Day 296

Thanksgiving Day.

And just what do I have to be thankful for? Well for starters I was able to walk around Disneyland with my wife's extended family for three full days last week and watch the joy and amazement in the wide eyes of my two beautiful girls as they soaked up all of the magic and mystery that Walt and his friends had to offer. It was wonderful. I struggled with a stairway or two during our short vacation but overall my knee, thanks in large part to continuing physical therapy, held up well.

Of course I'm also thankful for my loving family and a select handful of exceptional friends and the fact that I still have a great job and can comfortably provide for the basic needs of my family. If you're currently in this condition or better, now's a good time to stop and consider that many people are not.

Take for example, the thieves that robbed my house a couple of weeks ago. They probably don't even have decent health insurance. What they do have unfortunately is more than ten thousand dollars of what was until recently my family's stuff. At around 11am, in broad daylight, with about an 18 minute window between the time my wife left the house and I returned from PT, the heist was complete. It can take longer than that to get through the goddam express lane at Safeway. Apparently it's just not all that difficult to invade someone's home entirely unnoticed and walk out with as much as you can carry.

The real problem of course is that it's not just "things" that get taken. It is personal privacy, a carefully cultivated and highly imaginary sense of security, and perhaps most importantly, any feeling of control. All gone. In the past couple of weeks since the theft, I have been flooded with many of the same emotions that I had in those first few days after my knee injury - anger, despair, frustration, helplessness, an overwhelming desire for prescription narcotics. What I have finally come to realize is that loss is loss. Whether it is the loss of some healthy part of ourselves or the loss of material possessions, our reactions always seem to contain, in varying degrees, similar elements. Most notably, the primary component of any loss we incur is naturally accompanied by a renewed awareness that we are in fact not in control. Of course this lack of control always exists, but it does so in direct contrast with our (ok, my) inherent need to feel in control. Without a strong belief that my future is a direct result of my own focus and dedication and effort, I wonder if some of my self-generated motivation is in danger of being precariously relocated beyond the frayed edges of my character. If you can't turn the ship, why bother steering?

I now more fully realize something that I suppose deep down I already knew - that in this, as in all areas of life, there is a balance. No, we are not in control. Far from it. But at the same time our inability to control our future is balanced by the fact that we are also not entirely unable to affect the outcome. The reality lies somewhere in the middle - in an ability to have the effect of our input considered in the results. The obvious fact is, any bit of effect we can muster is always mixed with and sometimes superseded by the effect of outside forces, like other people and sheer luck - both good and bad. I suppose real character includes the ability to continue to strive to do the right thing, to work with unwavering dedication at improving and making a positive difference within ourselves and for the people around us, even while maintaining a conscious awareness that our efforts may at any time be counteracted by a random act of man or nature, or an unexpected dance move.

As part of my recovery and general goal of optimal health, I have recently increased my focus on vitamins and supplements. I haven't gotten around to any fun stuff like EPO or Viagra but I do now have a daily regimen that includes a highly nutritional meal replacement shake, a scoop of some sort of thoroughly disgusting veggie powder concentrate, Chinese green tea, a multi-vitamin, fish oils, glucosamine, MSM, chondroiten, and extra C and E supplements. By now I must be the healthiest person on the planet. Or maybe all of this is actually having no affect at all. Then again, maybe I will eventually become as healthy as I can be only to be hit by the crosstown bus. I guess I'm still struggling with this whole destiny control issue just a bit.


Speaking of vitamins, late for work a few days ago I tossed my daily handful of morning pills into the pocket of my jeans and headed to the office. Unfortunately in my haste I failed to consider that the aforementioned pocket may not have been entirely empty to begin with. After I arrived at my desk and got my computer started up I opened a bottle of water and thoughtlessly started gulping down the contents, tossing in a few pills with each swallow as I read through my email. Thankfully, a small but critical part of my consciousness apparently reserved for such things managed to notice the soft pliable texture of a foam earplug as it lodged against my tonsil and I was able through a skillfully executed combination of forced gagging and heaving bodily contortions to violently choke the wayward plug back out and onto my desk, much, I'm sure, to the enjoyment of my coworkers. Medical crisis averted, my immediate surroundings subjected to a freshly expelled mixture of spit bubbles and vitamin drool, I slowly checked the remaining contents of my pocket. The other earplug was, alas, already gone. Swallowed. Ingested, as it were, along with any false belief that I had long since matured beyond such an episode.

