Graduation!

So again, not about my knee, but my knee has been doing so good, it's basically a non issue at this point. Tomorrow I have the first day of my graduation, and on Monday, is just the medical school graduation. I am so close to being a doctor, it's crazy. I signed the lease to my apartment today, which has the most amazing closets ever. And with tomorrow being graduation day it's even crazier. I can't believe that I started this journey nearly 4 years ago and there is actually a light at the end of the tunnel. In a couple months, I will be taking care of my own patients, having actual responsibility. Pretty insane.

As far as my knee goes, like I said, it's basically a non issue. My knee isn't stopping me from doing anything. There is an almost like conduction delay, where I tell my knee to jump, and it takes a little bit longer for the signal to reach the muscles, and I am still working on the proprioception, but it's all workable. We just came back from a trip to Aruba and we hiked to the natural pool, which is very rocky and very slippery. I managed and my knee wasn't a problem, I just had to go slower to be sure I had my footing. But I made it and had an amazing snorkeling experience.

Sorta running?

So today was a milestone in my rehab.... today was the day I went out for a run, sorta. I am on a family medicine rotation right now, and I always hear teh doc tell his patients how important 30 minutes a day of aerobic exercise is, and how he runs 5 miles a day on the treadmill and has managed to lose 50 pounds so far. Well, I wanted to do something about it too. So I woke up this morning with every intention to go for a run. I set my alarm for earlier, and I woke up early. Looked out my window, and it's gray and gloomy and looks like it's about to pour. guess I'm not running this morning. So then, I go to work, and we get out, I get home, and it's still light out. Woohoo!

I quickly changed, didn't even put my clothes away, threw on my running shoes and went outside. Talk about deconditioning. At first, I just kind of stood there, unsure of what I'm supposed to do. I think my muscles just forgot after oh...  5 months of not running. So I started walking quickly. Hey, not too bad! And then I tried to start running. Not too bad, it certainly felt more stable than it did from before the surgery. Pain wise... there seems to be more pain now than before, but it's still too early to tell, and my knee still hasn't recovered 100%. The problem though is that my gait is completely off. I would take a short stride on the bad, right leg, but then a more natural long stride with the left leg. So then, my left leg was taking a pretty strong beating because I would pound my left leg with more force, since I wouldn't transfer so much weight onto my right, if that makes any sense. I realized this, and I tried to correct it, but it was really difficult.

I remember when I was learning to walk again after surgery, I had to try to really exaggerate the stepping motion with my right leg to actually get it into a normal stride. My PT explained the reasoning behind it, but I don't remember it now. So even though it felt like I was really exaggerating the motion, it wasn't a particularly huge motion in reality. So I tried doing that, trying to exaggerate my stride so that it started to feel more natural. But then I started getting the pain behind my kneecap, a similar pain to when I first started walking.

What ended up happening is partly from the issues with the stride and my good, left leg taking a beating, and partly fitness issues, but I would run for about 30 seconds and walk for about a minute. I think my "run" was actually slower than my walk, just because I was trying to figure out my gait again. But it did feel good to be back out there.

Just call me Sabeehah

Back from belly dancing, and my knee is actually starting to look normal most of the time. The lumpiness over the lower lateral incision is going away. It seems like I've kind of stalled at the discomfort level, when I get to the last few degrees of flexion, it't still uncomfortable, and it doesn't seem to be getting any better. It's not a prohibitive pain, but it's definitely noticeable. And if I try to keep my knee at full flexion for more than a minute, it starts to get stiff. I'm doing as much strengthening as I can, flexibility was never an issue for me. I don't have access to a gym, so I'm doing what I can with ankle weights and resistance bands. I got adjustable ankle weights so that as I get along further in the rehab, and I can go with heavier weights, I won't need to constantly buy new weights. Definitely something that is recommended. The ones I have are adjustable from 2 pounds to 10 pounds. I was warned not to do straight leg raises with weight that is more than 10% of my total body weight, and I'm not going to post my weight online, but I have enough in ankle weights to eventually get to that point.

I do have some medial joint pain in the knee, and it's irksome, but not enough to make me want to see a doctor for it. Maybe I should, but I figure I've just been working out more, putting more stress on the knee, and it's hopefully just an adjustment period and once I get back to the high level of activity, my knee will get used to it and then it won't bother me.

