Just What I Kneeded

What happens after a life-altering knee injury?


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Motivation is hard to find sometimes

I am no closer to not resembling a couch potato than I was when I last posted after a 5k in March. I did do the 5k I’d signed up for on April 2. Despite the BLOWING SNOW through the whole race, I actually made my best time yet, but it was also my first road race (read there were no real hills). Regardless, my current strategy of running exactly once a month–at a race–is clearly working.

Not really.

But sort of.

Seriously, who does this? Not smart people, that’s for sure. A friend of mine was incredulous after I told her about the last race, “How do you even do that? Just go out and run  5k?” I think it may simply be my stubborn streak.

I decided after the last race (yes, if you’ve been reading, it’s like the fifth time I decided) that I need a plan. For a variety of reasons, I’ve stopped doing pretty much anything active for the last four months (aforementioned one race a month doesn’t count), and I know I need to get back to it. I feel the need to get back to my PT exercises now more than ever because the knee is aching on days when I do nothing. I think the down time was good for the knee for a while, but even it has had its fill.

I made it my goal this year to do one race per month–12 total. I’ve managed to do the first four by the skin of my teeth. Now, I’m going to plan a bit better. I have the next two races planned–a 5k in May and a quarter marathon trail run in June. I’ve done both distances already this year, so I’m not worried about finishing. I am, however, worried about finishing with an intact knee. I can’t blow it now after all the blood, sweat and tears that I’ve expended rehabbing it over the course of five years.

So… I spent time this past weekend putting together a plan to get back to doing my PT exercises. I also ordered a Bosu ball and helped a friend make me a slant board so that I can do some of my most important exercises at home. Not completely sure why, but actually getting to the gym feels like such a burden right now. But it doesn’t (read shouldn’t) matter because I can do nearly everything from home. I also found a good online yoga practice, so I can start doing yoga at home, too. I’ve done it twice already, and, um… I’ll be easing back in to that. I’ve lost an awful lot of strength while sitting on my butt.

I also ordered a new pair of running shoes. I tried them on in the local running store, and they felt like I was seriously walking on clouds. I couldn’t stop smiling while I was wearing them around the store. But the price was a bit steep for me, especially for a pair of shoes that might not get all that much mileage. I had to leave them in the store. But then I found them online for nearly $50 less. I ordered them immediately, but I have yet to receive them, so we’ll see if that deal was too good to be true…

I hope I’m headed in the right direction. I certainly feel more motivated than I have in a long time. Maybe it’s because spring feels like it might actually arrive this week, and that has me feeling pretty happy.

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Fresh air

Do you ever get the feeling that you can’t breathe? That no matter how hard you inhale, no matter how much air you pull in to your lungs, it’s not enough? A feeling that you’re suffocating, even when you’re breathing? That pretty much sums up how I felt for most of September. I need October to be different. To be better. I need to be able to breathe in the fresh, crisp air of fall and feel that my lungs are finally satiated.

I started the month with a nasty staph infection. The infection and double antibiotics used to treat it knocked me on my ass for weeks. I felt awful. I was exhausted. I took more sick leave in the first two weeks than I have in the last 10 years (excluding time off for knee surgeries). When I did go back to work, it was exhausting. I would go to the office, work for eight hours, come home to sleep for four hours, get up for dinner and go right back to bed for the night. It’s only been in the last 10 days or so that I’ve really felt like myself.

Somewhere in there, my little brother–someone who is so much like me, it’s scary– and his wife suffered through a miscarriage. It was devastating. I hate seeing people hurt and knowing there is not a thing on earth I can do to ease their pain.

Then. Then my dad passed away early last Friday. It was unexpected. And it blindsided me. Even after I got the call that he’d been admitted to the ICU, I didn’t think the end was near. But he was there barely more than 48 hours before the doctors told us he’d suffered extensive and irreparable brain damage. He was not breathing on his own. I watched and wept as they removed the life support, and he took his last breaths. Now, I find myself tearing up at the most random times. When I see a guy with a grey beard standing in front of me in the grocery store. When I hear a certain song on the radio. When someone softly says, “Oh, I just heard…”

I know that things will get better. I know that time will march on and the pain of the last week will eventually fade.

But right now, I need a chance to catch my breath.


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My staph to bear (or why I will never celebrate Labor Day ever again)

Labor Day weekend has, historically, not been good for my general health and wellbeing. I’ve been sick over the holiday weekend numerous times. Eight years ago, I had emergency surgery over the weekend. And this year, I’ve been battling a nasty infection in my abdomen. So you can see there’s a trend.

No clue from whence this infection came. I noticed a red streak on my side about 12 days ago. I touched it, and it was slightly tender. Being the person I am, I then promptly ignored it and baled hay all afternoon. It was worse the next morning, but I had another busy day at the farm, so I ignored it. On the third day (Sunday), I figured I needed to see a doc, but it wasn’t an emergency, so I went canoeing down the White River. Monday morning came, and I left a message with the doctor’s office, still rather nonchalant–just thought I might need to have it looked at or something.

