Unspecified Derangement

2023 started out fine. Great, in fact!

Kayaking and hiking with Chad and the dogs, rollerskating with the my gang at Riverfront Park, jogging my usual routes.

A work trip to Chicago as part of the Arizona coalition at the Travel & Adventure Show. Got to spend time in that vivacious town and enjoy visiting with my family.

I was blissfully unaware that something big was lurking, waiting for me back home in AZ.

(insert ominous "Jaws" theme music here.)

Behold this quietly icy bridge. 

This little old bridge changed things for me in a big way. I've walked across the Bitter Creek Bridge (built in 1917) an estimated 5,000 times (20 times a week x 21 years). It connects our home address to our work address across a usually dry arroyo. 

 

On the morning of January 18th, in Clarkdale, I was walking to work my first day back from Chicago. In the few days I was gone, someone had tagged the beloved, historic bridge with stupid grafitti. Just pointless, stupid, juvenile tags. "NV Love" and some other squiggles.

 

It was very upsetting!

"When did this happen? I was gone for 4 days and this happened?"

In one hand I held a full coffee cup, in the other, my phone, snapping photos of the graffitti to file a police report, if no one had yet. I was seriously stunned, rattled by the foolish tags decorating "my" bridge. 

I made it to the far end of the wooden pedestrian walkway, snapping photos, but at 7:57am, my day changed. 

My year changed. 

Suddenly I slipped on a very tiny sheet of ice coating the wooden walkway of the Bitter Creek Bridge. I hit the ground quick, like in the snap of a finger. It happened so fast I am not sure how I fell, other than my left leg went the wrong way. I heard and felt a pop and then another. My knee went numb. I tried to get my bearings, I tried to put my leg back into a "normal" position, but my first thought?...

AMBULANCE.

I tried to stand, but couldn't. I was able to get up on my right knee and dialed 9-1-1. Coworkers passing on the bridge stopped, bemused to see me kneeling there. "What are you doing, El?" 

"Waiting for the ambulance. I fell."

The fire truck showed up first, fast, like within minutes. Next the police, and finally the ambulance.They checked my vitals and blood sugar. They joked about the coffee that spilled on the bridge, making a frappucino slushee. They helped me up onto a rolling stretcher.

It was the first time I ever rode in an ambulance. 

Crazy way to start 2023.

     

I'd sprained my knees and ankles before, plenty of times. My ligaments are stretchy like taffy and I usually bounce back fast. But I'm 50 now. 51 soon. And this just felt funny. Different. One of the few times I couldn't just shake it off. I went down fast, so fast I couldn't even reenact for you what happened.

There was something I'd never seen before- a funny "ski jump" atop my knee. That was new.

The E.R. took x-rays and after 4 hours of waiting, sent me off with crutches and a big black "immobilizer" strapped on my leg. Chad came to get me and I had to awkwardly climb into the back of his car and lay flat. I couldn't lift my leg. I had to grab it by the ankle and hoist it like a big piece of luggage.

From the ER we went to a few local orthopedic places unsuccessfully, eventually getting an appointment at Northern Arizona Orthopedics in snowy Flagstaff the very next day. 

Initial diagnosis was "Unspecified Derangement of the Left Knee". 

Which was funny. Like I was clinically "deranged."

   

The knee started to turn all kinds of weird, florid colors and the bruising slowly drained towards my ankle. We were hoping it was just really just an epic sprain and that ultimately it would heal on its own.

  

NAO pushed a STAT order for an MRI and by the following day I was in that big loud clanging, banging tube at the local imaging center back in the Verde Valley.

Tuesday morning the next week, after reading the MRI, Dr Doering at NAO called to tell me I needed surgery. MY ACL and MCL were "involved" in the accident, but just badly sprained, not torn. My patellar tendon had ripped off. The patellar tendon is really more of a ligament, but technically a tendon because it connects to a (floating or "cesmoid") bone, the knee cap. It's really the bottom portion of the quad muscle. It also connects to the tibia. Even after all of this, and countless web searches and Youtube videos it still remains somewhat misunderstood to me the architecture of this piece in my leg that ruptured.

This photo I found online seems to show it best.

By the next day, Wednesday, January 25th, one week from the initial trauma, I was luckily in surgery with Dr Yuri Lewicky of Northern Arizona Orthopedic. He's very well-regarded and had once been the sports medicine doc for the San Diego Padres and Chargers. He has kind eyes and a ski/surfer dude vibe.He's from Flagstaff

He also operated on my skate buddy Stacy's knee and she went back to doing Roller Derby like a boss. She later showed me her knee and there is barely sign of a scar! 

