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!