Running & My Knee

Slacker

2007-02-17T12:49:00.000-08:00

On Wednesday, we had a crappy New England storm. Instead of a nice 8-12 inches in Boston, it snowed for about 4 inches max, followed by sleet, freezing rain, and just plain rain. Further north, all precip was in the form of snow (check out the snow totals at Jay Peak . . . yep 60+ inches), but in the Hub after it was all over we had a flash freeze that made the city a skating rink. People's cars were suddenly stuck in 1-2 inches of frozen rock solid ice. This has made the sidewalks of Somerville completely un-runable for someone like myself who is still recovering from a knee scope.

Thus, I've been confined to indoor tracks, which stinks. On Friday, I just gave up and went home instead of using the 1/11 of a mile Marino Center track, and prayed that the sun had melted the ice off of the Tufts outdoor track. Nope, still completely frozen. Instead, I rode my bicycle for an hour, which was a major slacker move. I did do 40 minutes today at the gym (which was boring enough). Could be worse; there is always the worst case of using a treadmill.

The End of an Era

2007-02-14T09:13:00.000-08:00

Well, its a sad day. I had my last appointment with the Anne-ster yesterday. After downhill skiing and running on concrete with very little discomfort, I've left the confines of MGH Physical Therapy. Last night, I ran 400's at 5:00 pace (or a little faster honestly) which was definitely pushing the proverbial envelope. The big issue remaining that the front of knee can be stiff and sore after serious training, which Anne thought was normal. The knee definitely isn't swelling up or anything like that. Anyway, I took a picture with my digital camera of my Tar Heel Carolinian physical therapist which you can obviously see in this post. Her grin is not for the picture, nor the fact that she likes me at all, but due to a severe case of schadenfreude courtesy of the Duke men's basketball team that is absolutely tanking in ACC conference play.

Passed an exam, another today

2007-02-12T09:30:00.000-08:00

Yesterday I went skiing for the first time. The knee wasn't exactly perfect, but by large it performed as well as could have hoped. The only hairy part was on a steep icy slope I lost my edge and slid a bit, with my knee chattering down the hill. It was also pretty stiff after the 3 hour car ride home. To tell you the truth, the knee didn't bother me as much as the strange light nausea that I developed while skiing (and still have today). I sometimes develop motion sickness when I ski from the lifts and ups and downs, but this condition is persisting. I'm eating fine, and my stomach is holding everything down, so this is just something a little peculiar. Who knows.

Anyway, tonight is a bigger test - (drumroll) - I'm running on the roads. Yep, that means concrete. Its time to do so, and I'm tired of running on the track. I'm gotten up to 30 miles a week on soft surfaces; this was the requirement as set aside by Anne.

Millhouse says . . . "cold, so cold"

2007-02-06T09:18:00.000-08:00

I know its been some time, but we're almost all the way back. Last Tuesday I met with Anne and we both agreed that things were progressing and despite some lingering stiffness on the top of my knee, things were looking good. On Friday I met my dad for his birthday (56 !) and he was astonished about how incredibly normal it looked. That being said, I ran a few 400's as part of my workout at nearly 5:00 pace and I think I was going just about as fast as appropriate. I think I am going to stay at 5:00 pace or slower for my workouts for the next few weeks, before upping it to full tilt. I am going to try and run on the roads next Monday.

The title of post refers to Millhouse from the Simpsons contracting a tropical disease from a pet monkey that he and Bart find (Bart gets lice). This quote works very well for this post. The temps are waaaaay below normal in Massachusetts right now, with wind chills in the negatives (-5 to -10 F). This has kept me indoors, whether on a track or on an exercise bike. I feel bad for a woman from Israel who I went on a few dates with in November that had never experienced anything colder than about 25.

It would be nice if it snowed, however.

Additionally, relating to the disease part of the quote, I am currently surrounded by people who have contracted a (or the) local noro-virus. Two people in my office (potentially three), my roomate Elizabeth, and my roomate Bob's girlfriend have all had it, with the girlfriend (Jen) winning the prize of a loss of 8 lbs. Having had a noro-like virus three times in the past six years, where twice I had to go to the hospital, I'm praying I don't get it, and am washing my hands a lot. If I don't have access to anti-vomiting drugs, I'm screwed. Wikipedia reports that January 2007 was a Norwalk virus outbreak in Boston, with over 3,500 cases reported in the Boston area. Sounds like an inflated number, but wikipedia is always right (hah !).

Runner Code of Ethics

2007-01-29T05:01:00.000-08:00

Yesterday I was faced with an ethical question. I have to do all of my running of soft surfaces as required by Anne and my dad (my dad said - "no running on anything but a track surface for 4 months"). This means longer runs are starting to get boring. Now, last Wednesday it was nice because it was snowing, and running in the snow, as long as there isn't a lot of snow on the ground, is pretty cool. Sunday, however, it was warm (30+), and I found myself at my bedroom with an important decision; do I bring music or not. The party line has always been no music. If you're running for real, and not just for fitness, you don't need music. I never use music on my runs, except during Red Sox games. However, faced with a dull 42 minute run at the Tufts track, I broke out the music player. I must say, even thought there were commercials half the time, I can see its allure. A good song can really get you going. At the same time, it distracts you from your thoughts, and I've always found that there are at least a few good moments of clarity on any run. This clarity gets shoved aside by the tunes.

Strangely enough though, the best song of the day, the one that induced the most endorphins, was "Cecilia" by Simon & Garfunkel. This is not a song I usually listen to, although it is quite good. By the time the singers were into the whoa oh oh ohhh oh oh section I was running 6:00 pace.

I think the music is acceptable while I'm still stuck to the track. Once we hit the roads again, the radio goes back in the drawer, except for the beloved Red Sox of course.

