Just What I Kneeded

A llama, an Elmslie and DeNovo.


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Random camera pictures

I take way too many pictures with my phone. Half of them are just extra shots taken in quick succession so I can capture the action. You’d need a magnifying glass to pick out the differences in some. I then go back through and delete pictures like crazy because no one needs three shots of the same image, and let’s be honest, I don’t really need most of the pictures I’ve taken. They’re not anything that I’d print out and hang on the wall. But I thought I’d share a few here. For no reason.

Re-paved road in park.

Who knew new pavement was so awesome?

This picture is über exciting. That’s new pavement on the main road in my favorite park. It’s so smooth! And so fast!

Deer in the park.

Deer.

I always have my phone with me on my rides, and I managed to snap this as I breezed by some of the deer in my favorite park. You can’t stop completely to take the pic because then they get all suspicious and run away, so this is the best it gets when I’m on my bike.

Barn cat named Tarzan.

Tarzan. The (not so) wild man.

This little dude is Tarzan. He and his three siblings (Moxie, Batman and Tiny) were born early this spring in the horse barn. I was doing chores one weekend morning, and I heard what I thought was one of the barn swallows screeching. On further inspection, I figured out that a stray cat had given birth to a litter of kittens in the back of the hay stack on the floor of the barn. Tarzan was so named because he was absolutely wild when he first started venturing out into the world. We couldn’t get close to him, but we could pet and play with his siblings. That’s all changed, and he’s now the most ridiculous of the bunch. He comes to you immediately when you enter the barn, and you spend the entire time in the barn tripping over him. His purr is the loudest I’ve ever heard. As you can see, he likes to take selfies.

Llama in front of fence.

Studly.

The most important thing about this picture is not the gorgeous llama. It’s the equally gorgeous fence behind him. Look at how straight it is! I built that damn fence with my bare hands.

Nephew on the playground rock wall.

Little monkey.

This little monkey is my five-year-old ‘phew. If anyone asks, he’s not my favorite. I love my niece and all my ‘phews equally. For the most part. He’s the only kid on this planet that has made me pause longer than 10 seconds and think that maybe I need to have my own kids some day. He gives super ultra mega hugs of doom. What is a mega hug of doom you ask? Well, he runs to the other side of the room and then runs full speed right into you and tries to squeeze you to death. Depending in whether he catches you standing or sitting, he’s fairly successful in squeezing the breath out of you.

Girl on a horse.

The niece riding Pie.

I took the niece and the ‘phew to the farm a few weeks ago, and my niece rode Pie for the very first time. I think she might be hooked. The ‘phew wasn’t quite convinced he wanted to get on Pie, but he was really excited about taking pictures of his sister from the other side of the fence. This is one of the 57 masterpieces he took that day. What bothers me most about this picture is that my niece is only 7, and her feet almost fit into the stirrups that were set for me.

That’s it for now.


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Side effects

I mentioned a while ago that I was taking Celebrex in a last-ditch attempt to find some prescription help for the knee. My OS isn’t a big fan and explained why he doesn’t typically prescribe Celebrex. Then he went on to say that a handful of his patients with cartilage degeneration had found some relief with the medicine, so he thought it might be worth a try since I can’t stomach any of the narcotics that were prescribed, and the injections didn’t work. We plain don’t have other options.

At first, I didn’t think there were any side effects. It was the first medicine that didn’t make me nauseous or otherwise destroy my GI system. (I would much rather deal with daily pain than some of the GI problems caused by the prescription narcotics and NSAIDs that I’ve had in the past.)

I started having weird symptoms over the last three or four weeks. My shins itch like crazy, and there is no rash (which made me think I really was going crazy). I thought maybe the pool water was drying out my skin, and I started slathering on the lotion (“It rubs the lotion on its skin, or it gets the hose again.” Anyone?). I wasn’t convinced that was the problem because I’ve been swimming for more than six months now with no issues, but I didn’t have any other ideas. Then, a little over two weeks ago, I started having extreme dry mouth. At first, I thought I was dehydrated–simply not drinking enough water. The dry mouth persisted for a few days and grew bad enough that I had to try to figure out the problem because drinking 100 oz of water a day wasn’t getting rid of the dry mouth. My tongue was sticking to the roof of my mouth and my teeth, and it was getting raw.

Turns out, both itching and dry mouth are potential side effects of Celebrex. I finished the last of my prescription, so I’m going to wait to get a refill. I’ll see if the itching and dry mouth go away. I might not ever get a refill because I can’t tell for sure that the Celebrex was helping my knee. Even without side effects, there is absolutely no reason to take a drug that’s not helping. We’ll see. In the meantime, I’ll just keep swimming.


