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.

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!

Things are shifting

I had one of those days last weekend where I woke up with a great burst of energy and determination. I was not stiff or sore. No need to take any pain relievers (actually, as of today 1/18 - I went 6 days without any tylenol or ibuprofen; and took maybe 2000mg total over a 10 day period. AWESOME!). 

I set off for a one hour, intense work out at the YMCA at 8am. It felt fantastic and hard. Then it all changed. It felt like I had spun around 100 times, ran 10 miles, and was carrying a 60-pound pack through a thick, dark, musty swamp. My stamina was shot! Despite my long list of to-do items thoughtfully written out the night before including working from home, all my determination to be productive was gone and nothing got done except the essential which was walking to the bathroom or kitchen, grocery shopping and making a dish for our first Highland House pot luck dinner. 

My body and mind have not spoken this clearly and loudly in a long time... "STOP AND REST!". I had no choice but to surrender.

Sunday night our first week at the Highland House was capped with a delicious pot luck dinner and house meeting. 

I've noticed that my stomach has been sensitive to foods lately, even citrus in the morning. This tells me that I have some emotional build up. I've definitely had "emotional seeping"... where tears or a dip in mood come suddenly and unexpectedly in various situations. It's not great. I should probably create a container for some emotional release. I'm putting a lot of pressure on myself to perform my 40 hour work week, be present with clients and staff, friends and family and housemates. But I'm fading fast... 

I woke up tearful and exhausted beyond comprehension, crawling through the day at a snail's pace. Yet, not even thinking to take pain medication; I just didn't need it. Alon watched me struggle in the morning and gently held me and encouraged me to go to work. I acknowledged my feelings of wanting to stay in bed, feeling the weight of depression and fatigue come over me like a tsunami. I was almost breathless. With his encouragement, I carried on and was able to show up for my staff and my clients in a fairly low capacity but still present. I was glad for that but I still ask myself if it was the right choice. 

Next day... I feel like maybe my stride is picking up a bit. I had wonderful one hour massage this afternoon with Bree, which my leg and body were so hungry for. I feel much stronger in my morning routine, meaning when I get up out of bed I don't have to lean on the wall for a few minutes to stretch my leg or shake off the stiffness or gain strength. I can just get up and go (with a little limp). The pain and stiffness are just that much less. It's great! Lots of people are commenting on how much better I am walking during the day, so that's really nice to hear/see.

Little thing... A pillow between my legs while sleeping is still comforting, though I've realized not as essential. I still toss and turn a lot. I can lay on my back more comfortably allowing my left leg to relax (sometimes). That said, there is a new-ish pain and discomfort, a tightness perhaps, in my knee when I try to straighten my leg. More PT, more extension, more time will help it along.

Patience and not being hard on myself are by far the most difficult challenges right now. It was a lot easier to give myself a break when I was laid up at home for two and half months. After Christmas I was really hoping to resume a 40 hour work week, still attending to two-two hour PT appointments per week and other daily work outs at the gym. I'm realizing I just can't cut it... I feel like I'm letting myself down and others... though I was fairly reassured today by coworkers that I'm still doing a good job and working hard. My stamina and motivation at work are definitely suffering.
Cliches come to mind... We are our own worst enemy (and critic). If I don't have my health, I have nothing - it's true. I must take time again to really focus on the path that supports me in being the happiest, healthiest, and best person I can be right now. I'm struggling a bit with it, but I know I am where I am supposed to be, and all will work out.


Much love to all of you have been with me and supporting me during this crazy Rite of Passage! I love you all. Knowing your love and support are out there brings me up and gives me clarity in the really difficult times. Thank you!

The Darker Side of Me

Self-pity

Rehab is lonely

Being injured, different, damaged is lonely

My body doesn't work right

My body doesn't trust itself

My ankle is so swollen I can't see the bony parts

My knee looks deformed where the bone was crushed and reconstructed

I can't explain what this feels like, nobody knows it but me

I can't bend my leg into the "butterfly" stretch

I can't straighten my leg completely

It takes a really long time just to gain a few millimeters of extension when stretching

My foot is pronating in a new, weird way

I don't want to take another step

I have so much to do and I have to pace myself, I can't do it all right now

I'm done for today

I get to start again tomorrow, I'll be stronger then

What should I do for self care?
Refresh

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 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.

Update: Week 8 - Accomplishments

Hi!

