Getting unstuck

I've been doing Pilates at home on my (friend's) mini reformer, the AeroPilates, for about three months now. I've increased from once a week to three days a week, now to about every other day and sometimes more often than that. I've also been getting incredible "rolfing" or deep tissue massage which couples the physical massage experience with a much deeper stored memory (usually trauma), emotional, and spiritual release. The massage was every other week for about two months, then every three weeks, now every four to six. Every other week (on average) I attend a "restorative yoga" class which I nickname as "assisted naps". It's the slowest, most gentle, effective "yoga" one can imagine. I took this class the day after one of my massages last week, and for only the second time in a year was able to fully go into Child's Pose without much effort or strain. I quietly celebrated with a little wiggle of excitement as everyone else in the room dozed off momentarily. All of these acts of self-care have been incredibly transformational, moving, and encouraging. I've found the groove that has taken my body to the next level of healing and strength. 

At work, I've transformed my office to include a stand-up computer workstation. This allows me to get up and down a lot more frequently and even stand for extended periods of time. For a girl who battles the concept and physical reality of sitting at a desk all day, this sitting-standing combo has brought much relief and spring in my step you might say. I get up from sitting and can walk with ease, no stiffness when walking at all (usually having only sat for a few minutes, not a half hour or more).

The combination of Pilates, deep intentional massage, restorative yoga, and the stand up work station have dramatically improved the stiffness in and around my left knee. At times the massage has worked "miracles" in my opinion. I come out of a ninety minute session moving and feeling as light as a feather. My mood dramatically improves as well. The massage has truly facilitated incredible breakthroughs. The yoga instills relief and a sense of deep inner peace and trust and truth seeking. I wake up in the morning and it takes only a couple steps to shake the kinks out and walk normally to the bathroom. I end my day easily traversing the steps to my bedroom. I bike everyday, sometimes standing up on the pedals to power up a hill. All this without a hitch.

The thing that still bugs me is the soft tissue pain, mostly behind my knee, when I try to do a full extension. This is something my massage therapist and Pilates instructor/physical therapist and yoga teacher continue to monitor and reassure me that it just needs some good stretching. Regardless, it's frustrating. All the stretching and massage help certainly but only temporarily for this tiny little bit of stiffness felt upon full extension of my left leg. Last night I had this sudden insight. My subconscious lit up and said loudly, "Go get acupuncture." Then I thought, is it acupuncture or some other energy work - like reflexology or reiki - that I need? 

There's always something we can do to move through stagnation, even the tiniest effort or awareness can cause a dramatic shift. I've heard the calling to do something different about this bit of stiffness behind my knee, which has been plaguing me since my first "quad set" with the home physical therapist last year. I'm excited about this new awareness and invitation to bring in more alternative healing modalities. There's really no telling where it will lead in both my physical body and my day to day life. It's time to get unstuck, one level deeper.

My body is my temple

Quite a few people have asked me lately, "has this injury been a spiritual experience for you?" It's a really difficult question to answer. I think I can see where people are coming from though: has my experience affected me in some profound way? What is meant by "spirituality" anyways? I think it has changed almost constantly throughout my lifetime. In a good way. In a way that allows me to learn something new, see things in a new way, and not get stuck in a specific dogma that excludes all others. 

While blogging, I've shared with you the glimpses and glimmers of spirituality as it is often woven throughout my experience (and all of ours, if that's how we chose to see the world).

Today, while silently thinking about people's inquiry around spirituality and developing my own... I thought, "what is my spirituality to me right now?" At times I have been more focused on the intellectualizing of spirituality and religion, more devoted to my meditation practice, and more open and aware of the spiritual teachings of others. 

For the past 6 months I have been so enveloped by my recovery, physical training, emotional well-being, and relationships with my loved ones that my focus on spirituality has in a sense become less, I thought. When in fact I don't think it's become less. I think it has shifted even more from an external experience to an internal one. 

During this time I have never been so dedicated to my self. At the same time, my gratitude has never felt more abundant. I have never had to open myself up so much to receiving help and love from others. I have never been faced so directly with the challenge of self-acceptance and harnessing will power to overcome great personal adversity.

So anyways, as I sat kind of glazed over on a stationary bike at the gym staring out into a bright, sunshiney day I asked myself about spirituality - have I drifted away from it? What has changed for me? What is my spirituality now? 

An answer billowed inside of me:

"My body is my temple." 

