd stages. It continues to click and pop occasionally. Sometimes it sounds like little people are celebrating July 4th inside my knee; other times those little people are cracking their knuckles. But no matter how hard they’re partying, the little clicks and crackles don’t hurt or otherwise bother me. On the flip side, there are plenty of extended periods when my knee settles into a perfect groove and gives the illusion of being 100%. These are the moments when I think that I might return to pre-surgery activity levels in 6-9 months. Wishful thinking? Maybe. But to quote Obama’s campaign promises, these positive thoughts give me, “hope I can believe in.”

Right now, my biggest concern – besides getting the screws out – is the random twinges of pain on the medial side of my knee, which I previously thought might have been a torn meniscus. I’m not sure what causes this discomfort, and it’s difficult to pinpoint the exact spot. It kinda feels like bone-on-bone rubbing, but it also feels like the inner quad muscles might be weaker, thereby increasing stress on that spot. It doesn’t seem directly related to the ACI, but who knows. It only bothers me when I push myself during my leg exercises. While I’m hesitant to get scoped again, I might allow Dr. T to examine my knee when he removes the screws. It’s possible there’s a slight tear. It’s also possible that the clicking signals over-growth of the graft, which Dr. T could scrape that away. Or the clicking could mean the graft needs to harden some more, which I understand can continue for up to 2-3 years, especially for patella ACIs. If he scoped my knee, I’d also find out whether the graft worked. The MRI is an imperfect view of the ACI. The only way to be certain is via a scope. I’m just as hesitant to find out about the graft as I am to get scoped. It would be crushing to learn that the graft failed.

Let’s see….I’m slightly more capable on the sports field. I can now move laterally well enough to retrieve errant soccer passes from my kids, and the knee can handle demonstrating some dribbling moves. Mind you, I won’t be confused with Ronaldinho. I can just do more than I could a few months ago. At times I feel like I should try running and playing sports, but I know that’s neither wise nor practical.

Of course, that didn’t stop me from “practicing” running again. And by practice, I mean I took 3-4 steps to mimic the form of running. In some ways, I resembled a track runner practicing his starts. But not really. Track guys work on exploding out of the blocks. I’m just trying to see if my knee will cycle through the correct running mechanics, even in slow motion. No such luck. I couldn’t shake that hitch in my right leg when I tried to run. No matter how hard I tried, the knee just wouldn’t cooperate. I felt like Dinah from The Biggest Loser trying to hop up onto that 6 inch platform. She couldn’t overcome that mental hurdle of hoisting her sizeable self onto the platform, no matter how many times she tried. And when I continually failed to jog, my only solace was that, unlike Dinah, I haven’t ballooned to 300 pounds. I know I tell my kids it’s not right to make yourself feel better at the expense of others, but like Tom Cruise said in Risky Business, “Sometimes you just gotta say, what the f*ck.” And damn it, I’m a grown-up. So sometimes in my injured state, I need to take comfort any way I can, even it’s mocking fat people who can’t jump. (Sigh). Ok, that’s wrong and I realize karma will definitely take revenge. But I needed to vent for a moment. I’m done now. I take back my teasing of Dinah.

Long-time blog reader and frequent commenter, Jen, recommended running in the pool to help overcome these mental (and physical) hurdles. That’s a good suggestion. I haven’t been in the pool since the weather changed. We finally disassembled our trailer park, above-ground pool a few weeks ago. My backyard now has a sweet, UFO-looking brown patch of dirt. So if I plan on jogging in water, I’ll need to do it at 24-Hour Fitness, which isn't a problem. I went pool-walking there a handful of times early in my recovery. But going swimming in the winter – even a mild one like Dallas’s – is extremely un-appealing. I’m definitely concerned with shrinkage. But like Dinah eventually leapt onto that platform, I, too, can splash around an indoor pool when it’s 50 degrees outside.

Ok, if you’re interested in reading only about my knee, stop now. Otherwise, enjoy my car accident story.

Leaving the 24-Hour Fitness parking lot, I pulled out to the far left turn lane. It was a red light, and there were about 3-4 cars waiting ahead of me. I drive a Toyota 4Runner. As Jack FM was telling its listeners the radio station plays what it wants, the reverse lights of the beat-up, green mini-van 5 feet in front of me popped on. My initial thought, was, “huh? That’s strange.” And then the mini-van slowly rolled backwards. I immediately screamed out, “hey moron!! Stop!!” Too late. Pop. She tagged me.

When I stepped out of my car to inspect the damage, I wasn’t too worried; only 5 feet separated the two cars. The driver and passenger of the mini-van emerged at the same time. The driver was a 5 foot-tall, 200 pound Hispanic lady. She could’ve been 60 or 35 years old. No clue. The passenger appeared to be her daughter. She was slightly taller, and slighter less chubby. Like her mom, her age was vague. Maybe 40, maybe 20. Neither spoke English. Great.

She immediately started blabbering and gesturing at my car, and then pointing at her car. She then started yelling at me in Spanish. I speak conversational Spanish, enough to realize that she blamed me for her backing into my car. I was annoyed when she hit my car, but now I was irate that she faulted me for her incompetence.

I immediately told her to shut the f*ck up, you just hit my car. In Spanish. She quieted down. I was very impressed with myself. She was shocked a white boy like me spoke Spanish. Of course, she now expected me to speak Spanish well enough to understand every word she said. Not good.

I started examining my front bumper and noticed a decent-sized scratch. Nothing serious. The scratch, however, did not appear to be in a spot where her car hit me. Hmm. Before I could finish my inspection, I noticed the driver started acting suspicious, pacing a bit anxiously, like she was nervous. I wondered, (1) does she have insurance, and (2) is she an illegal alien? As I started searching other spots along my bumper, I told her we needed to exchange insurance information. Again, in Spanish. My high school Spanish teacher would’ve been proud. Muy bien, Jaime. The driver nodded, and both ladies retreated to the mini-van. I likewise left to get my insurance card from my glove compartment.

And then I heard the mini-van’s ignition start. Holy sh*t. The bitch was gonna bolt! I quickly shuffled – remember, I can’t run – to the driver’s side window and started banging on it. She opened the window and motioned ahead, suggesting we should move our cars out of the turn lane – we were on a pretty busy street – and onto a side street. Or so I thought that’s what she meant.

I returned to my car and the mini-van pulled away. Another car cut in front of me. The mini-van made the left turn onto the access road (that’s a feeder road that runs parallel to the highway). And then she was off to the races. Mother-f*cker gunned it. She had about a 20-yard headstart on me. The access road was empty. It was time to transform my 4Runner into the General Lee.

I floored it. The odometer showed 75mph. I jammed on my horn for the 4th or 5th time. I eventually caught her. As I pulled alongside her, I rolled down my window and started screaming at them to pull over. In English. I can’t speak Spanish in the middle of road rage. She sped up. Pffft. She didn’t realize I watched every episode of Dukes of Hazard as a kid. She wasn’t getting away.

