Huge

After 9am physical therapy this morning, I took the R train down to 95th street in Bay Ridge for a check-up with my doctor/surgeon/wizard. He seemed happy with his creation and decided I no longer have any use for the brace. This is good news because the brace represents extra weight and is very cumbersome to use. The physician's assistant said I could keep it if I wanted to, so in the backpack it went. I figured it could be a nice accessory to a half-assed Halloween costume. Alternatively, if I ever decide my life is going too well and I need to injure myself again, I'll be prepared. I also called the ortho-medical company that delivered my in-home rehab equipment back in August and scheduled a pick-up of the icing machine (that doubles as a beer cooler) and the large "continuous motion" machine that flexes my knee while I'm in a lying position. All things considered, life is slowly starting to return to normal.

It's still a bit difficult to get around, but things have come a long way since the first week or two after surgery. Back then, I couldn't go from my bedroom to the couch in the living room without breaking a sweat and losing my breath due to the pain it caused in my tibia and ankle (strangely). I can now bear weight on my left foot and get around the apartment using only one crutch, although I'm not sure if I'm supposed to really be doing that. I'm not a patient person when it comes to things like this, but I know not to do anything too stupid as to set myself back by causing further injury. I can take Walter out...together we make quite a sight hobbling up and down the street together. Dogs tend to take longer to do their business when they know you don't want to be walking them. Children don't know whether to stare at the strange limping man or the funny dog who prances when he walks.

The new instructions for my physical therapist include 1) flexing the knee well past the 90 degree mark and 2) strengthening my leg muscles. Hopefully in another couple of weeks, I'll be strong enough to walk without crutches or at least without a limp. I have trouble remembering what it's like to run down the stairs, work out at the gym, play basketball with the neighborhood kids, or take a run to the Brooklyn Bridge. The injury occurred in mid-July, which means it's been almost 2.5 months since I've done anything remotely active. It's maddening, but my goal is to be on a ski mountain by February. The sensations of free motion and the wind whipping across my face serve as more than enough motivation to take physical therapy as seriously as possible. One of the biggest things this experience has taught me is to never again take my health or active lifestyle for granted. All it takes is a simple act for it to be taken away, either temporarily or permanently.

So things have progressed well. I've gone from this sorry state...

...to this impressive state in only four weeks. Let's hear it for modern medicine!

Getting Around (finally)

If you don't think New York City is a friendly place, trying getting around on public transportation using crutches while sporting an ankle-to-thigh brace. I started using the subway again this week for the sole purpose of getting to school (after missing the first two weeks of class) and I've been surprised about the authentic kindness I've received. I've witnessed individuals tripping over themselves to give me a seat, others holding doors and asking me if I'm ok, and people offering to help me up flights of stairs. I always wonder exactly how someone would help me up the stairs. "Excuse me, can I help you?" "Yes! Can you bend down so I can climb onto your back? Actually, can you carry me while cradling me like an infant? That would be great." It's the thought that counts. New Yorkers can be some of the friendliest people around. If you're ever running late to JFK, bring crutches. Once there, you'll be escorted to the front of the security line and be given priority access boarding. It's like you are a celebrity who has six screaming children under the age of 3.

In Here is New York, E.B. White wrote that there are three types of New Yorkers. "There is, first, the New York of the man or woman who was born there, who takes the city for granted and accepts its size, its turbulence as natural and inevitable. Second, there is the New York of the commuter - the city that is devoured by locusts each day and spat out each night. Third, there is the New York of the person who was born somewhere else and came to New York in quest of something. Of these trembling cities the greatest is the last - the city of final destination, the city that is a goal. It is this third city that accounts for New York's high strung disposition, its poetical department, its dedication to the arts, and its incomparable achievements...the settlers give it passion...each embraces New York with the intense excitement of first love, each absorbs New York with the fresh yes of an adventurer, each generates heat and light to dwarf the Consolidated Edison Company..." This last group might be the best, but over the past few weeks I think I've been fortunate enough to be helped by all three.

In other news, I've been going to physical therapy in Brooklyn Heights three times a week. When I arrive, I feel like I've stepped back in time to the 1970s. Shag carpets are on the floors, strange flower pictures line the wood paneled walls, and the secretary looks like she hasn't moved from her desk in 40 years. My physical therapist is the lead singer of the Bee Gees and has hands the size of dinner plates. Really large dinner plates that can inflict some serious pain. I've been able to increase the flexibility of my leg from 65 degrees to 90 degrees in about a week but still have about 40-60 degrees remaining before I can fully bend it. I'm finally able to put some pressure on my foot while getting around and I'm hoping I can get down to using one crutch over the next week or two. The most important thing is that I get my leg to completely extend so that the back of my knee touches the surface my leg is resting on. It's important because this is where scar tissue can form, causing the knee to heal in a way that won't allow it to properly extend. I'm given "homework", which consists of mini exercises to do on my own. The pain is intense but it's a constant reminder that I'm on my way to getting better. That's all that matters.

