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.

Pictures: Hours 2 through 14 after my injury... don't look if you're squeamish!

Here are some images and x-rays, courtesy of Alon, from the Emergency Room and my Recovery Room at Boulder Community Hospital. 

DO NOT LOOK (at the first image) if you are easily made to feel sick, faint, or disgusted.

1. Here's my anatomically incorrect leg about 2 hours after the injury. I can hardly look at this. It's hard to see your physical body disfigured like this. Disclaimer: I know others have had it worse, and I certainly could have. But this is my story and it is all relative, and all I wanted to know the moment I hurt myself was that I didn't have any bone sticking OUT of my flesh. Fortunately, I did not. Below, I had just come out x-rays (then they ordered CT scan, which is when I started to go into shock). It took about 1 1/2 hours of administering various pain medications to get my pain from a 10 to about an 8 where I could turn over from the fetal position to my back and slightly straighten my leg in order to take the x-rays. The x-ray technicians, Mary & Paul, were outstanding, compassionate, helpful, and patient. I remember their names because I told them they were just missing "Peter".

2. Alon took this image to send back to my parents in Massachusetts... I look pretty terrible. My poor parents, just beside themselves with fear and frustration. But I was in really good hands at BCH and with Alon by my side. I don't know if this picture provided comfort for my parents to see me alive and drugged and in a hospital bed, but it's all they could get at the time. This was also pre-op, post x-ray. I believe I had just called them within the past 15 minutes or so with results from the x-rays, almost 2 hours after my injury. I can't believe I waited that long, but I sort of had to. I consciously did not make an earlier call because I had no information and was in too much pain to have a "conversation". I remember calling my Dad and saying, "Dad, I have bad news. I broke my knee." He said "Hold on," and put my Mom on the phone. I added a few more details and handed the phone to Alon. I could barely talk; I was losing my voice, shivering and going into shock, still in tremendous pain. I believe my sweet Alon was the best person to be with me during this difficult time, even though he didn't think he did such a great job. My family and I agree, ALON WAS AWESOME (not that he had anything to prove). Can you believe with me looking like this BCH almost had to put surgery off till the morning? I flipped out on the ER Physician Assistant, momentarily. Fortunately, the hard-working medical professionals and doctors at BCH put a specialist team together in about an hour and changed their minds... had me in surgery after about 30 minutes of seeing the x-ray and CT scan results.

3. Here we go... a more pain-free, fixed up, bionic Erin. This is probably around 7am on August 27th, about 8 hours after surgery was completed. I don't remember much other than I was glad that the pain was less and I had a wonderful night nurse, Bonnie, who was as fit as a body-builder and as sweet and calm as an angel. I remember some weird, random stuff from those first 14 hours. Like the anesthesiologist... for whatever reason I was giggling at him (under the influence of a ton of pain meds) with his curly brown hair popping out under a surgeon's cap, and thick black framed glasses.... telling him he looked like a cartoon! He never cracked a smile... he just put the gas mask over my mouth and off I went. At least I was making myself laugh.

4. First-person view of my leg in the CPM (Constant Passive Movement) machine from the hospital bed on the morning after surgery. This is pretty much the same set up and rig I have at home where I spend about 20 hours of my day.... moving every so slowly from 0-40 degrees. The purpose is to decrease the amount of scar tissue build up and maintain some range of motion while the bones and ligaments heal. Most folks with torn ACL and meniscus can add 5-10 degrees of movement with the CPM on a daily basis. Due to the severity of my injuries, Dr. Fulkerson ordered nothing above 40 degrees for several weeks. Aren't I special? I could work up to 50 degrees after a month or so when I feel able to do so. So far I toggle between 35-40 degrees depending on how tight my knee feels. It is subtle movement, but a significant and wonderful medical invention!

5. Below are a few of the best x-rays taken of my leg after the operation. I hope you can see them okay. Some are just kind of confusing, but interesting nonetheless. Alon and I got to see the top two at my follow up with Dr. Dolbear at Boulder Orthopedic (a very nice office, by the way) on Wednesday September 7th. They show a plate along the right side of the tibia (as you look at the photo) with screws going into the plateau and then down along the length of tibia to hold the plate in place. I think the plate kind of hooks at the top and there are about 6 screws that I can see. There was also a small medial fracture along the top of the fibula which was just reset and left to heal (an easy one they say). Alon snapped the photos of the other two x-rays in the operating waiting room when Dr. Fulkerson came out after completing my surgery. Word has it my tibia was crushed to mere fragments by about 1 1/2-2 inches! Then piled up and "glued" (bone graphed) back together with cadaver bone. In the top photos, you can see some of the metal staples trailing along the right side of the image, which neatly sealed up the incision along the outer side of my left knee. Based on the look of leg now, there also was some laproscopic surgery done through the inner side of my leg near the knee, for whatever reason. More to learn there when I see Dr. Fulkerson on Sept 22. This unique metal sculpture is a permanent structure meant to reinforce my severely crushed, fractured bones which will heal beautifully to 100% of "normal". Yes you heard me, 100%. Thank you, Dr. Fulkerson and the OR team.