Sunday, February 1, 2015

The story of a knee, Part 1

Warning:  This is a post I am mainly writing for myself - just to reconcile? justify? come to terms with? explain? the story of my janky knee.  There's lots of photos and links back to other posts.  There is also a bit of sad. Don't read it if you don't want to.  I totally understand.
The trouble began in high school.  I was on drill team for four years - loved it so much.  If you had told me that I was going to have knee troubles in middle age, I would have scoffed.  I felt fit and flexible, and young and strong.  And drill team was my LIFE.  You know - you define yourself in high school by your friends and activities and how you fit in, and I found my niche in drill team.
Here I am perched in a tree.  If you look veeery closely you can just make out an ace bandage on my left knee.  I distinctly remember my kneecap subluxing during the finale of a halftime show - the splits.  Did that keep me from climbing a tree?  No.  I either had a lack of common sense or a fearless belief that I was invincible.  (We'll go with the latter.)  And, no one told me not to.  My mother, an x-ray tech, took me to get it x-rayed as it hurt like a booger and was swollen.  "Normal" said the radiologist.  In actuality, I had probably torn a medial patellar ligament.  Too bad MRI was not in widespread use yet.
Fast forward to college...I remember injuring it again trying out for the Strutters at Texas State.  Lucky for me, I wasn't selected.  That same thing had happened - the kneecap subluxing laterally.  But it started happening with greater frequency.  (Once in the garage when I was pregnant with Firstborn, trying to scooch between two heavy things - my yelling could be heard by Hubby as he mowed the lawn) Brushing it across something unless it was fully bent could cause it to shift to the outside.  Eventually, my kneecap was tracking laterally all the time - it's not supposed to do that.  Over time I had damaged the medial ligament so much the lateral one could yank it harder sideways.  Then finally, in August of 2014 I tore my meniscus and went through a month of searing knee pain before I could see the doc.  During this time we lost Hubby's sister, bought a car, got the boys ready for school, and sent The Girl back to Waco for her last semester.  I was too busy to have it slow me down for long.  I work full time, the holidays were coming, and there were big things on the agenda. I saw an orthopedist and made plans to get it repaired.
So that's what I did on October 24th.  Eight weeks of pain, followed by surgery that I was told, would have about a two to four week recovery time.  A meniscus repair, and a lateral patellar tendon lengthening.
Unfortunately, or fortunately depending on how you look at it, when the doc got in there he found bone on bone and quite a mess.  My patellar groove on my femur was very shallow, adding to the problem with it tracking normally.  It was as bad a knee as he had ever seen.  He tells me that when it heals it should last a good long while...but he hasn't ruled out a knee replacement in the future.
That, dear reader, will send me over the edge.  I'm not that fearless teenager who climbs trees anymore.  I have discovered that middle age me is weak, and anxiety-ridden.  I learned a lot about myself during this recovery time.  I wish I could say that I handled it with grace and courage and a sense of humor.  But I didn't.  I leaned very heavily on a few people, and probably drove my family to the Crazy Farm a few times.  {Example:  Freaking out over a very small step leading into the house from the patio on Thanksgiving Day.  Why, Gina?  You stepped over it and back days ago.  Why can you not do it now?  Took 10 minutes to get me back into the house.  Then two more months to work up the courage to try that again.  I wish I could say that was the only incident of it's type.}
The cat never left the room I was in.  My Hubby made me fabulous breakfast, lunch, and dinner for the first week or so.  He set up a gravity lounger in the bedroom and helped me get to the potty, take sponge baths, kept me on a med schedule.  He did all of the cooking, shopping, and cleaning.  The boys starting getting themselves up for school, making their own breakfast, doing their own laundry.  People were being kind to me and waiting on me.  But I felt like I was missing life.  
Gosh, that sounds bratty.
 No one warned  me not to look under the ace wrap.  YIKES.
When I looked back at these pictures at the first of January, they wrecked me.  I sobbed for thirty minutes.  Why?  For the pain. For all the time I'd lost because I hadn't taken care of it years ago.  For everything I'd put my family through. For the shear horror of what I had actually had to get done.  I didn't realize when I set the surgery up that it was going to be such a big deal; well, I guess the surgeon didn't either.   I assumed it would be a quick repair, a quick recovery, a little physical therapy, back to my life.
See the tiny dot between the two stitched areas on the left?  That is a needle hole.  A few days post op, the doc took one look at my knee, had me lay back, said "just relax", and poked a needle in my knee to drain fluid.  I about came unglued.  I'm ashamed now that I couldn't hold it together that time or so many others.  I'm just not as tough as I thought I was, and I couldn't talk myself into being so.  That's the appointment where he explained to my husband that recovery was going to be "tough" due to the lateral tendon release.  He couldn't tell me - I was sobbing and shaking about to faint.
