Flexibility & Me

Today, I realize how important people are. If you let them, they tear you down--but, if you let them, they build you up.

I went to the doctor for a routine check-up a few days ago and they handed me a survey. Apparently, I was “overdue” for a depression survey. The questions they asked brought back painful memories of the things I have been through this year, but I was able to answer “no” to all of the questions, because somehow, I’ve come out of it all.

I realize, that I could not have done it without the people who love and support me. My husband is a constant motivator and I even have two people very close to me in a similar perpetual state of recovery that requires endurance and long lasting determination. I do hope that my companionship offers them the same solace and supply as theirs offers me.

I heard a story this week about a 70 year old homeless lady who died, under a blanket and a tarp. It was a cold, wet night and two establishments urged her to take shelter with them, but she refused. She died cold and alone. All I could think about was that she had to be somebody’s grandma. At one time, she had to be somebody’s child. I longed to know her story, why was she there, why was she alone and what thoughts would cause her to refuse a warm bed in the midst of a storm and go quietly into that cold night.

I realize that life happens and we need each other. Resist the urge to criticize one another and tear down. Be a source of supply. Be a refuge and a home to the homeless--in more ways than one. Because, no one deserves to die cold and alone under a blanket and a tarp. 

We had a company outing yesterday to watch my boss’s daughter play tennis. Today I found out that they go to warm up at 9am, then the match starts at 10:30 and they play around three games.

Less than a week ago the fact that I need to spend 20-30 minutes warming up my knee before I begin PT or ride a bike, properly.

Now, I’m more like, “Go Team!”

Milestones:

April 7, 2015

Surgery completed.

One Week Later:

In-home Physical Therapy began.

April 23, 2015

Surpassed my goal of 110-125 degree flexion--albeit only with a stiff and painful stretch. (At this point JAS Splint did more harm than good; it caused my quad to react and issued in severe back pain--I could not maintain the flex for more than ten minutes.) I did however acquire a STEM machine on Amazon.com that blocks the pain and allows for half an hour or more of fluid movement.

Within the next two weeks:

I reached 132, with a severe stretch and discovered the magic of a massage for the fascia tissue. The fascia tissue acts like cling wrap layered over each other and causes major resistance in the stretch, a short massage increases the flexion without the quad reaction and back pain.

Then...

Pilates, the highest flexion on stationary bikes, and even Pilates Reformer

As of June 4, 2015:

Motivation waning, but I have not arrived at the finish line. My new physical therapist, while he focuses on holistic healing, does not have quite the enthusiasm as the previous one. Hence, my motivational spam above. Words to live by, I may write more posts to remind myself (and my readers) that slow progress is better than no progress.

The current physical therapy involves strengthening small muscles that improve balance and stability and enhance your ability to walk. Each exercise or stretch does something miniscule to my body that I cannot measure and the results come slowly. Eventually, though--if I continue--I could walk as normally as any other person, without a second thought. Whereas, at this moment, I put a lot of thought into every short stint from my office to the restroom down the hall: “Tighten this, don’t let your knee wobble, engage your core, stand up straight.”

Lately, I’ve noticed myself slacking, because I cannot see a milestone ahead--no end to the drudgery and planning quick meals, because there is no time to cook after a two hour appointment when I get home from work. Then, I read a quote, which I did not include here:  “The excuses you use not to work out, are probably the same ones you use for everything else in life.” It made me see this as an opportunity to change habits; these other quotes simply provide fodder for the fire. They remind me that slow progress beats no progress and you have to work for the quality of life you aspire to achieve in any respect.

I am waiting for someone to call me to schedule the surgery with Dr. Bernthal--who scared me half to death with all of the worst case scenarios (dead foot, knee replacements and amputation, to name a few) I almost decided to just live with my knee the way it is, then I remembered how 10 years of "living with it" continues to reek havoc in so many ways--I tripped and fell four times last year (over cobble stone and a slightly elevated brick).