I pulled ahead of her again, and then immediately slowed down, forcing her to do the same. I then let her get ahead of me and tailed her. After a few switcheroos, I think she realized she wasn’t escaping and the mini-van finally pulled into the parking lot of a local grocery store. Before exiting my car, I took a few calming breaths. Maybe I even thought of the hot chicks doing Namaste Yoga on the Fitness Channel. That seemed to work, and I reminded myself there was no need to wage war on an elderly Mexican lady.

But when I asked her why sped away, she started rambling incoherently, pointing at me, then my car, and then her car. By now, I had reached the limits of my Spanish. For some reason, the driver grabbed some random Hispanic lady walking to a nearby parked car. I think she hoped this woman could translate for us. I’m not sure. But the driver also borrowed this woman’s cell phone. Odd. The other lady didn’t speak English much better. However, all three of them understood me when I accused the driver of telling a “mentira,” or lie, about pulling over. I think I successfully shamed her. At least she stopped acting belligerent.

I finally had a moment to inspect my bumper. After tempers cooled down, I told the lady I simply wanted a few minutes to see if there was any damage to my car. That’s it. I asked her to get her car insurance. The side of my front bumper had a fresh scratch, but, like I said, it couldn’t have happened from direct contact from the mini-van. It appeared the bumper flexed upon contact, and this "scratch" could be rubbed out. There were also a handful of little scratches around the license plate area where she had hit me. Nothing serious.

She eventually returned from the mini-van, but with no paperwork. She then told me she didn’t have insurance and again tried to blame me for the accident. Her temper flared, though this time I sensed it had more to do with frustration than anger. At that point, I said, F*ck it and called 911. I calmly reported the accident, emphasizing that nobody was hurt and the only reason I called was because the other driver tried to leave the scene. I minimized my role in chasing her down. The dispatcher said an officer was on his way.

The driver finally calmed down. She offered me $50, but insisted that I not call the “Policia.” I appreciated her offer, but told her I already called the cops. Besides, I told her I didn’t want any money unless there was actual damage to my bumper. She immediately huddled with the other passenger.

Shockingly, the cops arrived 2-3 minutes later. I only hope they’re this prompt if there’s a real emergency. I noticed the passenger immediately walked 200 yards away to a neighboring Denny’s. Officer Friendly (note: not his real name) was a white guy in his late 20s. Nice guy, as it turned out. I calmly explained the situation, though I left out the Dukes of Hazard references. Officer Friendly then called HQ to get a Spanish-speaker on the phone to get the driver’s side of the story.

I ultimately decided that any damage was inconsequential. Yeah, she probably caused a few small scratches, but the bumper already had plenty of little dings. When the cop asked if I wanted to file a report, I declined. So did the driver. Interestingly, the cop told me the driver had car insurance. I’m not sure why she lied to me.

When Officer Friendly left, the passenger returned. I think she was an illegal, or had a record, perhaps an outstanding warrant. The driver again asked if I wanted $50, though she conditioned her offer on me not calling the police. She was thoroughly confused. I declined her money, and reminded her that if she hadn’t fled the scene of the accident, I never would’ve called the cops. All I wanted was a chance to inspect my bumper.

I ended our conversation with a line from one of those early morning ABC Family Shows – Senora, lying and running from trouble only gets you into more trouble. That, and selling meth.

I’m not sure the lady understood me, but I no longer cared.

Monday, October 19, 2009

Celebrity Knee Surgery

Man, it’s been way too long since my last update. To make up for my absence, I was working on a mega-blog post. Ultimately, I decided to break things up. Hopefully, the next post won’t take 3 weeks.

Ok, let’s start with some celebrity knee surgery news. And no, I haven’t spent the past few weeks playing paparazzi. Or stalking Brittney Spears or Lindsay Lohan. Nor do I plan on turning this blog into some sort of National Enquirer meets knees. But this is relevant to my postings, and it's the first time the specifics of a knee operation have made major news.

Olympic Swimmer and Buffest 40+-year old Mom in the World, Dara Torres, is having knee surgery, possibly ACI (Hey Dara, if you’re reading this, leave me a comment). The press release announcing her surgery was a bit confusing. It’s almost like her press team purposely picked the least knowledgeable person on their staff to issue the release. Is she having ACI or some sort of OATS procedure?

Here’s the release (I’ve deleted the non-pertinent parts):

Dara Torres overcame staggering odds to make the U.S. Olympic swim team in her 40s. Now, an even bigger challenge awaits.

Torres' arthritic left knee is damaged worse than she thought, requiring a radical, reconstructive procedure that will leave her with a recovery of 12 to 18 months. But she told The Associated Press on Thursday she's not giving up on the London Games.

The operation -- tibial tubercle osteotomy -- will be performed Oct. 20 in Boston. Torres' shin will be broken and shifted to create more room for cartilage to grow around her kneecap.

She already had the first step in the procedure a couple of weeks ago, when cartilage was removed from a nonweight-bearing area around her anterior cruciate ligament so it can be transplanted to the area around her kneecap during the next operation.

"This is really going be new experience for me," Torres said. "It's a little unnerving. I was seriously freaked out when I read the literature."

Torres had shoulder surgery after the games and looked forward to competing fully healthy, only to suffer from increasing pain in her left knee. She made the team for the world championships but was clearly not at full strength. She was unable to do much lower-body training in the months leading to Rome because all the cartilage around her knee had worn out, leaving her with bone rubbing against bone.

"There are times when my knee just swells up like a balloon," she said. "When I'm going up and down stairs, I have to hold on to the railing. It's very tough."

After the surgery, Torres won't be able to return to her home in Florida for about five days. Then, she'll be on crutches for six to eight weeks. The first tentative steps in her rehab will be hooked to a special machine that limits the range of motion in her knee.

While she already was looking forward to a break from swimming, she's concerned that other forms of training -- such as biking -- will be off limits until her knee gets stronger.

"I don't know what freaks me out more: having my knee fixed like this or the actual recovery time where I won't be able to train," Torres said.

"I'm ready to get it done and move on," she said. "I just want to have some normality in my life. I want to be able to walk up and down the stairs without being in pain."

While the release mentions a transplant of cartilage, thus suggesting OATS and not ACI, it also pegs the recovery time at 12-18 months, which sounds more like ACI. Indeed, recovery from OATS procedures usually is much quicker, more like 6-9 months.

Anyway, a couple things about this release caught my attention. First, it describes the procedure as “radical.” I realize ACI or OATS-type knee surgeries are a big deal. Believe me, I do. I’ve been living with it for 9+ months. But it’s not like they’re growing a second head here, or trying to install gills on Dara. Hmm. Actually, that might work out to her advantage. Maybe they’ll stick in some extra white blood cells to help her swimming, just like Lance Armstrong used to do in the Pyrenees Mountains to win all those Tour de Frances. (I know, I know. Lance is great. LiveStrong! He never doped. And neither did Roger Clemens or Barry Bonds. And OJ couldn’t have killed those people since the glove didn’t fit. Riiiggghht). Calling this surgery, “radical,” doesn’t exactly inspire confidence in my ability as a mere mortal to recover. I realize Torres's PR team needs to set the bar high in case she's not able to return 100%. But still. Radical? That’s the knee surgery equivalent of fear mongering.

