I met with Dr. Meeks this morning and set a date for surgery.
I woke early enough to enjoy a good long shower and a necessary encounter with my razor. In need of a haircut and still bushy from my weekend at Potlatch, I did my best to fight back the fur and the fuzz. I spent a good amount ot time examining my bathroom, contemplating how navigable it will be when I am post-op. I may have to be quite creative to sit atop the throne.
My 8:45 appointment was a surprise to the good Dr's staff. I'm told he is unavoidably detained in a meeting. I chat briefly with Judy Walsh. She presents me with my MRI results. The pictures will have to wait for the Dr. I am instructed to return at 10:30 and I head back toward JP for breakfast at Sorella's (buckwheat pancakes are in order). I enjoy a tasty breakfast and pour over my MRI report and review the questions I plan to ask the good doctor. I envision a fast paced dialogue where I am granted detailed knowledge of surgical techniques and recovery strategies. I will scribble notes furiously and be enlightened as to the ins and outs of arthriscopic surgery. I have another cup of coffee.
Still 45 minutes to spare, I decide to complete the task I began at the bathroom sink this morning and head to Rocky II's barbershop. Rocky is glad to see me and begins his spiel about how slow business has been. I am only the fourth customer in the chair since he opened at 7 AM. Rocky complains about the Dominicans in the neighborhood and their 7 days a week open late hours barbershops. He tells me they are unlicensed, unschooled barbers. I ask Rocky when he began cutting hair. He reflects for a moment and tells me it was back in the old-country when he was 9 years old. He started by shaving customers with a straight razor. He was most nervous the first time he had to shave his father.
I make it back to Meeks' office and eventually am led to an exam room. Fittingly enough, it is the room with the fabled picture of Ben Worthen laying out for a catch in the 2002 World Championships for DoG. Dr. Meeks did Ben's shoulder. I study the picture and wonder if my rebuilt knee will lead to similar feats of flight.
I meet with the doctor moments after he gets into the office. Donning his white lab coat, he extends his hand. We shake and introduce ourselves. Meeks is a jovial man with a flashing white smle. His manner is relaxed and attentive. His face and neck match the red color of my bare feet and legs--sunburns as proof of our long weekends outdoors. A young, well dressed resident named Jason joins us as Dr. Meek's reviews my MRI films and briefs me on his surgical technique. Having done my homework, I ask him about the allograft options, how his tissues are sterilized, and how the reconstructed ligament is attached.
He sets my mind at ease and tells me there is no indication of cartilage damage. I tell him that I am wary of cutting healthy tissue and he agrees in a manner that says, "But of course." Doctors, Mechanics, any specialist for that matter, must get a lot of overly basic and redundant questions. But when it is my first experience with a sugery, a rebuilt transmission, whatever the unknown I seek an expert for, I want that expert to hear my concerns.
I tell the doctor that I want to return to an aggressive and competitive level of play, ideally in time for the tournament in Brazil (only 4 months away). I think I see a touch of reality reflected in the Dr's eyes. This is not a simple recovery, no matter how good the surgery or how cocky I am.
I am prescribed 3 weeks of P.T. 3 times a week, prior to my surgery. I will go to Scott Waugh, the PT for the Bruins for this. Conveniently, his office is across the hall from Dr. Meeks' I also select a date for surgery. 6:30 AM August 5th. The day after I get back from the Phish IT festival in Maine. Going out with a bang.
At some point in the last 1000 years, barbers used to do this kind of surgery. I should have checked for a 2-for-1 special at Rocky's. My knee is stiff and I am running behind in more areas of my life than I am comfortable with thinking about right now. Healing is a mind-body-spirit process and I am the administrator of a bureaucracy right now, it seems.
I got my MRI report this morning. I'll see if I can do anything to scan the films and get some of the better pictures up to accompany this text.
Boston Open MRI LLC
The Diagnostic Edge
Date of Exam: 07/03/2003
Exam Type: Left Knee MRI
Referring Physician: Dr. Meeks
Clinical History: Knee pain. Evaluate for ACL tear.
Technique:
Sagittal proton density with and without fat-supression, coronal T1, T2, axial fat-supressed proton density, and T2 sequences were performed on the left knee.
This examination was performed on a 0.3-tesla Hitachi Aris II open magnet system.
Findings:
There is an osteochondral fracture along the weightbearing portion of the lateral femoral condyle with subjacent marrow edema. Focal bone marrow edema is also noted in the posterior aspect of the medial tibial plateau. A moderate-size joint effusion is seen.
