Slow news day

Nothing major today, finally. Knee felt decent most of the day, walking around on it a little bit. Got the rental agreement for the condo, so can execute on that if I desire. Haven't seen anything any better at this point, although there are a couple backups and someone might get a little closer. Now I need transportation while I'm there. Other than that, headed into the holiday!

Good and bad

Good news, or at least, reassuring news. Talked with (at least, heard on voice) from Shirley, Dr. Steadman's nurse. Her basic message was "I can't tell you you're going to have surgery for sure, because there's always personal reasons why someone does not, due to timing or other reasons. But at 9 months post-op and limited mobility, you're certainly a strong candidate for surgery." Sounded like everything but 'I can't imagine you wouldn't have surgery" Nothing like a double negative.

Also got some good feedback from folks on the KneeGuru board that seemed to reinforce that as well. No one responded with "I saw Steadman and he said don't have surgery", so the odds seem pretty low that my month's worth of condo would be wasted.

Still working on the final price for the condo. Looks like car rental is pretty pricy up there as well; will need to spend some additional time on that one...

The knee is feeling a little better. This morning had some decent pain below the kneecap, but that seems to have subsided this afternoon (of course, I could just be limping on it differently).

Nothing like choices

Interesting day yesterday. Noticed that for the first time in a while, the area on the inside of my knee right below my kneecap hurt more than normal with each step. I had to consciously alter my stride as I walked. Same thing still seems to be in place this morning. Could still be from the concrete, could be scar tissue breaking up, could be long-term effects of consistent weight bearing, could be small yellow men with pickaxes who work only under certain conditions due to union contracts.

Also (almost) locked in a place. Was initially pretty please, until the gal dropped the 'oh yeah, I forgot to mention, that price doesn't include the 12.5% sales tax." That's annoying. It's now nearly the same price as a hotel I've been considering. But that's for a month.

Which now I have questions around. Met with Dr. Carey Windler, who's the orthopedic surgeon for the University of Texas. Nice chap overall, reminded me of a true 'doctor' from the old school who was very focused and business-like. I was impressed - they took a couple of additional X-rays, one with knees at 45 degrees off the end of the table anad one standing. He spent about 10 minutes asking me questions about my history, with some definite focus on when things changed - "so you had pain, was anything different? What was your range before the surgery? And after? How long did you keep that improvement". Data driven, which I appreciate as an engineer. Most of the details we had, but how fast things went up or downhill is always a little subjective.

He then reviewed my charts and reports for almost 20 minutes (at least, he was gone for 20 minutes - ironically, Vail condo gal called dring this time). Indicated that I have scar tissue surrounding the kneecap which creates no mobility in kneecap and I also have scar tissue in the joint. He came back and said pretty much the same thing as others - if you are improving or maintaining ROM, then keep going. If you are losing ROM, then doing something might be appropriate. I include the 'might' because he indicated (when asked) that you don't necessarily want to do something right away, because the inflammatory cycle will be aggravated. He also said to take glucosamine, do things at home every day, and see Angela 1/week to check ROM.

The part that was different, and the part that is causing some consternation, is he recommended waiting 4-6 weeks to see if I improved/maintained/regressed. I suppose that's prudent on his part, as opposed to rushing into surgery in a patient he's seen once. Patience isn't always a bad thing, but after 9 months, I'm pretty sure I'm headed backwards. Tough since I've seen three people with 3 different plans [Kilbride - do surgery now or later but do surgery, no rush; Burns - do surgery and do it before the wedding; and Windler - don't do surgery now, consider down the line]

So the main question now: What is the chance that Steadman won't recommend surgery at this point and how long should I plan to stay in Vail? Hopefully, I can get some more information fom others and Steadman's office before plunking down a bunch of money for a place I won't stay. Possible that I could go up and stay a week anyway, working with the physical therapists in Vail, so it wouldn't be a total waste. We shall see.