Next, the press release makes it seem like the “tibial tubercle osteotomy” is the main course. It’s not. The osteotomy is a side dish. An important one, sure, like the mash potatoes at Thanksgiving. But the ACI or OATS transfer is the turkey here. Yet there’s no real focus on the actual cartilage transfer (if it’s OATS) or cloning (if it’s ACI), only a brief mention of the transplant and some vague reference to creating more room for the knee cartilage to grow.

Since the release says her surgery is in Boston, I assume her surgeon is Tom Minas. I’m sure Minas performs all sorts of knee operations, but he’s widely considered the top US ACI surgeon, suggesting she’s having ACI. And Torres is spending 5 days either at the hospital or near the actual surgery site, something ACI patients do. Not me, of course. I was home in time for Oprah.

The release does nail her initial recovery period. She’ll spend the first 2 months or so on crutches and hooked up to my old friend, the CPM. But the most shocking omission? The release doesn’t mention the type of toiler seat riser Dara bought. Maybe she’s planning on announcing her choice on Twitter.

Anyway, Torres, like most rich athletes, will have many advantages. The best surgeon. The best rehab facilities. The best trainers. Plus, she’s a world-class athlete in amazing shape. And she’s a swimmer, which just happens to be the best possible recovery activity. I’m rooting for her to fully recover. Or pose for Playboy after getting a boob job. Call it the Girls of Failed Knee Surgeries. Ok, that's tacky. But I needed an ending to this post, and that's all I could think of. (Ed. note -- I just realized why the Playboy comment popped into my head. The last swimmer who "crossed over" to a certain degree, like Torres has, was Amanda Beard, and she posed for Playboy. Um, not that I ever saw her photos...)

Wednesday, September 23, 2009

Sound Familiar? Slow and Steady . . .

Not a lot has changed. I continue to slowly increase the amount of weight and reps on my leg presses, hamstring curls and step-ups. But I’m not sure if either really impacts the pace of my recovery. I mean, it does, obviously, because my quad needs to get stronger. But I don’t feel like these exercises will “fix” my knee. The knee just doesn’t feel normal, no matter how much weight I lift or how much stronger the leg gets. Don’t get me wrong -- the knee functions fine. I walk without issues, and go up and down stairs just fine. I just can’t “explode” off it, and can’t even imagine running at this point. For example, whenever I bend past a certain point, the knee starts to quiver, like a car engine struggling to start on a winter morning. Instead of gliding smoothly like a hinge should, the knee feels bulky, like a tennis ball rests between the patella and bone wedge. Maybe there’s a bunch of scar tissue there; maybe I still need to adjust to the osteotomy. Indeed, my shin gets irritated as much as, if not more than, my knee after a hard workout. But the knee doesn't feel right. Sometimes my knee issues remind me of those old school cartoons when somebody shuts down some massive industrial machine by shoving a rod into a spinning wheel. Hopefully, time will heal whatever is preventing my knee from becoming “normal.”

As for non-knee news, I’m a huge fan of the UFC (that’s ultimate fighting; you know, the sport where guys beat the crap out of each other inside a cage). I used to watch the first UFC shows on VCR tapes passed amongst friends back in college. And then I took a break from the sport, before getting hooked again when the reality show – The Ultimate Fighter – premiered back in 2005. The show rekindled my love of violence, and this time my wife got sucked in, too. And by sucked in, I mean, “all in.” I don’t do anything half-assed. Not only did I watch the TV show and the monthly UFC PPVs, but my wife and I plowed through all the old UFC shows we missed over the past decade. And once we finished watching those, we rented all of the fights from Pride, the UFC’s then-major competitor, based in Japan. All told, we must’ve watched 50 DVDs of fight cards. Good times.

The only thing missing was the chance to watch a card live. Usually, the fights are held in Vegas. Over the past few years, however, the UFC expanded and began holding shows across the country. On Saturday, Sept. 19, the UFC visited Dallas. We were there.

Several observations. First, the ratio of guys to girls was at least 300:1. And of the girls there, I think 70% of them were hookers, or were at least open to being rented for the night. Next, the ratio of graphic t-shirts to normal clothes was 743:1. I counted. The ethnicity of the show was striking. White males dominated, with a sprinkling of Hispanics. Also, there were probably more chicks there than African-Americans. But shockingly there was only 1 fight in the crowd. Unfortunately I couldn’t see it because the Jumbotron blocked my view.

The event was loud. I mean, really loud. Almost as loud as the Guns ‘N Roses-Metallica concert I went to back in 1993. The highlight, besides the fights, was the opening video montage before the PPV aired. The AAC darkened, and Baba O’Reilly by The Who started blaring. Then the scoreboard started showing knockout after knockout, along with flashing lights and smoke. I definitely wanted to kick somebody’s ass after it was over.

The fights were fairly entertaining. The last 7 fights – the 2 shown on Spike TV before the PPV and the 5 on the Main Card – all ended in KO or submissions, 5 in the first round. But it was the very first fight of the night that was most memorable. Two relative unknowns fought before most of the crowd had arrived. The stadium was probably 50% full, at best. Because it was so quiet, every leg kick – basically, a fighter uses his shin to kick a particular nerve near the other guy’s knee – echoed throughout the stadium. Holy f*ck. Those kicks pained me. To answer Maximus's question to the crowd in Gladiator, "Yes, I was entertained."

Hopefully the UFC returns to Dallas in the future. The event apparently did well financially. 17,000+ attended, and the event generated the 2nd most revenue ever at the AAC, behind only a Rolling Stones concert several years ago. Beer sales must've been through the roof, and the lines to buy t-shirts were 10-people deep throughout the night. And maybe by the time the UFC returns, my son will be old to come with us. He's a budding cage-fighter. In fact, I keep waiting for his school principal to inform me that he choked out some kid at recess. And honestly, when I get that call, part of me will be proud (assuming he choked out a bigger kid who was bullying people, of course).

Sunday, September 6, 2009

Random Knee Thoughts, 8-Month Edition

My kids are back at school, which is nice. I’m a huge fan of routines and schedules. Other than that, not a heckuva lot has changed over the past few weeks. Well, I am coaching my almost 4-year old daughter’s soccer team, the Rainbow Warriors. Within 3 minutes at practice, one of the girls either (a) has to go potty; (b) complains that’s she’s hot/tired; or (c) wants to know when she can play on the nearby playground. Coaching 3- and 4-year old girls is like herding cats. Rewarding, but sometimes it can be a major beating, too. Go Green Death. http://www.patriotledger.com/sports/x575725578/-Green-Death-coach-resigns

Back to my knee. Using the marathon analogy, I guess I’m at the 16-mile mark. I’ve made significant progress, but then I realize, “holy sh*t! I’ve still got 10 more miles to go. Not to mention that a pack of Kenyans just lapped me.” All kidding aside, the knee feels like it’s inching closer to normal. Baby steps, people. Baby steps.

