Pooh and Piglet

On the CPM Again, & again & again...

"Back in the saddle again...."

For your viewing pleasure, here is the knee 3wks out. That big ol' honkin' long pinkish-white thing there? That's from the original surgery, 1977, Agana, Guam. No arthroscopic surgery in those days, nosireee! I wore a plaster cast from the top of my thigh to my ankle. I never hated sweat so much in my life! And the itching? Oh, pu-leeeze release me!

This, today my friends, is a cakewalk by comparison.

-- Posted From My "Mobile Device"

ACL Update & Discipline

Peg asks, "How's your knee rehab coming along?" Thanks for asking, Peg!

It has now been 3 weeks since my ACL reconstruction. I am totally pleased & amazed with the lack of pain and the rapidity of recovery. I can bend my knee about 110°, and when I go to PT tomorrow, my therapist said she may let me get on the reclining cycle for a while. Depends upon how much I can flex the joint on my own (ie. my muscles do the work of getting my knee bent, not by cheating with my hands holding it flexed!).

I'm going stir crazy with the limitations - going up and down stairs is a trial in patience. But that's getting better, too. I just have to keep in mind that this is an investment of my time in the health of my knee. I also look at it as a view into the future if I don't do everything to recover 100%. I do not want to be disabled. That, my friends, is to be avoided entirely - whenever possible. Needless to say, I suppose, but I find it helps to articulate it.

I'm working from home right now, and finding focus is hard. O.M.G. I never thought I'd say this, but I think I prefer working at the office! I do have my own workspace at home, but there are so many things I want do that have nothing whatsoever to do with work.

I'll figure it out... Discipline. Yeh. That's it. Discipline.

A Brief Respite - It's Friday!

First, a shout out to my blog-friends Miguelito and dr sardonicus, whose blogs I enjoy very, very much. It's been a while... I love when you visit. You know, I just want to spruce up the blog-look a bit more, that's all. Still contemplating what I want. Maybe tabs for different things, rather than crowding on one page. Not really quite sure.

And T, I'll teach you how to embed links. It's not hard, really, but sometimes a little painful. Heh.

My first week back to work post-surgery has been unremarkable, I am happy to say. The only surprise that came was on Monday when health services at the Lab called me and said my doctor's orders included "no driving."

Say What?

I received this call while sitting in my office here in town to which I had driven. My doctor had not conveyed that message to me last week. After all, it's my left leg, for goodness sakes.

So, I am currently working 100% from home, which is actually a Good Thang[tm]. I went to my first PT session yesterday, which went well, but I have exercises to do at home between my PT visits. It will be easier to do this if I'm at home 100% of the time. I still have to wear the full leg brace pretty much 24x7, including at night when I sleep, but that part (sleeping with the brace on) ends next Thursday. At that time I would like to hear a chorus of Blogger Hallelujahs, please. Thankyewverymuch!

It's somewhat difficult to concentrate 100% on working. I feel distracted. Haven't found stride, nor hit on a routine I guess. Working from home is a good thing, but you really must be disciplined to do it well.

It's a work in progress. Much like the leg, I guess!

I'm looking forward to the weekend so we can re-group. I really want to make this time productive and successful, but for now - - -

Woo-Hoo! It's Friday!!

Update: Here I Sit

Late Thursday afternoon I saw my surgeon for my first time since the surgery. He was pleased with the progress. I was not pleased with his order,

"You must sleep at night with the leg brace on for 2 more weeks."

Argh. It is so hard to sleep with this fracking thing on at night.

He also told me that he didn't just replace the anterior crucial ligament (ACL), he did a total ACL reconstruction. He found that my ACL had, for whatever reason, adhered to the joint with scar tissue, and it no longer moved around, destabilizing the joint (Well, doh. Now we know why I couldn't rely on that leg!). In removing the ligament, also required was reaming out the space where the ligament should freely be able to run through. Thus, the reconstruction.

