Update: Week 12 (the three month mark... Yahoo!)

Monday

Met with my surgeon, Dr. Fulkerson, this afternoon. Alon came with me. In a nutshell, Lauri said"...I am so proud of you and so happy for you. You have made it over the hump. I am not going to have to go in and scope out any scar tissue. You are going to be fine. Keep working as hard as you have been."

She was very pleased with the fluidity with which my knee could bend and move (to about 115 degrees) and confident with my progress. The reassurance and feedback was very validating.

We all sighed with relief and Lauri gave me a very tight-lipped, reassuring smile and head tilt of "job well done". It was wonderful. I gave her a high five! You can tell she was also pleased that her hard work in surgery did not go to waste.

I was approved to weight bear at 50% (two days ahead of schedule). Do that for 7-10 days. Then doc said go to 75-100% with one crutch for 7-10 days. She gave me the leeway to trust my body and mind and take an extra day or so to transition where and when I need to (within the range she specified).

She also cleared me to go swimming, hot tubbing, and take baths! Yay!

Also, Dr. Fulkerson said the stabbing pain and soreness on the medial side of my left knee is likely a result from scar tissue. The scar tissue has built up significantly on the lateral side (where the tibial plateau was crushed) and where part of the incision is. This is pulling my knee cap slightly to that side causing some of that pain on the medial side. 

I also told her about the "figure four" resistance exercises that I am doing with April (my PT). We started those last week. That exercise works the muscle from the inside of my left knee, up the thigh, across the quad, and diagonally over to the IT band. That, along with weight bearing is likely the trigger for the knee pain. 

Lauri said if any consistent pain surfaces on the lateral side to let her know and that is of concern because that is where the majority of the damage was. Right now, I just feel some tenderness where the hamstring and quad attachment points are along the thigh. So I think I am in the clear right now as well.

I will see her again on December 2nd. We'll take more x-rays then (no x-rays were taken at this last visit).

Made it to the gym at 9:30 at night for a 25 minute work out. 15 minutes on the bike and 10 minutes of foam roller (on IT band, hamstring and calf) and some quad sets/extension stretches. It was a hard day and I felt like crap when I went, but glad I did.

Tuesday

Kicked some booty in PT: bent to 120 again. Grudgingly. I still cried on like the last 2 bends. It is still just so damn painful - all over the place. From the ankle to various parts of the knee, calf, quad, hamstring, and of course low back - which eventually relaxes as I begin to relax into the pain and try to let it go. I only took the 500mg of Tylenol before this session. The flexion/extension with April was slightly more painful, but I did not feel the "drug fatigue" that I would have felt had I taken the oxycodone. I think I'll save those for bed time (as needed). I was completely wiped out come 6:30, so Alon and I order Thai. I ate - quickly. Took a hot shower - slowly. And was in bed by 8:40. Took valium to chill out the overall soreness and pains in my knee. Asleep by 9:30. Zzzzz.

Wednesday 

Worked another long-ish day: 5.5 hours. That feels about perfect to me. Anyways, rested for a bit afterward but within 20 minutes of being home and literally putting my feet up, I could feel my leg start to stiffen and cramp. I went to the gym promptly doing my full routine. My knee, leg, and low back felt very loose while biking today. The rest was "routine". Might try swimming and hot tub tomorrow evening with Alon.

Thursday

No go on the physical activity today, outside of going to work (another 5.5 hours). Felt pretty tired, swollen, and soar with bouts of stabbing pains in my knee. All "normal". I was blessed with a very nice massage and girl-time from my friend, Bree. That was by far the highlight. She is awesome. I wish we could find more time to spend together. Anyways, despite that I still took a bunch of meds before bedtime (which was about 9am) = 500mg ibuprofen, 325mg Tylenol, 5mg oxycodone, and 5 mg Valium. I was out like a light... till about 4:30/5am. This seems to be the norm for the past couple of weeks - the waking up at 3 or 4am. Fortunately this time, I only stayed awake for a short period of time.