Over the past few weeks, I’ve stepped up the intensity of my knee exercises. At this point in the rehab, it’s more of the same. Basically, I just increase the number of reps, weight and difficulty. For example, I now do 25 step-ups on a 2-foot high stool with 25 pound weights in each hand, a far cry from doings heel touches on top of a phonebook back when I started my rehab. The gimpy knee remains much weaker than my good one; my quad remains squishy. And pasty. No matter how hard I try to isolate my bad knee, the good knee instinctively compensates. On the step-ups, for instance, the help usually arrives in the form of a small “push” off the floor by the good leg before elevating atop the platform. Luckily, it’s almost impossible to cheat on certain leg exercises, such as the leg press and the nautilus, 1-legged squat machines.

The knee still makes little clicking and crunching noises when I walk. It pretty much has been since the surgery. But it doesn’t bother me. The back of my knee also “pops” frequently, especially whenever I wake up first thing in the morning, or after my leg extends from a hyper-extended position. Again, no pain, but these can’t be good things. The crepitus usually signals overgrowth of the cloned cartilage. While not ruling out overgrowth, my OS noted that the new porcelain sealants usually prevent overgrowth. We’ll see.

The area of my knee that may or may not have a torn meniscus kinda aches, but still hasn’t limited my activities or rehab. I’m hoping MRI, Part 2 will reveal the extent of the damage. In a perfect (surgical) world, my OS could fix the meniscus tear at the same time he removes my screws. I’m not sure whether that’s possible, or even advisable. Or even whether, if the meniscus is torn, that I should wait until Spring 2010 to get it fixed, which is presumably when the screws will be removed.

That’s about it. Pretty boring update, I know. But that’s what you get at 8 months. Meat and potatoes.

Friday, August 21, 2009

An Impromptu 32-Week Visit and Firsthand Exposure to the Health Care Reform Debate

Last month I had an MRI of my gimpy knee. As I blogged about earlier, the MRI technician/specialist/whatever-his-title-is, thought he was checking for a torn ACL, not an ACI repair. Hey, mistakes happen, right? Well, he still wrote up a report. When I met with my surgeon last month, however, the report was not available. Instead, my surgeon told me he asked the MRI guy to re-do the report, which, I thought, meant focusing strictly on the ACI repair. Bad assumption, it turns out; more on that in a moment. Meanwhile, we reviewed the actual MRI pictures together, and Dr. T shared the good news that everything looked great. I still wanted the report, though. Dr. T said he would send me the revised report when it was available. He knows that, as a lawyer, I like written reports.

A few days after my appointment, I had yet to receive the “revised” MRI report. It turns out the guy never re-did his report. Instead, he simply noted on a separate cover sheet his mistaken assumption about my ACL. That’s it. Considering how much MRIs cost, that MRI probably wasn’t a good use of health care dollars. Consistent with today’s debate over health care reform, they’re not “my dollars” so, frankly, I’m not too concerned. Sad, but true.

Anyway, I still wanted a copy of the report. Even though it focused on my ACL, it nonetheless examined other parts of my knee, so that information would be helpful and I was anxious to review it. I finally received it about one week after my appointment.

Incredibly, the report failed to mention the ACI-repaired lesions on my patella and trochlear groove. At first, I thought this was yet another example of the technician’s incompetence. I don’t think it’s a stretch to say that the guy who mistakenly checked for a torn ACL would also miss a cloned graft, right?

Apparently not. When I finally reviewed the report with my surgeon, Dr. T told me he actually spoke with the MRI guy, who told him he was surprised to learn I had undergone a cartilage implant. When he examined the MRI, he simply didn’t notice any difference in the consistency between the “old” cartilage and the “cloned” cartilage. Now, I’m hesitant to do the Tiger Woods double fist pump because of the guy’s earlier screw-up. But it’s hard not to be pretty stoked.

(Speaking of Tiger, why didn’t the CBS golf announcers state the obvious at the PGA Championship: Tiger choked on those last few holes. Period. Even Michael Jordan missed potentially game-winning shots. It happens. Yeah, it sucks when your off day just happens to be during the final round of a major in a year in which you hadn’t won one. But there’s no shame in that. Hey, even the best f*ck up. Ok, back to my knee)

The MRI report, however, did identify some areas of concern, which I discussed with Turgeon. Incredibly, it said I had a torn meniscus on the medial side of my posterior horn.

What the f*ck?!?!

For the past 7 months, I haven’t been preparing for my UFC debut or even playing pickup hoops. Nope. I’ve spent my time on the couch or hobbling around an office with a bunch of government drones. My craziest activity has been riding a stationary bike – not exactly the kind of situation that leads to torn meniscuses, you know.

Before I share my conversation with Dr. T about the MRI report, let me explain a few things about a meniscus tear before friends and family freak out. First, this “tear” has nothing to do with the areas of my knee repaired by ACI. Totally unrelated (well, except for the fact that multiple knee surgeries surely have made my knee more prone to injury). Next, in the world of knee surgeries, a meniscus tear is pretty minor. Usually, a simple scope cures it. I’ve actually felt a slight twinge of pain in this particular spot for a few months. Nothing serious, though. The discomfort rarely lasts more than a brief moment, and doesn’t impact my daily functioning. I mean, I don’t want to downplay a meniscus tear. But I’m not overly concerned, other than how I could’ve possibly torn it during my recovery. I’m still shocked.

Despite what the report says, Dr. T isn’t convinced my meniscus is torn. During our initial review of the MRI pictures, I recall he noted some splotches on the MRI of some minor concern. I’m not sure he was pointing to the meniscus. But during our follow-up, he showed me the affected area. There was some “grayness” there, which apparently might be indicative of a possible tear. However, it wasn’t large or deep enough, in Dr. T’s mind, to say definitively, “Yes, it’s torn.” He said the only way to tell would be if he scoped my knee.

Of course, my response was a subtle, “No f*cking way.”

I only want him – or anybody – cutting me open if surgery is absolutely necessary. And it’s not necessary to “scope me” just to see if it’s torn.

So, as of now, I’ll just continue rehabbing as usual. Actually, Dr. T wants me to step things up to improve my quad strength. He reiterated that everything looks fantastic with my knee; he’s ecstatic how things turned out. Now it’s time to put Lou Ferrigno to shame with my workouts.

We also took another X-ray of the osteotomy, something we do at every visit. My screws and the bone wedge continue to irritate me. The screws bulge from my shin like the belly on a 9-month pregnant lady. You can read the Black-and-Decker label through my skin.

