Saturday, January 23, 2010

staring at the walls, recovering

So it has now been a week since I fell off the bike.  I'm still hobbling on crutches (doc did say it would be 3 weeks), I can now put some weight on my bad leg if I use the crutches to distribute the weight.  W says it would be easier with a walker, he's probably right.
I'm getting a bit tired of staying in, but yet don't quite feel brave enough to face the stairs.  We live in a split level, and I managed to drag myself up to the main floor last saturday with sheer determination.  I think I can get back down now if I use the crutches right, and slowly make my way down.  Getting back up again will be harder, but guess I can always do the same butt scoot I did the last time.
The team went out for another bike ride today, I am sorry I missed it.  They went about 12 miles around and near wildwood park.  Since it appears we can't go without having some form of excitement, W was the designated clutz and fell off his bike while going up a slight incline.  He said it was similar circumstance in that there was dogs involved and he didn't shift down enough to make the hill.  He rolled down an embankment and avoided going in the pond thanks to a wisteria bush.  He's ok, just a little sore.
I am sort of dreading going back to work this coming Wednesday.  Not only will I have to drag myself across the parking lot to the building, (now is when one of those handicap things would be handy), but then I will have to be there all day.  I find that my routine here involves short time spans of working in my office (organizing my desk, wasting time on facebook and other things that take up exorbitant amounts of time), and sitting in the recliner in the living room and either reading (mostly), watching tv (not so much), or napping (popular especially in the morning or late afternoon).  I won't have those options while at work.  I will have to somehow stay focused and working at my desk for 8 hrs.  I was also talking about it to M and mentioned that I wasn't even sure what I would wear.  She wanted to know what I meant.  Well, I can't fit a shoe over the aircast and don't want to go all day and/or do that much walking wihtout it.  She said just put a shoe on my good foot and leave a sock on that one.  I guess.  Did I mention that it is a big parking lot?  I think I may park in one of the visitor spots that are about as close as the handicapped.  Although they are often taken.  Most of the handicapped spots are always open, with only one or two having any cars in them.
M says to quit worrying about all that until after I see the dr on Monday.  I guess sometimes what drives me the most nuts is the unknown.  But since that is such a big part of MS, I guess I need to get used to dealing with it.

Sunday, January 17, 2010

Clutz.... How not to fall off a bike

Well the weather has warmed up here in central pa and we had a "heat wave" of 40's to low 50's weather. Great stuff. The cold effects me much more than hot weather.
The weather was so nice yesterday that we decided to go biking. M's sister got a new bike for Xmas, and she was itching to ride. So we went headed off from city island across the bridge and down along front street. I'd gotten a face mask which worked out great M teased me and called it my hannibal lecter look. But it worked great. The under armor pants and new bike shorts were great too.
I had gotten a second bottle cage for my bike for Xmas and had two bottles with me. I brought gaterade g2 instead of just water and it seemed to work well.
We went about 11 miles. I even was able to make it up the big hill ramp at the end of the path by the river closest to rail trail. I'd always had to walk it before. So I was feeling strong. It was a great ride. We started to ride on the rail trail but W was having trouble with his wheels bogging down so was M so we decided to head back toward the island. On Way back M and her sister were a ways ahead of me and I watched as they went up the ramp near the bridge to the island. A couple was there with their dog and the dog lunged and the woman had trouble controlling it. As I came up to the ramp I was watching them get the dog under control and I was busy thinking about that and didn't gear down enough to prepare for the hill. Soon as I passed the couple I knew I was in trouble. So thought i would have to stop and walk rest of way. I need to figure out a better way to stop on a hill. Last time I did that on a hill on city island I fell and strained my wrist. This time wasn't any better. I went to stand on my left leg and my trick knee went out. And down I went. Hard on my knee. Twisted my ankle and rolled down hill in process. As I lay there thinking how stupid. And what I should have could have etc. The couple came back to ask if I was ok. And wanted to help me up. I said I was ok and they didn't need to call anyone that I was riding with others. I was laying on my back thinking I may have broke something this time. M and her sister came back to check on me. W was there pretty soon too. I tried to get up on my own and knew my left knee and or ankle was really bad. They had to pull me up. I couldn't put weight on my leg so I used M and W as crutches and hopped (very slowly with several breaks by this point I was exhausted and had no reserves) to the top of the ramp to find a bench. They went back for the pilot to come get me.
They wanted to know if I wanted to head home or ER? I opted for going to OSS urgent care down in York. They have my records and is where my osteo is. I think it was good choice. The wait was less than at hospital ER. They took xrays of knee and ankle. Saw the doc on duty and he said I have a hairline fracture in my ankle and twisted hell out of my ankle. Also bruised the hell out of the tendons below my knee knee cap and had a hematoma (blood pooling right below kneecap making it look that much more swollen.) prognosis is that I'll live, it could have been much worse. But could have been much better. He said i'd feel the worse the day after and day after that. I'll be on crutches and using an air cast for about 3 weeks. I have pain pills and need to keep leg elevated and ice on ankle and knee.
Using crutches sucks. The nurse that gave me brief instructions on how to do it mentioned thst i would find using them is exhausting. Very true. M keeps after me to make sure I keep going. A combination of trying to keep me motivated and moving since I have to to get to wherever I'm going and partly that she really doesn't get the exhaustion. When my reserves are gone. I have nothing left. Just grit and determination. And i become even more unsteady unbalanced. Not good for a gimp on crutches with one knee and ankle already screwed up.
So now I'm home and recovering. Looks like I will have to postpone the arthoscopic surgery on my right knee until this clears up with my left leg.
There has got to be a better way to dismount off my bike if I get stuck on a hill and can't make it up. This fall and roll is just not working for me.