Some painn

A little pain this morning in the knee. Guessing it's finally hitting me from yanking the concrete. It's not a crazy pain, just letting me know it's there as I walk. Definitely creates a more noticable limp than normal. Headed to meet with Carey Windler, the UT athletic orthopedic surgeon this afternoon, just to get some more information before I head out to Steadman. And I'm glad I typed this entry this morning because I forgot my MRIs and X-rays and Lissa just said over the phone that she could pick them up from home -

Question Answered

Remember how I was wondering the effect of concrete on my knee? Found the answer last night. Not a whole lot of pain, but definitely has trouble walking around and straightening it. Still a little sore this morning as well. Overall, it definitely feels better than I suspect it could. Range has continued to be elusive. We didn't push on it in the last therapy session on Friday, it was probably around a little less than 10 to 90 on the bike, with some pain. Will see how that changes over the rest of the day.

2 down

Cracked through enough concrete this morning. Weather was nice enough to stay below the 80 degrees for the 45 minutes outside. I'm having a hard time determining the effects on my knee. It isn't really sore, and think I got a little more flexion afterwards. Still looking for a place in Vail, popped off another 20 of so emails last night. I don't think any of them are promising, but I did get a call from someone (still can't remember if it was Sharon or Shirley) with a decent place for less than 2 grand with high speed internet access! Other than the one with stairs, almost everything is around that. Of course there's the 5 bedroom mansions, but I don't think we'll be needed that.

Too EARLY

PT this morning @ 7 am, since they were slow during that time and I wanted to spend some time with Angela to talk about the upcoming surgery [Another plug: Folks at Elite Phyiscal Therapy are awesome. If you ever have anything wrong with you, head there. You hang onto this when you find someone in the health industry who cares about your problem after you've left their office]

But Lissa had a workout session at 5:30 and due to my inability to drive, I went with her. That's early. A ok day in therapy - no huge pain, but I didn't try a full revolution on the first time on the bike, and even after the table and hands-on work, I couldn't get around. On the table, my knee felt a little more painful and I had some pain below the knee cap, so I didn't push much further. Ran 10 minutes though! Hadn't done that in a while and it felt pretty good, although I had similiar pain as on the table to start.

Angela's main question was similar to mine - what is Steadman going to do that's different to fix the knee. She mentioned a tendonoscopy?, where they make cuts in the tendon to allow greater flexibility. Evidently, that area is called no mans land becuase there's a lot of blood vessels back there. She also mentioned she's see research in shoulders around scar tissue where the doctor (I think I heard this right) cauterizes blood vessels around the area so the blood doesn't flow as much so the tissue doesn't grow as fast. She also wanted to know any specific procedures Steadman had for PT that would keep arthofibrosis from returning.

We'll see how it goes. Oh, and she also said stairs after surgery ould probably be tough. Although I probably knew that. We're probably going to start looking outside of Vail for a place. 1 minute is about the same as 15 - the hard part is getting in the car, not sitting in it -

It's all about the paperwork

Faxed in the patient paperwork to Steady today. I thought about sending along some sort of summary, but finally just faxed everything in. The insurance gal, Laura, said she'd get back to me on the 5th. Ironically, it's because she's out all next week on wedding and honeymoon.

Probably not going to bang on concrete today. Spent about an hour copying photos for use in a wedding video. The knee was popping a bit as I moved it around. No pain, though.

Fire! Fire!

A good four-five minutes of banging on concrete tonight. Sparks actually fly. Raw metal on cement. Pretty tiring. My knee is a little sore as well. Nothing major, but I can definitely feel a little more pressure as I walk. Toold everyone at work today about the surgery and missing a couple weeks, mostly supportive.

Hey, good news that will probably be false as soon as I type this. Treo 600 is working fine. Able to synch the data off this morning, and for a couple hours, beeped incessantly. Lunchtime, back to playing chess.

Talked with a couple folks at Steady's. Crystal, the scheduling nurse, seemed to indicate in a voice mail that since it was arthofibrosis, it would likely be overnight. Laura the insurance gal indicated it would definitely be outpatient (or at least less than 24 hours). We'll see who's right on the 20th, I guess! Still waiting on the final word for the condo that looks good at the moment.

okay, so it's not about my knee

so I was talking with my sister yesterday on the phone while I was banging concrete. When I was finished, I put the phone on the ground near me in case you called. I forgot to bring it in, so I went out an found it this moning. Unfortunately, I had decided lalst night to also water the ground near the hole since most of the grass looked dead. Fortunately, it looked like eveything was ok but I backed up everything to my laptop before I left for work. Unfortunately, after doing that, it looks like the keyboard has gone haywire and random buttons are "pushed" while I watch the screen.
So maybe I need a new phone :-)
Also, my knee has been pretty stable lately in the pain department. It feels a little stiff and I have a little pain as I walk, but nothing major. Headed to physical therapy on Friday now, so we'll see how that goes.

