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Monday was a stunningly good day.  I’d had a good weekend, spend doing physical activities outdoors.  I got the dirt in the garden and planted my spring seeds!  I rode my fancy new bike outside!  Twice!  Then, when I got to my PT appointment that afternoon, I was asked if I wanted to try running on the treadmill for a bit.

Did I?  Of course I did!  Let’s go!  It was all I could do to get through the warm-up exercises, because in the back of my head it was all, “wegettorunyayrunningyayayayayayayay!”  I got on the treadmill and walked for a bit, then I picked it up for 5 minutes of running.  In one minute segments.  With a minute of walking in between.  At a very, very slow jog.  In the 15 minutes I was on the treadmill, I covered less than a mile.  Less than half of that was running.

But it was fantastic.  The knee felt fine and, despite the fact that I felt like I was clunking all over the place and had sort of forgotten how to run, I felt fine.  Everything looked great.  The clouds parted, angels sang.  It was basically the high point of my week.  At 4:30 Monday afternoon.  I was told to let the knee rest on Tuesday, but that I could try and do the same thing on Wednesday.

By 7:30 Monday night, it was a slightly different situation.  The knee was sore like it hasn’t been in weeks, and I seriously contemplated tossing back some ibuprofen before falling asleep.  I didn’t, mostly because I was already in bed when I had that thought and couldn’t justify getting up to do so.  However, when I woke up Tuesday morning?  It felt fine.  I listened to instructions and took it easy on the knee, skipping my planned bike ride in favor of doing some swimming.  When I woke up Wednesday morning with no pain?  I hit the treadmill again.

Once again, I ran my slightly-less-than-half-mile in one-minute chunks.  I took my one-minute walk-breaks in between.  And I added a nice long walking warm-up and cool-down to bring me to a nice even 30 minutes on the treadmill.  All of which my knee tolerated like a champ.  Until Wednesday afternoon, when I noticed the soreness creeping back in during class.  By the time I got home, it was aching enough that I actually threw an ice pack on it for a bit.  Again, something that I haven’t done in weeks.  As much as I wanted to ignore it, I couldn’t: the knee was not at all happy about running again.

Bummer.

So when I went in for today’s PT appointment, I told them exactly what happened.  I rested.  I ran.  Inside and on a treadmill, as per instructions.  And the knee was very clearly unhappy about it.  Heck, the knee was still sort of sore off and on today.  Clearly, this new activity was not, as the PT would say, well-tolerated.  She simply nodded and said, “OK.  So we still need to do more strengthening work.  Let’s try pool-running for now and see how that goes, and then maybe we can get you back running on land again in a week or so.”

So, that’s what we did.  We progressed the strengthening work I’ve been doing there up another level, so that my quads can hold my kneecap right where it needs to be, and I left with instructions to try pool running and yoga this weekend to see how those go.

I’m not going to lie: it’s disappointing.  I was so very sure that I was on the tail end of this, but apparently there’s still a good deal more work to be done.  My PT asked me today if I was getting tired of all the cross-training, and I said, “Sort of… but mostly I’m just tired of not being able to do things.”  Sure, the list of things that my knee can do is growing, but it’s definitely the limiting factor on how hard I can work.  I miss finishing a workout and feeling like I’ve actually done something.  Blessedly, I’ve been given the all-clear to get back to yoga, which will at least provide some sort of challenge.

But what I really, really want to do?  What I would just about pay someone for the experience of?  Is to go out and spend an hour sweating and panting and end up feeling sort of like I want to throw up and/or pass out.  I don’t even care if I do that running or biking or in some sort of crazy boot-camp workout.  I just want to get back to that sense of accomplishment that comes with finishing a crazy-hard workout like that.

So, yeah, not the “WOO YAY RUNNING I’M BACK BITCHES” post I was hoping for just a few days ago.  Maybe next week.

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Getting Better

I’m going to be honest with y’all: I am 100% totally over this whole knee thing.  I’m tired of thinking about it.  I’m tired of talking about it.  But most of all, I am tired of not being able to do things.

The good news is that things are definitely getting better.  The knee is on a definite upswing.  Heck, it feels totally normal about 95% of the time, and if I weren’t a runner?  I’d probably call it good at this point.  It definitely lets me know if I try and do too much, but the list of things it can do is growing rapidly.  I can ride the exercise bike at the gym with a decent amount of resistance on it.  I can swim.  I’m planning on trying to get back to yoga next week.  And today?  Today I rode a bike outside for the first time since the surgery.

