Monday, February 27, 2006

What's the big deal with your knee?

Let's see - one month between posts - that's OK, right? Well, I guess when right now I only have one reader, I'm not disappointing too many people, right?

To bring you up to date, it has been a rough couple of weeks here since the 16th. Before that, things were cooking along just fine...busy, but fine. On the night of the 16th, however, I was playing basketball at church like I do any other week (sometimes twice a week). In the last five minutes of what was going to be my last game of the year (I was supposed to be out of town for the rest of the games), I came down for a rebound at the same time that someone either hit my knee from the side or came down on top of me, depending on which witness you ask, my knee buckled, and it was all over from there. I was down on the ground in lots of pain and everyone was wondering what to do.

You know, the funny thing is, my very first thought after I thought "Ow, this really hurts" was "Man, I just don't have time for this right now. I've got to go to Dallas tomorrow to check on the progress of my house. I've got to go to California next week to visit my parents and so my son can celebrate his birthday with them. I'm supposed to go to China in two weeks. I hope this isn't serious. But ow, this really hurts". I was telling my wife about it in the ER later and she said, "so it really is true that your life flashes before your eyes, but not in reverse - it happens in fast forward".

Anyway, someone from my team took me to the ER and then was nice enough to have his wife follow him back to the church and drive my car home so that my wife could come and meet me at the ER. It didn't take very long to get seen (the benefits of NOT going to the big hospital downtown on a holiday weekend, I guess - that was the case the last time we went to the ER). They took some x-rays of my knee, gave me some ice and some Vicodin, put an immobilizer on it, gave me some crutches and sent me on my way. The doctor said the x-rays were negative for any fractures, but that I'd need to see an orthopedist and probably get an MRI done so they could see what kind of soft tissue injuries there were. He also said that based on the degree of swelling, he would be surprised if it was anything to do with my ACL, since that usually has a lot more swelling associated with it, but again, the orthopedist would be able to give me a better assessment.

So far, so good, right? I'm thinking at the worst I've got a bad sprain, maybe I'm on crutches and pain meds for a week or so, but nothing to mess up all my plans. So the next day, we load up the whole family in the Explorer and head to Dallas to check on the progress of the house. We put part of the back seat down and had me ride backwards with some pillows for my leg. Being on Vicodin, I ended up sleeping most of the way there and back. The house is coming along very nicely and other than my knee hurting, it was a good trip. I stayed home from church on Sunday to keep my leg elevated, but really by Saturday night, I wasn't taking the Vicodin anymore, because there was almost no pain anymore. I was only taking Advil for the swelling. I was even starting to use one crutch instead of two because I was able to tolerate a little bit of weight on my bad knee.

Side note on crutches: OK, I had no idea how much of a pain they are to get around on! My hats off to those who have spent extended periods of time on crutches. They are NO fun! I guess I should consider myself lucky that I've made it 31 years without having to use them before.

Monday morning, I went to see the orthopedist. She did some range of motion tests on my knee and ordered an MRI. She suggested that it could be my ACL after all, but the fact that I was not having any pain in my bad knee probably meant that I could start putting weight on my leg as tolerated. This was a big deal to me because if this was truly the case, then I could probably make it on the China trip with the least amount of disruption. She ordered an MRI so they could determine whether surgery was necessary, and gave me some more instructions on how to use crutches properly. Overall, a pretty good visit.

Later that day, I went to have an MRI done, another first for me. I'm not claustrophobic, but I can totally see where people would be disturbed by those machines. They are big and noisy and there is not a whole lot of space for you. The tech said that it would probably be Wednesday or Thursday before my films got read, so I was thinking everything would remain status quo until then.

The next morning however, there was a voice mail for me from the orthopedist's office. When I called back, they had received my films and wanted to get back in touch with me ASAP, first of all to tell me that I should not be putting any weight on my bad leg at all, since the MRI indicated there was a small fracture in my tibia and weightbearing could make that injury worse. In addition, the MRI showed a full thickness ACL tear and a "bucket handle" tear to my lateral meniscus (the pad of cartilage between your femur and your tibia), what they called a "full meal deal". Anyway, they wanted to have me come back in the next day to meet with the surgeon and discuss my options. Overall, not a great way to start the day, but still, I was not in too much pain and everything to this point seemed to indicate that I could still go to China if I really wanted to.

That day, I went to my classes and once again realized how difficult crutches made it to get around. When we had our final pre-China class, all of a sudden those awesome places like Tienanmen Square, the Forbidden Palace, and the Great Wall looked so much bigger now that I knew how tough it would be to get around them on crutches... Later that night, I started doing some research on ACL surgery and realized that wow, this was going to be a really big deal and the recovery was likely to be a long and demanding process. Suddenly, going to China started to make a little less sense.

When I met with the surgeon the next day, it became even more apparent that going to China would be an unnecessarily risky thing to do, especially since I would be halfway around the world and my knee would be very unstable until I had surgery. Plus, given the time of year, it was likely to still be rainy or icy in Beijing and maybe Shanghai, so that could make getting around even more difficult on crutches. My professor had told me that we could still make accomodations such as taking a taxi back to the hotel if I felt too tired, taking the tram instead of walking up to the Great Wall, etc., but that still didn't address the risk of postponing surgery and getting started on my recovery... When I put all these things together, my wife and I determined that canceling my trip was the wisest thing to do, even though I have wanted to go to China for probably fifteen years now.

So, as things stand now, I will have surgery next week (they want you to wait about three weeks between the injury and the surgery so you can get your range of motion back and strengthen your leg muscles, both of which help increase the success rate of the surgery). They'll repair my ACL and attempt to repair the meniscus (though they won't be able to determine until they get in there what type of repair they'll be able to do). In the mean time, I will be on crutches and in a leg brace until surgery.

We made our trip to California this past weekend and celebrated both my son's and my mother-in-law's birthdays with my parents. My son is turning three and my mother-in-law turned...well...she doesn't like to say, but let's just say it was a year with a zero after it. It was a nice visit and we got to see lots of friends in Morgan Hill. My wife and I celebrated the tenth anniversary of our first date and I joked that I liked the way the second ten years were starting off: she is now opening doors for me, carrying things for me, driving most everywhere we go, etc.

She threatened to break my other knee... :-)