But the belly dance classes I started, those are so much fun. I am having a blast doing it. We started last week, and it's such an amazing workout, and so much fun you don't realize what a good workout it is. It's hard too, I've been using muscles I didn't know I had. I'm not saying I'm great at it, in fact, I'm probably pretty darn terrible at it, but a lot of it is in the attitude I think. Fake it til you make it. We were told to channel our inner diva, and so I decided that means I need a stage name. I found a website that lists middle Eastern dance names for belly dancers, and I wanted to get one that had the same first letter as my real name. And so I found Sabeehah, which means "beautiful lady with a fair complexion". Oddly appropriate, I think. So next week when I go to the dance class, I'm not going to be myself, a somewhat nerdy, constantly fumbling, almost pediatrician... I am going to be Sabeehah! Master belly dancer, diva extraordinnaire! Graceful as a swan, beautiful arms, beautiful legs, hips and chest moving in isolation.

My foot did something strange

So my foot did something strange last night while watching a movie. I was lying on the couch, and just trying to bend my knee as much as I could, and then all of a sudden, my foot felt something that was a bit soft but harder than the couch cushions. Yep, my foot touched my butt yesterday! My housemate didn't realize what all my excitement was about, he thought I got way too into the movie we were watching. When I explained that I hadn't been able to bend my knee like that in 4 months, he still didn't get it. Then again, we're only living together for this month while we're rotating at the same hospital. It was too late to call anybody, so I took my excitement to bed. This morning, it just didn't feel nearly as cool, especially because when I woke up and tried it again, I couldn't do it. I need to be warmed up to get it to bend that far. But eventually, it will come back. After all, it wasn't all that long ago that I could only get to 90 degrees with my therapist pushing hard, and then all of a sudden, I got to 90 myself, and then when trying to get to 120, it was the same thing, I could only get it if my therapist pushed hard, and then I got it myself and without needing a warm up. So soon, I'll get there.

Bye bye crutches

I gave up using my crutches a while ago, but I held on to them just in case. Just in case what, I don't know, but I figured I should keep them for some time. Well, I haven't used them since my doc gave me the all clear from them, so I finally threw them out today. Put them outside, said tootle-loo. I wanted to take a picture of them, but by the time I thought of it, and went back outside, they were gone... guess someone walking past decided they could use a pair of crutches. Oh well. Still is very exciting. I kept my brace for now, not sure why. I think maybe I think I might need it just in case I tear my PCL again? Dunno, but that will probably go when I move for my residency.

Out on my own

Even though I've only just been released from PT, it feels odd to be on my own. It's almost like going to PT was a safety net. If I was worried about my knee, I could always have him look at it and reassure me that it's nothing wrong. Now, I'm on my own. Now, every little bump and crack makes me nervous. I know it's silly, but it just does. So what exercises do I do at home on my own?

• straight leg raises on my back, my side, and my stomach
• ham curls
• lunges with weights
• squats with weights
• leg presses with resistance bands
• leg extensions with the resistance band tied around a pole
• straightening my knee with the resistance band wrapped around my knee and a pole

I am really happy I had the surgery done, I think it was the right decision. I'm still not 100%, and wont' be for some time yet. But, it's getting there. When I start my residency, I shouldn't have any problems running around the hospital. The scars are fading, the swelling is gone. My gait is normal, I can go up and down stairs. I still get pretty stiff, especially in the mornings, or when I'm sitting for a while, and the while I can get to full flexion, the last few degrees are still not very comfortable. But at least it's not painful like it used to be. 

And just for a visual, here's a picture of my knee that I took the other day. It's looking relatively normal. 

Day 100...and freedom

Today is day 100 after my PCL reconstruction, and it's significant in several ways. First, I decided I need to thank my donor for giving me a chance at a normal life again, and in Asian cultures, a baby gets a name on the 100th day of life. Being how I am a huge sushi fan, and I love Korean BBQ, I am going to name my new knee on day 100. I have decided on calling it Neela. Say it out loud, Neela. Get it? I hope nobody thinks it disrespectful, but I named my cadaver when I was in my first year of med school, and since I don't know my donor or anything about them, at least this way, they can sort of live on.

