Scars, Adhesions, Crappy Blogs

Yesterday Richard the PT "worked on my scars." That meant he pressed down and moved the skin around my scars. It's hard to explain, but it does not feel good. How come I'm the only person at the PT clinic that is ever yelling outloud? I never hear the nice 97 year old lady yelling out in pain when she's doing work on her hip. Am I that much of a wimp? Perhaps.

This is funny because it's true.
http://dirtymicrobe.com/products/your-crappy-blog/

Endogenous Opioids

I saw the accupuncturist today. She put needles in the joint opposite of where I feel pain; in other words my left elbow. It was a very strange sensation. I felt like my arm was pinned down by a sandbag. And when she manipulated one of the points it caused an electrical shock to run down from my elbow to my hand. I don't know how much (or whether) it helped. I still needed to take a painkiller at 5:00 today. So much for "quantities of endogenous opioids." Maybe tomorrow. She said that I should go two days in a row because the treatments are cumulative. I'd really like to get off these painkillers. They too seem to be cumulative and make me into a zombie.

PK Log:
5:00 PM Vicodin

Bone Pain on Wikipedia

Why does my femur bone hurt so much? Because the periosteum has nerve cells. And that is what the surgeon "smoothed" or "shaved." I watched him do it. It was like watching a stone mason sand a piece of white marble. The physical therapist said that this is going to hurt "for awhile." Great.

Bone
"The exterior of bones (except where they interact with other bones through joints) is covered by the periosteum."
http://en.wikipedia.org/wiki/Bone

Periosteum
"The periosteum is a thin layer of dense, irregular connective tissue membrane that covers the outer surface of a bone in all places except at joints.... As opposed to osseous tissue itself, periosteum has nociceptive nerve endings, making it very sensitive to manipulation."
http://en.wikipedia.org/wiki/Periosteum

Nociceptors
"Somatic pain originates from ligaments, tendons, bones, blood vessels, and even nerves themselves. It is detected with somatic nociceptors. The scarcity of pain receptors in these areas produces a dull, poorly-localized pain of longer duration than cutaneous pain; examples include sprains and broken bones."
http://en.wikipedia.org/wiki/Pain_and_nociception

Accupuncture
"Although the mechanism is not fully understood, it is likely that acupuncture stimulates the release of large quantities of endogenous opioids."
http://en.wikipedia.org/wiki/Pain_and_nociception

I'm seeing an accupuncturist tomorrow.

PK Log:
9:30 am Vicodin
7:00 pm Tylenol
9:00 pm Vicodin

One Month

For those of you keeping score at home, it has been 4 weeks since my ACL reconstruction surgery.

Things are going pretty well. I'm off crutches. I'm walking without a brace. I walk slowly but am getting faster every day. I have just started to take the stairs up like a normal person. It took awhile to be able to flex my injured knee enough to raise it in front of me to the next step, then it took awhile to get the strength to push myself through the movement on that leg. I'm not strong enough to go down stairs leading with my good leg -- it puts too much strain on my knee.

Today is physical therapy. I'm going to warm up on my bike at home before I go. This is the session that came with the "take your painkiller before your next appointment." Lord have mercy.

And if you're wondering how much knee surgery costs -- my doctor billed my insurance company $20,500. My share is $5,272. That's a little higher than I expected.

Lost Weekend

This wouldn't hyperlink, don't know why. Copy and paste the URL into your browser. I don't know who the artist is but I appreciate the sentiment.

http://www.flickr.com/photos/gregbiche/232224439/

I slept most of this weekend. I think I was sleeping off the cumulative effect of painkillers I took Thursday and Friday. Not that I took that many. I think on Friday I had 3 over the course of the day and night. I seriously think I'm having trouble metabolizing these things. Or maybe I take them too frequently?

I avoided taking a PK all day yesterday. I only took Tylenol for the constant, gnawing pain at the abraised spot on my thigh bone (femur). It persisted through the Tyleonol yesterday but I was able to ignore it while I was out walking around. It's impossible to ignore when I'm trying to sleep.

