Week 4 Torture Update
Pain wears you down and out. Physically you’re spent; mentally, you’re just completely gone. I am exhausted from physical therapy today.
Here’s the knee before surgery and four weeks and one day post-op. Looking at this picture, I can actually see the beginning of some minimal muscle tone in the thigh. It’s about time! (No, it doesn’t take much in the form of improvement to make an ACL reconstruction rehab patient feel happy.)
I don’t expect it to feel good, but I never anticipated wanting a piece of wood to bite down on during such a big portion of it. My flexion was at 121 degrees before my PT decided he was going to stretch me a bit. With me on my stomach, he pushed down on the back of my knee (since I’m having posterior knee pain probably due to a knee capsule that needs some stretching) and pushed my heel towards my butt.
It’s excruciating. He takes it to the point where you’re going to go through the roof and then he pushes it a little more. I feel like my knee is going to explode or snap completely off the rest of my body. Today I found myself burying my head in the pillows trying not to scream. It got worse when my PT sat down and put my foot over his shoulder and used his whole body to lean in towards my body, forcing my knee to close the distance to my butt.
I realized I was holding my breath so I asked him to just give me a second to "go to my special place" and that’s just where I went. With Lil C, I got through bad contractions by going here:
I spent a good deal of time at the beach today. It hurt too badly. I just couldn’t stay there in that PT room. When all the stretching was done, my PT measured my flexion at 125 degrees. Something tells me that I’m going to have to fight for every degree from here on out. It’s ridiculously hard and challenging. I’ve been working on flexion at home, but I have been taking it to the point that it hurts, not beyond. I need to push it further and it’s a difficult thing to do to yourself when you know it kills.
While looking at my incision scars, I commented that it still feels like I have marbles under my skin, despite me torturing myself every night with cocoa butter pressure and massage. "How hard are you rubbing the incisions?" he asked me, as he began to demonstrate the appropriate amount of pressure. Judging from my subsequent squirming, it was quite clear that I am not pressing down hard enough. I really am going to have a drink the next time I do this to myself.
This was all discouraging, annoying stuff. There was some good news in the form of using the leg press for the first time with 30 lbs., riding the bike for 10 minutes, and getting about five more exercises including a prone stretch to aid with my extension, more quad building, and additional leg lifts. I swear I’ll be spending six hours a day doing my exercises now. As the mother of an ornery two-year old, I have no idea when that’s going to happen.
This might help though. I give you the official BBM torture device:
Tonight, we bought a brand new exercise bike to help with my rehabilitation. Getting on that bike every day is going to make a big difference. That’s what I’m telling myself anyway, in the form of a new mantra: "This bike is going to help me. . . This bike is going to help me. . . This bike is going to help me. . ."
My goal is to torture myself enough at home this week that my PT doesn’t have to do it for me any more. Something tells me this is wishful thinking.
***The latest reviews are up at The BBM Review and more will be appearing soon! Check out my new favorite book and some karate training bags.
Will I Ever Feel Ready?
Physical therapy brought flexion of 120 degrees yesterday. That’s a five degree improvement from just two days before. I also rode the bike, going entirely forward, for five minutes without any issues besides a small twinge of protest from the knee every once in a while. My PT added some new at home exercises to the regime; and next week, we’re adding the leg press. I’m getting somewhere. I’m really getting somewhere.
After PT, I took Big I to karate class. I stayed after her class to watch the advanced class again. Last night was so cool. They were working on self defense and there were bodies flying all over the place. When I went downstairs to check on Big I and the girls she was playing with, it sounded like a thunderstorm from bodies hitting the floor above. It was interesting to watch because I noticed so many things I might not have if I had been out on the floor. I paid special attention to distancing between people, and feel like I really learned something about off-balancing an attacker.
Looking at the techniques from a seated point of view was one thing. It wasn’t until later in the class, when people started hitting the ground with some good force, that I started getting a little nervous inside. How will I ever go back to doing those kinds of things again? How long will it be before I can comfortably let someone throw me around on the training floor? How long before I’ll be comfortable being uke again?
