Thursday, August 28, 2008

Week 5.5

I started classes on Saturday for my Master's program, so I had to force myself to walk about 15 minutes in the morning from the bus stop to the SOM campus, and 20 minutes to the bus stop to get home in the afternoon. That's a lot of walking, while carrying a relatively heavy bag. I gave myself a lot of time in case I had to stop and rest for a bit, but I was able to get to and from each location without too much trouble. Monday through Wednesday were easier days to walk, as my leg got used to the extension and touching heel-toe. I'm losing some of the limp, which my physical therapist noticed when I went in for a session today.

I'm finding that my schedule is only allowing me to have one session a week now. I don't know if that's a good thing or a bad thing, but it saves me $15 in copay.

So today's session consisted of the following:

Knee warmup with stim: 15 min
Stationary bike with resistance: 10 min
Leg press: 3 x 10 x 3rd weight setting (I need to find out what that is)
Step-ups: 3 x 20 with 2nd setting
Leg lifts: 3 x 15 x 1 lb
Side lying hip abduction: 3 x 15 x 3lb
Side lying hip adduction: 3 x 15 x 3lb
Passive knee/hip flexion: 3 x 15
Heel raises: 3 x 15
Wall squats with exercise ball: 3 x 15
Icing with stim: 15 min with 5 lb weight on knee

I ended up walking 15 minutes to lunch, 20 minutes to the bus stop, and another 20 minutes uphill back to my apartment after physical therapy. All that physical activity exhausted me (despite my high threshold for pushing myself), and I crashed at home for about 5-6 hours. It's a lot to do just a month and a bit after surgery, and while I knew I was pushing my limits, I just wanted to be "normal" again.

It is getting easier day by day to get up and walk - I'm able to go up stairs again (albeit with a bit of difficulty). I still can't go down stairs without throwing out part of my hip, since my knee doesn't like to cooperate. The mornings are hard, too - I wake up really stiff, and I have to take 5-10 minutes to stretch before I can shuffle to the bathroom.

Some days I just want to sit and do nothing, but looking at my knee reminds me that I can't just stop.

Friday, August 22, 2008

It keeps on getting better, but the light at the end of the tunnel is a long way off.

I had the monthly doctor's appointment yesterday at the hospital. They ordered X-rays to see how the screws in my knee are holding up, and I was given the okay to do even more at PT. My doctor also made me bend my knee more than I normally do, which resulted in surprise (woo I can bend!) and pain (ow, too much scar tissue and swelling). It's nice to know my body is healing well.

I was able to go to PT by myself yesterday - took the bus and walked the 10 minutes on my own.

At PT, we upped the exercises a bit and the session was somewhat more intense:

Knee heating with stim: 15 min
Massage: 5 min
Stationary bike: 10 min
Side-lying hi abduction: 3 x 15 x 3lb
Side-lying hip adduction: 3 x 15 x 3lb
Leg lifts: 3 x 10 x 1lb (I still have quad lag here)
Wall squats with exercise ball: 3 x 15
Heel raises: 3 x 15
One-legged balancing on an aerobic step: 3 x 15
Icing with weight on knee and stim: 15 min

I was pretty sore after this session, especially after having to walk. But overall I'm feeling more confident about walking (with less of a limp) and regaining strength in my leg.

I know it takes time, too, and it's been frustrating listening to my friends talk about all the great thing they've been doing with their summers while I've been immobile. I also know that I can do it all next year (provided I don't get hurt again, knock on wood), but it still seems like I missed out on a lot of fun. What bothers me most is that this was the summer that I could actually do stuff - meaning that I didn't have an internship to work, and I had just graduated from undergrad. Instead, I stayed inside much of the time and hoped my knee was getting better.

Sigh. I don't want to sound depressed but sometimes I feel like no matter how far I've come, there's so much more work to do.

Tuesday, August 19, 2008

Week 4

One month since surgery.

About two-and-a-half months since the injury.

I think I'm healing pretty well.

My physical therapist has me walking (albeit a bit strained) without crutches now. Today's regimen was a bit tougher:

Knee warm-up with stim: 10 min
Massage: 10 min
Stationary bike: 10 min
Leg lifts with stim: 7 min
Short arcs with stim: 7 min
Passive knee flexion: 3 x 15
Side-lying hip abduction: 3 x 15 x 3lb
Side-lying hip adduction: 3 x 15 x 3lb
Wall squats (1/4 way down) with exercise ball: 3 x 10
Game Ready icing with stim: 15 min

My therapist had me walking back and forth during the first half of the session and the second half. I had to remind myself not to walk with a limp since I can bend the leg now. It's hard when the knee is so stiff, and it's first instinct to lock everything up and swing from the hip instead of walking heel-toe.

While I was on the bike, however, I discovered I could bend my knee far enough to rotate forward, so I was able to cycle for 10 minutes. That was a complete surprise to me, since the last session I had I couldn't go backwards without pain, let alone forwards. I hope I can make it to my school gym at least twice a week to cycle.