Saturday, January 9, 2010

MS bike ride, getting involved

One of the incentives of trying to get in better shape, is that M is determined that we participate in the MS Bike Ride this year.  She wants us to form a team, the two of us, her dad, her sister and her partner would be members (least at the moment).  The ride near us is June 24 & 25 from Paradise and back. For more info see: bike MS: To Paradise and Back 2010.  Sounds ambititious.  When M first looked at it, she wanted to plan to do 150 miles - 75 each day and go for broke.  Considering we just got back on a bike this past summer that seems a little over the top to me. 

After checking into it finding out more details, we discovered that in ordre to register you have to pledge to raise at least $150 if you ride 1 day, or $250 if you ride both days.  Both days they have 25, 50 and 75 mile loops that you can ride.  If you form a team, then each team member still has to meet that minimum individually.  I'm not sure we will have a team.  But I do want to do the ride.  Right now we are talking about just doing 1 day, and we can wait to decide how far.  M is now thinking maybe going for 50.  I'm thinking I'm shooting for 25 to start with.  The money raised goes to local programs and services for the local chapter(s) of the NMSS (National Multiple Sclerosis Society) and to research.  I think last year the Paradise ride was co-sponsored by Central PA and the Greater Delaware chapters.  I didn't know anything about it last year.  But then I didn't really know anything about MS last year.

Once we have registered and I can figure out how to link that to here, I will post where someone can go in and pledge to sponsor me or my team.

Right now I'm working on trying to get in better shape so as to survive 25 miles on a bike at the end of June.  I only went a couple times out around locally before winter and we averaged about 10-12 miles so I think 25 is do-able.  I'm hoping that if I have the surgery (or for that matter if I don't) on my right knee that it won't effect the plan for us to ride.

Bees Knees

It seems for me, the odd years (2007, 2009 for example) have been the years that I've had various medical issues, found out that I have various things wrong with me, in 07 I had a couple minor/major surgeries, in 09 I found out among other things that I have MS. I also found out that I had nodules on my Thyroid (found during MRI scans that were for the diagnosis of the MS), I still no nothing for sure about the nodes, other than I get to go back in 9 months for another ultra-sound and that my dr wants to take the wait and see approach.

I also found out in 09 that my "good" knee actually is more bone on bone with Osteoarthritis than my "bad" knee. I still think of it as my good knee since it is still the stronger and more dependable one. What sucks is that since it's got arthritis behind the kneecap it is the one that aches the most at the moment, the other knee is manageable with periodic synvisc shots (at least pain-wise, it still threatens to just "go-out" on my for no apparent reason when I first stand up).

My bad knee has caused me to do my impression of a drunk at a local bar on more than one occasion. I don't know why bar/restaurants have the tables with the high stool seats? I sit for very long on those, and when I stand, I never know if my knee will work with me or not. Just recently, right before the holiday's we had gone out with M's sister and her partner for wings and I went to stand to go to the restroom and I felt the knee go, so I just rolled with it and landed on my back looking up at a couple that were waiting to be seated. The guy was very helpful and concerned and help me regain my feet.

Having lived with the "bad" left knee for the last 8-9 years or so, I was very unhappy to learn last year that my "good" right knee was actually in worse shape. My osteo doc says that xray's and tests are deceiving, that what matters is how they feel. True. And that would be fine if the right knee continued to feel ok and not bother me. But that arthritis behind the knee cap is annoying. It makes it hard to drive for long distances, I want to shift my leg around and find a position that doesn't ache and I can't. My doc calls it "movie theatre knee" because people that have it can't sit through a movie. I also can't sit still through lunch and pity my lunch companions that are unlucky enough to sit across from me. They know when it is worse than normal, guess the kicks in the shins are a good clue. It also wakes me up, and keeps me up at night. Which I'm finding with the MS, interferring with getting enough sleep is harder to overcome than it used to be.

