11 week Mark

T.G.I.F

Fridays have become my new favorite day. Friday is how I mark another completion of a full week of recovery. Fridays have become milestones for me.

I have to say the cliche thing now--The weeks have NOW been going by fast. I can't believe its already been 11 weeks and I'm feeling this good. 

I returned back to work last week under full supervision of the amazing PT staff at HSS.

                                Not that I'm trying, but I can't get away with anything! :)

I work with a brilliant team of physical therapists who have gotten to know my personality the last year and a half to know what I should and shouldn't be doing. I am not allowed to carry more than 5 lbs, so that means my clients have to work a little harder than they did before!

It has been physically challenging to be back in the swing of things. I have created this awful habit of taking a cab to work (10 blocks...I know don't yell at me). I was advised to do this from my Dr. In all honesty, she said to not walk that much....so I figure its okay. :) My hours start at 6 am and end at 2 pm. Talk about a large switch from sleeping in unit 10 am everyday. Its like I'm living another life...trust me, it isn't a bad one!

My right single leg squats will knock your socks off

The best part of these last few weeks has been the ability to progress into a smaller more mobile brace. Not only is it lighter and allows for more mobility, but its also silver and bad ass. Something like daft punk meets terminator. Its a conversation starter for sure. I even met a new friend at the gym to workout with, we met over conversation about our crutches and knee braces. We have since put together some workouts we can do with only one good working leg. Fun fact: during out workout yesterday I burned 5000 fuel points on my NIKE FuelBand. My arms are fried today.

Knee Braces bring everyone together.

I  have slowly progressed to walking, riding a bike, hip exercises, core exercises, retrograde treadmill walking, therapy pool sessions and balancing. Next week starts the fun life of learning how to walk up and down stairs. I have noticed my deficits in strength and balance. My neuromuscular control needs a kick in the ass, and my quad needs to get SOME definition back. Straight from my clients mouth: my legs are my best asset! One 'step' at a time. Literally. 

The leg press for me has been the hardest. I mean lets get serious, I've done harder things including flipping tires and squatting 2x my body weight. I have done the entire stack on the leg press (I don't even know the last time I used this machine). 

My therapist put me on the fabulous body master beast of a machine, placed the weight at 50# and said to push with both legs.

I looked at her like she had lost her mind. "Jess, I was doing the whole stack before this." I said. She didn't say anything and just told me to do it. After the 2nd repetition, my quads and glutes were shaking so much that I had to take a break in-between my sets. How could this have happened!? My patella was tracking all sorts of directions and I was so scared to feel a shift of weight back on the left leg again. I had to slow down, connect my brain with my body again and control every little movement. 3x10 at 50# bilateral. Work has started. As my quad regains its strength, I have been able to progress to more weight and now taking control of my patella...showing it who's boss. 

I've learned a lot about myself, my body, and my limits these last 12 weeks. I've also learned not to sweat the small stuff and to not take anything for granted. Rehab is hard, no doubt about it. I have a new perspective of how and why I do my job not only for my own rehab, but for others as well.

 

Chapter 4: The healing Continues...both mind and body!

Check it out: I started walking again! After a 7 weeks of intense relaxation and recovery...my left foot touched the ground again. Woohoo! No, this doesn't mean I'm training for a triathlon, crossfit, or even summer. It just means that I'm officially putting weight on my left leg and learning how to walk normally again. Its the small things in life that make it all worth while. 

My 6 week follow up with Dr. Shubin Stein went great. She was impressed about how I was doing and how strong my leg was after 6 weeks of shutting it down. This picture below to me looks so sad about how atrophied my quads have become, but have no fear because they are still firing! I was instructed to start putting a certain amount of pressure every two days to eventually return to weight bearing with the brace and crutches as support. So far so good: I just take 4x as long to get places. Just when I had the left leg swing non weight bearing gate down, I now have to change it all up! I was actually getting so good that I would walk as quickly as my friends...on my mobilegs. Not normal. 

The last thing I'll say about returning my left foot back to earth is this; I had this revelation that I grew taller. No, really I had to raise my crutches up another notch because my posture had changed! I'm back to the 5'3 I always was! 

6 week check up: check out THOSE screws!

