Feeling Sorry For Myself Therapy: An update on my knee

I'm a bit preoccupied with my recent injury and not blogging about much else, so I might as well update you on The Knee and all it entails. Warning: Self referential commentary and icky stuff below the fold. Friends, you already know much of this. People who don't know me, you don't want to read this. This is for the in between people. There will be no discussion of needles, because I'm done with the needles, so E.W., you're cleared to proceed if you wish.

Not all the people who went into the hospitable two weeks ago on the same day I did made it out alive, or at least so I assume. I'm lucky, and I use the word "luck" as meaninglessly as possible. I'm simply trying to make the point that I am uncomfortable blogging about my own negative experiences in any way other than as parody as humor, as I've done before. A friend told me the other day "I loved reading about your injury. I couldn't stop laughing! That was so funny." That might not sound like what one wants to hear from somebody who supposedly cares for you, but actually it is. That's all I wanted from my public writing about this.

I have a new relationship to the world around me for various reasons. I notice hard surfaces more now, and they seem harder. The oaken armrests of the chair I'm sitting in mock my soft human body parts. I am no longer inured to characters on TV getting thrown to the ground or whacked with 2 x 4's as seems to happen so often. Going down on the ice or missing the landing. Ouch. I feel a little burned by my experience. The world is covered with ouchy surfaces. I don't like them.

I'm wrestling with the problem of my own neediness. Lots of people are there to help, and everyone has been very good. Mostly, people are graciously taking over the things I used to do but can't now. So I see my wife now, en passant, as she goes from one thing to another. I discovered something that I can do for her that I never did before, which gives her back some time, and I hope to find more things like that. It is both heart warming and very troubling to find that yes, I really was doing stuff that was needed, and yes, I can (fortunately) be replaced, and yes, this is a huge burden for others. Not that they say it is, but it is.

I've discovered that my injury is actually rare and most people who have had "similar" injuries had something really different happen to them. My surgeon carries out hundreds of surgeries a year, and does about five of these a year, tops. The three different home inpatient visitors including two physical therapists I've seen have not done this particular kind of injury before. We are all googling me to see what to do and no do. I did not break my knee. I did not break my patella (The fact that some of my patella is gone is a minor aspect of this injury). My tendon was fully retracted. Cut in half. Disconnected. It is an ex-tendon. The knee was not dislocated, there is nothing to be pinned. The tendon simply came off, and then they simply sewed it back on, which involved drilling several holes. On the scale of things that can happen to your knee joint and you keep the leg, this is up near a ten out of ten, but with surgery and proper care I'll be fine.

Proper care means I don't move the leg for a long while, yet at the same time, deal with the fact that if I don't move the leg it will atrophy. So, I do move the leg, but only in certain ways. I have to do one painful and difficult, and in fact rather scary thing a few times a day, and just now a new thing that also turns out to be painful but is so freaky that it is worth it, has been added. So I do maybe five to seven painful variously freaky scary things every day.

Which all sounds bad, but it beats living in a refugee camp in Goma or taking a random bullet on some street corner. I just can't leave the house, get in car, go pick up my daughter or carry anything delicate or beyond a certain size including a baby.

Progress is so slow that I don't expect to see a lot of it in any short period of time. Progress is supposed to be slow. That's the thing. If I push to make "more" (of whatever I'm doing) I'll break it. I have to bend my knee a certain way, a certain amount. I know I can get the knee to bend more, faster, sooner. That is what one might want to do if this had been a broken bone or a dislocation. But under the circumstances, doing more quicker will break it. More surgery, set back to the beginning, stern looks from the medical staff, delay of start of fishing season, no carrying the baby.

Ok, enough whining. Let's talk about pain. Some of you may want to leave at this point.

I've had my share of injuries and illnesses that hurt, but I know that I'm having a new experience when I get to feel a kind of pain I've not felt before. There are several kinds of pain as you know. The stabbing white hot spike, the slicing dulled butcher knife through the joint, throbbing, and so on.

Have you ever had a shiver run through your body, perhaps because you are suddenly cold (or for any other reason)? The shiver really does start in one part of your body and then moves across different, other parts of your body. When it hits my injury, it produces a new kind of pain not like one I've felt before, such as a broken bone, torn ligament, muscle spasm, deep bruise, knife or sword wound, or being shot with an arrow. Different. The intensity is doubled if there is a fresh ice pack on the injury. So I've learned to put the blanket on when I put on the ice pack on just in case. Shivers hurt. Like a thousand angry grasshoppers jumping up and down on a delicate area of skin. On the pain scale of zero to ten its on a different scale. The weird scale. It's a four on the weird scale.

