#patellar dislocation

Hey, uh, I have a weird thing I can do with my knee! Warning, it's kinda gross.

"Do refrain from breaking anything, dear"

"Try to come back in one piece"

"Don't make me call the state department"

For the rest of eternity!

So, uh. Wow. This side of six months doesn't seem nearly as bad as six weeks did.

I'm back to biking and swimming, full range of motion, still a little weaker than it should be, but some of that is my pre-op timeline and some of it is my less-than-100% compliance with my HEP.

(It gets old. It really does. It's a mental game and I'm working on it, but the brain is the hardest body part to fix.)

My last follow up appointment was yesterday. I... may have forgotten that I have a grade 3 chondral defect on my patella. Like, completely.

So even though I still have some residual pain with single leg squats, I chalked it up to a strength issue and didn't mention it to the surgeon, which I sort of regret.

On the other hand, any cartilage repair procedures would be another 12-18 months recovery and I am SO not ready to chase that route.

Thus, celebrating my current victories, my clearance for any and all activities as tolerated, and I'll cross the cartilage bridge when I get there.

Has it really been that long already?

1 down, 5 to go before I get to ditch the brace (in theory), and not much longer after that before I get tropical recovery time. <3

Tuesday (boxing day!) was my one week appointment. They scheduled my appointments for me (I would never have chosen a 7:45 PT time), followed by an x-ray and the Uncovering.

I'm starting off at around 15 degrees flexion, and my quad is kinda sorta still firing (this gives me hope - I would only wish quad atrophy on my worst enemies.) The target is -4 to 140 to match my right leg.

The incisions look good, no signs of ooziness or anything else. I do have a little calf pain, which I mentioned, but it's more what's expected of an abused muscle than a blood clot.

More than anything, I was looking forward to showering. I've done long backpacking trips before, but there's something different about having dirt and dust all over and feeling accomplished than after you've spent sitting in your pj's, eating Christmas cookies and feeling like a proper potato.

Objectively speaking, it was the most stressful shower of my entire life. I didn't expect to feel so vulnerable without my brace, but I was.

I have a built in shower seat. I was able to prop my crutches just outside the door and get situated before taking off the brace, but I was genuinely afraid. Taking off my exoskeleton, the only thing holding my leg together, seemed like a terrible idea. But damn, did I want that shower.

It was jump scare level timing - I had just undone the first buckle when someone slammed a door in the next room, the crutches tipped over, fell into the shower, and landed on my knee.

It didn't hurt, but this is what I mean about the vulnerability of it - I don't think I've ever been so scared. Ever. And that includes the time I got caught in a blizzard in a strange city, ended up in waist deep snow in whiteout conditions and wondered if I was going to die.

After those crutches landed?

I had to remind myself there's no crying in the shower (...), and I clutched the washcloth bar like the 'oh shit' handle in a car accident and tried to pull myself back together.

I've never had a panic attack, but I can't imagine I was far off. I wanted to curl up in a ball and never come out. It's good that no one else was in line for the shower. It took me a good while to recover.

Eventually I got the brace off and managed to get clean, but that was more than enough excitement for one day.

I've been mostly self-sufficient, but after my shower I called my mom in to pass me my brace, crawled into bed, and slept for a few hours.

After that...things have been better. I can put full weight on my leg (still with the crutches, so I move carefully.)

My PT schedule is unfortunate because of the holidays, and I can't go back in for two weeks, but I've been doing extra credit exercises and I'm up to 30 degrees of bend.

I get to leave the brace unlocked when I sleep - I still can't sleep on my side, but having a little bend feels SO GOOD.

It is frustrating to be at this phase, trying to focus on making it through each day and not looking where I might be headed (I don't want to end up in MPFL hall of failed recoveries, but it's always a possibility.) Next year I want to be conquering whatever slopeside anxiety I've developed, someplace snowy and brisk.

I'll have more on this later, but I'm very aware that I need to (am in the process of?) making a mentality shift (I hate those.) PT seriously needs to become a lifestyle for me, and not just a bandaid. That's...not the world I come from, but I also come from a world where oil changes and other vehicle maintenance is optional.

If I can learn proper car maintenance, I can learn proper me maintenance, too. Just in time for the new year!

Today has been exceedingly educational. Aka, when everyone says "don't stop taking your meds" you should probably listen:

You might need them for longer than you think.

I tried to taper off the percocet - I did fine with 12 hours between doses, so buoyed by my previous success and relative lack of pain, I tried to hold out for 24 hours.

That turns out to have been a mistake.

