OS Follow-Up #3 -- Major Updates

It’s been 6 weeks since my surgery. This marks my first milestone -- the possible end of Phase 1, the “protection phase.” At this point, patients must satisfy several rehab goals before graduating to Phase 2 and beginning more strenuous therapy. I met with my surgeon on Wednesday to measure my progress.

As I’ve blogged about before, Dr. T is playing things conservatively. I assume that’s driven as much by his style as the osteotomy. At the 4-week mark, Turgeon informed me I would not be allowed to open the brace until the 6-week mark (which is 2 weeks later than usual) to give the osteotomy some extra time to heal, guaranteeing that my Phase 1 would last a little bit longer. That’s not terribly unusual, but I’ve been an overachiever all my life. I’m “one of those people,” so, as you’d expect, falling behind schedule is killing me, even if it’s not my “fault.”

During our visit, he x-rayed the osteotomy again and was pleased with how the shin was healing. Consequently, he allowed me to “open up the brace” – basically, bending the brace below the knee – up to 30 degrees. That might not seem like a lot, but it’ll significantly improve my level of comfort. With the brace bent, I’m now capable of sitting somewhat normally in a chair or car. It’s far from perfect – the leg can’t bend perpendicularly off the edge of the seat – but at least my leg can dangle a little bit instead of jutting outward like a missile. Opening the brace also unleashed a tidal wave of relief for the back of my knee. This immediate sensation is similar, I imagine, to the relief experienced by a woman who finally removes her corset after a 6-hour dinner party, or perhaps by an American Idol contestant who learns she advanced to the next round. I still have to sleep with the brace locked, which sucks. I haven’t slept longer than 3 hours in a single stretch since the surgery. But I figure that’s why God created coffee, right?

Dr. T also told me I could begin riding the stationary bike and walking in a pool. That’s also huge. My PT believes biking will help me gain those last degrees of flexion in my knee. Last week, I hit around 100 degrees passive flexion, and I need to reach 115 to advance to Phase 2. Other ACI patients have sworn by the benefits of pool walking. Frankly, I’m afraid of slipping in the pool area, not to mention being shirtless in public. I might wait another week for the leg to heal. That’ll also give me some time to finish my first HGH cycle so I can build up my pecs again. The swelling on the knee, while still noticeable, has gone down, and Turgeon said it looks fine.

Interestingly, Dr. T asked me to do a straight leg raise (SLR, for those at home) during the visit. I was a bit confused because SLRs have been off-limits while the osteotomy healed. In fact, raising my leg on Day 2 – essentially a modified SLR – triggered the pain that led to my panicked emergency call. Anyway, maybe Dr. T was confused, or maybe he just wanted to see my legendary quads in action, but I cranked out several SLRs for his amusement.

In my opinion, it was a successful visit. The conservative approach means I’ll be in the brace longer than most, but I’ve satisfied all of the Phase 1 goals, except the critical 115 degrees of flexion. Dr. T told me I can open the brace another 10 degrees next week. As soon as I get comfortable walking with the bent knee, I’m allowed to ditch the crutch(es). I don’t see that happening anytime soon. I still lack confidence in my knee’s ability to support my weight. Plus, the knee gets tired quickly. I see Dr. T again in 2 weeks. He anticipates allowing me to open the brace even further, before ultimately removing the brace for good 2 weeks after that meeting, or 4 weeks from today.

I had a PT session a few hours after my OS appointment, and shared the good news with Judy. She was especially ecstatic about me being allowed to bike. Judy’s a big believer in the bike. I also told her we could add SLRs to our sessions. Whoo hoo. Fun times ahead.

This was probably the toughest, most rewarding, humbling, and exhilarating PT session. Perhaps emboldened by Dr. T’s assessment, Judy tortured my leg. After the usual assortment of leg raises, I flipped onto my stomach for some passive hamstring curls. Good lord, this freakin’ hurt. Oddly, my knee never ached. Instead, my quad felt like it got severed from my leg. Judy repeatedly bent my knee perpendicularly. Each time it hit 90 degrees, my quad stiffened. It was tighter than Bar Refaeli’s ass. Normally Judy manipulates the leg a handful of times. With that in mind (apparently that’s a required quote before somebody reveals their vote on The Biggest Loser), I typically mentally prepare myself for 10-20 seconds of pain. This time, however, the pain continued. And continued, as she bent my leg 2-3 dozen times. I swore it lasted 20 minutes, but really it was closer to 2. Not good times.

After a few more leg raises and some stretches, we hit the recumbent bike. It took a moment to hop my good leg over the bike into the pedals, before hoisting my gimpy leg (sans brace) into the other pedal. Judy cautioned me to take it slow. There were no expectations. This was just another way to improve flexion. As my bum leg slipped under the pedal cover, I was acutely aware that this was the first time my leg was truly exposed to the “real world.” I was about to actually “use” my leg for the first time in 2009. I slowly pedaled forward until my right knee reached the apex, then it cinched up and I could not complete the revolution. Judy told me to slowly pedal backwards. With my left leg now in control, I reversed field easily until my right knee again hit its apex. And again it wouldn’t budge. I started to laugh. I couldn’t pedal a bike. Good lord, the mighty have fallen.

Undeterred, I began pedaling forward again. I got a bit closer to completing the loop, but the tightness in my knee and a healthy dose of fear stopped me. Judy re-assured me that it was okay if I couldn’t pedal all the way around. For some reason, this made me think of a woman telling their man, “It’s ok. That happens to every guy.” Of course, nobody’s ever said that to me before.

And then a minor miracle happened. On the backward pedal, I felt a few layers of scar tissue loosen and I made it all the way around. A reverse revolution! Success!! The scar tissue didn’t pop, it just gurgled a bit, providing some relief. I was in business.

Now I was determined to complete a forward revolution. On my first try after the reverse pedaling, I got stuck again. As I reversed course this time, I completed the backward revolution fairly easily. And then, jackpot. By shifting my hips slightly to my left, I was able to pedal all the way around going forward. And then another one. And another. Gosh darn it – I was biking. Pretty soon I didn’t even need to lift my hip or even slow down. Judy patted me on the back, and told me to bike for 8 more minutes.

On the next revolution, red lights flickered on the bike. Apparently, I picked up enough speed to trigger the computer. I was booking now. Judy, however, immediately shot down my newfound confidence, telling me I wouldn’t be able to sustain enough speed to keep the computer going. And she was right. As I decelerated through the down-pedal, the bike’s computer shut off. Power down. Judy gave me a “don’t worry about it, little camper” pat, and started to leave the biking area.

At that moment, I channeled my inner-Michael Jordan competitive fire and transformed Judy’s harmless observation into a massive sleight. Adrenaline surged through my blood more ferociously than a Lance Armstrong climbing attack in the Alps (except I don't have Lance’s EPO, of course). And then the computer flickered, and it stayed on. Judy had made it just a few steps when I coughed mischievously, “ahem. Oh, Judy, the computer’s working now.” Judy gave me a sly smile, like she had purposely challenged me. She then set the bike program for Level 1, and I happily finished my 8 minutes. Tour de France, here I come. Next up, the pool.