Things have gotten better, but I still feel like the osteotomy is holding me back, even more than the actual surgery. After reviewing the X-ray, Dr. T isn’t surprised. While the bone has filled in just, he says it’s continuing to harden, and thus the bone remains sensitive. Normally, the hardware can be removed at the 12-month mark, but in my case he suggests waiting several additional months to give the tibia extra time to heal.

Next up is another MRI in October, at the 10-month mark. Dr. T mentioned this time they’ll do a bunch of other stuff to specifically focus on the cartilage. My first thought? Uh, why didn’t they do this type of review the last time? Is there a particular reason to do another MRI only 3 months later? Again, because I’m not paying (I don’t have a co-pay for MRIs), I’m not complaining. The extra information can only benefit me. But this just seems symbolic of the current debate over health care waste. Maybe the additional test is just covering for the previous screw-up. I’m not sure. But part of me – that speck of a conscience buried far deep inside and which rarely surfaces – feels a bit uncomfortable being a party to possible wasteful spending.

And then I remember how often insurance companies screw over patients, and those concerns begin to fade away.

Tuesday, August 18, 2009

Passing the Beach Test

I almost posted a mega blog entry, but decided to split it up into two postings. The original posting was dangerously approaching the length when reasonable people would say, “ok, no human should write that much about their knee.” Hopefully the 2nd posting will be ready within one week’s time. It will cover my 32-week appointment and review of the report from the MRI previously discussed. I know you’re anxiously awaiting it.

Alright, the Summer of Travels (and delayed blog entries) is officially over. Multiple trips to DC. A long journey to Stockholm. But neither trip compared to, or could prepare me for, my first family Griswold Adventure: we drove from Dallas to Pensacola, Florida. 2 kids. 2 portable DVD players. A box full of granola bars and Pepperidge Farm Goldfish. At least 17 “Are we there yets?” A packed SUV. 660 miles. 13 hours. Ah, the closeness and joys of family.

I was admittedly a bit nervous about how my knee would handle the beach, namely the unevenness of walking in the sand. In addition, I was concerned with my ability to remain steady when waves crashed into me, whether it was carrying my 4-year old daughter a few feet from the shoreline or wading into the deeper waters with my 7-year old son. The knee held up well. No issues whatsoever. Jim’s Knee 1 – Gulf of Mexico 0. Now, I’m not about to join the pro beach volleyball tour anytime soon; Karch Kiraly’s AVP record is safe. But only a few weeks ago, I wondered whether I would ever regain some semblance of athletics. Yet, at least for this trip, my knee actually felt “normal.” Maybe, just maybe, it even felt a little spry.

While the instability of my knee never strays far from my thoughts – I probably think about my knee probably every 10 seconds – after my first day I stopped worrying whether my gimpiness would prevent me from enjoying my vacation. That was a refreshing feeling. I can just picture my fellow ACI patients nodding approvingly. In fact, right now my immediate goal is that my knee reaches a certain level of comfort so I no longer think about it constantly. Pretty high bar, huh?

The lengthy drive didn’t crush my knee, either. I drove the entire way home, all 13 hours. Now, with kids, this wasn’t 13 hours straight. In fact, we probably stopped 3-4 times in the first 5 hours alone. You really can’t tell little kids to “hold it” or pee in an empty water bottle, especially a 4-year old girl. It’s just not happening.

My parents, on the other hand, were old school. The car never stopped, unless it needed gas. Maybe, just maybe, if I begged enough my dad would slow down the car to 55 mph and let me roll down the window and pee from the moving car. Of course, my dad first made sure the wind couldn’t blow back my urine into his prized Gran Torino.

I’m not medieval like them (just kidding, Mom and Dad. This trip gave me an increased appreciation of your parenting skills). Seriously, all the stops make the drive more bearable, and gave me plenty of chances to stretch my knee. Did you know that Hattiesburg, Mississippi has a phenomenal rest area? Top notch. They even offered free, freshly baked cookies. I highly recommend it.

Wednesday, August 5, 2009

Sweden Rocks! - 7 Month Update

No, that’s not a typo. Nor am I Drew Carey, absentmindedly confusing the “mistake on the lake” with the “city by the water” (funny aside – I thought Stockholm was divided by a bunch of rivers; it’s actually dissected by the Baltic Sea). Speaking of Drew Carey, I never thought he was very funny, but I recently caught a glimpse of him on The Price is Right. Man, he’s fallen off the funny cliff. Paraphrasing the Dan Quayle debate insult, “I knew Bob Barker. And Drew Carey, you’re no Bob Barker.”

Anyway, I enjoyed a week of investigating in Stockholm, Sweden. Yup, that’s right. There’s securities fraud on every corner here, right next to the outdoor cafes. Corrupt Swedes.

Nah, I’m just kidding. The Swedes are good people. In fact, Uffe, some random 50-year old dude who sat next to me at the pub on Friday night bought me something called a Hoegarrden. It was more like a lunch bucket of beer than a mug. Coincidentally, it’s Gay Pride week here. There were probably 20,000 folks celebrating in the streets on Saturday afternoon. In fact, the loud clapping, whistling and continuous playing of the Village People interrupted my power nap. I don’t think Uffe was hitting on me. Not that there’s anything wrong with that. But he was at the pub with his wife. We did, however, swap phone numbers. You know, just in case I’m ever back in Stockholm or Uffe visits Dallas.

This was my first visit to Stockholm. A nice, relaxed, friendly city. Very clean and active. Everybody seems to either walk or bike places. And they take 3-hour lunches, usually at some outdoor cafĂ©. I could get used to this lifestyle. In fact, in a perfect world, I’d spend my day sitting at one of these outdoor cafes with my laptop, cranking out blog updates and finishing the mystery novel I’ve been working on for the past 3 years. And then I’d hop onto my Mary Poppins bike and pedal home, tweeting my bell/horn whenever an idiotic tourist wandered into the biking lane. One more thing: I’ve never seen so many pregnant women in my life. And not just pregnant, but bursting at the belly, ready to pop, 9 months pregnant.

How does all of this apply to my knee? Well, let me tell you.

The Stockholm trip was the culmination of a busy summer of travel, hence the lengthy gap between blog postings. This was my third flight in the past 2 weeks (before Sweden, I had two overnight trips to DC). My knee held up just fine on the flights. While the DC trips are a beating, the Stockholm flight really sucks. We fly from Dallas – Chicago (2 hours) and then from Chicago – Stockholm (9 hours), not including the mad “dash” across O’Hare to make my connection (actually, it was more like an old person power walk). The knee got a bit stiffer than usual, but a few laps around the cabin loosened things up.