I also saw my surgeon today, and he was quite pleased with my knee. I am too. He told me that after I was put under anesthesia, and they examined my knee, my knee collapsed and it was graded 3+. Right now, I'm at about a grade 1/2, and I feel a huge difference in stability and pain. My knee used to give out multiple times a day, now, by the end of the day, I realize that my knee hasn't given out at all, and the pain is much improved compared to how it was before the surgery, so I consider the surgery a success. He also told me that if I am able to do rehab at home, I can stop going to PT. My hamstrings are still weak, but I wasn't able to use them for 12 weeks, so that's to be expected. I can work on that on my own though.

Afterwards, I took the train back home and then went to the therapy office. I bought them a bowl of chocolates to say thank you to everybody, and say goodbye, and let them know that I was released from their clutches. I got a very warm reception. Lots of hugs, lots of I'll miss yous, lots of Be sure to visit us again. I now have the tee shirt to prove that I am a PT graduate.

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.

Back from vacation

So I came back from my cruise vacation yesterday, and it was brilliant. First, the knee stuff. Overall, it was pretty good. I wore the brace on the flight down to Orlando, and I had quite a bit of pain and swelling on the plane, I guess from the pressure changes. But I was able to sit in the bulkhead, which was nice cause it meant I had extra leg room. Once we got to the airport in Orlando, I had a wheelchair take me to baggage claim because it was a long walk over there. Got our bags, and found our shuttle to take us to our 7 days of rest and relaxation. The people at Carnival told me that I could get a wheelchair at embarkation, but being a platinum cruiser, I had VIP boarding anyway, and got to skip all the lines. Which was nice, because the lines were long by the time we got there. I did have to get a pat down at the cruise terminal, but they were much nicer about it at the cruise terminal than they were at the airport.

We got on board, and went straight to lunch. I kept the brace on mainly because I had nowhere to put it, since our rooms weren't ready until 1:30. During sailaway, I skipped out on the traditional dancing, I didn't think it would be smart for my already swollen knee. I bought a spa pass, which was great for me knee. $150 for a week pass, and it was the best $150 I ever spent. Our dinner table was in a great spot. Our ship has 2 dining rooms, one in the middle of the ship, and one in the back of the ship. Since I knew I would have to minimize my walking, I had requested a table for 2 in the middle dining room, since it was closest to my room, nad we got what I had requested, and also very close to the door, and no steps to walk up. I definitely appreciated that.

So like I said, overall, the knee was OK. When we got to the ports of call, we went to the beach, and walking over the sand was difficult, as was climbing into and out of the water with all that sand. I think I underestimated just how difficult it was going to be. On one of our stops, I was having a lot of pain, and it felt like my knee was almost subluxing, so I ended up wearing the brace as it was a long walk down the pier, but the beach was right off the pier. I think it did help somewhat, although trying to keep it free from sand was annoying. I did wear the brace around the ship every now and then when it started swelling a lot and making these cracking noises.

Whenever someone saw me with this big ole leg brace, people asked me of course what had happened. I think most of them thought it had happened on the ship. So after I told them I had surgery, they of course all had to show me their knee scars too. It's like it was some secret club. Everyone felt the need to show me their scars, and tell me their stories. Although going along with the slightly older clientele on this cruise, I think everyone I met had knee replacements. I also kept up with my rehab as much as I could. I went to the gym almost every day. I learned in the afternoon, it's much quieter, the only people at that time are the dancers and entertainment staff, and the older people. I didn't feel quite as bad riding the bike with a resistance of 3 when an 80 year old was next to me, as if some incredibly fit 20 something sat next to me thinking he was the next Lance Armstrong. And the dancers, well, they're so focused on themselves they don't care what anyone else is doing.

