Final Approach

It is now 37 days since the injury occurred and just 5 more days until surgery. I have to admit that deep down I am still very worried about the long term prognosis for my knee. And although I have the highest possible level of confidence in Dr. Stone, there is still a small part of me that is scared senseless of the surgery itself. Committed optimism is just not that easy to come by right now.

I’ve been through nine physical therapy appointments and I’ll have one final pre-op session tomorrow. My physical therapist has been exceedingly helpful and considerate, not at all the sadistic tyrannical stereotype I had heard about from others. That said, I’ve been told that pre-op PT is just a dry run. Post-op is where the real work is required. We'll see. When I started PT three weeks ago I was still in quite a lot of pain and I was well short of being able to pedal through an entire stroke on a stationary bike. By my third appointment, I had gained a bit of range so I set the seat as high as I could reach and after a few warm-up swings I slowly forced the pedal over the top of the stroke by rotating my hips in the opposite direction. Tears came pouring out of my eyes with the gush of pain and the release of the wide range of emotions I had been diligently covering up since Christmas night. It wasn't until that moment that I realized how much it would mean to me to be able to pedal a bike again, if even just barely.

At this point, the pain in my knee, although constant, is mostly quite tolerable except in the area of the MCL. The mild visible swelling has improved to the point where the right knee now looks nearly like the left knee, except that I have shaved bare the general vicinity of the right knee to enable the placement and painless removal of the electrodes during PT. My range of motion has gradually increased, at least in part a result of the reduction of swelling. I can now extend my leg to within 3 degrees of straight and I can bend it to within about 10 degrees of full flexion. Walking is getting better, although I’m still quite obviously limping and occasionally I get sharp shooting pains through different parts of my knee if I don’t step just right. I’ve been using the hinged brace but it doesn’t seem to really help – other than to protect me from an accidental hyper-extension. As the non-specific pain in my knee begins to subside, the pain from the sprained MCL is becoming more prominent and I am beginning to worry that the damage to the MCL may be much more severe than initially suspected. I am reasonably strong in extension (leg presses from about 45 degrees to straight), but flexion exercises cause a debilitating level of pain on the medial side of my knee. Again, probably the MCL. Advil, even in over the counter doses, provides a noticeable improvement in most of my symptoms but the surgery center has suggested that I avoid ibuprophen and the rest of the NSAID family for the week leading up to surgery to help reduce bleeding. I’ve already lost an inch from around my thigh and yet somehow I’ve gained five pounds. I suppose those two unwelcome trends are likely to continue in the short term.

I will try to post every day next week. I’ll be staying in the city at my brother-in-law’s where they have two ferrets that roam the house in search of weak and injured prey. I’m going to bring a long stick and take my chances. My surgery schedule, in case you’re following along, goes a little something like this:

Monday – Pre-Op, 11:15 am
Tuesday – Surgery, 7:15 am
Wednesday – Post-Op, 10 am
Thursday –PT, 11:30 am

After that I’ll come home and start PT sessions locally with follow-up visits to the Stone Clinic scattered throughout the calendar for the rest of the year.

I have never had any kind of surgery before and there is no way to describe how I feel right now. “Anxious” just doesn’t quite capture it. I’m trying desperately to focus on looking forward to the recovery process so that I don’t fall back and bury myself in the negative aspects of this injury and the many unpleasant 'what if’s' of next week. Dr. Stone’s assistant surgeon emailed me yesterday and gave me perhaps the best advice I’ve had yet. “Just think of it as a day off”, she said, “with a really good nap”. Geez, she makes it sound almost pleasant.