Tuesday, February 5, 2013

How I Tore My ACL



and my MCL
and possibly my meniscus

The Short story:

I hurt my knee skiing.  I’m having surgery to reconstruct my ACL.  I hate crutches.  I’m going to have so much fun skiing . . . next year.
Watch for swimmers!

The Long story: 
Christmas, 2012 was magical.  
Anchorage had a new layer of snow, and the temperature warmed into the 30’s, which feels just plain warm and balmy after hanging around -10.  I spent the week skiing and cross country skiing with the kids and some friends.  The 27th, we decided to make a day of it at Alyeska.  My two youngest children are pretty new to skiing, and they are doing great, but Alyeska is a more advanced resort (and more expensive) than Hilltop, which is a 10 minute drive from our house.  We were ready to head out to Alyeska when we checked the ski report and saw that it was raining (yes, raining!) at Alyeska.  We decided to stick to Hilltop one more time before trying Alyeska with the kids. 
Caleb.  Just to the left of his head, you can see Denali, glowing orange in the sunrise.


We had a great time!  The lines were very short.  The kids saw several friends.  The snow was a bit icy though.  No biggie.  We skied all morning until it was 12 o’clock and time for lunch.  I saw my girls on the lift and told them to meet in the lodge.  I convinced my youngest son, Caleb (6) to try a new run – one with a bit of a steeper hill at the end.  He was ready for a challenge.  I let him go ahead of me (if he fell behind me I wouldn’t be able to stop and help him up) and he came to a stop when he saw the steeper incline.  I reassured him that I could help him down the hill.  I did what I had done with all of the kids when they were little – I put my skis outside his and made a snow plow.  I have done this a hundred times.  Something went a little wrong this time.  Some how, one of his skis got stuck under mine.  I tried my best to pull him out, but we were going pretty fast, and my snow plow was being pushed wider and wider, until Caleb fell and kind of took my right knee down with him.  It was slow and awkward.  
I heard a snap and felt a flash of pain.  We landed in a very awkward pile.  My first fleeting thought was that I wouldn’t be able to do the Salt Lake City Marathon this year.  (True.)  I’m afraid I was a bit dramatic the first ten seconds.  I kept saying “I’m hurt I’m hurt” and kind of freaking out, until I looked at Caleb and realized that he was freaking out too.  So, I took a couple of deep breaths and tried to reassure Caleb that we were fine and I asked him to help me take my skies off.  My leg was stuck in a completely unnatural position, and he was tangled up with me.  I got his skis off and told him to walk down the hill and tell Dad to get the ski patrol.  The lodge was only 200 m in front of us, so it wouldn’t be hard.  I got my skis off, lifted up my right leg, and tried to put it in a more natural position.  And it felt better.  But it felt like my knee was loose and wobbly.  I didn’t want to wait, so I tried to scoot down the hill.  That was really uncomfortable, so I thought I’d try walking down the hill.  I picked up my skis and stood up, only with my ski boots on, I kept sliding.  So, to give myself a little more control, I put my skis on and skied down the hill.  I went in to the lodge and had a little lunch and Shon walked me over to the first aid station. 
They played with my knee (which was swelling up by then) and said they thought I had torn my ACL, and I should go to the Orthopedic clinic and get it checked.   I left with a couple of free passes to ski again, my leg in a knee stabilizer and with a loaner pair of all-terrain crutches – it is Alaska after all.  Since I didn’t hurt very much, I assumed that I had just sprained my knee.  (I realize now that if it were a sprain, it might have actually hurt worse!)
In order to sit in the car with my leg straight, I had to sit in the middle, next to Shon, like a red neck.  I think he liked it!  

The rest of the day, it continued to swell up.  It didn’t actually hurt much if I didn’t move.  I packed it with snow.  That really helped with the swelling and throbbing. 
Whenever I thought of the sound my knee made, I felt sick to my stomach – especially if I thought that perhaps I had torn something in there.  So, I just kept saying to myself that it was probably just a sprain.  I kept saying “tomorrow I am going to feel so much better.” 
I didn’t feel better the next morning.  Putting weight on my knee felt like trying to stand on a tower of blocks – I was going to fall apart.  That’s when I decided maybe it was time to get an MRI.  Being new in town, and not knowing what my insurance would cover, I went to see my GP.  He said he thought it was probably just a sprain but maybe we should get an x-ray to see if there was any damage.  Nothing showed up.  Then, as an afterthought, he tried pulling my leg forward, and it was very loose (classic sign of a torn ACL) so he sent me for an MRI. 
I love Nordic skiing!

I didn’t feel like there was any urgency, and Shon and I had tickets to see Stomp that night, so I almost didn’t get the MRI.  With Shon’s urging, I did it anyway.  (The concert was great, and we were able to move our seats to the wheelchair section, where I kept my knee up on a folding chair.  I tried to crutch it to the parking lot afterward, but using crutches on ice is surprisingly exhausting, so I ended up waiting on the street, with the homeless folk in front of City Hall!)
Perhaps this is a good time for me to mention that if I could do it all over again, I would just go straight to the Orthopedic clinic first.  I would have saved myself a lot of waiting. . .
Did I mention that it was the day before New Year’s Eve?  I should have known it would take a long time to get my results back.  I had the tests done on a Friday.  I hoped to hear the next day.  My actual results didn’t come back until Wednesday!  I happen to have a friend who is a radiologist though, so I called and asked if he could tell me a bit about the results (because, even though I kept saying that nothing was wrong with me, I knew there really was something wrong.)  He called me Monday morning and told me that I had torn my ACL and MCL.  I asked how bad I had torn them, and he said the MCL was a grade 3 tear.  Well, that didn’t sound too bad.  I did a little research and found that grade 3 is the most severe.  It was severed.  The good news was that my cartilage looked great!
Emily the snowboarder.

