2 Steps Forward

I took some time this week to evaluate where I am in this long road of recovery.  The 6-7 month mark is a tough time for me.  At this point I am tired of putting on a brace face when people  state “you are still on crutches?”  I deal with clients on a daily basis and in their defense have been on crutches the majority of the past 2 years.  I have a stock of positive mantras I tell them, but most days I am totally faking this positive attitude.   But in the past week I feel like I am making progress, finally.

I realized that my right knee itself is feeling much better.   The pain inside the joint has resolved and motion continues to slowly improve.  It is now the associated structures around the knee that is causing my issues:  the nasty tendonits in my ankle coupled with a lot of pain at my patellar tendon.  I have stopped wearing my braceand am only using 1 crutch most of the time.  I can walk without crutches but have a horrible limp and stress out my ankle.  Plus I only rarely take any pain medication.  I did this weekend, mainly for 2 reasons.  We have been having a lot of storms and the change in the barometric pressure is brutal.  Plus I have some cleaning I needed to get done and the pain decreases my tolerance to get up and moving after a long day.

I am doing most of the rehab on my own at this time.  I go to PT once every other week.  Most times I ask why as my questions never seem to be addressed and I do more on my own, but playing the game.  I am able to bike for 30 minutes consistently !  I have got the seat at a near normal height and have been working on increasing the intensity setting and rpms.  i am up to averaging 59 rpm and 50 watts.  This is a great step, but very humbling.  Prior to the remodeling of my knees I was averaging almost 240 watts over a 10 mile time trial course with rpms >90.  But a month ago I was still struggling to get the machine to turn on, so some nice forward motion.   I also can walk on the treadmill without a limp, if I hold on to the handrail.  As soon as I let go my limp returns.  I can not figure out why and how to fix it, yet.  I tried asking at PT and got no answer, so will continue to research with Dr. Google and see what I can figure out.

Next weekend is a big event for me.  I have a big, all expensives paid, corporate retreat provided by one of my major vendors.  While this might e normal for some, this is a first for me.  It is at a gorgeous spa located next to Lake Michigan.  It was a goal to be off crutches and try to blend in a little bit, be able to wear real clothes, and to be able to walk the grounds and take in the views.  Last week I was thinking there was no way but now I have a glimmer of hope.  Guess time will tel, I have another ocuple of days to continue to make improvements.  So here is to actually believing in my positive thinking and to continues progress !

6 Month Update

It has been just over 6 months since my second Carticel surgery.  I call this month the month of frustration.  I remember this feeling all to well from last time.  After 6 months and still being on crutches my patience and optimistic outlook are rapidly starting to fade.  I know I am close to being on the other side of this journey but not quite there yet.  Last time I thought it was because my other knee was giving me problems.  This time around I think it is just how it goes.

I was talking with my physical therapist today about how frustrated I am.  It is amazing how many things people have said to me:  why my recovery is taking a while, other treatments I should have tried, and how come you just didn’t get a knee replacement are some of my favorites.  Seriously ?!?  Yes I realize I go back to work quickly and work a lot of hours.  But I keep my knee up when I can, can arrange things to a certain extent since I own the business, and have a freezer full of ice packs I use regularly.  Plus staying busy and have other things to focus on has provided a sense of normalcy that helps get through day to day.  I think the damage was beyond a glucosamine supplement and chiropractic care.  And I did not want a knee replacement.  I am much happier with my own pieces and parts.  I went into this procedure fully aware of the complications and knew it would be a long recovery.  But when you are in the middle of it things get a little rough.

Part of the problem is the secondary issues that pop up as a result of the procedure.  And just when I think I have been through it all something else comes up.  For those who have followed some of my ramblings my have noticed I have been having some issues with my ankle (secondary to my lovely fibula). Saw another doctor this week and was diagnosed with some significant peroneal tendonitis and got a new brace.  Instructions were to rest and not do anything that caused pain (guess that means sitting on my cough – yeah right).  My question is how to rehab my knee and rest my ankle at the same time – cause we all know they are connected.  No once can answer that question.  Guess I need to figure it out and see what works.  Was told a good 4-6 weeks to get through this.  Ugh.

