by Teresa Sliwinski

 

 

 

Teresa Sliwinski at the age of 42 had a microfracture procedure which became complicated by a deep vein thrombosis (DVT). She decided to maintain a diary of the experience, giving KNEEguru readers a valuable insight into her daily life as she struggled with her rehabilitation. Location: Buffalo New York USA Occupation: Computer Sales Interests: Singing, writing, reading, scrapbooking, biking, swimming, working out at the gym, Tai Chi, bubble baths.

April 25, 2005 - Why is it that when I tell people I’m having surgery on my knee they see that as the perfect time to tell me some horror story about some poor human being whose surgery went terribly wrong. What makes them think these stories are what I need to hear at this point in my life? People can be so stupid.

May 2, 2005 4:45 a.m. – I’ve been tossing and turning for the last few hours. Between the pain in my knee and my apprehension about the surgery sleep is not coming easily to me these past few days. I have to keep in mind that both the apprehension I’m feeling and the pain I’m having are both quite normal. Pain is what tells us something is wrong. We probably wouldn’t live long if it weren’t for pain. I’m guessing that the butterflies in my stomach will most likely feel more like bats Monday morning. I’ve been quite fortunate as far as my health goes. What I’m facing now is just a part of life, a new experience.

SURGERY & A POST-OP COMPLICATION

May 3, 2005 - Well, this is it, the last day before my surgery. I’m not as scared as I had thought I would be at this point in the process. I have confidence in Dr. Marc and in God. I got my prescription for Lortab filled so I’m all set to handle the postoperative pain. Everything’s in place. My bag is packed, digital camera battery is charged, my crutches are ordered, car is cleaned out, I’ve rid the house of tripping hazards, there’s nothing more to do but wait.

May 13, 2005 - It’s a long, long, long road to recovery. There was a lot more damage to my knee than Dr. Marc had thought. He had to perform a procedure called Microfracture. I have five more weeks before I can even start putting weight on my leg.

May 20, 2005 - I ran into a complication from my surgery. I got a blood clot (DVT) in my calf. I’m now on complete bed rest. I have to give myself two injections of LOVENOX every day for ten days, yesterday being the first day of treatment. The shots sting quite a bit and I can’t rub the injection site afterwards because it will cause bruising, so I have to just let it sting. Well, these things happen in life.

May 25, 2005 - Today is the third week mark since my surgery. I have seven more shots left, three more days after today. I think I’ll get dressed and go outside. It is a beautiful, sunny day and I should not allow it to go to waste. There’s nothing that can be done about the past and do not know what the future holds. All I have is this moment and in this moment the sun is shining and there’s a gentle spring breeze. Nothing is paining me right now and things seem quite peaceful. Last night Rita and Ken came over and we played a game all evening long. It was a good time and helped break the boredom of being confined. The hardest part of the whole thing with the knee and DVT has been the isolation. It was nice having people over.

My tummy is quite bruised and sore from the LOVENOX shots but I only have a few more days of that left. My real worry is how long it will be before I can return to work and how long it will take for my knee to be back in working order. But it’s a fine day, a perfect day for a walk in the woods. I don’t think my leg will be healed on time to enjoy such things this year. Many people like to say things like, “Every cloud has a silver lining,” and stuff like that. But I don’t agree, some things just suck and that’s all there is to it.

May 28, 2005 - In a few hours I will be taking my last LOVENOX injection and will be very pleased to be done with that.

May 29, 2005 - It was good to get out of bed today without having to face having to give myself a shot. It is so good to be done with that! It is Memorial Day weekend. Everyone will be having picnics and parties, but of course I’m stuck at home.

Mike and I are not used to this much togetherness. He’s really getting on my nerves and I’m getting on his. I’m hoping that Dr. Andrew will not release me to return to work until after June 20th when I can finally start putting weight on my leg. It’s just too hard to get around at work on crutches.

May 31, 2005 - It’s about 2 ½ weeks before I will be able to start putting weight on my leg. I have to check with Dr. Andrew to see if that’s going to be OK. I have a whole list of questions to ask him. So, tomorrow I see Dr. Andrew for re-evaluation.

June 1, 2005 - Dr. Andrew released me back under the supervision of Dr. Marc. Dr. Marc gave me the go-ahead to resume physical therapy and use of the passive motion machine. He did not release me to go back to work and said he’ll decide that after my June 20th appointment. I am off of bed rest and am able to drive again which is really GREAT! It was quite a warm day. Under normal conditions it would have been quite enjoyable. However, it was way too hot to be hopping around on crutches. I can’t wait to be able to walk without them. I can’t believe how hard it is to use crutches; it’s really quite painful and exhausting.

June 2, 2005 - So, here I am in PT, it feels really good to be up and moving again even though the PT is hard. It’s good to be able to drive again so that I can do thing on my schedule not have to wait for Mike to fit it into his schedule.

It turned out to be one scorcher of a day. It’s nice to be out of work and able to enjoy the nice weather. I guess that since my vacation time is being used up by this recovery from surgery thing I should look at this as my vacation. It’s probably the closest thing I’m going to have to a vacation this year. It’s nice though not to have to worry about work and all that goes with it. It’s the longest vacation I’ve had since High School. I can’t wait to walk on my leg again; it seems like an eternity. I’m going to do the best that I can to work my physical therapy and prepare myself to take that first step. I wonder how it will be, how it will feel; will it hurt and how much will it hurt? How long will it be before I can take a walk in the park or will I ever be able to take a walk in the park again? Will I get to see the Falls this year? I guess I have to learn to live in the moment since I can’t plan anything because I don’t know what’s going to happen with this leg. Microfracture is only about 80% effective and the new cartilage won’t be the same as the original equipment I was born with. I don’t know how much I will be able to do or how much I won’t be able to do or how long it will take to get there. I have no other choice but to take it day by day. Even Dr. Marc can’t say because Microfracture is unpredictable. I wonder what we do if the surgery isn’t successful or what happens if I wear out the new cartilage like I did the original stuff. I can’t wait to be able to do laundry again. Getting Mike to do it is like pulling teeth and he doesn’t do it right when he finally does do it. I’ll tell you one thing, I’ll never complain about having to do laundry again. From this point on I will consider my ability to do laundry as a privilege.

Summer is always so busy with running here and running there. All sorts of parties and get-togethers. If there’s one positive thing about this knee surgery it is that it has been and will continue to be a good excuse for not attending every party. It looks like a lazy summer for me and for that I am quite grateful.

It’s 7:00pm, the sun is low in the sky and sunset will soon arrive. Soon I will be one day closer to the day I can walk on my own two feet once more.

June 5, 2005 - I stayed up until 5:00 in the morning using the passive motion machine. I wasn’t tired and wouldn’t have been able to sleep anyway. My knee hurts today, more so then at any other time since my surgery. Maybe I overdid it with the machine. I’m sitting here with an ice pack on my knee. I can’t take aspirin or Motrin or anything like that because of the coumadin.