The nurse called me back five times and left three messages saying that I needed to be seen ASAP. I went. The doc prescribed an antibiotic, told me to watch to see if it got worse, made an appointment for Wednesday and sent me on my way.

Over the next 48 hours, I didn’t think it was getting better, but I didn’t think it was worse. I told the MA as much when she was taking my info at the follow-up appointment before the doc looked at it. When the doc did get eyes on it, the infection was proclaimed “significantly worse” and we were now “fighting to keep you (me) out of the hospital.” Ok, doc. You now have my attention. That was the first time I really thought anything of it. Geez. I didn’t know.

The doc cut open my side to get the abscess to drain, packed the wound, showed me how to do dressing changes, put me on another antibiotic, made an appointment for Friday and sent me on my way.

I don’t do that well with blood and guts. It’s a good thing this is my body because there is no way that I could care for it on someone else (sorry future kids). The doc packed it with some kind of tape that stunk to high heaven (I think it was soaked in iodine or something), and I had to let it stay there. That was difficult. Dressing changes are not awesome, and this was way worse than any incision I’d ever had after surgery.

The infection itself is bad enough, but the antibiotics are an even bigger drag. I suffer strong side effects from most medicine that goes in to my body, and antibiotics are the WORST. I’m glad I’ve passed the half-way point on this course. I haven’t been able to do any exercise at all, much less do any preparation for the triathlon that is now less than a month away.

After four appointments with my doc in the last eight days, two antibiotics and numerous dressing changes, I can now say that I’m officially on the mend. I have to let the wound heal from the inside out, meaning that I can’t swim for who knows how long. That’s frustrating me. I also won’t be doing any other exercise until I finish up these meds because I can barely function. I feel like someone stole all my energy, down to the last drop. Like an energy sucking vampire maybe.

In the meantime, I keep thinking of that Chumbawamba song… “I get knocked down, but I get up again. You’re never gonna keep me down.” If you were a child in the 90s, I suspect you now also have it stuck in your head. You are welcome.


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Shake it off

I was going to title this “Haters gonna hate,” but I was informed no one over the age of 15 uses that phrase, except Taylor Swift. Pfft.

I’ve been at this knee thing for five years now. Almost. It will be five years at the end of March. In the beginning, people in my life were all really positive and spent lots of time cheering me on. I had all the help I needed in the first weeks after the big surgery, and people would go out of their way to be encouraging. I had people asking after me, and I wondered how they even knew about my knee. I was always thankful to have such support, and it was difficult to be anything but positive when so many people surrounded me with optimism.

Then came the last year. Some people in my life, though very well meaning, became downers. I was struggling quite a bit last year, and some people thought the best approach was to begin telling me that maybe I just needed to accept the knee was as good as it was going to get. I understand they were trying to be helpful, and they didn’t want to see me hurt. Except I wasn’t ready to throw in the towel, and I didn’t take it so well. It pissed me off.

It also motivated me. I wanted to prove them wrong. I wasn’t ready to believe that I wouldn’t be able to do simple things (like sweep my floor or go up/down stairs) without eliciting pain. I also still didn’t want to believe that I wouldn’t compete again, but that was no longer as worrisome as not being able to live everyday without pain.

One of the naysayers was my primary OS. He told me in June that he didn’t think there was anything else to do for the knee and that I needed to consider that this was maybe as good as the knee was going to get. I appreciate that he’d run out of ideas and was being honest with me about that, but I took it as a challenge. And I proved him wrong over the course of the next six months. Even if I get no better from here on out, I’m definitely better than I was last June.

I’m not writing this to be all “in your face!” (I like my primary OS, and I certainly wouldn’t be here without all the good work he’s done.) I’m writing this for the folks who might be reading and who have their own naysayers. Don’t listen to your critics. Well, you can listen to them, but prove them wrong. Whatever is going on right now, it’s your journey. You can let people help guide you along the way, but it’s ultimately your decision how you move through life. Make your life about you and not about what other people think, especially when they’re loudly whispering in your ear that you can’t do something.


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Holy shit

I sent my PT a progress report last week, and I told her that I really wanted to put “holy shit” in the subject line of the email. I didn’t because I thought it might get flagged as inappropriate, and the email was important. But this is my blog, so I get to title this post whatever I want to title it.

But why the title? Why the email? I’ll tell you why! Because I’ve never made such significant progress in such a short amount of time… ever. I don’t even know that I should be sharing this progress out loud in case it’s a blip or something, but I’m too damn happy to keep it to myself any longer.

