Monday, February 29, 2016

Recovery week #3

Entering week #3 feeling pretty optimistic. This weekend spent with the legs up really seems to be paying off! Here are a few shots from the surgery and immediate aftermath. I'll add some photos of the impingement when I can get them. 

In the recovery room... in an "unusually" good mood

 Comparison 24 hours out. Not looking too bad!
A majority of the work was done on the inside of the knee

Monday 2/29: I was feeling bold and went sans crutch at work today as encouraged by the doc.  It turned out pretty well but my leg got tired by mid afternoon.  I guess that's what happens when you don't use your leg to walk for a couple weeks! 15 minutes on the bike and felt okay.  Some discomfort but nothing unusual.

Tuesday 3/1: Day 2 with no crutch and feeling far better in a mere 24 hours.  Pretty cool! Had a few solid classes and breezed through a surprise 90min observation by the dean of academics (read: my boss). Thankful to my kids for stepping it up and having a pretty cool discussion about the evolution of politics we're observing in this country. 25 minute spin. The plan was 20. Writing this, I'm ashamed because I know that part of what got me into this mess is getting greedy and pushing my limits when the timing isn't right. I really need to work on patience and not get carried away when I'm feeling good. That said... I did feel really good this afternoon. I feel like I'm turning a corner and that has me beaming with gratitude.   Back to 15 or 20 minutes tomorrow...

Wednesday 3/2: Pretty basic day! I was up and down the stairs a lot today which made my knee a little cranky. Descending is lightyears more difficult than climbing, just in terms of coordination. The major incision went through part of my VMO which is one of the medial (inner) quadricep muscles, which, I've learned, is definitely a major component of walking downstairs. The things you take for granted!... Finished the day with 20 minutes in a very low gear on the trainer and plenty of ice.

Thursday 3/3: 25 minutes on the bike. Plenty of icing after. Swelling was noticably down today! Walking really well.

Friday 3/4: Lauren and I headed down to Newport, RI for a little getaway. We swam (indoors), hung out, and most importantly reaffirmed all of the stuff we're working on together. Iced the knee in the evening. Day off, in terms of activity.

Saturday 3/5: Today I rode the bike for 25 minutes on the recumbent bicycle because the upright bicycle had one of those enormous wide seats which is, in no way, comfortable. For a reason beyond my own understanding, it felt harder than riding the upright bicycle like when I'm on my bike at home. Kept it nice and light.

Sunday 3/6: ...And, I woke up sore for the first time in months (muscularly), specifically in my glutes. So what I realized is that the recumbent bike vs. the upright bike is a very different activity in a significant way. I do NOT understand how it's different, aside from the role of gravity, but still, there appears to be an important difference. Since I've been told I have under-active glutes in the first place, I went to the YMCA for my spinning time and hit the recumbent bike. Within minutes I felt my weaker glute struggle, and by the end of the 20 minute spin I was convinced that I need to be riding the recumbent bike for a while, and certainly for rehab of the knee. I also hit the machines for a few upper body reps. My goal there was just to wake up the mucle groups and get them ready as I'm 4 weeks out from the rib breaks and it will soon be time to get the core working in a significant way again.

Week in Review: 120 minutes of spinning, 1 set in the weight room, and significantly reduced swelling in the knee. Walking more. Icing regularly but that's boring to report on. Mobility routine must wait until I'm able to comfortably bear weight on all fours. Things are definitely looking up!

Goals: 150 minutes of spinning, 2 nights of 1 set on the weights. Maybe begin mobility routine.

Wednesday, February 24, 2016

Rehab Week #2

Wednesday, 2/24

I met with the doctor this afternoon and had the sutures removed and reviewed a bunch of pictures from the operation. The mass of bone and cartilage looked pretty impressive! It was nice to see the shot without it there! At one point, the conversation drifted to the pain I was experiencing before the operation and I learned that knee-cap impingement can cause hamstrings to snag and fire poorly, which are a part of the symptoms I would have when the knee was acting up. So, it all appears to be adding up, I hope.

The best news of the day was I received a green light from the doctor to begin a bit of PT at home. 10 minutes of light spinning on the bike to start, adding 5-10 minutes every 4-5 days as the knee allows. The logic is that moving the joint in a non-weight bearing position promotes healing of the cartilage. He also recommended I take glucosamine for the next few months  because it's a dietary supplement that acts as a building block for cartilage.