Friday 

Worked a solid 5.5 hours, sluggishly yet productively. Good to know I can still get things done :) Bumped my PT appointment to 4pm instead of 4:30, hoping that I will have a slightly increased reserve of energy. I took a 5mg Valium before the appointment to chill me out during the "bending" portion of PT - because I can get pretty worked up physically, mentally and emotionally - and ESPECIALLY when I am as tired as I am. I guess it kind of worked. Progress in that regard was 123 degrees of flexion. Extension is getting harder (to be expected with continual progress in bending). So two tricks I was taught this week with that one is to lay down, face down, on the bed, legs hanging off the edge of the bed just above the knee. Sounds yucky, right? Well, if my knee is not even close to hyper extension because of all the scar tissue, this exercise is fine. The other trick is to prop my foot up about a foot with my leg extended straight and just keep relaxing the leg and knee. Hold this position for about 5 minutes (same as the other one), and then come back to bending. Both feel excruciatingly painful in the end, BUT absolutely essential to get and maintain full extension in my leg. I did take 1000mg of Tylenol today. Seems a bit over the top but at this point my liver considers that a break. There is a pot luck at my friend Katrin's tonight. I hope I make it, but it's not looking good (energy-wise). There is the whole "mind over matter" thing, so who knows, I could get a second wind! This weekend is all about RELAXING and RECUPERATING. Boulder may get a good deal of snow Saturday, so I am hoping to cozy up inside, drink copious amounts of tea, read and maybe do arts and crafts, and grocery shop if I absolutely have to.

That last paragraph was a complete stream of consciousness but I don't feel like editing it and organizing it. This is after all, more a like a journal sometimes than anything else. I learn something about myself, and maybe my reader picks up a thing or two as well.

Take care and love to you all.

The Down-Swing to the Up-Swing

That sadness and fear and weakness that I pushed back during physical therapy on Friday seemed to resurface Saturday evening. What a surprise. 

The sharp, frequent, stabbing pains through the medial side of my knee were really getting to me. They've been happening with more frequency the last couple of days. I am certain it is from increased, constant weight bearing at PT from Friday. 

I had a somewhat "full" day Saturday with out over doing it, I thought. Started the day with a lovely Skype session with my brother Mike and his girlfriend, Alicia, in New York. Got a quick and tasty breakfast burrito at Illegal Pete's with Alon. Viewed an apartment (with a billion stairs and down branches everywhere). Scooted around Whole Foods with Alon (me: in a power scooter that could literally turn on dime, a 1000 times better than the Target version). And in the afternoon, I finally sat for about two hours while I got my hair colored. I decided to take the day off from the gym/PT. I was feeling fatigued since I woke up but decided to continue activity at a relatively slow pace, checking in with myself (did I want to go home and sleep or go grocery shopping with Alon? for instance). By late afternoon and night time, I was completely beat, a bit cranky, and the pain had not subsided at all despite 1000mg of Tylenol since morning. Alon and I cooked dinner and watched two movies. I iced my knee a bit, later on putting heat on the medial part of the knee. I was trying everything.

Did I mention Boulder was experiencing 60+ mph gusts yesterday? Today it's not so bad, less wind up, but still up there at probably 30-40 mph. Anyways, that kind of wind always makes me feel unsettled, even on a good day. And surely challenges my stability (physically and mentally) while on crutches.

As I write this and reflect more on my day yesterday, I realize, "Shit. I did not actually take it very easy." Well, I tried. I did go slowly, if that counts. The conversation I had with myself yesterday was "If I went home I would be letting the fatigue win and probably feel sad or something." 

I was starting to have regrets later in the day that I didn't go to the gym, since I was feeling so crappy. Alon reassured that I was fine and it was probably an okay thing to do (and it was).

The balance I was trying to achieve was activity without increasing my pain while not giving in to fatigue. That's hard!

By night fall, as I tried to stretch and massage my left leg in bed, I wept. Whether it was pain, fatigue, or frustration that set it off. There I was, crying yet again. Oh well. It was, again, cathartic. I remember yelling (in a nice way!) to Alon in the other room, asking if he could please put away the left overs from dinner. He was like, "Sure." Here's the straw the broke the camel's back last night: the fact that I couldn't do it; I couldn't muster up the strength to crutch to my wheel chair in the other room, put down the crutches, wheel into the kitchen, put everything away in Tupperware, clean up, and put stuff in the fridge. It was just too much. There's got to be a word for angry-self-pity-weakness-discouraged. That is what it felt like.

Anyways, that was my moment last night. The down swing to the up swing.

