After A Long Respite... I Am Back

My biggest fear was not ever being able to run again.

I had to take a break from blogging last spring. When I started this journey of surgery and recovery I thought it would take me a year to get myself back in form. I am relatively young, healthy and a fast healer (so I thought). Whoever said "life is what happens to you when you are making other plans" was so right on. My life was definitely not in my control. All I could do was push forward and hope for the best.

I had been planning on being back racing by summer (not fast but being able to complete a significant distance). I wanted my Ironman that I had lost in 2008. I just wanted to finish but surgery #2 took away all that. By the the end of August all I could do was cycle was 2 hours and my running was limited to 75 minutes. These times were not anything that was imposed on me by my doctor or PT, this is what literally my body told me was enough. So being a smart girl, I dropped the Ironman from my schedule.

Recovery from the second surgery was far easier than the first. After the initial 4 weeks, I was able to increase my resistance on the leg press by 40 pounds (on my surgical leg) in the next two weeks. Originally, I was told I would be running by mid to late June. I took my first strides on a treadmill in May. The running felt ridiculous and I was winded after 10 minutes. It was a start.

I progressed enough to be able to race my first triathlon, a sprint, on August 18. I ended up finishing 3rd, 7 minutes off my time the previous year. My run pace was 7:35 per mile for the 5K, a respectable time.

My real breakthrough this year did not even involve triathlon. I signed up with a team to run Dances With Dirt in Hell, MI. It is a 50k team relay. I ran about 13 miles over trails and through mudholes that went up to my chest. The last leg I ran, I had to drag "lefty" up the remaining hills because my muscles had basically called it a day. However, no matter how bad I felt after I finished, my leg was intact and after this race I finally started feeling that everything was going to be alright.

I have decided to continue bloggin but I am retiring this one in favor of a new one. I need the clean break from the surgerical issues that I have had over the past year. The new one is going to be a fresh start, more conditioning and (hopefully) racing. I still have a long way to go. The left leg is still smaller and I run with a funny gait sometimes. And my endurance is definitely not Ironman ready. But I have a renewed sense of hope that all of this is now behind me.

Getting Bored

I am having a love-hate affair with the leg press. Right now, I can press 65 pounds with my left leg. This is compared to the 130 that I was pushing prior to the second surgery. I need to hit at least 120 to start running again. It is a bit frustrating because I try to push but I'm hitting a wall. What people don't always realize is that after a surgery, muscles around the area tend to shut down. With the knee, it is the quads. It takes about 6 weeks for the muscle to regain the neuromuscular function and to start getting bigger. So no matter how much weight I try to push, there is no getting around these 6 weeks. The compounding effect of 2 surgeries plus and injury may make make strengh gains proceed more slowly. Only time will tell.

In PT I'm doing pretty much the same as I have been doing: Leg press (single and double leg), hip flexion and extention, calve raises, balance drills, squats on an unstable platform. I started working on going down stairs. Right now, I can go down step over step if I have a handrail. I just don't have all the strength back in order to lower myself under all my own power. Even with this muscle weakness, I have to say that this is the best I've done going down stairs since my injury last August. I'm not very fast but I'm better than I have been.

On a brighter note, I got back into the pool on Monday. The first 1000 yards it felt like I was swimming in mud. After that, it got a little easier. It will still be several weeks though until I get my strength and endurance back in the pool.

The Toughest Thing About Recovery...

...is being patient.

The major difference between these two surgeries (besides the actual type of surgery) is the fact that after this one I feel so good. I am just waiting for my body to catch up with the rest of me so that I can start training. At this point after Surgery 1 I was still dragging my leg around with me. Now I can officially do stairs. At least going up. Going down requires a lot of weight on the hand rail.

Two weeks out from surgery: I have full range, less swelling and mushy quads. Just the quads. Everything else is still strong. It will get better but it is going to take a while. I've been told by my PT that June 15 is the day I can go back to running. So long. I'll be on the elliptical before then and that is almost like running. Sort of.

I'm in PT twice a week right now and I fit in one extra day of lifting on my own (just to give those a little extra oomph). The other days I've been on the trainer pedaling away. The more I pedal the better it feels so as long as I keep the resistance low I can spin, spin, spin.