 Along with my physical rehab, I had to mentally check in as well. I went to Baltimore/DC/State College to visit my sisters and Parents. Met up with a few friends along the way. Even had a taste of old bay and Natty Bo in the 410. 

My younger sister has a heart of gold and gets to hang out with this little munchkin all day. How I wish I was 4 years old again...laughing, doing hair and nails all day, and hanging out with my sister...this girl lives the life! Melli and Emily took care of my 'boo- boo' on my leg for a couple days while we made mac and cheese, played princesses and waited for our princes to arrive. Even though they didn't come, we realized that all we needed was each other to be happy!

I then went to Penn State to hang with my parents for a couple days. I'm still rehabbing and taking care of my leg by seeing Saz in the training room at PSU. Home away from home...but this time I'm on the other side of the table...being treated not treating. Penn State will always be a part of me. Sitting outside in 65 degree weather watching the Men's Lax game with my Dad...these days I feel pretty blessed. 

I woke up this morning to the smell of freshly cut grass, sunshine and my Mom! I'm back off to the training room to do rehab...I actually got on the bike yesterday for 20 minutes. besides being out of breath after the first 10, It felt amazing!

Something about taking care of yourself mentally while going through changes physically makes these times a little easier. Thanks to the people in my life and where I've been....who knows where I'll go next!

(no worries NYC...I'm still coming back!)

Chapter 3: week 4 and Deep breaths. 

This week was tough. I can't sugar coat this. One of my good friends posted a quote the other day that went something like this..."Life is 10% what happens to you and 90% how you deal with it." Its true, my legs are not giving out on me, its my head that is in the wrong game...Can't give up on this now. 

Week 1: adapting to my surroundings, hanging with my mom (what could be better), receiving flowers, cards and cupcakes.

Week 2: On my own, eating all the cupcakes, lots of visitors, starting to adapt to NYC by cabs, trying to get a routine down in the gym. 

Week 3: Routine is in check, wishing I had more cupcakes, upper body workouts in place, learning how to move around better in my apartment, starting to read and explore.

Week 4:  Frustration has set in, rain+NYC+crutches= tears. No energy to make cupcakes. No little debbie here, just debbie downer. 

I have a great understanding that this was an elective surgery. This week was tough, and I'll explain why. I will spin this for a positive, don't worry. :)

This past week a lot has happened... 

1. The weather finally turned into 'spring' in the city and the sun is out. Vitamin D does the body good, however a hot brace and funky tan lines don't. I am lucky to live in an elevator building, but the process of first getting dressed for the weather is what wears me out. Packing a 'backpack' for the day and trying to make it look stylish? Did I mention sweating?  Forget about it. 

2. I had my first physical therapy appointment on Friday. God bless my therapist Jessica Hettler as I show up with make up all over my face and not being able to talk due to sobbing.  She was calm and patient with me and took my mind off of the negative and turned it around to allow me to see some light. All looks good and I'm right on target with my recovery. I got to 68 degrees of flexion! 

All positive things. It was getting to the appointment that was the worst. It was pouring down rain and it took me 35 minutes to get a cab because it was 9 am rush hour. I was going 10 blocks which equals a half a mile, which equals almost no effort for someone like me who would teach spinning 6x/week. I was now drenched not only from the rain but my face was covered in tears. I was hesitant to move in fear I would slip, my hands are occupied by my crutches, and my phone was in my backpack so it made it hard for me to even stop to call for a ride. It was a day where 'nothing is going right, get me out of this brace, I'm over this' type of mentality. I also didn't have a cup of coffee and that's never a pretty sight. As the day went on and the rain continued I had to keep moving.  My mom said the best thing to me. "Just remember this will all be worth it in the end, remember the amount of pain you were in before this, it will be a journey but you can do this."  Moms are always right. 

3. I went on a date: yes...gasp a date. I gotta do this right and dress to impress. Thankful for my sisters/bff's/sisters from another mister in this city or else I would have been a mess. Hair done, nails did, brace on, (oh wait that's not part of the song). I was ready. As hard as is was for me to swallow my pride of looking 'handicapped' I did it. We had a blast. Dinner, Jersey Boys on Broadway and a rose...what more can a girl ask for?

