This time the title sounds like something from a Guns ‘N Roses speed metal wannabe. Perhaps a ballad by Metallica? Unfortunately, it’s also the next surgery I’m scheduled to undergo.
A few weeks ago, I met with Dr. Turgeon and Dr. Berman on consecutive days. Both offered the same opinion: I need a bone graft. In fact, Berman had stated back in December that I needed a bone graft.
Here’s the deal. The space above my tibia created by the osteotomy didn’t fill in with bone as expected. The medical term is, “non-union of the bone.” Basically, the bone splintered off by the osteotomy now forms a wishbone with my tibia. The two Home Depot screws are the only thing keeping the bone from snapping off. If that space doesn’t get filled in, there’s a decent chance the tibia or screws might shatter or crack, leaving fragments of bone scattered throughout my leg. Quoting WebMd, that would be a really, really bad thing.
The solution is to borrow some bone from my iliac crest (part of the pelvis), mix it with some protein-rich putty, and pack it into the open space. Just like that.
Sounds straight-forward, yeah? It’s supposed to be. In theory, of course. So let’s hope the surgery works as it should.
Now the bad part.
For starters, I’ll spend the night in the hospital, unlike the ACI surgery. Deep breath. My hip will hurt like a mother-f*cker, just like Bo Jackson felt after a 260-pound monster piledrove his hip into the AstroTurf. Worse, the pain will be felt immediately, also unlike the ACI surgery. Back then, the femoral nerve block delayed the pain 1 ½ days. Not this time. I’ll wake up really sore, and, I’m sure, really pissed off. I’ll need to load up immediately on some good-old fashioned meds. That means the family drug store will be back open for business. Whoo hoo. Let’s hope I can stop at the vicodin. I really don’t watch to mess around with the serious stuff, like morphine. Selling it, sure. Consuming it, not so much. Just kidding. I don’t deal morphine. Only Hillbilly Heroin.
How long will this surgery put me on the DL? Turgeon and Berman gave slightly conflicting recovery timelines. I’ll be on crutches 2-6 weeks, and in a hinged brace (not the mongo immobilizer I wore after the ACI surgery) for 6-10 weeks. I should be full weight-bearing soon after the surgery. My workouts likely will be restricted for 3-6 months, at least until X-rays show the bone has healed. I’ll probably have to channel my inner Michael Phelps and use the pool to keep in shape. Not good times.
The surgery will be huge for 2 reasons. One, obviously, is the need to repair the TTO. Hopefully the bone graft will firm up the tibia, eliminating the ultra-sensitivity and my fear that a 4-year old soccer player might accidentally kick me in the shin and turn me into Joe Theisman.
Second, and more importantly, Turgeon is also going to scope my knee. That’s right. I’ll receive confirmation whether the ACI graft worked. That’s even scarier than the bone graft. While the scope is the more “minor” surgery, it’s actually more revealing. I’ll learn whether all the rehab, pain, and uncertainty was “worth it.”
Now, as much as I’d like to know whether the ACI surgery “worked,” I wouldn’t get scoped just to check out the graft site. However, I’ve got a fair amount of crepitus, particularly at full extension, suggesting overgrowth at the graft sites and possible scar tissue which need to get trimmed. Interestingly, Berman mentioned that scraping away the overgrowth might stimulate further growth of cartilage and hardening of the existing stuff. A nice side benefit to the unpleasant surgery.
On the other hand, it’s possible the crepitus indicates that the graft hasn’t filled in or the new hyaline cartilage hasn’t matured yet, which would not be a good thing. I’ve also occasionally experienced twinges of discomfort on the inside part of my knee, so I’ll learn whether my Holiday Inn-inspired diagnosis of a medial meniscus tear is correct. And these past few weeks I’ve suffered a few random pinpicks around my knee, which scares the bejesus outta me. Because of my osteotomy issues, it’s tough to pinpoint the exact location of these sensations. Sometimes they feel like they’re coming from the medial meniscus area; other times from the patella; and still others feel like they’re at the TTO site.
I don’t want to envision the possibility that my knee still has unresolved defects, but I need to mentally steel myself for that possibility. That would be a really crappy thing to hear after waking up from surgery. Unbelievably demoralizing.
Regardless of what the surgery reveals, I’m facing another lengthy recovery. I’ve learned that rehabbing is a lot like practicing sports. And sometimes the hardest part of sports training is working on your weaknesses. Nobody likes doing stuff they suck at, me included. This is especially true for kids. For example, the hardest thing for young soccer players to do is kick the ball with their non-dominant foot. The kids often resemble newborn giraffes struggling to walk after leaving the womb. Well, after the surgery, I’ll be forced to re-train all those obscure muscles in my leg that will have atrophied for the second time in the past 18 months. Let’s be honest here. I hated exercising my legs when I was healthy. I really hate lifting legs when all I can do are a bunch of functional leg lifts with no weight. I’m a guy. Guys have massive egos. We like to lift heavy weights. Me Jim. Strong! Guys pick up the biggest dumbbells we can find– even if lifting them causes a hernia – grunt loudly, and then drop the weights to make the loudest possible noise so folks, especially chicks, can see we just lifted something enormous. For some reason, we think this is impressive. It’s not, of course. But we’re dumb. We just can’t help it. And after checking out who witnessed our feats of strength, we flex a few times in the mirror. That’s right. Check out the guns, ladies.
But lifting your leg with no weight? Lame. Really lame.
I haven’t picked a surgery date yet. I still need to discuss a few things with Turgeon. Berman recommended replacing the existing screws with a new, flat-head screw that won’t protrude as much. I also want to learn more about what Turgeon would do if the cartilage hasn’t filled in or hasn’t matured. And I have a few more questions about the incision near my hip, like which side of my hip? Same side as my knee?