Here's a run down of some recent accomplishments in my recovery period. I haven't been so quick to update my blog lately, so this is about a two week summary:

10/8/11 - 6 week follow up with Dr. Fulkerson, my orthopedic surgeon, who says I might be able to start weigh bearing at 10 weeks and to keep my brace unlocked, encouraging as much bending and movement in my knee as possible. Push for 90 degrees ROM in the CPM (working on it!).

10/14/11 - First out-patient physical therapy appointment at Boulder Orthopedic Physical Therapy with April Smith (and Megan, assistant) - they are GREAT. I completed 6 minutes of half rotations (think back-forth not all the way around) on a stationary recumbent bike. This bestowed much confidence in me hence the follow couple days of advancements...

10/14/11 - Showering on my own, no brace or trash bagged leg. Showering every morning now which feels so great and no more sponge baths for my left leg.

10/14/11 - No bucket in the shower to prop my straight leg up on; instead using the removable plastic toilet seat to rest my foot on.

10/15/11 - Sleeping without the brace on; laying on my right side with a pillow between by knees and ankles or laying flat on my back with a pillow under my knees.

10/15/11 - No more raised toilet seat & no more bucket! We ditched the raised toilet seat which was helpful because, well, it just was. And since I can bend my leg comfortably to at least 60 degrees, there is no need to prop my straight leg up on a upside down bucket on the bathroom floor.

10/16/11 - Warming up my leg in morning using the CPM which we left on the couch for the first night in almost two month. This meant no loud, bulky CPM or ice machine in bed!

10/16 & 23/11 - Helped prepare breakfast and dinner. Put a chair in the kitchen and sat and chopped fruits and veggies, stirred the pot, and occasionally stood with crutches or hobbled around to get one thing at a time... a little scary because I had to be careful not to slip.

10/18/11 - Unassisted bathing; getting in and out of the bath tub on my own (still sitting down in the tub and using the transfer bench).

10/18/11 - No more toilet seat in the bath tub - sounds funny, but true! When I was able to shower without the brace, we ditched the upside down bucket in the tub and used the 8 inch removable plastic toilet seat thingy so that I could rest my foot on something and my leg wouldn't just hang like dead weight and strain my knee. Well now my knee is more flexible. It hangs, I bend it, and try to get some extra motion in the knee while I warm up the muscles with hot water.

10/19/11 - Completed my forth out-patient PT session and did 6 minutes of full rotations on the stationary recumbent bike. Struggling to keep my hip down (raising the hip was a learned compensation to provide more leverage to bend my knee - not helpful!) and PUSH THROUGH a full rotation. April Smith (my fabulous physical therapist) had me concentrate on engaging the quad and glute of my RIGHT LEG and pushing hard with the right foot, forgetting the left leg and just letting it follow the motion determined by my right leg. All while taking my right hand and pushing down hard on my left hip to keep it from popping up off the seat. My low back and hip muscles would tense up, and this is something I'm working on changing. By the end of six minutes I had about 5 really smooth, fluid rotations. THAT felt amazing.

10/20/11 - Went shopping... like a normal person... I fulfilled needs without over doing it. I bought a new fleece-lined hoodie sweat shirt for the cold weather approaching and some new yoga pants (since that is all I pretty much wear these days). These are some things I needed but in no way felt "up to doing" in the days and weeks prior. Simple, but good progress.

10/21/11 - Disability Claim - Began a dialog with my surgeon to submit paperwork for an extension of short term disability to long term disability coverage, as a safety net. WE HOPE I can start back to work sometime around November 21st. My short term disability claim expires Nov 19th. It takes about one month to process a long term disability claim. I may go back to work by November 19th, but it may only be part time for a little while. The disability insurance company's rule is that an individual can continue to receive disability benefits, with doctor's notes, as long as the individual is working less than 80% of their regular hours.  In my case that would be 32 hours or less per 40 hour work week. Doctor's notes, recommendations, specific instructions like "part time" or "light duty" or changes to the work place are required by the insurance company. I think it makes sense to get the ball rolling on the long term disability coverage as a SAFETY NET, with the goal of being back to work at 100% as close to that 12 week mark (Nov 19) as possible.

10/22/11 - Pampering and self-care! Got my hair cut today. Simple as that. Made me feel really good. Also went out to brunch and sat with both legs bent under the table (yay! normal!) instead of one propped up or sticking out straight. Opened several of my own doors (to public bathroom, etc.), crutched along the Boulder Creek and sat on a bench with Alon by the creek, enjoying the autumn day. I also crutched about 5 blocks along the Pearl Street mall to check out BCAP's Souper Bowlder display at the Boulder Arts & Crafts shop. Later that afternoon I took a nap for nearly 3 hours - I was absolutely wasted when I got home at about 3pm. Alon had to wake me up at 6:30pm!