The sooner the surgery the better as the damaged tendon begins to retract and become more difficult to repair.

My first surgery. Sent this photo to Momma Jo and Momma Mary.

Dr Lewicky signed my knee, as they do before surgery, so you're all in agreement about what's happening.

From upside down, YL looked to me like "72", the birth year of Chad and me, a number we're kind of nerds about, so I took this as a good omen.

The surgery was supposed to start at 2:00 but didn't until closer to 5:00. People kept texting me for updates. Once in the OR, the repair took double the time anticipated, two hours instead of one. Dr Lewicky told Chad it was "worse than expected", like a shotgun blast. Somehow the graboid worms from Tremors were referenced. They put anchors in my knee cap.

I woke from surgery shivering (aparrently a normal response to anesthesia) and crying when I saw Chad. The nurse and Chad helped me get dressed. I had a big ace banadage from thigh to ankle and some steampunk looking brace with dials and straps. It was dark out. They helped me into the back of the Tesla, where I groggily tried to call people back who had been worried about me and wanted an update. 

A couple of days after surgery,

 

I had to stay off my leg totally for 2 weeks which was a huge challenge. Immobilized at a zero degrees of bend. I couldn't do any of my activities.

 

I couldn't take a bath. I couldn't drive my car. I could do very little.

Up until the accident, I had been rollerskating twice a week with my homies, hiking rugged trails in Sedona and the Verde Valley, jogging 6 or 8 miles a week taking photos of funny random things I'd find along the road, winter kayaking with Chad....and now...

Now it all screeched to a hault.

I wasn't what to do with myself without those things. I relied on those things, to feel normal, to sleep well, to define who I was.

Chad had planned a late January Death Valley winter trip to a hot springs resort that we had to cancel. We lost our money because Delight's Hot Springs won't refund or reschedule you. They warn you on the website, but still that was a bit of a red flag when we booked it. Superstituously I later thought it was probably the cause of the accident. Tempting fate. We could find nobody to take over our reservation so I ate $350.

Early on, I laid in the bed in the front room, this tiny bed, the only one I could be in because I couldn't climb up into our platform bed, crying myself to sleep, feeling so sorry and sad that this had happened.

For two weeks I got around using a walker someone left in the Lost & Found at the train and Chad brought home. My arms got tired and my hands got callused, but I felt stronger in new ways.

Chad was so amazing at taking care of me. He really stepped up, always anticipating my needs, and just being wonderful and caring.

He would help me take a shower when he came home on lunch break. I'd have to wrap my leg in plastic and leave it sticking out of the curtain because it couldn't get wet until the incision started to heal (and it couldn't be submerged in water until totally closed and healed completely.)

He'd do all of the shopping and all of the caretaking of the pets and house.

  

Tons of pals stepped up as well, delivering flowers, meals, good cheer, DVDs.

While my "deranged" leg had never hurt that bad other than a dull ache, made worrisome by the lack of stability, but post-surgery the pain was intense. I took Oxycodone for 3 days, but that stuff is dangerous, plus it makes you constipated.

I had planned not to take them at all, but I needed them. Chad's mom advised me to "get ahead of the pain" because it was hard to catch up if you got behind. So I set my alarm to go off every 6 hours and took one pill (two during the worst of it). But after about three days, I was done, phasing down to Tylenol and then eventually nothing.

Soon I was back at work, working from home. 

 

My work family has been amazingly supportive too. Luckily, a lion's share of my job responsibilities can be done from home, in my PJs. 

My first surgical follow-up was two weeks after the surgery on February 8th. They told me I could put weight on my leg again and I was so pumped. Friends lent me this sweet little walker, with brakes and a seat. It was a game changer.  

I started walking to work again. (Anytime I passed that spot where I fell, I'd do it reverentially, respectfully. A moment of silence.)

I'm in physical therapy now, and 6 weeks post-surgery, eagerly awaiting an updated protocol for the next part of my rehabilitation. The physical therapists all tell me I am well ahead of average, and where I'd be expected to be, but time is essential with an injury like this. Time is needed to knit everything back together, and if pushed too early you could damage the repair.

"We have two kinds of people in Physical Therapy. Those who are barely motivated to work on things when they are here, and the others are people we have to hold back."