Anyway, this wasn’t what I was expecting when I decided to roll the dice on ACI surgery a little less than 2 years ago. I can only keep my hopes up that the knee will continue to improve over time, particularly if the bone graft fixes my osteotomy issues.
Thursday, April 22, 2010
Friday, April 2, 2010
The Osteotomy Blues
That title sounds like something B.B. King might sing about after visiting the ER. Ah, if only that were true. Well, I now know the source of most of my knee issues during the rehab. Or I should say, the source has now been confirmed.
A CT scan revealed that the bone graft from the osteotomy is not attached to my tibia. In medical terms, there’s non-union of the graft and the bone. The only reason the graft hasn’t floated away is because the two Home Depot screws are holding it together. Of course, these are the same screws that really ache and that I desperately want removed from my leg. Not surprisingly, this poses a major dilemma, which I’ll address in a moment.
Anyway, this discovery/confirmation explains my struggles to bend at the correct focal point; that my knee generally feels fine, but mechanically it functions differently, something I struggled to explain to folks, including Dr. T and Dr. Berman. I almost feel like the osteotomy defect has cheated me out a “true” ACI rehab experience. Ok, not really.
At least I know what’s wrong. And like the ending to the old G.I. Joe cartoons, “knowing is half the battle.”
So what does this mean? What’s next? Right now, I’m not sure. Presumably, I’ve got 3 choices: (1) do nothing, which means leaving in those f*cking screws and having an unattached bone wedge; (2) undergo a bone graft to fill in the “area of non-union” between my tibia and the wedge; or (3) see if the screws and the entire bone graft can be removed. None of these options is very good. All of them have drawbacks.
First, doing nothing means learning to live with the uncomfortable screws and a really sensitive shin. Plus, I can’t imagine having an unattached bone wedge inside my leg is a good thing.
Next, a bone graft means another major surgery. And several more painful months of recovery. And another several months of putting my life on hold. Not to mention there’s no guarantee the bone graft will work.
As for the final option, I have no clue whether it’s possible to remove the unattached bone wedge (along with the screws). In my non-medical mind, if it’s not attached, why not “take it out?” That seems logical, right? Besides, I don’t need the osteotomy anymore. The ACI graft has sufficiently matured, eliminating the need to alleviate the pounding absorbed by the patella. True, the osteotomy would alleviate pressure long-term, thus minimizing the risk that I’d re-injure my injury-prone patella. But since I don’t expect to play competitive sports anymore, I think the odds of a future injury are minimal.
Sometime soon I’ll discuss these options with Dr. T. And then I’ll seek out another opinion to be safe. Stay tuned.
A CT scan revealed that the bone graft from the osteotomy is not attached to my tibia. In medical terms, there’s non-union of the graft and the bone. The only reason the graft hasn’t floated away is because the two Home Depot screws are holding it together. Of course, these are the same screws that really ache and that I desperately want removed from my leg. Not surprisingly, this poses a major dilemma, which I’ll address in a moment.
Anyway, this discovery/confirmation explains my struggles to bend at the correct focal point; that my knee generally feels fine, but mechanically it functions differently, something I struggled to explain to folks, including Dr. T and Dr. Berman. I almost feel like the osteotomy defect has cheated me out a “true” ACI rehab experience. Ok, not really.
At least I know what’s wrong. And like the ending to the old G.I. Joe cartoons, “knowing is half the battle.”
So what does this mean? What’s next? Right now, I’m not sure. Presumably, I’ve got 3 choices: (1) do nothing, which means leaving in those f*cking screws and having an unattached bone wedge; (2) undergo a bone graft to fill in the “area of non-union” between my tibia and the wedge; or (3) see if the screws and the entire bone graft can be removed. None of these options is very good. All of them have drawbacks.
First, doing nothing means learning to live with the uncomfortable screws and a really sensitive shin. Plus, I can’t imagine having an unattached bone wedge inside my leg is a good thing.
Next, a bone graft means another major surgery. And several more painful months of recovery. And another several months of putting my life on hold. Not to mention there’s no guarantee the bone graft will work.
As for the final option, I have no clue whether it’s possible to remove the unattached bone wedge (along with the screws). In my non-medical mind, if it’s not attached, why not “take it out?” That seems logical, right? Besides, I don’t need the osteotomy anymore. The ACI graft has sufficiently matured, eliminating the need to alleviate the pounding absorbed by the patella. True, the osteotomy would alleviate pressure long-term, thus minimizing the risk that I’d re-injure my injury-prone patella. But since I don’t expect to play competitive sports anymore, I think the odds of a future injury are minimal.
Sometime soon I’ll discuss these options with Dr. T. And then I’ll seek out another opinion to be safe. Stay tuned.
Sunday, March 7, 2010
14 Months
Dallas has had an unseasonably long and cold winter. It actually snowed for 2 days in mid-February. I forgot how much snow sucks. Holy f*ck. It’s cold. Sh*t gets wet. Idiots drive too fast on icy roads.
On the other hand, kids have a blast when it snows. They get to pelt each other with snowballs. Mine built a wicked snow-woman.
On the other hand, kids have a blast when it snows. They get to pelt each other with snowballs. Mine built a wicked snow-woman.
