acl – My Truant Pen

Raising New Englanders

I am not a New Englander. I visited New England once when I was 14. Then again – for colleges – when I was 17. Most of my New England knowledge came from a weird combination of books and stereotypes. (Little Women, Daddy Long-Legs, Hawkeye from M*A*S*H … I would say the LL Bean catalog, but we actually didn’t get it.) Then, I came here for college. Early in the process I was targeting Pennsylvania. My first choice school was Williams, in the Berkshires of Massachusetts. But I found myself, a hot August day, in a double-dorm-room in a hundred-year-old stone building in historic New London with a roommate who was profoundly *from* a town fifteen miles away.

Since then, I have acclimated. I remember the shock and horror with which I discovered Dunkin’ Donuts doesn’t carry maple bars. (A fact which still mystifies me – why they’re a regional delicacy of a place with no maple tradition and entirely unknown in Vermont/New Hampshire/Montreal.) I mastered rotaries. I cheered on the Red Sox to their World Series pennants. I learned that “Wooster” and “Worcester” were in fact the same place. I have eaten lobstah in Glostah (Gloucester), listened to the Boston Symphony in Symphony Hall, developed a finely honed snow shoveling methodology, consider stop signs advisory and can’t help raising my fist to the chorus of “SO GOOD!”

But in one way, I remain distinctly un-New England. My junior year of college, I was invited with my college friends on a ski trip. They’d gone the prior year. I don’t remember why I didn’t go (it was probably some rot about seeing my parents more than twice a year). It felt deliciously grownup to be invited. I distinctly recall that we drove the Kankamagus – home to my frequent summer journeys in my adult life – in the crystalline snow of February. I’d never gone skiing before, despite living in close proximity to epic mountains. We rented equipment (I following the advise of my long time boyfriend) and hit the slopes.

Adam gave me a few lessons – which I accomplished well. After an hour or so, he deemed me ready to hit the slopes of Loon and try my first modest trail. The first few minutes of your first skiing ever are more terrifying than exhilarating, and I comforted myself that this was a thing people did. Look at all the people around me, skiing? Seconds in to the trip, I took a turn wrong. My leg did something wrong. I don’t clearly remember too much of what happened next. The ski patrol. The sled. The inability to hold weight on my leg. I limped back to our condo and have never – since that day – gone skiing again. I had torn my ACL – it took months before I could walk without limping. I tore my MCLS also later, and had major knee surgery and still feel my knee as an alertness of the possibility of pain. I will never ski again.

But.

I’m raising New Englanders. Grey and Thane are locals. They were *born* here. They belong here. They are from here in a way I will never be. And New Englanders? LOVE winter sports. There are ice rinks all over the place. It seems like every car has ski racks. To be from the New England suburbs (I don’t pretend that this is not a combination of both location AND privilege, because it certainly is) and not ski, or know how to skate well… not cool. Not cool at all.

So I was *thrilled* when our YMCA afterschool program offered (get this) SKIING LESSONS! I signed up before they even had official signups. They pick the kids up from school and take them directly to Nashoba Valley for ski lessons. The kids return around 7, having had an amazing adventure with their friends. Apparently Grey & Thane have been improving in their three lessons already, and there has been pretty much no whining. (I thought that 18 degree weather and a hard new skills would equal whining. I was wrong.)

The Y teachers/ski instructors are freaking saints. My two lunatics are on the left.

I was feeling all satisfied by having done New-England-right by my kids using the proxy of the Y, when somehow word came to my husband? Kids? That there’s an open skate time in the Stoneham Arena on Sunday from 4:00 – 5:30. The kids begged. Adam took them. I had a quiet ninety minutes. They have, by husbandly reports, improved by leaps and bounds.

Truthfully, I confess to be a little bit ashamed of how scared my knee makes me to do things like this. I mean, professional athletes have the same surgery, and they’re back smashing into each other scant months later. (See also: Gronk). But I think I might have a legitimate panic attack if I ever strapped on skis again. Even having my children doing it is easier if I don’t think too hard about it. The slicing and twisting nature of skates (did I mention I’ve only been skating two or three times? I’m a better roller-skater) makes me uneasy. My knee throbs just thinking about it. My failure to responsibly overcome this fear is no testament to me. But I’m extremely grateful that despite my unease, my children are learning to love snow and ice, and to be – well – real New Englanders.