Guess what? I get to go back to work on Monday. Well, hey, my brain and hands are working quite well, thankyewverymuch.

If I had extra sick-leave or vacation, I wouldn't be going back quite so quickly. But, I don't have that luxury right now. But, thankfully, I can work at home for the most part. Although, I do have an office nearby, so I will gimp over there on Monday to do a video conference with my buddies back in Berkeley. That way I can stay on the same page with everyone. That is important. It's too easy to get marginalized in this business of extreme engineering. If you don't keep your hands in the mix, you may not get back into the mix.

So, I'm sitting here, in my CPM and kicking back again for the weekend. Next week I start Physical Therapy (PT). I can't wait. Yes I can. It's gonna be painful! At least, that's what they tell me.

I hope they're kidding...

In Response to My Readers

I'm watching "Rocky and Bullwinkle" while in the CPM machine. Can't get better than that, can it? Heh.

It's nice to see some old signatures as well as new ones stopping by the comment line. Welcome to StephLove, and to Peg from PA. Peg, do you have a blog? How can I repay the visit if I don't have your blog address? I have enjoyed your comments.

The knee is coming along, thank you. I can put weight on it, and I'm up to about 70 degrees of flex on the CPM. A friend mentioned to me that her surgeon used a ligament from her patella (think she said) instead of a donor ligament. Well, unfortunately, that wouldn't work for me. About 32 years ago the original injury occurred when I played on an all-navy softball team. It was a Lesbian-Honored pass-time, although so many words were not said in those days. I was sliding into 2nd when the opposing player jumped up to catch the ball coming in from center field. Unfortunately for me, she came down right on top of my leg, dislocating the knee cap and a sundry of other injuries. The ligament over the patella at that time had to be re-attached to my tibia. Not fun. 7" scar on the front of my knee to show my battle wounds for the rest of my life. No arthroscopic surgery in Guam in 1977. :sigh:

The knee held up very well for about 20 years, and then about 7 years ago I was running up a ramp when I tore my meniscus. That slowed me down a lot. Had a clean-up surgery then. The knee was never all that great afterward. Fast forward to about 2 years ago. One of the orthopedic surgeons in our medical group is one of the surgeons for the Oakland A's. Lots of practice, thinks I. So, I started seeing him, procrastinated as long as I could, but then finally took the plunge.

Here I sit. On my butt. It's boring, but I'm very lucky. In a future post I will boast about my lovely wife who has been nothing short of an angel and a saint while taking care of me. And the girls. And the house, and the ornery cats. The woman needs a break!

I've got to come up with a wonderful reward for my lady. If it were not for her, I would be very, very sad.

Hugs, Honey!

Rewiring For Sound and the Heart of the Matter

Isn't it amazing what medical science promises to do for us?

Way back in the dark ages (circa '91?), while I was working for a company called Teradyne, in my capacity as resident guru I had reason to drive over to the offices of PacBell. (Later to be gobbled up by AT&T.) PacBell was your typical corporate mega-venue. Lots and lots of cubicles, youngsters pushing mail carts with inter-office mail, and loads of suits and pointy high-heel shoes. It looked to me like the offices of IBM-wannabes.

This California Casual Girl in Birkenstocks was completely out of her element. I may have gloated.

Anyway, while at PacBell I had the pleasure to meet a nondescript, balding, but genial man. His name was Scott Adams. Yes, the Scott Adams. The creator of Dilbert had not yet left his corporate environment and still worked for PacBell. We chatted for a few minutes, passing the time. I have always remembered the vanilla encounter, but I'm sure the memory of that occasion died a quick death in Scott's memory.

All the same, I have followed his career from afar. He lives about 10 miles from us, although our paths have not again crossed. He co-owns a restaurant near us, as well as another further away. I read his blog. And that brings me to the first subject of this post.

