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 weeks!.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.
- Ride a bike
- Upper body work
- 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 labelâ€¦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?
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 Niagara 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.