One of the problems with hurting yourself during a holiday is that all of the doctors are on vacation!  I tried to make an appointment with Dr. Manion, who I heard does the best knees. He was out of town, and wouldn’t be back for a week.  I figures it could wait.  Then, on Wednesday, my GP called me to tell me the results of my MRI.  He said “It looks like you’ve done a real number on your knee.  It isn’t an emergency, but you should probably have surgery some time in the next couple of days.”  What?!  That sounded a bit urgent to me. 
So, I made an appointment with another doctor I heard did good knees.  He fit me in that Friday.  I was very relieved to hear that I would need to wait a month or more to have surgery.  It took all of the pressure off.  He was very competent.  He showed me the MRI, and even pointed out that there was possibly a tear in my meniscus – which the radiologist hadn’t even mentioned.  He recommended that we take a graft from my hamstring (an autograft), and in 6 weeks fix my ACL, if my MCL had healed on its own, which it does 90% of the time.  I left the office with a much nicer, though still very bulky, leg brace, and instructions to keep my leg straight for a few more days, but to try putting weight on my leg more. 
Shopping.

Did I mention how much I hate crutches by this time?
Now that I knew there was no rush, I took my time and did a little research.  Shon (being an engineer) insisted that we get a second opinion.  I am a very loyal person.  I felt like I would somehow be unfaithful if I saw another doctor.  But, I also saw the logic in what Shon said, so I called and got an appointment with Dr. Manion, who had been my first choice all along.  I also started doing a little internet research, and talking to my friends/perfect strangers/physical therapists about their experiences with ACL reconstruction. 
Dr. Manion said all of the same things the other doctor had said.  Then he recommended that instead of taking part of my hamstring, we use a donor tissue, an allograft.  I had read about it, and saw that the results were nearly identical between allografts and autografts, unless you are an elite athlete, in which case, the autograft is slightly stronger.  I’m not an elite athlete.  I chose the allograft – the scaring is less, and the recovery is faster, since there isn’t a second site that has to heal. 
I’ve heard people say that they weren’t comfortable having cadaver parts in their body.  Let me say that I definitely prefer to call it a donated tissue.  Some really nice, healthy person has given the gift that keeps on giving.  The least I can do it refer to it them as a “donor” not a “cadaver.” 
So, then I had to decide which doctor to go with.  During this ordeal, I only cried twice, and once was when I had to call and tell the first doctor I saw that I had chosen another doctor.  (Seriously, I may be lazy and unorganized, but I am Loyal.)
The second time I cried was when I talked to my younger sister, Becki, who blew her ACL in high school.  She was an excellent athlete who had college scouts watching her.  When I thought of how hard it was for me, I realized how much harder it would have been then.  I’m sorry, Beck.  I hope I carried your books for you as you crutched around the school.  It probably felt like your friends had just moved on without you.  I know.  Sorry. 
I guess I have gained a little empathy.  That’s a good thing.
My ski buddy and I on the lift.  I swear it was so cold that time, I almost lost my nose.

Actually, I would say that in general, it hasn’t been a complete disaster.  I have learned a little more patience.  I have learned that my children don’t really need me.  What a great compliment – they have learned enough to take care of themselves, sort of.  (No one really folds their laundry, but that was extra credit anyway.)  I have learned that I have the sweetest husband in the world.  He is so patient.  And I can’t help but think that somehow this is all part of the plan.  Some times bad things have happened to me because I knew I was doing the wrong thing.  No.  The whole day that I had my accident I was where I was supposed to be, with my favorite people, doing one of my favorite activities.  It was all part of the plan somehow.  
I have been doing physical therapy 2 times a week for the past 4 weeks.  I went from not being able to bend my leg , to being a pretty normal person.  My injured let started with the ability to bend to 80 degrees (my good leg was 150) and ended yesterday at 147!  I love my physical therapist, Tiffany Zollinger.  She is just the right combination of encouraging and punishing.  I ditched my crutches two weeks ago.  I feel my knee slide forward whenever I walk up stairs, but other than that, I feel like a pretty normal person with a brace and a limp, and one leg that is way weaker than the other.  Man, you wouldn’t believe how fast my hamstring disappeared in my injured leg!  It was hard work to get it back.  It’s sad that I will have to start all over again tomorrow! 
Dr. Manion said I will use crutches for most of 6 weeks, and wait 4 months to run on a flat, controlled surface, and 9 months before I do anything athletic.  Good thing the snow sucks this year.  I’m going to have a great time skiing next year.  Maybe.
It’s Feb. 4, 2013.  Tomorrow morning is my surgery.  I’m ready.  I have already picked up my Continuous Passive Motion (CPM) machine, aka “leg-o-matic” with instructions to keep my leg moving 6 – 8 hours a day!  Seriously.  Am I supposed to sit 8 hours a day?!  I’m lined up for an ice machine.  My in-laws are coming to help out next week. (Thank goodness!)  I have the first 3 seasons of Downton Abby to catch up on.  And most importantly, I got a pedicure.  If I’m going to be stuck looking at my leg 8 hours a day, I better have nice toe nails!


Wish me luck.  I’m nervous.