Not just any bike.  My shiny new triathlon bike.

I probably could have tried it before now and been fine, but I was a little afraid of it.  Riding outside, you can’t control the conditions, and I was terrified that I’d get caught in a nasty headwind that would just do my knee in and leave it feeling horrible for days afterwards.  I just didn’t trust anything involved (my knee, nature, etc) enough to even try it.  Until today.

Irwin came with me, which was awesome for a variety of reasons.  Having him on his (gigantic, super-heavy, not-exactly-speedy) bike with me forced me to keep the pace easy, which kept my knee happy.  Also, in the case that my knee decided we were done before we got back to the car, I had a built-in rescue.  Lastly, I got to hang out with someone fun while I rode.  Outside.  For the first time in almost 3 months.

I can’t even begin to explain how great it was.  There’s something about riding or running or doing whatever outside that is just so, so much better than working out in a gym.  Sure, I get to have some recreational reading time when I’m sitting on a bike in the gym, but being outside beats it, hands down.

I’ve still got a long way to go – the knee’s not quite ready for running yet, and when I dropped the bike into a bigger gear to see how fast it would go*, it became clear pretty quickly that my knee’s not ready for that yet, either.  But it can totally handle a nice, easy ride outside on flat ground, even if there’s a bit of wind.

We’re not there yet, but for the first time in weeks, I really feel like I’ll actually get there.  Maybe even sooner rather than later.

*The bike will go fast.  Very, very fast.  I had it up to 17 mph without even trying that hard.  This is going to be so awesome once I get back into racing.

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“Dude, Bobo, get your tongue out of my ear.”

“Heh.  The cat gave you a wet willie.  Awesome.”

“It wasn’t so much wet, though.  It was more like a rough willie.”

“…”

“Um, wow.  That… sounds like something else entirely.”

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A week ago, I was feeling pretty discouraged about my knee.  The swelling was pretty much unchanged, which meant I was still hobbling around to a degree that was noticed by other people.  Both of my physical therapy appointments were… well, they were sort of iffy, as the knee didn’t really want to cooperate with doing anything.  Both PTs that I saw looked at my knee and inquired as to when I would get in to see the doctor next.  One of them even went so far as to mention that, yeah, this was sort of a lot of swelling for as far out of surgery as I was and it was a little… unusual.  Great.  Exactly what I wanted to hear.

So when I left town for a weekend in Chicago, I thought nothing of the fact that I wouldn’t be anywhere near an exercise bike for several days.  When I came home with a cold and decided to sleep instead of going to the gym?  I didn’t care.  And that was apparently exactly what my knee needed, because it has been worlds better this week than it has since the surgery.  I’m back to driving my own car and can even get comfortable sleeping on my stomach.  If I think about it, I can even walk just about normally.  They’re little things, for sure, but they’re little things that I haven’t been able to do in a month, so it’s pretty exciting.

Even more exciting is that since the knee was behaving, I was able to work it pretty hard in both of my PT appointments this week.  No complaints, no angry post-PT swelling or discomfort.  Just a much more functional knee than I have seen in quite some time.

Even with this week’s jump forward, I’ve basically let go of any time-based goals related to running, which has let me focus on what I can do now and how to improve that.  Even with the improved motion, that leg is still far weaker than the other one.  Today, the PT had me do some basic leg raises with a 2-pound ankle weight, and that was depressingly difficult.  Clearly there is still some work to be done there.  (On the flip side, though, doing those leg raises with a 1-pound ankle weight was almost impossible two weeks ago, but now it’s absolutely no problem.  So there’s progress being made.)

Here’s hoping that the upward trend continues.

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At the beginning of last week, if you had asked me how my knee was doing I would have told you it was fantastic.  I was getting more motion back and, right after icing it, I could almost walk totally normally.  The swelling was down, it wasn’t hurting anymore…. it was all moving in the right direction.

Then I ran out of the prescription anti-inflammatories I was taking, which at first was hugely exciting.  I’d been feeling completely run down and it seemed like they were to blame (especially since one of the side effects on the bottle was “drowsiness”).  My theory was pretty much proven correct when I couldn’t sleep the first night I didn’t take them, but I wasn’t too worried.  I figured my sleep cycle would even out in a few days and then everything would be A-OK.

I took my last dose of the drugs Wednesday morning, so when my knee was a little puffier than usual at my PT appointment Thursday evening, I didn’t think too much of it.  The knee did not approve of said PT appointment and complained mightily as I worked on new and exciting ways to straighten out my leg.  As I was leaving, the PT advised me to call the doctor for a refill if the ice didn’t help the extra swelling that was hanging out in there.  I sort of nodded and smiled and said, “we’ll see,” not really wanting to go that route unless I absolutely had to.

