Ouch

My PT put me through my paces in what may have been my final appointment. My hamstrings are aching now. I'm exhausted too. He decided it was pointless to stretch my hamstrings since when he raised my leg, it went almost to my head, and I barely felt it. My leg feels more solid, when he did the strength testing, the only part that was still weak is my hamstrings, but that's to be expected since I just started working on my hamstrings a couple weeks ago. But my quads, abductors, adductors, etc. were all 4+/5. Quite a big difference from where I started. My ROM is awesome after I get warmed up. He had me bend my legs to compare sides, and the other therapist who was working with a different patient goes "It doesn't look like you have a bad leg anymore. When did that happen?" So I'm happy with the progress. I feel lucky that my recovery has been pretty uneventful, and relatively easy. I had heard such terrible horror stories before I had the surgery, I was afraid that I would be still on crutches after 6 months, but I think I had the right combination of amazing surgeon, awesome therapists, and luck on my side.

If you gotta be something...be unique

When I asked my therapist about the PCL vs. ACL, he said that he has treated about 100 ACL post ops, and I am his third PCL post op patient. Quite a difference. I guess my therapist didn't have much experience with PCL's, but he's a very smart guy and knew what to do and what not to do. He graduated about 8 years ago, so in that time, I am his third PCL.

I am a rare breed :)

Earlier, I was looking for the address of my orthopedist's office, because I have a follow up on Wednesday, and I always forget what street he's on. Well, I started perusing his website, and came upon a link for his publications, and I found a few relating to PCL tears, which I thought was pretty cool. I found one article, pubmed link and read through the abstract. What struck me was not the results or clinical significance, but this part: "Between 1980 and 1997 [corrected], 29 patients underwent surgery for isolated PCL injuries at our institution. " That's the same institution where I had my surgery done, which means that in a 17 year period, only 29 patients had the same surgery as me. Granted, that was a long time ago, but the article only came out about 3 or 4 years ago, so there should be some sort of clinical relevance. And this isn't some rinky dink hospital, I went to the Hospital for Special Surgery, which is always voted as number 1 in orthopedics for something like the last million years out of all the hospitals in the country. All they do is orthopedic surgeries. Meanwhile, when it comes to ACL repairs, the hospital website claims that they do over 800 ACL repairs PER YEAR! They probably did in 1 week as many ACL's as they did PCL's in 17 years! How insane is that? And that 29 patients is not the number of patients done by the surgeon himself, it's by all the surgeons at the hospital. I'm glad I didn't know that before the surgery, I'm not sure I would have gone through with it had I known it was that uncommon. 

lumps and bumps

Thanks guys for giving me a day off!

Lucky me, I had the day off today because it's a holiday, and I was told to stay home. You don't have to tell me twice. So how did I take advantage of this rare day off? I went to physical therapy earlier this morning. I did have to share some unwanted news with my therapist though, I don't think he was too pleased with me. A few days ago, I went to examine my patient in the emergency room, who happened to be a little kid sleeping in her stroller. The first thing they teach you in pediatrics is to get down to their level. The second thing they teach you is to let sleeping children lie. If they're sleeping, it's the perfect time to do a heart and lung exam, if you try to wake them up, they're going to scream and cry. So I knelt down to listen to the heart and lungs, and that was the problem. I forgot that I can't squat that far down. I honestly just forgot that my knee can't handle it, and there was a very loud CRACK when I squatted.

My attending in the ER heard the crack, and he insisted on taking a look at my knee, and according to him, it wasn't loose, which was good. It did though feel a bit strange in the back of my knee, when I would do the hamcurls, it would feel like I was bending my knee over a ball or something. So I told my PT about it, and he took a look at it too. He thinks the crack may have just been some scar tissue, but I may have broken the scar tissue so forcefully that there was some inflammation in that area, or possibly some scar tissue just got loose and that was that ball sensation I was feeling. He did some heat, ultrasound, and stim to the back of my knee, hopefully it will get better soon.

Otherwise, things are going pretty well. My parents are awaay on vacation, which means I'm walking the dog 4x a day now, and so far so good. The only frustrating thing? I woke up the other morning to this:

My hammies exist!

Yesterday was an exciting day in PT. I graduated to being able to use the hamstring machine! It was very excited, even though it was rather uncomfortable. My problem is that because I have so much atrophy in my operated leg, it's hard to evenly distribute the weight between my 2 legs, so I ended up upping the weight so that I am near the max that my good leg can do on its own and then my right leg was forced to pick up the slack. Not sure if I'm explaining that very well or not though... But boy was I sore when I left. Still, it's fun to keep going in the right direction.

I asked my PT about how much longer he thinks my OS will make me keep going. He said that from his standpoint, the only reason for me to come to PT is for strength training, my flexibility is really good, and my ROM is good too. I see my surgeon in a couple weeks, so hopefully he can give me some insight on how much longer I need to keep going to therapy for. My therapist thinks there is a good chance I will be cleared to run when I see the surgeon in a couple weeks, fingers crossed that will actually happen.

I also just started an emergency medicine rotation, and I am actually pleasantly surprised with how well it's holding up. Sure, it's sore, and I do get some swelling by the end of the day, especially when I go to PT after the hospital, but it's pretty manageable. And it feels strong, which is what I'm most excited about. It feels stable. I'm on my feet all day, running all over, and I don't feel any giving out or instability. It's always a shock when I get home and realize that my knee didn't give out all day. I still don't think I'm used to it, but that's a good thing.