The local newspaper did a feature on Scott a while back and that was where I learned that he has been suffering from brain disorder, Spasmodic Dysphonia, that won't allow him to speak in certain situations. I think he cannot carry on a conversation with someone in person, but can speak on the phone, or in rhyme, or if he pinches his nose (How Annoying!). He goes into remission, at times. I think the disorder has been quite fluid in its symptoms. He also can no long draw the cartoons with pen and paper, but has to use a computer to generate the cartoons.

Well, today in his blog he reported that he had surgery to re-wire the nerves to his vocal chords. That must have been delicate work! I find it truly and wonderfully amazing that our body can be so manipulated to by-pass these devastating problems. I wish him the best in his recovery.

And, secondly, to the heart of the matter, in Seattle my 34 year old niece had heart surgery yesterday in an effort to control rapid heart beats resulting from too-rapid nerve firings. The effect of which has been seizures, sometimes landing her in the ER and the need to use the defibrillator paddles to shock the heart into rhythm. The surgery, cardiac ablation essentially destroys the nerve bundles that are causing the irregular and rapid heart beats.

We are all rejoicing in the success of her surgery. She's going home today to Olympia, and her husband, her Mom & Dad (my brother) will be doing their best to keep three, small, energetic children occupied as she recovers with bed-rest.

Life is good.

Doctor's Orders (Before and After)

On Thursday we took Katie back to UCSF for her knee injections.

(Side note - I've been writing "corticosteroid" injections because that's what the doc calls them, and others have said "cortisone" injections. Confused, I asked the doctor if they are the same thing - they are! That's good, cuz it's I like spelling smaller words...)

First thing they do is put a numbing cream on her knees and let is sit for 20 minutes. Then both of her doctors come in - Dr. Curran, a fellow in pediatric rheumatology and Dr. Milojevic, the attending. They prep Katie, telling her just what is going to happen, so there are no surprises. Katie hardly flinched - only when they first poked her. They had to move the needle around a bit to get the medicine well into the joints. After it was all over she said,

"It didn't hurt."

The doctors were amazed at her calmness. Well, for a kid that had a displaced fracture in her arm two years ago, this was nothing for her. She has a high pain tolerance. When she had to have surgery to pin her bones back together, she never took any pain medicine in recovery, because she said it "doesn't hurt."

Wow.

Our expectations were that, after the injections, we would visit the Conservatory of Flowers at Golden Gate Park, since on our previous Monday visit it was closed. However, after the injections the doc says, "Katie, we don't want you to do much walking. We want the medicine to stay in the joint where we just put it, not leak out. That way it is most effective. So, veg out in front of the TV or something."

Poof!! There went our plans to wander the Conservatory that day.

Of course, Katie was pleased with Doctor's Orders, as this meant her sister would do her bidding - to a degree. Heh.

She still has to take twice daily doses of Naprosyn. But, the kid will not swallow a pill. Her little sister can take any kind of pill - and loves to rub that fact in with her big sister. No, Katie has to gag every time. So her Naprosyn comes in liquid form, and it gets flavored. We are encouraging her to practice pill-taking with Tic-Tacs. Lately she has not liked the liquid medicine so much, so she is getting a bit more motivated to take pills instead. It's only a matter of time...

Here's what her knees looked like before the injections, and after:

Follow-up

It was about 9:30am as we made our way into the city across the Bay Bridge. We couldn't even see the city at first, due to the fog. As we passed Treasure Island, the city's buildings were finally visible – well most of the buildings were visible. The tippy-tops of the taller ones were obscured by the thick clouds which enveloped most of the western end of the city. We thought, "Oh great. It's going to be damp cold in the city today."

As quick as a shiver passes, we approached our exit into the city at Fell Street – and the sun shown brightly and it seemed as if we had been transported into a wholly different place and time!

Ah, micro-climes, gotta love 'em!

So, we drove through Golden Gate Park to take a meandering route to the medical building, scoping out what we wanted to do after seeing the doctor. We decided it would be nice to wander the botanical gardens later on.

