meniscus – My Truant Pen

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!”

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!

Kneed an update?

I am categorically incapable of figuring out how sick/injured I am. I hate it. Unless you’re running a fever, it’s so…. subjective. I mean, I have quite a high pain tolerance. I gave birth without so much as Motrin twice. (Witnesses claim I whined a bit towards the end of the second time, but what do they know?) I also apparently find my own motives hiiiiighly suspect. I must, in my heart of hearts, think I’m a lazy piker who’s totally overselling this hurt thing to get sympathy.

So when people ask me how I’m doing (or what happened to you) my knee-jerk reaction is to make a joke or a light comment out of it. Deflect. I don’t have the data to back up any assertion I might make.

How am I doing? Well, yesterday I used — and needed — crutches. I discovered I have a lot of upper body strengthening I need to do. (See there? Deflection.) Yesterday I found the walk between desk and car appallingly difficult. Yesterday I was mentally shaky and foggy – I’m still not sure why.

Today is better. I got a good night’s sleep. I stayed off my leg all afternoon and evening yesterday (except putting the boys to bed). I iced it and elevated it. This morning when I got up, it felt noticeably better. But as one of my colleagues reminded me this morning, healing from these kinds of injuries is not linear. By 3 pm today I felt completely worn down, sore, swollen all over. That’s actually been one of the harder parts – my entire body seems swollen and bloated, possibly from lack of accustomed movement, or maybe a side effect of the medications I’ve been taking.

I have an appointment with an Orthopedic surgeon on Thursday. The office is so close to my house, I could walk it. One block. It will feel completely lame-o to drive. I presume the dr. will do a cursory examination and then order an MRI. Another few days for that, and then I’ll finally have some facts. (Of course, if the facts indicate it shouldn’t be that bad, I’ll feel silly.)

I also totally need a better story about my injury. This one takes too long. “I jumped off a four foot wall” is sort of odd unless you get ALL the backstory behind it, which is jut tedious. No one seems to be buying the “ambush attack by kung fu ninjas” version, either. Darn it all.

So that’s where I am: wishing I had actual data to quantify my injury/pain, feeling somewhat better, trying hard not to push it, going to the doctor on Thursday.

Turns out you need your knees

Back in my Sophomore or Junior year of college, I once went on one of those “Spring Break” trips college students are supposed to do. However, I hung with a crowd that was responsible, practical and quite nice — so our Spring Break blowout was a ski trip to Loon Mountain in New Hampshire. The wildest we got was a reenactment of Braveheart in the living room. I recall now the 12 or so of us descending on parental houses on our way up and greatly admire the fortitude of those parents putting up with us!

It was my first time skiing. My father has very bad knees and my mother no powder-ambitions, so despite living quite close to some first rate skiing, I had never in my life strapped on those devices. Our first day my then boyfriend, now husband, patiently took me on the bunny slopes, showing me how to move about on my rented skiis. I did pretty well. After an hour or two, he decided that I was ready for my first gentle slope.

I made it halfway down that slope on my own power. The second half was in the back of one of those ski patrol sled thingies. I had badly injured my knee.

I’ve never gone skiing again. I couldn’t walk properly for nearly six months.

The rest of that fateful trip was spent in agony. I hadn’t learned critical lessons like: pain killers help kill pain, going to a doctor when you’ve seriously messed up your knee is a good idea, or the critical “Always pack enough books so that if you bust your knee on the first day of a weeklong skiing trip you will still have enough to read.” The “bookstore” in town carried pretty much nothing I wanted to read. It’s a spot that happens to be convenient to our summer camping trips now, so I return not-irregularly, and always wince when I do.

So why do I bring up this fateful memory, now in the lushness of mid-May?

Well, I’ve had highly intermittent trouble with this knee. I likely tore the meniscus badly. The meniscus provides side-to-side stabilization, and does not heal once it’s been injured. So every once in a while doing something simple like stepping across a log, or putting a child into a car it “goes”. The knee slips out of position. It hurts like Hades for about 5 minutes, then I can at least go about my business. It aches for 24 hours, then is forgotten.

Yesterday, a lovely fine day, my husband and sons were playing baseball in our stamp-sized back yard, and Grey hit a “home run” over the fence. I had a few extra moments, so I figured I’d make myself useful by shagging balls. Now, there is no easy way down from my yard to the downhill yards. We have a 12 foot cement wall separating us. So at one point I had to jump down about 4 feet to the next landing (my neighbors yard is lower and terraced instead of having one big wall). I was quite careful (and had done this many times before). But this time, when I landed, excruciating agony was my reward. I laid there, frantic in pain, and called for my husband. He fetched me, helped me back up (the long way) and got me to ice my leg and take ibuprofin. (See? That right there? That’s called maturity and learning from your mistakes.) Thirty minutes later, out of town friends of ours appeared at our doorstep for dinner.

As it became obvious my leg was not going to “bounce back” (and I worked my way through a full injury-shock cycle), I called my neighbors, who are Physicians Assistants. My friend the ER PA came over, looked at my leg, and explained exactly what I should do. (Which involved going to the ER, getting an X-ray so if we need an MRI we won’t have to jump through that hoop, and getting crutches.) Now, usually going to the ER would be really hard for us. There aren’t any grandparents around to call for backup (although we do have great friends and neighbors we could’ve leaned on if we had to). But this time… voila! There were our Maine friends right there, happy to help. So that’s how it all transpired.