Another thing I am dealing with is some swelling around the port sites that do not want to go down.
I got the idea from PT to start adding some extra compression with gauze and tape.

Then I place the compression sleeve over the entire thing. It just helps to keep everything down. Yesterday, it looked like it was starting to go down so I ended up leaving the tape on overnight. The only time I have been taking it off is to do my stretching because the tape pulls on the main incision and it is still a little tender.

I've got a great collection of compression stockings and sleeves. This one is from Zensah but the main ones I use are just some cheaper compression hose that I got from PT that you can cut whatever length you want. They come in different degrees of compression so I tend to wear a lighter compression one at night.

Post-Surgery Update And A Photo of Beans

I do not have children... yet. It's just my cat in the background that sounds like a crying baby.

This is what I have to tell people when they are on the phone with me.

This is my first update since my most recent surgery. I admit, I've been a bit lazy, a bit busy, but mostly just exhausted. This whole process to get my knee back healthy has been a little more than I was originally prepared for. However, this most recent bump in the road may have been just what I needed.

It all started last week the Monday (March 29) before my surgery. I found out that I needed authorization for the surgery. This wouldn't have been a big deal if I had found a little sooner. The insurance company originally told us we didn't need it. Then, two days before surgery, they told us that I did AND that it usually takes 72 hours to RUSH an authorization through. I was in tears and beyond stressed. To top it all off, the insurance company told us that I wasn't even authorized for my first surgery even though they had paid for it in full. Talk about lack of communication. Eventually everything got straightened out, my authorization done in under 72 hours. The day before surgery I found out everything was okay.

After that, surgery was nothing. This was done by the same doctor, but in a different hospital site. This site had a TV so Aaron didn't have to entertain me the whole time. This time I was also allowed clear liquids and black coffee up to 6 hours before surgery. I really think that helped to make a difference because I didn't feel so bad coming out of surgery. I went in at 3pm (I even remember them putting the oxygen mask over my face) and woke up a little after 4pm feeling great. In fact, I felt amazing. I had no pain. For the first time since my injury, my knee felt right. While I was waiting for the doctor I started bending it up and straightening it back out, just to see how far it would go. It turns out that I had a very large cyclops lesion (I was right!!!). The doctor manipulated the knee (bending and and straightening it and cutting out scar tissue) and took out the screw. The screw was working it's way out on it's own and I was forming bone around it. The incisions were placed in the same place as the last time so I won't have any new scars. I couldn't have hoped for an easier time.

The next two days I headed to physical therapy. Dale went really easy on me the first day. Lots of gentle movement, some straight leg raises and then hooking my quad up to electric stim. The day after that, I did a little more. Some squats on the shuttle press, calf raises and more stretching.

This week is when things started to get tougher. I got to do some serious strength training. Most of the swelling has gone down and it actually makes walking harder because my quad is so weak and my balance is really bad. I am actually more afraid of falling now than I was last week. I did leg press, dead lifts, tons of squats and cycling. I was so sore and tired midweek that I could hardly get myself off the floor. It isn't even the muscles that I am trying to train. My right leg is actually more sore than the left. It takes all the work than the left can't do.

My leg press weight is really bad. I think that I topped out at 55 pounds this week. I need 125 ideally to start running again. My doctor told me that at the earliest I could start back running 4 weeks after surgery. I'm hoping than since I have been doing so much strength training these past few months that my muscles will bounce back faster. I'm scheduled for PT two times a week for the next month and I plan on doing a third day of lifting on my own. Last time 3 days of lifting per week got my strength back in about 6-8 weeks.

Scar Tissue, Manipulation, and Screws

I went for my pre-op appointment with my surgeon yesterday. From looking at the MRI he doesn't think that I have a cyclops lesion. I looked at the images myself and I THOUGHT that I saw one. It wasn't really obvious. I had to look at them several times and reference online before I located it. We'll find out who's right when he goes in next week. There has to be something there. Why else would my quad be atrophying?

