I paid to have my ass kicked! I had another physical therapy session last night. First thing we did was take a measurement of the range of motion I had in my knee, I got 102°, only a 2° increase from Monday. Next I went through the torture of them physically stretching my leg to increase the ROM. Most of the stretching was just gravity doing the work but it was quite painful. And on an aside, what the hell is with the 1 to 10 range of pain? I have the hardest time trying to describe pain and where specifically it is coming from. Let see, my knuckles are white from holding onto the side of the table and you have to keep reminding me to breathe, how much pain do you think it is 4? Despite the pain, regardless of the fact that I complain about their number system, I really don’t mind if it hastens the time until I get off the crutches and out of the brace. We measured once again and I was getting to 104°.

I then got set up on a large version of a CPM machine. I was on that for quite a while and that gave my knee a good stretch. The next stop was the bike. The nice thing about the bike was I was able to get a little speed and no pain at the same seat height as Monday. I also ended up lowering the bike seat two notches over that time period. At the lowest notch that I had it on (I think it was 6, not that it matters) I could feel the stretch in my knee but was still able to pedal with some speed.

After I was done with the bike I had one last measurement of my ROM, 110°! I was very happy with that, still not at my goal to move onto the next section of rehab but at least I seem to be making decent improvements. If I am able to get to that 120° mark by Monday that will only put me one week behind the schedule and maybe I can catch up.

The last thing we did was electro therapy with quad settings. A little over two hours from the start of therapy I was done. To say the very least I was beat! I plan on going to the gym this afternoon to ride the bike; hopefully I’ll have no problems making a full rotation now.

It is six weeks today since the surgery and I didn’t make the 120° passive motion but I did improve. Friday I crutched my way over to the MAC (Malcolm Athletic Center) to ride the bike. At therapy this past Thursday I was able to do full rotations on the bike so I figured I’d be able to do it on the bikes there. Well, I was able to raise the seat as high as I wanted but the pedals are longer so I really was not able to do the rotations. Regardless of that I did half moons and continued to try to make a rotation. Before I was done I was able to do a few rotations but I should have apologized to the person on the bike besides me. The first time I made a full rotation a got a shock of pain and made a voluntary yelp that scared the life out of him. It embarrassed the hell out of me but the funny thing (other than the fact that it made him jump) was that he looked over initially but then went right back to biking like nothing happened.

Over the weekend I went to my in-laws to use their bike. I could not even get close to making a full rotation on that. Their bike I think is older than me and the seat is very limited as to how high you can raise it. Needless to say I had it at its highest level. I still used it and made half moons on it, anything to increase my ROM.

Yesterday at therapy I knew that I didn’t have the 120° but I did think the swelling went down a bit. We took a measurement of the ROM and I had increased to 98°. At this session I rode the bike, I went down to a lower level on the seat. When I was done with the bike I had some pain while trying to straiten my leg, first time I have had any real issue with that. My PT seems to think that it is possibly due to the fact that my knee was bent for an extended period of time while on the bike. After the bike I did electrolysis on my knee (not the type that just runs currents through it to reduce swelling but the type that induces the muscle to flex, I love that one) and quad settings. At the end of the session my ROM was 100° and the swelling (although looked like it had gone down a lot) was down from last session by a ¼ of an inch.

I have included a couple pictures of my knees so you can see the amount of swelling. At this point you can start to see my knee cap now but you can see the amount of swelling that is still there compared to my right leg. Something else that is a bit disheartening is the amount of muscle I have lost on the left leg. I have no thigh or calf in the left leg any more; you can really see this if you compare the calf muscles.

I went into PT yesterday not feeling very good about my progress so far. I (thought I) had worked rather hard on my knee the past couple of days to try to increase my range of motion. First thing we did when we got there was to measure the amount of swelling and my range of motion. The swelling was about the same and I only gained a couple of degrees of ROM.

I think my PT saw the fact that I was disappointed with my progress so far. She called another PT over that has had some experience with Carticel to take a look. First off she didn’t seem concerned with the amount of swelling that I had on my knee. She then went through some initial tests to make sure that there were no calcium build-ups that are impeding my motion. Good news seems that there aren’t any. The next thing we did was some aggressive (another way of saying painful) stretches and exercises. By the end of that I was able to get a ROM of over 80°.

Next they had me get on the bike. They wanted me to start doing half moons but I was able to do full pedals (at no resistance and slowly with pain). I continued to do this for about 45 minutes while receiving electro-therapy. At the end of my session we did another measurement, the swelling was the same but I had 90° ROM. I was very happy with the progress of that session.

The reality! This coming Tuesday will be six weeks after the surgery. At six weeks the goals are to have full passive knee extension, minimal pain and swelling and a ROM of 120°. The only goal I have reached is the full passive knee extension. I’m going to work my ass off this weekend to increase my ROM but 30° in a couple of days will be a lot. The other issue is that my insurance only covers the PT for 60 concurrent days so I really do not want to fall behind on the rehab schedule. This afternoon I’m going to stick my way over to the gym to ride the bike. I hate walking around on the crutches in public (I have to go about 6 blocks to get to the gym) but I need to start seeing progress.

It has been five weeks yesterday and the swelling has gone done enough that I can just make out that there is still a knee cap there. For me this is just not going fast enough. I just do not have the range of motion yet. By week six (according to the physical therapy protocol) I am supposed to have a 120° ROM, I am not even close to that yet. There are a couple of improvements though.