Celebrities

2007-01-26T04:52:00.000-08:00

On Saturday night, Boston will host a very high-end elite track at my training center called the Boston Indoor Games. The link is bostonindoorgames.com. Anyway, since there is a collegiate tonight (Friday), many of the athletes appeared last night to get a look at the track before their races. Most notably, the Ethiopian contingent, featuring Tirunesh Dibaba and Meseret Defar (the top female 3K-5K women in the world) jogged around and did some striders. Their effortless strides made me nauseous. Additionally, John Godina, a many time Olympic medalist in the shotput, threw the shot around and gave a few pointers to the collegiates who were practicing at the same time (including a few members of our club). Due to a scheduling conflict, I'm going to miss the meet, and will have to catch it on the teevee the next day. My old teammate and acquaintance, Sam Burley, will be competing in the 800m. To use the old cheer, Go Sam Go.

Losing track of space

2007-01-22T04:58:00.000-08:00

Some of the readers out there know that on occasion I've lost track of my spatial dimensions which has resulted in some silly incidents. On a camping trip in 2001 I once was looking into the trunk of a car and almost broke a tailight because my right hand was holding a spoon (as I leaned over, the spoon nailed the light). Yesterday was a similar type of goofball maneuver, which involves the ole' knee. I was at my club's annual track meet, retrieving a pen from my backpack which I had stashed under the bleachers (Harvard has pull-out bleachers). As I crouched down in a squat to come back out from under the bleachers, my right shoulder bopped into a corner, and my momentum suddenly went the opposite direction. My friends Sloan and Kit watched in horror as I fell backwards, my knee bending more and more. I had passing thoughts of the whole thing re-tearing. Luckily, it seemed to survive. However, I landed on my left hip, which was sore for the rest of the track meet, essentially a butt bruise. It feels better today.

You're not supposed to get injured on your off/rest days !

Fight the establishment

2007-01-19T04:36:00.000-08:00

Yesterday I went to practice and started the usual routine, 30 minutes, then a fast mile, followed by a cooldown. However, after my 30 minutes, I noticed that a female member of a different club was doing her workout at the pace I was looking to run, so I jumped in. She (name is specifically Marisa Petrillo) was in the middle of 10-12x400 at 6:00 pace, and I did 6 with her. This is good, except it revealed a complete lack of cardio fitness. Lungs were all right, but my heart was racing. As for the knee, it was quite confused. I won't deny there was a little swelling. That being said, icing did very well, and it seems to be OK today. This type of workout was of course completely unauthorized, but I was getting bored and this seemed perfectly reasonable. Yesterdy was 10 weeks and it was high time I get in to some sort of workout. It didn't even hurt that much during the actual intervals, although we still had that problem of the top of my knee being tight (scar tissue, joint capsule etc.). Today, when I go to jog, we'll see what happens.

Update

2007-01-16T04:57:00.000-08:00

As I'm improving, these posts are getting shorter and shorter. As has always been the case throughout this recovery, I've had a week of virtually no improvement followed by a week of dramatic improvement. From last Tuesday to today was a good week. Except for perhaps the first few steps, I pretty much don't have to worry about the knee anymore - it is time to talk about another problem, the lack of fitness. What I'd like to do is aim for next Tuesday (January 23) as the date for my first workout. This would obviously be at a very slow pace, probably with the distance women, but nonetheless it would be a workout.

On Saturday my yogurt exploded in my backpack all over my running shoes, causing me to use an older pair for a few days while the regular pair dried out from the clean-up rinse. The old Asics felt so much better than the Mizuno's. I'm definitely going back to Asics when the pair of Mizuno's are at the end of their shelf life.

The Netherworld

2007-01-12T05:05:00.000-08:00

Well kiddies, I've now reached that always fun part of rehab, that being where no one really has any definitive answers. Gone are the protocols, the simple exercises, the endless icing. Now we're in the "use pain as your guide" phase, which is a road I've been down before. Anne did have some helpful reminders at my last PT session (adding a third day of lifting, a wacky hamstring stretching exercise that will help), but its up to me to figure out what I can and cannot do at this point. Based on Wednesday's excellent run, I'd say I'm getting better, but if I based it on Monday's run . . . not so much. We're in limbo, standing on the Pelennor Fields between good (Minas Trith) and evil (Minas Morgul). If you didn't get the reference from the last sentence, don't worry about it - it was a stretch anyway.

There is also the ongoing question of painkillers. People I have spoken with have said that starting an ibuprofen regimen might not be a bad idea (I haven't taken any). I need to consult with Dad on this one before making a decision. It should not be lost that my sensitive stomach may not tolerate long term use of Advil/Motrin/whatever. I found Aleve (naproxen) to be worse while in college.

Winter, Welcome Back

2007-01-10T17:11:00.000-08:00

This week hasn't been that great in terms of improvement - felt awkward, still with the weird clunking femur-on-fibula sensation at the beginning, tightness in the back etc. Today at work however, the knee felt an ounce better. I stalled at home before going out to run because its finally winter here - when I went outside it was about 25 with a wind chill in the teens. Some minor discomfort below the knee at the start, but at around 13 minutes, 13:15 to be more exact, I felt this warm sensation around my knee; it was finally warmed up for the first time in 10 weeks, and I ran the remaining 27 minutes feelin' pretty good. My fast mile was a relaxed 7:30, and it was much smoother than the 6:59 (and after a day of lifting). I'm heading to PT tomorrow, armed with a few questions. This was an improvement today.

Broken Record

2007-01-08T04:57:00.000-08:00

First off, this bizarre weather is starting to be a a scary broken record. Yesterday, the Patriots smoked the Jets . . . . and it was 55 degrees out. While my heating bill is about 50% of last year, this global warming issue officially has me scared, mostly because there are so many other problems in the world and I can't stop any of them. I do know that CO2 emissions primarily come from transportation and power generation, which is obtusely related to what I do . . . . but who knows.