Arthroscopy 101

I'm going to rewind a bit and share some of the finer points of anterior cruciate ligament (ACL) reconstruction surgery. Although my diagnosis included a torn lateral ligament, torn meniscus ligament, and torn ACL, it's the ACL that's considered to be the most important of the bunch, therefore requiring the most attention. If you're reading this and you're already bored, I apologize and you are excused. If you aren't, take my hand and let's begin this exciting journey together because learning is fun!

ACL reconstruction can be an elective surgery, which means it's not entirely necessary (unless it's a severe case). If you are willing to change your lifestyle, i.e. become less active and accept the fact that you'll never be as athletic as you once were, the injury will heal itself over time but the knee will never regain it's full strength. Apparently there are hundreds of thousands of these surgeries every year and skiing accidents represent a huge portion of the causes of ACL tears. I guess I'm not as special as I thought I once was. Just another idiot. An idiot who skied down the mountain (Deer Valley, Utah) on one leg after falling. That wasn't a good idea.

My surgery was of the arthroscopic variety, which is a minimally invasive procedure involving the insertion into a joint (arthro) with a tiny camera (scope) to assess the damage and make repairs. The repairs are made using other tools that are inserted into the knee. The incision on the front my knee is about three inches long with another incision of an inch or so made on the inside of my knee for the meniscus repair. My ACL was rebuilt using a graft from my patellar tendon, which is just one of several options a surgeon can use, including a hamstring graft and a graft from a cadaver. Once the surgeon finished his magic routine and carved a happy face and his initials inside my body, I was all set. The entire operation took about three hours, which is why general anesthesia was required. I was released into the wild after several more hours of recovery room observation.

If you've read this far, I commend you, because I almost fell asleep several times trying to write it. Also, the season premier of How I Met Your Mother is coming on in a couple of minutes and I haven't eaten dinner. Priorities.

Let the Good Times Roll

I can't sleep. While that's not necessarily news, I decided I would make the most of this particular round of insomnia and be productive for a change. My ACL reconstruction and meniscus repair surgery was about two weeks ago and I guess this is my attempt at sharing how things have turned out so far. When I think about what both doctors told me a month ago (it's important to get second opinions these days. Treat your body like you would treat a rare automobile), I laugh to myself. They both made me feel incredibly confident about the entire thing, from what the pre-surgery routine would entail to how recovery might progress. "Son, you'll be dunking a basketball and running 4 minute miles again in no time." This is what I wanted them to say. "We do these procedures all the time. It's both routine and highly successful" is what they actually said. "Your life is going to be absolutely miserable and your left leg will eventually look like it belongs on the body of a ten year old girl" is what they really should have said.

When I was escorted into the operating room on September 1, I thought I had just walked onto a movie set. There were 7 or 8 people in scrubs milling about (this many people seemed excessive, but I'm no expert), large monitors everywhere, overhead lights that could illuminate a baseball field, and a chimpanzee running around with a scalpel. When the nurses finally got the chimp out of there, the anesthesiologist strapped me down and started asking me about sports. I was onto his little game of trying to make me feel comfortable, but I played along anyway because I can be irrationally competitive. He must have won, because the next thing I remembered was waking up while being rolled into the "recovery room" of the hospital - a rather morbid place full of people in various stages of consciousness, misery, and nudity. My leg appeared three times its normal size due to the underlying ice wrap, several layers of dressing, and a brace. The pain was bad but I was given a "block" (basically a nerve injection) to numb it down. I was lucky to have my parents help me out of there a couple of hours later. I also owe my brother big-time for helping me with everything ever since the moment I came home.

So it began. The hard part. The car ride home made me want to vomit immediately, but I held it together because that's how awesome I am. I needed to save energy to get up to my fourth floor walk-up apartment. When Andrew and I first saw this place before moving in, I thought to myself "Ha-ha! I cannot wait to hurt my knee and then scale these stairs!" Going up was, and still is, exhausting. At least now I have it down to a science. The stairs serve as a good metaphor for the entire uphill battle of this recovery so far. What the doctors failed to tell me (although I really should have known) was to expect an almost utter lack of mobility over the next several days and weeks. The saying "you never know what you have until it's gone" is applicable here. The next time you stand in front of the mirror to comb your hair, cherish the moment you lucky bastard. Anyway, I wasn't worried about the operation itself, but about the crushing inevitability of being inactive for a long period of time. Apparently I didn't realize just how inactive I would be. I'll save the thrilling details for another entry.

I hesitiate to complain because an innumerable amount of people go through far worse and suffer far more than I ever will. This blog will just be my take on things as I experience them - a sort of self-serving record of some of the lousiest weeks I can remember. More (hopefully) to come later. When I can't sleep, you win!

Oh, I originally hurt myself skiing back in the Winter and finally did myself in playing basketball this Summer. I probably should have mentioned that earlier.