Yesterday I saw the doctor for the first time since my knee surgery.

We almost didn't make it to the appoointment.

While loading the car, Kris forgot about my bike rack, and when she slammed the trunk, the rack (which is trunk-mounted) gashed her forehead. She hollered for help, but I couldn't see what was the matter; I was trapped in the front seat, unable to rush to her aid because of the damn leg brace.

Like all head wounds, this one bled out of all proportion to the wound. (Can you name the book from which I stole that line?) Kris managed to get inside, to clean and bandage the injury, but she felt woozy, and had a tough time driving to the hospital for my appointment.

At the clinic, a nurse removed the brace and the cryocuff and the bandages. I saw the knee for the first time since the surgery. My lower leg was swollen, and there were patches of skin which had great indentations from the various braces. The areas of incision were quite small, and, other than the stitches, there was litte evidence of the surgery.

The nurse wiped my leg clean. It felt terrific to have her rub this area, which had spent the last week beneath the mass of braces and padding. I hadn't been able to itch or rub these patches of skin for days!

Dr. Black examined the knee. It looked fine, except for the swelling. "Have you been elevating the knee?" he asked. Actually, no I haven't been elevating the knee, except when it's in the CPM machine. When the knee is elevated, it's at maximum extension, and it is when the knee is extended that it hurts most. He told me that the knee should be elevated at all times.

"And have you been using the CPM machine?" asked Dr. Black. Yes, I have, from six to eight hours per day. The range of motion in my knee is now 0-90 degrees, though it's much more comfortable at 5-85 degrees. Extension (when the leg is straight) actually hurts more than flexion (when the knee is bent).

"This is true for most people," Dr. Black said. He was pleased with that I was spending so much time exercising in the CPM machine.

The doctor and the nurse began to remove the stitches from my knee. However, one stitch gave them trouble, and as they tugged on it, I grew cold and clammy and warm and nauseated all at once. I felt faint. The nurse noticed that I'd lost my color, and she told me to relax, to lie down. Dr. Black gave me an injection of something which quickly numbed the knee, and they resumed work on the stubborn stitch. Eventually they had to make another small incision, which required stitches of its own.

Some friends had told me they thought I ought to be up and around, walking on the leg by now. Dr. Black said that this was true for many people, that they would already have been putting weight on the leg, but that it certainly wasn't true in all cases. He had asked me not to put weight on the leg before this appointment, and he didn't seem to think I was behind in my recovery.

Dr. Black told me that now I was ready to put weight on the leg, to take some tentative steps with it, but only with the brace locked at full extension. While resting, with the knee elevated, I could unlock the brace in order to gain a little flexion. I'm allowed to put pressure on the leg, or to flex it, but not both at the same time, so driving is still out of the question.

"What about showers?" Kris asked. "When can he take a shower?" The nurse laughed. I'm still not able to take a shower because of the dressing on the wound, but, with a bit of twisting and turning, and with Kris' help, I ought to be able to take a bath, as long as the knee and its dressings stay out of the water.

Finally, we looked at photographs from the surgery.

The first set of photographs shows the torn cartilage.

I'm not certain which of these photographs is the before photograph and which one is the after photograph. Though the tissue in the top photo looks smoother, Kris and I both think that Dr. Black said that it is the image showing the damage. At the left of the photo, in the rear, you can see a mass of cartilage that appears to have several tears.

This complex tear to the medial meniscus was the source of my knee pain. Dr. Black said that the tear was so severe that he had to "scrape half of it away", whatever that means. In the bottom picture, though the tissue is not as smooth, you can see there's a portion that is missing.

These images of the anterior cruciate ligament are more dramatic.

The top image shows the knee before the surgery. The hollow space at the tip of the instrument ought to contain a ligament. Mine's not there.

To repair the injury, Dr. Black took an ACL from a cadaver and grafted it to my knee. You can see the repair in the bottom photograph. My new ACL fills the hollow (though it's somewhat difficult to see because the light has blasted away that portion of the image).

To summarize: the doctor says that my recovery is going well. I'm a little behind in some areas (walking), but ahead in others (exercising the leg). We have another appointment next Friday, and I'm to spend the next week exercising the leg, both in the continuous passive motion machine, and in periods of walking around the house, placing weight on the leg with the brace locked at full extension. Perhaps by next weekend I'll be able to drive.

How do I spend my time during rehabilitation? I spend it like this:

I spend my time on my back, either on the couch in front of the television, or for hours at a time in the continuous passive motion machine.

The CPM machine raises and lowers the knee, very S-L-O-W-L-Y. The cryocuff keeps the knee cool and provides pressure to it; you can see the cooler (which contains ice water) in this photograph.

This picture also shows the keys to my sanity. In particular, you can see the blue tote bin which contains my books, my comics, my DVDs, my pills, the phone, my water bottle, my eye mask (the little doo-hicky I cover my eyes with so I can sleep), etc. On top of the tote are the Godfather DVDs that I borrowed from Nick (look for a weblog entry about these films soon). My iBook is, of course, never far from my side.

Toto is usually on me or near me. She was sitting on the dresser when this photo was taken.

I've got another week of this left. It's not as fun as you might think. Fortunately, I get to mix in some activity this week!

On this day at foldedspace.org

2001 — False Alarm   Custom Box Service has an alarm system which includes motion detectors. For whatever reason, at least once a month these motion detectors are activated during the middle of the night and I have to get out of bed to drive out to the shop and turn the alarm off. Last night was one of those nights.