But grown-ups can’t enjoy snow like kids. At least I can’t. See, I immediately succumb to my childish whims. Snowball fights rock. Who doesn’t enjoy throwing sh*t at other people? Good times. I start out lobbing a few snowballs at the kids. I playfully duck a few of their weak throws. But things spiral downhill quickly. While I’m goofing around with my 4-year old, my 8-yr old crushes the side of my head from 3 feet away. Oh, it’s on. My competitive instincts immediately kick in, and I transform from mild-mannered Bruce Banner into the Incredible Hulk. I need to win these snowball battles, even if I’m competing against people too short to ride Space Mountain. And I’m not content just cracking people. Nope. I want to inflict bodily harm. Before you know it, I start packing a bunch of baseball-sized WMDs into my snowballs. Acorns. Rocks. Anything to weigh down those puppies. This leads to a predictable chain reaction. Eventually I cripple one of my kids, my wife gets pissed off, and then I get no nookie for a few days. Not good times. Like I said, snow sucks.
Anyway, we finally had a decent day. Spring-like, even. Probably hovered around 60 degrees. I went biking. This was a completely different experience than my last outing. I rode around White Rock Lake and back home, about 16-18 miles total.
The knee felt good the entire time; it felt fine afterward, too. I even managed to push off my bum knee a number of times to “stand up” during my bike ride. There really aren’t any hills big enough that require riders to stand up, but, again, the competitive juices kicked in and I wanted to be able to stand up, so I kept practicing every 5-10 minutes. The first few times I tried to stand up, I was unable to complete the loop. It was a bit embarrassing. I stood up, did a half revolution, my right leg weakened, and then I got stuck at the top, forcing me to sit back down. I was playing Jack-in-the-Box on a mountain bike. It reminded me of my first efforts trying to ride the recumbent bike after my surgery, when I struggled to complete a full revolution. But halfway through my ride around White Rock I managed to “stand up” for 10-20 seconds at a time. Interestingly, I didn’t have to sit back down because the leg hurt, but because I was completely winded standing up for that short period of time.
I enjoyed my outing, but I don’t understand uber-cyclists. You know exactly the kind of people I’m talking about. The weekend warriors that wear yellow jerseys and spandex, ride in packs, and bark out instructions like they’re in the middle of some Tour de France team time trial. And you know what? Spandex is not a good look for most of these chubby riders. But I did ease into their world a few times during my ride.
Several times, I had the choice of whether to pass someone or draft behind them. Tough call. When you pass someone, you get to bark out, “on your left,” like one of those biking douchebags. And yeah, I felt like a dork, but, also, strangely superior; like sitting in first class on an airplane and watching people trudge back to coach. I paused briefly during the pass to savor the moment. I needed to make eye contact. I wanted them to acknowledge their master.
But sometimes I chose not to pass people. Instead I hovered a few feet behind them, drafting like a NASCAR driver. Drafting is a lot like stalking, actually. You just follow somebody, making them feel uncomfortable by remaining in their shadow. But when I wasn’t feeling creepy, I pretended I was at some Olympic Velodrome practicing my drafting skills. Of course, there’s really not a lot of wind resistance to avoid at my embarrassing speeds. But it did provide a pretty sweet view of some of the hotties on the trail. And those were the riders I didn’t mind stalking….
My next checkup is in 3 weeks. Not much has changed over the past month or so. I continue to increase my workouts. My gimpy knee still goes into convulsions during 1-legged squats, shuttle presses, and heel touches. The inside of my quad remains hollow. I struggle to perfect good “bending form.” But the knee continues to get a bit stronger. Baby steps.
I’m most anxious to learn how the tibia is healing. I want the screws removed, but I’m not sure how the leg will respond once their gone. Dr. Berman recommended undergoing a bone graft. That’s something I consider an absolute last resort. I have no desire to suffer through another major surgery and recovery. However, I need to learn the potential risks of having a “weakened tibia.” Does that mean the leg might break during normal activities? Would it complicate my knee recovery? Stay tuned.
Anyway, we finally had a decent day. Spring-like, even. Probably hovered around 60 degrees. I went biking. This was a completely different experience than my last outing. I rode around White Rock Lake and back home, about 16-18 miles total.
The knee felt good the entire time; it felt fine afterward, too. I even managed to push off my bum knee a number of times to “stand up” during my bike ride. There really aren’t any hills big enough that require riders to stand up, but, again, the competitive juices kicked in and I wanted to be able to stand up, so I kept practicing every 5-10 minutes. The first few times I tried to stand up, I was unable to complete the loop. It was a bit embarrassing. I stood up, did a half revolution, my right leg weakened, and then I got stuck at the top, forcing me to sit back down. I was playing Jack-in-the-Box on a mountain bike. It reminded me of my first efforts trying to ride the recumbent bike after my surgery, when I struggled to complete a full revolution. But halfway through my ride around White Rock I managed to “stand up” for 10-20 seconds at a time. Interestingly, I didn’t have to sit back down because the leg hurt, but because I was completely winded standing up for that short period of time.
I enjoyed my outing, but I don’t understand uber-cyclists. You know exactly the kind of people I’m talking about. The weekend warriors that wear yellow jerseys and spandex, ride in packs, and bark out instructions like they’re in the middle of some Tour de France team time trial. And you know what? Spandex is not a good look for most of these chubby riders. But I did ease into their world a few times during my ride.
Several times, I had the choice of whether to pass someone or draft behind them. Tough call. When you pass someone, you get to bark out, “on your left,” like one of those biking douchebags. And yeah, I felt like a dork, but, also, strangely superior; like sitting in first class on an airplane and watching people trudge back to coach. I paused briefly during the pass to savor the moment. I needed to make eye contact. I wanted them to acknowledge their master.
But sometimes I chose not to pass people. Instead I hovered a few feet behind them, drafting like a NASCAR driver. Drafting is a lot like stalking, actually. You just follow somebody, making them feel uncomfortable by remaining in their shadow. But when I wasn’t feeling creepy, I pretended I was at some Olympic Velodrome practicing my drafting skills. Of course, there’s really not a lot of wind resistance to avoid at my embarrassing speeds. But it did provide a pretty sweet view of some of the hotties on the trail. And those were the riders I didn’t mind stalking….
