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. 

Week 4 (almost)

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

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. 

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).

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!

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.

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.

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!