My running is a broken record too. Lately, each run consists of 4-5 minute warm-up where my knee feels like complete garbage; it feels like my femur is crunching into the top of my tibia. This resolves itself, and I drop back into a relaxed jog at about 9:15 pace. Hopefully if I'm not limping, my left (good) quad doesn't get tired. at 30-32 minutes I try to run a fast mile, which last night was in 6:59 (thank goodness not 7:01). The swelling in my knee is still preventing me from 100% range-of-motion, and its awkward as well as tiring because I'm 10 pounds heavier and out of shape. I end up with 40 minutes of running, or probably about 4.5 miles. The back of knee continues to be stiff and not fully healed, and I need to do a better job of icing that area. I will talk to Anne about this on Thursday.

Thanks Tom

2007-01-02T18:39:00.000-08:00

"The coach is mostly around to say 'Man, you're lookin' good today.'"
--Jack Daniels (a very famous coach)

Today I did my 32 minutes at the Reggie Lewis center in the company of my teammates. This being the beginning of January, we were joined by the distance squad that comes in from January to March. Our distance coach, goofball Tom Derderian, is known for being occasionally a little blunt. He also had (or still has) one true talent, which was being able to run obscene mileage (130-150 miles per week) without getting injured, which enabled him to run a 2:19 marathon in 1975. His coaching . . . . well, success with Tom comes with being a skeptic. This of course belies what I really enjoy about him, an unrelenting enthusiasm for running.

Anyway, after my jog, Tom was standing there watching his group run (he is having some plantar fascia issues, I think) and said something along the lines of how much I'm hobbling. I knew that my form had went down the toilet toward the end and I was limping, but I didn't think it was too bad. Anne had examined my gait last week and thought it was fairly close to normal (of course, that wasn't after multiple miles).

Me: I didn't look too good huh ?
Tom: You look awful. If you're thinking about doing a workout, don't.

Fantastic. Go Team.

Almost New Years Blues

2006-12-30T17:54:00.000-08:00

Today was a positive day, but filled with some negatives. I'm trying not to be glum, but it is was it is. I went to a track meet at BU today and hung out with my teammates while they raced. I took split times, cheered, and chatted with some people I haven't seen in a little bit (my friend Carol is studying medicine in Maryland, she was up on break). I ran 32 minutes or so around the outside of the track at a good pace, and picked it up quite a bit to at least 8:00 pace when I was running with a teammate who was cooling down. The knee is responding. It is getting better. This is a good thing. However, I miss training and competing quite a bit. I HATE seeing people I usually run against racing. I'm not sure which is worse, not being able to run at all or being restricted in the running I do. The problem is that I have to contain myself or else bad things will happen and we'll be back where we started. Nonetheless, the thought of not racing at all until March is pretty rough. When I hurt myself my dad said "this is just a blip, don't worry." Well, it aint no frickin blip. I guess I'm in a running funk.

One year ago this weekend, I ran the best distance race of my life. 38:10 in the 10K with a few pretty decent hills. Now I can only run 5K in 30 minutes - fabulous.

Running Continues

2006-12-27T16:57:00.000-08:00

Just returned from Day 3 of the running adventure. It was pretty darn cold (and breezy) out at the Tufts track, but the track surface is very soft and good for recovering slow pokes like myself. Even though my goal was 30 minutes, I did clock myself to see just how fast (or slow) I was plodding around. Turns out my pace was about 9:45 per mile. I tried hard to pick it up a little on the last lap, staying in my comfort zone for the knee, and ran at about 8:50 pace. Although the knee feels weird, it seems to be all right structurally. The main issue is that my legs (especially the right) are weak. I have ziltch-o knee drive unless I consciously think about it. Furthermore, I think I am favoring my good leg - which is not good for the good leg.

On a brighter note, I went to practice last night and saw the old GBTC croo at the indoor track. Although I could obviously not partake in the workout, I was able to merge my 30 minutes with their warm-up run, and while they ran their intervals I lifted and then iced down. We practice at the Reggie Lewis Center, a fantastic public facility in Roxbury Crossing. The key was that to start my 30 minutes, I had to restart my watch (recall the first day I just ran 2 miles straight up). For 9 weeks, my watch had exclaimed "21:06," which was from when I instinctively stopped my watch after tearing my cartilage and killing my knee. 21:06 is history, and let me tell you if my Timex had memory I wouldn't have saved it.

The anti-climatic Day 1

2006-12-26T03:36:00.000-08:00

I was considering making a completely sappy post about my first day of running, but decided that would be, well, awful. Yesterday, under partly cloudy skies and a temp of 43 degrees, I gingerly jogged around the Tufts track. I first started with walking the turns and jogging the straights - did this for a mile - but after not feeling any real discomfort I took a lap off to walk and then jogged 2 miles straight on the track. It must have looked pretty funny, because I was going so obnoxiously slow at the start. My brain was perfectly comfortable in sending the signals, but my body was completely confused on what to do. Nonetheless, by 1 mile in of the jog, besides the fact that both legs felt weak, I was moving at perhaps 10:00 mile pace. There wasn't really much pain associated with it, although there was some soreness under the left incision towards the start and a slight discomfort near the injury site on Lap 7. I iced down afterwards and everything seems to be all right. I'm excited to try again, although I'm not sure what I'm going to do with the rain. We'll see.

Maryland, My Maryland

2006-12-24T05:01:00.000-08:00

I'm in Maryland visiting my aunt for the Christmas holiday (hey, just because I'm Jewish doesn't mean I can't take advantage of the day off). My aunt's machine uses a modem, so more tomorrow when I get home. I will say that last Thursday, instead of jogging, I went to PT (there was an opening) and I must admit that it was a bit superfluous; not much had changed.

Jogging commences tomorrow on Christmas Day. Film at 11.

Ode To the Marino

2006-12-18T09:46:00.000-08:00

On Friday I went to the Northeastern Gym (the Marino Center) for the last time this year - its being renovated over the break. When it re-opens on January 3rd, I'll be jogging again hopefully which will radically change my workouts. I'm going to take a moment to do a shout out for the ole' Marino. Northeastern has always been probably the #7 college people think of when they think about Boston schools. Come on, try to make a list, and I'm sure Harvard is at the top, followed by . . . . and see where you put Northeastern. It occasionally shows up on the national radar screen because of the wildly popular co-op program, but that's it. In NU's defense, its not a bad urban academic institution, and the engineering school is quite good.

