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.

Lost in Unknownland

I'm having a hard time stopping my tears right now. I've tried really hard to my blog posts as positive as possible, even when I'm having a hard time. Most of the time I feel as if it's best to keep any serious negativity or sadness to myself as it can be too personal to share. Tonight though, I guess I'm feeling the need to cry and let it all out. I'm scared and lost, unknownland has really gotten to me. I'm lost in that in-between period of recovery. What is normal at this point and what is not? I'm feeling some pain in my knee and I'm unsure whether it is OK. I haven't done any physical therapy exercises since my appointment on Wednesday since I am uncomfortable with how my knee feels. No, it's not terrible pain, not at all. It's some aches, but sometimes some shoots of pain at the front my knee, reminiscent of when it first started to hurt. The discomfort tends to be the worst when I take the first few steps when getting up from sitting down for a period of time. Also, I don't remember a time, even after my last surgery, when I felt like my knee was so weak it could give out under me. I have felt this way a few times in the last 3-4 days and I'm really concerned. Dr. Dye's referral for physical therapy says this:

Begin gentle Post Op rehab
Program for left knee
Advance as tolerated
NO PAIN!!
Pain free
Home, gym program

It says "NO PAIN" in capital letters with two exclamation points, I did not exaggerate that statement. Alex, my physical therapist, says there is a difference between an ache that is "bad pain" or an ache that is a reaction to healthy exercise and is to be expected. I understand this, but to be honest, after 3 years of suffering from this darn overuse injury, the difference is not always clear. During my PT sessions, Alex and I make sure I'm not feeling any pain and adjust the exercises accordingly. Still, the reaction my knee has after the session is always unknown until it happens and my knee is still in the healing process. I imagine there could be several explanations, good or bad, for my knee discomfort. I just wish I knew what they were.

I'm terrified that my chances of a full recovery are already ruined. Dr. Dye said the first 2-3 month of my recovery are critical. Since he has responded so quickly to my emails in the past, I'm going to write him tonight and see if he responds tomorrow. Don't worry, I promise to keep the message professional, but clear about how my knee is feeling and what has happened over the past week. I won't let him know I am writing through my tears. Hopefully, Dr. Dye will set up an earlier follow-up appointment for me (my next one is a week away) and will be able to alleviate my fears that all is progressing as expected. That's all I need right now.

Physical Therapy and Unknownland

I've entered into what I call "Unknownland" with my knee. I'm so confused and conflicted! Up until this week, even with my mistake last weekend, each day my knee seemed a little better than the last. This week, after my physical therapy appointment, for the first time my knee felt worse. I don't blame Alex, my PT, since I can't be sure whether the new exercises were the culprit or not. There is also the possibility that the slight pain I've been feeling in my knee is normal. The synovectomy was sure to upset the sensitive nerves that are in the synovial lining. Maybe the fact that the swelling in my knee is slowly going down, makes the area more sensitive. That is only a theory I have, I only wish I could see inside my knee and know exactly what is going on.

The surprising addition to my routine this week was cycling. Alex put me on a stationary bike for 5 minutes at the end of my appointment on Wednesday. You wouldn't think anyone would be excited about 5 minutes of cycling, but I was! My biggest complaint going into the session was that my knee was feeling so stiff and tight. Alex said the worst thing I could do right now was to not move my knee. After the bike ride, my knee definitely gave it more flexibility. Alex recommended getting on my trainer for 5 minutes in the morning and evening to help continue this process. Thing is while doing this the last few days (morning only), there has been a little more pain under my knee cap and my knee feels even a little less stable. I know physical therapy is to help my knee get stronger from the surgery and the sedentary activity afterwards. It's just that feeling a little more pain makes me think I have to back off the PT exercises and reminds me of over-doing it in the past. Yes, it's a confusing situation. I left a voice mail message for Alex this afternoon and have not heard back from her yet. We'll see how I feel tomorrow. Hopefully, the feeling of "Unknownland" will lessen a bit.

The Weekend - A Big Mistake

I had a really hard day yesterday. I'm kind of embarrassed to be writing this post, since I told myself I was going to follow the "letter of the law" in my recovery from my recent knee scope. What I did on Saturday was a really big mistake, I just didn't think. I really wish I had a do-over for the weekend. I learned the hard way that my knee is not strong enough at this point to be up and about all day. It's not that I expected to be able be that strong at this point in my recovery, it's simply that I didn't think it through at all. By then, it was too late.

I got up yesterday morning and quickly got ready for my drive to the East Bay. I was looking forward to getting my haircut and running some errands in Walnut Creek. My haircut didn't turn out quite as I hoped. I'm still evaluating whether or not I like my new bangs or not and that just fueled to my angst later on in the day. My goal at Broadway Plaza shopping center was to buy a new pair of jeans. Not designer denim by any means, just a simple pair with loose fitting legs. You see, I don't have many pairs of jeans (yes, we can wear jeans to work at Old Navy, casual attire is the norm) that are easy to roll up to ice my knee in the middle of the day. I found some jeans I that would work, but overall everything I wanted to check off my list on Saturday took longer than I expected. I hadn't been shopping in quite some time and I had more than one purchase to make that was long overdue. By the time I was done at Broadway Plaza and stopped at Trader Joe's, my knee was aching and I didn't have my crutches for help. Oh no! I was so upset and terribly afraid I had messed up my knee. In hindsight, I should have known I couldn't do that much walking. What was I thinking?

I made it home to San Francisco around 6:00 PM and immediately put my leg up, iced my knee, and cried to let it all out. I used my crutches to get around my tiny apartment and did all I could to stay off my feet. Once I was off my knee, it felt fine and didn't seem to swell up more than it's current state. Thankfully, this morning I woke up feeling alright. It's been a rainy day and the only thing I did on my feet was go to the drugstore around the corner for a few things I couldn't pick up yesterday. Otherwise, I have been taking it easy. I even did my taxes! Other than my PT exercises (I'm skipping the hardest one for now), I will not be putting any strain on my knee even if Alex my physical therapist intended me to. Call me a little gun shy, yes. For the next few days anyway. I'm going to be much more careful in the coming weeks and months. I cannot afford any more mistakes.