It was fun when I saw the staff in their though. There is this one guy that runs the comedy club on board, and he sat on the bike next to me, and had his script that he was reviewing for his warm up before the comedians come out. He was fun to talk to, and let me hear some jokes from his warm up that night. I also saw the cruise director there once. These people are like mini celebs on a cruise, so I got a kick out of seeing them there, almost like I was seeing someone famous. Usually, after the gym, I would hit the spa. They had this mineral pool, it was nice hot water, with jet streams and what not. In there, I would usually do some leg extensions, knee extensions, lifting my leg, and walking up and down the length of the pool. Stuff like that, that my PT told me to do. And then of course, I would just melt into the relaxation after that was done. From there, you hit the steam rooms and saunas. I can't tell you how incredibely relaxed I would feel after that. I made sure to make an ice pack after the spa though, because the first time I didn't, my leg got very puffy. But it was brilliant, that spa is the best invention ever. Besides the mineral pool, there are 2 different steam rooms, and 2 saunas with heated tile lounges. I could have spent the entire week there. And the showers in the spa were amazing. They had shower heads that came out from the sides, and misted, and all these other settings. Loved it.

Speaking of the mini celebs I saw in the gym, there were some real celebs on board. They were shooting "Alvin and the Chipmunks 3: Chipwrecked" on my cruise. Jason Lee was on board, as was the guy who plays Ian Hawke, and of course the Chipmunks and Chipettes. We were asked to sign up as extras if we wanted, and on the last day, my boyfriend and I got called to be extras. It was fun, but I'm not sure if I would do it again. It was a very long day, it was cold, and we had to be in shorts and tee shirts. "My" scene is at a Chipettes concert, make sure you look for me :) I can't say the filming bothered me at all, they were really nice about answering questions for anybody even if you were just watching the filming, explaining what was going on, how things work, how they later do the animation, stuff like that. And they in no way took over the ship, they would close off only a small part at a time. Besides, with all them filming, there was less people competing for deck chairs. The only problem was that in the scene, we were supposed to be dancing. I kind of bounced around as my dancing, but after a while, my knee started getting really sore and swollen. After about 7 hours, I asked the background director if I could leave. We already did the parts where I was near the principals and he was moving us around to fill in the stage so they could shoot the concert from another angle. He was really great about it and said "You can leave anytime you want. This is your vacation and we're not paying you. We're thankful for whatever you give us". So for all that, all I got was a drink card, which was valued at $6. Still it was an experience, and maybe I'll see myself when the movie comes out.

I met the biggest celebrity on the ship: ALVIN!!!

Leaving on a cruise ship

Tomorrow, I leave for a wonderful week long cruise. My bags are mostly packed, boarding passes printed out, passports found. But of course, before I go, I had a PT session today. I think I had a break through today. I somehow reached full flexion. I'm not quite sure how that happened. It wasn't comfortable, and I couldn't hold it there, my foot would slide out, but he sat on my foot and kept it at full flexion. The thing is, I don't think I was all that excited about it, I was much more excited when I got around on the bike or when I took the brace off. Now, it was just like, oh, cool, I got full flexion.

My therapist had his student with him again today, and I was telling her how I know that I must have made some progress, because when I first went on the bike, I could hardly make it around, and I was going very slowly. I had to rock back and forth before I could get my knee around, and my therapist had to help me push it around. Now, I can just hop on the bike like it's nothing. I don't know why, but every time I go on the bike, it amazes me how just a few short weeks ago, it seemed impossible, and it seemed like this whole rehab business would never end. It seemed like I would be stuck doing the same exercises, staying at the same place for months and months. Instead, 2 months on, I can fully bend my knee after being warmed up, I can hop on the bike like it's no big deal, I can walk on the treadmill at a brisk pace, I can use the quad machines, started doing wall squats.

My plan for the cruise is to do as many of the exercises that I can do as possible. I'm going to aim for every day, but I can't guarantee that will happen. He did tell me to try to swim because that will be a great exercise for my knee, and I can do a lot of my exercises under water which will help build up the strength, but not put as much pressure on the knee. Lucky for me, the ship I'm on has some special pool in the spa that is supposed to promote healing, it's got minerals and jets in it or something. So I plan to do what I can in there. Hopefully I won't fall too far behind on my rehab.

My home for the next week!

Not quite....

Yesterday, I posted that I thought my knee was going to be stiff and barely able to bend because I was in bed for the past few days being sick. Well, my therapist must have magic hands because he got my knee to almost full flexion, I missed full flex by about 3 degrees, which is nothing!! But, it's not quite full flexion. No clue how that happened, but I'll take it. It's not comfortable getting to that point, but it doesn't hurt quite as much as it used to. I guess that means I'm healing? I'm starting to become a normal person again.