I guess I’m having a difficult time imagining myself at full strength. I feel like I’m always going to want to protect my knee and not do anything that might aggravate it. I’m going to need to really trust my partner and feel comfortable working with him/her in the future. Most importantly, I know I can’t rush back. I need to listen to my body and take it slow. When I do go back, I’m going to have to be very cautious and sit things out if I don’t feel I’m ready yet.
Tackling increased flexion and a bike each week is going to be a piece of cake compared to the mental readiness it’s going to take to get me comfortably back on the training floor.
High Five Inducing PROGRESS
Today was the most painful day yet at physical therapy. It was also the best day so far. I’m not afraid of a little pain. I just need a healthy dose of "gain" to go along with it. Today I got it all.
Before we get to the details, here is my knee, three weeks and one day post-op:
We started with ice and stims. My PT was much happier with the appearance of my knee today as compared to Friday. He contemplated using heat, but played it safe. My PT told me I can start using cocoa butter on three of the four incisions. He showed me how to rub the scar tissue away and it hurt. I told him I’m going to need to have a drink before I do that to myself each day. It was all I could do not to physically make him remove his fingers from my incisions as he showed me how to torture myself.
After that bit of "fun," I completed my quad sets and leg lifts with weights. I also used a strap to stretch out my very tight leg muscles. Because my PT was busy with a new patient, I got busy working on my flexion by myself. While getting my stim and ice treatment, I was reading "My Journey with the Grandmaster" by Kyoshi William Hayes. I was reading this chapter about the hidden techniques in Okinawan karate. Much of the chapter talked about individuals and how to each person the martial arts, even within the same style, is a little different. He compared serious students to those who just walk through kata, never seeing the true meaning or hidden techniques inside.
I don’t know if it was my "Karate: it comes from within" t-shirt I had on, the reading, or a combination of both; but for some reason, I began to think about the mental aspects of martial arts training. During my flexion exercises, I stopped thinking of it as a physical hurdle and started thinking of it as a mental one instead. I closed my eyes, took a deep breath, and seisan style, breathed the air out as I forced my knee to bend further and further. I took my time, willed my twitching muscles to relax, and continued to work at it for 20 minutes.
At one point, my PT walked by me and smiled. "We’re going to have a good day," he said, referring to my flexion. After several more minutes, he came back to take the measurement. He told me I needed 110 degrees to try the bike. Doing it entirely by myself, I was able to push it further than I ever have before.
115 degrees.
My PT was so elated that he got the biggest grin on his face and shouted out "HIGH FIVE" as he reached his hand up to meet mine. It was such a good moment.
He had me strap my brace back on and them adjusted the brace so that I can bend my knee however much I want when I’m not walking around on it. I locked it back into place and walked to the bike.
My PT warned me not to expect much. My first attempt at a complete rotation didn’t work. It hurt so badly it made me draw a quick breath. He told me that it was o.k. if I didn’t make it around at all, to just go back and forth, making sure I stayed comfortable.
Backwards went much easier and after a few tries, I was able to go completely around. He told me to continue going backwards and then if things loosened up, I could try going forward again. He left me alone for 3.5 minutes. I gradually worked through the pain going backwards, and built up the nerve to try going forward again. I had to point my foot to make it, but I did it. I continued to go around forward and picked up the pace just a bit. By the time the last minute rolled around, I was able to go completely around without having to point my foot to make it more comfortable.
After doing so well on the bike, my PT helped me get down and had me do some exercises with the tension bands. I was able to complete three sets of 10 and felt my quads got a decent work out. When all the hard work was done, he told me that people rarely make a complete rotation on their first try on the bike, let alone many like I did. I was beaming, and the best news was yet to come.
My PT told me I can unlock my brace to sleep from now on, and next week he’ll probably unlock my brace permanently so that I can start walking less like a peg-leg pirate and more like a normal person. He congratulated me on a good day filled with progress and I left.
When I got in the car, my new Feist CD was playing and "I Feel It All" came blaring out of the speakers. It’s an awesome song and the reason why I now own three of her CD’s. (If you can’t see the embedded video, click here for the song.)
Although I like her music very much, I have no clue what she’s talking about in most of her songs. It didn’t matter. "I Feel It All" was the most appropriate song for today, because that’s exactly what I did.
