Thursday, June 26, 2014

The 3 Month Mark

Pardon my inactivity in the last month, but I've had several things going on.

Getting my Master's- finally!

And this:
Road trip home

And getting to see this view again, too:

Hence, the lack of posts! There also hasn't been that much news to report. However, here a few new things:

First, I finally lost my last crutch (only after 10 weeks!). When I returned from CO, my physical therapist was on vacation, so I saw one of his colleagues. I was a little apprehensive about it, but now I'm really glad I saw someone different. First, it wasn't as much torture, and getting some space from my normal routine really helped. The other therapist also showed me how to use a foam roller to massage my legs. I had been looking into myofascial release therapy to help loosen my muscles and make bending easier. However, at $80 per session, that's just not happening. But, the foam roller has been a great alternative, especially working my quads, and I've noticed that's really helped with the bending. 

Second, I got to go back on the elliptical last week, as well as leg weights at the gym. I'm up to about 20 minutes of cardio (10 on the bike + 10 on the elliptical) as well as leg extensions (12 reps x 3 sets at 45 lbs); hamstring curls (12 reps x 3 sets); and leg presses (12 reps x 6 sets) doing both legs and one leg. My quads will probably take another 6 months to get back to where they were, so using these machines is a great step forward to help strengthen my muscles. 

Finally, bending. My nemesis. I try not to focus on it too much because I then forget about everything I have accomplished in the last 12 weeks (including walking normally). However, I face the very real possibility of my knee surgeon deciding to do a manipulation in the next few weeks. Knee manipulation is a fancy term for knocking me out, and bending my knee all the way, since I cannot do that on my own. Then in the 3 days that follow, I go to PT every day and have it snapped continuously for half an hour. All this without hardcore painkillers. Yet, it may be what I need to snap out of my mental block that's preventing me from bending my knee and get my full range of motion back. The longer I take, the more I risk permanent stiffness and inability to bend my knee, which I do not want. I know I have improved- I can get to 130 degrees and can rest relatively comfortably at 120-125 degrees, but it's not good enough. I see my surgeon on Tuesday, so I'll know more then!

Thursday, May 29, 2014

The 2 Month Mark

"We must all suffer one of two things: the pain of discipline or the pain of regret or disappointment"- Jim Rohn.

Pardon the drama of this quote, but I feel it is appropriate for where I am in my recovery. I passed the two month mark on Wednesday and the pain still hasn't gotten much better with bending. At physical therapy today, my therapist reminded me that most MPFL patients regain full range of motion after 8 weeks, and I'm still nowhere close to that. However, I made a lot of great progress at PT today. Doing wall slides, I was able to push my knee to bend to 115 degrees, which while it was not comfortable, made me feel much better. I never want to get to the point in my rehab where my doctor or physical therapist tell me that if I had sucked it up and gotten through the pain sooner, that bending would be easier. No matter what happens, I want to not have any regrets or wish that if I had done more or tried harder, things would have been easier.

One thing I have made a lot of progress with is biking. I started with pedaling backward about 3 weeks ago. Because of all the bending and the pain, my therapist had me start pedaling with the seat much higher than normal, which was a weird sensation. At first, I was barely able to get my leg around and when I did, it was painful. However, I slowly progressed from being able to do about 20 reps with the seat at 13 to doing 50 with the seat between 11 and 12. After a week, I was allowed to pedal forward as well and in the last 2 weeks have progressed to 110 reps both forward and backward with the seat at 9. Today at PT I actually felt like I was really riding a bike, not just doing rotations. I stayed on for 5 minutes and was able to get up to 55 RPM (which was tough because I am so out of shape!) It felt great to hit that milestone and feel like I was really making progress. I don't vouch for how many rotations to do or how high to have the seat but biking is a great way to help get range of motion back after surgery!

One thing this rehab has taught me to appreciate is toughness. I hope no one else's MPFL rehab is this painful and I don't want to scare anyone by commenting on how bad mine is. However, I'd be lying if I didn't include the pain because it really has been tough to get past. Keep in mind that this is coming from someone who's dislocated their knee, had 3 surgeries, and whose body is used to protecting their knee like no one's business. Those of you who haven't had surgery before may not have the same mental blocks (I hope!). However, I have learned to push past the pain and push myself like never before. I have had to learn to pass the threshold of what my body thought was too much pain multiple times and keep pushing until I felt like I could black out. Yet I feel stronger because I know my body is capable of so much more than I ever thought.