Yes! This made perfect sense to me! To me, it meant that all the while this divine presence, the spiritual teachings I sought or thought that I might be missing were always within me and within my own experience as a physical being of this earth. This is great, I thought! Keep going! Ride this wave.

I didn't just hear the words my body is a temple or hear someone nearby say it (cuz lets face it, it's not the most original phrase, especially here in the yogi capital of the world: Boulder). I really felt my body as a sacred temple - as a place to experience my "awakening" of sorts. This body of mine is a place to cherish, to nourish, to take care of, to believe in, to accept, to love, to protect, to give of freely, and to be amazed by! 

Deep in my bones and in my muscles with each revolution on the bicycle the words echoed in my mind and resounded in my heart. It was reaffirming to know and deeply feel that my dedication to myself is not fleeting and it is so important. This is a forever commitment to myself. Who knew I would be woken up in this way by this injury and recovery process? 

This body of mine, this thing so easily taken for granted, so under appreciated at times, so neglected in the past... is not only what takes me on my spiritual path but it IS my path toward awakening, toward understanding, toward gratitude, and toward cultivating more love and acceptance of myself and in turn, of others.

5 Month Update

Physical Therapy:

• Roughly 3 more months of PT - next week I will be winding down from 2 x per week (for the next 2 weeks) to 1 x per week (weeks 3-6) to once every other week (weeks 7-12).
• Range of motion is 131 degrees on my own
• Hamstring strength is very good
• Quad strength is getting better, still needs work

Body's Condition:

• Hips and knees seem better aligned (evident during squats)
• Gait is improving, limp is almost unnoticeable at times 
• SI joint displacement leading to joint pain and sciatic nerve pain down right leg / off and on for last couple of weeks - becoming less frequent.
• Very tight psoas and hip flexors
• Increasing ab strengthening exercises to hopefully minimize the low back and hip pains  
• Weekly myofascial release (focusing left knee region) and massage therapy (Thai/full body)
• No pain relievers (Tylenol/Ibuprofen) for knee related pain in about 2 weeks!

Personal Update: 

For all intents and purposes, I have permanently reduced my work week hours to 32. After trying to hit 40 per week after the new year it proved to be too much. My overall health and rehabilitation were suffering. After reaching the decision on Monday and getting it formalized and approved on Tuesday, today I felt like a renewed person. I am very much looking forward to the reduced hours - after a lot of battling with myself, disappointment, and purposeful realigning of my goals to be more realistic, more achievable, and less devastating. 

The inquiry I find myself in more and more goes something like:

"What decisions can I make in each moment, every day, and over my lifetime to deeply feel as much health and happiness as possible?". 

The intention I wrote out this morning on the community "2012 intentions board" in my kitchen was:

I will do everything in my power to bring more personal awareness to and to achieve my optimal physical, mental, emotional, relationship, and spiritual health.

This is where I am at now. I am really starting to open up to some new awareness, to shed some old beliefs and perceptions, and to tap into the richness this experience has brought me. It feels really good and wholesome, very freeing. 

Surgeon's update to come ... next follow up appointment is this Friday, 1/27/12!

Physical Therapy Highlights!

Today was a fantastic day at physical therapy! Flexion was measured at 135 degrees with the unwavering assistance from my physical therapist, April. I made it to this position not once, but twice. It was awesome! Of note, I can be released from physical therapy once I am able to bend to 135 degrees on my own.

Last week we made some of my exercises more difficult. The most challenging is the one-legged, side-lying squat with a squishy balancing disc placed under my left heel (for pushing off of). Two sets of 5. It was remarkably easier to get started and keep the momentum this week, though still teeth-clenching and bursts of vocalization to make it through each repetition. Some day I will be where this girl is: http://www.youtube.com/watch?v=tME4WKWr5d8. The next hardest would be the "monster walk". Imagine taking a thera-band (silver - maximum resistance), tied around your ankles, held taught at about should width apart, bending into a partial squat and stepping side ways. Going quite slowly to keep control of movement of both legs, and remaining in a squat. Each leg, inside and out, gets a total work out, not to mention the glutes, hamstrings, and calves. I did three laps across the gym floor (about 25 feet in one direction). And my legs and butt were on fire! Here's a muscly guy doing a wimpy version: http://www.youtube.com/watch?v=8CGNwL5xSd0.

Weekly Rewind (week 15+)

The update that just wouldn't end...