I feel it all, I feel it all
I feel it all, I feel it all
The wings are wide, the wings are wide
Wild card inside, wild card inside. . .I know more than I knew before
I know more than I knew before
I didn’t rest, I didn’t stop. . .I don’t know what I knew before
Now I know I wanna win the war. . .No one likes to take a test. . .
Fly away. . .
Fly away to what you want to make. . .
I felt the pain today and over the last couple weeks. I feel the disappointment of having to stop training and delay my Shodan (Black Belt) test indefinitely. I worked through all of it today, and I felt the satisfaction. The progress that I’ve been trying to wait for so patiently finally made an appearance. It’s not a Shodan test. It’s rotation on a bike, something that would have been easy to do a month ago; but I can honestly say that the accomplishment I felt today feels as monumental as I’m sure passing my Shodan test will feel someday.
I couldn’t stop the onslaught of tears that started pouring down my face. I feel every jolt of the pain that sometimes takes my breath away, but it makes the resulting accomplishment taste that much sweeter.
I do indeed "feel it all" and today, in spite of the pain, it all felt good.
Ordered to Lounge
After hearing the surgeon say that the crutches are only for my comfort last Friday, I decided to take a mental leap of faith and ditch one. I’ve been operating with only one crutch all week long.
I took Big I to karate class last night with only one crutch, and even managed to make it up and down that scary flight of stairs to the upstairs training room to watch the advanced class. It was great to be there, see everyone, and watch some karate.
Feeling so good, today I took another leap. Although I’ve been ditching the crutches altogether to get around smaller rooms like the bathroom and kitchen, today I walked into PT without them at all.
My PT was shocked. "No CRUTCHES!" he exclaimed. I asked him if I was walking o.k. without them and he said I was walking fine. It was when I took my brace off and pulled my pant leg up that the smile faded.
I was swollen so much so that my PT couldn’t see the top of my knee cap like he could just days after surgery. I’ve been ordered to back off a bit with my ambitious no crutches plan. I need to use one crutch, lounge, and ice more often. PT’s orders.
Because of the swelling, my flexion remained the same today. I’m stuck at "around the same place" I was on Monday. That’s probably PT talk for going backwards a bit. Backwards is not the direction I want to go. Bending my leg underneath that training table is the worst part of PT. It takes several minutes for my knee to get warmed up enough to bend, and then I have to fight the muscle tightening and twitching that happens all throughout my upper leg.
When I’m doing the bending and trying to push it a bit, my leg shakes and twitches and I have to back off and just breathe through the pain before trying again. When my PT sits in front of me and gently bends my knee, I don’t twitch. Today I told him he is able to instantly make me relax. I told him he is endorphins in human form. He got a kick out of that. Maybe it’s because I know and trust him after working with him for two months now. I just wish I could have the same relaxing effect on myself when I do the bending and stretching.
Although I may have been a bit overly ambitious with eliminating the crutches, the increase in activity is a necessary evil. I lost my help mid-week, and meeting the needs of a demanding two-year old all day long is not exactly what the doctor ordered. I tried to take it easy as much as possible, even allowing Lil C to have a Pop-Tart for lunch one day (Shh, don’t tell anyone!). I guess I probably should have held off on doing that load of laundry today too, but when you only have three outfits that work with your knee brace, laundry is another one of those necessary evils.
It’s all just too soon.
I guess this is where my resolution of being a more patient person comes into play. It’s just such a confusing place to be right now. I want to get better and progress with my recovery. The doctor basically said I only needed the crutches for my mental well-being. My PT says I need them until I’m through this acute phase, and from the looks of my knee today, he is right.
For me, this weekend means going back to the couch, pillows and frozen peas. Baby steps.
***The latest review is up at The BBM Review. If you have gift cards, holiday money, or returns and are interested in some fun, interactive toys for your children, check out the Cranium Bloom review.
A Difficult Resolution to Make
It is easy to forget why I put myself through ACL reconstruction surgery when I’m not in the dojo and around the people I train with on a regular basis. Although I miss karate greatly, after enduring these past two weeks, it would be easy to convince myself that going back is a bad idea. It’s a very scary prospect, the thought of reinjuring my knee or hurting the other one.
