An Empty Bag of Tricks

Today I learned Dr. Dye has nothing left in his bag of tricks for me. At this time, it sounds like I'm a part of the unfortunate 10-15% of his patients who are not responding well after a Synovectomy. Maybe it's due to my unfortunate setbacks (some I feel very guilty about, I should have not made those dumb mistakes), or maybe that is simply the alchemy of my knee. It's one that is extremely slow healing and it's been that way from the onset.

I told Dr. Dye my knee feels better after the steroid shot, but it isn't great. He said the shot should continue to help me and I could see more improvement over the next few weeks. Then he mentioned he rarely uses the shot on his Synovectomy patients. What? I was confused, this was different than what I heard him say last week. I guess I misunderstood. He said he uses steroid shots for arthritis patients often, but rarely for patients like me. That was when I realized he had gotten to the bottom of his bag of tricks. Dr. Dye felt my bad left knee then my right knee and said my left knee was still warm, which means there is still some inflammation going on in there. He said to continue to ice my knee a few times a day, swim and cycle within my "envelope of function," and keep taking the anti-inflammatory. He will see me again in 6 weeks.

All I can do now is continue to be patient. Dr. Dye said there is still more healing for my knee to do. It has now been almost 20 weeks since my surgery. I haven't lost all hope that this surgery will have helped, but I don't think I will know for quite some time.

Back to Business

This week I was finally able to return to traveling for work. Now I can say I'm 100% back into my role at work and no one needs to cover my press checks for me anymore due to my bum knee. Yay! It was 3 days of press checks in Los Angeles so a business trip not too far from home was a good place to start.

I flew in on Sunday night since I had an early call on press on Monday morning. I decided to try a hotel I had never seen before, just because it wasn't all that far from the airport. It was the Sheraton Delfina Hotel in Santa Monica. I had to chuckle when I drove up. It turns out the hotel is right across the street from Santa Monica High School (Samohi). When I was in high school I was a member of the choir. We went on "tour" to So Cal for a week and one of our stops was a visit to sing at Samohi. The high school didn't look like it had changed at all! It was funny how the sight of it immediately threw me back 20 years! Yes, 20 years... our reunion is right around the corner.

This was the view from my balcony on Monday morning. My iPhone camera didn't catch it very well, but this was an ocean view from a far. It was a little hazy that morning. All in all the Delfina was a decent hotel. The lobby/bar area was kind of dark and swanky, but the rest was fairly Sheraton standard, comfortable and clean.



The next two nights I stayed at the Universal Sheraton Hotel in Universal City. I've always liked this hotel. When I first stayed there a few years ago, it seemed a little dated. I was glad when they embarked on a full renovation and it's just about finished. I didn't take a photo this time, but the best thing about it (when you get a room in the tower) are the floor to ceiling windows. There is some freeway noise, but usually, it's not too bad. I liked the artwork in my room. Doesn't this chair look a little Alice in Wonderland-ish? I'll take a photo of the windows during my next trip.



I have to admit, there is something about room service I really like! Someone bringing me food to my room that I don't have to make myself or pay for in the end... very cool. I enjoy ordering breakfast with a small pot of coffee in the morning and leisurely drink it as I get ready to start the day. I don't order room service for every meal. The options aren't all that healthy (mind you, I'm not the most healthy eater, but I really shouldn't be tempted to order a "personal" pizza that could actually feed 4 people) and are quite expensive. Even if I can expense it, sometimes I feel guilty when I can get a less expensive meal somewhere else. Ordering room service a few times during a business trip is nice though and I think I deserve it. : )

Four Steps

It was inevitable. I knew that one day I would be forced to run a few steps before it was time to do so. In the last 4.5 months since my surgery, I haven't run one step. No picking up the pace to rush to a meeting, to catch a bus, or even to hurry through a door held open for me. For the most part, I've told myself, "What's the rush?" I knew it would not be worth getting anywhere faster in the end since my knee is still healing. I've even wondered whether I would actually be able to run if someone started chasing me!