I think the word is freedom

Today was a huge day! I took my brace off!!!! The big ole clunky brace came off my leg, and I survived!! Technically, the brace should have come off tomorrow as that is when I am officially 8 weeks post op, but I had been walking without it at home, and I figured there isn't much difference in a day, so I went to the mall, and bravely left the brace at home. My knee feels so stable, that I'm not quite used to it. I'm used to my knee always giving way on me, every step being wobbly and shaky. Now, I still have a limp because I still haven't quite figured out this walking thing, but I feel so much more secure, my knee doesn't feel like it's sliding around. By the time I came back to my car, my knee was feeling quite a bit sore, and I did have more swelling than normal, which is to be expected. But the soreness is not in the same place where I was having pain before the surgery, most of the soreness now is around the quad tendon area, before a lot of the pain was on the medial side of the joint line, and I think the soreness is just from weak muscles. Tomorrow, I plan to walk into PT wearing my yoga pants which are a little bit more figure flattering than the baggy pants that I've had to wear because of the big brace.

On the bad side, I was sick all weekend, laid in bed for about 3 days straight. I didn't do any of my home exercises, so my knee feels very stiff now. I tried to work it as much as I could earlier before I went to the mall, but I'm afraid that when I go to PT tomorrow, it just won't bend as much as it did before. With this rehab, it seems like if you miss a few days, you fall behind pretty easily. My leg definitely feels weaker than it was on Wednesday, because I haven't done any leg lifts, no quad sets, no exercises with the theraband. I guess it's true if you're just lying in bed for 3 days normally, but I guess I noticed it more because of the atrophy in my leg. Hopefully it won't be too bad tomorrow.

All alone in therapy

We got hit with a little more snow last night into this morning. It really wasn't that bad, and the streets were cleaned much faster than it was after the blizzard. I went into the hospital this morning for my rotation, and then back home. I knew today I was going ot be in the hospital later, so I scheduled my PT for later in the day. I got out earlier than I expected, so I called and asked if I could come in a few hours earlier. I have never seen the therapist that excited.

I walked into the office, and it was filled with the staff, but absolutely no patients. One hand therapy patient I think, and that was it. Apparently, the average age of the clientele happens to be in their 80s, and most of them just go to PT cause they don't know what else to do. I work mainly with "Boss Man", but there is another therapist there as well that I have seen a couple times when he was unavailable. Lets call her "Nice Lady". "Boss Man" had a student with him, and "Nice Lady" was bored out of her mind, so she kept me company while I went around doing my exercises. I don't think I ever laughed so hard in my life. I have no idea how many sets of 10 I did because I just couldn't keep count. She kept going on and on about how she wants an invite to my wedding next year. Only thing is i'm not engaged yet. Hmm... maybe soon.

So today I worked with "Nice Lady", and while she was stretching me, she let me in on a little secret. Apparently, "Boss Man" loves it when I come in and he grabbed me as soon as I called to make my initial evaluation appointment because I'm young and have an orthopedic injury, and I'll actually get better, unlike a lot of the elderly patients that are really there because the docs don't know what else to do with them. She said that he "salivates" when I'm coming in because I have a real injury and I don't complain about the pain involved or having to do too much. I always knew I was their favorite patient :)

The other advantage of being the only patient and being stretched by "Nice Lady" instead of "Boss Man"? We were able to put what we wanted on TV. Which meant we could turn off ESPN and put on "Say Yes to the Dress". "Boss Man" was teaching his student something, and there was only 1 male PT aide there, so he was quickly outnumbered by the rest of us that wanted to watch "Say Yes to the Dress". Much easier to have my knee bent when I can watch people choosing pretty dresses, or laugh at the terrible dresses they chose.