Yesterday, a karate friend came for a visit and it was just the mental boost I needed. Seeing him and discussing karate and training brought it all back to me, the reason I put myself through this. He brought me a book on training for speed, and the visit lit a fire under me. My fear of going back was trumped by a new determination to get back in there. I need to get back in there. Just being there makes me feel better, and that is what I’ve been missing these past couple weeks. My goal is to get back into the dojo within the next two weeks.
This may seem like a minor thing to someone who doesn’t know my dojo. However, my dojo is not exactly easy to get into. There is a big step to get up into the dojo with double doors, which is challenging enough on its own for someone who has to walk with a completely straight leg. The big step is followed by a full staircase of very narrow steps. The railings do not extend to the very top of the stairs. Since injuring my knee in October, I’ve been sitting and scooting up and down those stairs Lil C style. Just being able to get in there would feel like such a huge accomplishment right now; and I know it would feel good to see everyone and watch them train. This will be a big step back to independence, and one that I need to do soon. It has nothing to do with my knee, but everything to do with my mental well-being.
I worked a bit on that independence this morning. I showered, got dressed (minus putting my shoe and sock on my left foot because I just can’t do that yet), and drove myself to physical therapy. Everything took twice as long to do as it usually does. It felt good to be in the car by myself, but I need to remind Mr. BBM to not use the emergency brake. I had to contort myself into a pretzel to apply enough pressure with my right foot to release it, since my left foot is just not ready for the job yet.
The drive was going fine until my new navigation system started talking to me from its concealed location on the floor. I about jumped out of my skin, thinking someone was in the back seat. Flustered from that little scare, getting out of the car almost induced a panic attack. I’m semi-claustrophobic. I don’t like being stuck. I can barely stand being in my knee brace sometimes because of feeling confined. In order to get into the car, I had to slide the seat all the way back so as to pull my bent and sore leg into the car without twisting it. Once in the car, I moved the seat back up a bit to be able to drive comfortably. Forgetting I had done this, I tried to get out of the car without first moving the seat back and started having an internal freak out session when I couldn’t get my leg out of the car.
I tried to quiet the anxiety by telling myself that if I was able to get in the car just five minutes ago, then there’s no reason I shouldn’t be able to get back out. It was then that I remembered to move the seat back and life got a little easier.
We started my PT session with ice and stims as usual. I was able to complete my quad sets with only a small rolled up towel under my knee for the first 15 and then nothing under my knee for the last 15. My knee cap feels a little funny when I do them that way, but I need to make sure I can keep full extension. My PT gave me a 2.5 lb. weight for my leg lifts today and that went fine. I’ve been doing leg lifts like crazy at home so I think I’m getting a little stronger.
Then it was time for the bending. The first few bends are always so difficult. My knee feels so stiff and uncomfortable, but after five or six, I can move a lot better. My PT helped by gently bending my knee for me after I had done a bunch on my own. It felt so much better when he was doing it for me. I don’t know what it is about him, but he’s very soothing and he helps me relax. He brought out the measuring device and I dreaded hearing the number since I wasn’t feeling like I was bending that much.
109 degrees.
That’s a six degree improvement from just three days ago. Today is the two week mark post surgery and my PT said that at this point he likes people to be at 90 degrees. He said I’ve "shattered" that. Despite his encouragement and a number that can’t be denied, I have to say that I don’t feel like I’m shattering anything these days.
The progress may seem rapid to my PT and to others, but to me it seems to be at the pace of a snail. I want to feel normal in the worst way. I want to be rid of the crutches. My PT asked me why I feel I still have to use them. I showed him how I walk without them. It’s not pretty. It’s a stutter step on that left leg to quickly get me back on my right. Putting full weight on my left leg feels like teetering on the edge of a cliff. My quad is still rebelling.
He said we’re going to try to get me off the crutches within the next week or two. He told me to try to use just one at home, and keep putting more and more weight on that leg, since it will also help my quad muscle come back to life. Once home again, I was able to get around with one crutch in my kitchen. My goal for the next few days is to put more and more weight on that leg for longer periods of time.
When I first injured my knee, one of my instructors told me that "injuries teach us patience." I’m not a very patient person, but I think that my resolution for 2008 will have to be becoming more patient. Otherwise, this rehabilitation is going to be too frustrating and annoying. Becoming more patient is the only way my mind and body are going to be able to get along.
What’s your resolution for 2008?
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