Monday, May 26, 2014

Before & After

My apologies for not posting as frequently lately, but I've been far too busy finishing up my last paper of my Master's degree (well, procrastinating finishing it, but close enough)! With all of the ups and downs that I've had and now that I'm possibly facing a second surgery to bend my knee all the way, I wanted to remember just how far I have come since surgery.

This was taken 2 days post-op:

This was taken today, almost 2 months post-op:

Please excuse how white I am (though, for those of you reading this who know me, I usually resemble a ghost, so not much has changed). All joking aside, I'm very pleased with how much the swelling has come down. I like to think my knee now resembles a grapefruit or some sort of small melon, not a bowling ball like it used to.

Something I've learned the most since surgery- it's all about perspective!

Sunday, May 18, 2014

More Milestones & Limits

I had a great milestone this week- one of my best friends who I've known since middle school graduated with her Master's, and I was able to make it to SF to have dinner with her to celebrate. Anyone who knows me is aware of my obsession with SF and being unable to go for over 6 weeks was another form of torture. I wasn't sure how my knee would react to sitting in a car for over half an hour (thanks, traffic) or at a crowded table for over two hours, but I was sick of being cooped up at home and ready to get out. I'm so glad I did. I had a wonderful time, and getting out of the house and having yummy (and free!) food was amazing.

I will say though, this little outing made me realize my limits, as I spent most of the next day in bed recovering. My knee is still very cranky and doesn't enjoy being bent for long periods of time, so I definitely paid for all the sitting I did. It definitely made me question my progress and my rehab and how easy all the sitting I'll be doing at my upcoming graduation will be.

Another limit- my PT finally got my knee to "break", which led to the worst (I mean worst) pain of my life. Yes, I'd rather go through a dislocation without pain pills than ever experience this again. One of the things that has been impeding my progress is my body wanting to "protect" my knee. Whenever I try to bend it too far, my quads start balking, which prevents me from bending it anymore. However, with much help and pain from my PT, he was able to get my leg to the point where my quads were too weak to protect it anymore and just snapped, letting my knee bend far past where it had been. While this is a good sign, the pain I experienced was quite frankly traumatizing, and having to go back 2 days later for more was also pure agony. However, I do see improvements, such as being able to get to 90 degrees a lot quicker and being more comfortable bending my knee and sitting. I do worry though, when my PT and surgeon tell me this is the most painful MPFL they've seen. I just am waiting for the biking and bending to get easier with more repetitions, because so far, that has yet to happen and that's the most frustrating thing of all.

Sunday, May 11, 2014


This week has been all about milestones. On Monday, the brace came off. On Wednesday, I lost one of my crutches and (sort of) relearned how to ride a bike. On Thursday, I left the house by myself for the first time since surgery. What a week!

After my second post-op visit last Monday, my surgeon thought I'd be on crutches at least another month. So, it was definitely a surprise when my physical therapist said I could ditch one of the crutches and probably be off them completely by this week. While I appreciate my doctor being conservative, I must say I favor my PT's views at this point! He also brought out the upright bike which at first was very exciting, and then quickly became depressing. Both my dislocation and first surgery were hard, but didn't involve any new ligaments, so relearning bending was not much of a challenge. I was back on the bike and actually pedaling normally about 6-8 weeks out. However, this wasn't the case with MPFL. With a new ligament comes an added set of scar tissue and extra pain, so I can barely make it around backwards on the bike sitting far too high up. I'm not sure which is harder- actually rotating my leg around or keeping my feet on the pedals. I try to increase the # of rotations every time I bike, so doing 35 today felt great!

I think the hardest part of this rehab is trying to compare it to either my dislocation or one of two surgeries, which is not only impossible but very depressing. I have to remember that all the milestones I hit in previous rehabs may not be possible now, but that does not make this rehab a failure. It is simply a sign of the severity of the surgery I had, almost 6 weeks ago now!

Monday, May 5, 2014

The Brace is OFF!

I obviously am having trouble containing my enthusiasm! Today, I had my second post-op visit with my surgeon, Dr. H. I'm almost at 5 weeks post surgery and I was really excited for this visit to get some flexion on my brace and be able to put weight on my leg again. I was shocked when Dr. H told me I no longer needed my brace- my first thought was that I was getting a different one, but he said, to my joy, that I no longer had to wear a brace at all. He also said I could be fully weight bearing and bend my leg whenever and how ever much I want. The only catch? I still need to use my crutches, but I can put my left leg down which is a lot easier (though I will miss all the calories I burned & my new arm muscles).