My next checkup is in 3 weeks. Not much has changed over the past month or so. I continue to increase my workouts. My gimpy knee still goes into convulsions during 1-legged squats, shuttle presses, and heel touches. The inside of my quad remains hollow. I struggle to perfect good “bending form.” But the knee continues to get a bit stronger. Baby steps.
I’m most anxious to learn how the tibia is healing. I want the screws removed, but I’m not sure how the leg will respond once their gone. Dr. Berman recommended undergoing a bone graft. That’s something I consider an absolute last resort. I have no desire to suffer through another major surgery and recovery. However, I need to learn the potential risks of having a “weakened tibia.” Does that mean the leg might break during normal activities? Would it complicate my knee recovery? Stay tuned.
Monday, February 8, 2010
Where Are They Now, Knee Edition
I've always loved the “Where are They Now?” articles. It’s like catching up with a long-lost friend from junior high on Facebook. You also discover the answers to really important questions, like Which Biggest Loser winner got chunky again? Does Joanie still love Chachi? And, hey, whatever happened to Cousin Oliver? I always assumed he wound working on really cheap Indie films, bragging to everybody on set about the time he saw Marsha naked. Or maybe he dabbled in some fetish amateur porn like the creepy director in 8MM. God help us if Sam the Butcher played Machine in one of Oliver’s snuff films. Anyway, that’s why I love these articles.
Obviously, the status of my knee doesn’t quite drum up the same level of interest as Cousin Oliver’s career. But that won’t stop me from sharing. It’s been 6 weeks since my last update, and over 13 months since my ACI surgery, so I think it’s time for a “How is the Knee Now?” blog entry.
Alright, let’s start with the big picture. I don’t have any functioning limitations. I get around just fine. I don’t have any daily pain. And unless you analyzed my walking form like the Zapruder Film, you probably couldn’t even tell that I had knee surgery.
But the knee’s not 100%. My ultimate fighting career remains on-hold. Interestingly, different things bother me now than before I went under the knife, which both worries me and gives me hope. Let me explain.
Before ACI, the knee occasionally ached below the knee cap and behind my knee, near the spot where the knee bends and your calf ends. Now? Those spots are pain-free, though I haven’t “tested” myself with athletic activities. Of course, my previous occasional twinges of pain happened during normal activities; I didn’t need to play sports to trigger the discomfort.
Instead, the medial – or inside – area where the knee bends kinda sometimes bothers me when I push off; going up stairs sometimes causes a slight tweak. Nothing major, but it’s enough to make me “think” before pushing off, which serves as a constant reminder that the knee still lacks strength and stability. Going down stairs is no problem. I previously thought I might’ve torn my meniscus, but Dr. T and Dr. Berman disagreed. However, something still doesn’t feel right.
What does this mean? Strangely, it could be good news, because the ACI areas feel fine. And it’s also possible that my knee might return close to normal if this un-related problem goes away. At least that’s my hope.
So what might be causing the slight irritation on this new spot? Possibly the lack of muscle strength.
Right now, my entire quad and the surrounding muscles are still pretty squishy. The teardrop shape that usually forms between the quad and kneecap? Let’s just say my quad isn’t crying. I mean, the knee no longer looks like it belongs to a starving African child. But it seriously needs to bulk up, like a scrawny high school athlete getting ready to play college ball.
This is especially true for the inside muscles that run from my knee to my quad. That part of my leg looks like a crescent moon. Plus, the area immediately above my kneecap resembles the chin of an elderly person. Thankfully I don’t have 14 different folds or wrinkles there, but there’s a bunch of saggy skin present.
I’m hoping that, as the muscles continue to develop and strengthen the overall knee, the twinges of pain around the inside of my knee disappear. That’s what I’ll focus on over the next couple of months; to see if the pain decreases as the muscle grows.
Ok, here are some more knee thoughts:
I still have crunching sounds in my knee. But it only sounds like popcorn when I squat or extend my knee quickly. No pain.
Whenever I almost “hyper-extend” my knee – basically straighten it out a tad bit beyond straight – the knee pops. It’s the exact same sound my knee makes when I first wake up in the morning, or when I stand up after sitting for a long period of time. Again, no pain.
My hamstring is pretty soft. I’ve started doing various dead lifts. Unfortunately, the major exercise to strengthen hamstrings – hamstring curls – seems to hurt my shin.
I struggle to isolate my right quad because, during 2-legged exercises, my left leg over-compensates. It just can’t help itself. My left leg has always been the dominant leg, even before the surgery. I continue to do 1-legged exercises, mainly the shuttle press and calf raises, along with a variety of step-ups. Lately, I’ve been doing step-downs and holding the bottom position (almost like a 1-legged wall sit) for 20-30 seconds. That seems to be helping. Of course, my leg trembles freakishly like it’s going into epileptic shock.
The knee feels better immediately after I exercise, i.e., when the muscle is tight/tense, which suggests to my un-trained medical mind that the lack of muscle strength is causing the twinges of pain near the medial meniscus. Again, that’s what I hope is causing the problem.
Sometimes when I walk my right leg is a bit “stiffer” than usual; my knee fails to bend the same amount as my good leg. Insert your own pirate peg leg or Heisman Trophy pose joke here. I wasn’t creative enough to come up with one.
I’m unable to “fire” my calf muscles, but that’s not from a lack of strength; more of a function issue. Calf raises just don’t feel normal. I think it’s because of the osteotomy; that raising onto my toes tugs on the shin bone, which irritates the bejesus out of the screws.