The twisted leg pain is also new. It is not an entirely unique pain ... I've certainly felt the pain of a twisting joint before ... but this is a twisting of a joint that is not moving, and that makes me feel as though my leg is somewhere where it isn't, and at the same time like it is being twisted off. But it is just sitting there. That is one of the two pains that commonly wakes me up. I wake up feeling like something's got my leg. If I put on the light and remove the blanket and stare at my leg, the pain slows down. That's the only way to make the pain slow down.

The other waking up pain is a version of the burning poker pain that is a little new for me but not entirely unfamiliar. I should mention that stabbing white hot poker pains do not actually feel like being stuck with a hot poker. That is just how we describe it. The hot poker feels quite different because of the sudden dulling damage to the neurons. This waking pain feels like a hot poker exploding OUT of my knee joint, as though it originated inside somewhere.

I can sit there for long periods of time with what I would call no pain. In fact, the pain is always there, but I don't feel it. If you ask me I'll say I don't feel any pain, then I'll check in with my knee and the pain is actually there, but I was ignoring it. So when the medical staff asks me about the pain I always pause and think about the answer, because they want to know the truth and not what my brain is pretending.

But really, most of the time the pain is low level with the occasional sudden shift to real pain, which then goes away. Unless I'm taking pain killers at the moment. Then, the low level pain is dulled out of existence unless I really feel for it (which I don't). But, since I take the pain killers strategically, the spikes of pain that come along are stronger when I'm on the pain killers. The pain is worse by the end of the day, worse at night, and worse after a fair amount of activity.

Formerly, I had two kinds of friends. Those who had seen me in my underwear and those who had not. By the time this is over, I think everyone is going to be in that first category, like it or not. I only have two outfits: A blue robe and another blue robe. I recently made enough adjustments and developed enough finesse to put underpants on and off without too much difficulty or risk. Regular pants (including whatever pants you can think of) are just too difficult because of my brace, and my need to adjust it frequently. Socks are a possibility but so is running for the Senate. Not likely any time soon.

One of the four main muscles that make up my quadriceps would not fire when I tried to flex, which was a concern. So now I have a small electronic device that will make any muscle fire. I think that quad muscle was not firing because when it did it pulled on the knee and caused pain. But now I get to press this button and force it, and having done that a bit I can get the muscle to flex on its own. That's good. Ouch. But that's good. But ouch. Well, it does give me something to do!

Two other small items: 1) I always had strangely square knees. Now, one of them is nicely rounded off. 2) This is going to leave a kick-ass scar.

So, I'm not feeling too sorry for myself, and if the above sounds like I am, well, screw you I busted my freakin' knee, man, get off my case. I am feeling sorry for my family who must endure the dead weight that is me. This enforced inactivity is scheduled for many weeks to come, and that will be followed by slow, controlled, steady rehab.

OK, everyone, stay well.

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"delay of start of fishing season" -- that's really crappie!

By ancientTechie (not verified) on 09 Mar 2010 #permalink

Sweat pants or atheletic shorts (the big, baggy kind) are easy to get on over that kind of brace and offer a degree of modesty. Also, either easily can be moved out of the way enough to access the site if you need to in a hurry. Also relatively cheap so you don't feel bad about ruining them.

Progress can seem really slow, for a long time. Be patient, pushing too hard can set you back a lot further than you think. I wore a brace like that for 4 months, and the first 2 months of it it only had 20 degrees of movement.

By Morejello (not verified) on 09 Mar 2010 #permalink

I was about to offer to find you someone with a kilt that would fit you. Then I realized you probably can't do that little swing prior to sitting that makes them not horribly uncomfortable to sit on.

You just need stripper pants.

Yea, I have the sweat pants and giant flannel pants. I wore sweat pants to the one DR appointment I had to go to. So yes, I can work with them. Also keep in mind that to sit on a toilet my feet have to be four or five feet away from each other. Now that you are imagining that (sorry) imagine that with pants of any kind, any length. It's not happening. So, it isn't just accessing the brace and getting the ice packs on and adjusting the ace bandage (all of which can be done with shorts or underpants).