So, I spun for 10 minutes at home in a very low gear. The knee took a minute to get used to the motion but soon I was spinning relaxed and smooth. It felt so good to be able to do something.

Thursday, 2/25

10 min spin. Felt considerably better  moving through the range of motion.

Friday, 2/26

10 min spin. The knee wasn't happy today but probably because of a bad step I took at on the stairs at work.

Saturday, 2/27 

I took the day off from activity. Plenty of ice and rest.

Sunday, 2/28

20 min spin. Nice and light spin in a low gear. Iced after.

Week in Review:

  • 50 minutes of spinning.
  • ~8 hours of icing
  • made it through a full work week
  • at almost no pain in the ribs (3 weeks since the breaks)
  • generally uncomfortable walking. Still using a crutch get around
  • a lot of swelling persists in the knee. I'm told this is normal.

Goals for next week:

  • 90 minutes of spinning
  • ~8 hours icing
  • no pain in ribs
  • begin core work
  • begin walking without crutch? we'll see... not rushing this one. 
  • reduce swelling in knee

Monday, February 22, 2016

Week #1: Post Surgery

I'm treating recovery from surgery as a training block of its own. I'll be setting goals and logging progress in any measurable ways I can. I'm not sure what specific goals to set beyond reducing the swelling and growing comfort when walking and that sort of thing at this point. I should know more about the recovery timeline when I meet the doc on Wednesday and have the sutures removed. Then I'll be able to set goals for strength, flexibility and so forth.

My goals for week 1 were really just to get the swelling down. Since Tuesday afternoon, I spent 99% of my time lying down with foot raised or reclining on the couch with my foot raised. I spent hours upon hours icing and measured the passing of days by meals and new doses of anti-inflammatory meds.

So after one full week, the swelling in my knee reduced from looking like a cantaloupe to more of a grapefruit. I couldn't bend the knee in the first couple days but by now I've been able to bend it with gravity's help past 90 degrees. The swelling is far worse when standing and it feels really awkward to walk but I'm able to move around pretty well on crutches.

Last night I got antsy and my brother took me to the grocery store. Walking around leaning on a shopping cart for a few minutes felt like freedom!! But, by the end of the trip I was exhausted and and the swelling in my knee had gotten to the point where I needed to lie down. It was the test I needed to know for sure I'm at. It was also good to get out the house!!

Goals for next week:

1) start walking without crutches
2) limited pain in ribs. Ideally none!
3) get off anti-inflammatories by week's end.
4) begin leg lifts
5) begin yoga/ mobility stuff

Wednesday, February 17, 2016

Day Zero

Today is a big day. Today is the first day I get to start building and looking to the future instead of not-so-patiently waiting for the surgeon's call to the operating room. I'll save the gory details of the surgery, aside from saying that the procedure was estimated to take about 40 minutes and it ended up lasting about 2 hours. The doctor found a lot more work to be done once he got inside. As such, my recovery might be a bit more prolonged and uncomfortable than originally estimated. At this point, I don't know when I'll be feeling good enough for PT or cycling or eventually running. But, when that stuff eventually happens, I'll be doing it with a knee that no longer has broken bone fragments and gnarled cartilage.

One interesting thing to note is the doctor is convinced that everything wrong with the knee was caused by a traumatic event, like a blunt force impact which broke part of the knee cap and began damaging the cartilage. Of course I'm guessing, but my gut tells me that I can pin-point the trauma to a night run back in 2010. JVG and I had been running for a town line going downhill on Mill Road in Durham when I slipped on ice fell head first down the hill. The first thing to make contact was my knee. The next day it was ballooned up, turned shades of green and purple, and I didn't run again for the next 9 months.

Back then I didn't have the kind of insurance that easily allowed for things like imaging and my attitude at the time was to just to be patient with injury. Let it rest and it will come around. It had occurred to me that maybe I had done damage like tore a meniscus even though, to this day, I'm not sure what that would even mean or feel like. In 2013 I got an MRI that would eventually show signs of mild arthritis, but the image fidelity wasn't precise enough to show the reality of the damage that was going on inside my knee. It confirmed to me that my meniscus and ligaments were all clear, and so moving forward, every time my knee flared up. I chalked it up to overuse.

