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
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8 comments:
Hi Jim! Congrats on your rehab progress! I don't know how I haven't stumbled upon your blog sooner, given that I've spent four months this year in bed! I had my ACI done two days before yours. A 3 x 4 cm deficit under the patella, coupled with a lateral release of the patella.
Oh yeah, it's been great fun! I've enjoyed reading your blog and will check out some of the older posts and will be checking back often.
It's so interesting to see how different ACI lesions and different surgeons dictate slightly different ideas and rehab protocols. And how unless you've been through something like this, walking is something that can get taken for granted!
Good to hear from you, Jen. Yeah, the ACI downtime sucked. At first, I thought I'd be able to enjoy the time off; catch up on some movies and reading, etc. But for the most part, I just wallowed in bed.
So, how's your knee doing at this point? Full ROM? Bending? What kind of rehab exercises are you doing? Any suggestions? I still struggle with 1-legged bending/squatting exercises past 45degrees.
Funny, same here. I couldn't read, write, or watch movies, no attention span whatsoever. Might have something to do with being wacked out on Percocet for two months?
I struggle to answer "how is my knee doing"? It truly is a day by day thing, and I tend to do a fair bit of comparison to the "before" level of activity. Having said that, I think I'm doing well. I've not had any major setbacks, just s-l-o-w and steady progress. At this point it's a lot about managing my swelling. I suspect it will get drained this week, since I've had a pocket of swelling above and lateral to the knee for two weeks now, despite lots of icing and at points dialing back the activity.
My ROM is good, though not equal to the left leg, I'd say I can get 150 degrees on the right. I have to fight to keep full extension, doing daily weighted extension work. I practice a lot of yoga, and have throughout the rehab; I credit that to my ROM never being an issue. But I find I have to do a lot of "routine maintenance" to undo a lot of the tightness and weakness that comes with being in the locked brace for 4 months. Did you have a lot of quad atrophy? I sure did.
I bend pretty well, but less so when there's swelling, like now. My rehab routine these days includes a lot of pool walking (forwards, backwards, side stepping), and deep lunges. I still haven't been given the okay to kick.
I also do the stationary bike at very little resistance (like levels 1-3 on a 1-20 scale), I do forward/backwards walking on the treadmill with incline and flat, I've gradually been increasing the weight on the leg press machine, doing one and two legged presses. I do a lot of functional movements with physio balls, bosu balls, and medicine balls (I've the good fortune of working with a trainer who had a knee replacement).
Walking for too long can cause swelling, how about you? Stairs are very day to day. Going down is still the most challenging part, but getting easier/more comfortable. I'm also noticing unconscious habits of not using my right leg, not loading it with body weight, you know...all those things done to protect it and stay off it. It feels "better" than it did a month ago, but it feels "weird" and I don't entirely trust it, if that makes any sense.
When you say you struggle with the one legged squat, what do you mean? Pain? ROM limitations?
For me, I noticed my squatting has improved as I've focused on getting stronger glutes, and really rethinking how one gets up from a squat and being conscious about using the glutes. (Overall, I've noticed a need for increased mindfulness in some movements and have been focusing on using my body differently for the same actions...but I'm a yoga/anatomy dork like that....)
whew, sorry for the long winded response....
oh, and one more thing...
a lot of scar tissue. Under the patella in the fat pad area. My OS said that's common with patellar ACI's and people sometimes need to have it scoped out.
What about you? Any ongoing scar tissue battles?
Jen,
I have had two surgeries. (See the comment on Jim's post below for history.) I have a question for you---what did your pain feel like before surgery?
My quad is so atrophied two years after my first surgery. Wonder if it is nerve damage.
Anyways, I am going to a cartilage specialist on Wednesday and praying he doesnt recommend surgery again, although--i dont want to stay the same!
Speaking of pools, they are so painful for me!! I cannot swim and only walk. It feels like there is sooo much pressure in my knee.
Is your pain less now? How did you strengthen your quads? It took me 4 months to do a straight leg raise...
Becca
Hi Becca,
Before surgery, I'd gotten quite adept at ignoring the pain and plowing through; an ability cultivated over the years, which, I think, landed me in this situation. So I don't feel like I'm an accurate judge of pain. I would sit with a bag of ice, barely able to walk, after teaching a spin class, but i was too dumb and stubborn to stop teaching for a while.
Having said that, I took an awful lot of ibuprofin. I'd been receiving Synvisc injections for 6-8 years, and the time between shots was getting shorter and shorter.
Despite all the surgery related junk, my knee seems better already, less crepitus (popping/grinding). It's still weak as hell, but the grinding is gone.
my quads took a long while to get strong. I tried driving at 3.5 months and could only press the gas pedal enough to go 20 mph. Sad! I did TONS of SLR's, and they hurt. It sucked, but I knew it was the only way to get the ball rolling. Knowing what I know now, I'd get on the quad tightening sooner post-op, do even more SLR's. For a while, I got more concerned about ROM than strength and I had to play catch-up.
Good luck to you Wednesday! It's a bummer your knee is so problematic for you and you're so young!
Jen -- You're much more flexible than me. Probably all that yoga! My good leg has ROM of between 145-150; my gimpy leg is almost there.
My knee rarely swells anymore after exercise or walking. It's still slightly more swollen than my good knee. But it doesn't bother me like it used to. These days, I ice it only after a particularly strenuous workout, or one of my son's sports practices (I'm the coach) in which I'm moving around more than I probably should.
I totally understand the mental focus on walking correctly and the even distribution of weight on both legs. I try to do the same, but definitely cheat most of the time. Can't help it.
My knee feels awkward squatting on 1 leg, at least beyond 45 degrees. Not only is that the point where the patella starts bearing weight, it's also the spot that seems to trigger the osteotomy. The knee feels like it's bending on the wrong spot, if that makes sense. I can do 2-legged squats without problems, though, again, my good leg instinctively does most of the work.
I don't think I've had any issues with scar tissue, or at least I haven't noticed any problems I can attribute to scar tissue (nor has my OS identified any issues). Curious to see what the MRI reveals.
4 months in the locked brace? Holy cow! Was that normal protocol for your OS? I think I was out of the locked brace sometime around 8-10 weeks; don't remember anymore. I've permanently erased those bad memories.
Definite quad atrophy. My bad leg is almost the same size as my good one, but it's as strong as jello. Of course, my surgery knee was my weaker leg beforehand; I'm left-footed (from playing soccer).
Look forward to keeping up with your rehab.
Jim
Pretty post. I just stumbled upon your post and wanted to say that I have really enjoyed reading your posts.joking Thanks for all your great posts.
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