It must be terribly interesting to be a doctor with new discoveries happening all of the time. I don’t think we will ever reach a day when medical science has it all figured out though. You know, I’ve never heard a doctor say, “I don’t know.” It’s almost like they are afraid to admit to a patient that they just don’t know, that medial science hasn’t found all the answers yet. Maybe that’s something they teach them in medical school, to never say, “I don’t know.” I remember one time I was really sick. I had a fever and I was really dizzy and just felt really weak and bad. I went to the doctors and he checked me out and then the nurse came in to take some blood. She looked at my chart and said, “Viral syndrome aye?…you know what that means?” I shook my head NO. “It means he doesn’t know what the heck is wrong with you.” I had a fever, which would indicate an infection of some sort, but he couldn’t find an infection anywhere. Throat, ears, nose, lungs, tummy…everything seemed fine. Yet there was the fever and dizziness and my color was really bad. I don’t think doctors should be afraid to say, “I don’t know,” if they really don’t know. After all, medical science has not come up with all of the answers yet and probably never will. Still, it must be satisfying when a doctor goes home knowing that he has made someone’s life better, has made a difference in people’s lives or has improved their quality of life. It must be wonderful to be able to go home knowing that you did something really important and significant for at least one person that day. If I get laid off from work I want to go back to school and take up something were I can go home at the end of the day feeling like I did something important and significant. I could never be a doctor or nurse ‘cause I could never stick people with needles and stuff. But I want to do something that makes a difference in people’s lives, something significant. I don’t know what though, I’ll have to do some research to figure it out. I used to be a firefighter and am EMT (emergency medical technician) and I miss the satisfaction of doing that. Of course, physically I could never go back to being a firefighter or an EMT but there’s got to be something I can do that will be satisfying and significant. My period is coming up soon and I’m concerned about it since all I can take is Tylenol and that stuff doesn’t even put a dent in my period pain. I’m also having difficulty with my headaches since I can’t take the Excedrin Migraine that I usually take for them and Tylenol won’t even put a dent in my headaches. I’ll have to give Dr. Joe a call and see what he recommends.

June 8, 2005 - I’m getting really anxious to try this knee out.

I only have 11 more days until my appointment with Dr. Marc. Hopefully he will let me start bearing weight on my leg and I will have a little more freedom to get around and do some things for myself. I hope he says I can go back to work because I’m getting quite stir crazy. I can’t wait to take a nice long soaking bubble bath, it’s been a long time and bubble baths are one of my favorite things.

June 9, 2005 - Only 9 more days until my appointment with Dr. Marc and I can’t wait!

June 10, 2005 - A lady from Benson came and picked up the CPM. I have to find satisfaction in each small step of progress I make. There’s not going to be any overnight miracles. My recovery is going to be one small step at a time. I can put on my compression stockings, socks and shoes now without my knee hurting. That may not seem like much to most people but just putting my socks and shoes on was an agonizing task before the surgery. For me it’s a big improvement. As my appointment with Dr. Marc gets nearer and nearer I am growing increasingly impatient to start bearing weight on my leg. It is hard to resist the temptation to give it a try but I just keep reminding myself that if it’s not ready yet I could ruin all of our hard work. I don’t know how hard it has been on the doctor’s part but still, let’s have respect for the man’s work! On my part is has been a lot of patience and quite a struggle. I wouldn’t want to mess it up now after all our hard work.

June 11, 2005 - I woke up feeling quite depressed. I’ve been trying very hard to stay upbeat and positive but it’s not easy. My period is coming up and I’m sure that isn’t doing anything to improve my mood. I guess it’s normal to have those occasional bad days and I’ll have to allow them but I can’t afford to let myself stay in that mood for too long.

I wonder how bad my knee was. I wonder if I ask Dr. Marc to rate it on a scale of 1-10 compared to all the other microfracture surgeries he’s performed where would mine rate - ten being the worst he’s ever seen? I’m wondering exactly how bad was mine and will there ever come a day when I can forget I ever had surgery on my knee? And I wonder about my other knee. If my right knee was this bad what does my left one look like? They came as a matched set after all. It’s like headlights on cars. The headlights are new and installed in the car at the same time yet, one always blows out before the other, why is that? My knees were installed brand new at the same time but one wore out before the other and I wonder why that is and how many years the other one has left on it. Will I be going through this same thing with my other knee a year or two from now?

June 14, 2005 11:51pm – I just finished doing my PT exercises. I really didn’t want to go indoors to do them; it’s such a nice night out tonight. I’m restless and unable to settle into bed yet. I can’t wait for Monday to arrive. I pray that Dr. Marc will be able to give me the OK to start weight bearing on my leg. This waiting is just pure torture. I have a physical with Dr. Joe on Friday, which I am not looking forward to. I always feel quite violated after a physical. And I know he’s going to order bloodwork and I already feel like a pincushion because of the weekly coumadin checks I have to have done. These weekly blood tests are really getting on my nerves big time. I’m feeling quite intolerant of them.

June 15, 2005 12:02am – I’ve just crossed over the threshold to another day. After I get through today I’ll only have four more days until I see Dr. Marc and hopefully begin on the path toward walking again. I should get to bed in order to get back to a regular sleeping pattern in the event that the doctor gives me the OK to go back to work. Soon a new day will dawn and the hours will drag by until another day of my confinement is over. Time surely drags when one is waiting like this. Today is the 6th week mark from the day of my surgery on May 4th and six weeks have never gone by more slowly.

Seven more hours and another day will be in the past. 8:00pm – It just got too chilly to sit outside and enjoy it. Four hours left of the day. This waiting is making me nuts!

June 17, 2005 2:00am - I have a physical with Dr. Joe today at noon. Two more days after today and I just can’t wait! 10:30am – I’ll be leaving for my physical at 11:00. I’ve discovered that I need to allow 30 minutes leeway for getting places because it takes so long for me to get from the house to my car and from my car into the building. I need to stop several times to rest before I get to where I need to be. Now that I’ve found a doctor who took my knee pain seriously I need to find one who will take my headache pain seriously and stop telling me to take Tylenol when I’ve already told him that Tylenol doesn’t work, doesn’t even put a dent in them. I think a lot of my current troubles could have been avoided or caught earlier if a doctor would have taken my knee complaint seriously years ago. This knee has been giving me trouble for years and years and nobody would even bother to order x-rays until Dr. Joe. What’s more, the condition of my knee turned out to be way worse then even Dr. Marc had expected. So maybe now Dr. Joe will listen to me about my headaches now that he knows I’m not some hypochondriac or drug addict.

Why does time drag so when one is burdened with apprehension? I’m waiting for the clock to read 11:00am but it seems to be moving at a very slow rate, minutes seem like hours. I just want to get this physical over with.

It has cooled off quite a bit and is much more conducive to hopping around on crutches; there’s one thing to be grateful for.

Once I’m done with the physical I have a long wait until Monday and my appointment with Dr. Marc. I’m sure those two days are going to feel more like weeks than days. Will I be able to start weight bearing on my leg? What will that first step feel like? Will it hurt? Will I get to go back to work? What if the doctor says I have to wait another two weeks? I’ll go nuts!

