24 Degrees

Did my first exercise on a Power Plate vibrating platform. Not a fan! Had to keep my chin rolled down to my chest or the vibrations were overwhelming to my head. But after doing three sets of thirty second stretches on it, Bob was able to measure my dorsiflexion (how far I can bend my ankle towards my toes) at 24 degrees. Since before my surgery I couldn't get my ankle to neutral (zero degrees) this is a great improvement. Now if I can get my walking gait better.

Still having pain through the inside of my ankle and Bob found a muscle knot in my calf today that almost got him kicked when he tried to massage it. Still not good at standing on my toes, but found going up on my toes on the leg press noticeably easier today.

After PT it was off, through the building maze, to see Dr. Ellis. He seemed very pleased with my progress and thought I would be a new person by the time I see him again in six weeks. He said Dr. Shetty had called to talk to him about my neuropathy and I told him about my EMG later this month. He gave me a new PT prescription and I gave him triple chocolate, double toffee cookies - seemed like a fair trade.

Touch Your Toes

It has been just over four weeks since my surgery. It feels like longer! At least I am in matching sneakers, not something I had attained a month after my first surgery.

Because of my schedule I am having PT every third day for two weeks - Tuesday and Friday last week, Monday and Thursday this. Probably a good thing. Still having a struggle on the leg press and Bob added new stretches yesterday that had my right calf protesting. He also has me working on my hip strength as he noticed I'm doing a bit of a swivel when I try to climb stairs foot over foot. I swear by the time I finish one round of home exercises it's time to start the next. On my own I have added practicing stairs on the three steps between the elevator and my apartment.

On a happier note the swelling in my left foot has gone down enough that I could wear my red polka-dot Keds this weekend. They add a bit of whimsy and garnered a few compliments.

Still battling the disassociation with my foot, though since starting with Bob I have some signs that I might be regaining some feeling in my big toe. Instead of just looking at it, Bob has recommended touching it. He said sensory input from fingers may help my brain. So when I put on the Topricin, I also feel my foot, explore my toes and heel. So far I've learned I need to get a pumice stone and work on removing some dead skin.

I have to say that getting up has become significantly easier. Before this surgery I would lie in bed and worry about how long it was going to take for me to feel secure walking. I would stand up and windmill my arms as I tried to get my left foot to flex enough to allow me to stand. Now I can just get up without having to over think it - my only worry that my slippers will slide on the wood floor before I have full weight on them.

I feel like if I could just get my talus (ankle bone) to pop back into proper alignment every thing else would be fixed. I have to assume Bob agrees, or he just like pulling on my foot.

Basically, I went to Dr. Hubbard to fix one problem and he left me with a myriad of others. Because of the neuropathy and the achilles tightening I rolled my foot out to the side which tightened the tendon on the inside of my ankle and partially tore the peroneus brevis tendon on the outside of my ankle, and allowed my talus to shift locking my ankle. All of which Bob, Dr. Ellis, Dr. Shetty and I now have to fix.

Remind me again why hitting people with my cane is bad?!

Grunting Through the Easy Stuff

Stand on your toes. Go ahead, I'll wait. You can even hold on to the couch or wall. Should be fairly easy.

Not for me.

Had physical therapy today. I learned that Bob has very strong hands as he gripped my ankle and worked on manipulating my bones. Then he had me roll my foot, like I would when taking a step. Ouch. But nothing compared to what came a bit later.

Then it was time for standing on my toes. I found myself throwing almost all my weight to the right foot. Bob decided that wasn't hard enough, so he asked me to only use my left foot. That did not work, so we moved to the leg press and tried it there.

Using both feet, with my right doing most of the work, I could press 50 pounds up on my toes and then  let my heel flex beyond the bottom of the foot brace. He had to remove all the weight before I could use just my left foot, and then I felt like I was pressing 500 pounds just to get my foot to move less than an inch. I found myself wanting to grunt like Maria Sharapova during a Grand Slam tournament. I also felt a bit pathetic, that something that should be so simple as standing on your toes is absolutely beyond me at the moment.

