The One Year Mark

I cannot believe it has been a year. It literally feels like I just moved back from Denver and just had the surgery, and now I've gone on vacations, feel pretty much back to normal and have been working at a relatively physically demanding job for the last 4 months.

I know I have been lax at updating this blog. I was thinking about why and I realized that it's harder to mark milestones as the months go by, and I stopped thinking about my knee so much, as I was able to get out more and get my life back.

A couple milestones (as much as I can remember them):

• I believe I hit full bending around the end of August, so about 4 1/2 months post-op. I won't mention the usual bending time, as I far exceeded that am still a little embarrassed to admit that. However, I am proud that I did it on my own, and at my own pace, and never gave up. 

• I had my last physical therapy visit in October and my last visit with my surgeon in November. I am back to full strength at the gym and feel stronger than I ever have been. I do about half hour on the elliptical, then weights: leg extensions (2x12 at 96 lbs); leg curls (2x12 at 106 lbs); hip adduction/abduction; leg press (3x12 at 125 lbs); squats (5 lb weights for 50 reps); and lunges (5 lb weights, 25 reps on each leg); and side lunges (no weights, 25 reps). I think one of the toughest things has been staying consistent with workouts (especially squats, lunges, etc), now that I'm working and don't have as much time. However, I've found that making time for about 10-15 minutes worth right after I get home a couple times a week has really helped. 

• I am back working full time, and have been for the last 4 months. My job involves a lot of physical work (lifting and shipping), and my knee has been fine the entire time (I better not jinx myself :)). 

I also got to experience a lot of fun in the last few months, for which I am very grateful. 

I was lucky enough to spend 2 weeks on the east coast in the end of September and got to see one of my favorite views again! I am still in awe of the fact that I was only 6 months post-op and able to walk and spend most of the day on my feet for 2 weeks straight and not experience any pain or negative side effects. 

I think one of the hardest things about my rehab was that I struggled for so long and then seemed to heal overnight. It was hard to try to get my life back and still deal with the pain, and then all of a sudden, feel like I didn't have to think about my knee anymore, but feel like my life wasn't catching up. I know my journey is not complete, nor will it ever be, because after 3 surgeries, I will (like it or not) always be thinking about my knee. However, I am no longer in pain on a daily basis and feel like my knee is more stable than its been since I was first injured in high school. My surgeon asked me at my last visit if I was glad I had the surgery, and I was so glad that I could enthusiastically respond, 'yes". I am so grateful for all the love and support I had and truly hope this blog will help other people on the same road I was just a few months ago. 

The 3 Month Mark

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

This:

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!

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.

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!

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.

Milestones

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!

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.