June 18, 2005 - Only one more day to wait after today. I had a really good appointment with Dr. Joe. He took a long time with me and took the time to talk to me for quite a while. That’s quite unusual these days. Usually a person sees a nurse or physician’s assistant and then they get to see the doc. For a whole two seconds. But Dr. Joe took a long time with me. We talked about my quitting smoking and he gave me a prescription for the patch. Then we talked about my losing weight and he hooked me up with a nutritionist. We talked about my headaches and he gave me a prescription for Tylenol/codeine. Then he brought up the topic of mammograms and why I didn’t get one done like he told me to the last time I saw him. I told him that they are just too painful. If course he tried to talk me into it but there’s just no way I’m going through that pain and humiliation again. If they want to save women’s lives they are going to have to find a less painful method of early detection. At the very least they could give a girl something for the pain ahead of time to lessen the trauma. Heck, before my surgery they gave me medication that made me forget I was even having surgery but they can’t do anything to make mammograms less painful? That machine would have come in quite handy during the Spanish inquisition.

June 29, 2005 10:00am – It’s finally Sunday and tomorrow is the big day….I can’t wait. I was just starting to plan what I’m going to do after my appointment tomorrow then I realized that the whole idea is silly since I don’t know what the doctor is going to say and there’s just no point in working out a plan until I know. After I see Dr. Marc and know exactly what’s going on there’ll be plenty of time for planning. The only day I can plan is today and tomorrow because I know at least part of what tomorrow holds. I can pick out what I’m going to wear to my appointment and get it ironed and ready to go. I think it will make it easier on both the doc. and me if I wear a dress with a pair of shorts under it. Yes, I’ll wear my blue jumper, it’s very comfortable and will suit the situation perfectly. It would be so cool if I can totally walk without the crutches at all but I’m not counting on it…I think that would be expecting a bit too much. After all, he’s a really good doctor but he’s not a magician, I can’t expect miracles.

I wonder how doctors choose the field they want to go into. I mean, what sort of person wakes up one day and says, “I think I’ll become a proctologist,”? (Eeeeks!!!) There are so many fields of medicine to choose from, how does one decide out of all of the choices, which one is for them? How did Dr. Joe decide he just wanted to be a regular physician and how did Dr. Andrew decide he wants to deal with veins and DVTs and general surgery. And how did Dr. Marc decide that orthopedics was for him? I have so many questions I could probably drive a doctor right out of his freaking mind if I were to ask them all. I’ve tried to look up and learn as much as I can on the Internet but I still have tons of questions. For instance, in the literature they gave me prior to my surgery it said that the operating room is kept quite cool and it explained why that is. But my question is how can a surgeon maintain dexterity when his fingers are freezing cold? How can he concentrate on what he’s doing if he’s freezing his butt off? I’m glad I don’t remember anything about the operating room ‘cause I hate being cold and that would have bothered me a lot no doubt about that. Even in the recovery room, I had this really nice, cozy warm blanket…it was so nice and snuggly. But the arm that had the IV in it had to stay out from under the covers and that arm was really uncomfortably cold. I don’t know how surgeons can work in those conditions. And Dr. Marc had on short sleeves the last I remember seeing him before the surgery. I like painting but I can’t imagine trying to paint in conditions as cold as an operating room. If someone put me in those conditions and said, “Here, paint.” I’d ask them if they recently hit their head really hard.

June 20, 2005 - Dr. Marc gave me the go ahead to start bearing weight on my leg and also to go back to work on Wednesday. I’m going to try to go to church on Sunday. I couldn’t get up the stairs before but now that I’m partial weight bearing I may be able to do it.

I’ve had a headache for about 4 days now. I can’t take the Excedrin Migraine, which is what works the best for me thus far. The Tylenol / codeine doesn’t really take it away, it takes it away for a few hours but as soon as it wears off the headache comes right back. The Excedrin Migraine takes it away and it stays gone but I can’t take that because of the coumadin.

I’ve decided to try taking a bath, I couldn’t before because I was afraid that I wouldn’t be able to get back out of the tub. I pretty sure I can do it now that I can put some weight on my leg.

June 24, 2005 - I am really tired of walking on these crutches.

Part of me wants to ask my physical therapist how long he thinks it will be before I won’t need them any more. But then there’s another part of me that is terribly afraid of what the answer is going to be. The tendon in my left ankle is pretty tight and sore today. I’ll ask about that in PT, maybe I’m not doing something right when I’m walking on my crutches…I can’t wait to be rid of these things.

June 25, 2005 - It’s a beautiful, sunny day today. I’m thinking about all of the things that I used to take for granted. For instance, I was just thinking that I’d like to get a newspaper. Before my knee got bad it was simple and easy to just get up and walk to the corner store to get one. But now, getting a newspaper takes effort and planning. Why, just getting from my rocking chair to the couch takes planning and effort. I long for the day when I will be able to just get up and walk without having to think it out first. I still can’t do the laundry myself because I can’t navigate the basement stairs yet. I swear, I will never complain about having to do laundry ever again.

June 27, 2005 - I have to get my blood work done again before work this morning; I am so sick of these blood tests I could scream. If I knew before my surgery what I know now there are definitely things I could have done that may have prevented the DVT. If I had known what a pain in the ass it is to be treated for a DVT I would have researched it more and would have found out that smoking increases the chances of a DVT and I would have quit the minute I found out I would need surgery. If I had known what a genuine pain it is to be treated for a DVT and that being over weight increases the chances of one occurring I would have been more diligent about my quad sets and my ankle pumps. The quad sets hurt my knee quite a bit so I didn’t do them as much as I should have but I didn’t know easy it was to get a DVT and I didn’t know what torture it is to be treated for one….it’s absolutely brutal! I wonder why I didn’t get compression stockings immediately after my surgery to help prevent the DVT in the first place. If I had known then what I know now I would have asked for them. I don’t see how wearing them could do any harm and they may have helped.

June 29, 2005 - Today is my first day as a non-smoker. After what I’ve been through with my knee and the DVT quitting smoking seems like a synch…. Easy stuff next to what I’ve been dealing with. I’m walking on my crutches much better now. I hardly need to lean on them at all, only lightly. I’m hoping that I will be able to go on to using only one crutch soon. At least that way I’ll have one hand free for carrying things and opening doors and such.

July 2, 2004 - I started walking with a cane today. My therapist hasn’t given me the OK to do that yet but I just couldn’t take the crutches any more. I have so much more freedom using the cane. I took a walk in our back yard and it was wonderful. The first time I’ve been able to do that since May 4th. My lilies are in full bloom, my pink roses are beginning to fade, a week from now they’ll be gone and I would have missed it. I walked to the corner store to get a beverage and picked up something to eat from Uncle Sams next door to the corner store. It was so good to have the freedom to do that again. Oh it was grand to go into a store and look at all of the choices and make my own decision instead of just having to accept what ever Mike decides to get me. And it’s a most beautiful day out today, not too warm, not too cold. It would have been a perfect day for a hike but I’m not quite ready for that yet and wonder if I ever will be. It is most wonderful just to be able to get around a little better and I really don’t think that my jumping the gun on this has hurt me in the least.