It’s not yet clear to me how badly injured I am or am not. It definitely not just a slip. I think there must be some additional injury or tearing (although it might be just a sprain?) I’m set up for a full-fledged Incident, with orthopedics etc. I have a knee immobilizer, crutches, and plenty of Ibuprofin. I slept in a looong time this morning, reckoning nothing does better for healing than sleep. My husband has set me up on the couch, and my plan is to let the knee be for as long as I can. I’m starting to feel hopeful I’ll be able to move about somewhat tomorrow (you know, go to work?) and not be a bump on a log for the whole week.

But I’m struck by how lucky I am in all of this. I have done that same “shagging balls” when I was home alone with the kids. I don’t know what I would’ve done if they were in the backyard and I was direly injured hidden in the fields behind them — especially if I hadn’t had my cell phone with me. But this time, my husband was right there and ready to help. Then having a neighbor so helpful and nearby was truly amazing. It certainly helped me prevent repeating my mistakes from the initial injury. Next, having friends happen to be in the neighborhood who could and would watch after my children while I went to the ER with my husband was a tremendous stroke of fortune. Handing over my insurance card at the ER, I considered how blessed I am to have good insurance, so I could seek treatment for this injury and afford to pay for it. And of course, I’m so lucky to be married to a loving, capable partner who can take care of me and our family through all of this. Finally, it just so happens that this is a week when it’s ok that I’m not 100%. Those weeks are rare.

No one gets through life without bad luck. We all get sick or injured sometimes. I feel remarkably blessed, though, that my bad luck came with so much good luck associated with it.

My son is trying to kill me

The other day I picked up a two year old girl. I’m quite accustomed to picking up young children, since one (not naming any names THANE) walks wonderfully well, but not in the directions I want him to go. Therefore, traipsing between engagements, he gets carried. So when I picked up this little girl, I thought I knew what I was doing.

I nearly threw the poor child into the ceiling, she was so light. Featherlike, even!

My son is not. No, not he. Not Mr. I’m Wearing 2T Clothes at 13 Months. Not Mr. I Eat More Than My Four Year Old Brother (Please Pass the Cheese).

We’ve decided to call him Mr. Moon, actually, because 1) he is entirely made of cheese 2) he weighs as much as a huge lump of rock.

I digress. That sweet child is attempting to kill me, his loving mother.

Friday when I went to pick him up from daycare it was slippery. I had just gotten my young son from Abuela and had given him his first 20 “I missed you” kisses on the cheeks and was walking down the stairs to the car, holding his massive weight in front of me. Now you think you know what’s coming, but you’re wrong. I can’t blame the fact that there was one more step than I expected on the slipperiness. I just plain missed it. I tumbled to the ground, using my body in ways it was not intended to be used in order to keep my baby from hitting the pavement. Better yet, Abuela was still watching from the door. If my body is going to already have to take a hit, couldn’t my dignity at least be unblemished? But nooooooo. FYI, he’s heavy and has a lot of inertia.

Yesterday I had a less than delightful day and was glad to be trudging home. My husband was doing aikido until about 8:30, so I was on my own with the boys. Grey was just telling me how his preschool teacher was unhappy with his attention span and filling me in on exactly which joke drove her nuts during Circle time, while I carried Thane to the car through the snow.

Flash back a million years to college. One year for Spring Break about 10 of us rented a condo and went on a ski vacation. This was possibly the most exciting vacation I’d taken without parental supervision, although we were the tamest, most polite bunch of college students you’d ever want to meet. (Except for the home made pudding. Don’t ask.) The very first day, my boyfriend (now husband) took me on my very first ski trip. We spent an hour or so on the bunny slope. I was doing well. Then we went down our first real run.

I made it the rest of the way down the hill in the back of one of those ski patrol sled thingies. That was the first and last time I ever went skiing. I didn’t walk properly for about 6 months. As a permanent reminder, I have a torn meniscus in my left knee.

You actually need your knee ligaments for less than you might think. I live my life quite happily without it, most of the time. I backpack and play raquetball. I hoist my kids around. But every once in a while my knee is in some position where it needs the support of ligaments it no longer possesses. When that happens, I crumble to the ground in blinding pain.

And so it happened. I took a step. My knee collapsed into agony and so did I, once again holding Thane and attempting to keep him from hitting the ground with me. For a very, very long five minutes I was kneeling in the dark in the snow next to my car trying very hard not to cry while Grey (oblivious) whined about why I hadn’t opened his door and Thane squawked protest to my death-grip on him. And what can you do, so vulnerable, in pain, responsible? You pull yourself together, attempt to stand, buckle people into their car seats, and call various members of your family to complain.

My knee is very achy today. If experience is true, it’ll be sore and stiff for a week, and gradually get back to normal.

I’m hoping my “bad luck in threes” was actually fulfilled this morning. Right in front of me, a driver failed to notice the slowing traffic and plowed into the car in front of him, making a nice 4 car pileup that I had front row seats for. A state patrol officer was right there. No one was hurt — I pulled over to see if they needed my eye-witness report which they didn’t.

I do hope that there isn’t another fall ahead with me holding Mr. I Put Lead Weights in My Diaper, because I’ve been very lucky so far to only hurt myself.

Wish me good luck trying to avoid his next assassination attempt!

Little innocent me? Never. You don't have any cheese, do you?