Stephanie, I thought about the kilt idea and was even going to ask you about it, but I really need to be wearing thin indoor clothing. Simple activities work up a sweat. I don't know if i'd want to wear a kilt many hours a day and have to wash it daily, and as you say, there are techniques (that I'm not familiar with) that would have to be considered.

It would, of course, give me an opportunity to wear my made-for-a-kilt pistol holster.

I sit quietly, speechless.

By NewEnglandBob (not verified) on 09 Mar 2010 #permalink

I share your pain, almost literally. I badly damaged my left foot in a bad accident about thirty years ago, and was on my back for six weeks. Trouble was, I lived alone, so I wasn't even able to get food. I ended up having to get some nice old person bring me meals from the local council for two weeks. My girlfriend happened to be overseas for that period.

I hope you have better support systems than I did back then.

I missed your original posts about this, hope the recovery goes well. Best I did was tear my patella which snapped right back in place so no surgery was needed -- but there's something about a knee injury that is just so incredibly squeamish-shudder-inducing.

And the tale of you thumping on the floor as everyone checks out Huxley was indeed funny.

Actually, Greg, keep the kilt in mind once you're a little steadier on your feet. Managing one doesn't take that much, there are a few around in very lightweight fabrics, and they have the advantage of being something you can throw on when a visitor shows up. You're going to have a lot of those.

I can so relate to the paragraph about your changed attitude toward hard surfaces! A couple of months ago, I trotted out my front door with a carefree step, trod on a patch of ice, and landed on my face, seeing stars as I hit the ground. Luckily, there was no concussion or broken bones. But now I can't walk in the dark, or on my driveway at any time of day, without a slight trepidation. I wonder if I will have stopped hesitating when I pass that spot by the time it's 80 degrees out. (Very glad I can't relate to the rest of your post, of course.)

I feel for ya. I fell June 2006, tripped over a little hole in a parking lot. All my (substantial) weight landed on the end of a speed bump encountered first by my right knee; my left knee landing on the parking lot level.

My injuries were not serious. I could walk without pain the next day... but I could not stand for anything, including clothing to touch either knee for a few weeks. I finally had the right knee xrayed 3 months later because I still could not tolerate anything touching it.

Knowing the pain I felt (and still feel sometimes) with what amounts to a huge bruise, I am having trouble comprehending what you must be going through. I'm thinking there are no painkillers THAT good.

I disagree with a lot of your opinions, but I feel for you with the knee pain.

If a man-skirt would work for you, how about a sarong instead of a kilt? Tropical-weight fabric, and it wraps on and off. Mid-calf length, so it shouldn't ride up when you sit down.

I have much empathy. Reading your story, I involuntarily bent my knee (that has an old injury) about 45 times. I wish you safe recoveries, and please keep blogging about it. Like I have to tell you that!!!

I am accustom to wearing the Central African version of a sarong (for men) and I'm comfortable in loin cloth. I often wore a loin cloth in the Ituri. Here in the US I only did that once, and that was for Halloween. I was dressed as myself in a loin cloth. The loincloth and the kilt in combination should work, especially as spring approaches.

I recommend velcro boxers. They are in common use in rehab and I'm surprised nobody has given you any. Picture regular longish boxer shorts, with velcro along the complete length of the outside seams. To get on or off, there is no need to get a leg or two thru a garment, you just stick them between your legs, pull up the front and back, and slap the outside seams together. You could use them as shorts outside in the summer as well. Let me know if you're interested, I'll find some for you. Patients love them, especially the guys.

I was just about to suggest the velcro boxers also. I don't have any though.

The reason stuff atrophies is because the nitric oxide that is generated when it is used isn't present to signal the building up pathways.

When bones are strained, they generate NO and that NO signals deposition of more mineral exactly where there is the most strain.

Similar things happen in other mechanical tissues.

I had a similar experience with my reaction both to proximate hard surfaces, and my reactions to characters on TV falling or getting whacked, after getting sideswiped by a van while bike riding ca. 20 years ago. Since then, increasing age and my inherently poor balance has put quite a damper on my willingness to do much of anything in icy weather.