The knee also handled all the walking around Stockholm. I must’ve walked over 5 miles on at least 3 separate days, perhaps as much as 10 miles on one day, most of them on uneven cobblestone. No problems. I also went up and down plenty of steep steps. I did grip the railing, not because I needed to, but as a precaution. The knee still doesn’t feel “normal” going up and down steps. Actually, it’s fine going down, but heading up still feels abnormal. The strength just isn’t there. If I push off oddly, the knee lacks total stability. (It’s also possible I might’ve torn my meniscus, which, hopefully, is unrelated to the cartilage repaired by ACI. I’m waiting to hear back from the surgeon. Will post more when I get some answers). While the knee doesn’t hurt and I really wasn’t limited in what I could do – other than being unable to sprint across the street if a car came barreling through the intersection – the inability to move freely is frustrating. Again, the analogy of an athlete past his prime struggling to acknowledge his body’s limitations is the best way to describe my situation.

At this point in the rehab, I still struggle over whether the surgery was “worth it.” Unlike most other ACI patients, I wasn’t in daily agony, or unable to function properly. The knee occasionally suffered sharp pains, but I was generally able to perform basic athletic activities, though I couldn’t run or jump without extreme pain/difficulty. I opted for surgery because I was concerned that things were about to go downhill, and didn’t want to reach that abyss when it would be too late to repair my knee.

And that’s what makes my Monday Morning Quarterbacking over the surgery decision difficult. Yeah, I’m still worse off now than I was before the surgery. But it’s foolish to think my quality of life wasn’t about to experience a steep drop if I hadn’t gotten the surgery. Of course, part of me wonders whether I could’ve contained the pain/uncomfortableness by curtailing my activities, while still preserving my ability to perform simple athletic activities. Maybe that’s wishful thinking. I don’t know. Thinking about the “what ifs” really sucks.

I hope that my recovery progresses to the point where I function at least at the level I was at pre-surgery. If so, I’ll consider that a success, because, like I said, I suspect that things were about to get worse. Even at 7 months, it’s still too early to tell whether the ACI surgery “worked,” at least worked as I hoped it would. I feel like it’s election night and the polling places have just closed, but the race is still “too close to call.” In real life, unfortunately, I won’t know the results when I wake up the next morning…

Saturday, July 11, 2009

Taken Down a Notch

There's nothing like a 4-year old birthday swim party to remind you of your mortality.

First, I can't I'm posting a blog entry at 1am on Saturday night, but I'm still wide awake after watching UFC 100. Brock Lesnar is a very large dude. Real good times tonight.

Ok, back to the swim party. One of my daughter's fellow princesses celebrated her bday party at the community swimming pool. I dropped by after work. It was the usual scene -- tons of little kids splashing around the shallow end in the arms of moms and dads, while the older siblings cannonballed into deeper waters.

I relaxed in the shallow end with my daughter. Naturally, she wanted to practice swimming to me. Well, she really doesn't "practice," or at least it wouldn't look that way to folks without kids. But if you've got kids or have spent time at a pool with little ones, you've seen the scene. The munchkin hangs onto the edge of the pool, demands that you stand about 5 feet away, and then she launches herself into your arms. Now, if the parent remains where the child insisted they stand, there isn't enough distance to take a single swim stroke, let alone actually swim.

But crafty parents slowly drift away from the edge after their baby launches into the water, forcing them to take a few strokes before mom/dad rescue them from drowning. I don't think Parenting Magazine would approve. However, just like everybody knows about Code Reds even though they aren't written in the field manual, same goes for these swim tactics. I can see other parents nodding approvingly.

Once the child reaches you, they're either celebrating their swimming abilities, or they're coughing up 3 gallons of water. But they've definitely got the death grip on the parent.

After a few seconds, it's time to return to the pool's edge. And, for me, this is when the pain happened.

Olivia immediately shifted around in my arms until she was standing on my lap and facing the wall ready for the return trip. Basically, she planned to use my lap to springboard back to the side of the pool. I used appropriate caution to protect my knee as she positioned herself. What I didn't anticipate, however, were her legs flailing around. As she attempted to gain traction on my quads, her legs often slipped below my lap. Now they were in the danger zone. She didn't catch me in the nuts. But it was worse. Oh, much worse.

The backs of her heels cracked sharply into my shin, EXACTLY where the 2 screws hold together my tibia. Holy mother of God; that f*ckin' hurt, even worse than watching Bartman snatch that foul ball from Moises Alou.

Eventually Olivia planted herself on my lap and finished her return trek to the wall. Sadly, I didn't get a moment to grieve. As the tears trickled down my cheek, my daughter's much larger friend landed in my lap. This girl delivered a solid 4 or 5 mule kicks to my shin before I could heave her to the edge. Actually, my initial reaction was to club the girl and let the lifeguard deal with her carcass. But I'm pretty sure the moms would've given me the business if I clotheslined this girl. Don't be so surprised. These are the type of parents who get pissed when baby seals get clubbed. No sense of humor. So I gritted my teeth and screamed out for my wife to replace me in the water.

Ok. I don't support clubbing baby seals. That was just a joke. Harpooning them, yes.

Anyway, these little girls are ferocious. I have no doubt my daughter will kick the crap out of the first boy dumb enough to pull her hair.

In the meantime, add "swimming with little kids" to the list of things I absolutely cannot do at 6 months.

Tuesday, July 7, 2009

6-Month MRI Results

Relief. Well, partial relief anyway. (More on that in a second.) My visit with Dr. T was punctuated by several high-fives, each as awkward as the ones between Tiger Woods and his caddie after a heroic birdie putt. Even though I didn’t hoist the Claret Jug during this appointment, I nonetheless received some good news.

The 6-month MRI showed that my graft is healing “beautifully,” to use Dr. T’s choice of words. The graft is completely filled in. First high-five. No overgrowth, fissures, cracks, or other deformities. Second high-five. Most importantly, the cloned cartilage appears to be bonding smoothly with the existing cartilage. Final high-five.

Unfortunately, we didn’t have an MRI report to review, so I’m hesitant to suggest that everything inside my bionic knee is “beautiful.” The MRI technician thought he was supposed to examine a potential “ACL” surgery, not ACI. He said my ACL looked great. Um, thanks? Since I’ve never torn my ACL, I guess that’s a good thing for the technician’s career prospects. I told Dr. T he should take credit for making my ACL look as good as new. Anyway, I’m supposed to get the correct report sometime this week. Hopefully Dr. T didn’t miss anything during his independent review of the films.

Dr. T was downright giddy, perhaps even happier than I was. He even called me his “poster child” for the ACI surgery. While I’m pretty stoked to learn that my knee’s healing as well as can be expected, I still worry whether my knee will ever become “normal” again. Plus, I’m hesitant to rejoice until I see the complete report. Now, I don’t want to be a wet blanket, ruining the good news like Gretchen Mol in Rounders. But the MRI doesn’t explain the random aches or clicking in my knee, nor does it answer why I’m still having difficulty bending/squatting on 1-leg. Hopefully, those issues are just part of the natural healing progression, as Dr. T seemed to think. In fact, after the final high-five Dr. T tempered his own enthusiasm, noting that ACI recovery isn’t a 10-K race, but a marathon. Well, if that’s true, hopefully I just passed the 13-mile marker ahead of a bunch of Kenyans, fully hydrated and without any cramps.