I was up at 11:45 pm, 12:30, 1:45, etc. Eventually just got up, took Tylenol, and read at 4:30. I was hoping I'd get sleepy and go back to bed. No such luck. The throbbing kept me from feeling sleepy.

I'm going to contact the accupuncturist I saw last year to talk to her about pain management. In the meantime, back on PK today. Blah.

PK log
8:00 a.m.
7:00 p.m.

House Hunting

We went to a few open houses today. Here's Brett studying his elaborate spreadsheet, keeping us to a tight schedule. No time for dilly dallying!






This van was parked outside one of the buildings we saw today. It sort of creeps me out, but I have to say I respect the retro-ness of the van.

[click on the photo of the van to see the detail of the window decals]

Lucky

Moby in the backyard. He says, "I fail to see the humor in this."

I made sourdough pancakes today with the sourdough starter my mom made while she was here. They turned out pretty well. Not quite up to the memories of my grandma's sourdough hotcakes though.

Anyway, the egg I used had two yolks in it. Isn't that supposed to be lucky?

SO sleepy!

I was out last night until 11:00. We watched an episode of The Sopranos (Season 5, episode 4) then went to bed at midnight. I slept until 9:30, then went back to sleep at noon and slept until 4:00! That's crazy! I think the heavy sleep today was a direct result of taking painkillers yesterday for the post-physical therapy. The physical therapist will say it has something to do with my "parasympathetic nervous system" blah, blah, blah. I feel like a loser! Who sleeps for 13 1/2 hours? Insane.

I've been in a lot of pain today. It's the spot on my femur where the doc "shaved" or "smoothed" an abrasion. After sleeping so much today I avoided taking any painkillers until after dinner tonight. Balancing pain and reaction to the painkillers is tricky.

113

This is a shot of me "walking up the wall." It's a closed kinetic chain exercise I do at home. I took a picture of my knees because I think my right knee (the rehabbing knee) looks like it's the widest part of my leg. (It is not. But my left thigh is 1" bigger in diameter than my right.)

My knee flexed to 113 degrees today. I should be able to push a bicycle pedal around one full rotation pretty soon. In fact, I think I can do it tonight now that Brett has brought my bike upstairs. We have one of those bike stands to make any bike into a stationary bike.

Ice Cream

We have two apartments above ours in our building. Our neighbor on the third floor brought me sorbet and a Sopranos DVD last week. Our other neighbor heard about that and emailed to see if I need a refill. She is going to bring me ice cream tonight. So sweet!

I'm walking without crutches all the time now. But today I have a long day ahead of me. Going all the way to Harlem for a meeting and then back to Brooklyn for my physical therapy. I had a similar day on Tuesday and was almost unable to walk by the end of the afternoon. Really regretted not having a crutch that day to lean on so today I'm taking one along just in case.

Sleep is still a problem. I woke up at 4:30 am with a lot of pain. Brett brought me an ice pack and Tylenol. I'm surprised I had so much trouble. I had a light day of walking yesterday and spent a good amount of time icing my knee. Drat.

No sleep till Brooklyn!

I'm not sleeping well at all. The brace was not the problem. It's my knee. The ports where they scoped my knee are still healing. The incisions were not long, but they were deep. There are at least 4 incision points on my knee. But there is one major one on each side of my knee cap that are the problem. At the end of the day when my knee is swollen I can't put any pressure on either side of my knee. I'm a side sleeper so every night I wake myself up from turning onto my side and bumping my knee. Last night was bad. And after today's physical therapy, I'm pretty sure tonight will be a tough night as well.

But it's all going to get better eventually.

Blog Title Inspiration:
http://www.youtube.com/watch?v=RI2IyHXJo5M

A little PT inspiration

At physical therapy today I was only able to flex my knee to about 90 degrees. I guess it's supposed to be flexing more so Richard the therapist called my doctor. He asked if he could "be agressive". The doctor said that would be fine and that he expects to hear me screaming all the way in his Manhattan office from Booklyn. Great.

And it gets better. On my way out, Richard said that I should probably take some pain medication before I come to my next seesion. Oh my God. I could hardly walk this afternoon. What's Thursday going to hold in store for me? The good news is that by the end of the session "we" flexed my knee to 108.