I have just uploaded my January pictures. We had a great adventure in Cambridge at Harvard’s Peabody Museum of Archaeology and Ethnology. I also got some more great blizzard-day pics!

A year of zombie life

September 16th is one of the dates I remember. On September 16th, a year ago, I became a zombie.

The story is this: 14 year ago, I went skiing for the first time and snapped my ACL. Being young and dumb, I figured six months of limping was normal for a sprain. Then 18 months ago I jumped off a wall and tore my meniscii – both of them – badly. A summer of physical therapy, then I re-injured it and the MRI showed that I had massive damage to my knee. I was scheduled for an ACL replacement surgery and repair of both my meniscus.

I think that exactly this time last year I was fading in and out of consciousness, in and out of pain. I don’t remember that day too well. The rest of the week I spent ensconced on this very couch, an awesome ice pack circulating cold water over my bruised and violated knee. It was a long, slow, obnoxious journey back to (mostly) full mobility from there. I hated the crutches stage. I limped for months and months. Even now, I can feel that my knee is different than it’s partner on the right.

There are a few things I bring out of this experience.

First is gratitude. My new knee with its excellent function is a gift. There was a person who chose to be an organ donor. There was a family who affirmed that donation – in grief – after they lost that loved one. We all think about donating hearts and lungs and livers: the life-saving organs. But there is so much more than just that. There are tendons, eyes, skin – things that make life better. I carry a bit of my donor with me – and it carries me. There is a person who lives on, in some small way, in me. And I am grateful.

Second is also gratitude. It turns out that chronic pain and difficulty moving are mentally, emotionally and physically debilitating. Last year was one of the hardest – the worst – years of my life. This year has, so far, been one of the best. There is more to it than just pain and disability vs. no pain and ability… but that is a huge amount. It is salutary for the young and able bodied to see the world through other’s eyes. I’ve been fearful walking across slick ground in a way I never was before. That gives me sympathy and care for the octogenarians who always walk with such caution. I also being to understand the toll chronic pain takes on its sufferers.

Finally, there is the moving on. This appendage has taken up a tremendous amount of space in my psyche in the last year: with the pain, the fear, the disability, the limitations. But that’s pretty much over with. Now I have all this lovely extra space in my thoughts for new things, like guitar!

So that’s a wrap. One year later, I am signed up for the next Red Cross blood drive and saying, “Sayonara knee preoccupation!”

Marvels of modern medicine

There is more to me now than there was this morning. Where I once had a missing ACL and two frayed menisci, I now have an ACL and two shaved down menisci.

I would like to take a moment to talk about the tendon they put in my leg this morning. This tendon was a donated by an organ donor – someone who marked their driver’s license, or talked with their family. I have every hope that the man or woman who is giving me the ability to walk, run, jump and move died at a very old age surrounded peacefully by their family.

When we think of organ donation, we think of the big life saving donations: the heart, lungs, kidney. You might think, “I’m not healthy enough for any of my organs to be of use.” But for other things that make a huge impact on quality of life – knee tendons, corneas etc. – it makes a tremendous difference. I am incredibly grateful for the foresight and generosity of spirit of the donor who has given me a leg to stand on.

That said, let me fascinate you with a discussion of my morning! (Note: if you are faint of stomach regarding medical procedures, please feel free to stop reading now!)

My surgery was originally scheduled for noon. Yesterday, I got a call asking me to come in at 9 instead. On one hand, this was very good news since it’s hard to wait and think with no food, drink or (GASP) coffee! On the other hand, I had to be there two hours early, and Grey cannot be dropped off prior to 8 am. Putting all that together, I drove myself to the hospital.

My procedure was done at the same hospital where my sons were born. I took the same road, just as the sun was rising to burn off the morning mist. It was a lovely day. There was remarkably little waiting around, it seems. I was questioned, prepped, pregnancy-tested (negative!), written on, informed and advised. It seems like a very long time ago. I was wheeled in to do a nerve block before my husband returned. After they had put in my IV and added the block, my husband and my pastor both arrived in the recovery room. We prayed together, joked, talked logistics and waited. It seemed like only a few minutes after that when they kicked the guys out to finalize my preparation for surgery.

One of the last things I remember was telling the nurse how fascinating I found one of the drugs they gave me. I was given a tremendous number of drugs for this procedure. But just before pushing me into the OR they gave me a drug which would allow me to interact and react perfectly normally with them but which would not permit me to remember what happened. Sure enough, that conversation is my last memory. I know that I was awake after that. I assisted and followed instructions. I probably asked questions. I remember none of it.