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Brunch

Over the past six months or so, I’ve started a new “tradition” with the niece and the ‘phew. I take them to Sunday brunch when I’m in town visiting. I usually let them pick the place, unless I’m in the mood for something specific. Then I try to sway them, but I always tend to lose that argument. Their favorites are Dunkin Donuts, Panera and Bob Evans. They’re little donut fiends, but I’m not really into fried dough, so I’m trying to expand their selection a bit. The ‘phew likes the pumpkin muffins at Panera. “Aunt Laura, I’m kind of a huge fan of this!”

This whole brunch thing is a fairly enormous step for me. I’d never gone anywhere alone with them before last spring when they were almost five and seven. For seven years, I’d always had one or both of their parents along, so I wasn’t responsible for… anything. Suddenly, I’m responsible for EVERYTHING for those two hours while we brunch. The first couple of times caused heart palpitations. It’s not that they’re bad kids; they’re actually pretty great and generally well behaved. It’s just that the responsibility for two lives is frightening. What if something goes wrong? Anything could go wrong!

My ‘phew is old enough now to go into the bathroom on his own. For obvious reasons, I can’t accompany him in to the men’s room. But letting him go into the restroom all by himself the first time that he was with me was terrifying. There might have been any number of problems in there. There have been reports of crocodiles in toilets, you know.

Panic aside, I have a fun time with the kids. Though I have yet to finish my food without help from at least one of them. My ‘phew gobbles up his food, announces he’s stuffed full (“Aunt Laura, I cannot eat another bite!”) and then asks me for the last half of my waffle less than two minutes later. My sister keeps telling me that I can say no. But she’s wrong. I can’t say no. I try sometimes, but it always ends in yes.

Pig pancakes.

I think it’s a little creepy that the pancakes look like a pig, and there’s bacon sitting RIGHT THERE.


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The secret shame of swimming

I’ve been swimming. A lot. Over the last seven months, I’ve worked up from barely able to complete three laps to being able to swim three miles  (105 laps) in one session. That qualifies as a lot.

I’ve also continued to bike a bit and to do my PT exercises a couple of times a week.

What’s bothering me at the moment is that I’ve managed to gain weight, even though I’ve been more active in the last three months than I’ve been most of the last three years. The difference is swimming. I think. I’ve never been a swimmer, and I don’t think I’m a particularly efficient one now.

Admittedly, I love my fro yo and other things that aren’t particularly good for me. But my eating habits haven’t changed much while I’ve added exercise, so I would expect that I would at least maintain, if not lose, weight.

I started looking into this because it’s annoying me. I’ve gained less than five pounds, but it’s still annoying to see the scale head the wrong direction.

I haven’t yet found any real research, but it does seem that there is some controversy out there about swimming and weight loss. I didn’t start swimming for weight loss; I started because it’s pretty much the only thing that I can do without hurting. So the anecdotal “evidence” might not totally apply to me, but it still has me wondering.

First, there’s the possibility that I’ve gained weight because I’ve built up some muscle mass. I don’t think this is the answer, despite the fact that there has certainly been positive changes to my right VMO. I haven’t seen enough of a change to warrant weight gain.

Second, there’s the idea that you have to work a lot harder to burn calories in the pool because you’re not towing around your whole body weight. Not sure on this one. I suppose it could be true that I’m not burning as many calories swimming as I do when I’m doing other exercises, but I’m never in the pool less than an hour. Plus, I’m not carting around my own weight when I’m biking. I’d need to know more before determining if this is the problem for me.

Third, there’s the idea that the cooler water in the pool sucks the energy right out of you, making you feel hungrier afterward because the body is trying to warm up (eating is one way to do that). If you’re not careful, you might overeat or eat more than you even realize. I don’t know what I think about this one either, at least as far as it relates to my own situation. As I said, I do get hungry after I swim, but once I realized this, I’ve been careful to drink water first and then eat a snack. It’s also much less of a problem for me now that I swim at night rather than in the morning.

There’s a lot of people with a lot of differing opinions, and most of them are just that–opinions. All I know right now is that I’m annoyed. I need to figure out how to lose the weight I gained before I gain more and start looking like a marshmallow. I think I’m going to start switching up my exercise in the pool. I’m going to do more speed work and try out a few different strokes. I’ve been focused solely on freestyle because I know that one won’t hurt the knee too badly, but I think it’s time to try something new. I think I need to get back to strength training, too. It’s just that there are only so many hours in the day, and I’d have to give something up to be able to do more. It’s a delicate balance between what I want to do and what I probably need to do. Bah! It shouldn’t be this hard.