Turns out, we never outgrow the benefits of paying attention. Be careful out there.

Day 272

Welcome to PT, Phase 3.0

First there was the challenge of pre-op physical therapy. Twenty visits, maybe more. Then there was post-op PT - another couple dozen visits to the original pre-op clinic, a handful of encounters with the painfully competent Stone Clinic torture crew, and one stop at a third place where a still-in-school therapist spent most of my session consulting a PT book to determine how far he should try to bend my leg. He never got the chance.

Shortly after that I fell off the PT wagon. I was back to riding. I was playing music. I built a patio cover in my backyard. I was too busy getting back to my life to bother with mediocre PT and far too discouraged to find anything better. Maybe I could just finish recovering on my own.

Fast forward to my six-month follow-up with the Stone, and another visit to his PT room. “You really need to get back into therapy”, I was told by the therapist, her eyes staring directly into mine to clearly convey the “or else” element of the message. “You don’t want to wait too long.”

Too long, she explained, was now quickly approaching. One year is the the generally accepted window for improvement. Beyond a year, physical improvement, although possible, is as about as likely as keeping all of your blood on the inside during a shark attack.

So at the direction of the Stone therapist, and from somewhere in the haze of discomfort following the Condor Century, I decided to follow my neighbor's recommendation and check out yet another local PT clinic - BodyMax. With little in the way of expectations, last week I went to my first appointment. Craig, the owner, met with me and assessed my progress: “You're a bit behind”, he pointed out. "Well we've covered the obvious", I thought to myself, "So what now?". But before I could ask he moved directly into explaining what I needed to do to catch up – stretching, ultra-sound, myofascial release*, and targeted weight training. No surprise, the BodyMax PT clinic looks like a gym, with an impressive assortment of weight machines and cardio contraptions - stationary bikes, ellipticals, stair masters - all in a large open room. Surrounding the gym area are a dozen smaller rooms - therapy rooms and offices. In short, the facility is excellent and Craig and the rest of the team are pros. By the time that first appointment was over it was clear to me that I was finally in the right place. In fact, it was so overwhelmingly obvious that my joy quickly devolved into a subtle resentment of the situation as I realized that had I started there first, I would probably be done by now.

*Technical note: The web has abundant information about this but the following should suffice for our needs here: Fascia is the seamless web of connective tissue that covers and connects the muscles, organs, and skeletal structures in the body, which is located between the skin and the underlying structure of muscle and bone. Muscle and fascia form the myofascia system. Myofacial release is the name of the therapy that is designed to release bound up or stiff areas of that system. Apparently the foundational premise of this therapy is “if it hurts to rub there, then keep rubbing”.

In any case, I have now completed five sessions with Craig at BodyMax. My strength and flexibility are both improving. I am thrilled with the results already. There has been an increase in pain but seemingly as a necessary and presumably temporary result of the therapy. Craig was not satisfied with the zero degrees that I had achieved in extension and wanted as much hyper-extension as the “good” side so we're "fixing" that. He also reasoned that in order to protect the joint during activity, the end point at extension needs to be slightly soft and pliable. Before I started at BodyMax, my knee still had a rather painful and abrupt stop at full extension – no give. In the world according to Craig, no give is no good. For one, it’s asymmetrical, and two, it causes the knee to be more injury prone. Creating “pliability” where none currently exists is not a pleasant process to say the least, but that kind of unpleasantry is nothing new at this point either.

I suppose the message of the day is Hope. It is a sensation that I have only recently begun to regain in terms of recovery and although I’m definitely not ready yet, when I’m sufficiently rehab'd I will be eligible for the BodyMax ACL Bridge program – which is designed to bridge the gap between simply functional and athletically able. Hopefully by the time I post next, I’ll be knee deep in that program. If I’m still not ready, it sure won’t be for lack of effort.