I feel like I can not top my post from December 2nd with all that excitement about walking. Since then, it's been a little hellish with good moments in between, no doubt. I've finally come around to posting an update after getting over sleep deprivation and feelings of depression:

Saturday 12/3

- woke up, headachy and sore, and took a hot aromatherapy Epsom salt bath

- walked around without crutches in the morning - snow and ice just beginning to melt, clutching Alon's arm tightly, as I stepped purposefully from house to car, car to Centro (for breakfast with friends, Jesse & Dan who were visiting from Germany!), Centro to home (where I CRASHED OUT, watched movies, read book, took bath), no pain while walking - what freedom!

- night time sleep ended abruptly and too soon, from 3am-6am, lots of deep soreness in my entire leg and also shoulders for some reason; valium/tylenol/ice/heat/pain relieving creams did not touch it.

Sunday 12/4

- woke up not too sore, but not well rested either - another sleepless night with pain and soreness like no other prevailing. I guess my muscles were doing overtime!

- we still walked around (no crutches) just to the Trident (for tea and hanging out) and actually it seemed to help me feel better.

- but I continued to feel the pains of my perseverance, as a full-body soreness began to creep up on me from my toes to my mid back in the early evening

- another morning's sleep wasted, up at 4am, wide awake and hurting. this was really starting to bum me out.

Monday 12/5

- fatigued, groggy and feeling depressed, I made it to work at 9am with the light at the end of the tunnel being my appointment with Dr. Fulkerson at 2:15, and then I would call it a day.

- doc confirmed strong progress and my next appointment will be at the end of January (yahoo!)

- Dr. Fulkerson wants to do an MRI sometime in the next 6 months to check my ACL (does it need sugery?).

- hardware (plate and six screws: which I plan to make into some behemoth jewelry!) will come out sometime around August 2012 and may be coupled with ACL surgery if deemed necessary - healing time would be 2 to 8 weeks depending on what gets done (plus more rehab if ACL is operated on).

- amidst all of this, Alon and I went to check out a new housing opportunity which would cut our living expenses in half! It's a community house, in a huge mansion (that's like saying a mansion mansion, which it was) in the historical district of downtown Boulder. We were quite impressed and will await an interview with all SIX housemates this coming Sunday.

- Monday evening I cried myself to sleep, just tired and sore beyond relief, with the help of Tylenol PM (at the recommendation of Dr. Fulkerson)

Tuesday 12/6

- woke up at 5am... at least it wasn't 3am! grudged along to work, groggy and foggy and hurting. I didn't hide it very well. I was back to using one crutch most of the day in hopes that it would provide relief. 

- I hadn't been to the gym since my PT appointment on Friday - I couldn't decide if that was okay or not. April (physical therapist) assured me that it was and walking again was going to be just as hard as I my experience was dictating, and to rest and recover and take it easy on myself! PT was low key that day. I could barely keep it together walking down the hall to PT. I remember saying "It's hard to tell myself 'It's okay, the day is going to be okay', when I am clearly not feeling okay and the day sucks hard! 

- I can't imagine the perseverance and strength my Mom had, for instance, when two years ago, every 3 weeks for several months, she just kept feeling shittier and shittier, chemo treatment and treatment - YET - you just know that whatever tough shit you're going through is part of the healing process. Her doctors told her "Give me a year and I'll give you your life back". That is an awesome phrase for anyone to hear who is going through an injury or illness that does have a light at the end of the tunnel. That's what I try to remind myself of during my darkest of moments (along side letting myself just have my dark moments). I am coming back to life, it's just difficult, that's all AND I am so fortunate and blessed in so many ways, so "SUCK IT UP, ERIN!".

Wednesday 12/7

- slept til 6am, wandered through the day, meeting after meeting, showing up, and getting maybe 3 things done on my to-do list. Produced a couple smiles, laughs, and went home - exhausted.

Thursday 12/8

- regaining my mental acuity, I started the day at work by participating in my 3rd phone conference of the week. I think I may have said one intelligent statement that was well articulated, asked one dumb question, and carried on with my day... some insane heel pain is whooping up, not sure what to make of it exactly.

- I worked out a 32 hour per week schedule with my supervisor earlier in the week - who has been SO supportive and flexible while I try to navigate recovery + work + maintaining my sanity. So, once again, my work day ended around 3:30pm which is REALLY NICE. Went home, biked 20 minutes at the gym to loosen up my knee and later on crashed out with my friend - you guessed it - Tylenol PM.