So Sci-fi!

Anyway, the procedure went well. I came up from anesthesia extremely concerned about whether I had been polite under its influence. That was my first question, not “How did it go” or anything. Apparently I was at least unremarkable under the influence.

I did not have a chance to talk to my surgeon (consciously) after the procedure. He did talk to my husband, though. Although the surgery was a success, not all the news is good news. More of the meniscus was damaged than he had expected, so he had to remove more cartilage than he expected. I have pictures. They look like white stripes. Also, my knee shows some very early signs of arthritis. He said we would discuss this more in my follow up, so I’ll wait to find out what the implications of these two things are. I’m guessing, however, that the Boston Marathon is right out for 2012.

Then I came home! I’ve got some cool gear – for example a neat ice-pack-like device that circulates ice water under my brace. Oh, and an epic brace. But I am already limping around on my crutches, and bearing some weight on my leg.

I’m a little concerned about my big time painkiller. I’m still (I believe) under the effects of the nerve block, so the whole weight of the pain hasn’t hit. However, my reaction to my pain pill is a) throwing up anything that might be in my stomach b) falling dead asleep. While there are ways to mitigate nausea, this is less feeling queasy and more “OMG Bring a bowl NOW!”. This is particularly a problem since the last time I ate anything was last night during the Pat’s game. HUNGRY!

I just did manage to keep something down, but I have a hunch it’s because my last round of vomitus included my pain pill. Not a sustainable model, folks. So I plan on calling tomorrow to see if I can find something less problematic.

Tomorrow I start needing to move and do exercises. I suspect that even that minor effort will wipe me out. But I find hope in that this is, if all goes well, my last knee recovery. I’ve been up and down all summer, but when I make this recovery, I’ll be at the best I can be.

So that’s the news with me. My thanks to everyone who sent prayer and good thoughts, and to all those who decide to share their bodies with others once they are done with them.

Back to life, back to reality

The vacation is over. The children have returned. The schedule is resumed. The fall planning has begun. The rules have been reapplied.

We’re back to our life. But with some changes. (NOTE: One being that I’ve been picking at this post on and off in 5 minute increments for about 4 days now…)

Last night, after Thane’s bed time, my husband, eldest and I laid on a blanket in the backyard, vainly fighting the full moon and suburban light pollution for a shooting glimpse of majestic fire. We laughed, joked, poked each other, and listened to the symphony of insects performing every summer evening. This was a moment that probably would have been an option in our pre-vacation world, but that we would have been to stressed, blind or busy to see. In the lassitude of people whose emotional needs have been met, though, we had a really joyous hour together.

In other urgently important news, Grey does not have a loose tooth. No he does not. He has TWO loose teeth. His bottom two center teeth are extremely wiggly. One has an imminent departure date. I was sniffling a little at dinner about him losing his teeth. He got very sad and tried to assure me that he’d done his very best to take good care of his teeth – brushing and flossing them! Factual analysis of his actual oral hygiene practices aside, I had to rush to reassure him that losing teeth was perfectly normal and expected – but that I like him the way he is and it’s hard to watch him growing up so fast. He gave me some big hugs, that made me feel better about it. (At least until I consider that I should be banking them against the inevitable teenage hug-drought, but that’s just borrowing trouble.)

And then there’s my knee thing. I believe I’ve agonized at length over here about my KNEE and how I’ll have to actually have surgery. I feel like a total wimp. I’ve always seen myself as a strong stoic person (hey! Stop laughing!) In fact if you’d asked me why I chose to give birth – TWICE – without drugs I’d say something about how it wasn’t actually that hard after you got over the screaming bit, and the toughest part was that your jokes just weren’t that funny between pushes. (Ah, hormones! How easy you make it seem in retrospect.) I begin to suspect, however, that I’m actually a wimp about medical procedures. You see, I have no problem with needles. I’ve given about five gallons of blood. No problem! And I’ve never caviled at the procedures I’ve needed. But, uh, I haven’t needed any. Or at least many. This will be my first time unconscious. Not asleep, but knocked out. I’ve never fainted, blanked out, passed out, gone unconscious or had general anesthesia before. This will also be the first time anyone has ever cut me open in any way. And it will definitely be the first time someone has inserted a cadaver tendon threaded through my knee, after trimming off ragged bits of meniscus.