I'm used to dealing with pain, working through pain, but this kneecap thing is something different. I am sure it is not the worst pain I've ever had. It is just the most annoying.  And it is getting worse. The shots don't help like they did on the other knee.  I saw the ortho doc and he says there is little else to do at this point.  As he said, we have talked about the fact that what I need ultimately will be to replace both knees (initially 8 yrs ago it was just the 1, now it is both).  And that what we need to do know is to do what ever we can to put off when we will do that.  You may ask why? I know lots of my friends did. Well, in order to do the surgery to replace a knee, they have to trim the ligaments and tendons and use them to attach to the artifical knee.  Unfortunately the ligaments and tendons are something that the body will not grow longer, so apparently it is only possible to do 2 replacements of that knee due to the length of these.  Replacement parts are improving, and the titanium they use for the knee itself is very good and lasts a long time.  Unfortunately the plastic they have to use to simulate the cartiledge is not so good and only has a life span of 10-15 yrs. They are finding new techniques and plastics so that might change but they haven't been in use long enough to really know.  So the long and short of it is that they don't like to do knee replacements on anyone until they are at least in their mid- to late 50's.  I'm in my 40's. 

When I saw my dr this past week, I pointed out that I was now in my late 40's - 47 to be exact.  But he said he would really rather it be at least 6 yrs from now if not closer to when I'm 55.  I can see the point - worst case (have to look at worst cases, because I've found in my life and in my family they often come true - prepare for the worst and hope for the best), I could have a replacement today at 47, have it only last 10 yr, and get my 2nd at 57 and now if it lasts even 15yrs, that will put me at 72 and unable to walk.  Not bad maybe.  However, my dad was 79 and would have continued on if it weren't for getting GBS (Gilliam Barre Syndrom) at 76 and never completely recovering from it.  My mom is still going and is 83.  Course if that 2nd knee only made it 10 yrs, I'd be 67 and unable to walk.  Not good.  I explained this to an acquantance and her response was, well, then at that point why not cut your leg off and get a full leg prosthesis.  Hmmmm. Yeah, why wait, do it now?

So my doc offered that our other option at the moment for the pain-in-ass kneecap was to do orthoscopic surgery on it, go in with a camera and clean out any irritants, loose cartiledge, and smooth any rough spots and arthritis.  This could help and is less invasive and easier recovery than a knee replacement.  The knee would be sore for a while, and I would be on crutches for a bit.  Since I work as a network engineer and sit at a desk behind a computer most of the time, I would only miss 3-4 days of work.  Risk is that it might not really help all that much. Or it might not last that long.

So, I spoke with my big brother, who is a cardiologist, 11 yrs older than me, and who I trust when it comes to medical delima's and asked for his thoughts.  His take was that this wasn't his field, but based on what his friends (in the field) say, my doc is right, we need to wait on the knee replacement.  B says knee replacements are still in their infancy.  Hips and other things (shoulders?) are well established.  Knees are different, partly because of the need for the plastic which we haven't discovered something that holds up well or long enough, because of the only being able to do the replacement 2x in a person, etc.  He said his guys say that I would be best to wait until I'm at least "HIS" age - as in 58, before thinking about a replacement.  His suggestion was that if the knee was giving me fits, he thought the orthoscopy would help, and anything to delay the replacement was worth doing. 

So everything seems to lean toward doing the orthoscopy.  I'm afraid though.  That's my "good" knee.  The dependable, stable one.  It may hurt but I can count on it.  The other one isn't in pain at the moment - it will in about 6 months or so, start aching and then it will be time to think about another round of shots.  But even though the left doesn't hurt, I can't count on it.  It might fold.  So contemplating having surgery on the good one, and having to depend more on the bad one is a bit scary.  I mean I depend so much on that right leg.  It stablizes me when I first stand up, until I can feel that my left will carry my weight.  That's the knee I kneel on if I have to kneel down (I don't recommend it with knees like mine), and I even kneel on it on the bed each night to climb in. So many things currently depend on that knee - old dependable.  "Old" being very fitting in that my osteo says while I might be 47, unfortunately I have the knees of a 67 yr old.  I'd like to find her and swap back...

This morning, my knee is really bugging me.  I'm having a hard time sitting to write this.  I stretch it out and prop it up and that's ok for a while (like 5 min) then i have to move it.  I get up and walk around.  I sit down to work again.  For another 5-10 min.  That is like my typical morning or afternoon at work. when the knee flares up, I can't find a "happy" position.  Excersise doesn't even help either.  My left when it starts flaring is helped when i get on the bike and ride for a while (either the excersise or real doesn't matter).  I try that but doesn't help with the kneecap.  In fact it stays irritated when I'm riding.  So I try to ignore it.  I did ride the excercise bike this morning about 15 minutes then i gave up.  I also did 15 minutes on the wii fit.  I'm trying to get in better shape (one of my "non-resolution" intentions for 2010).

If the knee keeps up I guess I will proceed with orthoscopy.  If that works, then I'll still be able to depend on my stable knee and it won't drive me nuts.  So if I look at it that way it could be a win situation.  Least enough to buy a little more time.

A New Year, Time for New Resolutions

It's a new year, 2010. Start of a new decade. New Years is always the time for new resolutions, everyone makes plans and states their good intentions, many of which fall by the way-side soon as they are spoken. For that reason I prefer not to make any new year resolutions, and just state that my intent is to make this a better year.