I have writer brain, so I'm filing this all away for future reference. But I understand now that people react very differently to pain. I think I always sort of knew that, just like I know sometimes I feel sick because I have a bad headache, and not because my stomach is upset.

I saw a lot of posts about people crying, or screaming, when they didn't keep up with their post-op meds (or waited until the nerve block wore off to take them.)

I didn't see anything about throwing up, so I'm going to add my experience to the hat which is to say:

Pain makes me nauseous. I felt sick to my stomach before I even realized I was in pain. When I did, it was that burning again - only worse. I've never been tazed, but I'm imagining it feels something like this, on your whole leg.

Imagine someone replacing your leg with a hot fire poker.

The good news is, percocet kicks in pretty quick. So after white knuckling it for about 30 minutes, hoping it would just pass, I gave up and went for the meds.

I will say, my diversion tactics seem to work to a certain extent - pain is noise and if I give my brain enough other noise to focus on, it seems to help.

Some of it is literal noise - apologies to my eardrums, but it's for a worthy cause. And the rest is sensory - I refilled my water bottle with cold water and put it against the side of my face. I'm not saying I could have functioned in that state, but it was slightly more bearable (and I managed not to puke while waiting for the meds to do their thing.)

Tomorrow we're going to stick to the 12 hour schedule, but on half doses. Just to be on the safe side.

I took my notes and that's not an experience I care to relive.

On a bright note, I finally started Horizon: Forbidden West today. I set it to Ultra Hard to make it last as long as possible - so far so good, since I haven't managed to beat the tutorial boss.

It'a good to have goals.

And skills - I've gotten really good at using my non-op leg to move my bad leg around. I had a lot of practice since I injured it mountainside, then had three days before leaving, then on and off the plane and back to the airport again, and all the time after when my quads weren't firing.

Nurse Hottie was shocked post-op by how well I could maneuver without help. I didn't consider it much, but now I'm remembering a friend explaining how she had to hold her son's leg when he went to the bathroom or showered, and how it was awful for both of them because sometimes she would drop it on accident.

Which is a lot of words to say that no one can be as careful with your knee as you are, and I've been really lucky because I've been managing without a designated Leg Lifter.

Which is probably why I was so startled today when I finally dropped my leg for the first time. I've been elevating on an wheeled ottoman, with stuff behind it so I can't accidentally slide it away. The problem is that then it's in the way when I want to get up, and I can only push it so far, so I need someone to slide it the rest of the way.

Well. They did that thing, but boy was I ever not ready. I'm not sure who was more surprised when my leg came crashing down. It hurt (surprise surprise), but I'm pretty sure it's going to take more than a little unexpected gravity to undo my surgeon's fine handy work.

My lesson here is to put up warning signs, by which I mean micromanage and advocate loudly for your needs to whoever is helping you.

I knew it was too good to be true. I still felt mostly good last night into today, with the exception of a short bout of nausea this afternoon. I suspect it was more related to the white chocolate coffee bombs I combined with my meds this morning than the pills themselves.

Now it's probably 36 hours post-op and I think, much like a fresh start in the gym, day two is going to be the worst. I was already starting to feel it earlier, and I was so ready for my 10:00 pill - it's midnight now and my next is in two hours.

It's a weird pain. I've broken my foot before, and that hurt, but it was mostly sharp, and afterwards it hurt like a bad bruise.

This is...burning, in the truest sense. It's that stinging sensation right after you catch yourself on something hot, only instead of swearing and shaking as it fades, it's just...there.

It's constant and throbbing, but I'd put it at a 7, or maybe 8 out of ten right now. It hurts, but I think it hurts more because I'm giving it my attention.

I'm not sure reading is a sufficient disengagement from reality - going to try a game or a show to get me to my next dose (and hopefully a nap afterwards!)

It may be partially my own fault. I was feeling reasonably well earlier, so I did a snack tour to the kitchen and back, and did 2-3 rounds of quad sets and attempted my straight leg raises.

Typing that makes me realize I was a touch ambitious. But I probably would have hurt, anyway, so at least I did something?

Full bucket of ice, half a pack of cigarettes, 200 miles to Chicago. It's dark and I'm wearing sunglasses.

I just want to give a quick run down now, because my memory is pretty shot and some of this might be helpful.

Check in was nice and smooth, I got suited up, peed in a cup, and then my mom and aunt were allowed back to hang out until it was time to go.

I was joking with my nurse (medical staff is the BEST) about unfortunate timing of menstruation (she'd also had surgery on her period before - TMI, sorry.)