Well, that day came yesterday (no, don't worry, no one was chasing me). In the afternoon I was packing for a trip to Los Angeles for work. I decided I needed to walk up the block to the mailbox to drop off my NetFlix movie. Here is where it happened. The light was red, but I looked up Franklin Street and no cars were coming. I could see up the street for a few blocks. I decided I could cross the street safely to the mailbox. I have no idea where it came from, but there was a far off *honk* when I was halfway across the street. It actually sounded like a scooter honk, but once I heard a second *honk* I realized maybe a car was approaching. Yikes... Now, on one hand, why was that driver being so rude? Sure, I was crossing on a red (my mistake), but there were no other cars around and clearly they saw me. I'm pretty sure the driver didn't even tap their brakes. I figured the last thing I needed was to be hit by a car so I was forced to run four steps to the curb. Left, right, left, right. Or maybe it was right, left, right left. I don't remember, other than it was four steps.

There were a few things I noted once I made it to the curb (beside the fact I wished I waited for the green light). 1) My right steps were fine. 2) I wasn't surprised to find my left knee buckled a little under the weight of the steps on that side. On the positive side, I didn't feel any shooting pain. On the negative side, it showed how weak my left leg is right now. Even though I didn't feel pain during the steps, my knee was sore/achy from that point on and is now finally starting to feel better over 24 hours later. All from two running steps. Wow, as if I didn't already know, it really is going to take a long time for the nerves to finally heal and be able to take the load of running. I hope I can start building up the strength in the muscles around my knee soon. The steroid shot has seemed to help (minus the minor "jog") during the last week. That voice in the back of my head does worry it will only allow temporary relief, but we will see. Again, time will tell. Hopefully I can get back to PT soon and I will only cross on GREEN lights.

The Magic Shot

Hello, hello! I finally had another follow-up appointment with Dr. Dye this morning. It was the first one in 6 weeks. My plan was to discuss my recent "break" from physical therapy and my current knee pain. He came in and said his usual, "OK, how are things?" I said, "Not so good." "Alright, talk to me," he said. I explained the shooting pain in my knee when I attempt a seated straight-leg lift. I also told him that my physical therapy isn't progressing since there is not much I can do without feeling pain at the front of my knee. Dr. Dye asked me to lie down on the exam table and did a few tests to check my knee/kneecap mobility and asked the usual, "Does this hurt? Does that hurt? Etc, etc." His conclusion was that I probably have a "frond" (think palm frond) of synovium that is catching and causing the pain. The synovial lining is quite sensitive with many nerve endings. I thought his diagnosis made sense since there have been times that my knee gets kind of stuck in one place, then something adjusts and I'm able to bend my leg properly. It's not exactly a pop, but something moves a bit to allow my knee more freedom of movement.

Dr. Dye's treatment was a steroid shot. Alex, my physical therapist, wondered if there was some latent inflammation in my knee that just needed a cortisone shot, or something along those lines, to finally calm down whatever was getting irritated. I was glad to hear Dr. Dye came up with her same thoughts without me telling him what she said. I'm not sure what kind of steroid he shot into my knee, but he said it should feel better by the weekend and could progress to further improvement over the next 2-3 weeks. Dr. Dye said some people with arthritis call this the "magic shot" and request it often since it makes their knees feel much better. The problem, he said, is that they go out and play tennis and hike, but don't realize they could be doing further damage their knees. Apparently, the steroid can soften the cartilage in the knee making the knee more susceptible to wear and tear. He told me not to go out an run a marathon. O... K... No problem!

So, how do I feel about all this? I'm learning to try my best to not think about it too much. Time will tell. Sure, I hope this shot will fix that extra-irritated spot under my knee cap and then I will be able to progress further in my healing. Alex said sometimes this type of shot just gives the knee the extra boost it needs to get better. I'm trying to stay positive, but at the same time, it feels a little like one additional last-ditch effort. I know from experience there is no "magic pill," or "shot" for that matter. Dr. Dye told me it's not uncommon for him to use this shot for his synovectomy patients so I'm not exceptionally worried that I may be in the low percentage of patients where the synovectomy didn't help. He did mention if a few tries at the steroid don't work, he may have to scope my knee again. Yikes... I cannot even fathom that idea right now. Dr. Dye only mentioned it in passing, so I'm going to let it go in one ear and out the other... There. It's gone.