Suffice to say that this was the best day I have had in a long time. I have been a little down recently with my rehab not progressing to the degree that my doctor and PT would like, and I was only hoping that I wouldn't be stuck in a straight leg brace anymore. The thought that I would have nothing on my knee never even crossed my mind. I still have a long road ahead- I'm probably only about 30% of normal, I have little to no quad muscles (and I get a neuro stimulator this week), and bending my knee usually leads to excruciating pain. However, this is a huge step forward and a huge improvement. Allowing my leg to be bent all day will lessen the stiffness and make hitting 90 degrees  (and farther) that much easier. And, putting weight on my leg as I walk will help wake my quads up.

I know I have expressed my gratitude many times, and I'm sure my doctor or PT will never see this,  but they are my heroes. Prior to surgery, my doctor could easily dislocate my knee with his hands if he was so inclined. Today, he showed me that my kneecap barely moves. It truly is a second chance with a new knee and I could not be more appreciative.

Wednesday, April 30, 2014

90 degrees

This number has been entrenched in my head the last few weeks, and based on my inability to reach it, will stay there. Now, what in the name of everything holy am I referring to?! One of the markers my surgeon and physical therapist are using for my rehab is how far I can bend my knee. The goal was for me to reach 90 degrees flexion (bending) by 4 weeks out, which is today, and then be able to bend it fully after 8 weeks.

However, I did not reach this goal. After much agony at physical therapy today, I made it to 75 degrees. I was thinking of blaming this on not being stretched out, and having my leg locked in extension the 12 hours prior to the appointment. I realized that my PT would laugh this off as a reason, so I kept it to myself. I did improve from last week, but I can't shake the feeling that I let my doctor and therapist down. In the 7 years I've worked with my physical therapist (yes, it's been that long), I have never failed to reach a goal, and I did today. I'm trying to stay positive throughout this experience, but I have had some ups and downs. It's so important to focus on the positive- what you CAN do.

A great way to relearn to bend your knee:
  • Lay on the floor, preferably carpeted, with your bottom about a foot or two from a closed door. 
  • Extend your leg all the way up on the door until completely straight.
  • Gradually (and gently) bend your knee until you can't take it anymore. Tip- adding a pillow case or a sock will help move your leg faster. 
  • Get this amazing app, which shows you, in real time, how much your knee is bending. 
I don't vouch for this reaching any goals in any sort of time, but it is a nice feeling to see how much your knee is bending and seeing the improvement first hand. Side note- I am amazed at how much technology has improved since my first surgery. 

Tuesday, April 29, 2014

Week 4 (almost)

One of my new scars- biggest one I've got! Glad to see it looks good (relatively).

Sunday, April 27, 2014

Week 3

Well, almost week 4. Crazy how time flies! While physically I feel about as good as can be expected- not too much pain- mentally, I'm struggling. I've learned how to bend my knee and regain my quad strength so many times, so I know I can do that again. But, mentally, struggling through all the ups and downs and then hitting plateaus where you don't see much improvement, I feel weak.

At almost 4 weeks post-op, I am expected to be able to bend my knee to 90 degrees by this week. However, after much stretching, I'm only at 65 degrees and I just cannot push through the excruciating pain much more than I have been and I know I won't get to 90 degrees. It was also extremely demoralizing to have my physical therapist break out the neurostimulator machine last week. For anyone who's not familiar, this machine forces your quad muscles to fire, which helps try to "wake them up" and regain strength. After my dislocation, I used this machine in the latter stages of my rehab to get the last bit of strength back. So, having to break it out this early in the game made me feel defeated. My therapist isn't quite worried yet, but I can tell he's slightly concerned that my quad hasn't started firing yet.

The size difference in my quads are still quite noticeable:

However, despite these minor frustrations, I am counting down until May 5, when I see my surgeon for my second post-op appointment. I hope to be able to weight bear, bend my leg while standing, and drive. Those little things will go a long way to improve my outlook on this whole process. This week, I'm going to post my physical therapy routine as well. 

Saturday, April 19, 2014

The Two Week Itch

Technically, the 16 day itch. Close enough. I'm sure you know the feeling when you start something new and it's super fun- the new routine, enjoying some time off, catching up on TV and movies and basically being a useless member of society- until that feeling wears off. Day 16 and that's me. I'm beginning to feel rather antsy and bored with any and all of my entertainment options. Luckily, I had my torture appointment today- that's what I've renamed PT, and no, it's not quite that bad- so my day bed looked extra comfy this afternoon. Some good news and bad news came out of my fun trip to the physical terrorist, so let's start with the not so happy.