July 5, 2005 - It was a most wonderful day. I went out to my parent house in West Falls and swam in the pool all day. Dad made dinner and I had a really great time. After that I joined Mike at a party at Rita and Ken’s house and had a grand time.

I’m not quite sure what to do about physical therapy. Should I let them know that I jumped the gun on the walking thing? It seems silly to use the crutches just to go to PT when I haven’t been using them at all. Who knows, maybe they are waiting for me to throw the crutches away on my own. Maybe they don’t tell you that you don’t need them anymore. Maybe they just wait for the patient to tell them they don’t need the crutches any more.

July 8, 2005 - Today I had my first appointment with my nutritionist, Jeff. Everything is getting on my nerves today. I’m sick and tired of being sick. I’m sick of this knee and not being able to do what I want it to do. I’m sick of the blood tests, I’m sick of the compression stockings, I sick of the physical therapy, I’m sick of doctors, I’m sick of my life revolving around this knee and the DVT…I’m sick of everything…all of it. At least now I have a diet plan and that’s one area of my life and health that I can take control of. So much is out of my control that it’s comforting to find something I can take control of and do something about. Most people would think that trying to recover from surgery and the DVT along with quitting smoking is enough and that adding a change in the way I eat to the list is just too much to take on all at once. But the life style changes I’m making like quitting smoking and changing my diet lets me feel like I am doing something, like I do have some control over something. Losing weight will help my knees and it will help prevent another DVT and that’s something I can take charge of and control myself. There’s so much that’s out of my control that I feel that I absolutely HAVE to take control of the things I do have control over.

I purchased an exercise ball and a trampoline similar to the one they have in PT so that I can do some of the exercises at home.

July 13, 2005 - I’ve thrown the crutches and cane away except for when I get up in the middle of the night and when I first get up in the morning. My balance is not very good during those times and the Achilles tendons in both of my legs are really tight when I first get out of bed. I complained to Mike A. about it and he gave me some stretches to do but it’s not helping much. Nowadays if I’m having trouble walking it usually has nothing to do with the knee but most often it is my Achilles tendons that are the trouble.

July 16, 2005 - I can’t wait for my life to stop revolving around my knee and the blood clot. I am looking forward to the day when I can forget that I ever had surgery or a DVT and get back to normal. A day when I no longer have to do PT or submit to weekly blood tests. I’m anxious for the day when I can put all of this behind me. That probably won’t happen till November at the earliest and November seems like such a long way off. Anyway, I’ve had enough rest and rest is a fictional thing anyway. Even being confined to bed is not restful and in fact is quite stressful because of the boredom. There really is no such thing as complete rest except in death and maybe not even then. You’d think being in bed and having someone waiting on your would be restful but not being able to do things for myself was the exact opposite of restful.

July 19, 2005 - Today I had no pain or almost no pain in my knee, even throughout my physical therapy session. After years of pain in that knee it feels very strange to have no pain. I keep limping on it out of habit not because I need to. It is the most peculiar feeling having no pain or very little anyway. I hope it stays this way, I hope it’s not just a momentary reprieve.

July 23, 2005 - My knee got quite sore Thursday afternoon. When I went to PT Friday, Mike A. was concerned about the sudden change giving my history of a blood cot. He called Dr. Marc but he wasn’t available. Later in the day Greg, his medical assistant, called me. He hadn’t been able to get hold of Dr. Andrew because he was out of town on vacation. So he told me to go to the emergency room. To make a long story short, all of the tests came back fine. It was just as I suspected I had just overdone it and was understandably sore from it. While I’m incredibly grateful for my doctors and everyone who has been a part of my recovery, I am most tired of my life revolving around this leg and around my health. I can’t wait to get my life back.

July 28, 2005 - My knee is coming along well but I’m still a long way from being back to normal, back to the way it was before it started acting up so bad. Near the end of August I’ll have another Doppler / ultrasound done on my leg to see if the DVT is gone yet. I hope that it is because I simply can’t do another three months of weekly blood tests.

July 30, 2005 - I’ve decided that I’m done with this knee. I’m going to do everything I normally would do as far as it is possible. I missed the spring hiking season and I’ll be damned if I’m going to miss the autumn hiking season too. I’m going to walk as much as I can so that I’ll be ready when falls gets here. I’m sick of being sick, sick of being injured. My knee could hurt for months or even years so I’ve decided that I’m not going to let it stop me from doing the things I love to do. I’m going to start working really hard to get this leg and my life back to normal.

July 31, 2005 - I did a great deal of walking yesterday and my legs are quite stiff today as I expected they would be. Fall is my favorite time of the year. I should do some laundry but I can’t bring myself to do anything today except sit here with my ice pack. The tendons in the back of my legs are really tight. Once all of this blood clot and PT stuff is over I need to get to the dentist for a cleaning. I just can’t deal with one more medical issue right now.

August 1, 2005 - My knee is feeling better and better all the time. Many of my days now are pain free. Of course, I’ve still got a long way to go but I’m definitely making progress.

August 4,2005 - I have two more blood tests to endure before my appointment with Dr. Andrew and I get to find out if the DVT is gone yet or not. I see Dr. Marc again on August 29th. I don’t see why I have to have these weekly blood tests. Every one has come back fine and Dr. Andrew hasn’t had to make any adjustments to my medication…not even one so I don’t see the necessity for them. I would think that every other week should be more the sufficient.

August 5, 2005 - I’ve decided that after my appointment with Dr. Andrew on the 22nd one way or another these weekly blood tests are going to stop. Hopefully the clot will be gone and it will be all over with. If it’s not gone and I have to stay on the coumadin for another three months then Dr. Andrew is just going to have to accept my doing the blood tests every other week. Yesterday was 13 weeks since my surgery and my life is still revolving around my leg and I’m running out of tolerance for it.

August 6, 2005 - My knee is feeling great today. I’m actually having way more pain from the tendons in my heel then I am from the knee. I ordered some shoes that I hope will solve the problem with the tightness in my tendons. They aren’t very ladylike and in fact, are the ugliest shoes I’ve ever seen but if they solve the problem then I don’t really care what they look like. My new shoes just arrived and I can’t wait to try them out and see if they solve my problem.

August 9, 2005 - When I arrived home from work last night I found a voicemail message from my physical therapist saying that my insurance will not cover any more PT sessions. I decided that since I am feeling very strong now and have very little discomfort I can probably continue the PT exercises on my own. I’ve purchased all of the equipment I need in order to do the exercises on my own and can always pay for a session with Mike if I run into trouble. The shoes have worked great. If the heel of my shoes is too high it hurts my knee but if the heel is too low my Achilles tendons get too tight. These shoes are low enough that they don’t hurt my knee and high enough to take the stress off of my tendons…they’re perfect.