Our appointment was for 11am – the doctor didn't show until 11:45, and then rushed through the exam. (This was the attending rheumatoid pediatric physician; we saw the attending for immunological disease last time.) At the end of the exam, she said that Katie needed the corticosteroid injections, but that she couldn't do them as she had other patients booked and backed up. I was not amused – since this means we need to make another trip BACK to SF for the injections.

On a positive note, she said the prognosis for Katie's RA condition is good. It could go away eventually – her Moms can only hope. Again the doctor expressed the most concern regarding the uveitis link – that's where our vigilance is required. The one concern she expressed was that the arthritis usually presents much earlier in children - but that it is not unheard of to present at 12 years old.

So, that's where we're at right now.

We spent the rest of the day milling through the botanical gardens, taking pictures, watching turtles and birds, and watching hawks. The weather was perfect! And better than on any weekend when there are far too many people.

Next time we hope to go to the flower conservatory where they have a beautiful butterfly exhibit (yes live butterflies!) we want to see.

(Megs is in front of Katie)

Spring Break in SF

This year the family Spring Break excursion will be limited to the Bay Area. Generally, we like to go somewhere new for fun, kick up our heals, and have a few laughs.

Instead, on Monday we will be taking our 12 year old, Katie, to UCSF Medical Center for her first check-in since late January after being diagnosed with a form of Juvenile Rheumatoid Arthritis. Specifically, her type is called Pauciarticular (paw-see-articular), which is the name given when it affect 4 or fewer joints. It is treatable and could "go away" in time. A mother can only hope.

She has been taking twice a day doses of Naprosyn. But, the swelling in one of her knees has not decreased much. They will probably be giving her corticosteroid injection.

The catch is that children with this form of arthritis are at the highest risk for getting a chronic eye inflammation called uveitis (u-vee-eye-tis). So, in addition to seeing the pediatric rheumatolgist, Katie needs to be seen by an ophthalmologist every 3-4 months to catch any sign of it early on. It can be treated early, and if it isn't the disease could lead to blindness. After 3 yrs if there is no sign of the disease, then she can be seen every 6 mos until she's 21 yrs old.

This was a lot for us all to take in.

Subsequent blood tests determined that she doesn't have some of the more serious forms of the disease. That was a relief.
It scary stuff in a way - kids used to be crippled by RA - but the doctors explained that that is rarely the case today. And in Katie's case, she has a very treatable form of the condition that she may grow out of completely. We'll just have to wait and see.

On the positive side - once the her knees are normal again, she can resume the running that she loves so much in PE! No limitations there at all. I am so grateful that we have access to a wonderful Medical Center.

When we're done at the hospital, it time to have fun! We may drive down the coast, or maybe go to Ocean Beach and build some sand sculptures. Or, maybe we'll go for a horseback ride on the beach.

The weather is supposed to be wonderful.

Thanks for the Germies

It's all her fault.

Megan came home from school last Thursday with a cold. Her left nostril and eye had the faucet turned on full-blast. The poor kid couldn't be more than a few paces away from a box of tissues. But, she was a trooper. Didn't moan or groan. No complaints, although her eye was as red as a summer tomato. Didn't complain as she grabbed tissues to stuff in her pocket when we went out to get her some new shoes.

Those germies came to roost in my nose. In my eye. I have Big Sneezes. I need a containment facility for the germs.

Now Katie's got it, too. Those germies? They're growing wildly in Katie's nose and her eyes.

Megan feels just fine today. I'm so happy for her!

Now I'm worried that we'll spread those little germies to some new friends. We've been invited to the home of the parents of Katie's classmate, Mitchell. Kandy knows them through PTA, and says they are very nice people. They've never met me. Nothing like a good first impression, eh?

I am afraid that as soon as I walk in their door I'll sneeze a doozy, and they will never forgive us for darkening their doorway.

I wonder when the contagiousness goes away?