(Ok. If this was a newspaper column or magazine piece, this blog posting would’ve ended with that previous sentence’s beautiful wrap-up. Fitting and humorous. But screw my editor’s advice; I’ve still got a few more things to share).

6 months is probably a good time to mark my progress. Here’s what I can do:

• Walk for miles (and chew bubble-gum at the same time). On the treadmill, I’m now up to
3.5mph and can handle an incline of 6-8 with no problem. I can also shuffle sideways and walk backwards without tripping over my feet.

• Stationary bike at fairly high resistance. I’m getting a “real” bike sometime this month. I haven’t owned a bike since the early 1980s when I traded in my 300lb NY Giants dirt bike with the banana seat for a discounted, blue Sears 10-speed (my dad used to work at Sears).

• Moonwalk across the kitchen floor in my parachute pants

• Elliptical machine for 25-30 minutes at a fairly tame pace and incline

• Gently kick a soccer ball with my kids

Here’s what still gives me problems:

• 1-legged squats/bends beyond 45-60 degrees; 2 legged squats and wall sits are ok because I “cheat” a bit by placing more pressure on my good wheel

• Kneeling; crawling; kneeing evil-doers in the head with any amount of force

Here’s what I can’t do/haven’t even tried:

• Running

• Jumping

• Eat 68 Nathan’s hot dogs in 10 minutes (or even in 10 months)

6 months down; 6-12 more to go, I guess. I now embark on that vague recovery stage. I really don’t have any more major milestones or markers to pass, though 8 months (32 weeks) might be considered one. Everything’s now incremental advancements based on subjective feeling. I’ll continue to slowly increase the amount of weight or reps on various quad-building exercises. Once I gain sufficient strength – though I’m not sure what’s considered, “sufficient” – I’ll progress to rollerblading -- one of the pitstops between walking and running. I’ll probably piss in my pants the first time I do. Actually, Christina will probably be more nervous; maybe she’ll pee enough for both of us. After that, it’s just a matter of time (and Dr. T’s blessing) before I try more aggressive activities, like light jogging. That’s still at least 6 months away, but then again, I can’t believe it’s been six months since the surgery.

Monday, June 29, 2009

Almost 6 Months -- MRI pending

I like coffee. I really do. That has nothing to do with my rehab; I just thought I’d share that.

It’s been an unusual past week, week and a half. I experienced some minor discomfort in my knee, the first time I’ve felt something other than the occasional swelling and soreness. I don’t want to overstate the discomfort, but it was a somewhat piercing pain, like a little pinprick on the medial side. This is where my lesions are, though not where I felt pain pre-surgery. Hopefully it’s nothing serious. It didn’t last more than a few moments, and only a handful of times. I think I over-did a cardio workout last week. At least I hope that’s all it was.

Perhaps emboldened by the somewhat normal state my knee seemed to achieve, I did a fairly moderate cardio workout. I spent 15 minutes on the elliptical, followed by 15 minutes on the bike, followed by another 15 minutes on the elliptical. No break in between exercises, with the entire time spent at a level only a notch or two below what I used to do pre-surgery. Too much, too soon? Perhaps. I’ve since backed off, returning to a gentler level on the elliptical. The “pain” has since disappeared.

Now, I don’t want to suggest that by calling my knee, “normal,” I’m close to returning to pre-surgery levels. God, no. By normal, I mean I can walk around without people gawking at me like I was John Merrick. I still lack any athletic prowess, and occasionally resort to the “old man shuffle,” as a friend described my movements at a recent baseball practice. And I don’t see myself cliff-diving in Acapulco anytime soon. But I’ve now reached the point that I feel dirty for parking in the handicap spots. Is that progress? Or just a sign that I’ve developed a guilty conscience?

My knee continues to click/catch at random moments, sometimes even making soft clicks while walking normally. No pain or discomfort, though. And if I walk slow enough, or focus on walking a certain way, my knee won’t click/catch. I still start each morning with a lovely “popping” sound when I finally exit my bed. That’s just my knee waking up in the morning. On the positive side, the back of my knee – popliteus tendon? – no longer aches or pops. Anyway, I’m hoping the MRI reveals the cause of these noises.

Ah, the MRI. I enjoyed the cold comfort of the human test tube on Monday morning, laying perfectly still for 35 minutes. Jack FM – the radio station without DJs – provided the in-flight entertainment. Amazingly, the films were ready immediately after the MRI, though it’ll take a day or so to prepare the actual report. I review the results with my surgeon on Wednesday, exactly 6 months after my surgery. No need to speculate what the MRI will show. I’ll update later.

I suffered an emotional setback recently. Not a death blow. More like Johnny sweeping Daniel-san’s leg. My knee’s healed sufficiently that I can kick the soccer ball in the backyard with my 7-yr old. Nothing sophisticated. Just some simple back-and-forth passing, using my good leg 95% of the time. I tried teaching my son a few dribbling moves, but quickly discovered I lack the lateral movement even to demonstrate them. I’ve got 1-step range, and that one step is R-E-A-L slow. Very depressing. I hope this is only a temporary limitation, but I’m pretty concerned it’s permanent. I never imagined I wouldn’t be able to physically assist my son’s sports development. That’s extraordinarily difficult to accept. Hopefully my mediocre athletic abilities return over the next 12 months as the cloned cartilage heals.

Wednesday, June 17, 2009

Tragedy is Comedy

One of my favorite expressions compares tragedy and comedy. I’ve heard several versions used, but it goes something like this: “The difference between tragedy and comedy is 15 minutes.” The precise timeframe might vary, but the sentiment is that once you step away from something -- even something terrible -- you’ll be able to laugh about it. The trick, it seems, is being able to survive those first 15 minutes.

Now, I’m not sure 15 minutes is enough time to process a tragic event, just as I’m sure there are certain events that are never funny. I mean, I can’t imagine pounding Budweisers with a buddy 15 minutes after witnessing a fatal car crash, and then laughing about how far the dude’s body flew through the air.

But I understand the point behind this expression. To move beyond a tragedy, you need to create enough distance to de-personalize the situation; enough space that you’re able to laugh without offending or being offended.

That’s been a valuable lesson to learn during this recovery. (Yes, I realize there are plenty things worse than ACI knee surgery, but give me some leeway here). It sucked tremendously having my wife heave my crumpled, naked body onto a shower chair (without any chance for some shower nookie). And it sucked having to beg my wife to bolt down the toilet seat riser just so I could take a dump. Tremendous indignities. Some men have been permanently scarred by far less.

But you know what? Some of the sh*t ACI patients suffer through is pretty damn funny. Seriously. Being forced to poop on Nutty Professor-sized toilets? Freakin’ hysterical. Except, of course, when it happens to you. You just need enough time to remove yourself from that humiliating moment to recognize the humor. The sooner you do so, the easier the recovery will be.