The ACL is abnormal. There is a loss of the homogenous dark signal of fibers of the anterior cruciate ligament consistent with an ACL tear. The PCL is intact. The quadriceps tendon and patellar tendon are homogenously dark.
The lateral collateral ligament complex and medial collateral ligament are normal.
Both medial and lateral menisci are homogenously dark without evidence of a meiscal tear.
The patellofemoral relationship is normal.
There is no evidence of chondromalacia patella. A tiny popliteal cyst is noted in the posterolateral aspect of the joint.
Impression:
1 - ACL Tear
2 - Osteochondral fracture, lateral femoral condyle, with bony contusion posterior aspect of the medial tibial plateau.
[tmo notes]
Obviously the part about the torn ACL is clear enough. The other bad bit is the part about the osteochondral fracfure. When the ACL snapped, my weight came down hard on the edge of that bone and it cracked a bit. That explains the lateral pain I experience. The good news is all fhe other knee parts appear well intact from the report. The "homogenously dark" stuff is connected and getting lots of blood. No signs of tears.
I asked Judy about the cyst and she explained that the fluids that have collected in my knee cycle around and out toward the back of my knee. The fluids get trapped and a small cyst forms, causing some of the stiffness I am experiencing. It will go away. Time to stretch... Some Advil is probably in order, too.
Get on down
...
I get to get on the Good Foot
I got to do it on the Good Foot
Do it with your Good Foot
James Brown knows where it's at.
Today was better. My attitude is no longer "I am broken."
I am recovering.
Dawn D. called me back at work and dropped her knowledge of knee reconstruction and rehabilitation. I could barely keep up. I feel like I've joined some weird cult with initation rites nvolving the sacrifice of various Cruciate Ligaments and cartilege.
Found this quote today;
One must never lose time in vainly regretting the past or in complaining against the changes which cause us discomfort, for change is the essence of life.
-Anatole France
I spent a good part of yesterday lamenting what happened and assesing the moments leading up to my injury. It is eerily ironic how much foreshadowing you can pick out of an experience after the fact. Dawn D. reminded me that we talked about blown knees on Saturday at the tourney and I know that a few points before my blowout, Nate and I were talking about our soccer careers. I commented on how being left footed had degraded every joint from hip to ankle. D'oh.
I woke up without my alarm this morning. The power outage from the night before made for a quiet start to the day at Perkins Sq. Perhaps all of the door slammers and morning shouters overslpet.
I awoke at 7 AM to my impossibly stiff left leg, frozen in place over the pillows used to elevate my swollen knee. The swelling is full on now. By the early light of day, the reality of this injury came crashing down. I block the sight of this reality with a pillow over my face and pound the palms of my hands into my muffled brow. I replay that fateful step that broke me. My mind, refreshed from sleep, cleared of the shock, exhaustion and ibuprofren gladly replays the feeling of my leg bending unaturally I relive the snap/sproing of once taught ligaments and tendons giving way. I feel nautious.
I reset my alarm clock, cheerily flashing it's best guess at the time, and opt for another hour of sleep. I am unready to face this day.
I awake another hour into the day and begin to reconstruct myself under this new edict. The cocksure attitude I held last night on the fields and at Volker's vanishes with the undeniable stiffness and swelling that invaded my knee last night. Unable or just unwilling to stretch, the injury feels compounded by my sore, tight, post tournament muscles.
My room reflects my state of mind. Cleats and jerseys are scattered about the floor like guilty accomplices laid to waste. An immobilization brace snuggles under the covers of my bed and an ace bandage intertwines with the sheets leading the way to a watery ice pack. I begin to reconstruct myself. A shower is necessary, but not before attending to the call of nature. These are the tidbits of information you want on your discharge sheet. The basic "How do I deal with the simple process of life with a broken part of me?" I decide to slide and squat in a fashion that is anything but graceful until I can catch myself with aid of the nearby sink and lower seat to seat. My left leg splays out stiffly across the bathroom floor. So far so good.
The shower is the next task. Fortunately there are ample handholds and I manage to remove the sunscreen and grime that covers my limbs. I tenderly scrub both knees and begin to feel a little more human. After my shower, I shave and examine the weary soul staring back at me. I grit my teeth and shift my weight. I need to know what still works down there. I feel the stubborness welling up inside. I can beat this. I can overcome. I better take it slow.
I dress for the day and don my immobilizer. The walk to the T-stop takes 12-15 minutes on a good day. I expect I will double this time today.
Today is the day I finally blew out my knee playing Ultimate.