However, someone in the facilties department in the early 1990's was a true genius. This person thought, hey instead of having crappy rec facilities for non-athletes and making everyone go to Gold's Gym or the Huntington Street Y, let's build our own gym and market it to students. They found a very wealthy donor (Mr. Marino) and spared no expense. When it opened in 1996, the Marino Center was the premier collegiate recreation space in the country. All of the facilities people at universities around region had the Bill Simmons "Troy Aikman Face" of being completely dumbfounded that little Northeastern had produced a facility that was not just better than any at Harvard or MIT or BC or BU or Brandeis or Williams or Amherst, but that this recreational space blew theirs out of the water and was drawing away potential applicants. BU, a bitter rival for applicants and athletes, had to spend about 3 times as much just to make sure its facility (which opened last year) was bigger and more impressive. BC didn't even try.

Anyway, for now I'll have to use NU's smaller rec space, the Rosen-Badger Center. However, I'm pretty psyched to see what the Marino will look like when they clean the place and open it for the next semester.

Here is a link if you have never seen it:

https://www.campusrec.neu.edu/marino/images.shtml

Double Dribble

2006-12-14T16:28:00.000-08:00

I meant to post yesterday (Wednesday) about Tuesday's workout but . . . oh well. Consider this a double post.

Tuesday's workout was the most vigorous to date. 40 minutes with 4 7-minute hard intervals, simulating a hill climb. Again, I used the Schwinn bicycles with the manual resistance rather than the computerized bicycles. After cycling and doing the prescribed lifts (press, curls, step-downs) I noticed that the basketball courts were open. I snagged a ball and shot some hoops as a cooldown. Of course, I couldn't take a jump shot or run after the ball, but I did dribble around in a very very light jogging way that dribbling is. There has been substantial gains from week 4 to 5, more than 3 to 4.

This brings us to today's appointment with the Anne-ster. She is detecting through her telepathy (or as Space Ghost would say, "Special Powers") that I'm itching to go, and we did a bunch of balance drills on foam mats and other apparatuses. She had me jog in place on the trampoline, which seemed to be a precursor to real jogging. However, she said real jogging was a week away at Week 6, which I think is right in spite of the mental strain it will create. Thus, one week from today in the company of perhaps no one, barring any unforseen weirdness I will attempt to jog a bit on the Tufts track near my house. In the meantime, I will continue to bomb away on the bike and strengthen my leg muscles. This will be a rough week mentally to say the least.

Anne also thinks I'm inflexible. This is not new news. Not only is my dad not flexible, my mom isn't either. I'm doomed on both ends.

Tomorrow is the first night of the minor Jewish holiday that unfortunately gets stuck next to the Christmas spending hysteria, good ole Hanukkah. As Adam Sandler would say - "Hanukkah is . . . . the festival of lights . . . . instead of one boring day . . . . we get EIGHT CRAZY NIGHTS !"

Monday Mourning

2006-12-11T09:26:00.000-08:00

"Monday is an awful way to spend 1/7 of your life"
--My friend Isaac Benowitz

Yesterday I utilized the Schwinn old style exercise bikes at Northeastern that are hidden up on the top floor near the rowing machines. It was much easier to use, because you could change the resistance very easily with a knob, instead of hitting buttons and waiting for the computer to do something. I did a bit of an interval workout - 8min warm-up, 5min hard, 5 min easy, 5 min hard, 2.5 min easy, 2.5 min hard, 2 min cool down. Next time I go (tomorrow), I am going to go up to 35 minutes. I am also getting significantly stronger in the upper body, although considering pre-injury I was an 142 pound stringbean anything is better than nothing.

Additionally, I am being helped by the administration side of track & field; being in two different governing bodies (my club board and the USATF chapter board) has kept my mind a wee bit occupied with that side of my sport.

Getting very antsy to jog, but I know its still about 10 days away.

Halfway Home Doldrums

2006-12-07T17:14:00.000-08:00

Today is 4 weeks, which is halfway through the expected 8 week recovery period. I'm a little glum because I'm starting to miss the "joy of running" as Jim Fixx would say, and I didn't perceive a lot of improvement from 3 wks to 4 wks. Anne introduced some more challenging drills, and my knee was creaking and sore all the way home. It is also adjusting to the new weight training which is quite a step up from the drills I was doing from 0-3 weeks. The swelling really hasn't changed in some time. I just have to hang tight, stay in the pack, and we'll be good to go after New Year's.

Additionally, I made the mistake of telling Anne about my blog. Now the entire PT staff at MGH, including Missy the front desk chief, thinks I'm a complete wack-job. Maybe I should keep my blog G rated . . . . or maybe not.

Upping the Tempo

2006-12-03T16:05:00.000-08:00

I saw Anne on Thursday and she said that I could go for 20 minutes on the elliptical and 20 minutes on the bicycle, which was perhaps a little more than The Doc had said (30 minutes per instrument) - but naturally since I want to do as much as possible I took her advice. I went to the Northeastern Gym (which by the way is FANTASTIC) and utilized the arc trainers there. I'm not sure if I like the arc trainer better, but its definitely safer for my knee. Anne also recommended a few conventional lifts, which is cool because they are very familiar to me (e.g. leg press). I must say though that with these exercises there is a very fine line between improvement/ strengthening and causing swelling.

On Saturday I attended the first indoor track of our season. Our cross-country runners, in shape from the XC season, all ran very well in the 5000m. Although it was nice to spectate, I would much prefer to compete. I miss competition. One of friends, Jeff Rockwood, commented that you always get hurt when you're in the best shape. Jeff was in great shape last year when he had a season-ender when he destroyed his ankle on the long jump pit.

Doctor Gill was again prominently displayed during the NFL game when Mark Vrabel got his "bell rung," code word for a concussion.