August 15, 2005 - Today may be my last blood test. I know one thing for sure and that’s that I will not be getting a blood test next week. I don’t care if Dr. Andrew says I can go to a schedule of every other week or not, I’m making a decision on my own this time. I will submit to blood work every other week and that will have to be good enough. This every week thing is just ridiculous. I see my nutritionist, Jeff, on Friday and Dr. Andrew next Monday. I hope and pray that I be done with Dr. Andrew and coumadin and blood tests then.

August 19, 2005 - I have an appointment with Dr. Andrew on Monday and I can’t wait to see if my clot is gone or not.

August 20, 2005 - I am most concerned that my knee will not be ready on time for the fall hiking season.

August 21, 2005 - Well, tomorrow is the big day when I learn if my DVT is gone yet or not.

August 22, 2005 - I just got back from my appointment with Dr. Andrew and it was very good news all around. My DVT is gone and I do not have to submit to any more blood tests. Dr. Andrew wants me to finish the rest of the coumadin I have but I’m not going to. He said that when I get down to the last 3 pills that I should take them every other day instead of every day. I’m considering the pill I took today as one of the last three which means that I skip Tuesday, take one on Wednesday, skip Thursday and take my last pill on Friday. I have to take 81mg of aspirin a day once I’m off the coumadin and that’s something I will have to do for the rest of my life. Three days after my last pill I can pretty much resume a normal life. I’ll have to wear the compression stockings for the rest of my life too but that I can tolerate if it means I’ll never have to go through this ever torture ever again.

August 23, 2005 - At my appointment with Jeff, he said that the weight would come off a lot faster if I walk at least 10,000 steps a day. So, I’ve been trying to do that every day.

August 25, 2005 - I had a wicked headache this morning and am quite grateful that I can go back to taking my Excedrin Migraine pills for it. My headache is already diminishing. I went out to do my 10,000 steps and I can’t believe it but I tripped and fell right on my knee. I’m icing it right now and am praying that I didn’t do any significant damage. I just can’t believe I was clumsy enough to fall on that knee of all things.

August 27, 2005 1:00am – I don’t know why but I feel very nervous about my appointment with Dr. Marc on Monday. I guess I’m afraid he’s going to tell me that I’m not doing as well as I think I am and that I shouldn’t be walking 10,000 steps a day and that I won’t be able to go hiking this fall. I’m afraid I will still be on very low impact activities when I want things to get back to normal.

August 29, 2005 - Just as I feared, Dr. Marc said that the replacement cartilage is not the same as the original stuff and that I should ride a bike for exercise instead of walking. It’s bothering me that I’m only 42 years old and I can’t go hiking any more. But, there’s nothing I can do about it except adjust. My hiking days are over but a whole New World of biking has opened up for me. The problem being that I can’t take my bike everywhere I go. I’ve been walking during my lunch hours and that has helped me quit smoking. I can’t ride a bike during my lunch hour. I think that my next automobile will have to be one that is big enough to carry a bike. But look at me complaining because I can’t hike any more when not that long ago I was thrilled just to be able to do laundry again. I need to find bike trails to replace my hiking trails. I won’t be seeing Dr. Marc again for six more months, which I was surprised about. The stuff I read on the Internet said that most people could return to normal activity in six months so you’d think he’d want to see me at the six-month mark, which would be the beginning of October. As it is I won’t be seeing him until February. Well, the article did say that every case is different and maybe Dr. Marc knows that, in my case, six months isn’t going to be nearly long enough. I wonder if I will ever be able to return to normal activities.

August 31, 2005 - I faxed a letter to Dr. Marc and Greg asking if I can do just some light hiking if I used a cane to take some of the impact off of my knee. I also asked them if swimming is OK. Another question I had was if this not hiking / walking thing is just for now or is it a forever thing. I think this is the day of the week that Dr. Marc is in surgery all day so I’m not expecting to get an answer today.

September 1, 2005 - Greg called back and left me a voicemail saying that if I hike on level terrain and don’t do any hill climbing or anything I can probably do it but it is risky. So, now I’m trying to decide if it’s worth the risk. He did say that I could swim as much as I want because there’s zero impact with that activity. He did not answer the question of whether not walking and hiking is a just for now thing or if it’s a forever thing. Which tells me that they don’t really know at this point. Dr. Marc is very careful about not giving his patients false hope.

PROGRESS

September 5, 2005 - I had microfracture surgery on May 4th and since then I have found the following improvements:

• The first improvement I experienced was that I could put on my shoes and socks without being in agony. Now, that might not seem like a big deal to most people but for me that was HUGE.
• Once I found the right shoes I found that I could walk as much as I wanted to without pain.
• On August 29th Dr. Marc told me that the cartilage in my knee is still fragile and easily damaged and that I should ride a bike for exercise instead of walking. I told him that I can do all kinds of things that I couldn’t do before and he asked, “Like what?” And I showed him that I can squat down to pick things up off the floor now. He looked disappointed, like he thought I was going to show him something spectacular. Before my surgery I avoided doing that all together. When I had to pick things up off the floor I usually pulled up a chair and sat down to pick them up. When I did squat down I always needed something to lean on to help me get back up. Now I can do it quite easily without any struggle. That may not seem like much to anyone else but for me it’s HUGE!
  On August 30th I faxed a note to my doctor’s office asking if it would be ok for me to go hiking. Greg called me back and told me that if I hiked on fairly level and even terrain I could do it but there’s still a risk of damaging the new cartilage. I thought about it for a couple of days as to whether it was worth the risk. Autumn is my favorite season of the year and I’ve always cherished hikes in the fall. But was it worth risking starting over with my knee from square one? Or maybe even worse. Microfracture surgery only has an 80% success rate to begin with. Did I want to lessen those odds even further by hiking when I shouldn’t?
• On September 2nd Mike and I went to a concert at Darian Lake. I brought along a cane just for stability in the event that someone bumped into something or me. As we walked across the field from our car to the entrance line I realized that I would never be able to hike in the fall even on level terrain. The walk across the field was a real challenge and much trickier then I had anticipated. I didn’t feel steady at all. Every little bump or dip threw me off balance. The small pebbles and rocks rolled under my foot and I kept feeling like I was going to loose my balance. I was glad I had decided to bring the cane along.
• On September 5th I had been asking my husband to get my bike down from the attic since my appointment with Dr. Marc on the 29th. I finally got tired of asking and determined that I would do it myself….where there’s a will there’s a way. So I got my bike down from the attic and out the door. I didn’t want to venture too far from the house on this first trip out so I just rode up and down the street for about 15 minutes, until my legs were too tired to keep going. I went back into the house and rested for about an hour and then went out again for another 15 minutes or so. This time my knee was a little sore but it went away after about an hour or so. Later on I took off my ugly shoes and found that the knee was a little bit sore. I was tired so I laid down for a while, when I got back up the knee felt fine again.
• Another improvement is that I can walk up and down stairs without struggling. Before the surgery I had to lean on the railing and had to grab it and pull myself up the stairs. Now I can go up and down without leaning or pulling on the railing. However, I do still need to keep one hand free to use the railing for balance.
• Balance seems to be the biggest challenge for me right now; I’m not sure why that is. Come to think of it, balance was a real challenge for me as a child; I had to attend special gym classes to deal with it. I remember some of the exercises they had me do back then and wonder if they would help me now...it certainly wouldn’t hurt to try them. I especially notice a lack of balance when I first get out of bed in the morning and sometimes grab my cane for stability. The pain and discomfort I expected but the lack of balance was something I hadn’t anticipated. I’m really concerned about winter; it will be here before we know it. I’m worried about falling on the ice. If just walking across a field is a challenge what is walking on ice going to be like? I’d better work on my balance as much as I can before the snow flies.

