Monday, April 11, 2011

Another Journey From Reader Susan

the first day post op after, with the cadaver tendon before picture of my knee, those strandy things at the upper left hand corner is all that was left of my PCL, or at least that's what my doc told me.

Hi skinnygurl!

I'm sharing my PCL story in case you want to share it on your blog and maybe allow your readers to hear about another experience. I first tore my PCL in May 2005 when I fell ice skating, I caught a rut and landed square on my tibia, pushing it back. I heard a sort of pop, but didn't think too much of it at the time. I got up and finished my skating session, figuring it hurt just because I fell. Afterwards, when I got off the ice, I couldn't bend my knee enough to sit onto the bench, the manager had to get my skates off for me. Getting into my car, I had to move the seat all the way back just so I could get in. I kind of just ignored it all though, as I was leaving for a trip to Israel a couple weeks after that. I bought a knee brace and kept it wrapped up. When I came back from Israel, and it was still bugging me, I went to a doctor who took a couple x-rays, and said I just had a little chondromalacia and sent me for PT. Obviously, it didn't help much, and eventually, I just got used to the looseness of my knee.

A couple years later, I started medical school, and during our first year, we had a musculoskeletal physical diagnosis lab, which included the diagnostic tests of the knee. We practiced these exams on each other, and when my partner did the posterior drawer, and it was unexpectadedly positive, she jumped, gave a little yelp. Our group preceptor came over, looked at my knee, did a couple other tests, and told me these tests have virtually no such thing as a false positive, he was 99.9% sure that I had a torn PCL. So there was my diagnosis, given in a rather unconventional manner. He told me if I tore the PCL, I likely also had other damage, since a PCL tear rarely happens in isolation. I had to see an orthopedist for my insurance company to approve an MRI, so I went, told him my history, and he sent me for the MRI. MRI report comes back as normal. The ortho looked at it himself, and said he disagrees with the radiologist, the PCL looks torn to him, and it didn't matter what the MRI report said about the PCL, it was most definitely torn just from the exam alone. And wouldn't you know it, I'm one of those rare beasts who managed to tear only the PCL. At that time, he told me surgery is not recommended because I was functioning at a high level already, I was skating, running, basically doing everything. Surgery is also more difficult and complicated than an ACL repair, so he basically just told me not to do anything at that time, and I was happy with that answer.

Flash forward to about 2 years after that, and I started getting more and more instability and pain in my knee. It was constantly giving out on me, just collapsing for no reason. I eventually had to stop skating and running because of the instability. And then it started giving out just walking up the block. That was kind of the turning point for me. I went back to the surgeon to ask about reconstruction. He told me that he agreed I needed surgery, but he wasn't comfortable doing it, since it's such a rare surgery. He sent me to Hospital for Special Surgery, and in July 2010, I met with a surgeon there. Surgery was scheduled for the beginning of my one month vacation, which happened to be just before Thanksgiving. November 23, 2010 I went into the hospital and had the distinct honor of being the only PCL reconstruction that day. I walked into the OR, and there had to be about 17 medical students and residents waiting for my surgery, guess they all wanted to see the PCL repair since it's not a very common surgery. I don't remember too much after the surgery, except that I had to meet with a PT before I could be discharged to learn to use crutches, and he was incredibly good looking and very strong. I wish I had worn nicer sweatpants because he really was very handsome.

The next couple weeks were pretty much all the same, laying on the couch, playing video games, needlepointing, going stir crazy. I started PT at day 13 post op, which was exciting at first. But then I could only do exercises on the table since I was non weight bearing for 6 weeks. The interesting part is that I had to go on residency interviews during the time I was on crutches. It makes for a very interesting time, wearing a suit, bulky brace, and being non weight bearing and spending a whole day on your feet. Definitely was not easy, and not something I would want to do again. But my arms got really toned. At 6 weeks, I was cleared to lose the crutches, and I was able to start doing more intense PT using the treadmill, the weight machines, etc. After that, it seems like the rehab just started going a lot faster. 8 weeks post op, and I was able to lose the big bulky brace. My surgeon said he doesn't recommend any sort of functional brace because there isn't anything that would really support the PCL anyway. Still not allowed to run though. At 12 weeks, I started using my hamstrings again.

14 weeks post op, I went back to see my surgeon, and he signed off on my case. He said the PCL was stable. There is still some laxity, but I went from a grade 3+ to a borderline 1/2. He told me before the surgery that if I get back a degree of laxity, it's considered a success with the PCL. He explained it will never be perfect, but it should be stable enough that it won't collapse on me and I can do everything I want to do. If I was a professional, it would be unlikely I could go back to playing at a professional level, but to kick around a soccer ball with my friends, or go ice skating at a semi-serious level, or run 5K or 10K shouldn't be an issue. He told me I could start running again at around 20 weeks post op, and I wouldn't need to see him again unless there was a problem, and I can stop PT since I could do all the exercises on my own anyway.

Well, I started running slowly at 19 weeks post op, not much difference in a week, right? And when I say slowly, I mean really slow. I completely forgot how to run, it's almost the same sensation I was getting when I was relearning to walk, I had to think about where I was placing the foot for each step. I have been doing a walk/run every day so far this week, and so far, it's holding up really great. I'm really happy with how secure it feels. Once I get into the groove and find my stride, I don't worry about my knee collapsing. I also went to my first zumba class, which was a great test for my knee.I'm not able to do a lot of the jumping, but I kept up with the class and my knee didn't hurt at all. I also started a belly dance class at around 17 weeks post op, which started me getting confidence in my knee, even though it's not very stressful for the knee. I know it's still early, but so far, I'm really happy with my decision to do the surgery. Going through the rehab, I was wondering if all this was worth it, if I would go through all this rehab just to end up with a knee that wasn't any better. But now, I'm not thinking about my knee when I walk, I just walk. I can run, I can zumba. I haven't gone back on the ice yet, since that requires a lot of deep knee bend and I'm just not able to do that yet without a lot of pain, but being able to run and survive a zumba class gives me the confidence that I will be able to do anything I could want to do. I'm happy that my knee is no longer holding me back, and I'm sure the people around me are happy to because I don't complain about my knee as much either.

Anyway, there's my PCL success story. Hopefully it wasn't too long and boring, and maybe someone else can benefit from reading it.

Thank you for sharing your journey Sue. Us PCL Survivors know the length and pain of recovery so please don't feel as though your story is too long or boring. I'm very happy to share and like you hope someone else can benefit from you!


Molly said...

What a great story! I'm so happy for you that you have had a positive experience.

Skinnygurl said...

I was my pleasure to post your story Susan,so glad you had a positive experience as well.
Thank you for sharing it with us.