Post Op Visit

2006-11-29T04:51:00.000-08:00

On Monday I had my post-operative visit with Dr. Gill, and he was very pleased with my progress. However, he cautioned me not to get back to vigorous activity too fast, and suggested that I only up the cycling to 30 minutes. He did comment that I could try the elliptical machine. 6-8 weeks looks like the timetable for full recovery, which would be early January. Luckily, my training partners (Dana and Aaron) have been complete slackers too and haven't been working out. In both their defense, they have had a lot to do (Aaron has started a grad program at MIT).

Meanwhile my knee continues to improve. I now experience virtually no discomfort at all when walking around, and have a tiny limp that perhaps only Anne and my dad would notice. The swelling, slowly and inexorably, is decreasing. When I cycle I can see my knee joint actually functioning.

The big question is, of course, what are the long term effects. To start, as Dr. Gill's nurse always says, any meniscectomy can increase the chance of arthritis. That being said, this procedure has positioned my knee to be in the best possible shape to avoid such problems, and Dr. Gill seemed confidant that I would experience no future problems - his actual quote was "you know, this might save you from future arthritis because we've removed the discoid portion." I think in the literature I've been reading, some future problems usually come about when the meniscus is both discoid in shape and overly thick; my meniscus was of the normal thickness.

Most importantly, I can downhill ski this season too. No restrictions after 8 weeks.

I think I've managed to attach some pictures to this post - yes, this is the inside of my knee. In the bottom one, you can see the obvious tear, and in the top set, you can see how he trimmed it back (notice the right angle).

Last comment - The MGH Sports Medicine Nurse Practitoner, Deirdre Fleming, is very pretty. She probably knows this, as every guy in the waiting room while I was there subconsciously against their will stopped reading their outdated magazine and acted like an adolescent. This most likely occurs 3-5 times a day, every day.

Warm Weather

2006-11-27T04:56:00.000-08:00

There used to be this thing that happened in October called "Indian Summer" - when it would get warm for one last time before the November cold rain (and occasional snow) set in. With the advent of global warming, this now occurs in November itself, and my goodness its scary. The high temps have been solidly in the 50's, and it may eclipse 60 this week. Let's just say its perfect running weather, and yours truly is on the sidelines. That really stinks. Its worse because all of the recreational joggers are out and so happy with their I-Pods and their expensive clothes blah blah blah.

I rigged up my bicycle on the training stand and rode for about 20-25 minutes while the Pats won in a hard-fought game against Chicago. Since it was warm in the house, I actually produced sweat for the first time in a month. Today I have my post-op appointment with Dr. Gill, and hopefully he will tell me I can resume cardiovascular endurance work on the bicycle (e.g. 60 minutes with resistance) or the elliptical machine. I know the pool is best but unfortunately I'm a runner so I sink even though I can swim competently.

Odds & Ends: Today's thing you take for granted that I can do again: getting out of the driver's seat normally. Additionally, if you wondered who that was escorting Junior Seau to the locker room after he shattered his arm, yes that was Dr. Gill, team doc of the Pats.

Something completely different

2006-11-23T10:13:00.000-08:00

This post will talk about something unrelated to my knee - which by the way is getting better still. I can ride a bicycle for 20 minutes or more with no pain. Back to the other story - on Tuesday, something weird happened. At about 8:30 AM, while at work, the left side of my face went numb. Not completely numb, because I could still feel my cheek if I pushed on it, but numb and strange. Seeing how my regular doc is only a 10 minute walk, and that any facial numbness can be a symptom of, well, you know, bad neurologic stuff, I did a walk-in and she performed a number of neurologic tests. They all seemed normal, but she ordered a head CT scan anyway just in case. I would like to point out right now that my regular doc is excellent, very empathetic, and was very supportive of me coming in (additionally, a Penn graduate like me). Well, the numbness went away, but my TMJ joint is still a little sore. I guess the whole thing was from stress, and I was gritting my teeth while I was sleeping - or a migraine symptom, or who knows. If anything had happened seriously, my doc assumed the radiologist would have called her. Quietly, she probably ordered the test for my piece of mind. My pulse rate was 125 in her office while I waiting as I started to build a circumstantial case, that my left arm was also sore, I had had pain in calf muscle underneath where the surgery was (a clot !). I seem to be fine.

I'm sitting with my beloved cousin Dave at my aunt and uncle's house in Westchester County for the holiday. Happy Thanksgiving.

Stairs

2006-11-18T06:19:00.000-08:00

Well, as of Friday, I conquered yet another item that we all take for granted, stairs. Going up stairs had always been easy, but coming down them was another story - it just wouldn't bend far enough. Now it will, and I can go down them delicately, but it looks normal. Not so coincidentally, Anne reported at PT yesterday that I had gained almost 20 degrees of range of motion (excellent). She also allowed me to increase to 20 minutes on the bicycle, which is great because not only will it help my range of motion, but 20 minutes may even approach a cardiovascular endeavor.

Mentally however, its been rough, mostly the last 3 days have been in the 60's. Luckily, by next week it will be 42 and I'll feel much better. Anne didn't agree with me (she is from North Carolina).

Freddie Mercury Likes Bicycles

2006-11-15T09:38:00.000-08:00

Yesterday I went to PT and had my first post-op visit. Although there hasn't been any loss in range of motion, there haven't been any gains either - which I guess is all right considering I had knee surgery in between the two appointments. Anne thought I was walking better, and she threw me on the exercise bike, which was pretty bizarre. My knee would not allow for going all the way around, so I just rocked back and forth. Finally, I got it to work going backwards, and then lastly forwards. I pedaled for about 5 minutes, which felt strange and not entirely pleasant. All in all, I'm satisfied with the improvement, although its starting to be less and less each day (more incremental than noticeable). However, I'm peeved because Anne gave me Dr. Gill's protocol which contradicted the post-op instructions that Eileen the recovery nurse gave me. Most notably, the protocol said I should take off the outer bandage immediately for icing, while his recovery instructions did not want me to do this. I didn't take off the bandages, and feel that the ice I used didn't really penetrate. This means that there is swelling in my knee that could have been avoided. On the upside, Anne gave me exercises in the 2-6 week recovery period of the protocol to do now - at only 5 days. This means things are doing well.
This week its been very warm, and I hate seeing everyone out jogging around the neighborhood. However, unlike pre-scope, I know that I'm improving slowly and inexorably, and will be back in action by New Year's Day.