I do wonder what went through Dr. Marc’s mind when he got inside my knee and found what he found. I’m sure it was nothing he hadn’t seen before but I imagine it’s a lot like when I discover that a customer’s FedEx priority overnight order didn’t ship. My first response is “DANG!“ It’s nothing I haven’t dealt with before but having to call the customer to give them the news is never one of the highlights of my day. Some customer’s take it in stride others freak out. I imagine it’s the same for Dr. Marc. Some patients take it in stride while others probably freak out. I’m sure what the doctor found inside my knee was nothing he hadn’t dealt with before but I doubt that giving me the bad news was one of the highlight of his day. When he told me I was determined to take it in stride. After all, my freaking out about it wouldn’t have changed anything. I couldn’t function very well the way it was and so far, it’s been worth it. Being non-weight bearing for six weeks was a real pain in the rump but my knee sure is a whole lot better then it was before the surgery. Even if the faux cartilage only lasts ten years, that’s ten years I wouldn’t have had before the surgery. It wasn’t like it was going to go away all on its own. I think that another thing that helped me right from the start was that I was determined to maintain a positive attitude no matter what happened. I was determined to treat the whole thing as an adventure. If a person goes off on any adventure they are going to run into good things along the way and they are going to run into some bad things along the way. When Dr. Marc told me about the microfracture procedure and that I’d be off my leg for a minimum of 6 weeks and then the blood clot and having to give myself shots every day, twice a day for 10 days, I took it as all part of the adventure. If you had told me a year ago that I’d be giving myself shots twice a day for 10 days I would have asked you, “Did you hit your head really hard or something?” It’s not my most cherished memory but it was interesting to find out that I could do it if I really had to. I just looked at it as a matter of life and death and I did what I had to do. And then being on complete bed rest for two week….I don’t know why they call it rest because it’s not very restful, it’s really aggravating. There were lots of good points in the adventure too. The first time I met Dr. Marc I felt very at ease with him. I was pretty sure I’d need surgery on my knee just by the way it felt and the wacky things it was doing, so you’d think that I would have been nervous meeting the surgeon who was going to do the deed. But the minute he walked in I felt this calmness come over me. Even in the hospital when they were preparing me for surgery. I was pretty upset with the whole I.V. thing and that they didn’t let Mike come in and hold my hand while the nurse was doing it. And then the one doctor came in and put an antibiotic in my I.V. and it burned like crazy. So by then I was getting pretty upset and agitated. Then I spotted Dr. Marc at the foot of my bed and I immediately felt calmer. I wonder why that is. The nurses were really great. When I started waking up I wanted to roll over on my side but the nurse wouldn’t let me...I wonder why they have to keep you on your back. I had lots of cuddly, warm blankets on and felt warm and snuggly. It was nice. And then they took me into the second recovery room but I don’t remember how I got from the bed to the chair. I remember Dr. Marc came in to talk to me but I don’t remember if it was in the first recovery room or the second recovery room. My physical therapists were really great too.

It does bother me though that there are pieces of the whole thing that I should remember but don’t. After the doctor put the relaxing medicine in my I.V. I don’t remember anything after that until I woke up in the recovery room. Mike says I kissed him and said, “see ya’ later,” but I don’t remember it. I don’t remember being wheeled down the hall. I don’t remember anything about the operating room. I don’t remember any of it but I shouldn’t have been out cold yet. It’s weird! I keep trying to remember but I just can‘t. I remember he put the stuff in my I.V. and then asked me if I was getting woozy. I said, “No” and then it was about two beats and I said, “Yes”, and that’s the last thing I remember even though Mike says I was still awake. It’s disturbing! I keep trying to remember but I can’t. It’s so weird!

Another thing is that my throat was sore the next two days after the surgery. I wonder if they ended up having to put an airway in. Greg told me they wouldn’t be doing that but maybe that changed.

September 7, 2005 - My knee was a little bit sore when I woke up today so I did some of my PT exercises, sometimes that works but this time it didn’t. So I took some Motrin and it went away and stayed gone for the rest of the day.

September 8, 2005 - My knee felt fine all day. I did some more Internet research on microfracture surgery and found an article that said that the faux cartilage is like filling a pothole in the road. It’s not as good as the original stuff and breaks away easier. The more cars drive on it the faster it deteriorates. So, I guess, the more I walk on my knee the faster the faux cartilage will deteriorate which is why Dr. Marc told me to ride a bike for exercise instead of walking. I wonder what happens if the cartilage does wear out again. Or what would have happened if the procedure hadn’t worked at all.

It must be wonderful to have a career where you can go home at the end of the day with the feeling that you really made a difference to people’s lives today. Seeing the hockey player back on the ice or the ball player back on the field must be quite satisfying I should think.

September 9, 2005 - My knee feels just fine this morning. I was just thinking how fortunate I am to have such a terrific health team on my side. It started with Dr. Joe, he’s super nice and actually listens to me when I talk to him. He’s the first doctor who ever paid any attention to my knee complaints and it’s a dang good thing he did and sent me to Dr. Marc. I had my yearly physical with him about 6 or 7 weeks after my surgery. The first thing he said to me is, “I’m glad to see you, there’s been a lot of changes for you since I last saw you.” In the course of the physical I told him that I never want to be sick again. I told him I wanted to quit smoking and that I wanted to lose weight because both of those things increase the chances of another blood clot happening and I never want to do that regiment ever again. That was probably the worst experience of my life. Of course, Dr. Joe can’t guarantee that losing weight and quitting smoking will keep another DVT from happening but if you do everything you can do and it still happens again then at least you know you did everything in your power to prevent it. Also, losing weight will help keep me from needing the services of Dr. Marc again. And then he told me something that was amazing! That he used to weigh around 300 pounds but now he seems fit as a fiddle. He’s living proof that it can be done. He put me on the patch to help me quit smoking and he sent me to a nutritionist, Jeff, who has been just wonderful. I’ve lost about 12 pounds so far. I’m trying new, healthier foods and many of them I like better than what I used to eat. There’s these “GO LEAN” waffles that are really good and unlike the waffles I used to eat, they stay with you for a while. The old kind of waffles go right through a person and you’re hungry again an hour later. And the high fiber pasta tastes better then my old pasta and it doesn’t stick together when you are cooking it so I don’t have to watch it like a hawk. It’s not about being on a diet; it’s about a complete life style change. Before I used to see a piece of cake or a bowl of ice cream as ‘spoiling myself’ but now I see eating healthy as ‘spoiling myself’. It’s all about a change in attitude. Jeff also wanted me to walk 10,000 steps a day but Dr. Marc did not support that idea. The walking would have also helped keep blood clots away. I’m not sure that riding bike is as effective in preventing another DVT as walking would be. I guess it’s all about find a balance.