So I'm scheduled for scar tissue removal, manipulation (this is when they bend the hell out of your leg to loosen up everything) and... screw removal. Apparently, these screws (used to hold the new ACL down in the beginning) don't dissolve as well as they are supposed to. Mine seems to be working it's way out of the bone. Fun. My surgeon says that in the best case scenario, they are able to just use a screwdriver and back the thing out. This idea has me more creeped out than the manipulation. I was tempted to just tell him to leave it in but I remembered a woman who had several screws put in after a knee surgery. Her body was rejecting the screws and she was having a lot of difficulty getting the strength back in her leg. He's going in anyway, might as well get the darn screw.

I've been cleared to start physical therapy the day after surgery. However, my doctor warned me about pushing to hard after surgery. Part of the reason I am going to PT is because if left to my own devices that is what I am likely to do. Also, my big fear is not being able to get full motion back in my knee like last time. I am not going in for another surgery so what I get after this one, is what I get.

Well, At Least I Can Swim

It is a little over a week until I go back in for surgery. My knee has calmed down quite a bit now that I'm not doing things that make it unhappy. That means I have had to cut out the leg press and forgo any aggressive stretching until the scar tissue is taken out. Running in any form is out, this includes the elliptical. I can still cycle indoors but the only thing that I seem to be able to do without any restrictions is swimming.



So I have been swimming and swimming and swimming a lot. This is the most that I've done since before my first surgery. I know that I am going to have to take a couple weeks off from swimming after the proceducre. I'm trying to get as much training in now so that maybe I'll bounce back faster once I can get in the pool.



We had a couple of our cats, Strider and Beans, farmed out to be watched by another family while inspections were being done in our apartment complex. It got delayed so they ended up being gone for 5 days. Beans had a great time playing with his friend, Oliver. Oliver was the cat that we had watched a couple weeks ago. However, our other cat, Strider, refused to eat during that time. He holed up in a room by himself for days at the house. The person who was watching them is my husband's coworker. He started calling him Ghandi. The day before we went to pick him up from the house, Strider disappeared. They searched their house. We searched their house. No Strider. We started calling him Houdini. Yesterday he was finally found by Oliver, holed up near the ductwork in the ceiling of the basement. Poor little guy. He was so thin and sad when we finally got there to get him. Now that he is home, he's eating well although he's still a little skittish. I guess we'll be having in-home house sitters from now on.

Get It All

I'm a bit calmer today after resigning myself to the fate of another incision. I now know what to completely expect: the pain, the stiffness, the swelling. This time should be different. This time it should turn out better (or so I am told). What I am finding out this time is that I'm not that afraid of the surgery, it is the rehab that has my stomach in a knot.

I'm returning to the site of my last clinical for my rehab. I stopped over there yesterday because after contacting Dale he told me to rule out a meniscal injury. I really didn't think it was that because I didn't have the symptoms in the right place. Everything that is clicking and grinding is right underneath the kneecap. Right now, scar tissue looks like the culprit. My patella has adhered down and is not moving well. And if your kneecap doesn't move, neither does the rest of the knee.

So I've been told, if the surgeon is going in, make sure he gets EVERYTHING and that I get full flexion and extension with surgery. Remind him several times, if need be. Apparently, my body likes to make scar tissue so removal of the offending stuff is crucial along with early mobility of the knee. Remembering from last time, it is going to kill. However, I am hoping that the pain tolerance I have developed from rehab after my last surgery is going to carry over to this time.

Later on, I got my MRI taken. This time, they made me wear a gown (no safety pins flying out of my pocket this time!) and I didn't get any music to listen to. Just ear plugs. I only had to go in partway because it is my knee that they were looking at. I spent my time trying to figure out all the buttons on the machine. I found the emergency stop buttons. Those were bright red. The whole thing was done in about 30 minutes and I got to leave with a copy of the images. I tried to look at them this morning but I can't see much. It looks like there is some tissue under the kneecap. I found my new ACL. It was near the PCL. The reason I found it is because it doesn't look "normal". It is where the ACL would be but it looks different and there are suture lines in it. Or something like that. As long as it holds, I'm fine with it.

I head back to the doctor in a week. I don't expect him to change his mind on surgery. And unless there is a way to take a chisel to it, I don't expect the scar tissue to disappear on its own.