Shock the monkey

Lots of electricity today at PT rehab for me. The head PT is back from his 6-day test, so he put me through all sorts of painful manipulations of my knee. It is always interesting (and quite uncomfortable) when he's doing this, but I try to concentrate on what he's telling the student because it's neat. Kind of like my own personal Discovery Channel special about how a knee works! Both of us wish that I was further along in my progress, so today was very aggressive treatment at the clinic since I am doing well with all the rehab exercises at home, only I'm still not developing enough strength to be able to walk unaided. Makes absolute sense to me for them to "bring the pain" there since I don't have any of that equipment at the house...

I found a link about the new knee pain I mentioned in an earlier post. The one developed during rehab and was a minor setback of about a week. Check out this page and scroll down to the "History" paragraph for the short answer.

That has some good information about the inflammation of my Popliteus Bursae medial (inside) of my knee joint, irritated as a result of my (much) weakened quads. Some over-exertion at some point likely caused this. Who know how... Might have even done it in my sleep. My quads in my left leg are far less capable than those in my right, and even though I'm exercising with maximum reps several times a day at home, I'm just not able to gain the strength (and the related knee control). Grr!

Also, since the muscles aren't able to work properly due to my continued issues with effusion (fluid around my knee joint), it's making it difficult for me to develop strength there. It is interesting to me how the presence of fluid "notifies" the muscles not to attempt to exert on the knee as a way of protecting it from further damage. All well and good, only I'm needing to circumvent that somewhat to progress in my rehab. That condition is causing the most hindrance with the rehab. You can click on this article with a lengthy name and look at "Conclusions" near the bottom of the page.

Also, that's how they are addressing this now (cold and electrical stimulation) to overcome this since I should be more recovered than I am now. They've always done that at the end of the sessions, but now it is more aggressive, with 2 sessions. The first being the normal stimulation to the quads where I perform a strong quad set while the power is on, then rest; repeat. The second is the application of (quite a bit) more current/voltage with my leg elevated and wrapped in the cold therapy wrap. Pretty uncomfortable until the numbness from the cold started!

Hopefully this will allow me to progress better. It certainly was MUCH more of a "workout" feeling in my knee area than normal, and for some reason I'm feeling tension not just in my knee and leg, but throughout my body. I feel like I've done a proper "workout," and not just had electrodes hooked up to my leg. Even worked up some sweat in the process today, and now I feel like soaking in a hot bath.

Strange, but I can deal with some pain if it means progress. I really need to get back on my feet again and be able to start walking and such again so I can lose the weight. Here's to that goal! :)

Smoke

Everyone has probably been to a restaurant where the distinction between the smoking and non-smoking sections is something pointless. Perhaps it is only a different area in the same large room, or maybe there is some attempt at erecting a partition of sorts. Then again, in some places I have seen where every other booth or table is the method; smoking, non-smoking, smoking, non-smoking, etc. Obviously, the last example is a good illustration of what happens when a moron is given the power to make laws.

Arguments for and against "smoker's rights" aside, there are valid reasons for having completely separate sections of a dining establishment set up, each with their own ventilation systems. Millions of people have medical conditions that would seem to make such an arrangement a good idea, or, as some may say, mandatory. That is the only way to truly provide a "no smoking" atmosphere for those patrons who choose to dine in one. I've never been in a place where such considerations have been taken in the design of a place of business. Apparently, restaurants are simply not willing to go that extra-mile and spend the money, choosing rather to comply with the letter of the law as opposed to the spirit. It's all a numbers game for them; butts in seats, average cost of eating, server them fast and street them faster.

There have been hundreds of times where I have not had the chance to choose a non-smoking area. Maybe it's because I really don't care THAT much and also know that the whole "secondhand smoke" war is based on horribly flawed research. Often it is because I'd rather eat that day rather than wait for one of the 3 non-smoking tables (in the midst of a room full of smokers, no doubt), or perhaps the establishment doesn't even have separate sections. It's not that big a deal for me. I grew up in a family of smokers, used to smoke myself, most people I know smoke, and the time I spend in a restaurant where people are smoking is not enough to bother even my medical disaster sinuses. Heck, sometimes it even smells pleasant, especially a good cigar or should someone be smoking a pipe. At times it even does the service of covering up the odors of the people you are often forced to sit near. I'd much rather smell someone's cigarette than the foul stench of someone's idea of a good-smelling perfume or cologne that they apparently immersed themselves in. Heck, I have ASKED people to light up cigarettes in order to cover up the rank odor of a perfume!