I have a big corporate retreat (i.e. all expense paid weekend at a beautiful resort) coming up in 2 weeks.  I was hoping to wear real cloths and be able to blend in with the other business owners.  Not looking like that is going to happen.  I still needing crutches +/- boot on my foot and unless some miracle happens will likely be the care in 2 weeks as well.  So much for blending in.  But one day this will be an amusing chapter in my life that will help me keep life in perspective.  Just anxiously awaiting that time when this experience is in my rear view mirror.

The Leg Bone is Connected to the Knee Bone

The complexity of the human body never ceases to amaze me.   I have come to realize that the majority of my current issues are secondary to my knee, not my knee itself.  The pain in my ankle has become horrible and by the end of the day is so swollen and puffy you can’t see any landmarks.  I spoke with my surgeon about it – recommended having the foot and ankle doc look at it.   Talked with PT about it – just keep pushing through.  For the past 2 weeks I was walking around home without my brace or crutch.  At work was either using my brace or a single crutch.  I knew I was compensating horribly and did not have anything close to a normal gait.  Talked to PT / surgeon about this and asked if I should take a step back and start walking in a “normal” fashion with support or keep up what I was doing.  Both said keep up with the plan.  I need to build strength and it will come, I just need to give it more time (if I get told that one more time ….)  Well by Tues night I was so miserable I could barely move.  So decided to use 1 crutch at home and both at work on Wed.  I had a better day (although I was much slower) and when I went to the gym I actually did better.  So kept up with the crutches for the week and have had a better ending than a beginning.

So what have I learned, accomplished this week.  (1) always trust your gut and listen to your body.  I have fought a lot of doctors and magically I am right most of the time (2) my fibula is not my friend.  It is jammed at my ankle preventing me from walking.  And as I learned this week trying to flex my knee with my ankle flexed is painful (think driving, ouch) (3) Got the seat of the exercise bike down to 7, originally was at 10.  Today was able to pedal consistently for 20 min, although my rpms were only in the low 40s.  But it is improvement (4) I actually swam for 5 minutes this week.  My knee tolerated it.  The best part of this was it was hte first time in almost 2 years I got a glimpse of what life was and can be again.

Next week see my foot / ankle guy to see if can get things moving forward.  So then maybe my ankle bone will connect to my leg bone, then leg bone connect to the knee bone, and the knee bone connecct to my thigh bone.  Next stop on putting Humpty Dumpty back together is working on my very angry SI joint.

Two Steps Forward, One Step Back

Week 2 of my version of a training plan is coming to a close.  This week did not go as well as last week.  I have to keep telling myself that I have been struggling for 2 years so I won’t get better overnight.  However this is difficult to accept sometimes.  I think part of my problem is I had PT this week (got to skip last week) and I always leave feeling like I am not doing enough and/or am being a whimp.  You couple that with the fact I have a recheck with my surgeon last week and not feeling so good about myself.  I am still struggling with flexion.  Without really pushing my knee gets tight around 95 degrees.  Once I work it can get just over 105.  At PT this week got to 115 but it was not pretty.

Plus I am still stuggling to walk.  My ankle is killing me and continues to prevent me from rolling through my forefoot.  It is my lateral malleolus / fibula that is the culprit.   The chiropractor worked on it this week and my PT did as well.  The idea being thrown around right now is getting an injection in my ankle to calm it down.  This idea is not settling well with me.  First I am sick and tired of being hurt and being poked with needles.  Second I react to lidocaine and the other caines so would not have the anesthetic effect.  I likely will cave in because I so desperately want to get better.  Right now it is way more painful than my knee and is part of the reason I am awake right now in the middle of the night.  I tend to fall asleep easily when I get home from work because I am exhausted.  But hen I wake up3-4 hours later and am up for a good part of the week.  It is amazing the crazy things you can find on the internet when you can’t sleep 🙂

Tomorrow my goal is to write out a very specific training plan to start working more on my core, balance, and proprioception.  I keep asking my PT for input and am not getting much so putting it together by myself.  Will continue with the bike, walking in the warm water pool, flexion, and exercises for my ankle.  Last week I saw the chiropractor and the week before got a massage.  So hoping for a quiet week.