By the time I got home after 2 subways, 2 buses and a combined 11 blocks of walking (that was just after I left HSS), all I wanted was to put my feet up for a bit. When I got back up a but later my ankle was so stiff it hurt to flex to neutral. And I am expected to abuse myself with these and 10 other exercises five times a day!

I just keep repeating the mantra that this will be worth all the pain!

Dr. Shetty, my neurologist, called yesterday and agrees with Bob that I may have had the lack of feeling in my heel before this surgery, but because I was not walking properly I did not notice. No suggestions on how to handle the disassociation I am still having with my foot. She did order another EMG - now scheduled for late April, just shy of a year after the first one.

Someone asked me today what to do if the feeling never comes back. I don't know. I'm trying not to think like that. Hoping a positive outlook will produce a positive result. Originally everyone - Dr. Hubbard, Dr. Tsai, Dr. Shetty - kept telling me the feeling should come back in a year. It's now been 14 months and Dr. Shetty (the only one of the doctors I am still in contact with) says it could be 18 months. I couldn't find any information on the Neuropathy Association website. Seems they tend to focus on illness related neuropathy.

I have to push it back or the fear of never being able to walk normally again will overwhelm me. Bad enough that Bob has ordered me to keep the cane until my gait is a bit better - especially when my cops keep telling me I will be arrested if I start hitting people with it.

Right now it's time to do more stretches!

PT Drama and New Shoes

Today was my first appointment with my new Physical Therapist. Bob was recommended by both Dr. Ellis and Mark (my pre-surgical PT). He has over 20 years experience with a focus on feet and seems to also have experience with nerve issues.

Had a minor bit of drama at the beginning of my appointment when the therapist I had seen on my last two sessions wanted to know why I wasn't seeing him and implied that since he had done my initial evaluation I was supposed to be his patient. How does one nicely say that he was a place-holder until Bob returned from vacation and had he been the therapist I was assigned to, I'm not sure we would have been a good fit?

Nothing against the first PT, I am sure he is very competent, but he had me doing a few minor exercises like rolling my ankle, pointing and flexing my foot, and using a dog leash to pull my foot and stretch my calf - all without weight bearing. They are all good basic exercises, but he also talked about taking it slow and not doing anything more strenuous then the bicycle until the swelling in my ankle had dissipated. In contrast, Bob jumped in with two new floor stretches as well as two new bed stretches specifically designed to remind my nerves they go all the way down to my foot. He's pushing me to run through the routine at least 5 times a day.

Bob is doing what I really wanted and needed, which is treating me like one of their athlete patients. Though it was a bit disheartening to hear him say it could still be months before I would be discharged from PT. After two years, two surgeries and too many physical therapists to name, I am getting tired of the whole process!

The only complaint I have is the same one I had with Carlos, but hadn't realized until I saw Christine. Because it is a large facility the therapists see more than one patient at a time - though this seems to be two at a time as opposed to Carlos' schedule of four. But it still means the PT is jumping between patients, meaning both that my appointment doesn't begin on time (Bob didn't come get me from the waiting room until 15 minutes after my scheduled start) and that I am left alone to run through a set of exercises and then twiddle my thumbs until the therapist returns.

On the plus side, Bob could push my foot past neutral today. In fact, when Bob pushed, my left foot flexed further then my right could on it's own. He also said my heel pain, recurrent blister and calf cramps are from my foot having spent so long in the equine position - and that the pain is likely to get worse as I begin wearing sneakers full time this weekend. I am now trying coconut water to help with the cramps.

After PT I did something I haven't done in a very long time - I went shoe shopping! Admittedly it was for sneakers, but beggars and all that. Earlier this week it occurred to me that all my sneakers (by all I mean my two, possibly three, pairs) are designed for walking or cross-training, and as such they have built-in heel lifts. So today I spoke to Steve, Dr. Ellis' PA, and confirmed I needed flat sneakers - Bob actually recommended earth shoes, but not until I'm a bit further along. So I went to DSW and picked up a pair of red polka-dot Keds and gray Roxy Castaway high tops.

The negative of moving from air-cast boot to sneaker is that my walking speed - already fairly slow - will, for  awhile, become sloth-like. Always something to look forward to!