Well, the fragrance-free section argument will have to wait for another entry... Right now I'm going to focus on what has got to be the most stupid action ever taken by a restaurant. And this restaurant even has separate smoking and non-smoking sections (albeit divided by a short, basket-weave partition wall). I'm talking about that icon of pseudo-Southern home cooking and atmosphere known as the Cracker Barrel.

Last night, after I had finished Physical Therapy, the wife and I decided to go to the local Cracker Barrel and have some of the best homestylesque food ever to come off of a Sysco foodservice truck. It had been a while since we had been out ANYWHERE, and my taking her out to dinner there, her choice, was the least I could do considering all she does for me. We walked in (well, I hobbled in on crutches...) and were seated right away, in the non-smoking section. I've sat in that same seat at that same restaurant many times before and have never had any problems with smoke bothering me. Heck, the smokers were thirty feet away, and there weren't that many of them. So now we come to the Problem.

If you've ever been to a Cracker Barrell, then you likely know the general layout. This one has a huge stone fireplace in the center of the dining area, between the entry and exit doorways from the kitchen area. Tonight there was a fire going in it, just a few glowing logs. I honestly thought that it was a gas fire... I mean, what kind of moron would have a real fire going inside a building? Well, it WAS a real fire, and as we ate our dinner, the manager kept tossing wood onto the fire until it was one roaring blaze, churning smoke out into the room as well as up the chimney. Our eyes started to burn from the smoke, and eventually we had to leave. I was starting to have trouble breathing, and the last thing I needed was to have an asthma attack in the middle of a restaurant.

While in the car on the way home, I noticed that I was still smelling nothing but the smoke. I tried blowing my nose, but that didn't help. Then I noticed that my shirt smelled as though it had been hung outside next to a campfire all night long. My wife's hair and clothes were the same way! Even after returning home and taking off the offending clothes, the irritation persisted until she showered and I took a bath, as the smoke particles had apparently embedded themselves in our skin. Even that wasn't enough, as it turns out, since I wound up not only tossing my cookies (or rather my Old-Timer's Breakfast), but also having problems sleeping and waking up the next morning with infected sinuses, with which I am still suffering. All this brings me to my point which can be summed up as follows:

BIG BONFIRES DO NOT BELONG INSIDE A BUILDING, ESPECIALLY NOT IN THE NON-SMOKING SECTION!

I hate to yell like that, but whatever moron had that idea probably needs some screaming, at the very least. I've written the Cracker Barrel corporate HQ about the incident and will be interested to read their reply, should they decide to do so. Heck, I'll probably excerpt it here, should it be entertaining. So now I suppose I'll have to start calling restaurants ahead of time and ask them if they have huge fires going inside the building. Sound crazy? Yes, it is. Unfortunately it's also quite sadly true...

1 month post-op

Went to PT today and since that new pain was not hurting as much as it was, they put me back into a little bit more normal rehab exercise routine. Still didn't do everything, and only 30 reps of what I did, but at least I had a feeling of accomplishment. I let them know that the instructions I had previously received (to lay around all weekend with my leg iced, elevated and to not do anything) had been properly followed. Yes, I know... It was pretty much a no-brainer there.

There was a student observer there today who was, well, observing for a bit until one of the other PTs snagged him to do her paperwork. I suppose that they have to start learning somewhere. Not only am I a patient, but apparently I'm also now homework. I guess they aren't allowed to touch anybody since all he did was watch my PT move my kneecap around before he was appropriated by the other therapist. After I had run through some exercises, they hooked the electrodes up and started back on the more aggressive pulsing current workout. It wasn't as much juice as I used to get, and they had something under my knee for added support for when I did the quad sets, but better that than have yet another setback. So far I've only had the 2 minor setbacks, which they say is pretty good.

I also made sure that they had sent over their report to my Orthopedic Surgeon so he could look at what they have and make the determination on my returning to work doing light-duty work. I have already spoken to my boss about this, and he said that he had plenty of things I could do in the office that wouldn't require my moving around. It would be nice to go back to work for a couple of reasons. First off, I don't have any money if I'm not working, now that my short-term disability has run out (AFLAC). Second, I'm getting pretty bored being homebound! Sometimes I want to just go walk around the street outside with my crutches, but that is on the BAD IDEA list, since a fall could render me back to square one, or even worse. Hopefully I'll hear back from my OS this week regarding the work thing.