A new side effect

2006-11-13T15:41:00.000-08:00

Today I went to work, and it wasn't too bad. I brought along an ice pack and iced twice, 10:00 AM and 3:00 PM. My co-workers were sympathetic. On the way home, something very cool happened: for the first time in over a month, I climbed the stairs relatively normally. That was cool. My right leg was not perfect, but at least it was oriented in the right direction.

The side effect is this - I'm not running my guts out, or more accurately not doing virtually any exercise, so I am gaining weight. My mom essentially force fed me all weekend (not that I was complaining), and when I weighed myself, the scale read 149 ! I haven't been over 150 since college when I was sprinting and quite a bit more muscular. Granted, one of my goals this year on the track was to gain weight in muscle mass, but it seems I've arrived at my goal by adding a little flab. Then again, most 5-10 folks would probably love to be only 149 (especially my dad).

Patriots & Pouring Rain = Excellent

2006-11-12T09:46:00.000-08:00

Sunday at around 1:00pm, and it looks like its going to be a slogfest at Gillette Stadium between the Patriots and their rival Jets. An absolutely lovely way to spend the afternoon, especially if the Pats rebound from their horrific performance against Indianapolis.

My knee continues to improve. Although my range of motion is very poor, I have absolutely no pain in any direction. I think that the PT will help things along, although Dr. Gill indicated there may be a higher chance of fluid in my knee because it was my lateral meniscus (outer) as opposed to the medial meniscus (inner). I also hope, that by the end of the week, I can stop driving to work and resume using the subway.

In other news, the Boston Globe published their ski preview today, which was depressing. Its a distinct possibility I might not ski this entire season thanks my stupid meniscus tear. It will be much easier to cope with the lack of skiing as opposed to the lack of running, because as awesome as skiing is, the best part is still taking off your ski boots (except for those moments where the snow is perfect).

The Diagnosis

2006-11-11T06:06:00.000-08:00

As for the actual condition of my knee, the situation looks good. I said in a previous post that the MRI radiologist had said that I had menisci susceptible to tearing, but as it turned out the condition was called discoid menisci, meaning mine never fully developed and I had extra cartilage. The tear was primarily in this extra portion, so what Dr. Gill did was "saucerize" the meniscus, meaning he trimmed it down so it looked like a normal lateral meniscus, taking most of the torn portion with it. The tear did not extend into the vascular portion, so there was no need for repair. Dr. Gill was very happy, and said he anticipated my "full return to sports." Sounds good to me. My mom chimed in that this might be one time that all of the Tab she drunk while pregnant helped out.

As I am writing this, I am off of the crutches and gingerly walking around. Later today I will take off the dressings, shower & shave. I fully intend to work on Monday, as I have not needed to take a Vicodin in over a day (and not for sleeping last night). I can ride an exercise bicycle on Tuesday at PT for range of motion purposes.

The Details

2006-11-11T05:05:00.000-08:00

Sorry for the delay on this post. My mom's wireless card has been malfunctioning, so I couldn't connect to the internet from downstairs where I have been living for the last day and a half. I can now climb stairs, so here we are.

This post will cover the details of Thursday, but not the diagnosis.

I was a little late thanks to the ongoing construction at Charles Circle. I'm totally in favor of the new construction of the T Stop because the Charles stop had the dubious distinction of being the closest to MGH . . . . but not handicapped accessible. I was supposed to arrive at 11:15, but did not check in until 11:35. My mom commented how much "hoo-ha" there was in the Day Surgery Unit, which makes sense as MGH is one of the largest hospitals in the region and does a ton of day surgery. Surprisingly, the specialties are not segregated, even though Orthopedics could probably have their own day surgery suite by themselves (as could abdominal surgery for hernias, appendices, and gall bladders). I was called at 11:45 to change into the surgery clothes (johnny, pants, slipper socks, bathrobe), and returned to the "Penn Station" waiting room. At 12:45 I was called in for good, and my mom went off to the 'caf downstairs to get a salad. I went into pre-op (by the way, the nurse who took me in wins the cutest nurse award, even though I wouldn't see her again) and proceeded to answer about 9,000 questions from various people and signed various consents. I met one of my two anesthesiologists, a lovely woman named Laurie Shapiro. She noted that the other anesthesiologist was named Daniel Goldfarb. You know you're in good hands when the two anesthesiologists are two Jews over the age of 40. We discussed the merits of general anesthesia vs. a spinal (I kind of had a choice), but the fear of the catheter made it a no brainer, and I'm a pretty young healthy guy anyway. She put in the dreaded IV, but did a fantastic job - she used a little fast acting anesthesia first. After reading a Boston magazine while I waited for a bit, the Ortho fellow showed up and explained the procedure while shaving my knee. His name was Dr. Vasquez, and was a native of Worcester, Williams College 1997 and Columbia Med School 2001. When he was done Dr. Goldfarb arrived in my bay and gave me some relaxant that made me feel like I had just drunk 3 martinis, and we were off to the OR (it was 1:40) - Dr. Goldfarb pulling and Dr. Shapiro pushing and directing traffic. We got to the surprisingly small OR room (which is good because Seinfeld says the smaller the better, implying fewer people would want to watch because it was routine), and Dr. Gill was not there. He was still finishing up on another person (that doesn't sound like fun, moving from OR to OR). No matter, I moved myself onto the OR table, said hello to the other people (nurses, Dr. Vasquez again), and Dr. Goldfarb placed an oxygen mask on me while Dr. Shapiro placed some monitoring instruments all over, apologizing that the EKG readers would rip off my Eastern European chest hair, hurting quite a bit, and that he would rip them off himself before I was awake. I was told later that actual surgery began at 2:05.