And the more people I talk to, the more this surgery sounds like a big deal. I mean, weeks and weeks of badness. Probably two weeks of incapacitation, followed by a long period of limping. I don’t do well with incapacitation. I prefer to tough my way through the pain and do stuff anyway. In this case, doing so will be stupid and irresponsible. I have no coping skills for when I’m not allowed to tough it out.

It probably means I will have to (gulp) ask for help. So my husband will be with me the day of the surgery. My MIL (who is a saint) is flying down for that week. But that second week? I’m hoping I will be able to limp to the bathroom and get lunch for myself by that second week. But no way can I take care of my children, do the laundry or dishes or make dinner. And our household generates enough work to keep TWO people busy full time doing it. I’m terrible at asking people for help. I’ve had so many kind friends volunteer, and I don’t know how to graciously and gratefully accept.

I guess this whole surgery thing will teach me many things.

But first! We have a first day of kindergarten approaching. I’m hoping to sneak in a camping trip over Labor Day. I have two neat kids who are a ton of fun. My husband brought home about 20 boardgames from Gencon. We’ve had fun playing them together, and with friends. (And hey! We’ve been married for eleven years now!) And all my counters are completely covered in the bounty of my CSA. (Seriously, two watermelons and two cantaloupes!)

And of course, my usual sporadic once-a-week-a-third-of-what-I-want-to-tell-you postings will now resume. At least that should improve with surgery!

ACL? ACL? We don’t need no stinkin’ ACL!

I waited a long time in the doctor’s office before he came in. The walls were plastered with various problem joints: knee, hand, ankle; and the ways they can all go horribly wrong. I averted my eyes from diagrams of pins and screws and plates and fractures.

Finally, after a good wait, the doctor came in. “The more we look, the more we find!” were his opening, cheerful comments. “They told you about the ACL tear, right? Here, you can see it on the MRI.” (I could do no such thing.) Then he directed my eyes to several other locations on the screen, “You can see the roughness and tears in the meniscus over here. And over on the other side – that white spot is a cyst formed because your knee is leaking fluid. There’s another tear in the meniscus on that side. And see this bruising? This must have been from your recent fall. It will take quite a while to heal. We call that a bone bruise.”

At the end of the session, I have five things wrong with my knee, three of which must be addressed:

1) Completely missing ACL. He says I must’ve torn it 12 years ago when I went skiing for the first time, and I haven’t had one since.
2) Meniscus tear 1 (lateral) – from my recent fall
3) Meniscus tear 2 (exterior) – from my recent fall
4) Cyst – from the meniscus tear
5) Bone bruise – from the recent fall

The cyst and bone bruise should heal themselves – or be healed by treating the meniscus. But that’s not one, but two surgeries laid out there. I would have to get ‘scoped for the meniscus. The ACL recovery would be rather more involved, probably including a cadaver tendon threaded through my knee and attached at both sides. Recovery would be in the months – to possibly a full year before I’m 100% A-OK! And lots and lots of physical therapy. (Although there’s a good prognosis that 100% A-OK would be the eventual outcome.) I honestly don’t know if I am going to do the ACL surgery, or if I’ll do it now. Maybe 7 and 10 would be better ages than 2 and 5 to be out of commission for a few weeks. And if I’ve gotten this far without an ACL… do I really need one? I’ve apparently hiked the Wonderland Trail without one. On the flip side, they make meniscus tears more likely, and meniscus tears make arthritis more likely. I think Dr. Google and I will have a long chat about this, but there’s no rush. The doctor said I could be a triathlete without an ACL – running, swimming, biking are all ok activities. Basketball, soccer and side-to-side activities are a real problem. I’d probably need a brace for even hiking.

The meniscus tears are more acute. They’re the probably cause of my swelling and pain. And possibly I have them because I had no ACL to protect me. So I have consented to the scoping surgery. I’ll schedule it for after my summer vacation.

The crazy thing is that with all this bad stuff going on in my knee… I’m actually walking ok. Not perfect, but ok. I was walking almost perfectly, WITH all five of these elements in play. I can walk distances without harm. I have most of my range of movement. I’m just…. kind of scared of it all. It all sounds like a big, painful deal that will have me flat on my back for weeks. I mean, when I got really sick this winter I couldn’t even take a few days off from my responsibilities – and I could make it upstairs. How would I do with weeks flat down and months of weakness? I don’t have TIME for weakness.

So that’s the news. I suppose the bright side is, well, I’m wasn’t overreacting to this injury!