So, now I’ve feeling much better and much more energetic but I can’t do a whole lot with it because of my knee….I guess that’s a good problem to have though. It’s amazing how quickly I’ve seen improvement in my lung capacity. When I ride my bike I end up stopping because I either run out of time or else my legs get too tired. Before, I’d have to stop because I was too winded to keep going. There’s a big difference there.

Last Saturday night Mike almost smacked me in the nose with the headstock of his guitar. I was glad my knee was working well so that I could duck! It was a very close call, probably less then an inch away. I thought, “I don’t know if any of my doctors do noses.” I probably would have had to add another doctor to my growing health care team.

September 10, 2005 - My knee feels GREAT this morning. It feels fine, like I never had surgery on it and nothing was ever wrong with it. Of course, the problem with that is that I did have surgery on it and I do still need to be careful of it. It feels like I could run a marathon but the reality is, I can’t. I do have some tightness in my Achilles tendons but that should be relieved once I put my ugly shoes on. I’m wondering, if this had happened to a professional athlete would it be a career ending injury?

Yesterday I read about a new procedure where they use bones from other areas to create new cartilage and this new cartilage is almost identical to the original stuff. The FDA hasn’t approved the procedure yet but if and when it is approved it sounds like it will be a far better option then the microfracture surgery. By everything I’ve read on microfracture it seems like it is only a temporary solution. It sounds like the replacement cartilage will eventually deteriorate. Maybe the new procedure will be approved by the time that happens to me though, I can always hope. I want to make a list of things I definitely can do not a list of things I can’t do.

1. Ride a bike
2. Swimming
3. Upper body work
4. Total Gym (I know I can use that because they use it in therapy.)

I think I need to join a gym first off, one with a pool. I wish I could take Dr. Marc or Mike A. or other such person with my to the gym and they could tell me what machines I can use and which ones I can’t use. I want to be as active as I can without rushing the deterioration of the replacement cartilage. So, I can’t hike any more, I’m not going to dwell on the things I can’t do anymore. I’m going to concentrate on the things I can do but I first have to find out what those things are that I can do. Lots of things have changed for me and I need to accept that and adapt.

September 11, 2005 - My knee is being funky today, about 1 out of every 20 steps hurts but I don’t know why. I’m going to try some Motrin and see if that does any good. The Motrin worked and I did laundry and went grocery shopping. It’s actually more fun going shopping now that I’m watching what I eat. It’s sort of like a treasure hunt trying to sort out the healthy foods from the non-healthy foods. It’s interesting that some things that are labeled as being “High Fiber” and “Heart Healthy” and such really aren’t when you read the label…other things are not labeled as Healthy food but when you read the label they are quite healthy. It’s also very interesting trying new foods and finding new, healthier ways of preparing foods. But the most interesting thing is that I can eat continually all day long and actually lose weight in the process. Once I started reading the labels on foods it wasn’t hard to figure out how I got to be 185 lbs.

September 19, 2005 - I had a strange dream. I’m thinking it was a combination between my going to the dentist Saturday and a flashback to my surgery. In the dream I was at the dentist’s office but I’m thinking that is because the dentist is a more vivid memory then the surgery. Other then that I was at the dentist’s everything else was exactly as if I was having surgery. They put this hard, plastic thing in my mouth and then they put on an oxygen mask. I let them do all of that but then something in my head said, “NO!!” and I pushed the mask away and then somebody said something about getting a needle. I’m guessing that they started the anesthesia at that point and started the oxygen after I was out. Then again, I don’t know if this is what really happened or if it was just a dream. I know that when a person doesn’t have all of the information the imagination often takes over and fills in the blanks all by itself and oftentimes it fills in the blanks with incorrect information. So, I have no way of knowing if this actually occurred or if it was just my imagination trying to fill in the blanks.

September 20, 2005 - I’ve been trying to research blood clots and microfracture surgery. I have been quite successful in procuring information about DVTs but information about microfracture does not seem to be readily available. I wish I had done the blood clot research prior to my surgery because if I had known then what I know now I do think there were things I could have done differently that may have prevented the DVT in the first place. Of course, that was my own fault because I certainly had the resources to do the research. If I had known that smoking increases the chances of a DVT I would have quit before my surgery and I wouldn’t have smoked like I did after my surgery. If I had known that sitting for long periods of time increases the chances of a DVT I would not have asked Dr. Marc if I could return to work until I was at least partially weight bearing. If I had known that being over weight is a contributing factor to DVT formation then I would have lost weight. And if I had known what a genuine pain it is to be treated for a DVT then I would have put my feet up more and I would have taken the ankle pumps and quad sets a lot more seriously then I did. Maybe these things wouldn’t have made any difference at all, maybe the DVT would have happened no matter what I did or didn’t do. But if I had done everything I could to prevent it I wouldn’t be sitting her now wondering if making these changes would have made a difference. Now my goal is to prevent a reoccurrence of the DVT so I have quit smoking, am losing weight, wear my compression stockings, put my feet up as much as possible, take my aspirin every day, exercise as much as possible and do all of the other things that I can do to prevent a reoccurrence. This way, if I do get another clot at least I will know that I did EVERYTHING I could have done to prevent it and I won’t be left saying, “If I had only done this or that or this maybe it would have made a difference. At any rate, I’ve already had the opportunity to use my experience to encourage someone else. One of the guys at work had surgery on his foot and he was non-weight bearing. I asked him if his doctor told him to do the ankle pumps and the quad sets and he said that he did but that he really wasn’t doing them very much. So I told him about my DVT and about what torture the treatment for them is and I straightened his ass right out. I got him doing the exercises the way he was supposed to be doing them. (He just started weight bearing yesterday.) I figure if I can keep other people from making the same mistakes I made and can keep them from going through the same thing I went through then maybe my getting the DVT had a reason and a purpose.

September 22, 2005 - Yesterday I joined a gym. It has a pool and Dr. Marc has given me the OK to do as much swimming as I care to do. It has a stationary bike exactly like the one they had in physical therapy and I can do all the upper bodywork I want in the weight room. Also, Greg called me back and said it is OK for me to start back with my Tai Chi which I believe will help my balance greatly. He said to just listen to my body and if something hurts then stop. I tried to find my old Tai Chi instructor but he doesn’t seem to be around any more. I can start off on my own with the videotape and if that doesn’t do the trick I can look for a new instructor. There’s a guy at McKinley mall teaching classes but I’ll hold off because I’m getting in a bit deep in the money department. I’m paying Jeff $45 a month for his nutritional advice. I’m paying the gym $45 a month and I just can’t afford Tai Chi classes right now. As soon as I’m finished with Jeff then I’ll start in with the Tai Chi classes. Until then, I can use the video; I’ll have to take it slow and easy to start with anyway. I need to test the waters and see how much Tai Chi the knee is able to take. I may only be able to do 15 minutes at a time, in which case classes would be a waste of money. I have to work my way up to a full hour of Tai Chi before I can make good use of an instructor’s time. I’ve decided that in the mornings I’ll spend an hour at the gym doing the weight room and stretching. Then, after work I’ll spend a half-hour in the pool and a half-hour on the bike. That should help me start to lose weight and start to get into shape. Plus, I think building up my upper body is a really good idea. I had a really hard time with those crutches and even though the surgery was a huge success. The reality is that my knees are not good and I’m only 42 years old. I have a feeling I’ll eventually be using those crutches again one day and the less I weigh and the stronger I am the easier it will be. I am still going to walk during my breaks at work though because it’s good for keeping blood clots away. I have to find a balance between what’s good for my knee and what’s good for the rest of my body.