One down, one to go

Bingo! Finally hit the bottom of the first concrete blob that the post was in. Need to get new concrete to replace the old. Now on to the second one. Also close to finding a place in Vail. So close! If I can walk 20 steps, then I'm done. If not, we'll wait to see if one can avoid the stairs at this place. Bada Bing!

Fly away

We're booked for flight. We'll be hanging out the weekend before, skiing down the slope at Vail before the appointment and surgery on the 19th and 20th. Lissa's schedule to return the 1st and I chose the 17th of Aug, just in case. Most of the people I've heard from seem to wish they stayed longer than the week Dr. S recommended, so figure I'll set myself up for excitement if I heard home early than a mad scramble to determine how to stay longer. Plus, it's Vail. Who wouldn't want to stay longer. So far, I've found some decent rates on places to stay - we'll see how that goes.

Still going

on the blog, at least. Exercised again this morning, so finally hopped up on that horse again. Forgot to take the ultraset, but the overall pain wasn't that bad - another 20 on the efx, 10 half spinning on the bike and 5 minutes of walking. Overall, the leg feels pretty strong - it just won't straighten or bend. Also received a couple more emails for places in Vail - the first one still looks like the best. Need to schedule the flights tomorrow as well, just to check something off the list. The concrete posts will probably be the hardest thing on the list, figuratively and literally...

Planning a trip

We're now at the planning stage. Trying to find flights with miles for 25K instead of 50K on American. Good news is I can fly directly into Vail. Also have a couple decent leads on places to stay, so we'll see how that goes. Bad news is looks like Aetna is out of network for everybody in the chain, from Doctors to Hospital to Physical Therapy folks. One of the insurance folks called today and was going to call me back with some more details, but that could get tricky. At least I'll have some nice time in Vail...

Away we go

Nothing really new today, other than I started a posted to get feedback from people who had already seen Obi-wan to get suggestions on traveling to Vali. I forwarded my mother the link and she read all about all the problems and it worried her! Oops, sorry mom. Still waiting on a call back from Steadman's insurance. I did spent about 30 minutes last night trying to bang away at the concrete. I might try again tonight, considering taking some roxycontin while I do so. Also trying to figre out whether I should still see Dr. Shelbourne in Indianapolis as well, since my sister is there and parents are within a couple of hours. Lots of upcoming travel, but hey, it's the summer!

A vali we go

Just heard from Sharon at Obi-wan's office. She actually called home first to talk with Lissa. Schedule on the 19th of July, with surgery potentially on the 20th. Bring x-rays/MRI and reports plus operation reports. She said I could expect to be there for 2-3 hours, so bring something to read! Guessing that's not time with Obi-wan. Expected at least 5-7 days in Vali after the surgery, but I've read some folks have more. Now the fun begins.

Burns thoughts

So saw Dr. Burns today. Running a little behind, but a great guy. Really enjoy all his folks. Here are some of the Q&A thoughts.

Do I need another MRI or X-ray before Steady? Nope.
Could you write another PT script? Could, but insurance will cut it off suddenly, so might save those for after next surgery. Angela could indicate in report that she is releasing until next surgery and patient will do on own.
My first MRI post first surgery didn't really show any scar tissue, but one this April showed a lot. Is it possible that we remove all the scar tissue that we can see but are back where we started from the first MRI? Possible - it's also possible that Steady will decide that 5 degrees is a 100% success, he'll probably determine that once he's in the knee. He'll probably start by removing as much star tissue as possible - good news is a lot of it is in the front, which is easier to get to and may be the main cause of extension loss. He may use "biters" which cut through scar tissue due to the quantity, whereas most here is just burned away (my phrase). He will get as much as he can and then might cut something behind the knee while insuring he avoids the artery that is back there. Steady is the expert in that procedure (I don't think Shelbourne believes it is necessary from a post I read on kneeguru).
I was correct in my reading of the op notes - I did have 5 degrees on the table during the MUA and only 10 degrees during the actual debridement (wrong way!)
It's possible I might have multiple surgeries, but it would be unlikely for them to be closer than 3 months apart [so they shouldn't interfere with the wedding, but who knows. I read another post on kneeguru where someone went back on the table almost the next day, so I'm guessing it happens immediately or takes a while]
He didn't have a good guess at rehab (ok, I actually forgot to ask)
He also said he knew of Shelbourne, and laughed that when Shelbourne came out with the accelerated rehab paper, Steady said he'd been doing it for years. He's a good surgeon [but it was obvious he favored Steady. I appreciated the fact he didn't try to say I shouldn't see Shelbourne or say anything negative about him