Friday 12/9

-  did I mention the INSANE HEEL PAIN?!!? I looked it up: The heel has a fatty cushion called the calcaneal fat pad that when not used (or injured, say from running too much) will deteriorate causing pain to the heel bone like a deep bruise with added sharp, crippling pains. Thin bone spur or plantar fasciitis (now I can relate to those people too!!) With increased use of my foot (i.e. walking) the fat pad will naturally build back up and the pain should subside. It's a balance between use and rest, ibuprofen and ice, and perhaps purchasing new kicks and a gel heel insert.

- PT was really good today (once the drugs kicked in)... we added new exercises to the routine - including harder squats, extension, and a cool exercise on the Pilates Reformers - and I just felt REALLY GOOD and STRONG and HAPPY! Everything glowed, even me.

- Alon and I ate dinner at home - a little something I whipped up in the microwave. Then I took us out for what was just supposed to be apple pie, but ended up being another full meal at Riffs (go to this restaurant - it's new in Boulder - and EXCELLENT in all ways!)

On the Pilates Reformer. Spring loaded tension as I do a half squat and slide my leg out. 2 sets of 10, also in reverse position.

Saturday 12/10

-  CHILLED. Bought travel size foam roller and new running shoes (after trying on at least 20 pairs in the last 2 weekends - found a pair that was comfortable!) :)

Highly recommended!

Sunday 12/11

- Finally went to the gym again and then, CHILLED.

- Alon and I also attended the interview as housemates at the Highland House which went really well. Seems like a cohesive, mature, good-natured, honest group of people to live with... we will see... and we will let the feeling sit for a couple days. Probably find out Tuesday what their final decision is.

Monday 12/12

- Worked til 4. Sat with Alon at Atlas Purveyors for an hour afterward enjoying a delicious home-brewed Rooibos chai and brought a black coffee to our famous Vincent, the street corner vendor (at 16th & Pearl) of The Denver Voice.

- Made a nice dinner of baked salmon with an organic locally-made apricot-jalapeno jam (bought at this summer's Peach Festival in Lafeyette with my Mom), coupled with spaghetti squash, and garlic-ginger sauteed greens.

- Got psyched up with Alon to go to the gym for an hour an a half at 8pm. Did my whole PT routine, dropping the biking portion down from 20 to 15 minutes (to avoid knee pains), and felt really good about it.

Tuesday 12/13

- Busy day of work with back to back meetings. 

- 20 minute coffee break with my friend Mary at Trident.

- Then a hearty PT session where we introduced 5 minutes of stair stepping (which almost killed me) and two variations of squats on the total gym where I used my left leg only (almost impossible), a modification on the wall slide squat where we tried to get 75% use out of my left leg and 25% out of my right, and two additional squats - one free standing bilateral functional squat and the other one standing on just my left leg using TRX straps. There is an undeniable learning curve here for my neuromuscular pathways, but at least I feel physically and mentally strong enough to try them now. Major progress and more to come!

- Alon and I got accepted as the new housemates at the Highland House. We are very excited! We'll be moving around January 5th (hiring movers, no doubt!). The cost savings is immense and the environment will be really cool and beautiful and wholesome (not cultish or sketchy, don't worry!).

Ta Da! That's it for now. Who actually read all this without falling asleep? Maybe just Mom and Dad and Mary... that's okay... love you guys :)

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.

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! :-)

Physical Therapy Breakthough!

Pain is okay today. Still took an oxy and rubbed pain reliever cream (like icy hot) on my knee today because I could feel some sharp pain seeping in. But as I type I am sitting without a brace with both legs dangling over the edge of the couch. Right ankle crossed over left, applying slight pressure to push my left leg back. Knee feels tight, but tolerable.

Kind of made a break through in PT Tuesday! I was laying face up on the exam table (per usual - sometimes we do face down, and that is no fun). Face cloth in mouth to bite down on and muffle my screams. I know, kind of a pathetic sight. Squeezing the bajesus out of the stress ball in my right hand. Right foot pushing down furiously into the table top. Glutes flexed... talking myself into relaxation. April by my left side ready to get me bending. I had come into the appointment, smiling and laughing, the usual Erin. Then, Jekyll meets Hyde.