Home Gym Update

I finally got my home gym updated to help with my rehab.  Right before my first Carticel procedure I had full handrails installed on both sides of my staircase and kept the old partial rail.  I installed that in my basement this week.  So now I can do mini-squats, step-ups, and such with the hand rail.  I also installed 2 bolts with clips on them to attach thera-bands.  So basically I have everything I need to continue this long journey.

I have my road bike on a computrainer upstairs, just anxiously awaiting for me to be able to ride. Hopefully soon.  Right now continue on the exercise bike at the gym 3 days a week.  Slowly making progress.

Training Plan Week 1

The first week of my training plan is in the books.  Since my goal is to get back to racing I decided to try and get back into the groove with a weekly training plan.  So here is a quick summay of my adventures for the first week.

Exercise Bike – 3X in week . Started out with seat at 10, ended at 8 and was able to get monitor to stay on

Treadmill Walking – Daily.  Started at 5 min and increased to 8 min.  Alternate days of walking with shoes and without.

I had high hopes of some more exercises but did not happen as I had hoped.  Almost have the basement updated to accomodate my new challenges.  Should be done in the next day or two, will post pics.  I did go to the gym and walked in the warm water pool.  That was a hurdle as I did not want to do it at all, but made to commitment so I did it.  Was not a fun time but at least I followed through.

I have been weaning myself off from support for walking.  At home I am not using the brace.  I will use crutches when I first get up after sitting down for a while because it is very uncomfortable.  Once up for a bit I don’t need them.  At work if there are no clients I alternate between no brace and a brace.  When clients are present I use crutches or brace.  Overall it is an improvement from the previous week.  My PT would like me not using any support (like I don’t) but with my job it is a little difficult.

Yesterday I got a “massage” to help with my foot and ankle pain.  It is amazing how much pain and dysfuntion there is in my whole leg not just my knee.  Pt seems to be centered on my knee.  I am trying to work on the rest.  Goal is to get to my chiropractor this week for my poor SI joint.  Also having issues with peroneal tendon, anterior tibialis muscle, and the muscles in my foot.  Need to continue to help with the areas around my knee to continue to gain motion and strength.

So next week a quick summary of goals are:  Bike – be able to ride and have the clock work for entire 15 minutes.  Continue walking on treadmill to teach myself gait and how to walk standing straight (not an easy task).  I also need to work on exercises for my lower back and ankle as well as continue my knee exercises.  I see a bit of KT tape added to my routine of compression this week.  I can post specific info and exercises later.

The Emotional Toll of this Journey

I have tried to be a very positive, glass is half full, be grateful for what you have type of person during this long ordeal.  But there is another side of this journey that takes it toll on you emotionally.  I will be the first to admit I certainly have my moments where I break down, feel sorry for myself, and just want to quit.  I often have people ask how I manage everything.  The answer is you do what you have to do and find a way to make it work.  Did I want to go back to work 3 days after by Carticel procedure?  Absolutely not but given that I own my own business and if I don’t work I don’t make any money and can’t pay my employees.  So off to work I went.

I don’t think I have ever cried this much in my life. The worst time is primarily in my car followed by the shower and the middle of the night.  I can’t tell you then number of converstions I have had during a drive.  The typical conversation in my head is “I can’t do this” and “I don’t want to do _____ (fill in the task)”.  But then I tell myself you need to find a way to get through.  On one hand I feel sorry for myself with a very limited support system and living by myself.  I do have people I can ask for help but I don’t want to abuse the situation.  This has been going on forever and I don’t want to be a burden to my friends.   Very few know just how much this whole experience has rocked me to my core.  But on the other hand when I come home I can have my melt down, go to bed early, etc and not have to worry about talking to anyone.  I can be selfish and do what I want and not have to worry about anyone else (OK except for caring for the dogs).  I think it is important to realize each person has their own journey and their own struggles to overcome and you should not judge anyone else.

Part of the reason I am struggling right now is it is the beginning of race season.  I am getting a lot of e-mail for races I did  in the past.  Friends are posting training and racing info on social media with all their success.  And the weather has finally improved and makes you want to get outside and enjoy.  This is the second year I am on the sidelines.  Deep down I had hoped of a smooth recovery and joining my friends on some fun races / relays.  But I have faced the ugly truth that will not be happening this year.  I am happy I am making progress but very frustrated at how slow it is going.  Plus I would really love to sleep through the night and have a day without pain.