Ob. Stupid Hospital Tricks:

When I got sideswiped, my bike bounced off the side of the van, but inertia intervened and as he continued to turn, I struck again. There may have been some interaction with the rear bike wheel; I went down hard on one side of my pelvis, the courier bag under my ribs, and the foam lining of the bike helmet cracked in multiple places. I ever-so-slightly skinned an elbow.

I have a significant double-major scoliosis; it twists first one way then the other, with significant rotation, first one way then the other, and the thoracic rotation rotates the rib cage. Lying on a flat, firm surface (like a backboard) is exceedingly uncomfortable due to loss of flexibility (even osteoarthritis in places), even moreso when the thought (by me) cracked pelvis is taken into account.

At the hospital, the priority seemed to be to check for cervical injury. This took a while, as apparently a part of the procedure (maybe having to do with insufficient ER beds) was to put me on a stainless steel table and abandon me for half an hour. Now, it was a hot day, I'd just biked about 10 miles, and was wearing bike shorts (lightweight tri-shorts probably) and a sleeveless t-shirt. On a heat-conductive table. Under an air-conditioning vent that was part of a system intended to cool not only that building but the nearby Charles Street T station in Boston.

Recap: pelvis I think may be cracked; damaged short ribs; being forced into an impossible contortion, i.e. lying flat like a normal person, causing my lower thoracic spine to complain and my right scapula to feel like it's being pried off of me, I'm shivering like hell so of course all the muscles are tightening up.

Eventually satisfied that my neck was intact, I finally get onto a bed, and they start sticking electrodes on me, possibly mixed with other sorts of examination; I remember being surrounded by 3 or 4 people. Of course, this involves pulling up my shirt.

I had pierced nipples (and not those dainty little mall earring types, but something like a metric 12-gauge).

One of the nurses gasped in horror, and looked like she was going to faint. She didn't, but managed to say, "Doesn't that hurt?"

By Uncle Glenny (not verified) on 09 Mar 2010 #permalink

"Formerly, I had two kinds of friends. Those who had seen me in my underwear and those who had not."

I very clearly remember saying "never woulda guessed i'd see you in a bathrobe" when i walked into your (in-laws) house the other day. I'd like to hope I followed with a proper hello, but I can't remember....i think i was in shock. lol.

Asha, I'm going to say something that as an artist and a writer you already know: Sometimes a thing happens that can't not turn into something. A moment in your life turns into a song, for instance. Surely I knew when you made the bathrobe remark that there was going to be a blog post....

I'm not sure if there was a proper hello, but that's OK, I think we did that number at least once already. We're beyond that. We've moved on to "What's in your refrigerator and can I fix your DVD player for you?"

Anyway, I can see why you would be in shock. It is a VERY nice bathrobe. The blue one.

It sounds like you're handling the injury about as well as well as anyone can. I don't have any of my own stories of severe injury (combination of a physically inactive life and dumb luck), but I know something about how much it changes a person's life from family and friends who have had serious injuries.

You may want something like these in addition to the Velcro shorts: track pants that open on the sides.

And, of course I wish you well and hope you have a recovery that is as speedy as possible.

Greg, a practical discovery from when I spent 2008 with each leg out of action in turn:

You can open the outside seam on a pair of pants and attach velcro or tie closures along the opening. The result is a pair of pants you can wear over a cast or brace.

I found it damned handy (esp. with fleece pants) in an Arizona autumn; I hope you find it even more so in a Minnesota spring.

By D. C. Sessions (not verified) on 10 Mar 2010 #permalink

Don't rush it and in a few months you'll be picking up Huxley again.

As for your 4' - 5' leg separation on the crapper: please don't use a public toilet...I don't wish to hear about Greg Laden's arrest for "Wide Stance" solicitation.

Your physical therapist can register at orthopaedicprotocols.com and can find guidelines to help you progress safely. A combination of the high tibial osteotomy rehabilitation protocol and lateral patellotibial ligament reconstruction and patellar realignment with osteotomy for patellar instability would probably help guide your rehabilitation.

Your therapist can also do some manual techniques around the knee joint to potentially address the "twisting" sensation. Without knowing the mechanism of injury - the sensation you are feeling could be a combination of the way the injury happened OR the simple fact you aren't using your knee so your brain is making up stuff due to lack of input from the knee going into your brain. Not sure if that makes sense... but the same kind of weird stuff happens to people who have lost an arm or a leg except their complaint of pain has a combination of a weird position and very tight spasms in the non-existent body part. I know weird...