When I woke up Friday morning, my knee was incredibly stiff and swollen, all from being under the warm bedcovers all night.  I decided I’d call the doctor after my morning class, to get the refill process going just in case.  I still wasn’t convinced I absolutely needed to, but the refill would be free and it couldn’t hurt to have it lying around, right?  Exactly.

Friday evening there was a potluck after class, and after a few hours of standing around in a really warm room, my knee was puffy and warm and really, really uncomfortable.  I’d gone from not really caring if I got a refill or not to checking my email every 30 seconds to see if Walgreen’s had it ready or not.  Clearly, while I was ready to be off the drugs, my knee was not.

Sadly, the story didn’t end there.  When I called the doctor’s office to get a refill, they told me to call the pharmacy, who would then call the doctor for approval.  OK.  So I did that.  Sadly, it appears that the pharmacy and doctor’s office didn’t connect on Friday, so my refill is still waiting for an approval.  And my knee is still increasingly puffy and temperamental.

The good news is that it’s not really any more painful, but it definitely feels like a step backwards.  I can’t stay on the exercise bike as long, it’s much harder to move comfortably if I’ve had it in the same position for a while and, well, it’s just not as comfortable.  Considering how good it felt last week, this is more than a little annoying.  Unfortunately there’s not a whole lot I can do about it, but I’m doing what I can – icing it, keeping it up and remembering that it’ll get better.

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Earlier this week, I had my post-op appointment and got cleared to start hitting the exercise bike for short periods of time with no resistance.  I was also told that as long as I did that and range of motion exercises on my own, I’d probably be fine without physical therapy.  However, if I wanted to go that route?  My insurance would cover it, because we have really, really good insurance.

I went the PT route.  I figured that in addition to making sure I had a well-rounded rehab, it would also keep me on track.  Having to check once or twice a week with another person would keep me on my exercises, and it would also give me someone to bounce ideas off of, and they could tell me if it was going to be a good idea or bad idea.  Basically, I’m using the PT as a babysitter to make sure I don’t try to do too much too soon.  While there’s very little chance of me hurting anything in my knee, I could definitely piss it off pretty good and set myself back a good week or so.  No thanks.

Hey, insurance will cover it.  Thank you, Giant Software Company.

So I had my evaluation appointment Wednesday morning, and it sucked even more than I thought it would.  I knew they were going to test my range of motion.  I knew they were going to see how much motion they could get out of my knee (i.e., more than I can).  I knew it was going to be uncomfortable, but I wildly underestimated by just how much.  As I was sort-of whining to a couple people about that, they all said the same thing: “Hey, this experience as a patient will just make you a better therapist down the line!”

Which, while true, is akin to hearing that a period of seriously sucky experiences “will build character.”  However, they did have a point, because up until this week, I had no idea that post-injury and post-operative PT were so wildly different.  Post-injury PT is a bit uncomfortable, but it’s in ways that you’re pretty much used to.  If you’re active enough to hurt yourself, you know how it feels to do tough strengthening exercises and stretching.  Sure, having someone use manual therapy to loosen up your IT band isn’t exactly a walk in the park, but you don’t really have to do anything besides sit there and take it.

Post-op PT, however, is all about moving whatever joint it is that doesn’t want to move.  It wants to stay in one spot until all of the swelling is down.  It doesn’t want to stretch the range of motion it has available, and it most certainly does not want to hang out at the end range of motion.  Yet, that’s exactly what you need to do.  And you can’t just sit there and take it, you have to actually do it to yourself.

Yeah, that’s a difference I wasn’t really expecting.

However.  I’ve been good and doing my exercises and I’m continuing to see small improvements every day.  A little bit more motion here, a little less discomfort there.  On Wednesday morning I could barely get through one set of 10 leg lifts, and tonight at the gym I busted out 3 sets of them without a problem.  (That’s another thing I was horrified to see: how much strength I lost out of that leg in less than a week.)  I’ve hit the bike for 10 minutes the past couple of days, and while the first few minutes are a little rough, by the end of the time it feels awesome.  The motion’s getting a bit smoother, and today I made it a little further than I did yesterday.  As long as my knee doesn’t feel awful in the morning, I might try and see how 15 minutes goes.