Anyway, rehab is coming along pretty quickly now, which I'm really happy about. I had an interview on Tuesday, and I made it  the whole day walking without the crutches. And interviews are long days, so I was really glad that I was able to make it the whole day without any pain. And when I came home from the interview, I had some great news that made any pain go away. I just can't say what it is yet! But I am at 130 degrees of flexion actively, and 135ish passively. I'm using heavier weights on the leg raises, I worked up to 5 pounds at my last session. Today, I started doing step ups on taller stairs, and I started doing leg extensions on the machine set at 10 pounds, using both legs. The bike is no problem for me anymore. I started the treadmill as well, but only at 1 mile per hour. The sad thing is, the treadmill tells you how many calories you burn, and in the 7 minutes I went on the treadmill, I burned 9 calories. That's how slow I was going, but it was fun.  Or maybe because I was on the treadmill talking about chocolate melting cake....

It's pretty crazy that when I first started PT, I thought I was going to be doing this boring stuff forever. The bike used to be torture for me, and I would have to rock back and forth before I could get my leg all the way around. Now, I can just hop on and go, and I can actually turn the bike on by pedaling, and keep it on, which is new for me too. I'm getting able to do more and more things, and it seems like the rehab is just going on at lightening speed now. Or maybe that's just because for so long, I couldn't do much off the table, and now I have much more freedom.

I leave for a cruise next week, and I promised I would do my best to go to the gym and do some exercises on the ship. I have to use the bike, walk at grandma speed on the treadmill, do leg extensions if the machine has a low enough weight (no more than 10 pounds of weight right now), as well as a lot of my floor exercises. This way, I can try to avoid losing any flexion. I might still lose a little bit because I'm not going to have someone pushing my leg to the absolute breaking point, but hopefully it will only be a couple degrees that I would be able to get back really fast.

6 weeks and change

I am just over 6 weeks post op. I already mentioned how I'm cleared to walk and weight bear, and the brace comes off in 2 weeks. The same day as my appointment, I went to physical therapy, which was great. I got to do a lot more stuff because i was finally cleared to weight bear. My knee is starting to look like a normal knee, the scars are starting to fade.

In PT, I started doing some exercises with those stretchy rubber band things, started doing step ups, and some other stuff that I can't remember. There was a PT student at the time as well, and my therapist was just running through some basics about the knee, using me as the example. He explained to her what the different scars are from, and was telling her why he likes his job so much, because you can really see people get better. Apparently, I was "really bad" when I came in fro the eval, I only had about 15-20 degrees of extension, and saying I had 60 degrees of flexion was being generous, and my knee looked like a balloon. Well, when I was there for my first eval, he told me that the swelling wasn't that bad, and I had "decent" range of motion. You know what his response was? "If I told you the truth, you would have just been disappointed, especially because you couldn't do anything at first". Gee thanks. But he probably was right, I was already not exactly depressed, but definitely blue after the surgery because I couldn't walk, couldn't go outside, it was really really tough at first, and if I had been told that I had more swelling than normal, it may have pushed me over the edge.

The best part? He measured my flexion again at the end of the session on Wed. On Monday, I got to 120, and that was the number that I went to the doctor with. On Wednesday, he remeasured me at 125 on my own, and 130 when he pushed it. I have no clue how I got that much improvement in 2 days, but I'll take it. On Monday, I get to go on the treadmill for gait training, because I really forgot how to walk. I walked a bit without the brace in therapy, but I think my muscles either shrank up so much, or they just forgot how to walk. I think the other issue is that I got so used to my knee being loose, that I had to compensate before the surgery, and that's how I'm used to walking, but I don't need to walk like that anymore. I don't know, it's complicated. But hopefully on Monday, I'll get to start relearning how to walk.

The other exciting thing was getting cleared to drive. I had an interview yesterday about an hour and a half from home. The program paid for a hotel room the night before, and so I drove out there after therapy on Wed. Wed was a busy day, right? Well, i got there fine, and crashed as soon as I got into the room. Thursday was a long day with a tour that involved lots of walking. I took the crutches for that, since I didn't want to walk that much right away. And then i had to drive back home, which took about 2 hours with traffic. By the time I got home, my knee was sore, swollen, puffy, and about 3 different colors. But, it's better today, so hopefully no long term damage.

Shout it from the rooftops!!!