The Psychology of Neuropathy

When the nurse removed the splint yesterday I remember looking at my foot and thinking it looked wrong. I knew it was my foot and yet felt disconnected to it. Then as I mentioned, when I felt my ankle and discovered the lack of nerve response I wanted to cry.

The disconnect continued when I removed the boot to go to bed last night. I again stared at my foot and even took cell phone photo of it.

But I felt like I had no connection to it. Later in bed, I tried to position my foot in neutral. When I looked down I could see the angle of my foot, but when I closed my eyes I couldn't have said where on the bed my foot was and if pushed would have said my toes were down almost in a ballet en pointe position. 

While the pain was less this morning, the psychological component was still there as was the lack of sensation, leading to a very nervous shower. I felt safer in the air-cast boot, as I knew my foot was tightly encased. 

With this worry in mind I played phone tag with my neurologist this morning while having my physical therapy evaluation. I also did some internet research when I got home, but could not find any articles or abstracts dealing with psychological disconnect and neuropathy. But it feels like it should be related, especially as my sciatic axonal neuropathy presents with hyposthesia (loss / lack of sensation). I will try to talk to Dr. Shetty when she gets back from her conference, especially if this emotional component continues. Just what I need, new and strange foot issues!

On the positive side, I was able to get around in the boot with just my cane while outside and no support in my apartment. I even took a bus and subway home from PT (the return of my sociology study of who offers me a seat on mass transit); stopped at Target to pick up a few items; and was able to walk the six blocks home - albeit slowly. 

The physical therapist sent me home with simple stretch exercises, though he seemed loath to start pushing me to stretch while standing until next week. Did tell me to bring a left sneaker to my next appointment. 

Relatively quiet weekend ahead as I try to balance my need to stretch and move with not over exerting myself and doing more harm than good. 

In Theory

I hurt! In theory I wanted the splint gone and with it the knee-walker. In actuality, I was very happy to cheat and use the knee walker for a few minutes this evening to feed the cats.

My foot and ankle hurt, my calf hurts, even my hands hurt. But as I explained to the guys who drove me home when I had the cab drop me off at Barclays Center so I could stop at Starbucks, I am supposed to be putting weight on the foot and walking. Heck, I even start physical therapy tomorrow.

The FDR Drive had surprisingly light traffic and I arrived at Dr. Ellis' office about 20 minutes early. I had assumed he would be running late, so I packed lots to keep me busy. Decided to finally start reading the Time Magazine cover story on health care in America. That became a bit ironic when he sent me for a sonogram to check for a blood-clot. The one amusing spot of my wait was trying to figure out why the young woman opposite me thought wearing 5" (maybe 6") platform ankle boots was appropriate for an appointment with a foot surgeon.

The nurse removed my splint and I found my self tearing up in fear. Even with the general anesthesia and the minimally invasive surgery, I couldn't feel my ankle when I touched it. And later when Dr. Ellis had me stand on my bare foot I felt like the floors were all slanted as I could not feel my heel. (I will call Dr. Shetty, my neurologist, in the morning,)

Dr. Ellis wants me up and moving ASAP to ensure that the achilles does not have a chance to tighten again. It was a bit disconcerting to hear him say he basically ruptured the tendon. He again described putting in the cuts and forcing my foot to neutral. And today when it was out of the splint I noticed it wanted to curl in and did not like when he pushed the ankle to a ninety degree angle from my leg. As I mentioned he had me stand and put as much weight as I could tolerate on my left foot and work on bending my knee.

Dr. E says stretching is my top priority. He wants me working on the foam angle in my bare feet tonight and starting physical therapy three times a week as soon as possible. Since no billionaires decided they needed an unlimited supply of triple chocolate double toffee cookies, I am starting PT at the HSS rehab center tomorrow morning. My pre-surgical in-hospital physical therapist had recommended someone in that center who supposedly has 20 years experience specializing in feet. He is on vacation, but I should be able to start with him as soon as he returns. In the meantime, I have an evaluation with someone else at the practice. Not looking forward to my long commute (car service tomorrow, but eventually one to two subways and a bus each way) three days a week, but, if at the end I can walk, it will all be worth it.