I decided to try to drive my car to the PT yesterday. The only reason I mention this is because my car is a stick and I have not been able to drive it since the surgery. I managed to make it there without much discomfort, the way home a bit more but I was worked over a bit. The best part is that I drove into work today! I was able to stay in bed a couple (yes couple) extra hours since I didn’t have to get up quite so early for my ride.

The PT seems to think the swelling has gone down a bit and was happy with that. She has also suggested that I try to take time at work and lay down with my leg elevated, not a very easy task at work. While there she had me doing isometrics with electro-stim. She also added a couple of stretching exercises for both my hamstring and calf that I now need to incorporate into my routine. The most painful part of the PT session was the knee massage I got before I was done, it is still quite tender.

I had my first physical therapy session this past Thursday. Not much to speak of, it went pretty much the way I had expected it to go. I ended up going to the same place in Concord that I went for the last two procedures. No one there was failure with the rehab protocol for cartilage replacement (as most people aren’t) but luckily I was smart enough to bring Carticel rehabilitation manual.

Karen the therapist was surprised by the amount of swelling I still had (five weeks and still no kneecap). I am now taking 600mg every four hours as well as compression and ice to combat the swelling. I need to continue doing the leg lifts and ankle pumps. I learned a few new passive motion exercises; at this point I really am not supposed to do much active motion. As well as the passive motion I have also added Patellar mobilization (moving the knee cap around), quad settings, and multi-angle isometrics. The last two is just flexing my leg and surprisingly it is a lot of work.

My PT schedule is now twice a week. I’ll be back there again on Tuesday (tomorrow) and I’ll report on the condition then and maybe have an updated picture of what the knee is looking like (not a huge change).

I’m back to work! I was planning on going back to work on Monday but Mrs. Bentley woke up with a nasty head cold. As I mentioned before, Tuesday the CPM machine was going to be picked up so I planned on returning to work on Wednesday. The pain I got from the CPM never dissipated and I never went past 90° and I can still only get about 40° outside of the CPM.

The CPM was removed by 9:30 Tuesday morning. Spending 6 hours a day on the machine despite how boring and painful it was really broke the day up. Not being able to do that really enforced the fact that I needed to get out of the house and back to work! You can only do so many leg lifts.

It was great to be back at work. I didn’t get much accomplished in terms of work; I spent most of my day going over other peoples work and changes that have been made to my projects. Right now I am getting a ride into work from a neighbor of mine; I get there before 7 and am leaving around 3:30, very odd hours for me. It is an odd feeling being the first person in the building (not just the office). I am going to have to figure out other arrangements for next week as he will be taking a class.

There may be a chance that I can borrow my brother-in-laws car for a while. His is not a stick and I should be able to drive it. The only issue there is that the garage that I park at is a few blocks away and I end up parking on one of the upper floors and it doesn’t have an elevator. I’m working with the parking department to let me park on the first floor. They are still waiting on a letter from my doctor stating that stairs can be treacherous for me while I am on the crutches. My HR person also notified the STD people that I have started back to work to find out that my doctors office never faxed back the papers they need. That was a bit disappointing since I had giving (and watched the doctor fill out) all of the paperwork to the doctor back on August 12th. Worst comes to worse I have enough vacation time to cover the laps in time; I’d just hate to waste it on my knee.

Work was relatively comfortable up until about 12:30. At that point it seemed like I could not get into any position that was comfortable. I’d lock my knee, flex my knee, put it up on the garbage can, and walk around a bit. It seemed as if I could not sit more than 10 minuets at a time with out my knee screaming. I’m guessing that each day it should get a little easier.

Once home I iced my knee for a couple of hours and did my exercises. I finally sat down to get entirely depressed by the Sox lost. It’s great to be back to work and have some normalcy!

Three weeks and still no knee cap! There is still a lot of swelling around my knee. I need to be doing more of the Ice Man to reduce this. This was a week of just increasing my ROM and decreasing my drug intake.

Monday, September 26th I am down to only two pills, one when I wake up in the morning and another before bed. By Wednesday I have increased my ROM to 70°. This sadly is only on the CPM machine. If I try to move my knee outside of the machine I can only get about 20° (even now I max out at 40°). By Thursday I have increased my ROM to 80° but it is painful! I have also decreased my drug intake to just one Perkaset before bed.

I have scheduled my physical therapy to start on October 13th. I don’t know if they scheduled it out this late (one month after the surgery) intentionally to get the most out of the PT because of the procedure I endured or because that is the earliest they could take me. After the first visit I should have regular visits every Monday and Thursday.

Friday the dog has to go back to the vet to get her bandages changed. She is already acting more like herself but still hops to stay off her left hind leg on the occasion. I have increased my ROM to 87°.

Saturday I have increased my ROM to 90°! Once I hit 70° I start to feel some pain, by the time I reach 90° there is a lot of pain. I’m planning on staying at 90° for a while or at least until the pain subsides. I did not take any pills today!

Back to no knees! They removed my CPM machine today, Tuesday October 4th; the insurance only covered it for 21 days. I have been doing other exercises but today started doing them more consistently. I am doing ankle flexes with the use of a rubber band to give tension. I am also doing leg lifts in all four directions. None of these exercises seem to give me any pain, I just (sadly) get physically tired from doing them. Afterwards I have some, what I think are normal, aches in the knee. Again I should be using the Ice Man more to alleviate both the pain and swelling!