Not-to-mention, I have worked so hard and come too far to give up now. I decided to go through with it, plus I talked to my PCP and she explained that he was covering himself legally and at the end of it all, he said "this will not be the most difficult thing I do all day." As long as he does not get too cocky, we should be okay :/ 

On the plus side, I'm glad he's not fresh out of medical school. And my manager has graciously decided to force me to use my vacation time for recovery--she informed me that I should not plan to make any trips this year. But, that's status quo I guess--our country really sucks at caring for people, we should take lessons from Ireland, I'm so jealous of their vaca time and family oriented life styles. 

The cherry on top: I pulled something in my foot, so now I can't do the bridges and weighted squats I've been doing to reverse the atrophy in my muscles. I had hoped the exercises would help with the post-op PT.

Ten years after mysterious pains thwarted my range of motion and "the unknown" caused fear to creep in, after two surgeries and three relapses, in a few short seconds the words "It'll all be over in a couple of months," floated through the air and perhaps I should have found a solace in them, but they came after so many other words--so many other promises and hopes.

Not-to-mention, they came after the doctor shattered my hope of non-invasive surgery--he would have to cut open the back of my knee to remove an aggressive, but benign, tumor before it caused damage in my otherwise perfect knee. If they missed one percent of it, it would aggressively grow back. They could not do arthroscopic surgery, because the back of the knee has too many precious parts--nerves that control the foot and the ability to walk.

I feel like a pinball as they send me from PCP to PT to OS to other OS (apparently, the best in the west--but he does not perform surgery anymore, so he will assign me to someone on his team that he has trained and all I can think is, "Everyone has to perform their first surgery on someone, but I REALLY do not want to have some new, green surgeon working on a part of my body that controls my ability to walk.").

Thankfully, my husband was there, he asked all the important questions, I.E. how long before she can walk, afterwards? The answer: immediately. Which is more than I can say for either of my Arthroscopic surgeries, but there is always that terrifying moment, right before you go to sleep on the operating table, when you think about the possibilities. I know that moment well and I live it now--a hundred times a day.

Medical Centers in Long Beach, CA

So, I decided the best way to explain my experience at the Imaging Center for the MRI was to Yelp it out.

By the time I got to the PT office I was on the verge of tears, that inevitably spilled over after the doctor asked if I was okay. His Yelp review from me can be found at: http://www.yelp.com/biz/southland-physical-therapy-costa-mesa?hrid=6OOeRH9rs6bzU36I6Rv-Jw

I read the results and presumed that the only way out was to cut the little pieces of debris out of my knee, before they started damaging it. I also presumed that, since this was the third time this has grown back, I would have to go through this in the future again and again.

However, my PT explained to me that, if the debris is just cartilage, we can push through it with an MUA or more PT, so, I left in an infinitely better mood and I will see the Orthopedic Surgeon today for the a fore mentioned consult. 

I feel great! Like I could conquer the world!

A massage therapist took away all of my pain for a full day over the weekend and I still feel the residual affects. Also, I feel like I can move more freely this week, the physical therapy is easier and I walk without a limp--I even descend the stairs gracefully in the afternoon.

My husband and I will head to the gym today, for the first time since my roadblock surgery. I am one hundred percent looking forward to it, I even made a schedule. The time has come to jump back on the elliptical--while I still can.

I had an MRI yesterday and I have a consult with an Orthopedic Surgeon Friday, so we will see what the future holds--but, today: we run!!

On a more positive note, I understand my mother better than I ever have. She has Spina Bifida, so she has lived with chronic pain and been through several surgeries in her life.

Only now do I understand the oppression of not being able to walk with your family and care for the house regularly--you choose between doing more and paying for it later or doing less and having less pain, but more guilt, later.

Thankfully, my husband and my dad are both men that stand by their wives and find joy in caring for them in every possible way.

My hope is that the Lord made me as much of a fighter as that woman; she beat the odds on every occasion and she's still fighting with all of her might. If anyone thinks I'm strong, they should meet the woman who made me.