Dr. Ellis is pushing me forward quickly. I only get the air-cast boot for a week before he wants me in sneakers and I see him again in three weeks. Since the pads of my hands hurt from gripping my crutches tightly, both before and after I was allowed to put weight on my left foot, that seems like a herculean challenge. I'm just trying to figure out if I can get to and from PT tomorrow with just my cane.

For now it's all about putting one foot in front of the other. 

Achilles Seeks PT Sugar Daddy

I spent the weekend talking myself out of texting my last Physical Therapist. While I was sure my saying thank you would be appreciated, I didn't think interrupting her weekend was the best way to do it.

"Physical therapy is important" is a phrase I have heard from both of my current surgeons and my neurologist. My neurologist adds "especially for you," referring to my neuropathy and the hope that proper PT will help my nerves reconnect to my brain.

I am aware of how important physical therapy, and the right physical therapist, is to recovery. After all it was a year ago this week that Dr. Hubbard put me in a cast for 11 days after I possibly pulled my achilles seven weeks after my first surgery, when my physical therapist at the time had me use the BAPS board. After my knee surgery, my recovery improved greatly when I changed physical therapists.

Six months after my first achilles surgery my health insurance stopped paying for physical therapy, saying they  didn't see improvement. After my open letter to Beth Israel, the hospital began to cover the cost of my PT. Eventually Dr. Hubbard recommended I see a physical therapist who had worked at Beth Israel before starting her own practice. I only saw Christine for two months, but discovered having a therapist who specialized in feet and spent an hour one-on-one was very beneficial. I didn't even mind traveling to midtown twice a week and had finally trained the local Starbucks baristas on how to make my Chai. I will never know if seeing her from the start could have saved me from Achilles 2.0, but she was the therapist I wanted to text this weekend as I began to realize how important the strength and balance exercises she ran me through were helping me maneuver through my daily activities in the week after my surgery.

I was hoping to return to Christine for my physical therapy after this surgery, until my insurance shot down that idea. Which is where my need for a Sugar Daddy comes in. Christine does not take my insurance and my insurance will not cover any of the cost if I go out of network. I could argue that Beth Israel should continue to pay, since some of my need for physical therapy is still related to my neuropathy, but I'm not sure that is a fight I would win outside a courtroom.

I realize that much as I liked Carlos, I need a therapist who has a real focus on feet and achilles and someone who will work with me without getting pulled to other patients during my appointment. Ideally, I want that person to be Christine, but simply can not do math that allows me to spend $400 - $600 a week and feed the cats or myself.

I am hoping that when I see Dr. Ellis tomorrow he will let me exchange this hot, annoying splint for an air-cast boot and some walking around. If so, we will discuss my return to physical therapy.

If it ups the incentive, for the money to see Christine, I'll bake at your beck and call.

Back in the Saddle (or on the Therapy Table)

I'm delicate. Or at least my ankle is. That is the take away from Carlos' conversation with Dr. Hubbard. He was impressed that based on my description alone Dr Hubbard was able to name the BAPS board that seems to have caused my need for a cast.

Carlos also told me at least twice this morning that my physical therapy may feel boring and quiet for the next few weeks, but that is what's required to get my ankle back on track without risking any damage. It was a quiet session. Part of the problem was that at least two of the exercises Carlos wanted me to do to help strengthen and stretch other parts of my leg and back required me to put weight on my foot - making it a non-starter. No band exercises that would stretch the achilles. Instead it was some massaging to get fluids flowing and deal with the tightening of muscles tired of the bondage boot, followed by some leg raises with the weight on my knee and then spelling the alphabet with my foot. Finally some stretching and ice.

It felt more like maintaining the status quo then moving forward, but I am putting my trust in Carlos for the next two weeks until I see Dr. Hubbard again. I am already mentally reminding myself to pack sneakers and my wedge flipflops for my next appointment.

PT again on Friday, not with Carlos as it's an insurance evaluation appointment. My therapist and I have to convince them that I need more appointments. Silly, but that's health care in the US!