Disclosure: I am not associated with orthopaedic protocols. Just thought I'd offer my insight so you can get back to life sooner versus everyone floundering over how to progress you! :)

It's not pinin,' it's passed on! This tendon is no more! It has ceased to be! It's expired and gone to meet its maker! This is a late tendon ! It's a stiff! Bereft of life, it rests in peace! If you hadn't pinned him to the patella he would be pushing up the daisies! Its metabolical processes are of interest only to historians! It's hopped the twig! It's shuffled off this mortal coil! It's run down the curtain and joined the choir invisible! This...is an EX-TENDON!

Okay, so what are you reading while you are incapacitated? Unless the pain meds make it heard to concentrate, I'm guessing you are reading a lot and we'd like to hear what, and what you think about it.

It is true that I'm not spending a lot of hours in the day reading, but I am reading some.

I'm reading an unpublished novel that I won't say anything about, and a book called The Dante Club. Later today I hope to get my kindle charger and then I can also start reading whatever the heck I was reading before. Which I recall not being very good.

Having an arm in a cast drove me insane (I don't think I ever recovered). Tearing a piece of my patella was no fun either, with the leg atrophying (losing ~30% of volume) in only a few months and taking years to get back to almost normal. I wonder if brains atrophy at a similar rate? With my current job providing no intellectual stimulus I suspect my head is almost as empty as Jenny McCarthey's by now.

By MadScientist (not verified) on 11 Mar 2010 #permalink

Aha ... people going ice-shy and "any hard surface shy". When I was smacked in the head with a softball I turned softball and baseball shy for a few months, but for whatever reason when I was shot by a moron I never turned gun shy.

By MadScientist (not verified) on 11 Mar 2010 #permalink

I am a compulsive reader (can't go to sleep at night without reading) and I read mostly non-fiction. However, Verghese's "Cutting for Stone" is an incredible novel and out in paperback and I highly recommend it. If you are interested in reading about the causes of the current recession, get the Joseph Stiglitz book "Freefall."

I review some books before they are published as part of Amazon's Vine program.

Here's a link to my reviews on Amazon if you have any interest in adding to your "to be read" pile:

By Anonymous (not verified) on 11 Mar 2010 #permalink

I know the feeling. Broke a shoulder, and could not move half of my body for two weeks, another six weeks before I could shrug. Do ask friends and families who come to visit to read to you. While convalescing, I learned to sit still and listen. It wasn't bad. Pain and injury can get one feeling down (don't underestimate that) so there's a good reason for you to be determined at being cheerful.

I would heartily recommend either a hippie skirt or a wraparound skirt - trust me, they are comfortable and (relatively) easy to manage.

And as I have the capacity, I will feel for both your family and you. I hope you manage to heal quickly and without complications.

Finally, I would like to congratulate you on managing a relatively rare sort of injury. The best I have ever managed was to pull a muscle in my back that is almost impossible to pull. This totally blows that out go the water, though it did in fact have me crying like Huxley probably cries sometimes.

Hey, I understand all too well about the twisting sensation even when you're sitting still, not moving the knee(s) at all.
I'm at a place in my arthritis (both knees, lower back, right thumb) where the cartilage seems to go all chalky and fall apart in spots.
There's swelling, a feeling that someone is jamming a thumb between the bones and wiggling it around and, my favourite: the sudden, unpredictable & EXCRUCIATING pinch like biting one's cheek/tongue, or getting a finger caught in the car door hinge.
At times like this, all I want to do is curl up in front of the TV, wrapped in a big warm quilt & overstuffed pillow, a hot chocolate and big bag of tortillas with dip. I don't want people over, and I don't want to do anything. I'm angry and frustrated and ashamed of being so pathetic.
Still, the stark reality is, IT *HURTS*, DANG IT!!!!!

I have had my tendon cut as well. Totally get the pain descriptions. It never totally goes away. Still feel the odd gripping and white hot poker at times. Oh and like I scraped my knee on the inside of my skin. Hope things have improved for you.

I would heartily recommend either a hippie skirt or a wraparound skirt – trust me, they are comfortable and (relatively) easy to manage.

By Giuseppe Lowe (not verified) on 08 Feb 2017 #permalink