This was not overuse, though. The surgery made the knee eternally better because the junk in there messing everything up is gone. The wounded cartilage is smoothed out, and the bone spurring has been eliminated. The future is far brighter than the past because I'll actually have the opportunity to train for more than few weeks without chronic, increasingly painful swelling, etc. Despite the pain I'm in currently as the knee heals, I'm so excited for the future. Today is day zero. The comeback begins!

Friday, February 12, 2016

Recent Moves and Last Post Pre-Surgery

Busy little week here with some highlights.

Saturday, 2/6 - skied at Killington with Alex Hall, Alex (the brother) and my cousin Colin. Despite the man-made snow the conditions were pretty solid and had an awesome day on the slopes. The knee didn't get too cranky. I went down 3 times which is unusual for me. The first time, I managed to nearly impale myself on my own pole. Sharp pain in my side in certain positions but not bad enough to slow me down. Another time I hit a whale going way too fast and over-rotated into a front flip. I was having a little too much fun out there I guess! Ate at Worthy Kitchen on the way home. Lights out by 9:30.

Sunday, 2/7 - got outside for a round of disc golf, hiking through the snow around the Amesbury Pines. Threw pretty well but didn't have the power I normally have. Caught the end of the 5 mile race in Salisbury where Alex took it home in 25:30 or so. Seemed like a really nice day for a race.

Monday, 2/8 - 90 minute hike with Lauren at the Ward reservation in Andover. A few great views of the Boston skyline and caught the best sunset I've seen in a while.

Tuesday, 2/9 - 60 minute bike ride on the trainer. I've got a great set-up on the deck with a blue-tooth speaker so I was jamming to some 90s rock and got into a good gear and cranked. The neighbors looked at me like I was crazy as they pulled into the parking lot, but they'll just have to get used to it. I'm not going anywhere! My right side hurt a bit more than before.

Wednesday, 2/10 - No activity. I met the surgeon for my pre-op appointment. Sounds like a pretty simple operation... 2 or possibly 3 incisions. 40-60 minutes conscious sedation with a spinal tap to numb me from the waste down. 6 weeks no running minimum, It might be up to 3 months no running depending on what the doctor sees. Physical therapy to start 10 days after surgery.

Thursday, 2/11 - No activity. Visited my primary care because the pain in my side was keeping me up overnight. Guessed I had a bruised rib or contused my liver or something. The X-ray came back and I had 2 broken ribs (10 and 11).  Whoops... They should take about 6 weeks to heal. Considering how I'm out of running for at least another 6 weeks with the surgery, the breaks aren't that concerning to me. They should heal up just fine.

Friday, 2/12 - No activity for the next few weeks with the ribs restricting anything aerobic and core related. I'm turning 30 this year, so maybe following the surgery I'll learn how to slow down a little bit and stop hurting myself!! I'm knocking a lot of things off the bucket list this week; first broken bones (outside of stress fracture), first surgery, first February without racing since middle school, etc.

I'll probably take a step back from the blog until I have some news about how PT is progressing or if the surgery presents any new info. Thanks for following along! Good luck to everyone preparing for the GP races this March! Stay healthy, my friends!

Tuesday, February 9, 2016


Confirmed to go under the knife early next week. Pre-op tomorrow to go over the finer details. Thankful this can be done over a school break so I don't have to miss any time with my classes.

Thursday, February 4, 2016

Surgery is a go. There's a bone and cartilage "nugget" lodged between my femor and patella causing the pain and inflammation I've been struggling with for the past year. It's causing further damage and could possibly become dislodged and move to the main knee joint which would immediately cause the joint to lock up. I'm excited to finally have a definitive direction. Scope date TBD. 

Tuesday, February 2, 2016

The latest

MRI results posted in my healthcare portal and although I can barely decipher the technical jargon, it sounds like there's evidence of loose floating cartilage or scar tissue behind the patella. The report also said something about "mild subchondral patellar bone marrow edema" which a quick google search suggests to me that I have fluid or swelling in the patella itself. Sketchy!

In other news, I ran for 55 minutes on trails between the Ward and Harold Parker systems on Sunday and felt great. Beautiful "Spring" day in January.

And on Monday I ran a short loop starting from Andover center up past Phillips Andover along some quiet roads by headlamp. Smooth easy running.

My attitude about training at this point is that I'm not training, but to stop running cold turkey is an unbearable concept. I should learn more about the next steps tomorrow when I see the doctor again.

Over and out!