When I go in for PT there is always at least one elderly person doing stuff similar to what I'm doing. For instance, the gentleman I saw today was doing the side steps I did last week. He said he is rehabbing from a cyst in his brain that had to be removed. He said one day he woke up and couldn't walk. That's how he found out about the cyst. Afterward he had to rebuild everything -- walking, talking, everything. He told me that it's all worth it.

Cruel and unusual punishment

I started "REAL" physical therapy today. I thought I started PT last week. No. That was baby stuff. The real work started today when the therapist worked my knee from 65 degrees of flex to 95. I didn't get there in one shot. We worked on it incrementally and it was pure pain. Holy cow. (I'd swear but am afraid my dad, step-mother or nephew will see this.)

I seriously almost fainted at one point. Fuuuuuuuuuuuuu-dge. I haven't had kids but I don't see how it could be more painful. OK, it probably is. But, whatever. Today was real, honest to God pain. And I get to go back for more!

Morning Drama

Being close to a fire station is a mixed blessing. We hear a lot of sirens -- usually in passing. This morning, though, the sirens didn't move past the building. I was a little nervous for a second.
Thank God it was a false alarm.

I wish I were able to move more quickly. I would have taken a picture of the truck from the back so you could see the full-sized American flag this truck is waving.

It's very reassuring to know that should we ever need the NYFD, they will be here tout suite.

Week 2 - Post Op Appt

Today was my 2 week follow up appointment with the doctor. He was happy with the way my knee looks. He said "that's a strong knee!" with such enthusiasm, I have to believe he thinks it worked.

So, now I'm free to sleep and rest without the brace. I still need to wear it when I walk -- but it doesn't need to be locked anymore. Hallelujiah. I can't tell you how much I'm looking forward to getting my first decent night's rest tonight.

I have a couple of ideas to write about here but may not develop them. One thing I've been thinking of is that the blog is really an evolved slide show isn't it? I mean really. Come on. And probably the right word isn't 'evolve' but 'devolve.' In the old days you would have to sit through trays and trays of candid snapshots from some trip you didn't go on. But now you get images of post-surgery bruises. Delightful! And to add insult to injury, blogs require that you put in effort to READ the mind-numbing narrative instead of just listening in the darkened room while your least favorite uncle tells you about the family vacation to Busch Gardens.

Never mind about the other ideas. I'm going to bed.

Who Loves You?

Dogs and babies love the crutches man. See for yourself.

Postcard

Wasting Away

For your viewing pleasure. Here's what my leg looks like today.




And here's Moby sitting in the middle of an array of physical therapy doo dads. He's like a cat. Always has to be in the middle of whatever you're doing. Oh, hey! I know that looks like a glass of wine sitting at the ready. It's not what you think. I don't drink a glass of wine and do my PT exercises. I drink a glass of wine and THEN I do my exercises.

Day 9

Every day I wake up feeling a little better although I’m still really tired. Several people have suggested it’s the lingering effect of anesthesia. I guess that could be it. I think it is also because I have to sleep with this heinous brace on my leg and it keeps me from getting a decent night’s sleep.

1 Week

Hey, if you ever need a good cry, watch the season finale of Six Feet Under right after your mom leaves you after perhaps your best visit with her ever. Talk about emotional discharge! Holy mackerel. I'm a wreck!

I think the only thing that will make me feel better is either fish & chips from the Chip Shop or chips and guacamole at any one of six nearby Mexican restaurants. Whatever I do tonight, chips will be served.

So, I made it to the one 1 week mark. On one hand, I can't believe how fast it's gone by. On the other, I'm sick of wearing this brace, sick of walking with crutches, and feel like the recovery is never going to end. Blah. Then I think of how incredibly lucky I am in so many ways and then feel like a complete jerk for dwelling on a condition that is only temporary.

A friend of mine asked me if I wanted to go skydiving this summer. No way. Can you imagine risking breaking both my legs and/or every other bone in my body right after I get my knee and leg back to 100? No way, Jose. No way.