That said - On Tuesday October 25th during out patient PT with our beloved April Smith, it was easier to get to 98 degrees than ever before (still painful). Maybe it was all that talking to my knee in the wee hours of the morning. At 108 degrees of flexion my hip actually relaxed with less effort each time. We did this repeatedly with the same success about 3 times. We held it at 108 degrees for about a minute each time. It still hurt, but I could mentally and physically feel a shift. It made me (all three of us) so happy. We all realized this change was happening. All the while, Alon hovered over me holding me down and pushing my shoulders down into the table so I wouldn't skootch back. It actually worked as awful as it sounds. And I loved having Alon there, with his good energy and intentions and strength supporting my progress. 

April noticed that the muscles in my leg were contracting less (or something like that). She said we have worked through most of the muscular pain. The muscular contractions and pain were previously stopping us from progressing (she could feel it as could I). She said she felt like I have started to move into an actual physical stop, the scar tissue. This is good. This is okay. She says it should be easier and less painful to work through the scar tissue. Should I believe her? I do.

I can really see and feel progress, like my left leg hangs more easily around 90 degrees and I can push just a hair beyond that without so much pain as before.

YAY! Love to you all!

Dear Left Knee, that's right I'm talking to YOU.

It was 3 o'clock in the morning on Tuesday October 25th when I woke up with stabbing pain through the sides of my knee and deep soreness, which had continued over the last 24 hours or so. It kept me up for about 3 hours. About one hour into it I decided to take 7.5mg of oxycodone, even though I had taken one plus 5mg of valium about 6 hours prior. I haven't had to take this much heavy pain medication back to back to help me sleep for about 2 weeks.

I decided to have a little heart to heart with my left leg and left knee. It went something like this:

Dear Left Knee,

I want you to know that I hear you, I feel you, and I love you. I know you are hurting and tired. The rest of your body is here to offer love and support. We will be patient while you recuperate and regain your strength. Please try to be patient too and just rest. You worked harder than usual this weekend and last night. I know you're trying to be more social, mobile and active, and we realize it takes its toll on you. We commend you for your bravery and attempts at finding joy and normalcy in your day to day life. It suits you. Keep trying and keep taking it one day at a time.

Tonight you're feeling a bit hopeless and frustrated, tired and obviously in pain. Like someone is stabbing a knife through one side of your knee and out the other, while your quad and hip are in spasm. We feel it too. Your body is here to support you. You're not alone. In fact, your feelings are universal.

We hope you can find some peace in knowing that we (your body and mind) and many other humans and living beings in this world may experience something similar to what you're going through or see someone they love struggling and fighting like you are. We hope you can find that restful place inside you. Know that it's okay to let go of the pain. That others share in your pain.

Rest and peace are everywhere in every thing. You can tap into within you and all around you. Let the pain and discomfort and emotions you feel sink into the earth or float up into the stars. The universe can take whatever it is you can't or don't want to handle right now. You are not a coward for doing this. You are human. You should not feel the need to do it all and keep it all together all of the time. There are billions of people and other sentient beings that are sending you love and light right now. Right now. Receive that love and light and let it fill you up. See your pain and struggle for what it is. Let it go as much as you can. Let in the abundance of life and healing power of peace and compassion and gratitude.

With ever lasting love,

Erin

Week 7: Bullet points from my first week of out-patient PT

Take the pain meds about 1 hour BEFORE your PT appointment. If you have a good physical therapist, which you MUST, she/he knows what they are doing and you're not going to re-injure yourself. I am pushing through the pain and difficulty of scar tissue, swelling, and stiffness accompanied by muscular atrophy.

Arrive 10 minutes early to get some heat on this part of your body about to be worked on. This gets blood flow to the area and loosens up muscle (what's left), soft tissue, and tendons.

Bring a stick, leather swatch, or as I did, a face cloth to bite down on as you cry and scream at the top of your lungs including many expletives within ear shot of the rest of the physical therapy office.

Make your appointments at least 2 weeks out at a time, and get the days and times you want.

Bring a friend (if you're the type who wants people around during trying times) - someone with a strong stomach who can take seeing you in pain and working hard without offering pity or condolences.

I was at 67.5 degrees at the beginning of my appointment and the physical therapist got me to 90 degrees with a half hour of aggressive assisted flexion. It sucked, but anything is possible!

Massage the area of the injury and the scar as often as possible; break down scar tissue and restore sensation. Make friends with your body; with the painful parts, the numb parts, the skin that feels spongy and weird. If you don't want to massage it, have a trusted friend or massage therapist do it.