I woke up with a headache this morning. Scarfed down a bowl of gluten-free granola and drove to the gym, where I proceeded to do rehab work out. I felt good about getting there and that is was the right thing for my body and mind. I was still very stiff and sore when I work up. The work out did help with that. The interesting part again was the first few minutes on the bike. I just cried. Discretely trying to wipe the tears from my cheeks. I focused my pain, tiredness, weakness, and frustration into the healing process and strength of my leg. I listened to some good music in my headphones and 15 minutes went by on the bike. I continued with the rest of my work out and headed home about an hour and a half later. Slightly less tired, slightly less pain.

Update: Week 11 - Mind Over Matter

Mind over matter:

In no other instance was this truer than a shared experience today during my first half hour of physical therapy with April and Alon.

I was bending at 116 degrees. We'd done it three, maybe four times. We'd been going for about 15 minutes or so, of bending and extending (straightening). Sharp pains increasing like daggers stabbing through the side of my knee. The knee began to tighten. Mentally I started to feel weak and tired. (I was actually tired going in - I think the oxycodone I took an hour before hand was making me feel fatigued. I may skip it next time, since the only time I seem to take them is right before PT). My hip was lifting off the table. Then I could only get to 110 degrees or so. Frustration and weakness set in. The tears began to fall. My breathing got short. April reminded me to stay calm and try not to get anxious or down on myself. Alon demonstrated deep inhales and exhales. I mimicked them.

"Don't let it get to you!" I thought to myself, then said it out loud. 

"Acknowledge the pain and fear and frustration, briefly. Then, tell yourself to RELAX."

"JUST RELAX." I repeated over and over out loud.

"It's okay. Calm down. Relax into the pain. You're okay. Nothing bad is going to happen."

Then, we got to 116. 118. 120!

I actually felt relaxed. My body was laying in a somewhat peaceful state. My mind was somewhat peaceful as well. The discomfort and tightness in my knee and quad was there, but it was not unbearable. I was talking. Taking long slow inhales and exhales. LAUGHING EVEN. We were making jokes of some kind. I think I said, "Let's do it for all the American Soldiers!" (Being that it was Veteran's Day.) I was half-joking (at least Alon & April laughed) but also trying to find any inspiration or distraction I could to KEEP GOING and OVERCOME.

Bent at 120 degrees we held this for about a minute. I relaxed and straightened the leg (always painful after bending like this). Then back to 120, not two, not three, but FOUR TIMES. I was absolutely amazed. My mind and heart and soul had overcome the mental and physical barriers of pain, fear, weakness, and frustration yet again. Right then in a matter of moments.

It was some kind of bliss seeping through a sieve of pain and frustration from sheer will and determination. I felt liberated.

Update: Week 10 (going into 11)

So as of Sunday, November 6th I started weight bearing 25% of my weight, or roughly 40 pounds, onto my left leg. How this happens is I stand with my right leg planted on the floor and my left leg on a scale. I press onto the scale until it reads 40 pounds. Then I walk around trying to mimic that weight and sensation. I'll come back to the scale a couple times during the day to see if I am maintaining that pressure. It's hard! Usually I am at about 25-30 pounds when I think I am at 40. It doesn't hurt my leg much at first, it's mostly awkward and feels slightly unstable. 

I am also experiencing some of the "pins and needles" or tingling feeling in the bottom of my foot, mostly on the ball of the foot, towards the middle, and along the arch way. This happens as I walk and put added weight onto my leg and foot. It's normal. It means I am getting sensation back and re-establishing those nerve endings and pathways to my brain. It's uncomfortable, temporarily painful, but I just keep walking and the tingling tends to work itself out.

I am being mindful to not develop a limp in my stride, just keep it as smooth and steady as possible, which right now also means walking quite slowly. And I am trying to even out my hips as I walk as much as possible because Lord knows my left hip is rotated and a few inches (it feels like) higher than my right hip from holding the leg UP and out of the way for so long.

My low back gets a little cramped up from time to time, but mostly my body is holding up well.

I am still going to PT twice a week and the gym on off days - aiming for at least 4 days per week at the gym (doing the same exercises as I do at PT). I've had some struggles recently getting to the gym, from tiredness, soreness, etc. but once I get there I end up feeling 100% better! On that note, I encourage you all to get your asses to the gym or at least do SOMETHING physically active EVERY DAY. Your body will love you for it.

Last week's PT stats are as follows: added 3 different types of squats to the hour and a half session (ouch!)... good, effective, and tiring. My range of motion last week was something like 98-110 and 98-112. Today I went 98-116! And on my own, I could bend my leg (after some warm ups) to 113. That was incredible! I couldn't believe it. I really need to stop being so hard on myself and give myself some more credit... as stated by my physical therapist. She said I am making great progress, and to expect some harder days and nights ahead (again!) as I start to weight bear more and increase exercises and mobility.