10/22/11 - Guided visualization used instead of pain meds to fall asleep. Alon took me on a verbal and visual journey through the stars and deep into the earth to help easy my pain and relax. He was great! It was a new approach brought on by the fact that I was just sick and tired of taking oxy or valium to fall asleep. So Alon's technique really helped and I think has a lot of promise if we take the time to keep practicing it. Alon actually fell asleep about 15 minutes before I did in this initial trial which was pretty funny, but all good!

10/23/11 - Washed a few dishes (about 10 minutes worth of standing and "doing"). Did a load of laundry by myself - I might think twice about telling Alon about this :-) I basically dragged a bag of dirty clothes while crutching from bedroom to laundry room (about 15 feet apart), separated items, and started her up.

10/23/11 - Skyped with family showing them how I can bend my left knee and lift my leg up and down. They were very excited so that was cool.

10/23/11 - Range of motion - "Gravitational Flexion" progresses at home. I sit on the kitchen table with both legs dangling off. I bend as far as I can go. Then Alon takes one hand and places it on the top of my ankle, where leg meet foot. I push into his hand as hard as I can, then relax, then he pushes my leg back. I keep my seat, pushing my left hip down and massaging my leg in different spots. We repeat this 2 or 3 times and hold each one for a few minutes until I can't bend any further. It HURTS! Duh. Then we release my leg altogether. I bring my leg up to straight, trying desperately to kick Alon's hand that is suspended high in the air. I more like just barely tap his hand. I repeat this part a few times till the motion is relatively fluid and smooth and then return to the bending exercise.

10/24/11 - Made tea for myself and Alon and put a few dishes away this morning! After that 15 minutes of doing stuff I was tired (mostly in my arms and right leg). The blood also rushes down into my left leg/foot and my left hip is holding so much of the weight that it also starts to feel the strain. So I hustled to sit down and stuck my leg in the CPM (up to 80 degrees in CPM this morning!).

Range of motion (ROM) - At the beginning of each physical therapy appointment April and I take about 30 minutes of loosening and bending and straightening my left knee and leg. It SUCKS, but it is worth every second of torture so I can make a full recovery. Here's a recap of how I'm doing at the start of 30 minutes (when I arrive) to the end of the 30 minutes. April assures that I am doing well and making progress, despite measurements that vary and show decreases:

Degrees of ROM:

10/12/11: 67.5 to 90 (took 500mg Tylenol)

10/14/11 65 to 90 (took 7.5 mg Oxycodone and 325mg Tylenol;

10/19/11 85 to 110 (took about 10mg Oxycodone and 650 mg Tylenol);

10/21/11 70 to 90 (just barely - I was very tight and soar from PT two days prior and did not take any oxycodone before this appointment)

I think next time I am going to try 5mg Oxycodone, 325mg Tylenol, and 5mg Valium. My low back and hip muscles were going into spasm on 10/21 so I think the Valium would help with that. Also, I get pretty worked up emotionally, so the Valium might take the edge off a bit. I also think the Oxy/Tylenol helps me get through the first painful 10 degrees (somewhere between 90 and 100 degrees) and then I just deal with it. This pain and emotional management thing is an ongoing learning process!

By the way... my quad, glutes, adductor and abductor muscles are getting visibly stronger now from two weeks of PT and daily home exercise routine. I just need to make sure I keep up on my shoulder and back exercises at home (using a T-band) because I've been slacking off there with all the focus on ROM lately, and my shoulders are starting to hurt a bit (from crutches/walker and previous shoulder injuries). ALSO, my left foot is getting better but still soar/swollen (tendonitis) and not back to 100% of its range of motion yet. When I stretch the foot it almost feels like I have shin splints. Eight weeks later, the left foot and knee are still a bit swollen. Most of my bruising is gone - just one little one left on the lateral calf that we are rubbing out daily.

A bit of reflection...

I've realized a lot recently about taking things granted - my life, my body, my friends and loved ones, help and kindness from others, the way I spend my day (thinking, eating, laughing, stressing out, doing, not doing), my sanity, and my "good" moments. I have a renewed appreciation for all of these things every day.

 Me at Boulder Creek this weekend.