Keep pushing yourself at home with all PT exercises, including the range of motion, at least two times per day, as prescribed. Take the pain meds, suck it up, and make progress!

The Constant Passive Movement machine is still in active use. My goal is to increase by 5 degrees every day or so - or at least continue to make steady progress. Sometimes I have hit plateaus, like at 40 degrees and 60, I was there for a few days and that's that. But today (Sunday) I'm at 75 degrees. And by Wednesday, by God, I really hope to be at 90 - feeling the pain but able to keep my left hip down and body relaxed with as little wincing as possible. I've decided to try to do the CPM for a half hour per day at max range of motion a few times per day and then lay off it while I sleep.

Unlock the brace. Let your leg swing, dangle, and move as much as possible.

Trust your physical therapist. Your mind and body might say "Stop! It hurts!". Your PT will say otherwise. Listen to him/her. You want to walk again and do athletic type activities again, right? 

DO THE WORK. DON'T SLACK. ASK FOR HELP TO MEET YOUR GOALS.

TREAT YOURSELF RIGHT. LOVE YOURSELF. REWARD YOURSELF. YOU'RE NOT A BABY OR A WIMP. 

(All of the info above and through out this blog is my experience and interpretation of instructions from my doctors and physical therapists regarding my injuries. Consult your own medical care providers regarding your own specific care and injuries.)

The Super Cool Pre-Op X-Ray of My Completely Obliterated Tibial Plateau!

Okay, so here's what you are looking at in the picture below (the most obvious injuries):

• Femur up top (thigh bone, the human body's largest bone) and tibia (shin bone) beneath it.
• See how the femur is slanting to the right (my body's left lateral side)? Well, it's supposed to be straight up and down.
• Look at my tibia. Your right (my left side of body) is crushed. The femur has sunken into this crushed space of the tibial plateau. Crushed from the compression fracture. Pretty sick!

 

What is a little bit harder to see is the medial (your left) side of the tibial plateau: the flared top part of the tibia that meets the femur/knee joint, is also fractured. Nearly split off from the shaft. The fibula, which is the smaller bone behind the shin, connects to the tibia at the top lateral side (the crushed side). Because of the crushing fracture, the fibula broke too. Oopsie! There's a fracture in the shaft of the tibia, lower down, not visible here. The medial meniscus tore (was cut and sewn), and the ACL, still intact, took a chunk of bone and split right off of the knee joint.

Anyhow, I'm keeping the faith. I'm 31 years old. I've got a plate and 6 screws in my left leg. Nothing like this has ever happened to me before. This accident happened on August 26, 2011 while riding my bike going less than 10 mph, doing nothing fancy, just taking a turn I've taken a dozen times three blocks from my home. Freaky things happen! Life happens. I'll make a 150% recovery because I plan on being in bad ass shape after this "recovery" is behind me.

That is all.

6 Week Update: Medical, Emotional, Mental, & Physical

MEDICAL UPDATE:

Here are the bullet items from my appointment with my surgeon, Dr. Fulkerson, yesterday (Thursday 10/6/11):