Bad news:
  • My therapist learned how much I sound like a sailor when I'm in a ton of pain. My knee has been extended completely straight since surgery, hence the stiffness and pain that ensues when I try to bend it. I felt pleased after I progressed to bending it about 20 degrees (that's how doctors & therapists measure progress after surgery); however, my therapist quickly decided that he was going to force it to bend about double that, which led to the swearing. 
Good news:
  • However, despite the torture, I was able to find a positive in that bending my knee on my own now is a lot easier and I can bend it more, albeit not to 50 degrees, but I'm also not a masochist.  I also feel a lot stronger and I can see my quads firing a lot better now. 
  • I'm also close to being weight-bearing, which is great news. My doctor is being very conservative and wanting me to wait up to 6 weeks before putting weight on my knee, but my physical therapist is fighting that and I may get some great news when I see my doctor in 2 weeks. I'm also going to start a few weight shifting exercises in PT next week, so that's a plus. My therapist told me I'm about average when it comes to being 2 weeks out of MPFL reconstruction- average strength, average flexion/extension and average swelling. However, I want to be better than that, and I'm really trying to step up my PT routine (which I'll do another post about soon).

Monday, April 14, 2014

Day 12/13

I had my biggest outing (other than doctors/PT appts) since surgery yesterday to see some good friends in town for a conference. Anyone who knows me knows that I'm a huge fan of the UN and of Model UN conferences. I did Model UN throughout undergrad and getting to visit my college advisor and a close friend from my UN internship at the conference was just what I needed. Getting out of the house and seeing different faces made me feel social again, which was much needed.

It is so important to get out and do something other than watching tv, reading, and napping all day, and changing your routine. I may have paid for overdoing it just a little yesterday, but getting to see some of my closest friends was well worth it. It also made me feel a lot more confident and like I'm progressing in my rehab. It is so easy become negative and worried and think that your rehab is going nowhere and getting out yesterday really reminded me that I'm so far ahead of where I was even just one week ago. I know that one week ago, I wouldn't have been able to crutch as far as I did or even have the energy or desire to leave the house. While I am enjoying my down time and getting caught up on reading, it's important to push yourself and your body and try to get some of the endurance back.

I feel fairly settled in on my routine at home- getting up, getting dressed, and trying to fit in physical therapy about every hour. Each day I try to see if I can do something new- picking up clothes, grabbing my crutches, getting out of bed on my own, etc. One piece of advice- after almost two weeks of having your parents dress and bathe you, it's nice to feel a little more independent, so try to push yourself- it'll feel great!

Thursday, April 10, 2014

Day 9

I know I have been lacking a bit in updating this, but as my routine until today consisted of food, naps, movies, more naps, bad reality shows and more food, I didn't think I was missing anything :)

I finally got my act together and sent the letter to the family of the donor whose tissue was used to create my new ligament. I was not expecting to have strong feelings pushing me to write a letter to the family. I was afraid of trivializing their loved ones death by stressing how important a ligament was to me, since a bundle of tissue does not carry the same weight as a heart, lung, kidney, etc. I was also afraid of seeming too grateful for something that didn't save my life. Granted, it will improve my quality of life, but seeing as I was able to go on the elliptical the day before surgery, my mobility wasn't too impeded. However, I could not shake the feeling that I owed the family a letter. I wasn't expecting to feel such a strong connection to a person and family that I know nothing about, except for the fact that someone else's tissue is now in my body and giving me a second chance. It's a second chance to run, to bowl, to hike, maybe to even play tennis (hopefully my father's heart can withstand this). While these may seem small or even minute, the last 9 years have been one road block after another and this surgery is my second chance to be active and not think about my knee giving out in almost anything I do.

I do not expect to hear anything back from the donor family- most of the personal information remains anonymous. However, I hope they know the impact they've had on my life.

Another milestone: I started physical therapy today. I really do have the best Physical Terrorist (yes, he calls himself that) ever. He's been with me since my first surgery in 2007 and really is great at his job. It's just trying to do leg raises when your quads and glutes are like mush and your knee hates you is pretty much torture (and he enjoys my suffering a little too much). This is definitely where the hard part starts- I have to work up to 4 sets of 20 leg raises (on my back, stomach and sides) and quad sets every hour. Pro tip- in the weeks before surgery, try to do leg raises or any sort of quad-strengthening exercise as much as possible on the injured leg (the other one will have plenty of work to do while you crutch around). While you will still lose all your muscle function, it will help the function come back quicker.

Overall, though, I feel great and remain awed and overwhelmed by the love I have received, especially from my mother, who despite of her not perfect health, spends every day taking care of me. I am beyond blessed.