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Teenage Dream

If I’d had a bucket list when I was a young teenager, going to see Garth Brooks in concert would have been near the top. I was a big fan back then, and I knew every word to pretty much every song (he did have a few songs I hated–hello, The Fever–and therefore didn’t know the words). I used to put the kid I baby-sat down for her nap to the tune of Somewhere Other Than the Night (probably not the best song choice for a three-year-old). But I never got around the seeing the man in concert before he “retired.”

When I heard a few years ago that Garth was going to be playing shows in Vegas, I thought immediately I’d fly out there just to see him. That didn’t happen because I’m not a millionaire and tickets were hundreds of dollars.

But now he’s officially “unretired.” His last kid just graduated high school, so now he’s back at it. So I obviously had to get tickets to one of his opening shows in Chicago. (On a related note, I hate the process of buying concert tickets anymore. There’s too many robots set up to grab tickets, and you’re left with what you get. We were lucky to get pretty good seats, but it was for the second show of the evening that didn’t start until 10:30–that’s 11:30 Indiana time. We didn’t get to the hotel until about 3a.)

Garth went and got old. Not really old, old. But old enough that he can’t sprint around the stage and sing at the top of his lungs quite like his did when he quit some 13 years ago. Good news is that you could tell he wasn’t lip synching; he missed words because he was so out of breath. Occasionally, I wondered how much of his staring at the crowd in apparent awe was genuine and how much was because he needed to catch his breath. Ok, I’m being a little hard on him. I couldn’t do what he did–he put on a full-out, no holds barred concert. And it was awesome.

The beginning worried me that Chris Gaines was about to make an appearance because there was a lot of weird man vs machine stuff going on. Reminded me of a Schwarzenegger movie. I couldn’t understand a single word of what he said/sang. Luckily, that all ended with the first song. Then he launched into all the old favorites.

Unlike Cher, Garth didn’t do any costume changes. But he did keep switching his guitars. He had one guitar that was pretty plain and had a “B” marked on the lower side. At one point when he strapped that one on again for the umpteenth time, he said the crew called that one the “safe guitar.” Safe because it was never turned on. “I just use it to hide my gut!”

He owned the stage. So much didn’t change from the concerts that I’d watch on NBC. I don’t know why, but I remember they were on NBC. He also owned the fact that he’s slowed down just a hair. He was trying to catch his breath when he said, “Guys, I’m, like, 114 years old now. You gotta give me a break!”

His wife, Trisha Yearwood, who I think is hilarious and awesome came on stage in the middle of the show to sing a few songs and, I think, allow Garth to sit down for a minute. She didn’t stay on long enough because she didn’t get around to singing Walkaway Joe. Though, they apparently did this song on opening night.

At one point, about 90 minutes in, I turned to my sister and shouted that the only thing missing was the confetti (a reference to my recent awesome experience at an Ok Go concert). Less than two minutes later, confetti guns were going off. Seriously. They shot confetti and unfurled streamers all over the audience.

At the end, the band came out for an encore. To my dismay, they played the one song of his that I truly hate–hello again, The Fever. I was so disappointed to be leaving on a  lame note. But then! Garth came back out by himself and took audience requests. Two of the songs he sang were She’s Every Woman and The Red Strokes. Two of my favorites.

I’m so glad I went. Check that off the bucket list that I don’t have!

Garth Brooks at Allstate Arena in September 2014.

My first glimpse of the man in the flesh.

Just thought his face was funny in this one.

Just thought his face was funny in this one.

Garth Brooks sings The Thunder Rolls.

This was during The Thunder Rolls. Watching the rain pouring down.

Garth Brooks and Trisha Yearwood at Allstate Arena.

Garth and Trisha not singing Walkaway Joe.

Garth Brooks at Allstate Arena.

This was as risky as he got climbing on things. This was during the first encore when he was singing that one awful song.

Sleepy.

Someone was sleepy. You should not fall asleep in my car, no matter how late the night before was for you.

 


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24

Today marks two years–twenty-four months–since my DeNovo NT cartilage graft and tibial tubercle transfer (the Elmslie-Trillat, to be exact).

I thought I might write something to mark the occasion, but… I’m not sure that I have much to say. As you know, if you’ve read this blog at all, the last two years have been full of ups and downs, but there have been mainly ups the last few months. I’m continuing to slowly improve, at least as far as my ability to build strength. The pain shifts around a bit–hurts more some days and less others. I captured most of what’s going on in a fairly recent post about my positive progress. I’ve been able to do much more this year than I even hoped this time last year.

I suspect that, if things continue to go well, this date will come and go next year without a second thought. That’s the goal anyway. To put it all behind me.

I think the best update I can give right now is that I’ve been spending more and more time with the horses. They’ve been sadly neglected (as in they’ve been running around like fools free on pasture) this summer because there has been so much work to do with the llamas. But their show season is almost over, and I’ve had more time to work with the horses. There’s a TON of work to be done, but we have to start somewhere. So I started with a spa day for Pie.