Let’s see, what else? The area surrounding the screws in my osteotomy remains sensitive. It doesn’t hurt if left alone, but god forbid I accidentally crack my shin against the couch or one of the 4-year old girls on my soccer team kick me instead of the ball.
The area on the lateral (outside) of my osteotomy bone wedge remains numb. Some of the nerve/nerve endings got severed or damaged during the surgery, which was expected. No real issues, though.
Because of the bone wedge, I still struggle to bend normally, like I can’t find my “bending focal point.” Hard to explain.
There have been other changes to my body. Before the surgery, I functioned just fine on 5-6 hours of sleep. I settled into a nice routine. I’d put the kids to bed around 8, spend an hour or so catching up on personal stuff, before plowing through the latest DVDs or stuff on DVR until 11-ish. Then I’d wake up sometime between 4.30-5.30am to exercise. And I felt great.
Now? I need at least 8-9 hours of sleep. No matter how hard I try, I cannot wake up early enough to exercise in the morning unless I hit the sack by 8pm. And since that’s never going to happen, morning workouts remain part of my dreams.
On the positive side, I continue to slowly regain what I call, “athletic mobility.” I finally can perform basic athletic movements, like dribbling a soccer ball or basketball. My difficulties now are with that third step explosion, the steps taken after performing the initial move. I can move easily enough to demonstrate the actual move, but can’t continue the move with any speed. For example, I can showcase a cross-over dribble to get past the initial defender, but lack the strength/speed to continue the drive all the way to the hoop. Call it the old man Iverson, only even slower.
I haven’t tried running, but I think I’ll be able to soon. As I continue to re-build my quad, I think I’ll be able conquer the slight hitch that rears its ugly head when my pace quickens beyond a leisurely stroll. I doubt I’ll ever challenge the Kenyans, but I would like to move faster than the elderly. Or at least be able to dodge traffic if a car decides to play Frogger while I’m crossing the street. But all of this is contingent on the twinges of pain disappearing as my quad grows stronger. Fingers crossed.
Obviously, the status of my knee doesn’t quite drum up the same level of interest as Cousin Oliver’s career. But that won’t stop me from sharing. It’s been 6 weeks since my last update, and over 13 months since my ACI surgery, so I think it’s time for a “How is the Knee Now?” blog entry.
Alright, let’s start with the big picture. I don’t have any functioning limitations. I get around just fine. I don’t have any daily pain. And unless you analyzed my walking form like the Zapruder Film, you probably couldn’t even tell that I had knee surgery.
But the knee’s not 100%. My ultimate fighting career remains on-hold. Interestingly, different things bother me now than before I went under the knife, which both worries me and gives me hope. Let me explain.
Before ACI, the knee occasionally ached below the knee cap and behind my knee, near the spot where the knee bends and your calf ends. Now? Those spots are pain-free, though I haven’t “tested” myself with athletic activities. Of course, my previous occasional twinges of pain happened during normal activities; I didn’t need to play sports to trigger the discomfort.
Instead, the medial – or inside – area where the knee bends kinda sometimes bothers me when I push off; going up stairs sometimes causes a slight tweak. Nothing major, but it’s enough to make me “think” before pushing off, which serves as a constant reminder that the knee still lacks strength and stability. Going down stairs is no problem. I previously thought I might’ve torn my meniscus, but Dr. T and Dr. Berman disagreed. However, something still doesn’t feel right.
What does this mean? Strangely, it could be good news, because the ACI areas feel fine. And it’s also possible that my knee might return close to normal if this un-related problem goes away. At least that’s my hope.
So what might be causing the slight irritation on this new spot? Possibly the lack of muscle strength.
Right now, my entire quad and the surrounding muscles are still pretty squishy. The teardrop shape that usually forms between the quad and kneecap? Let’s just say my quad isn’t crying. I mean, the knee no longer looks like it belongs to a starving African child. But it seriously needs to bulk up, like a scrawny high school athlete getting ready to play college ball.
This is especially true for the inside muscles that run from my knee to my quad. That part of my leg looks like a crescent moon. Plus, the area immediately above my kneecap resembles the chin of an elderly person. Thankfully I don’t have 14 different folds or wrinkles there, but there’s a bunch of saggy skin present.
I’m hoping that, as the muscles continue to develop and strengthen the overall knee, the twinges of pain around the inside of my knee disappear. That’s what I’ll focus on over the next couple of months; to see if the pain decreases as the muscle grows.
Ok, here are some more knee thoughts:
I still have crunching sounds in my knee. But it only sounds like popcorn when I squat or extend my knee quickly. No pain.
Whenever I almost “hyper-extend” my knee – basically straighten it out a tad bit beyond straight – the knee pops. It’s the exact same sound my knee makes when I first wake up in the morning, or when I stand up after sitting for a long period of time. Again, no pain.
My hamstring is pretty soft. I’ve started doing various dead lifts. Unfortunately, the major exercise to strengthen hamstrings – hamstring curls – seems to hurt my shin.
I struggle to isolate my right quad because, during 2-legged exercises, my left leg over-compensates. It just can’t help itself. My left leg has always been the dominant leg, even before the surgery. I continue to do 1-legged exercises, mainly the shuttle press and calf raises, along with a variety of step-ups. Lately, I’ve been doing step-downs and holding the bottom position (almost like a 1-legged wall sit) for 20-30 seconds. That seems to be helping. Of course, my leg trembles freakishly like it’s going into epileptic shock.
The knee feels better immediately after I exercise, i.e., when the muscle is tight/tense, which suggests to my un-trained medical mind that the lack of muscle strength is causing the twinges of pain near the medial meniscus. Again, that’s what I hope is causing the problem.