Saturday, April 5, 2014

Day 4

The fun continues! For those who aren't fluent in "knee speak" as I call it, the basic gist of my surgery was putting in a new ligament connecting my kneecap to my thigh. Sounds about as painful as it actually is. This all stemmed from a dislocation when I was 16, which I didn't realize was as traumatic as it was until about 6 months ago. After a lateral release worked but didn't ease my loose jointness or all of my pain, my doctor recommended MPFL reconstruction. I didn't even know that was a ligament until about 6 months ago either.

Yesterday was my first post-op visit, where I was finally able to see my knee and get a fancy new brace, which hopefully will allow me to bend my knee sometime this week!

Not as scary as I thought it'd look:

My other amazing milestone was getting to shower today (finally!!). After four days, you start feeling pretty gross and even more of a pain on those around you. It was quite a process but I felt like a totally new person and smelled like something other than the hospital! So far, this recovery has been a lot of what I expected, but still very hard and very painful. I am eternally grateful for my amazing parents who are putting up with me and basically doing everything for me (tip- find a great gift for whoever is lucky, or unlucky enough, to put up with you the first couple weeks). I am also overwhelmed and humbled by the love and support I have received by so many people in my life. While this is just the beginning of my recovery, I am lucky to have such motivation and support. I really hope that this blog can be a source of hope and inspiration for people who are going through MPFL reconstruction and like me, are scared, nervous and hoping for the best.

Thursday, April 3, 2014

Day 2

The combined euphoric feel of the anesthesia and nerve block have warn off a bit, so the joint pain is sinking in. Oh, I didn't miss that one bit. Yesterday was rather uneventful, just the way you prefer surgery to be. 

Before reality hit

I don't remember much after my new best friend, the anesthesiologist, gave me some "anti-scary drugs", until I woke up in the recovery room. Luckily, everything went very well and I was able to come home a short time later, where I bonded with my new gadgetry...

My other new best friend, the nerve block, came in very handy. I was able to make it until this morning without any pain, until it came roaring back all at once and I had to pull out the pain pills. The only downside I will say is carrying around the fanny pack that has all the medicine in it- I feel a bit like a bag lady. 

Tomorrow is a big day- I get to see my doctor and find out how much longer I get to have my immobilizer and hopefully, I'll get to see my knee for the first time!

Friday, March 21, 2014

2 Weeks Out

The reality that I'm having relatively major knee surgery in less than 2 weeks hit me today- all it took was a lovely packet of instructions from my surgeon's office and the panic attack ensued. Since I left Denver and am now back home, everything has hit me in stages, and today was one of them. It's here, it's real and there's no turning back now (well, I thought about it, until my dad about read me the riot act). While I'm excited for my new gadget and about 8 different kinds of painkillers/nerve blocks, all my memories from past surgeries are coming back and I am very scared. Not only is this the hardest surgery of my three, but I'm actually being opened up, as opposed to it being done arthroscopically, which adds an extra dimension of possible problems. While in my heart I know everything will be fine, it is very hard to mentally prepare yourself for walking into the operating room, only to be wheeled out a short time later unable to take care of yourself. In the meantime, I plan on enjoying the next 12 days- lots of squats, bending my knee whenever I feel like, walking- all the things I'll be missing terribly the next few months.

Saturday, February 15, 2014

My journey, thus far.

I'm not one to usually post blogs, but after being inspired by this MPFL reconstruction blog, I thought it may be helpful for others going through this to have an idea of what they're getting into. My story began as a 16 year old high school senior and avid tennis player, until one day my knee betrayed me. Ever since that dislocation almost nine years ago, I have struggled through five major rehabs, two surgeries and more trips to the ortho surgeon/PT then many make in their lifetime. I was in my usual cycle- working out, feeling good, until I did something most people consider normal and got hurt, bowling of all things. After another few weeks on crutches and feeling completely useless, my doctor broached the idea of another surgery. While I'm a believer in things coming in threes, I also wanted to stay as far away from the operating room as possible. Plus, the whole idea of reconnecting my kneecap to my thigh bone sounded painful and well, awful. However, after numerous second opinions, soul searching and agonizing over my decision, I decided to have an MPFL reconstruction on April 2.

As April 2 gets closer, I am definitely experiencing a version of "buyer's remorse"- will the surgery work? Will I be in less pain or will I be in more pain? Will I be able to run outdoors again? Will tennis be in my future? I am scared, I feel guilty for putting my parents through another few weeks of basically doing everything for me, and I wonder if I'm making the right decision. As I finish up my last full quarter of graduate school, prepare to move back to California, and get ready for all the unknowns ahead, I am hopeful that this blog will in some small way, make a difference for someone else having to make the same decision I did.