Back on Track

I emailed Dr. Hubbard yesterday to say that while I was having minor twinges, it was much less then the pre-cast pain. And that when I felt along the tendon I was no longer feeling the need to kick in agony. Happily, his response was no MRI and I can return to physical therapy. So, I have made an appointment to see Carlos on Tuesday and left a message reminding him to call Dr. H.

I celebrated my clearance with a walk in the Spring weather yesterday and am going to try to get some photos shot today. Trying to decide if I should push it with a trip to the Botanical Gardens tomorrow. Probably not, but I need the activity!

We'll see how next week plays out.

Physical Therapy is Hard

I surprised myself by coming home today in pain. I did not think the little bit of stretching and activity I did today would hurt. Carlos had warned me. He gave me a rubber band to do exercises at home, but said that if I was in pain tomorrow to leave off until Wednesday.

Don't even feel like I did that much. Started with a painful massage as Carlos worked to get the low and fluid retention moving in my calf and foot. Then leg lifts with a four pound weight followed by drawing the alphabet with my foot and ankle circles. We finished with the rubber band stretches and ice. I guess I was still frozen when I left, it wasn't until I got home that I realized how badly I wanted to take the brace off and just prop up my foot.

When I was finally willing to venture off the couch five hours later, I discovered my heel very tender and a bit cranky at being stretched to the 75 degrees or so that the boot requires. For all the pain, I know Carlos is being sensitive and is concerned that I might tear the stitches holding the achilles together.

So perhaps it is a good thing that most of tomorrow will be spent in front of the computer. I will continue to elevate and ice and we will see what PT with Edward brings on Wednesday.

Busy Friday

Two packed buses passed before one stopped to pick me up this morning making the 14 block, 20 minute walk or 10 minute bus ride, into a 30 minute commute. Fortunately I had budgeted extra time before my physical therapy appointment and was there on time.

Edward did my assessment. Having been my therapist in the attempts to prevent surgery he knew my heel. I was able to flex to 8 degrees (I believe Edward said zero is a full flex). I also did fairly well on the pointing. This appointment was more about seeing my post-surgical range of motion and what we needed to work on. I re-iterated the note on my prescription, that Dr. Hubbard is adamant that I do not walk or put any weight on the heel unless I am in my boot.

My first proper PT appointment is Monday with Carlos. We joked a bit about his needing to remember what the term "gentle" means before my session. So for the next two weeks I have PT three times a week and then we will have to re-evaluate for my insurance.

Spent the rest of the morning running from one meeting to another and then hanging out waiting to meet a friend for lunch. Now home and waiting for another appointment and then friends over for dinner. All while trying to convince my body not to give in to the cold germs that seem to be attacking.

Doctor's Appointments

Can't decide if it is a plus or minus that I was in and out of Dr. Hubbard's office in less than 30 minutes. The plus certainly came from not having to sit in the waiting room for more than 5 minutes and I got most of what I needed dealt with - even if I wasn't 100% happy with the answers. It was just a surprise when I left the office and reached the sidewalk to realize it wasn't even 11:30 (I had walked into the office just after 11:00).

With Marco on vacation, I had Greg as my PA. I had met him briefly the morning of my surgery. He looked at my heel and recorded some notes on the computer. I mentioned my neuropathy concerns and that Dr. Williams had recommended a neurologist. He thought it was a good idea to schedule an appointment and get the opinion of a specialist. Dr. Hubbard didn't fully agree.

Dr. H. did clear me to start physical therapy three times a week, though he again emphasized that I am not allowed to walk without my bondage boot. He said I should wait until after I have started physical therapy before considering seeing a neurologist. Told me that if it was related to the surgery, it was probably from the nerve block the anesthesiologist used, not from the surgery itself. He also recommended I see his choice of neurologist at his hospital.

When I got home I called Dr. Williams' recommendation and left a message. We'll see when she can see me and what she has to say. In the meantime, I see Dr. H again in three weeks and have my physical therapy evaluation on Friday. I have decided I want Carlos as my therapist this time. I like Edward, but I suspect Carlos will make me work harder - the way Matt did after my knee surgery.