It wasn't a beautiful knee before, what did I expect?  A compression stocking on the other leg kept me from developing a blood clot 'cause that would have been bad...
I discovered bruises and pockets of fluid.  My ankle was ridiculous.
As the days passed, the bruises came more and more to the surface.  The big one here must be exactly where the tendon was cut. (You can still see the marks the surgeon made on my knee with a sharpie.)
 Some lasted a long time. 
Eventually I got my stitches out and threw that damn stocking away that I was wearing on the right leg.  My days became filled with: eat a very tiny amount, take drugs, sleep, eat a tiny amount, take more drugs, sleep, text, drugs, sleep, pee, don't forget to try to eat, cry, cry, cry.  Gradually, I moved to the front room so I could reclaim my desk.  My mother dropped me like a hot rock. No more calls, no letters, nothing.  My sister said sorry for your luck, read the Gospel.  Can you imagine?  How absolutely uncaring and unloving.  That hurt, but not as bad as my knee.  It's all I could focus on, so I let the other stuff gradually go.
Physical therapy day dawned.  I was ready.  I was going to knock it out of the park.  Just tell me what to do, I'll do my best.  Well, it wasn't the happy experience I'd anticipated.   From the get-go I was told I wasn't using the crutches properly; never mind that no one showed me that in the hospital.  I spent a lot of time getting counseled for saying things like DAMN IT and I CAN'T, and expressing frustration at the lack of knowledge about the healing process. {Stop asking about swelling, Gina!} A little more patient education would have gone a long way to managing my fears and expectations about recovering.  There were lots and lots of tears.  A frustrated PT.  And I was feeling more and more downtrodden and the days quickly slid right into the Christmas season.
I think I made the PT feel bad, but she was making me feel bad, too, by the way.   I wasn't trying to garner pity from anyone, I was just having a damn hard time. She took charge and  got me a shower chair for home use.  
No more sponge baths in the sink.  Healing was happening, slowly.  I started turning a corner around Thanksgiving.  Stopped jumping and gasping whenever she touched it.  She began to tell me I was making progress.
My ankle swelling went down. Some bruises starting disappearing -  not all of them.  And I still feel like my psyche was bruised, I do.  I'm just not as tough as I imagined I would be.  I'm a caregiver - caregivers care for others, but they make lousy patients.
 My knee became more knee-like.  With the shower chair I could shave!
And I started crying less, trying hard, working on my home program like a mad woman.
 She's getting better every day, that knee o' mine.
 I took her for granted.
She can be strong again, I just have to have a little more patience, a whole lot of faith, and give her more time.
I struggled a little with depression.  I leaned heavily on people when I should have leaned heavily on myself.  The only one who could really help me, was me.  I started self-talking myself into fighting mode.  You have to do this.  You can do this.  You got this.  When I felt scared I would remember things the therapist said:  "You have to trust your knee.  Nothing bad is going to happen.  You are letting fear hold you back.  This is nothing more that fear.  It lives in your head, not your knee."  I made a rule for myself:  If you've done it once before, you can do it again.  And you can try it at least once.  
And I prayed a LOT.
Home exercises took me 30 minutes or more, three times a day.  What else did I have to do?  Shop on-line for Christmas, text...not much else.  But on Christmas Eve, the PT gave me a gift:  a neuromuscular stimulator.  It seems that my thigh muscles, the quads, had forgotten their job.  They were, in effect, unplugged, and now we had to retrain them to contract and lift my leg.
That made me happy and annoyed at the same time.  Why wasn't I told that my leg could forget how to work?  I wanted to call the doc and rail at him, but what good would that have done?  On all my follow-up visits, he barely spent time asking me what I could do.  Told me I needed to get off the crutches and walk. Once, he made me try, and I almost fell. SIR, If I could walk unassisted, I would leave this office right now.  
Obviously, the return to work wasn't going to happen when I thought it would.  I faithfully used the stimulator, and in January I went from two crutches, to one, then a cane.  And I
was shaky on the cane.  Progress was slow, but steady.

To be continued...

1 comment:

Joy said...

I bet writing about all of this has been therapeutic. I hear a lot of grief in your post. What a terrible journey you and your poor knee have been through. I'm sorry about your mom and your sister....people often lack the ability to really empathize unless they've gone through it, too. They don't "get" why it's such a big deal. And God forbid you're not OK within the time frame they think you should be ok in... ;) A few months after my husband died, a friend said, "Oh, are you STILL sad?" like I was taking way too long with this! :)

Thanks for sharing your story, and I hope you continue to heal and progess!


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