I am back from my follow up visit with the surgeon, I am now 6 weeks + 1 day post op. I think I must have been the happiest person in the office today. Why is that? Because he told me I can get rid of the crutches! And in 2 weeks, I can get rid of robobrace!!!! And after that, no more braces, no more crutches, I can walk like a normal person, wear normal pants again! I asked him if I would need a smaller brace, and he told me that since there is no good brace for the PCL, there is no point in wearing a brace that won't protect the graft. And I can drive again!!! I can't even tell you how excited I am. I made him repeat it 3 times just to be sure I got it. This was the conversation with my doctor:
Me: So I can get rid of the crutches?
Doc: Yep, use them only if you feel you need them.
Me: And I can drive again?
Doc: Yep, as soon as you're comfortable. And you can take the brace off if you need to.
Me: And in  2 weeks, I can get rid of the huge brace and just walk normally?
Doc: Yep, I usually get rid of the brace 8 weeks after PCL repair. If it was the ACL, you would already be out of the brace. And when you come back in 2 months, we'll see about getting you running and other fun stuff again.
Me: So you mean to tell me that after 6 weeks on crutches, 6 weeks of relying on other people to drive me, and 6 weeks of wearing baggy pants, I can lose the crutches today, take my car out of the driveway today, and in 2 weeks, look like a normal person again?
Doc: Yep, exactly right.
Me; And you're not playing some sick joke on me? You're not going to turn around and yell "Psych!" You have to be non weight bearing another 6 weeks and subject me to a lifetime of unfashionable pants?
Doc: Nope, you're doing good.

I really didn't believe him, but I was so happy, I could have kissed him. Especially because the brace will be off in time for my cruise. I leave on Jan 22, the brace can come off around Jan 18 or so. He did tell me though that if I will be doing a lot of walking, I might want to wear the brace and take the crutches just in case. He recommended that I wear the brace and take the crutches to get through the airport and onto the ship because it's a lot of walking, and he thinks it might be too much too soon after taking the brace off. But I'm ok with that, because while I'm on the cruise, I should be ok. Still can't wear heels on the cruise, so I'll be taking only flats, but I can wear shorts and skirts and not get crazy tan lines.

Something about a dancing dog and a smiling big faced kid sums up how happy I am right now.

Kinda funny though, he walked into the room and didn't realize I was post op PCL, he hadn't looked at the chart yet, but I had taken the brace off and put it in hte chair, with the crutches nearby, and he goes to me "Did we do a meniscus repair?" and I said "No, PCL". And then he goes "Oh that's right, we're making you go slow with that. If you were post op ACL, the crutches and big brace would be gone by now, but you're extra special."

I am still continuing with PT for now, and go back in 2 months for another follow up with the surgeon. And then after that, he said chances are I won't need to go back anymore. He said that I"m ahead of the curve when it comes to the rehab, he said most people are still pretty stiff and don't have as much flexion as I do, but I have good range of motion, and a smooth motion with the knee, which is apparently uncommon 6 weeks post op. I guess I got lucky with a good surgeon, and as much as I complain about him, I do have an amazing therapist.

Quote of the day....

"If you're not singing an opera, I'm not bending your knee enough"-courtesy of my therapist while I was begging him to stop. Apparently, if I was able to talk and curse at him (accidentally, I really didn't mean to call him those nasty names) then he really could bend further. It was only when I wasn't able to talk clearly that he took it far enough.

At least he's good natured enough to not take offense when I drop a few f-bombs on him, he knows I don't really mean it. They actually hung up an article that says that if you feel the need to curse, it's better to let it out because it apparently releases endorphins which makes you more able to deal with the pain. So I suppose you can say that it might even be encouraged. But it's only when the patient starts singing an opera that he decides that the knee has bent far enough.

Tomorrow, I go back to see my surgeon. Hopefully I will have some good news and be cleared to do more fun stuff at PT. I have a very nice progress note from the PT, my first day, I only had 60 of flexion, yesterday was 120. It's kind of nice to see that progress. I'm hoping I go see the surgeon tomorrow, and he lets me get rid of robobrace, get rid of the crutches, and start driving.

And as a thought of the day... why don't they make heated crutches? They could attach a solar power thing onto the crutches maybe so that when they're outside, the metal doesn't become freezing cold. I hate it when I'm walking outside in the freezing temperatures, and then go inside, take the gloves off, and I can barely hold onto the crutches because they're so cold. Guess that's the downside of aluminum crutches.