• I experienced a BI-LATERAL tibial plateau fracture (TPF). This was new to me. I thought only the lateral side was crushed but the medial side had a huge fracture down the entire length, splitting it off into a triangular piece. I became fully aware of this on Thursday when Dr. Fulkerson, Alon and I looked at the pre-op x-rays together. This is the first time I had seen the pre-op x-rays - they were troubling and interesting to say the least.
• Medial: closer to the body's midline. Lateral: closer to the left (in my case) or right side of the body.
• There is a Roman Numeral scaling system for TPFs that goes from I-VI (least severe to most severe). When you have a bi-lateral TPF both sides of the plateau are fractured and you are in the range of IV to VI, based on my internet research and chatting with my doc. I was likely a V. Had both plateaus (instead of just the one) been crushed or broken off completely I would have been a VI and likely a candidate for a full knee replacement! Holy crap, right? Imagine if I came out of the operating room with a scar from mid thigh to mid shin and a truly bionic knee, not just a plate and a 6 screws? This new news, increasing the realization of the devastation of my injury and need for a major comeback scared me immensely and totally overwhelmed me. As I write this (one day later), I still feel scared and overwhelmed.
• My injury: The medial side of the tibial plateau was severely fractured (like the picture of the left knee in the link above) while the lateral side was severely crushed (just small pieces of bone fragment and chunks of cartilage flaking off - patches of cartilage gone for good) - the latter was the primary concern during surgery.
• Lateral TPF: This is the side that was crushed, bone graphed and plated. The top contour, from front to back, of the lateral side of the tibial plateau was congruous (smooth) which is great, yet still lower than the lateral side which is, well, not so great but not surprising. The surface formation was also good. Dr. Fulkerson's goal was to raise that crushed side up as much as possible to its original state using the bone graph and plates. She did her best, and a great job at that. It is what is now and she is satisfied with the outcome. My call to action now is to strengthen the crap out of my left leg so I'm not weak in that area and have less of a "knock-knee" (that she predicts).
• Medial TPF: This is the side that had the jagged break that created a triangle piece of broken bone. Looks like it's healing ok. No surface damage or crushed bone here like the other side. Still SHOCKED that this side was busted too... oh well!
• Other fractures: There were two fractures along the shaft of the tibia that were clean breaks and are healing if not healed by now. The fracture at the top of the fibula that connects to the lateral plateau: same. 
• Weight-bearing: The non-weight bearing issue is basically related to the crushed plateau and how quickly that heals. It is possibly that I might be weight-bearing at ten weeks instead of twelve. Exciting! We'll see at my next follow up appointment in four weeks (Nov. 7th), which will be the ten week mark.
• Ligaments: The meniscus tear was in the back on the medial side. Dr. Fulkerson said she had to cut some of it in order to do the repair. She said there was an avulsion of the meniscus. The ACL, as I mentioned before, was not visibly torn, but instead tore off with a piece of bone attached to it. She gently, accurately placed the puzzle back together and is hoping for a complete recovery. She said it is possible that there were micro tears in the ACL, but of course impossible for her to tell since she is an awesome orthopedic surgeon but does not have microscopic vision. At this point, there is no way of knowing how either ligament is healing. We'll know more as I go through the physical therapy, etc.
• Physical therapy: I received a prescription from Dr. Fulkerson to start out patient physical therapy next week (exciting and scary!), one to two times a week until they can progress me to more visits per week. Part of me is thinking "Well, it's about a 3 mile walk to PT. I wonder when I can do that?" Then, a friend or loved one gives me this stare down like "You're crazy. Give it time." And I am reminded to "be in the moment!".
• Prognosis: Overall, Dr. Fulkerson is "reasonably optimistic" that I will make a "near full recovery". So that's about the best news you can get from the mouth of a reasonably cautious, very talented doctor.
• There is no additional surgery needed at this time. My assumption is, sometimes there could be additional surgery at this time if someone is healing properly. I have been encouraged to bend my knee as much as possible to avoid having surgery to "scope out scar tissue". Yuck. I am currently bending at about 85 degrees, but could go to 90 with an extra dose of courage (much needed at this point!). My goal is to advance my range of motion (ROM) by about 5 degrees every day. We have a new technique for this (see "gravitational flexion" below).

PHYSICAL/MENTAL/EMOTIONAL UPDATE:

So speaking of bending my knee. I am feeling very disconnected from this part of my body right now. I have been feeling this way for the last few days. Disconnected from my left leg in general. For six weeks I have been lifting my leg with both hands in and out of the brace or on and off the CPM when necessary or up onto a bucket to rest when I go pee, as if I was a paraplegic. This is incredibly frightening. The entire experience.

Yesterday, with Dr. Fulkerson we tested my range of motion in this way, Gravitational Flexion: sit up on the examination table, scoot to the end so that the knee is past the edge of the table. Brace removed, Dr. Fulkerson rests the heel of my left foot in one of her hands with her other hand supporting near the top of my calf. My leg is now out in the open air, supported solely by this woman, who I thought I felt trust and respect for. However, I was scared. My reaction to this test: I start to cry, shake, hyperventilate, tell to her stop, ask her what she is going to do next. NOTHING BUT FEAR. So much fear came over me: it felt like someone was pushing me out of an airplane with no parachute. 

Dr. Fulkerson immediately identified with what I was feeling. Told me it was understandable and reasonable, that she would probably react the same way AND that FEAR was going to be my biggest obstacle right now and then I HAD to get through it/over it. It was an earful - but she was right! Yes, I need to listen to my body (and I do) but the mind is a powerful thing that has the ability to convince of something that is not true or prevent me from progress, in this case. We talked about how my leg would not snap off and break in half, that the plateau fractures would not get re-injured in this way, and that I was okay and I was going to get through this.