I'm icing with the Cryo-Cuff now since my knee is totally swollen from the activity I put it through today. Recovery sure is exhausting.

Thursday, August 14, 2008

I <3 physical therapy.

This is what my knee looks like three weeks later. The swelling has gone down significantly and I can somewhat see my kneecap again!

Seriously, I'm so glad I ended up going to Sports and Physical Therapy Associates instead of the hospital's physical therapy clinic. My therapist is so knowledgeable, understanding, and just plain amazing. And the people who work there are incredibly nice, not rushed and unhappy sounding, like at the other clinic I was going to go to originally.

My therapist decided to push me a bit today, since she felt that I was ready to get a move on my strengthening and range of motion. This is what we ended up doing:

Knee warm-up (heating and electro-stimulation): 10 min
Massage: 5 min
Quad sets with stim: 10 min
Leg lifts with 2 lb weights and stim: 10 min
Rotation movement on stationary bike (as much as I could do - I ended up doing about 15 rotations backwards since forwards isn't possible yet): 10 min
Side-lying hip abduction with 2 lb weights: 3 x 15
Side-lying hip adduction with 2 lb weights: 3 x 15
Knee arcs with stim: 10 min
Hamstring stretch
Icing with Game Ready and stim: 10 min

Today was a really good session and my therapist was pleased with my progress. I was quite pleased to see that my knee was responding so positively.

After PT, I went to visit my office and show everyone the scars and whatnot. It seemed pretty quiet for the most part, and everyone was happy to see me. I do want to go back, but not just yet. The front desk chairs aren't fit for my leg, and there isn't any other place I can sit just yet. So we'll see when I will actually go back.

A week till my first "class." I can't believe how fast this summer has flown by.

Wednesday, August 13, 2008

Week 3

I can't believe it's already been three weeks since I had my surgery. I can bend my knee to sit down now, and I've regained some strength in my quad. I still have to walk around with one crutch to support myself, but at least it's not two crutches. I've been going to PT twice a week as well.

What bothers me now is my health insurance. I've been constantly watching my claims on my insurance website to make sure they go through. One of them was already denied because my PCP hadn't sent in a referral. I spoke to them today about it after I saw that the referral had popped up, and they asked me to get ANOTHER referral for that same exact day, despite the fact that it was already in their system. If the claim still stays denied, I might end up having to pay for it . . . which wouldn't be good since I just bought my books for the fall semester (some of them anyway - cost me about $300). I'm deathly afraid that my other claims for my surgery won't be covered, despite the fact that my plan states that all surgeries will be covered as long as a referral is sent to the doctor. I had that done, but it's been several weeks now that those claims remained "In Process." That happened to the denied claim and I know that I can't afford to pay the other claims.

I hate uncertainty. I also hate how my health insurance is confusing, and while it is a good program, I can't say that the customer service is that great either. This insurance fiasco is stressing me out unnecessarily, and it's making me feel real uncomfortable about going to the doctor's again.

As for PT, I've moved up to some new exercises. This is my routine every other day now:

Heel slides: 3 x 15
Quad sets: 3 x 15
Ankle pumps: 3 x 15
Passive knee extension/flexion: 3 x 15
Side-lying abduction: 3 x 10
Prone hip extension: 3 x 10
Side-lying hip adduction: 3 x 10
Hamstring stretching

Of course, I ice and elevate every day, too, but the need to elevate is becoming less. I also massage each day to decrease the swelling. It's been helping a lot . . . the only thing I'm worried about now is the random clicking I get inside the knee. It's hard to do complete heel slides as well, since there is still some swelling there.

Things to look after now:

- New PT referral
- Continuously check on insurance claims

Tuesday, August 5, 2008

Week 2

It's only been two weeks since the surgery but I feel like it's been forever. I remember when I first tore my ACL and was waiting for it to "heal" so I could walk normally again, and now I'm back where I started about two months ago (perhaps even worse off).

The first week was difficult. Everything just hurt - even attempting to move my leg caused me unnecessary pain. But after I was allowed to remove my dressings and really start the icing, the swelling came down a lot and I started to bend again.

I think I'm at 95 degrees; I know I can do 5 degrees with an almost straight leg (which I couldn't do before). Last night I discovered I could lift my leg (with my knee stabilizer on), which means that my quad does remember what to do. The only problem with that is that once the stabilizer is off, my quad forgets everything again and I'm stuck trying to move my leg around with the aid of my arm.

I started PT up again today (and twice a week for the next three weeks) per doctor's orders to get more range of movement in the knee. I had electro-stimulation before and after my session. I could only do quad sets and heel slides (with a band to assist), but that's the regimen until my leg remembers its flexion. The next session is on Thursday - we'll see how the muscle feels then.

I've picked up crutch walking at a very quick pace - I can race people now, haha.

I hope I can at least limp by next week. We'll see.