Sometimes when I walk my right leg is a bit “stiffer” than usual; my knee fails to bend the same amount as my good leg. Insert your own pirate peg leg or Heisman Trophy pose joke here. I wasn’t creative enough to come up with one.
I’m unable to “fire” my calf muscles, but that’s not from a lack of strength; more of a function issue. Calf raises just don’t feel normal. I think it’s because of the osteotomy; that raising onto my toes tugs on the shin bone, which irritates the bejesus out of the screws.
Let’s see, what else? The area surrounding the screws in my osteotomy remains sensitive. It doesn’t hurt if left alone, but god forbid I accidentally crack my shin against the couch or one of the 4-year old girls on my soccer team kick me instead of the ball.
The area on the lateral (outside) of my osteotomy bone wedge remains numb. Some of the nerve/nerve endings got severed or damaged during the surgery, which was expected. No real issues, though.
Because of the bone wedge, I still struggle to bend normally, like I can’t find my “bending focal point.” Hard to explain.
There have been other changes to my body. Before the surgery, I functioned just fine on 5-6 hours of sleep. I settled into a nice routine. I’d put the kids to bed around 8, spend an hour or so catching up on personal stuff, before plowing through the latest DVDs or stuff on DVR until 11-ish. Then I’d wake up sometime between 4.30-5.30am to exercise. And I felt great.
Now? I need at least 8-9 hours of sleep. No matter how hard I try, I cannot wake up early enough to exercise in the morning unless I hit the sack by 8pm. And since that’s never going to happen, morning workouts remain part of my dreams.
On the positive side, I continue to slowly regain what I call, “athletic mobility.” I finally can perform basic athletic movements, like dribbling a soccer ball or basketball. My difficulties now are with that third step explosion, the steps taken after performing the initial move. I can move easily enough to demonstrate the actual move, but can’t continue the move with any speed. For example, I can showcase a cross-over dribble to get past the initial defender, but lack the strength/speed to continue the drive all the way to the hoop. Call it the old man Iverson, only even slower.
I haven’t tried running, but I think I’ll be able to soon. As I continue to re-build my quad, I think I’ll be able conquer the slight hitch that rears its ugly head when my pace quickens beyond a leisurely stroll. I doubt I’ll ever challenge the Kenyans, but I would like to move faster than the elderly. Or at least be able to dodge traffic if a car decides to play Frogger while I’m crossing the street. But all of this is contingent on the twinges of pain disappearing as my quad grows stronger. Fingers crossed.
Friday, January 1, 2010
2010 -- New Year, New Way to Think
Full disclosure: this post is not about my knee, but about something bigger: our ability to think for ourselves.
As you welcome in the New Year with a fresh batch of recycled resolutions, I’d like to share the profound words of David Foster Wallace. Back in 2005, he spoke to the graduating class of Kenyon College. His speech was titled, “This is Water,” and it conveys Wallace’s struggles to define thinking and master empathy. His theme is captured in this little gem: “Think about it: There is no experience you’ve had that you were not at the absolute center of it.”
Wallace’s speech, I hope, causes you to re-consider how you view the world, or at least the small part of the world you inhabit. I hope it causes you to think before you speak; to seek information and form your own opinion, rather than follow the herd. Just like the mid-range jump shot, these attributes are a lost art.
In today’s partisan climate, people increasingly surround themselves with like-minded folks, especially the ones who are supposed to be “leaders.” Republicans only watch Fox; Democrats only watch MSNBC. Right-wingers listen to Rush Limbaugh; liberals follow Huffington Post. Issues are no longer debated. They’re not even spotted.
These days, you have to subscribe to multiple news sources just to get a (somewhat) complete picture. The media only reports stories with angles that reflect the viewpoints closest to their readers or reporters, failing to examine stories from all sides. It’s all about the angles. The source of your news says as much about you as your actual views. In fact, think about what your opinions would look like if you only listened to Bill O’Reilly or Keith Olbermann? While I realize they aren’t traditional newscasters, in today’s world most news is delivered this way. If your reaction to the mention of either of these guys is something like, “Man, that dude is so biased. Only a (liberal or conservative) would believe his cr*p.” Well, imagine how somebody with the polar opposite viewpoint reacted to that statement. Yup. They feel the exact same way about what you watch and read.
Here’s a challenge. Try watching one of those programs exclusively for 2 days, then switching to the other one. Just grit your teeth. Maybe half of the stories will be the same – the current health care vote, a bombing in the Middle East, etc. – except they’ll be covered from diametrically opposite angles. The other half of the program will address stories the other show doesn’t even mention. And yet people who watch just one of those shows are expected to get a complete picture of the issues? They’re supposed to debate things intelligently, let alone civilly? Um, yeah. Didn’t think so.
This dichotomy has trickled down to the local level, as our communities have become echo chambers, little cocoons of isolated thoughts and viewpoints. Neighborhood “for sale” signs should also include notices like, “Democrats only” or “Liberals need not apply.” Society has reached the point where “diversity” needs to be expanded beyond skin color or religion. Things don’t appear to be changing anytime soon. Remember last November when we were supposed to have moved beyond red states and blue states? Well, it looks like Obama’s ascendancy was a mirage, a temporary flash of hope. I can’t say I’m surprised, though I admit I had hoped things would change. But the venom spewed over the past decade wasn’t really about Bush, despite what was written for the past 8 years. George W. just happened to be an easy target, a caricature of ineptitude. The problem was how the rest of us debated stuff.
Fox holes used to be the last line of defense for the brave. Now? They’re refuges where folks willingly hunker down with sycophants. Who loses when people put on blinders and cannot have their views challenged? Everybody.
