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 café. 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…

6 comments:

Lynn and Matt said...

Jim-
It's good to hear an update from you. Your travels sound exciting!

I feel your struggle over whether the surgery was worth it. Right now for me (six weeks post op) definetly not sure. I am hoping by six months I will be more sure--maybe not.

I'm still enjoying the shower seat. Just progressed to partial weight bearing yesterday.

Thanks for the updates. You help me realize there is life after ACI!

Jim said...

Hey Lynn. The first 2 months are, by far, the hardest part of the recovery, especially that first month. Once you regain mobility -- man, you forget how dependent on driving you are -- life gets much better. I'm just going through a bit of 2nd guessing largely because, by this point, I hoped to be closer to "normal" than I am. But, as my surgeon just told me today, my knee's healing perfectly, and he's optimistic that I'll be able to do more active stuff sooner rather than later.

Jen said...

hi Jim! It sounds like you're doing really great. Walking those miles? Seriously impressive!

I hear you on impatience and wanting to return to normal more quickly. I have a theory, that we now have a new definition of "normal". I wonder if one can go through something this big and not have it be life altering?

The other thing I notice is just how individual the recovery is from person to person, depending on the size of the ACI implant and the location....for me, going up stairs is a snap, down stairs is the challenge. But yeah, stairs don't feel quite normal.

I can't define it, it doesn't hurt, but things just don't feel quite right, and I don't feel like I can completely trust the knee. I've also had to deal with swelling; I've had my knee drained three times in six weeks. A bit of swelling gets in and settles in, which reduces my ability to get full extension. My surgeon's not concerned, but those around me think I'm overdoing my activity. It's hard to see it that way, given that I'm only about as 60% active as before. I miss hiking so much! I'm practicing small stretches of hiking down hill, which is absolutely the most challenging thing.

Do you feel like you walk normally now? I still feel like I'm doing some compensatory movements, like I can't completely naturally place my heel on the ground and roll through the foot with bent knee. It feels like my scar tissue gets a little sticky below the fat pad. Are you having much in the way of scar tissue issues?

Anyway, you are doing awesome!!!

Jim said...

Hey Jen. Sorry for the delay in responding. I'm not sure if I'm having any scar tissue issues because I don't know how that would feel. What are some of your symptoms?

I no longer walk with a limp (unless I'm really exhausted or hurting), but I do feel like I've got a slight "hitch" to my gait. It's probably imperceptible to others, but I still sense the abnormalcy. I'm starting to think that's permanent, but I remain somewhat optimistic it'll go away when I regain 100% of my strength.

Wow, getting drained 3x. Would the swelling go down on its own? Does the fluid build up after strenuous activity?

Do you have any screws? I've got 2 as part of my osteotomy. They'll come out sometime early next year. The screws stick out, and prevent me from kneeling. And the area surrounding the osteotomy still is pretty sensitive.

Look forward to hearing back, especially about the scar tissue issues.

Jim

Unknown said...

Thanks so much for writing this post. I am considering ACI and have been told that it is the best option for me. Like you, I have several lesions in my knee that are down to the bone. I have had two surgeries on them, and now can't do any sort of outdoor recreation that I used to cherish (jogging, hiking, biking, skiing). I have been reading your blogs all night and it leaves me with so many questions about whether it will be "worth it" as you've said. Do you have much pain now? I have pain every day, sometimes a lot, sometimes a little. Would you say now that it is worth it?

Jim said...

Heidi -- that's the million dollar question, of course. I think it really depends on the type of pain you're experiencing beforehand. I'm probably different than most ACI patients; my knee wasn't totally wrecked beforehand. I could still do athletic stuff, but at a significantly reduced level and my knee hurt afterwards. I chose the surgery before things got really bad. I hope that I'll be able to resume some basic sports at the 12-18 month mark, but I don't know if I'll ever be able to again.

It's tough to fathom, but, if you have ACI, I wouldn't count on ever doing the more active outdoor stuff again. It's possible you'll be able to, but definitely not guaranteed. That's really tough to swallow mentally, I know.

kneeguru.co.uk has a ton of ACI blogs I suggest you read, too.

I don't mean to be a downer; just realistic. You just have to adjust your goals, I think. My knee no longer "hurts" on a daily basis walking around, though I still have to somewhat gingerly handle stairs.

I hope that helps. Good luck.