That's the last thing I remember. My eyes closed (although I don't remember them telling me I was going out), and I don't recall even seeing Dr. Gill. My eyes opened and I was in recovery with a zillion other people, with Dr. Goldfarb and my recovery nurse (Eileen) staring at me. I didn't feel all that great, so Eileen gave me some anti-vomiting meds through the IV. Dr. Goldfarb, seeing that I was awake, moved on to his next patient who was in pre-op. This would beg the question - is the actual surgery time the most relaxing for the anesthesiologists, because they don't have to run around ?

The anti-vomiting drugs worked, and I rapidly improved. My parents were astonished about how good I looked when they stopped by, especially my step-dad (Les). My two stepbrothers had just undergone small surgical procedures, and Les said they were like zombies compared to me - alert and able to have a serious conversation. This was a testament to my anesthesiologists who were knew what they were doing. Eileen maneuvered me into a chair for the second stage of recovery, and at that point Dr. Vasquez came in and talked to us. I had some crackers and Shasta ginger ale (Shasta being the only brand ever used at a hospital, but virtually never consumed outside of one), and left at 4:50 with crutches. I was only in recovery for an hour (the conscious part, plus maybe 20 minutes of unconscious), and we had to wait a second for Dr. Gill, who was trying to complete another scope while I was in recovery (!). I had to take a Vicodin to get to sleep that night, as the pain was significant on the side where the scope incisions were.

Schedule of Events

2006-11-09T05:30:00.000-08:00

For those out there who are interested in the schedule of today's events, here they are. There is nothing else more to say; I am ready for the scope, and am hoping that the vascular portion of my right lateral meniscus is not torn.

Mom shows up at the office: 11:00
Arrive at MGH Same Day Surgery: 11:15
Move into pre-op: ~12:15
Scope starts: ~1:15
Scope finishes: ~2:30
My first vomiting episode because the anesthesiologist messed up: 3:00
The second episode: 3:45
Leave the hospital: 5:00
4x400 relay: 5:15 (women before men)

That is all. Feel free to call my parents' cellular phones if you have any questions.

Calm Before the Storm

2006-11-08T05:09:00.000-08:00

Today is Wednesday, the last day before the scope (thankfully). I can't wait to get this over with, to begin the process of rehabilitation and recovery. Even if my vascular portion requires repair, I'll just wait longer until its healed up. I have confidence in Dr. Gill's abilities as well as his staff.

Speaking of his staff, I had a better PT experience yesterday. The radio was blaring louder, the receptionist was nicer, the stupid trauma ward curtains were pulled back, and Anne wasn't wearing her lame-brain way too serious lab coat. I even made her laugh twice, especially when I mentioned the blog. She said that no matter what procedure is done, I'll be like a "new person" at our next appointment next Tuesday. Her exercises seem to be working, as my knee shrunk by 2-3 centimeters (swelling down) and my range of motion increased by 10-15 degrees. This is good because today I had no qualms parking in the $9.00 lot, even though there is a two block walk to the office.

The Democratic party surprised me by doing very well. Now comes the tough part (are you listening Deval Patrick ?), now they have to actually govern.

Countdown at Cape Canaveral

2006-11-07T05:13:00.000-08:00

Its Tuesday morning and there are a few days left until my scope. MGH has not called yet and told me what time they want me to arrive . . . I think I'm either the AM or the PM shift (hopefully, they don't cram in a midday shift too). I've never been so excited for something that will be so unpleasant.

In other news, the parking lot that I have been parking at spontaneously raised their daily rate to $12.00. I am going to start parking at the $9.00 lot that is further away. There didn't seem to be any rational for the increase; its not as if new property taxes were assessed yesterday. Truth be told, I'm hopeful that if the knee doesn't require repair I can start taking the subway again, because I greatly miss the subway despite the pleasure of getting to work really fast in my car. My car, with its 120,000 miles, did not sign up for this type of labor.

Additionally, today is Election Day. I am a far left liberal politically, and I hope that the Democrats do as well as they can. I did vote for one independent in the local election (Rosemary Macero for Governor's Council), and two members of the Green-Rainbow Party. I can't wait until January when the Congress changes over and Dennis Hastert has to give is position to Nancy Pelosi - a woman (oh no!) !

Stay the course

2006-11-04T15:01:00.000-08:00

As I speculated in the previous post, I'm going to stay put with my scheduled scope procedure next Thursday. It seems like egos started to get punctured, and somehow Dr. Gill in Boston has decided that he will in fact repair the vascular portion of my cartilage if it needs repairing. Dr. Rodeo, the surgeon in New York who recommended Dr. Gill in the first place, assures me that the Patriots man is perfectly capable of doing the procedure. I guess there was a misunderstanding; Dr. Gill wasn't aware that we wanted to take the most aggressive approach. Perhaps the two docs had a conversation I didn't know about (entirely possible), or my dad gave him the guilt trip; who knows. End result - we're in countdown phase to Thursday. My poor father, who has been making all of the phone calls and emails and is a wreck, escaped to The Hamptons for the weekend. I'm focused on the surgery. Let's get it done.

Additionally, the knee itself is getting a little better. I have better range of motion (I can put on socks without pain for the first time in two weeks), and the swelling is down a bit. I'm not sure if this is due to a renewed vigor with the ice pack, or just the natural course of healing. I'm also doing the non weight bearing exercises that Anne recommended; they may be helping too.

Gimme some . . . . PT !

2006-11-03T05:05:00.000-08:00

1) Concerning the previous post, things may be swinging in the opposite direction. I can't say what the outcome is yet, because I don't know. However, it is more likely now that I will have the surgery in Boston as planned in less than a week. I'll update you folks (the readers) when I get more info.