Which brings me to Wallace’s graduation speech. It’s not too late for society to become a bit more open-minded, a bit less hostile, and I think his words will help. For 2010, don’t just promise to lose weight or spend more time with your family, admirable goals. For the next 12 months, vow to step outside the box. To listen, before deciding. To contemplate, before reacting. To gather information, before offering a knee-jerk opinion. To try to see things from another perspective. You’ll be pleasantly surprised.
Happy New Year (and now I’ll step off my moral and philosophical soap box and return to knee updates.)
(Below are excerpts from Wallace’s speech; the full text can be found here. I highly recommend reading it) http://online.wsj.com/article/SB122178211966454607.html)
Thinking this way tends to be so easy and automatic it doesn't have to be a choice. Thinking this way is my natural default-setting. It's the automatic, unconscious way that I experience the boring, frustrating, crowded parts of adult life when I'm operating on the automatic, unconscious belief that I am the center of the world and that my immediate needs and feelings are what should determine the world's priorities. The thing is that there are obviously different ways to think about these kinds of situations. In this traffic, all these vehicles stuck and idling in my way: It's not impossible that some of these people in SUV's have been in horrible auto accidents in the past and now find driving so traumatic that their therapist has all but ordered them to get a huge, heavy SUV so they can feel safe enough to drive; or that the Hummer that just cut me off is maybe being driven by a father whose little child is hurt or sick in the seat next to him, and he's trying to rush to the hospital, and he's in a way bigger, more legitimate hurry than I am -- it is actually I who am in his way. Or I can choose to force myself to consider the likelihood that everyone else in the supermarket's checkout line is just as bored and frustrated as I am, and that some of these people probably have much harder, more tedious or painful lives than I do, overall.
Again, please don't think that I'm giving you moral advice, or that I'm saying you're "supposed to" think this way, or that anyone expects you to just automatically do it, because it's hard, it takes will and mental effort, and if you're like me, some days you won't be able to do it, or you just flat-out won't want to. But most days, if you're aware enough to give yourself a choice, you can choose to look differently at this fat, dead-eyed, over-made-lady who just screamed at her little child in the checkout line -- maybe she's not usually like this; maybe she's been up three straight nights holding the hand of her husband who's dying of bone cancer, or maybe this very lady is the low-wage clerk at the Motor Vehicles Dept. who just yesterday helped your spouse resolve a nightmarish red-tape problem through some small act of bureaucratic kindness. Of course, none of this is likely, but it's also not impossible -- it just depends on what you want to consider. If you're automatically sure that you know what reality is and who and what is really important -- if you want to operate on your default-setting -- then you, like me, will not consider possibilities that aren't pointless and annoying. But if you've really learned how to think, how to pay attention, then you will know you have other options. It will actually be within your power to experience a crowded, loud, slow, consumer-hell-type situation as not only meaningful but sacred, on fire with the same force that lit the stars -- compassion, love, the sub-surface unity of all things. Not that that mystical stuff's necessarily true: The only thing that's capital-T True is that you get to decide how you're going to try to see it. You get to consciously decide what has meaning and what doesn't. You get to decide what to worship...
And I submit that this is what the real, no-bull- value of your liberal-arts education is supposed to be about: How to keep from going through your comfortable, prosperous, respectable adult life dead, unconscious, a slave to your head and to your natural default-setting of being uniquely, completely, imperially alone, day in and day out.
And the world will not discourage you from operating on your default-settings, because the world of men and money and power hums along quite nicely on the fuel of fear and contempt and frustration and craving and the worship of self. Our own present culture has harnessed these forces in ways that have yielded extraordinary wealth and comfort and personal freedom. The freedom to be lords of our own tiny skull-sized kingdoms, alone at the center of all creation. This kind of freedom has much to recommend it. But of course there are all different kinds of freedom, and the kind that is most precious you will not hear much talked about in the great outside world of winning and achieving and displaying. The really important kind of freedom involves attention, and awareness, and discipline, and effort, and being able truly to care about other people and to sacrifice for them, over and over, in myriad petty little unsexy ways, every day. That is real freedom. The alternative is unconsciousness, the default-setting, the "rat race" -- the constant gnawing sense of having had and lost some infinite thing.
As you welcome in the New Year with a fresh batch of recycled resolutions, I’d like to share the profound words of David Foster Wallace. Back in 2005, he spoke to the graduating class of Kenyon College. His speech was titled, “This is Water,” and it conveys Wallace’s struggles to define thinking and master empathy. His theme is captured in this little gem: “Think about it: There is no experience you’ve had that you were not at the absolute center of it.”
Wallace’s speech, I hope, causes you to re-consider how you view the world, or at least the small part of the world you inhabit. I hope it causes you to think before you speak; to seek information and form your own opinion, rather than follow the herd. Just like the mid-range jump shot, these attributes are a lost art.
In today’s partisan climate, people increasingly surround themselves with like-minded folks, especially the ones who are supposed to be “leaders.” Republicans only watch Fox; Democrats only watch MSNBC. Right-wingers listen to Rush Limbaugh; liberals follow Huffington Post. Issues are no longer debated. They’re not even spotted.
These days, you have to subscribe to multiple news sources just to get a (somewhat) complete picture. The media only reports stories with angles that reflect the viewpoints closest to their readers or reporters, failing to examine stories from all sides. It’s all about the angles. The source of your news says as much about you as your actual views. In fact, think about what your opinions would look like if you only listened to Bill O’Reilly or Keith Olbermann? While I realize they aren’t traditional newscasters, in today’s world most news is delivered this way. If your reaction to the mention of either of these guys is something like, “Man, that dude is so biased. Only a (liberal or conservative) would believe his cr*p.” Well, imagine how somebody with the polar opposite viewpoint reacted to that statement. Yup. They feel the exact same way about what you watch and read.