I ended up at 70 1/2 degrees last week—Woot, Woot. However, the fact that surgery still loomed over my head gave me a healthy fear that made me work hard and push through the pain for the past five days. I knew that if we hit a plateau, that would mean one kind of surgery or another--which, in turn would mean starting over with three more months of physical therapy. Three more months of twice a week two hour visits and pushing and pain and tenderness/inability to bear weight or walk properly or sit for long periods of time.

My family took me for a low key hike for New Years, which made me very sore. Then, I went to the mountains on a winter trip with a bunch of friends and the fear of falling on the ice kept me safely in the cabin for the most part--so I skipped the group activity to do physical therapy indoors.

Finally, I had my third visit yesterday--well, technically my 23rd visit, but my third visit since I started this blog and my 8th visit since my invasive unrelated surgery that became a major roadblock to progress.

My range digressed to 73 degrees and now I have decisions to make--Surgery, Manipulation under Anesthesia, or continue the way we are--if that's even an option. I won't even know if that's an option for potentially several days.

I googled M.U.A. which was a bad idea--wikipedia freaked me out, until I read the disclaimer that the page had severe errors and could not be approved by Wikipedia. WebMD and Youtube were more helpful, since I didn't stick around at the doctor's office to get the print out--I left in the middle of my exercises, because the emotions started to leak out of my eyes, and I could not handle the pain without the mindset that it would make a difference in the end.

Today, I have new perspective and new strength. I realize that the daily pain I am in is abnormal, so I am open to other options. However, as far as I understand, the M.U.A. on average increases your range by about 15 degrees long term--so the more I can do on my own, before the M.U.A., the more beneficial the ultimate results.

My concerns: I put all my hope in PT, then hit a wall. Then, I put my hope in the JAS Splint, and it failed me... I realize now, that I put my hope in temporal and uncertain things. My hope, now is that "all things would work together for good, to those who love God" (Romans 8) In whatever way the Lord intends it. I cannot put my hope in riding a bike, or walking well, I have to fight for the eternal things--the things that really matter and will not fade away.

In the WebMD Knee & Hip Replacement Community, community members discuss what to do about range-of-motion issues after knee surgery.

My physical therapist wants to know my pain level, on a scale of 1-10, but I am better with words:

"I’m pushing; there’s tearing—I want to cry; I want to vomit, but I punch the chair, instead. I look up and cringe—twenty-five minutes to go. I look down and to my dismay I see a seventy-four degree angle. I’ve come so far, and have so far still to go."

Failure is not an option, but pain and fear are inevitable.

I'm twenty-seven years old, and this is my last chance to improve my mobility before age determines my fate.

In October I began physical therapy for the fourth time in a ten year period. I can actually feel my skin tissue being more stubborn than it was five years ago.

I had a benign tumor removed when I was 17 and the scar tissue that resulted from the surgery removed when I was 19. Both times after the physical therapy my knee reverted back to its initial state before I even knew it and I was back to only bending 90 degrees--which I could live with, because I learned to compensate with my other leg, I just couldn't ride a bike.

Until one day I began to trip over the tiniest things and a blinding pain  traveled up my leg each time; eventually these pains caused me to fall.  I developed a limp. Apparently, my muscles were atrophied--my right quadricep and calf muscles were nearly half the size of those on my left. 

My first appointment with the latest and greatest physical therapist fixed my limp and we made great progress for 6 weeks, my knee got all the way to 71 degrees.

Then, I hit a wall--I had to completely stop doing physical therapy for a month, which caused me to lose all of the ground we had gained. I've been back for a month now, we made it to 72 again last week, but something happened and I don't know what today will bring...

The pain is different, now--I might have torn something. The brakes hit; the car jolted, I was unprepared and jerked my knee. It took me a good five minutes to stand again after that, I seriously thought I would have to have my husband carry me into the house.