My therapists are trying to kill me!

I was starting to like my physical therapists, I really was. And then they tried to kill me today. They added all new exercises to my repetoire, and I ended up so sore afterwards, I swear, they do it on purpose. Instead of doing step ups, they now had me doing this move where I stand with my operated leg on a step, and then keeping my other leg straight, I bend my knee to bring that leg to the floor. Ouchie momma. And I was using the small little step too, not the regular sized steps. And after that, squats, but I was told to squat lower than before. And then lunges, oy vey the lunges. I'll admit, I have a little phobia of lunges, I was doing a lunge on the ice once, hit a rut, and ended up with a nasty concussion. Granted, these lunges were not as deep as the skating lunges, and I'm in a more controlled setting, but still, there is always a little hesitation before going into a lunge.

I apparently bend like this dude.

And the table work? Nope, not satisfied with my old stuff, he added weights to the hamcurls (1 pound, but still!) and made me do bridges, and increased the weight on the leg raises. I was doing 5 pounds, and this time, he bumped me up to 7.5 pounds. I don't know how my leg managed to stay on after all that. And then came the stretching. The other therapist, the one who is normally nice, she came to stretch me because the one who normally stretches me was busy with another patient. She wasn't aware just how flexible I really am. So she was trying to stretch my hamstrings, and put my leg on her shoulder, which I guess for most patients, is enough, but I couldn't even feel it. So then she gives me a "look" and goes further and further. When she had my leg past a 90 degree angle, and I still wasn't feeling a stretch, she says to me "I think you must be the most flexible patient we have. How is it that he always manages to hurt you? You're so flexible, you're like Gumby. I can't do anything to hurt you". Apparently, my lack of screaming in pain from stretching made me uninteresting. The novelty of being her only PCL reconstruction patient has worn off, and that no longer makes me interesting. I used to be interesting just because of my surgery. But not anymore. And I'm too apparently too flexible to make the stretching interesting. So it appears that I am now useless.

Give me a month, and I will look like that.

As for other exciting stuff? I start a new rotation on Monday, Emergency Medicine. Hopefully it will go well and my knee will hold up well. And I also signed up for a beginner belly dance class, starting at the end of March. Should be low impact, but looks like tons of fun. And hopefully, it will help me get back into shape. It's a bit of a different workout, but I can't wait for it to start.

Looking at the positive....

The other day, I was complaining to my friend about my PCL surgery and rehab. No one has ever heard of a PCL, very few people have experience treating PCLs, the rehab is slow, long, and boring, and you have to always explain what it is. But mainly, it's the rehab being slow and long and boring. For the first 6 weeks, I wasn't even allowed off the table at PT except to ride the bike. I had to use the crutches to get anywhere, and I would see all the people with ACL's come in already walking for their initial eval after surgery. Didn't seem fair to me. Well, when I was done complaining, he says to me "Look on the bright side. If you ever need to have your ACL done, the rehab will seem like a walk in the park". He does have a point.

And more positive, I was given permission to try to find my hamstring today. I think it may still exist, somewhere. I just need to find it. Maybe I"ll send out a search team for my hamstring.

One day....

One of these days, my knee will be normal again. Until then, I have those moments where I briefly forget I had surgery, and then I out of habit will try to curl my legs under me when I'm sitting on the couch, and end up with a lot of hurt. I must remember not to do this.

My PT told me that I will start trying to find my hamstrings on Monday. I tried to use them today, just to see what would happen. The answer? Not much. I was standing, and just tried to bend my leg. Didn't exactly work, my leg just didn't go anywhere. I think I listened a little too well when my doctor told me not to use my hamstrings, because now, they just don't exist anymore. I had some measurements done at PT the other day, and there is less than a centimeter difference between my knees, but I do have a weird lump over the lateral incision of my knee. It's not painful, just lumpy. My thighs, there is still a couple cm difference, but it's likely more from hamstring atrophy than the quads. My quads are getting stronger and stronger though. I am up to 20 pounds on the knee extensions, and 5 lbs when I do leg raises, probably go up to 6 or 7 pounds on Monday. I'm walking at a speed of 2.8 on the treadmill for 10 minutes, and I ride the bike at a resistance of 6 or 7 for 10 minutes as well. I don't feel unstable when I walk, which is awesome. Before the surgery, I would feel like my knee was slipping everytime I took a step, and it would give out on me constantly. Now, I don't have that sensation, so it definitely feels more secure. I still can't go and walk a marathon, it still is not second nature to walk and I feel it, but it's not painful, more of uncomfortable.

My boyfriend thinks that when I go to PT, it's more of a gossip session than a therapy session. I'm one of the youngest patients they have, the therapists are not that much older than me, and the aides are around my age, so I have a lot of fun when I go there. The people that work in the office are I guess on the younger side, my therapist is probably in his early-mid 30s, the other therapist is 31, and I'm 25, so I'm not that much younger than they are. But I guess it's good if you like the place you're getting your PT from, sure we gossip, but I can gossip and ride the bike at the same time! Multitasking!

And now, with Superbowl Sunday coming upon us, I am not sure who I'm rooting for. I somehow got suckered in to entering a Superbowl bet at my physical therapy office, I had to buy in for $10, and the winner is determined by the score, it's some weird system and I'm not exactly sure how it works, all I know is I bought a square, and someone will tell me if I win. Come Monday, I might be $500 richer :) Course, if I did win, all that money would go right back to them because I'm paying $15 per session as my copay, but still, it would be nice to win something.