Needless to say: don't let a brace and crutches define who you are, you have to let your personality make the first impression. Oh, and also don't let them stop you from dancing (in your chair that is.)

Ready for a night in the city

4. Adding new exercises and a routine to my life. I continue to lose muscle mass, as seen in the picture below...sometimes I think its okay because we know the size of my legs prior to this surgery. Just embrace it. But this picture tells a lot of what has to be done for the upkeep of my leg...we also can't forget about the rest of the body. My current routine is listed below: Its a little intense so brace yourself.

battle ropes say heyyy

Daily Knee Routine: 

1. Kneehab unit for quad stimulation and contraction: 4x/day for 20 min each. I use a towel under my knee for quad sets. 

2. Bone Stimulator: 3x/day for 20 min each. Doesn't feel like anything, just gross to clean up after the gel. 

3. Continuous passive motion machine 4 hours a day. I am now able to allow this machine to move my knee to 60/70 degrees of flexion. Its almost getting to the point where its calming. Its a great conversation starter too: people want to try it. I'm going to start selling tickets.

4. Ankle pumps with green theraband 3x10

5. Calf stretch 15 seconds 3x10

6. hanging off the bed assisted range of motion stretch (now we're talking!!!) 

7. Game ready/ICE as often as possible. 

Now to the good stuff: THE GYM!

1. UBE: As mentioned in the previous post, we have now formed a new relationship. I think its really going somewhere special. 

2. Glute squeezes. Trust me I've researched and tried to think of it all...this ass needs a lift and thats the only exercise I can come up with. As per a conversation with a friend the other day "why don't we work on getting you walking first before you start thinking about butt exercises." Thanks Jon Fass. 

3. Cable unit: lat pull downs, single arm rows, trunk rotations, chops, lifts, overheard presses, tricep extensions, bicep curls. 

4. Free weights: as long as I'm sitting or lying down, I can do it all. This is where I add in chest exercises IE: alternating dumbbell presses, flys, tricep extensions. 

5. CORE: I've been doing a lot of pilates based roll ups with and without weight. medicine ball throws against the wall (also great for the arms). Regular and side curl ups. And my favorite of all time: battleropes. 

Now I couldn't have done all of this on my own....thanks to great friends like Jill Greenwood and some rockin' trainers to lend a helping hand I've been blessed with getting my sweat on at a time like this. 

At the end of a strength session: I typically feel like this:

I promise I wasn't jumping on one leg over those cones. I wish...

5. Nutrition 

Now: on to the holy cow I can't eat like I used to part.

Throughout these 4 weeks I can honestly say the best I've eaten and felt the best was week 1 when my mom was here. Nothing better than Mom's cooking. We only ate out once and it was Thai food. YUM. My mom prepared meals for me that I never thought possible in my small Manhattan apartment. 

After she left: I thought about doing a few things. I researched nutrisystem, heat to eat meals, juices, you name it. I did end up buying a package of BluePrint juices in which I drank for a couple days, but by the end of the day--all I really wanted was something to chew on. It was a great purchase, but something about just drinking your meals wasn't the most inviting thing to me to sustain. I mean...a girl also needs chocolate.

                     

blue print juice

So  now, I continue to eat things in moderation and when I'm hungry. Its honestly hard to be on crutches and to maneuver food and beverages around your own apartment. I like to cook, but standing on my right leg the whole time I'm attempting is never a fun experience. I'm sticking to ordering my 'fresh direct' food delivery every week and getting fresh fruits and vegetables, mixing it all together and making sure I get my daily dose of vitamins in order to heal right. 

I'm also taking my supplements per Dr. Shubin-Stein consisting of:

1. citracal

2. Vitamin D

c'mon Bone...heal faster!!

6. Finding things that make you smile. This week was rough. Yes now I understand that I can't let my legs do all the talking, I have to keep my mind strong. Its the small things in this world that you miss out on if you continue to feel bad for yourself and keep your thoughts in. I went to visit the kids I babysit for today and remembered how to use my imagination, laugh, and smile. We had a pretty intense concession stand going on in their back yard...thank god I'm only 5'3 and I could fit in this club house. 