Wires Crossed

Ok, just got another call from Steadman's office. Somehow they thought I wanted an appointment on the 5th, not the seventh. They also didn't get the message that I wanted a surgery and office visit. Wacky. Pleasantly surprised they called back so quickly this morning, but getting a little worried that spots may be going fast. If they call back again, I'll probably just nab one. It would really suck to move back to August after this much activity and excitement.

A weak weekend

Well, I suppose it's good news that I didn't have enough pain to complain about it today, and the bad news is I didn't do enough to blog about it. I did spend about 3 hours over the course of Sunday banging a heavy metal pole into concrete. Our wooden fence blew over lsat week, so we took a couple posts that had rotted out at the base. When I remove them, the measured just uder 6 feet. Off to home depot for 6 foot posts. Nope, we only have 8 foot posts, they say. I nearly ask them to cut one down to 7 feet, but I didn't. Digging for about a minute, 'clink'. Concrete. With 2 feet of my 8 foot post in it. I'm about a foot or so into the first of two of these suckers. 50/50 on whether I finish myself. Good arm exercise, though. If I can list it tomorrow.

Much ado about something

Got a call from Sharon at Obi-wan's office this morning. She gave me 6 dates in July that might work,but for visit only. I took the 7th of July, and then she said she'd also check if I could visit in July for a possible visit and surgery. Hooray! Since I thought that wouldn't happen until August. Just for kicks, I also call Shelboure in Indy - he could see me pretty much whenever. Pat was really nice on the phone, said I'd bring all my info - they have a hotel you stay at down the street and do therapy in the room for about a week after surgery. Said he was a soft tissue expert as well. So it was a good day; now just need to figure out how to schedule everything in.

Funny, from talking with my mom about this, she evidently talked directly with Dr. Eakin!@? Not surprisingly, she couldn't remember his name, but only that he lived in palo alto. He said Steadman was the best and closer than he was. It was funny. Typical of my mother to do something amazing, not know it, and not remember anything about it.

But at least the wheels are in motion, and things might happen sooner than later, which is good for the wedding and probably my knee as well.

Good times

Feeling pretty good today. Knee hasn't bothered me - an occasional buckling feeling but I think that might be from trying to walk a little straigher. Also made an appointment with Dr. Windler finally and will pick up all my records from Schoch next week. Think it will be nice to actually see all the data together, who knows, might bring something to light that I hadn't thought of before. We shall see -

Therapy,

Interesting time in therapy today. Did the normal exercises, except for anytime on the treadmill. 8 pounds on the table, direct to 5 minutes on the bike. Then to the table, with 10 minutes of assisted ankle raises, then manual patela mobes, then overpressure. And the knee was measured at 5 degrees. Yup, 5 degrees. I haven't been in a week, I had knee pain yesterday, and today I had a little knee pain right around the bottom of the kneecap with the overpressure, but measured at 5 degrees. Wacky. Flip side, I did notice on a couple of steps since then the knee started to briefly buckle inward, might be from the fact that at that angle it can't support that weight, but we'll have to keep an eye on that one. With that, a little nervous about mowing the grass, so we'll probably look for some backup for that this week.

Kno knew knees

Feeling pretty good today. Been walking on it without too much difficulty or pain today. Called two doctors, one in San Antonio and one in Dallas who trained with Steadman. Unfortunately, both of those guys have decided to focus mostly on shoulders, and one of them doesn't do second opinions. So another word of advice from folks local may not be an option. Might be able to find someone, as I found another longer list of folks that trained with Steadman, so we'll see how that goes. Off to therapy! Seems like it's been so long...

ok, knee's on the way up

After the drug. But I think that's as much to my walk as it is to the pain residing. I'm guessing that i just lost my train of thought, so this post is pretty much done. Still some ow. Actually, just remembered. Don't think I could mow the grass in my current state. That pretty much sucks.

