Friday, May 29, 2009

5 Months

Wow. 5 months. I still remember lying awake at 3am in mid-January for something like 18 straight nights. Man, I watched a ton of crappy movies on TNT. But not Honey. Jessica Alba. Mmmm. She made many nights bearable.

Anyway, with my leg trapped in a clunky brace, I wondered whether I'd ever sleep through an entire night, let alone walk again. Now? Well, I'm still a tad bitter about my gimpiness, but I'm generally functional. Even my limp sometimes disappears. And I'm getting ready to try the elipitical machine for some desperately needed cardio. The recumbent bike just ain't cutting it. The 12 pounds lost immediately after the surgery returned. And these pounds I packed on aren't the type like those following an HGH cycle. These extra pounds kinda just hang on me like a cheap suit.

I'm down to 1 PT session/week. I'm heading to the gym about 5x/week, banging out most of the same exercises on my own. Plus I do tons of SLRs at home sitting on the couch every day. My right quad is still pretty squishy, but if you squint hard enough you can see the contour of some tiny muscles. Kinda like my abs when I was 12 years old.

I'm also trying to resume a normal workout schedule. Prior to the surgery, I used to head to the gym 2-3x during my lunch break at the office. These trips were in addition to the 2-3x each week I'd head to the gym in the morning. Though my somewhat chaotic work schedule isn't exactly cooperating, I'm close to recapturing that routine. And that's a good thing. My happiness is closely tied to maintaining a schedule. Just in time for summer.

Friday, May 22, 2009

20 1/2 Week Update -- OS Visit

Actually, it’s been 143 days since my surgery. The ability to easily calculate the amount of time that’s elapsed is the biggest advantage of having surgery on New Year’s Eve, I guess.

I met with Dr. Turgeon Friday morning. My biggest question/concern was the crunching noises whenever I perform open chain exercises. The knee doesn’t hurt, thankfully, and I wanted to know whether I should continue performing these exercises despite the noises.

Dr. T said nope. He wants me to avoid open chain exercises for the next month. The graft is still healing, and he doesn’t want to risk damaging it. He didn’t seem overly concerned about the noises. He manipulated my knee a few times and noted the noises only happened at the initial contraction point when the patella and trochlear groove first bear weight. Actually, the knee really didn’t crunch during my visit today. Gotta hate it when the problem doesn’t occur the one time you want it to; that’s the Murphy’s Law of ACI surgery in action. On the plus side, the knee now barely clicks during full extension, and doesn’t click at all if I extend the leg at a glacial pace, an improvement over my last visit. Overall, this isn’t necessarily a positive sign, but it’s terrible, either.

I scheduled an MRI on June 29, with the follow-up visit on July 1. I’ll get an early Fourth of July present. Or lump of coal. I’m not sure what to expect from an MRI at the 6-month mark. It’s more like a mid-quarter progress report. The MRI really will reveal only bad information, like an incomplete graft, fissures or adhesions on the graft site, or excess scar tissue. Hopefully the MRI will indicate that the lesions are filled in, but it’s still too early to determine whether the cloned cartilage has adequately bonded with the existing stuff. That probably won’t happen until the 10-14 month mark, I believe, though sometimes you can tell at 8 months. And sometimes you really can’t tell unless the doctor actually scopes the knee. We’ll see. As much as I’m looking forward to seeing the inside of my bionicly repaired knee, that’s actually kinda perverse. If you think about it, the best case scenario is I learn things are on track, not that I’m healed. That’s the same kind of news I’ve heard for the past 20 ½ weeks. Basically, the MRI might not tell me anything new. Except now there’s a chance I might discover that something inside my knee is seriously jacked up. Not good times.

Wednesday, May 13, 2009

4 1/2 Month Update

Nothing terribly new to report. The knee continues to feel better, and I’m slowly regaining what I consider, “basic functional use.” That doesn’t mean I’m back to normal. Far from it. But I’m able to walk without difficulty, and I’ve picked up enough speed to keep up with the elderly.

My limp is barely noticeable, but still present. The leg gives out randomly once or twice per day, usually for a nanosecond, and then I quickly recapture my normal walking form. Stairs remain problematic. I don’t have to avoid stairs, but I do need to handle them with care, especially going down. I’m just now heading up and down 1 step at a time, rather than planting both feet on a step before continuing, though I still occasionally do that. I also still use the handrail.

Here are some other highlights and lowlights at this point in the recovery:

• The most troubling part right now is the continued clicking, grinding, cracking, etc. during random exercises. Crepitus, I believe, is the technical term. No pain, fortunately. The hard part is determining whether to stop once the knee makes these noises. Dr. Petersen, the Swedish ACI pioneer who examined me last month, advised me to avoid doing knee extensions if it caused “clicking.” I know exactly what “clicking” feels like and can tailor my exercises appropriately. Some of the noises, however, isn’t clicking. It might just be harmless scar tissue breaking apart, or it might be a sign that the activity is aggravating the knee. The uncertainty sucks. I want to build up my quad strength, but I don’t want to jeopardize the healing process. This will be issue #1 to discuss with Turgeon next Friday.

• I started walking on the treadmill. Right now, I limit my speed to 3 – 3.5 mph, which is a pretty moderate walking pace, with the incline levels ranging between 0-3. Twenty minutes on the treadmill at this pace and incline won’t impress Bob and Jillian, but at least I can work up a minor sweat. But more importantly, it doesn’t cause any pain.

• I ride the recumbent bike at a moderate clip for about 30 minutes every day. I’m not going to break out the yellow jersey (actually only dorks wear one), but I manage a slight sweat. The biking and treadmill are my only forms of cardio. Hopefully I’ll be able try the elliptical soon. Meanwhile, I’ll continue biking, which is supposed to be the best rehab exercise for ACI patients.

• I still have some swelling in my knee, especially after I exercise or spend a significant amount of time on my feet. The knee’s no longer a grotesque cantaloupe, but it’s not pretty. Thankfully not as ugly as Hedu Turkoglu, though.

• Bending and squatting are still beyond me. I can handle wall sits, but maneuvers that require short bursts of pressure on the knee are off-limits. I started to add shallow lunges, but the knee crackles inconsistently, and I’m afraid to continue. Again, something I need to address with Turgeon.

• The back of my knee still pops softly after being in a locked position.

• I traveled to DC for a few days last week. TSA’s security measures concern me. The two Home Depot-sized screws in my leg didn’t set off the metal detectors. Hopefully terrorists would embed weapons inside body parts, but you never know. . .

• My passive flexion (meaning, on my own) is 130 degrees, and my active one (where Judy crunches my leg) measured 138 degrees today.