Re-scheduled the appointment for the custom orthopedic shoe inserts once again since I'm still not walking under my own power. Apparently walking with crutches is somewhat an improper way to walk as it is, so no sense in not getting them properly broken in by having my weight in all the wrong places. Ah well, at least by now I'm sure they are nice and dry! They were handmade of leather from casts of my feet. That doctor's shop is pretty neat, actually. When I was in there the first time, he showed me some sandals he had made for himself. They looked a little like Birkenstocks, but obviously more orthopedic, and every bit as high quality as any high-priced show of that type you could imagine. Probably one of those dying arts these days with so many mass-market orthotics being marketed to consumers. In fact, he showed me a whole drawer of those type things he keeps around just to show how cheap they are. He didn't have to sell me, I had already been through the Dr. Scholl's most expensive line long ago (they last maybe a month or 2 max), and there are some other weird plastic/foam things that they sell on TV and you can buy in stores that cost about forty bucks, but probably cost the manufacturer fifty cents to make. Not only are they flimsy, but they're not even comfortable. Heck, if you've got that much to spend on something, that's about what my portion was from the Insurance to have real custom ones made!

I guess one can't expect quality medical components from the same TV people who sell lighted, battery-powered nose hair clippers...

Better safe than sorry

Well, the head PT doesn't think that I've done anything major to damage my knee. No torn medial collateral ligament or anything like that. He says that it's most likely some localized inflammation. Just happens to be near a nice big nerve; what luck I have. Might have moved wrong or somehow shifted my weight on it by accident, or just plain overdid it trying to exercise. At any rate, my instructions for the weekend aren't going to be too hard to follow. I'm to not move around much, do only about 10 reps of just a couple of exercises, keep ice on it and keep the leg elevated since the knee is swelling again from this new irritation. I suppose planting my ass on the couch and watching movies will keep me in compliance there.

The downside is, of course, that my climb towards normal activity has slipped down a bit. Turns out that post-op rehab is one of those 3 steps forward, 1 step back kind of things sometimes, as opposed to a steady upward arc that most would prefer. I'm concerned because it's going to be still several more week before I will be able to pick up computers and carry them around or crawl around under people's desks and hook things up. Hopefully I will be able to work out something with my boss so I can return to work on a light-duty schedule where I can work from a computer. Maybe I can do some things for his real-estate side business, since that's mostly programming, web design and hosting stuff, all things I've done in the past anyway. Have to do something soon... Rent and dozens of other bills are all coming due soon and we're fresh out of money. Too bad I can't be like the government and just print more. My wife scrounged up some change from her purse and car today and we bought a couple of Powerball tickets today after my PT. Who knows, maybe I might actually have some good luck and win. That would certainly help put my mind at ease!

I don't have to spend time in the CPM anymore, and in fact can call the health care company on Monday and have them come get it (before they charge me for another month). The important thing I need to keep doing regularly is manually push my patella over to the inside. Now that the majority of the fluid has left the area, it's going to be that which keeps it from re-attaching to the tissue. If that happens, they my Orthopedic Surgeon will have to go back in and cut it away, and the whole process starts over. Plenty of incentive there to keep pushing that knee over to the medial side as far as I can, no matter how uncomfortable!

This coming Monday and Tuesday I have doctor's appointments. Monday I have the re, re, re-scheduled appointment to get my custom orthopedic shoe inserts. I'm still not walking on 2 legs yet, but I figure I may as well go this time as opposed to rescheduling it for the 4th time. If nothing else, it should make my right foot and leg feel better since it's having to do all the work. Tuesday morning I'm back at the Oral Surgeon's place so they can check on the progress of the tooth I had cut out. Perhaps they want me in so early just in case he needs to take out the ones alongside the gaping hole after all. I for one am going to hope not on that. Also next week my PT team is going to get with my Orthopedic Surgeon and see if he will sign off on me returning to work on a light-duty status. I know that it's a huge increased risk of me falling and injuring myself if I walk around in the world even a little, but my AFLAC is going to be running out in a few days and I've got to be able to do something to keep the bill collectors at bay. I'm sure he'll understand.

So here I am, taking it easy this weekend and then running around some next week. At least my initial fear that something was seriously wrong with my knee again were unfounded. Better safe than sorry I always say, especially with the kind of luck I have.