On a completely separate topic, here’s a list of TV shows I’ve enjoyed through the power of Netflix. If you’re about to undergo ACI, I recommend picking up some of these DVDs to help pass the time during those first few days/weeks.

The Wire – “real” look at inner-city Baltimore, with each season focusing on a different aspect: drugs/cops, docks, politicians, schools and the newspaper industry. 5 seasons. Probably the best show, start-to-finish, I’ve ever watched. Lots of great characters; lots of plot lines. It might take a few episodes before you’re fully invested, but stick with it. You won’t be disappointed.

Extras – Ricky Gervais stars as movie extra who makes it big. 2 short seasons.

The Office – we’ve only watched the American version, but clever stuff.

Big Love – Polygamist family life. Season 1 was much better than Season 2, though we heard Season 3 is solid.

Arrested Development – smart person’s comedy. 3 seasons

Mad Men – sophisticated drama focusing on the 1950s NYC advertising world. Only 1 season available on disk right now.

Friday Night Lights – just started watching this high school football show, but so far it’s solid. 3 seasons

Curb Your Enthusiasm – uncomfortable humor at its finest. 6 seasons

Entourage – Hollywood star enjoys life with boyhood friends. The first season was excellent, but it steadily went downhill. Still, it's mindless entertainment. 5 seasons

Friday, June 12, 2009

Slow and Steady (hopefully) Wins the Race

Another week, 2 more degrees of ROM. I'm gaining flexion on a timetable closer to a regular diet than the crash course Adkins -- I just keep adding a few degrees here and there. I'm now at 143 degrees, about 2 degrees shy of my good leg.

I went swimming for the first time. Not pool-walking; real swimming. A few weeks back, we set up the 20-foot round, 3-feet deep, above-ground pool. It sits right next to the camping trailer and the '75 Impala resting on concrete blocks. Real classy addition to our backyard. But the kids love it, so I can't complain.

Anyway, I actually swam the length of our pool a few times. My swim stroke can best be described as "painfully ugly." Well, assuming you can see my form past my blinding "office glare" tan. Truthfully, I can't call my swimming motion, a "stroke." That would be an insult to swim strokes; thrashing about is more accurate. But luckily it only takes me 2-3 "strokes" to cross my pool. Anything longer and I'd drown. No, wait. I'd just stand up. The pool's only 3 feet deep. Phew.

Similar to using the ellipitcal machine, swimming felt...odd. My leg felt more like a broken flipper, flopping precariously like a creaky door barely attached to the hinges. Not sure if that's my gimpy knee; the weak quad; or just my uncomfortableness with swimming. I doubt I'll swim regularly enough to give Michael Phelps a run for his money. But I do hope to get decent enough that the life guards won't have to rescue me. Or at least good enough to avoid having to wear my daughter's Strawberry Shortcake floaties.

Saturday, June 6, 2009

Frustratingly Normal

First things first. 141. That’s the number I’m slapping down. It’s got a mystic feel, like a 300 bowling game, or .400 batting average. No, it’s not my IQ (c’mon, don’t insult my genius with that piddling score). Rather, 141’s my new ROM. Breaking 140 is like shattering the flexion glass ceiling. It’s still 4 degrees shy of my good leg, but it falls comfortably within what’s considered full range of motion. Hopefully I’ll recapture those last 4 degrees, but I don’t feel like I’m missing anything if I don’t.

I experimented with a handful of new cardio exercises this week. Well, not new in the sense that I’ve never done them before; I just haven’t done them since my surgery. Some worked; some didn’t.

First, I fell in love all over again with my old friend the elliptical machine. Even before the surgery, I stopped running and rarely used the stair climber. Too much stress on my knees. The elliptical (some call it, Precor) became my primary source of cardio. Low impact, easy to use, and capable of various speed/intensity, the elliptical was a great way to sweat off 500 calories. This week, I set the machine at level 1 for both the height of the glide tracks and the resistance. Man, I felt like an 85-year Eskimo taking a leisurely stroll across the Tundra after chowing down on some penguin meat. The motion felt . . . strange. My knee didn’t hurt. I wasn’t tired. And my form was generally normal. But something didn’t feel quite right. The best way to describe it, I guess, was the sensation amputees report they feel from their missing limbs. Now, I’ve got all my appendages, so I really don’t know how that feels. This just seems to be the right description. Or at least the best I’m able to do. Anyway, I anticipate slowly increasing the level of difficulty on the elliptical, and finally being able to sweat off some of the extra poundage.

The treadmill proved far more difficult. For the past 2-3 weeks, I’ve steadily increased my pace and incline setting. Most recently, I cruised along at a 3.5mph clip at the 4-incline setting. After 20 minutes, I was glistening like a Southern Belle sunbathing on a glorious summer day. Glorious, that it, because she’s topless. Unless she’s really fat. In that case, put the Mumu back on, honey. Or scrape together a few yards of fabric to make one. Seriously. (Sorry, a sudden mean streak crept upon me. The kids were beating the crap out of each other. I’ll return to my jovial self shortly).

Ok, back to the treadmill without the boobie analogy. I tried lateral walking. Basically, that’s shuffling sideways, something middle-schoolers do at basketball practice. I slowed the treadmill down to 1.5mph, its slowest setting and took a couple of normal walking steps to acclimate myself before trying out the new motion. I didn’t think it was possible to move that slow. Sadly, even 1.5mph was too fast for my lateral walking. I simply couldn’t comfortably shuffle at that blistering pace. It felt like somebody was yanking out the rug beneath me.

The same thing happened when I tried to walk backwards, only this time I also resembled Elliot, you know, the really dorky 2nd grader with the coke-bottle glasses who always gets picked last at kickball? True, I simply couldn’t handle this speed at this point in my recovery, but I was also painfully uncoordinated, tripping over my feet and otherwise stumbling around, trying my best not to fly off the back of the treadmill. For somebody who used to dig 60 mph spikes, not being able to walk sideways or backwards was depressing. Taking the “glass is half-full” attitude, I’ve got a new athletic challenge. It’s just embarrassing that the “challenge” is something my 3-year old can do.

The past few weeks have been interesting. Several times I actually feel normal, forgetting the 2 screws and 13-inch scar decorating my knee. No pain. No limp. No uncomfortableness. I even handle stairs with minimal difficulty. But then I instinctively try to do something a bit beyond my limit – for example, trying to move 2 steps to catch an errant throw at my 7-year old’s baseball practice – and instantly my deficiencies snap me back to reality. I realize how limited I still am. Like an athlete past his prime. His mind knows what to do, but the body won’t cooperate. Actually, I’m way past my prime, so my body wouldn’t cooperate even if it wanted to. Nonetheless, I feel relatively decent about my long-term prognosis. Sure, I get beaten down plenty about the lost opportunities over the past 5 months and more than occasionally worry that I’ll be forced to embrace a lesser quality of life. But overall I remain hopeful I’ll regain full use of my knee. If so, expect a new Guinness record for backwards walking in 2010.