Every day I am a little less deranged. A little closer to healed. Every excercise adds up. Every vitamin taken. Every mile walked, at 1mph. (Now I am up to 1.9mph)

 

I do all of my physical therapy homework. I do extra credit. 

200 leg lifts on each leg, both sides, in multiple directions. An hour's worth of excercises. More. Watching a movie, always doing sets. 

Early on, the first sign of the patellar tendon rupture was the inability to lift the leg, as the part that connects the upper half to the lower had disconnected. I am working on rebuilding that connection, healing the repair, building the muscle. I can sling that leg around pretty well now. "Look, Chad. Watch this."

Bending it is another big challenge I work on daily, with heel crawls, a yoga strap. At my desk, I remove the brace and sit with the leg at 60-70 degrees. It's loosening up daily. It's a constant effort. Pushing a little harder each time, but not too hard. Then, the combination of the bend with the lifts. It's all kinds of weird, tight, sensations, but every day incrementally better.

I walk on the bike path, or on wide easy dirt trails. I'm up to 2 miles now. I graduated from the walker to a cane. Chad bought me a better ladder and one day I finally built up the nerve and strength to climb back into our platform bed.

Chad bought me a new kayak right after I got hurt, and it was a bit of encouragement to look forward to using it. Once in early February, when I was still on rigid recovery of zero weight on the leg, we went to the state park, just to enjoy nice weather and practice pumping up the new boat but when we got there, I was having none of it. Watching people walk their dogs, or paddle in the lagoon, ride their bikes, jog...I was even jealous of a lady walking with a cane. All it did was make me feel sorry for myself that I couldn't do any of that. I cried big stupid tears and actually it was a bit cathartic.        

                    

It also made this moment, about a month later, feel like the best thing ever....

As mobility increased and my surgical incision fully healed, I was able to get back into a kayak again and it felt amazing, especially thinking back to that glum day when I felt like such a loser.

I can't drive my car yet, because of the clutch, and needing to bend my knee tighter to fit in that little machine, so it sits waiting for me as I work towards that goal. It's all about goals.

This Karmann Ghia turned 50 this year and for this reason I'd entered it in the annual Clarkdale car show this March, for the first time, but had to cancel. I only lost $25 there, but probably another jinx.

Big life lessons:

1. When I was walking across the bridge, I was doing 4 things at once. Coffee in one hand, camera phone in the other documenting the stupid graffiti tags someone had hit the historic bridge with while I was gone in Chicago, and listening to Late Night with Seth Meyers on my headphones. I should have been focused on ONE thing. Walking across that quietly icy bridge. Multi-tasking is expected of us in this world, and we get used to it, but it's not good for us to divide our focus so much.

2. Chad is amazing. He gets great satisfaction taking care of me. For most of our life together I have been typical impatient Aries "I'll do it myself" and not waiting for his help or asking for it. I have slowed my roll some now, literally, and see what a caring, thoughtful man he is. I am grateful. He has really stepped up when I needed him most.

3. I will never take for granted how easy everything is when you have use of two legs.

4. It's hard to get around this society when you're disabled. I see that more clearly now, and how important it is for us to create accessibility wherever possible.

5. Americans love a comeback story. I get to star in my own comeback story.

(Cue "Rocky" theme)

Update. Autumn 2023
On March 28th things started to progress quickly....



By mid Spring I was getting around without any devices or brace, showing only a slight "surgical swagger." On Easter Sunday I drove my car again which definitely felt like a huge victory. 
I am not feeling up to skating on eight wheels yet, but I go to the skate park to roll with my pals,  
rolling a mile or more on 4 wheels, on a vintage office chair, a translation of chair scoots excercises I did at physical therapy. 



By June I graduated from Physical Therapy and joined Planet Fitness for further strenghtening..

   
By summer I was accomplishing my weekly goals of:

• 15 miles a week walking

• 1 hour on ellipticals

• 1 hour on steps

• 2 hours of home physical therapy exercises

Steps were a big deal-- the downhill much harder than the uphill. The first day I was able to do it one leg/one step and no hands on the railings felt like a huge success.
I haven't gone jogging anymore. I may not.
   

Back to kayaking, hiking, tubing, traveling...but forever changed. My physical therapist said, "You can still do the things you used to do, but your body is forever changed by this accident." 
I take handfuls of vitamins and am always working my knee health every spare moment. Leg lifts. One legged squats. Tracking and tackling new milestones. 
Nothing taken for granted ever.
Thanks for following along on my Knee News.
Hopefully this story helped someone on their roade to recovery after sustaining a similar injury.