Day 3

I am now on a blow-up bed in the middle of the family room, resting ironically at the precise location of the original injury. My leg is constantly elevated as it has been every day since surgery and I'm icing for twenty minutes every other hour or so. Last night I slept without the brace for the first time and thankfully I kept reasonably still. I have been sleeping with a brace for most nights since Christmas because if I happen to have a dream that causes me to flinch or stir, I am quickly and violently reminded that my knee is not available for such random movement.

Here are some of the movements that I am engaged in at this point (in case any of my PT friends are reading along)…

Foot Pumps – This is a repeated forward and backward motion of the foot moving at the ankle. It doesn’t sound like much, but it stretches and pulls on areas of the knee that I never knew existed.
Circles – Big ones and then little ones, to the right, to the left. Another ankle exercise to help the lower leg remain engaged.
Alphabet – The final foot related feat, drawing the alphabet in the air with the big toe using the available movement of the foot and ankle.
Quad Sets – Isometric contraction of the quads. I’m not quite there yet so I’m doing “flicks”, which is a repeated instantaneous firing of the quads.
Glute Sets – Isometric contraction of the glutes. This also tends to work some of the upper hamstring.
Range of Motion – Extension and flexion. Honestly, I haven’t done any of this work yet because it's been too painful and as a result I am down from about 30 degrees on the day after surgery to now less than 5 degrees of available motion. Will need to get started on this soon.

The pain is actually a lot better today, right on schedule. As long as my leg is up, the discomfort is completely tolerable. And, when moving from “leg elevated” to “leg down” to crutch my way around the house, the redirected flow and pressure in the knee, although still very apparent, is far from the excruciating levels of the past few days. This is a particularly welcomed development, I assure you.

For some reason it just occurred to me last night that this injury (likely to be known from this point forward as "The Christmas Day Incident") was the most severe injury I had ever experienced of any kind. Ever. I've had plenty of bike crashes, car accidents, and I even once opened up three of the fingers on my right hand in a mishap with a viciously sharp wood chisel. The misguided chisel assult resulted in an impressive distribution of blood across the garage and a few bits of unfinished pine lost forever in the fleshy parts of the fingers. But after a couple packages of gauze and a few feet of first-aid tape, the injury was under control and everything healed within a month or so. The knee though, this was different. This was a new degree of injury. And then I realized that this new “worst ever” injury honor had been quickly reassigned to the surgery itself, which although immensely more controlled, was far more damaging than the event that caused it to be necessary in the first place. I've noticed that in the language of physical therapy, the cleverly designed reference to this operative induced injury is “physical insult”.


One aspect of this journey that I somehow did not anticipate is the underlying disappointment of the surgical re-injury. For every one of the forty-two days between Christmas and surgery I worked hard at improving mobility and function and healing and although I was never 100% I was quite able to get around on my own with limited discomfort by the time I stepped into the OR. Now I am debilitatingly injured once again. And to some degree, even more so than before. I never used the crutches pre-surgery, and now I am absolutely dependant on them. I never needed pain medication pre-surgery, but for the past few days it has been critical. Alone in the house I just now spent twenty minutes getting myself into the kitchen to make something for lunch. As my stomach has begun to tire of the medication schedule, I have needed to be even more diligent about keeping myself regularly fed. Turns out, although I was able to empty the contents of the can and heat it up, there is just no good way to get a bowl of soup from the microwave to the table while relying entirely on crutches for your own movement. Even if I could somehow manage to get the soup to the table, I would still not be able to sit in a chair for long enough to eat it.

Obviously the reconstruction surgery was not unplanned nor the consequences entirely unforeseen, and I am still quite optimistic about my recovery. But I must admit it is still far more frustrating than I had expected to be so “physically insulted” and so very dependant once again.

When Dr. Stone asked, “Are you ready?”, clearly this is the challenge to which he was actually referring.