Life goes on. Looking back the past six weeks feel like they have flown by, but the day to day living seemed to take forever.

No side planks today

I had Robert for PT today. I like him - mostly because I said I didn't want to do side planks and he said okay. Matt would have immediately decided that was my next exercise! I'm back to Matt on Monday, so I know I have to work on my home exercises this weekend!

Despite no side planks, my knee is a bit sore today, between PT and spending a lot of time standing in the kitchen baking for the last two days I'm not really surprised. Probably time for some ice.

Back to PT

I had PT yesterday with Sejal. I was feeling under the weather, so I was not as good as I hoped to be. I was feeling a bit light headed and unfocused. She did introduce two new tortures to my repertoire - one-legged bridges (which were not as bad as the second torture - I mean exercise) and side planks. I felt I should be able to distribute the weight across my full forearm like I can with front plank, but instead all the pressure seemed to rest on my elbows making me very wobbly.

All the exercises you wish you didn't know existed. Just keep repeating "this is good for me, this is good for me!"

Just when I thought I was out...they pull me back in

Got a phone call today from my PT center telling me I was approved for four more sessions. I was sure I was done with PT - I have been walking in snow and ice doing most of my exercises at home and meeting with possible personal trainers. But, I am not going to turn it down so Monday afternoon it is back to therapy for me. I will have to stop at my doctor's on the way in and get a new prescription.

Just when I had started getting a little lazy and letting myself sleep until 7:30. I may get to the point where I can kick my own butt yet.

In the meantime, I know that despite my walks I have been spending too much time tied to the computer working on show submissions and book and grant proposals. Speaking of which, back to the grindstone.

Matt is Mean ... but he's doing it for my own good

Matt is not maliciously mean, it's just that PT with him is hard! Today he had me doing Plank push-ups - making me an absolute liar in even thinking my core was strong. I was very sorry I didn't take a pain pill before I went to PT.

I don't know what all I did Friday, but both my knees were incredibly sore on Saturday, and even today I am alternating icing them (the Game Ready went back this weekend).

Matt also wanted to extend my PT to twice a week for the next 3 weeks, as opposed to three times a week for the next 2 weeks. (My insurance has set a use by date of February 4th). The insurance coordinator at my PT center said no, but when I got home and called my insurance they said it would be possible if the PT center submits a letter (Either my insurance has a bunch of Johanna's in their call center or I got the same woman from last week). In the meantime, I am keeping my three a week schedule until I have a better answer.

It's the nonsense like this that gets to me. If my insurance has agreed to pay for ten sessions, what the heck does it matter if I use them twice a week or three times a week. Especially, if my therapist is saying that he wants to spread them out so I am good and ready for my next photo trip. I was told, in passing today, that my insurance originally denied any more sessions, something I probably should have been told. I guess the letter from Dr. Williams helped change their minds.

Perhaps members of the legislature should have to price out and pay for their own health insurance and then they would get their butts in gear and finalize a decent health care plan! (Of course, a large percentage of them would simply go on Medicare.)

Maybe monotony is good

I got a little stupid on my three week anniversary and pushed myself further then my body wanted to go. Including my shortened CPM session, my knee was on the go for 8 hours today with little to no rest. My knee, and the rest of me, rode three buses - standing on all three; walked 14 blocks; had physical therapy; and went grocery shopping. All without icing and elevating. (Did I mention the stupid part?) I knew I was close to the limit while walking to the supermarket, but also knew that because I was close to my limit if I went home I was not coming back out.

I got to my floor and had to sit on the stairs again for 20 minutes before I could tamp down the lightheadedness and nausea and muster the energy to walk the last feet to my door, forget carrying the groceries, jacket, messenger bag and crutches. Needless to say I am being bad and not having an evening CPM session.

I had a different Physical Therapist today from Friday. The center was a bit crazy with two therapists out sick and the others having to cover extra patients. Lena, today's therapist added two new exercises to my regimen and massaged my knee cap as opposed to Dina's forced bending. I have to say I'm not thrilled that they seem to bouncing me around different therapists - maybe it's good because each one brings something different to the session, but it makes it difficult to build up a rapport. Today Dina had to remind Lena who I was after Lena had started working with me and I was on the table directly next to the therapists computer station.