Ow.

Phunk. My knee is killing me right now. Walked 1/2 a block outside for lunch and the area on the inside of my knee right below the kneecap started screaming. Kept that up even after lunch. Every step hurt. Same spt as when I've been running and have had to stop due pain, but in those cases, i could still walk without much difficultly. Every step hurt in this case. Can't think of anything I specifically did this morning or last night that would've caused the problem, so I'm at a loss on this one. Obviously, the lack of PT or gym could be it, but that seems suspect since I've been on pretty much the same schedule for the last month due to sick/meetings/whatever. I'll probably pop a pain pill and see if I can schedule some dr appointment. Ow.

Little rougher

No exercise today, knee feel decent most of the day, walkedtoTexsadelphia. Did have some trouble,stiffness when standing up before walking to lunch. Also had a little soreness after riding to get a .99 junior banana split at Sonic. Decided not to go to PT today - ended up with a meeting anyway, so probably won't have been able to go. Not sure if my general good mood earlier was from lack of PT (mentla) or fact I exercised yesterday. Also had a little headache this evening, possibly could've been lack of drugs around that normal time, but always tough to say...alas, many things are tough to say these days.

Another day, another exercise

Lissa andI went to the gym this morning. Knee started to feel sore again after on the elliptical for 20 minutes; 10 minutes on the rowing machine. Walked around to get the mail too, whohoo! Two ultracet definitely helped that. Considering heading to the gym some mornings when Lissa heads for her 5:30 MWF sessions. But then again, that's pretty early. Ok, that's REALLY early.

Another day, not another exercise

Lissa went running this morning, and we didn't make it to the gym. The knee felt ok today; we were walking about the mall for a couple of hours, and it seemed like the knee has a little more extention. That actually created additional pain for a bit. Not sure whether I adjusted my gait or I got used to it, but the pain went away after a little bit. Read part of a paper online by a new guy from Indiana that indicated you normally slow down PT leading up to another surgery, to enable the swelling to decrease and the knee to get back to 'normal'. Assuming I'm going to have surgery in a couple months, that advice would help my mental state and my pocketbook.

Poppin' and drugs

Still didn't make it to the gym yesterday. Physical theraphy this morning either. Knee actually feels a little limber, ironically. Not much pain, but I can 'pop' the outside of the knee on some mornings. This seems to create some looseness in the knee (probably need a better word there, but maximum verbosity isn't on today). I can't seem to tell over time if therapy has been helping or not. I can't seem to get any additional flexion or extension afterwards. I'm considering just trying the drugs to see how that works. The pain med doc doesn't seem concerned at all about addicition at the dosage I'm at at once a day. He actually had an interesting point, it's not addicition to be concerned about, it's dependency. Assuming that means it's ok to go on something as long as you can wean yourself back off. I'd didn't take a neurotin at therapy on Wed. Huh, just now wondered if taking that only with therapy is actually helping or just flowing through my body like a piece of gum, since I'm not taking it 3 times a days, I might not get the benefit. But since none of the doctors have mentioned it either way, who knows?

This is drinking, eh?

Woozy. So very woozy. Wasn't until the end of therapy, but roxicotin. Whoo. Knee's feeling decent, was actually able to walk up the stairs a bit easier than normal. The knee felt pretty stiff as Adam pushed on it today. Might be becuase I as still, I did move from a strong flexion exercise right before he tried. Always tough to tell. Knee felt very stiff this morning though. Trouble moving it to much range at all. While at theraphy, did have some new pain, though. On the insde of the knee, right below the knobby section on the inside, had pretty good pain when I pushed on it, started when I started on the bike. First time I can remember anything around the knee begin tender. I also had the same pain as I've felt before, where the inside right part back of the knee was really sore and stretched. and moving from extension to flexion and back on the total gym or after the table flexion was pretty painful too. But right now, it's all about the drugs. woozy. if this is drunk, it doesn't feel that great. And I'm not feeling any more confident if I was to hit on a member of the opposite sex either. Uh, Lissa, no plans to do that. I should probably stop now.

The grass is always greener

Man, mowing grass sucks. Exhausting. Ironically, the knee wasn't too, too bad, but back was sore and I felt like I had run a marathon. Doing this all summer might really suck. Glad I finished though, as it rained like CRAZY last night.