But they gave me thigh highs and lace panties go wear - date night or surgery, amirite?

They sent mom and aunt out when it was time for good drugs - I got little anesthesia first, and then two nerve blocks before the whole team showed up.

I think the surgeon asked me what I was having done, and I gave the fuuuuull answer and not just "knee surgery." I also admitted (at some point under the influence) to cyberstalking the hell out of him, which is why I wasn't worried at all - this surgery is sort of his whole thing.

I distinctly remember him saying he'd do his best to live up to my faith in him.

They wheeled me away and were explaining what came next, and I must have asked about counting backwards from 10, 'cause I do renember asking what language they wanted me to pick.

I remember shuffling off my taxi and on to the table in what looked like the biggest dentist office ever, and being buckled in (the table is really narrow.)

After that...nothing.

The next thing I knew, the PA was showing me my pictures...I guess I pointed to one and asked if it looked more like a wine glass or his mother. (There go my chances of a date! Sorry, nurse Hottie!)

Everything else is sort of in and out. Mom and aunt showed me the video of the doc explaining to them what went down, and apparently my patella wasn't even sitting in its groove - it was sort of clinging to the trochlea like a climber on a cliff.

I have a grade III chondral defect where my patella punched it on its way out, but he said it wasn't as bad as he thought it would be (which means I may not need a second surgery for cartilage repair later! 🥳)

It feels SO good to have this surgery validated. I knew I needed it, but it's something else for them to say "yeah...you did good, all things considered."

They released me pretty quick after that. My aunt had gotten me a pain au chocolat for the ride home (DELICIOUS) but we also stopped for a peppermint mocha.

I didn't know until this morning, but you get intubated, too. Which makes sense, but my throat has been kind of scratchy and it tastes like something died in my mouth. The mocha helped. ;)

And now I'm home and cozy in bed and have been dozing. My leg aches at bit and I can feel the pulse, sort of like when you've bruised or cut something. My Home Nurse Squad went out for ice for my ice machine.

Nerve blocks are good, but the seem to mess with the bladder...I've been to the bathroom three or four times and I just want to de-fluid myself...but it's not along for the ride.

ANYWAY

I am actually (surprisingly) more calm than I expected. And more tired, which is good.

It's weird, but you won't know when to arrive for surgery until the day before (something to do with scheduling). It feels like a covert operation.

I got my Highly Suspicious Phone Call around two, and I have to be at the hospital by 9:30 tomorrow morning.

For the sake of my sanity (and not because the house couldn't benefit from my anxious energy) I visited my grandparents, a few friends, and then ended up driving out of town to visit my aunt for the weekend.

I listened to a great podcast (The ACL Athlete), that I wish I'd found months ago. He talks about the ins and outs of PT and rehab, and knowing when you need to switch PTs, along with good things to discuss with your surgeon and success stories.

I fully credit this podcast for getting me from A to B to C in the last week. It talked me down a lot while I was driving, and helped me get my head back in place for the PT I'm about to start over with - if you don't know, PT is exhausting. It's very much an endurance activity rather than a sprint.

(See aforementioned adhd and intense dislike for boring repetitive exercise.)

I didn't think about the surgery at all once I got to my aunt's (10/10). We watched netflix, shopped, and I helped her with her Christmas decorating. I also repaired many animatronic singing Christmas toys, which I'm pleased to say will drive my uncle nuts the holiday season.

I felt like a workshop elf and it was lovely.

Today we drove back in a blizzard, which was less so.

After watching cars weave in and out of rush hour traffic at high speed, and then skidding down the shoulder towards a car that had already spun out, I can confidently say I was NOT thinking about surgery. And I'm also drained - I'm glad my aunt offered to drive. It was stressful to watch and I'm out of practice in snowy weather.

I don't recommend it, BUT I'm pretty sure it's the only reason I'll be sleeping tonight.

I took my very thorough, very scrubby antiseptic shower (part 1 of 2 - you do it the night before and the day of.) I was probably more generous than I needed to be, but since hibiclens doesn't lather, I elected to rinse and repeat to make sure I got everything.

I have tylenol and stool softener and a bed rail to help me get in and out of bed. My brother loaned my his PS4 and I've borrowed Horizon: Forbidden West from the local library, so hopefully that'll be enough to keep me occupied until I start PT again.

There's...really not much else left to do. Maybe it's the benefit of being 10 months post injury, and having had the time to try PT until I was thoroughly convinced that I do need this surgery, but my freakout level is relatively low. I'm nervous but I'm ready.