I did meet a young woman who is going through PT is hopes of avoiding knee surgery. She is a freelancer and her biggest fear is how she would pay her bills during her recovery time. She was asking me questions I couldn't answer about short-term disability. Another problem in the health care crisis in America. I know I am dipping into my savings more then I would like to, but I am fortunate enough to have a build up I can tap into.

My other issue is that I have been unable to get ahead of the pain for the past two days. I have had a steady throbbing pain on the inside of my knee. The area has also swollen and is pressing against and over the metal rod of my brace. I've even tried going back on the Darvocet to no avail. I haven't quite decided if this is general "Hey, I'm healin' here" (yes, of course my knee has a Brooklyn accent) or if I need to put a call in to Dr. Williams office. For now I'm thinking a quiet night of ice packs and elevation.

Needless to say I didn't get any baking done. We'll see what I'm up to tomorrow, but my cops may have to go cakeless tomorrow.

55 Degrees

I am exhausted and sore. I had my first real PT session today. I did leg lifts and other muscle exercises as well as forcing my knee to bend on my own, followed by the therapist, Dina, forcing my knee to bend. She had me hyperventilating in pain. At the end of the session I could bend my knee 55 degrees before I wanted to scream and have someone put me out of my misery. She sent me home with exercises involving a dog leash. Now I just need a dog leash. (That's tomorrows quest - well that and a new Metro Card.)

My only complaint was that the ratio of patients to therapist was a bit high, which meant what should have been about a 30 - 40 minute session became 90 minutes because of the waiting while she was working with other patients. I selected this place over the smaller independent physical therapists because I thought they would offer better/more PT equipment and options. But either they need more therapists, or to not schedule the ones they have so tightly.

I also spoke to Melissa, Dr. Williams' Physicians Assistant, today after two days of playing phone tag. She has stepped me down to Motrin twice a day for pain and told me I can sleep without the brace. She also implied that despite my previous assertions Dr. Williams may be a bit of a sadist. She said if he had his way his patients would be doing 1000 leg lifts a day! Yikes.

30 minutes to go 3 blocks

I had this grand plan last night to prove I was on the mend and could still be independent. I was going to get up this morning and take the bus to Target to pick up a few things I wanted, then take another bus to the drug store to drop off my new prescription and then take a third bus to physical therapy. This morning looking at the pouring rain I decided not to go to Target, but figured I could easily walk the three blocks (two slightly up hill) to the pharmacy. I took me half an hour to get from my house to the pharmacy! The bus was also not a huge success. Not being able to bend my knee means there is only one seat on the bus I can take without having my foot in the middle of the aisle, and the 60 - 70 year old lady was not willing to give up her seat. So I stood, trying to hold on to crutches and the bus and then had serious issues getting down from the bus.

I got to the PT office and discovered they hadn't received my referral. That was cleared up and I met with the therapist to evaluate what I was able to do and what Dr. Williams wanted me to be able to do. I have some ability to bend my knee, though not very far and I am almost able to bear full weight on my left leg standing without my crutches. What I couldn't do, and find it utterly frustrating, is lift my left leg straight up while lying down. When standing I can kick or lift my leg with no problems, but lying down it felt like a dead weight and my brain just couldn't send the message to my leg to lift. When the therapist lifted my left leg I could only go about 80 degrees before feeling some pain. I know I've been saying my leg feels like a dead weight, but this is ridiculous. I can get the thigh muscle to tighten and move my knee cap, but there is some barrier to lifting my leg!

That seems like fairly good proof that I need physical therapy. And yet I could not schedule another appointment until next Thursday because my insurance needs at least five business days to approve the PT evaluation and even then they will only approve two or three sessions at a time. (It's far from ideal but go Baucus Bill!)

Ran into friends who drove me back to the pharmacy and then home. My knee is twinging from being poked and prodded and I am ready for a nap. On the plus side I was able to stop in the bookstore and get not one, but two new sudoku books.