I can’t wait until I get back to running, but that’s still several weeks away.  So for now I’m focusing on what I can attain in the next week or two.  15 or 20 minutes on the bike.  Sleeping on my stomach again.  Driving my own (manual transmission) car.  I’m not quite there yet, but I’m thinking that two out of three in the next week is totally reasonable.

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Recovering… Slowly

When I woke up Wednesday morning, I felt awesome.  Nothing hurt and, sure, I couldn’t move my knee a whole lot because it was still pretty swollen, but I felt like a million bucks.  So I went to class that afternoon.  Where I then spent 3 hours trying to figure out how to sit up in a chair and still have my leg in a comfortable position.  By the time I was on the way home, I was absolutely exhausted.  Because I was one day out of surgery and heading off to class like nothing had happened.

That seems to be a theme that’s carried through until, well, today.  I seem to be the only one who’s shocked by the fact that simply going through a day of classes wears me out, because I’m the only one that keeps forgetting I had surgery last week.  Relatively minor surgery, sure, but I still had surgery.  I sort of got the memo when I came home Thursday afternoon and took a 3-hour nap before having dinner and then going directly to bed.  Friday was a little better, but an all-day training for Girls on the Run coaches on Saturday was enough to completely wear me out.  I finally sort-of learned my lesson and spent Sunday camped out on the couch, only getting up and out for the one errand I had to get done.

Y’all, I’ve been sleeping for about 12 hours a night for the past few days.  When I say that a regular day of classes wears me out, I am not kidding.  Heck, yesterday I slept that much after a strenuous day of lying on the couch.  It feels a little pathetic, is what I’m saying.

On the plus side, I do feel like the knee is improving,  Sort of.  Since all they had to do was clean up some torn-up cartilage inside the joint, my main recovery task is to get rid of the post-op swelling.  Once that goes down, I should have my knee back.  So if I’m at home, I’ve got the knee up and ice is on it for 20 minutes or so every two hours.  I’m even sleeping with it elevated, partially because it keeps the swelling down and partially because it’s about the only way I can keep it comfortable.  The worst part about that?  I’m totally a stomach sleeper, which is a position that is pretty much unattainable (and only comfortable as long as I don’t move at all) in my current state.

I have busted into the big drugs a few times as I did get some pain from the incisional sites.  Happily, one dose at bedtime has proven to be enough to let me get to sleep and to control the pain throughout the next day.  (Also, I don’t really care as much if my knee hurts during the day, since I usually have something else to do or pay attention to that keeps me distracted from it.)  As a result, I’ve had some really, really, really strange dreams.

How’s the swelling, you ask?  Well, that really depends on when you ask me.  For the most part, it’s down significantly.  I probably have about 75% of my range of motion back, which is just enough to let me walk up stairs like a normal person, but not enough to let me go down stairs without having to step both feet down to the same stair before proceeding.  I also can’t quite straighten my leg fully, which means I’m still walking a little funny and can’t really support my weight on that leg for any length of time.  (The horrible, horrible downside to taking a gait analysis class right now: that’s ALL I THINK ABOUT when I’m hobbling around.  “Limited knee extension should result in forefoot contact. Why, yes, yes it does!”)  I felt like it was making noticeable improvement on a daily basis for the first few days  and now it’s just sort of hanging out at the same spot, which is a little annoying.  So I keep elevating it and icing it and thinking nice, happy, anti-inflammatory thoughts.

The other annoying thing is that all of that progress vanishes in about five minutes in the shower.  Thanks to my physical agents class this semester, I know exactly why that happens (dependent position of the leg + hot water/warm environment = super-swelling!), but it doesn’t make it any more comfortable.  When I hopped out of the shower this morning, my knee was back to the state it was immediately post-op, which meant I couldn’t really move it at all.  That was less than encouraging, even if it is motivating me to make my showering routine more efficient.  (The good news is that if I sit down, elevate the leg and wrap it up with the ace bandage they gave me, the swelling goes down pretty quickly.  But it’s still flaring up pretty good.)

I go back to the doctor tomorrow for my post-op checkup, and I’m guessing he’ll send me to PT where they’ll work on getting the inflammation gone for good.  I’m keeping my fingers crossed that I’ll have my knee back by spring break (in 3 weeks) so I can actually get out and do something fun like snowshoeing or cross-country skiing, but we’ll see what happens.

Is it annoying to still be in a “can’t do much, waiting to see how it goes” state with the knee?  A little, but the fact that I know it’s on an upswing helps greatly.  It still sucks right now, but it’ll be back to normal before I know it.

 

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