I'm doing a lot more around the house - that is: cooking and getting my own meals regularly. Not so much cleaning, feeding kitty, or making the bed or anything yet because I'm just not that agile or stable on two feet yet. But the last couple days, I've given myself a bunch of extra time in the morning and I'm fed, with tea to go, and ready for work in about an hour and a half. The hot showers in the morning (with hot water on my leg) still really help loosen up my muscles and give me time to work on flexion and extension in a seated position.

I have a care provider coming just once this week and once next week (while I am at work) to do some house cleaning and cooking. Then, hopefully I will be back to my home routines... which at that point, might include shoveling snow! BOOO :(

Speaking of yard work, Alon raked the front and back yard this past weekend. I watched. I longed to just rake the yard. I really would have enjoyed that. God, it is hard to just not be able to do certain things like that. I am thankful for Alon and know I'll be back at it soon enough, but damn, I still have a good deal of sorrow and frustration some days.

The other day I had a dip in mood, feeling sorry for myself and what came out of my mouth, to my surprise, was "I can't believe this happened." It's true. I still can't believe it sometimes. From the wisdom and truth of my physical therapist April today, she said something like, "You gotta have those moments and let yourself feel it. But at the end of the day, where is your anger and frustration going to get you? (The answer: Nowhere.) Focus all your (my) energy on working hard, healing and getting stronger. Focus your energy and emotion right into the knee!" And that was the moment today when I bent to 116 degrees. Good stuff! Powerful. Our minds are our greatest barriers sometimes. This whole process is really about balance and awareness, in every way. Isn't everything?

Responses to "Return to Work"

I think it is important that I share the two comments below that I received by email this past week from two loved and trusted people in my life. They are spot on and fill in thoughts and feelings where I may have trailed off (in my mind). I really appreciate the support and love that surrounds me while I walk along this bumpy path. These people (amongst others) really do complete me as a person. Thank you for telling me to chill out sometimes and for bringing things into perspective!

Comment #1
"With regards to your people at work I'd say: focus on YOU!  As you know, people respond in a variety of ways to challenging situations (i.e. fear, over-care-taking, awkwardness, pity, trying to cover their own asses in terms of liability yada, yada...).  You never know exactly why it is that people say what they do, how they do, when they do.

Just be clear about what your intentions are for next week, do your best, listen to your body and take breaks/"call it a day" when you need to. If you feel good and have energy, then keep on truckin' - to hell what everybody else thinks!! Let others' comments, tone of voice, facial expressions, body language etc. go by the way side for now.  If there are repeating patterns that come up again and again with the same person over the coming weeks, then I'd day sure, go ahead and bring it up/address it. Otherwise, my council is to forget about this level of analysis for now and focus on what your goals are, how you know you are feeling/doing and what you know you want/need to do. Make all this clear to others and let them deal with their own doubts/fears/issues..." C.F.

Comment #2

"You got it girl, always good to hear from you. Good job!  Have a great time back at work, that schedule sounds good :) I think getting your mind off yourself and back onto your job is gonna be great. You will love the new energy and business I bet, and you will sleep good at night!

Have fun and good luck, my sisterly advice is try not to confuse peoples concern, compassion, or wanting to help with pity or fear, ok? There is definitely a big difference... Remember over the years how compassionate you have been to others, even to people you never met before! You would have never wanted them confusing your compassion for anything else right? So give them a chance, let them care for you, it's ok, You would do the same for a coworker if it was reversed.

So be patient with people and just keep your heart open, soak it in, you will do great!! I'm not sure what happened there, or what conversations you have had with coworkers recently, I wasn't there, but to me it doesn't seem like the type of work place or community that would hinder your progress or productivity, so try not to worry to much, ok pal. Just reeeelax." B.B.

Retuning to Work

The short of it is I am starting back part-time at my work, Boulder County AIDS Project, on Monday November 7th. My goal is a twenty hour work week, 4 hours per day. Then building up to 2 full days and 3 part time days. Then 3 full days and two vacation days the week of Thanksgiving. And then, the last week of November, be back to 40 hours per week. This is a plan that my doctor and I talked over and agreed upon... work feels slightly differently, that I should do 3 part time days to start and "talk it over" and see how I feel. Kind of like the under-promise / over-deliver philosophy. I think, from their perspective, they are also being thoughtful, careful, and protective.

