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March 2003
 Mon, 03 March 2003
Today I had both a doctor's appointment and my fourth physio therapy session. I brought the crutches with me, but didn't need to use them to walk into the office.
Removing the staples
 | At the doctor's appointment, Dr Kobs' Physician Assistant, Malcolm, remove the staples from each of my wounds. It was a relatively painless process — just a slight twinge as each was removed. He used a small pair of pliers (from a sealed sterile packet) and just gave each a slight twist to pull each one out. He then dabbed a bit of stuff on each, I guess to prevent infection, and covered them with strips of sticky gauze. That was it. He wrapped my knee in a new compression bandage, but said I didn't have to wear it if I didn't want to.
He also said I could get the wounds wet. (can you say shower?) The sticky gauze will probably last about 3 days. Just dab them dry when they get wet.
Next, Dr Kobs came in briefly. He had a quick look at the wounds and was happy with the result. He said the surgery it went to plan. He stressed my knee to test the rigidity of the ligament.
He asked how far I had been able to bend my knee, but was concerned that I had only bent it 78° so far. He said that he had hoped I had achieved 90° already. He said that if I don't make 90° within a week then to call him because it may be indicative of a problem and that he might have to "go back in". Not good.
My knee is still quite swollen
 | So I had a mission at my physio session: get to 90°. Kiron told Jodi this. It was quite a good session — not as painful as Friday's session but still a fair bit. With some effort, she got it to 85°. The straightness of my knee was also improved at 3° (it was 4° last week). The exercises we did we to work on the bendability plus the strength of the knee:
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Leg raises, front and side
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Bicycling (turning the pedal as far as possible — she said a full turn requires a 110° bend)
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6" step up & step down (ie not a full step)
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Crouches like I'm about to sit down
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Balancing on the bad leg, catching a soft ball
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Lying on my back with knees up as far as possible, squeezing a soft ball between my knees
At the end, she massaged my calf muscle some more, showing Kiron and I what to look for when finding knotted muscles.
Jodi said I should do these exercises myself between, but should still keep my brace on. She said that ice and raising my knee will help the pain in my calf muscle. The next physio session is Wednesday.
Wed, 05 March 2003
Today I had another physical therapy session. Carmen took me there because Kiron was in Toronto on business (thanks Carmen). Today's objective: 90°. And yes I achieved it (hooray). First Jodi had me warm up on the bike. This meant trying to bend my knee as much as possible, even trying to do a full circle. She said that I'll be able to turn backwards first before I'm able to turn forwards. Apparently its easier. I was about to do 90° on the bike, but she wanted an official measurement, and that involved being on the bench.
So I laid on my side on the bench, and she applied pressure to my leg to "close the gap". It was fairly painful, but she said I was able to bend to 90° three times. Carmen said she could hear me groaning and "yeowing" from the waiting room.
The NMES device to get my quadriceps working
 | Next Jodi worked on the quad muscules. On my good leg, when I'm lying on my back, I can push down on my knee and the muscles above the knee will flex. However, the muscles above my bad knee are all mushy still. So, she attached an NMES device to me (Neuromuscular Electrical Stimulation) to get the muscles going again.
It was quite an interesting experience with that thing attached. It was like a tingly feeling. She started me at 40 milliamps (it goes up to 100) and later uped the current to 50 mA. Each "shot" lasted for 15 seconds and there was a 15 second pause between each. I did that for 5 minutes. Each time, I was supposed to push down on my knee to help it along.
After that, I did more exercises: standing on my toes, mini squats (like I'm about to sit down on a chair), stepping up forwards and sideways, ½ stepping down, catching a ball while balancing on one foot, leg raises while lying on my back. Then she massaged my calf muscle plus the area to the left of where the doctor went in to get the piece of hamstring (which is quite bruised still), then ice for 6 minutes. The session lasted for about 90 minutes all up.
Next time: 95°
Fri, 07 March 2003
Had a good physio session today with Jodi. I was able to go all the way round on the bicycle. The first time was a big shock and hurt a fair bit. Subsequently, I held my hand under my leg to keep the weight off it as it went round. Still hard and very little strength. But movement at least.