Pie.

Pie after her first bath (took about five hours to do all the grooming and bathing). I fear she’s gotten stained this summer because she didn’t come out exactly white.

After she had her pampering, I decided it was time to try to ride. I haven’t been up on the horses since about this time last year, and it hadn’t gone well, so I was a little worried. But it went amazingly well! I was able to not only ride, but post the trot. That means I was able to pivot up/down through my knees while Pie trotted in slow circles. It wasn’t pain free, but I could do it. So exciting! I think this proves that I’ve been able to build back some of the strength in my leg because I could barely ride a walk last fall. I thought maybe the first time was a fluke, but I’ve now been on four rides, and each one has been fairly good. Lots of taping, elevating/icing and Celebrex, but I CAN RIDE.


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Rare bird

A few weeks back, I had X-rays taken of my knees and legs. Don’t worry; there have been no new symptoms or a worsening of symptoms. I’m still in a pretty good place. In fact, I’m doing the best I’ve been doing in the two years since surgery. I’m just trying to work out why I still have so much pain doing certain activities, especially since some of the activities cannot be avoided or are actually kind of important parts of life. I can’t avoid stairs all the time, nor can I (unfortunately) avoid vacuuming my living room.

Good news is that my knees look ok from a radiographic standpoint; there’s no compartmental arthritis that has caused joint space narrowing or anything like that. Not so good news is that I’ve been subconsciously favoring my “bad” leg for so long, there are radiographic changes in my right tibia. The doc pointed to the X-ray showing my legs side-by-side and showed me the difference, which was pretty easy to see.

The left leg is normal (an opaque, whitish color on the image). The right leg shows radiolucency (dark bone when it should be whitish).

The doc indicated this is because I’ve favored/protected it for so long because of the pain that the stresses aren’t enough to keep the normal metabolic process going. You need to stress a bone to make it strong. Mine looks weak on film.

I was surprised to see that there were radiographic changes; I wasn’t aware that was something that could happen in my case, though I guess it makes sense. I think it also validates that the knee hurts. Duh. My brain likes to protect the things that hurt, so my body adapts new ways of doing things. I’ve talked about the incorrect movement patterns and the way I walk with my foot curled in at length. None of it is something I consciously do. At least not anymore, if it ever was conscious.

Side note. After I heard this, I started doing research… as usual. According to the Department of Radiology at the University of Washington, a person must lose 30-50% of bone mass before it shows up on a plain X-ray. That sounds great. Just great.

After looking at the X-rays, I’m pretty much sitting there just staring at the doc. I wasn’t exactly sure what he was telling me. I mean, I understood his words, but I didn’t understand what it meant. He said “you’re only as strong as your weakest leg,” so we still need to work on that a bit. Build back the strength. But first, he wanted me to work on ROM… again.

I was measured at only four degrees off of extension and had full flexion, so it didn’t sound like much of a big deal to me. Regardless, I was told to do nothing but work on getting full extension back. I was given three stretching exercises to do five times a day for two weeks. I was also told to do no more walking than absolutely necessary; I could continue with the bike and swimming but had to limit walking. You know that means no more Challenge Route.

I was a stellar patient (I can’t often say that since I frequently take things into my own hands), and I walked back in to the clinic after two weeks of stretching and had regained full ROM. That it had been accomplished without an exacerbation of symptoms was great.

I was really taken by surprise with the next steps. I had to build strength, but first I had to be tested so they had a baseline. I didn’t realize right away that this meant testing with the big, scary machines that I’d always been told would hurt too much to use for my case. Holy chipotle.

I was tested on both legs doing both leg extensions (ouch!) and leg presses (not as much ouch). Turns out, I am exactly equally deficient in all four ways they tested. Seventeen percent across the board. I was told that’s pretty uncommon. Most people are deficient in one or two areas, but few are equally deficient across the board. I’m no longer surprised when I hear things like this. I can’t tell you how many times my doc or my PT has said I don’t follow the book or I’m not like most people in how I move/compensate/function. This latest rarity apparently makes me the “poster child for a deconditioned knee.”

All of that to say… I guess I’m back in PT. Sort of. I’ve been given two exercises to do at home that are intended to help build strength until I go in again in about four weeks. At that point, my strength will be tested again. Joy of joys.

I have so many questions right now. How can the strength test be accurate when it hurts so much to do leg extensions in the first place? How are two simple exercises with relatively low weights going to make up for a 17% deficit in four weeks? I wish I’d thought more quickly and had these answered while in the clinic. I think I was so floored by the fact that I had to do strength testing that I couldn’t think of much else.

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