We graduated to a bent leg of 75 degrees, off the edge of the table, allowing gravity to do it's work. It was actually easy in a sense. There was NO PAIN, only fear. 

The mental trip was this: I was dangling my limbs off the edge of Half Dome (a 2000 foot flat faced rock at Yosemite National Park - a favorite spot for experienced rock climbers - otherwise a place to embrace one's fear of heights reconciled by natural beauty). Dr. Fulkerson said I could likely bend to 90 degrees right then but she thought she had traumatized me enough. We both laughed! I said, "We could try 90," with like ZERO conviction. She said NO and slowly raised me back up to 180 degrees. Where I kind of shuffled to get back into my security blanket, the leg brace.

So I think I have some stuff to work with!

Alon had his hand on my back the whole time I was with Dr. Fulkerson. I could feel his gentleness and strength right there coming through his hand. It reminded me of a Hakomi (type of psychotherapy practice) workshop exercise I had done with a partner, where the precise placement of a gentle hand on someone's back can fulfill a need and provide the exact comfort one desires. Alon somehow knew exactly where and how to place his hand. I imagine the experience might have practically brought him to tears watching me, but he seemed okay. Alon shared later that I made a huge step toward normalcy today and that I was very strong overcoming more fear and uncertainty and re-discovering ability! Yay! for positive reinforcement!

I do have some leg muscles left; coupled with desire and will power. I am able to do leg lifts and slides much more easily than before and so I have been trying to shift my behavior from this assisted lifting with my hands to mindful, coordinated action of: engage the core, tighten the glutes, tighten the quad, flex the toes, lift the leg. Go. Annnnd REST. There is no question that this process is tiring, frustrating, strengthening, and courageous. Whether I'm doing some sort of necessary bodily function or activity (like walking or bathing) or doing PT or modified yoga poses, THIS extreme attentiveness is what it looks and feels like. Eventually, it will all become second nature again and I can bend my leg more and do things with but for now I have to be completely present with whatever action I need my left leg to do or it won't happen or I risk hurting myself. 

Despite all this, despite my modified yoga poses in the sunshine in the backyard which give me a few moments of bliss and accelerated heart rate... I still feel very disconnected from my leg, from my body. It sucks. It's depressing. It's scary. It makes me angry. It makes me sad. I feel lost and overwhelmed right now. I balled my eyes out this morning, soaking the shoulder of Alon's t-shirt with my tears. Alon and my care provider, Pauline, agreed after that moment that I've been so strong and positive up to this point, it's okay to be in this space, in fact, it is NORMAL in my situation to be exactly where I am right now, emotionally. Not the normal I want but the normal I've got! So, okay... I'll just keep putting one foot in front of the other, take one day or moment at a time, and breath in all the loving support that my friends, family, co-workers, care providers, strangers, and neighbors have to offer.

Alon, my love and support and sanity and saving grace through all of this assures me that I just need to keep doing what I'm doing and that I'm healing great, even the doctor said so! 

The other night when I was going to bed all could think about was the bi-lateral fracture. So I needed a way to get out of the negative thoughts and into the positive. I asked Alon to give me something else to think about and he said, "Think about your muscles and how strong they are going to be." He's also said that I can probably put a 70 pound pack on and go back packing in the back country again someday. That these activities are not off limits. And I soon drifted off to sleep, thinking of my soon to be Wonder Woman figure :-)

There will be days when I'm climbing up hill both ways in a blizzard and then there will be days when the wind is at my back. Nevermind DAYS. Try MOMENTS. Moments in my day when the "wind is at my back"... these are the things I need to try harder to keep track of and relish in, and to talk about and think about. Like all the positive aspects of physical therapy and being around all these people who love and support me (and Alon).

Each of us experience our share of suffering, loss, challenge and chaos. What about the moments when we truly feel supported, at ease, progressing, and happy? Whether those feelings come from within or surround me in my immediate environment, this is a difficult time in my life where it is imperative to deeply acknowledge those good feelings which can put that wind back in my sail propelling me through the rougher patches of open water.

Thanks everyone for taking this journey with me on my blog; and I hope some one else with injuries or challenges like mine find my sharing of my experience helpful in some way. I know I have gotten a lot out of the stories you all have shared with me recently in relationship to past injuries and recoveries you've made. Our bodies and minds are amazing! Love to you all!