Here’s a challenge. Try watching one of those programs exclusively for 2 days, then switching to the other one. Just grit your teeth. Maybe half of the stories will be the same – the current health care vote, a bombing in the Middle East, etc. – except they’ll be covered from diametrically opposite angles. The other half of the program will address stories the other show doesn’t even mention. And yet people who watch just one of those shows are expected to get a complete picture of the issues? They’re supposed to debate things intelligently, let alone civilly? Um, yeah. Didn’t think so.
This dichotomy has trickled down to the local level, as our communities have become echo chambers, little cocoons of isolated thoughts and viewpoints. Neighborhood “for sale” signs should also include notices like, “Democrats only” or “Liberals need not apply.” Society has reached the point where “diversity” needs to be expanded beyond skin color or religion. Things don’t appear to be changing anytime soon. Remember last November when we were supposed to have moved beyond red states and blue states? Well, it looks like Obama’s ascendancy was a mirage, a temporary flash of hope. I can’t say I’m surprised, though I admit I had hoped things would change. But the venom spewed over the past decade wasn’t really about Bush, despite what was written for the past 8 years. George W. just happened to be an easy target, a caricature of ineptitude. The problem was how the rest of us debated stuff.
Fox holes used to be the last line of defense for the brave. Now? They’re refuges where folks willingly hunker down with sycophants. Who loses when people put on blinders and cannot have their views challenged? Everybody.
Which brings me to Wallace’s graduation speech. It’s not too late for society to become a bit more open-minded, a bit less hostile, and I think his words will help. For 2010, don’t just promise to lose weight or spend more time with your family, admirable goals. For the next 12 months, vow to step outside the box. To listen, before deciding. To contemplate, before reacting. To gather information, before offering a knee-jerk opinion. To try to see things from another perspective. You’ll be pleasantly surprised.
Happy New Year (and now I’ll step off my moral and philosophical soap box and return to knee updates.)
(Below are excerpts from Wallace’s speech; the full text can be found here. I highly recommend reading it) http://online.wsj.com/article/SB122178211966454607.html)
***
Thinking this way tends to be so easy and automatic it doesn't have to be a choice. Thinking this way is my natural default-setting. It's the automatic, unconscious way that I experience the boring, frustrating, crowded parts of adult life when I'm operating on the automatic, unconscious belief that I am the center of the world and that my immediate needs and feelings are what should determine the world's priorities. The thing is that there are obviously different ways to think about these kinds of situations. In this traffic, all these vehicles stuck and idling in my way: It's not impossible that some of these people in SUV's have been in horrible auto accidents in the past and now find driving so traumatic that their therapist has all but ordered them to get a huge, heavy SUV so they can feel safe enough to drive; or that the Hummer that just cut me off is maybe being driven by a father whose little child is hurt or sick in the seat next to him, and he's trying to rush to the hospital, and he's in a way bigger, more legitimate hurry than I am -- it is actually I who am in his way. Or I can choose to force myself to consider the likelihood that everyone else in the supermarket's checkout line is just as bored and frustrated as I am, and that some of these people probably have much harder, more tedious or painful lives than I do, overall.
Again, please don't think that I'm giving you moral advice, or that I'm saying you're "supposed to" think this way, or that anyone expects you to just automatically do it, because it's hard, it takes will and mental effort, and if you're like me, some days you won't be able to do it, or you just flat-out won't want to. But most days, if you're aware enough to give yourself a choice, you can choose to look differently at this fat, dead-eyed, over-made-lady who just screamed at her little child in the checkout line -- maybe she's not usually like this; maybe she's been up three straight nights holding the hand of her husband who's dying of bone cancer, or maybe this very lady is the low-wage clerk at the Motor Vehicles Dept. who just yesterday helped your spouse resolve a nightmarish red-tape problem through some small act of bureaucratic kindness. Of course, none of this is likely, but it's also not impossible -- it just depends on what you want to consider. If you're automatically sure that you know what reality is and who and what is really important -- if you want to operate on your default-setting -- then you, like me, will not consider possibilities that aren't pointless and annoying. But if you've really learned how to think, how to pay attention, then you will know you have other options. It will actually be within your power to experience a crowded, loud, slow, consumer-hell-type situation as not only meaningful but sacred, on fire with the same force that lit the stars -- compassion, love, the sub-surface unity of all things. Not that that mystical stuff's necessarily true: The only thing that's capital-T True is that you get to decide how you're going to try to see it. You get to consciously decide what has meaning and what doesn't. You get to decide what to worship...
***
And I submit that this is what the real, no-bull- value of your liberal-arts education is supposed to be about: How to keep from going through your comfortable, prosperous, respectable adult life dead, unconscious, a slave to your head and to your natural default-setting of being uniquely, completely, imperially alone, day in and day out.
***
And the world will not discourage you from operating on your default-settings, because the world of men and money and power hums along quite nicely on the fuel of fear and contempt and frustration and craving and the worship of self. Our own present culture has harnessed these forces in ways that have yielded extraordinary wealth and comfort and personal freedom. The freedom to be lords of our own tiny skull-sized kingdoms, alone at the center of all creation. This kind of freedom has much to recommend it. But of course there are all different kinds of freedom, and the kind that is most precious you will not hear much talked about in the great outside world of winning and achieving and displaying. The really important kind of freedom involves attention, and awareness, and discipline, and effort, and being able truly to care about other people and to sacrifice for them, over and over, in myriad petty little unsexy ways, every day. That is real freedom. The alternative is unconsciousness, the default-setting, the "rat race" -- the constant gnawing sense of having had and lost some infinite thing.
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