The eccentric exercises and the Graston-like (but done with the handle of a reflex hammer and by myself) work that I’ve been doing for the last two-ish months seems to be helping. Like a lot. Over the past two weeks, I’ve been able to do the eccentric phase of the single leg press with 105 lbs with minimal pain. And the eccentric single leg extension with 35 lbs through the ENTIRE ROM with minimal pain. Can we just take a minute to appreciate that last sentence? Not the part about the weight–that’s kind of lame yet–but the part where I’m suddenly able to do a single leg extension through the entire ROM. I have not been able to do that since the initial injury nearly five years ago (five years in March). In fact, I would elicit pain just straightening my leg when in a seated position. It’s not entirely pain free, but it’s a huge improvement.

I do the exercises after I’ve been in the pool, so I completely warmed up. I’m still having lots of trouble on the stairs, but I think it might be because I do those cold. I’m hoping that the improvements in the gym carry over to real life.

So, yeah, 2015 is just full of possibility at this point.


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Suck it up, Buttercup

It’s been nearly three months since I updated on the knee. It’s about time I bring y’all up to speed. Much has happened.

I wrote in September that I’d had an x-ray, been diagnosed with some bone loss and a “deconditioned” knee. Then I started another round of PT that began with regaining ROM followed by strength building. (This was a new doc and a new PT. I’d given up trying to get my surgeon to own that he’d fixed the cartilage problem as best as it’s ever going to be fixed–a good thing– but that there was something else that needed to be addressed. He just seemed to be focused on the cartilage.)

We started with single-leg extensions with a 5-lb ankle weight and single-leg press with 60 lbs. Those low weights were all I could do without eliciting significant pain, even though the strength test indicated I could do much more (but there was pain with the test). I worked up to 30 lbs on the leg extension and 90 lbs on the leg press in the first four weeks. I thought I was doing pretty well, despite increasing pain.

After the second round of strength testing (four weeks after starting the exercises), I was told that I should push harder to add weight and that I should push through the pain to do so. Ok. Bring it on!

In the next four weeks, I added another 60 lbs to the single-leg press (150 lbs total) and another 10 lbs to the single-leg extension (40 lbs total). At some point during this round, my knee started hurting when I was in the pool–even a simple flutter kick elicited pain. I’d never had much pain while in the pool, so I should have called it off at that point. But hindsight is 20/20, and I had a PT encouraging me to push through all the pain (suck it up!).

After the third round of strength testing showed that my numbers on BOTH legs were decreasing for the leg extension (because pain!), we decided it was time for another chat with the doc. I was, once again, not following the normal pattern of progression.

Doc said I was trying too hard to get the strength back (that’s going against what his PT said, but whatevs). I asked very specifically if we were sure that it’s the cartilage causing the problem. My thought has been for a very long time now that there is an issue with the patellar tendon; I’d even discussed it with my surgeon seven months ago, but he didn’t agree after a cursory exam. New doc said he would be disappointed if there was something else wrong with the knee (me, too!) but that he wanted to send me for an MRI to make sure since my last imaging studies (MRI, bone scan and CT arthrogram) were done 18 months ago.

New MRI taken a month ago showed a number of things. Cartilage fissures and subchondral cysts on the weight-bearing surface of the lateral tibial plateau were unchanged. There is a new fissure on the mid medial side of the lateral tibial plateau that is already more than 50%. There was a lot of info about the cartilage behind my kneecap–there’s thinning in a few areas under there, but largely unchanged since the last scan (all indications the graft is doing ok). There is arthrofibrosis or a joint body in the intracondylar notch near the tibial insertion of the ACL. There is scarring of the infrapatellar fat pad (Hoffa’s fat pad). And, wait for it… patellar tendinopathy.

I met with the doc after the MRI. I was concerned about the new cartilage fissure. I don’t think there’s pain from it because I couldn’t have said there was a new fissure or any other new problem on the lateral tibial plateau. But I was worried that there was a new fissure even though I’ve only been doing PT and low-impact activities for the last 18 months. He indicated that the degenerative process has started in the cartilage, and there’s just not a whole lot that can be done to stop it. I’m not going to make the problem worse, but I can hasten the process if I do high-impact activities like running. Good thing I’m not a runner.

We talked at length about the patellar tendon. He said it’s not an inflammatory problem (it’s a degenerative problem), but he thinks it’s worth pursuing PT geared specifically at addressing the tendon. He said surgery is not on the table because the degeneration is so widespread. If I were, say, a basketball player with a focal defect, he could go in and cut it out. The tendon would heal. I don’t have a focal spot that’s bad; it’s all bad. I’m glad we’re not talking about another surgery, but I’m not happy that there is such widespread damage in the tendon. I don’t want to dwell on it, but I wonder if the damage would be so bad if we’d addressed this specific issue when I first asked about it.

I’ll write more about what we’ll do for the patellar tendinopathy in another post.