Balancing on one knee while catching a ball
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We then did the measuring thing. Lying on my side, I got to 90° without too much difficulty which was a bit of a surprise, and then with a fair bit of effort, we got the knee to bend to 95°. Lying on my back I was able to get to 90° myself and 95° was a bit of a struggle. Jodi said it would much easier now that I've reached the 90 mark. She said the next milestone is 120° within the next two weeks.
Then another 15 minutes with the NMES device I used on Wednesday to build back my flimsy quads.
Strengthening my leg muscles
 | We did more exercises too: toe raises (15), squats on the Total Gym (lie at a 35° angle on this bench that moves up and down), step up, step sideways, step downs, balancing on the bad leg while catching a ball (the 1 lb ball this time). New exercises were sitting on a stool and dragging myself along using the heel of my bad leg - that was hard to do. Also,
As an extra bonus, Jodi unlocked my brace (yippee). I can now bend my leg to 50° while in the brace. I'm supposed to lock it up while I'm asleep (those sharp jerky movements can kill).
Two appointments next week: Monday and Friday. Jodi said that with a bit of luck I'll be able to drive by Friday (hooray!).
Sun, 09 March 2003
Last night was rough. My supply of OxyContin, the 12-hour slow release pain drug, ran out either Saturday morning or Friday night, and now I think I'm suffering from withdrawal symptoms. Not good. There appears to be plenty of info on the Web about severe cases of withdrawal.
I wasn't able to sleep well last night — quite restless, and I'd wake up every hour or so. It was like I had too much nervous energy and couldn't settle down. I'd also either be cold or sweating. I feel pretty poorly today. Hopefully it won't be like that tonight.
Thu, 13 March 2003
The last few days my knee has been sore. I suspect that its because I've been spending more time sitting in a chair with my knee bent, rather than on the sofa with my knee straight. Hopefully that will improve.
My wounds are healing well
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I've taken off the remaining sticky gauze now, and the wounds appear to be doing well.
I think my withdrawal symptoms have almost gone now. I'm not as restless as I was. Its still uncomfortable sleeping with the brace on, and after about 3am this morning, I took the wretched thing off and had some decent sleep.
My last physio session was Monday. I'm now only going twice a week, instead of the 3 times in the past 2 weeks. On Monday I was able to bend it 110°, some 15° more than last Friday. So, as Jodi said, bending is becoming easier. In fact I was able to bend it to 106° on my own. Jodi didn't have to apply too much force to get it to 110°. Now she wants to concentrate on straightening my knee. I can't quite straighten it yet, so I'm doing exercises to work on that too.
My next session is tomorrow, Friday. Jodi said that she'd test my reflexes to see if I'd be safe to drive. I'm going to sit in the driver's seat today to practice moving from the brake pedal to the accelerator.
Mon, 17 March 2003
Well today was a milestone. At physio this morning, I was able to bend to 130° today (lying on my back, using a towel around my ankle to pull my leg towards me). Still very painful, but better than the 118° I did on Friday. And the good news is that Jodi says I no longer have to wear my brace for normal activities (eg walking, shopping, driving, sleeping). Excellent!
I'm still not driving yet. On Friday, Jodi said that with Dr Kobs' permission, I can drive as long as I'm wearing the brace. However, Dr Kobs wasn't in on Friday, and Malcolm, his assistant, said I needed to speak with the doctor directly for approval. So Jodi said she's call Dr Kobs today to get the approval. She said that I should practice driving (and breaking) in a car park before I venture on the road. Good idea.
Exercises were good today. I can bicycle in full circles now, without a great deal of difficulty. It still twinges at the tight point round each time, but I'm getting better at it. I'm also on the treadmill for 5 minutes forwards and backwards. Step ups, downs and sideways, 20 each. Trying to build up my leg muscles again, especially the hamstring. I'm still doing physio twice a week, and will do so again next week. After that, back to once a week.
I'm also putting this gel Mederma on the wounds to reduce the scars. Apparently its good. It ought to be - expensive stuff.
So, good progress.
Mon, 17 March 2003
Update! Called Jodi this afternoon and she called the doctor again. Yes I can drive! Hooray. I need to practice around the neighbourhood first however.
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