On Monday, November 7th it will be 10 weeks and 2 days post-injury/post-op. I feel ready and excited to return to my previous routine. Well, within reason - who wishes they didn't have to work or cook and had people waiting on them hand and foot? Seriously though, this transition is good and I am ready for it! I am also working with a bit of nervous energy. I believe it is mostly to do with dealing with people who have not seen my progression all along and who might be scared or nervous that I will "reinjure" myself at work. 

I am so freaking careful and body-mind aware at this point that I do not expect to be derailed in this transition. Of course, there will be moments and I will just keep a keen awareness of myself and what's going on for me. I have goals and a sense of something to prove TO MYSELF, but not so much to others yet inevitably and naturally that will occur. Regarding some recent conversation with my employer, in some ways I feel very supported and there is a strong degree of excitement and confidence with my return. And yet there is also, from different people, what I interpret as doubt and a lack of trust that I am able to accurately assess and assert my needs and set appropriate, safe boundaries. I do not need others to do that for me, especially my employer (which is sort of what it is feeling like, but I must not ruminate on this...). Maybe we will butt heads, maybe it will be a more relaxed "coming together" of sorts. I hope for the latter.

Certain people at my work habitually operate from a fear-based perspective and that will not help my recovery process. I believe that is what is evoking my response of distrust. It also evokes a response of feeling powerless and incapable. This is NOT how I am going to spend my energy or any portion of my recovery process at work! I am just venting it here. I say this with the most kindness and compassion I can muster: some coworkers are in for a realization because I am not going to put up with people looking at me and treating me through a lens of their own fear and discomfort. I will let them know it's direct impact on me, like how I do my job and progress in my recovery.

Boy, does this bring up personal stuff or what?! I am now "on the other side of the fence" where some people see me as compromised, challenged, etc. and their fear is a bigger barrier than anything else to my progress in the world.

In the last two months I have learned a great deal about when and how to push myself, how to interpret my body-mind experience, what to anticipate, how to articulate my concerns/frustrations/advances, and when to back off and relax and be patient with myself. I sense now I am going to be pushed in a new way (like with the care providers and doctors) about how to be patient with others, let them express themselves, and also how to be direct and nip things in the bud so shit does not get out of hand! Actually, I have a feeling I am not going to be all that patient. Patience in this context will not actually serve me or others. What a realization for me! It will behoove me and others to be upfront and straight forward and not hold back what I am feeling and thinking at work, about work, and about my healing and recovery - who or what may or may not be helping or hindering my progress and productivity.

Everyone I have talked to lately agrees that we are all impressed with my progress! This comes from a variety of perspectives including my surgeon (Dr. Fulkerson), physical therapist (April Smith), parents, friends, Alon, and my massage therapist, Bree, and just today - my Shiatsu healer, Dale (who last saw me at week two). And of course, me! 

I continue to work hard every day to get my physical stamina and mental acuity back to where it was (or better). And I think it shows. Getting to the gym yesterday and doing my PT routine and biking made me feel great and tired, but not like I had to go home and sleep kind of tired. Alon and I actually went out and had a nice lunch afterward. The stamina dip is expected and normal. I've realized there are times to work through that and it makes me feel stronger and more present. Then there are times to just close my eyes and let my body and mind recover. I am better able to tell now more than ever before in life, what I need and when as far as personal needs go.

That is my rant for today. Thanks for virtually checking in! :-)

Play Therapy at the Park! (pictures)

Yesterday, Alon and I and our friend Kat went to North Boulder Park. While Alon and Kat walked her dog, I played on the swings and started making up my own exercises. It was freeing, uplifting, empowering, and fun! Before hand, I honestly just wanted to go home and fall asleep, but deep down I wanted to test my endurance and push myself. I had already pushed myself that day (socializing, eating out, crutching around plus a lack of sleep)... but I am so glad I pushed a little more and discovered these moments of joy in the fresh, crisp Boulder air at the base of the Foothills.

Here I am (click on photos to enlarge):

Extension on the way up...

Flexion on the way back...

Runner's lunge, Position 1: Flexion. The majority of my weight is supported by the swing's saddle, my back (right) leg, and hands. Just a light toe touch on my left leg (permitted by doc).

Runner's lunge, Position 2: Extension. Just trying to straighten that left leg and feel a good stretch!

Look at me, I can fly! :-)