The Purge

It's time, time to let go of my beloved subscription to Runner's World. I have the issues from April, May, June, and July sitting by my coffee table, unread. It just hurts too much to read about all the active runners and training for races when I cannot take part. I kept the subscription over the last three years I haven't been able to run, holding onto some hope that my knee will heal and eventually I can start running again. I'm not saying I'm giving up hope completely, but I've recognized I need to let the magazine go. I stopped my subscription to Triathlete Magazine over a year ago, but Runner's World was more close to my heart and I wasn't able to stop reading it until recently.

I realized it yesterday when the July issue arrived. Typically, I immediately turn to the last page where there is always one well-known person highlighted in a section called "I'm a Runner." This can be anyone from a politician, to a movie star, to a celebrity chef. I find it fun to read whether they are a casual runner, or if they have completed marathons. Last night, I simply tucked the magazine under the last issue I received and didn't even look, it didn't even cross my mind. Wow, that is significant.

I think I have the magazine coming monthly until the early Fall. I'll probably hide away the issues I haven't read somewhere safe. This morning I pulled out all the well-read past issues of Triathlete magazine and Runner's World that were in my magazine rack and threw them in the recycle bin. There were a lot of them and they were heavy! It was sad, but I needed to do it. It was a "cleansing" of sorts. Maybe, years down the road, my knee will actually heal enough to get out for thrice-weekly jogs. If this happens, I'll look into starting up my subscription again. Until then, it's time to let it go.

On a Break

I'm now "on a break" from physical therapy. Last night I headed to my usual every-other week appointment with Alex, my PT. I knew I was going to tell her I couldn't handle more challenging exercises, my knee just wasn't any different than the last time I saw her. I've still been experiencing a sharp pain in the front my knee under my kneecap. It really bothers me that when I sit on the floor and try to lift my left leg while keeping it straight, pain shoots through my knee. I usually have to bend my knee a little to be able to lift it. That sharp pain seems to be the main thing that keeps me from progressing further in my recovery. Alex seems to think the problem is irritated tissue and eventually it will heal. The really frustrating thing is that I remember I could lift my leg straight up, without pain, shortly after my surgery. Alex gave me an exercise early on where I strapped a 5 lb weight above my knee and held my leg up for short counts and did repetitions. There was that one Saturday in March where I did too much walking and soon after I couldn't do that exercise anymore without pain. Dr. Dye said the weight was too heavy for me and criticized the physical therapy. Alex doesn't think the weight or the walking should have irritated my knee that much for it to still be this bothering to me three months later. It's a mystery. I'm starting to wonder if a new injury resulted from that time soon after surgery. I know the healing time from a synovectomy is supposed to be long, but the sharp pain makes me wonder if my knee is ever going to heal from this 2nd surgery.

So, Alex said at this point she can't help me any more. She felt really bad about it, but she admitted how much she struggles to find exercises that work for me. This wasn't a surprise to me. I can tell she just wracks her brain each time I see her to figure out something that won't irritate my knee and somehow is able to strengthen certain muscles surrounding my knee. I have mixed feelings about the PT "break." Part of me expected it and I am almost relieved. I was so stressed about the fact I could only do my exercises maybe only every other day since my knee seemed so sensitive that I felt guilty all the time. Alex said maybe I just need to take a break, keep doing the exercises that are working for my knee and contact her in a month or two when my knee feels better. I hope this is exactly what happens. The other part of me is worried that there is something wrong since Alex seems at such a loss. Clearly, she hasn't worked with any other patients like me.

I have a follow-up appointment with Dr. Dye in a week and I'm going to be very clear about my concerns. It will be interesting to find out if he is supportive and helpful, or if he takes the surgeon route of "It's not my fault, your knee just won't heal itself."