So right now I admit that life is not a bowl full of cherries.  But it will get better and when it does I will have a sense of accomplishment of overcoming all these obsticles and have a new appreciation of life.  It is OK to have bad moments / days and to cry.  Recognize it, deal with it, then move on because tomorrow is a new day.

I Did It !!!

Today is a day to celebrate the baby milestones in this long road to recovery.  This morning I was able to get the exercise bike to turn on and stay on !  I started out with my seat at 10 to be able to turn the pedals 1 week ago.  This morning got down to 8 and could turn the pedals fast enough to get the bike to turn on and stay on.  In full disclosure it would pause for a moment then restart – never fully turned off.  A big milestone for me.

It is hard to believe just over 2 years ago I was the state time trial champ in my age group and today I am celebrating getting a bike to turn on.  I felt stupid when I almost felt like crying when I finished my ride.   I did have to laugh when I stopped.  The display read less than 10 min averaging 4.4 mph but then had a message that said Great Workout.  It did make me smile.

It’s A Fibula Thing

I continue to make micro-baby steps forward.   I am happy that things are progressing but frustrated that it is slower than I had hoped  Have I ever said patience is not my strong suit.  I can walk around the house without brace or crutches but have a lurching gait with my butt sticking out for counter balance.  So graceful.  At work I will walk with either brace or crutches.  I thought I was doing great until I went to the gym.  I was going to do paperwork so decided to leave crutches in the car and just go in with my brace.  Walking across the parking lot that has a slope and an irregular surface was quite a challenge.  Halfway through I had a moment of panic about keeping myself upright.  But I did it.  Part of me was happy I was able to do it but the other part was frustrated that walking across the parking lot was so challenging.

So far I am meeting my goal of going to the gym 3 times a week.  I go in on crutches because after riding the bike for 15 minutes it is difficult to put weight on my leg without wanting to cry.  I feel like I have a spot light on me the entire time I am there but am trying to work through it.  Now that I have been doing more PT my ankle has become very painful.  I remember this from the other side.  It is laxity in my fibula.  It started around 3 weeks of non-weight bearing with pain on the outside of my knee.  Now there is pain on the outside of my ankle.   The issue is the pain stops me from being able to roll through the front of my foot when I walk.  So therefore I have a lovely lurching gait.  I continue to work on it.  Walking on the treadmill is helping.  I can hold onto the handrails and really focus on my gait.  When I stand up straight I feel like I am leaning way to the right, a consequence of 5+ months of crutches.  This will get better.  Taping helps and looking to get a massage.   If I remember correctly it took a good 4 weeks to get things better but to be honest my left leg still is not 100% after a year.  I continue to hope as I finally start to get more active and gain some muscle mass back this will improve.

Right now the pain is getting to me.  l  I think I am so used to my knee hurting it has become a way of life.  However the ankle pain is new so seems over whelming.  Right now I am working on baby goals and trying to look at the big picture.  Instead of focusing on the fact I can’t pedal fast enough to get the exercise bike to turn on or the fact my gait cold scare small kids I need to remember that a month ago I could not put weight on my leg.  I try to be a positive person but there are days when it gets to me.  Tonight is not one of my best but tomorrow is a new day.

Easy Grasshopper

It has been a busy week and the number of ice packs in use right now is a testament.  I had PT this morning and got a gentle reprimand to slow down a little.  For months I have been so restricted in what I can do so have been trying to rejoin the world.  Although it is a bit ironci given the tone / lectures in the past.

Sure everything hurt but I expect to at this point. Plus I know there is pain you have to work through to improve.  But I can admit that maybe, just maybe, I have been doing a little bit too much. I set my alarm for 3:30 am just to take pain meds to get through my PT session.  When I showed up my right knee was very swollen and did not want to flex.  But I did get it loosened up nicely.  By the time I finished my sesion my left knee was swollen as well as my right ankle and foot. My muscles in my ankle and foot are rebelling about having to work for the first time in months, the slackers.  I had to wear crocs at work today because my foot was to swollen to fit into my sneakers.  Not the best footwear but it worked.  My initial goal was to go to the gym after work tomorrow.  I am thinking probably not my brightest idea.  It is supposed to be sunny and warm tomorrow.  So I think I will come home and let the dogs outside to play.  There is always Sunday.