7. Knowing that there are other people out there that are going through the same thing as you are.  I have a friend all the way across the country who is a devoted trainer and athlete who tore her ACL 6 weeks ago She texted me the other day that she was in pain and couldn't understand why--what was going on--oh just a fractured patella. We are now twins across the country with left legs that are out of commission: but it is our goal and job to support each other...and damnit we will find a way to squat again. Emily Zaler--girl we got this!

I also made a new friend last night at a restaurant... his friends approached me because we had matching 'crutch covers.' So, we posted our crutches up next to one another, sat down and shared stories. We had in common mutual feelings of how it was difficult to get around, expensive, annoying and frustrating.

We also had in common how amazing our friends were that they wouldn't let us sit at home alone on a Friday night...

he was jealous of my mobilegs

Chapter 2

CHAPTER 2: Work it Out

To clear up any other questions from the procedure: I snapped a photo of my operation report. If you want to geek out with me about it: Please...lets talk!

No Complications: AMAZING. SUCCESS

My 2 week follow up was great: stitches out, range of motion was great, quad sets in place.....Now what?

had to throw in an awesome x ray

I've been taken out of my 'everyday' life. My work, my workouts, my social life: its all different now.

I have to switch my mindset and start asking people for help. This has been one of the hardest things I've done in the past two weeks.  If you know me: you know how independent I am.  If you don't, to give you an example: I've moved 7 times in the past 7 years, with the past 3 on my own apartment. I started a paper route with my golden retriever when I was in grade school.

If I don't know the answer: I'll seek out and ask questions. However, it has always been hard to depend on people, I always want to fix it and do it myself. I have to switch my mindset on a lot, but this has been the hardest.

Now: with only one leg, I've realized how much harder daily activities (such as showering, taking out the trash, making dinner) are. I've also realized how amazing the people in my life are. My mom came the first week post op to take care of me. I don't think she sat down once. I was so excited to have her here, to meet my friends and wonderful people in NYC who have become a huge part of my life.

My friends and sisters have been here for me so far to visit: and I can't say again how grateful I am for them. Below is a picture of my sister Molly and I "strolling" in central park in my fly wheels....also known as my rented wheelchair.

I waited one week: then I couldn't do it anymore...I've had enough sitting on my couch: I grabbed my crutches, hailed a cab and went straight to the gym. Being disabled in NYC is not the best of cities for commuting. It is getting a little pricey, however it is do-able.

Just because I couldn't use my leg, didn't mean I could jump on the 'excuse train' and say I couldn't workout.  The challenge was figuring out what I could do to get my heart rate up, start my body in healing itself by exercise, and stimulate my mind. The gym has always been a comfort zone to me, but now everything seemed so out of reach. I looked around at the spin bikes and free weights: my mind automatically went into overdrive for the desire to start using them. We are creatures of habit. It isn't until we start becoming comfortable with being uncomfortable that we have to realize we have to say anything is possible.

Enter: my new BFF: the UBE. Even on a light resistance: this thing is hard! The biggest upside to this is it has an RPM option on it: so you're darn right i'm still making SPINNING playlists with my arms!

I have made it a point to get to the gym at least 4 days a week to get my upperbody cardio and lifts in. Other things I've been doing at home consist of abdominal training, isometric glute strengthening, right leg strenghtening exercises. My motto: where there is a will: there is a way!

UBE: forward, backward: all day

UpperBody Pull Day

I mostly get looks from people that scream out "you're crazy." I give them a look back, smile and try to work a little harder :).  I'm no professional athlete, however I now understand the frustration of being injured and going through this side of the rehabilitation program. It has to be taken one day at a time, but I have to also make the best of that time. I could easily sit here  and watch every episode of mad men and breaking bad for hours, but my butt then starts to get numb and that's just not a good feeling--nor is it a good look. I have to become comfortable with asking people for a little extra help... knowing I'll pay it forward. 

So I've decided to make the best of this. Somedays it requires getting up at 5:30 am to hitch a ride to HSS to workout and somedays it requires my friends pushing me in my wheelchair to the gym. 

No matter what, I'm not riding the excuse train--I've found my will...so I will find my way! 

What the HECK did you have done!?

CHAPTER 1: What didn't I do to my knee? 