I asked myself; if I had to choose to either have another knee surgery or another blood clot which would I choose?

September 27, 2005 - My knee feels perfect and hasn’t been bothering me at all but this morning I awoke with terrible pain in my right hip. I could barely walk and it felt like the big muscles in my leg were seizing right up tight. I took some Motrin but it didn’t help much.

September 28, 2005 - My hip hurt so much that I barely got any sleep at all. I took Motrin and the Tylenol / Codeine but it didn’t even put a dent in the pain. My hip has done this before and it took about a week for it to go away the last time this happened. I keep taking the Motrin and give it a week. If it’s not better by then I’ll make an appointment with Dr. Joe.

September 29, 2005 - I went swimming this morning and then spend some time in the whirlpool and my hip felt quite a bit better after that although it still hurts.

September 30, 2005 - My hip feels fine now, thank God! I’m going to a gym now that specializes in programs for people recovering from surgery. Many of the classes are pool/water classes. Many of the women who attend the various pool classes are recovering from arthroplasty and they seem to enjoy discussing their various experiences. It made me wonder what the determining factors are between microfracture and arthroplasty. One of the ladies was describing her condition before her arthroplasty surgery and her symptoms sounded very much like mine. It made me wonder what factors determined that microfracture was the best course of action for me and what factors determined that arthroplasty was the best course of action for her? The instructor of the class had a knee replacement and she was walking in far less time then I was. And she was in PT for a shorter time then I was. So it made me wonder what made microfracture surgery preferable to arthroplasy in my case and what made arthroplasty preferable to microfracture in her case.

Don’t get me wrong, I’m absolutely thrilled with the outcome of my surgery, I’m just always asking questions, always wondering about stuff. I wonder what would have happened had I not gotten hooked up with Dr. Marc when I did. How much more damage would have had to take place before microfracture surgery was no longer an option? I feel very fortunate to have found Dr. Joe, who was the first doctor I ever found who took my knee pain complaints seriously. And I feel very fortunate that he referred me to Dr. Marc when he did. I wonder how doctors find out about each other enough to recommend them to their patients? How did Dr. Joe know enough about Dr. Marc to feel comfortable referring me to him? And how did Dr. Marc know enough about Dr. Andrew to feel comfortable referring me to him? Anyway, I’m enjoying going to the gym in the mornings before work. I spend all day helping other people and making their needs my number one priority. It’s nice to start the day by putting myself first, by taking care of me first. When I was recovering at home, I realized that at that moment; I wasn’t of any use to my customers, my husband, my house or my church. In fact, I couldn’t even take care of myself. I realized that unless I take the time to take care of me I can’t be of any use to any one else. It doesn’t matter how much knowledge a person has or how many college degrees they have or what skills they possess if they are too sick or injured to make use of them. One of the ladies at the gym asked me how I hurt my knee. I told her that it’s mostly just from the wear and tear over the years. She said that I seem to be a bit young to be having such problems and she asked what sort of things I’ve done that may have caused the damage. I said that it’s probably a combination of things over the years. First of all I used to play tackle football when I was young with some of the guys in the neighborhood and of course, none of us wore any protective equipment. I remember taking some pretty good hits back in the day. And then I worked at Tops supermarket for a long while where I did a lot on kneeling on the hard floor. After 10 years of that it started feeling like I was kneeling on pins, I suppose that was the spurs that caused that sensation. That’s when I realized that I would not be able to do that job for the rest of my life and realized that I had nothing to fall back on and that’s when I decided to go back to school and get my degree. I was also a firefighter and an emergency medical technician for quite a while which probably added to the damage. I also did a lot of camping, hiking and hill climbing, over the years. Not to mention the genetic factors in that my grandmother on my father’s side had terrible trouble with arthritis pain in her knees and hip. I wonder why most of my pain is on my right side. My right knee, right hip and right shoulder all cause me trouble. The shoulder, now that pain I can explain. When I was about 13 I slipped coming down the stairs at my parent’s house. I reached out and grabbed the railing and my shoulder hurt for a long time after that. Then I was involved in rear end car accidents three times in 4 years and I’ve had pain in my right shoulder blade on and off ever since in spite of the fact that I had physical therapy for it. But I wonder why it’s always my right side that gets hurt more often then my left side or maybe it’s that my joints are stronger on my left side because I’m left handed and do everything left handed. Many left handers are somewhat ambidextrous but in my case I’m very left handed. The only thing I do right-handed is swing a baseball bat. I was checking out the UB sports medicine web site and it says that all of the doctors that work there are also teachers at UB. I wonder what Dr. Marc teaches?

FOLLOW-UP

16th February 2006 - Hello, it’s me again and I have some GREAT news to add to my journal.

Monday 02-13-06 was my last OS appointment. Dr. Marc said that I can do anything that my body will allow me to do. He said to start out slow and build myself up to where I want or need to be. I asked him if it is OK for me to start training for a 10K bike ride for Roswell Cancer Institute that is coming up in June and he said, “10K?...sounds good to me!” He said that it is also OK for my husband and I to take walks in the park and at Niagra Falls but expressed a concern, “What happens if you get deep into the woods or in the middle of the park and you knee starts hurting and you can’t walk back?” He told me to take it slow and easy and stay close to civilization until I build the muscles up enough to be safe walking farther. It’s funny because Dr. Marc always shakes my hand when he comes into the examining room and always shakes my hand at the end of the session. This time, we were both so excited that he must have shaken my hand at least a dozen times. I’m not sure who was more excited about my recovery, him or me. It was the best day ever!

3rd March 2006 - I hired a personal trainer to help me get ready for the 10K bike ride. The biggest problem is my flexibility so that’s what we’ve been working on the most. We’ve been stretching me and stretching me, and AnnMarie has gotten me to the point where I can touch my toes again. I told her that my goal is not to win the race but to just finish the race. I don’t care if I’m the last one to the finish line - I just want to complete the course.

June 24th, 2006 - I just got home from the 9 mile Ride For Roswell. Going into this I thought it was 9K (which is about 6 miles) but as it turned out it was 9 miles which was a lot longer ride then I have been training for. Thankfully, I was able to complete the ride and in fairly good time too. Here are some photos.