Why would I go through all of this?

I've been putting this surgery off for quite some time. There is never an optimal time for surgery, especially an elective one. I've been putting up with this knee pain since the days of osgood-schlatters at the age of 15. After that, a car accident at the age of 16 dashboard injury did not help the cause. A lateral release done in 2008 provided me with some type of relief. It didn't last long: obviously 5 years later here we are. 

A lot happened within those 5 years.

A stubborn (yet curious) mindset, Crossfit, figure show, triathlons, a ZILLION spinning classes, 5 moves to new apartments, 3 boyfriends, 5 seasons of Penn State Football, training at Athletes' Performance, and can't forget making AMAZING friends in all of these cities. 

This takes us to TODAY. 

I have had the opportunity to work with the best of the best. The surgeons, physical therapists, sports performance staff and medical teams at The Hospital for Special Surgery in NYC. 

http://www.hss.edu

I am under the treatment of Beth Shubin-Stein. What an amazing-powerful-intelligent woman. We tried some conservative procedures such as changing my workout routines, some physical therapy routines, and euflexxa shots. I even shut myself down...still no results. I was having pain walking to and from work which in Manhattan is 10 blocks= 1/2 a mile. I felt like I was 100 years old when I tried to walk, standing up from the floor was painful, and stairs...forget it. 

I prepared as much as I could for this day to come. I had to have the surgery. I know I'm not dying, I count my blessings that I'm alive everyday and that I do have both of my limbs. I'll shed one tear: only one and say now that this is hard. 

Getting finances in order, sick, vacation time, insurance, benefits, covering spinning classes, travel, having caretakers. Its insane what preparation had to be done! I did do one insane thing though: I watched the actual procedure Dr. BSS sent me that she performed on a patient. I'm good with that stuff, but this is pretty intense. If you're interested let me know...we can geek out together. 

So: here is the info on the surgery and what procedures were done. I'll follow up with how rehabilitation is going and what the protocols are and how I'm feeling if you're interested in following me through this wild time of my life.  :) I can't be more thankful for the support I have in my family and friends. Its true: during these times you find out who the truth is in your life. 

Thanks for reading!

xo

KFED

Issue: Left Knee pain ALL THE TIME. Manhattan: this is not the time OR the place for this nonsense. Have to get this joint fixed! Here we go...

Surgery Date: March 15, 2013

Surgical Procedure: 

Tibial Tubercle Transfer

lateral meniscal repair

lateral release repair

DeNovo cartilage transplant

I'm sure most of you know what the meniscal repair and lateral release are: so I'll get to the good stuff.

A tibial tuberosity osteotomy (which refers to the part of the shinbone that the patellar tendon is attached to), a procedure to improve the Q angle and reduce the pressure on the patellofemoral joint, can improve patellofemoral symptoms in patients with significantly enlarged Q angles and a relatively well preserved patellofemoral joint space. Joint preserving procedures are usually reserved for patients less than 50 years of age and are no longer indicated once significant cartilage loss or “bone on bone” disease is present.

http://www.hss.edu/conditions_patellofemoral-arthritis-in-the-knee-overview.asp

These are NOT my MRI's but mine did look similar. 

Essentially no cartilage left on the lateral aspect of my patella. 

In the tibia tubercle realignment procedure (also known as a tibia tubercle transfer), the location at which the tendon attaches to the tibial tubercle (the bony prominence below the patella) is moved forward and toward the inner side. It is then held in place with two screws. The screws hold the bone in place while it heals and help the patient become active sooner.  

My ACTUAL x-rays :)

DeNovo® NT Natural Tissue Graft is an off-the-shelf human tissue, consisting of viable, juvenile hyaline cartilage pieces and is intended for the repair of articular cartilage defects in a single-stage procedure. The DeNovo NT Graft surgical technique mitigates the need for harvesting and suturing of

a periosteal flap, unlike autologous chondrocyte implantation (ACI), as it employs a fibrin sealant to secure the minced tissue pieces into the defect. 

I'll spare you from the picture. It just comes in this little package and has to be molded to the spot of where it is inserted. 

Science. IS. WILD. 

Up Next: CHAPTER 2:THE RECOVERY