Yesterday I went to PT for the first time at MGH. MGH PT is serious business, I mean this place is the Ritz-Carlton of PT. You could eat dinner off the floors, very similar to my Mom's house. There are so many machines you could try a different one every day and not use the same one for a month. My therapist, Anne Viser, has to wear a lab coat. She also passes what seems to be the primary requirement for physical therapists, being really pretty. Now my cousin Mike Berne would ask which type of hotness we are dealing with here, and Anne definitely fits into Mike's primary gift to the world, his invention of the term "intellectual hotness." This means the initial reaction is not the same as one would have if they had dinner with a supermodel, but the sum of a quiet personality, looks, and an unknown secret potential combine for a serious candidate. Jill Hennessey of Law & Order fame was the pioneer of this description. Anne will read this and conclude I'm either wildly immature, or a 27 year old sociopath.

However, despite Anne and her attentiveness, MGH PT so far lacks a very important issue: fun. If I'm going to PT once or twice a week for many months, I want to look forward to it. This should not feel like I'm going to the doctor. The waiting area was no different than my dentist except with fewer magazines, and the exam area looked like an ER. If this persists, I'm switching to BU. At least people there smile and occasionally laugh.

It's the end of the world as we know it, and I feel fine

2006-11-02T03:43:00.000-08:00

Well readers, if there are any out there, there has been a dramatic shift in treatment, surgery date, and surgeon. Yesterday, the New York opinion, Dr. Scott Rodeo , questioned the rush to meniscectomy by my original surgeon, Dr. Thomas Gill. I have a radial tear in my lateral meniscus, which starts in the avascular portion and MAY enter the vascular portion. The vascular portion is the part with blood flow, the part that will regenerate with a little help. Research has shown beyond a reasonable doubt that you always want to repair knees and keep as much cartilage as possible. If the tear is all the way through, and I proceed with the meniscectomy, I'll be left with two independent pieces of cartilage. This will not be as structurally sound as one piece, and it won't be a big deal immediately afterward but within 5-10 years I may not be able to continue at a high level in track and field if my gait is quietly affected. This is not an option. Dr. Rodeo has experience in repairing this type of tear, even though it is difficult and not very common. Dr. Rodeo's opinion was corroborated by Dr. John Richmond, who agreed that repair of the vascular portion is critical. Both surgeons were confused that Dr. Gill did not want to go forward with repair of the vascular portion if the tear was all the way through. Personally, I'm not sure that we have enough firepower, considering the three of them only work for the Red Sox, Patriots, Celtics, Giants, and the US Swim Team.

Dr. Rodeo has an opening November 22nd, and after a quick conversation with Dr. Gill (who may be guessing that the vascular piece is not torn) I'll be going that route. This means I'll have my procedure at the Hospital for Special Surgery in Manhattan. This also means I wait 10 more mentally excruciating days. However, with Dr. Rodeo at the helm, this means A) if the vascular portion is not torn, I've only wasted 10 days and B) if it is torn, I'll have a surgeon who I have confidence in to repair it. The recovery for repair is much longer, but it worth it if my athletic career is at stake. Dr. Richmond cited a study that only 50% of patients who have complete radial tears can fully function athletically at 10 years with their lateral meniscus in two pieces.

I'm praying for a cancellation so I can do it sooner. This is brutal.

Something To Pass the Time

2006-11-01T03:50:00.000-08:00

Yesterday morning my surgeon's nurse called up and after a quick conversation recommended I go to MGH physical therapy (my surgeon is at Mass Gen Hosp as well) before the surgery to work on strengthening. This was a fantastic turn of events; at least I'll be able to do something to improve my healing time as I sit here on my arse waiting for my meniscectomy. Truthfully, its a good idea, because my quad is getting noticeably smaller. My downstairs neighbor is an occupational therapist, and when I showed her my muscle imbalance she was pretty freaked out. I have an appointment for PT on Thursday, and the hopefully one more before surgery.

Unrelated, they just announced the nominees for the Rock and Roll Hall of Fame, and none other than REM was among them. That's a little scary, as REM was the first band that I really followed independent of my parents. I bought the album "Automatic For the People" when I was 13 and memorized virtually every song. My friend Jon and I used to play it over and over at overnight camp back in the day. Anyway, if REM can be a nominee, I'm officially old.

My quadriceps

2006-10-30T14:16:00.000-08:00

Yesterday, while walking into the bagel shop, I felt kind of a bizarre cramping in my right quadriceps, and I felt it this morning too. I think my quad is starting to weaken. Perhaps "atrophy" is too strong of a word, but the muscle is definitely a lot smaller than the left quad. This is exacerbated by the fact that the left one is now doing even more work. I left a message with my surgeon's nurse, and she has been prompt in returning my phone calls in the past. Today though, she didn't call back; I will call her again in the morning. I feel like an experienced PT person could rig up a brace for my knee to protect it and then I could do some supervised quad strengthening. Older folks with degenerative tears that have to wait often do pre-surgery PT - my request can't be that uncommon.

My third opinion, a surgeon down in New York, has still not given my dad his opinion yet on my knee. I would certainly like to know it, even though I presume that it will the same - partial meniscectomy.

10 days to go.

Cold rain

2006-10-28T06:08:00.001-07:00

It's really gross outside. Winds 20-30, occasional sideways rain, temps in the 40's. This is one of the few instances so far that my knee has helped me out, because there is nothing worse than running in cold rain. Of course, I could have engineered an off day for today, but that's another story. Today I would have been in Philadelphia for Penn Homecoming, but I had to decline on account of . . . . of course, the torn cartilage. Luckily, even with non-refundable plane tickets AirTran gave me some semblance of a refund (minus $50 dollars). I'll have $109 dollars toward future flights, and I already have trips planned to Pennsylvania in April 07 and June 07, not to mention the Passover holiday in Maryland.

This might be a good time to talk about running in the rain. I am not one of those macho types who says suck it up or it will make you stronger etc. I hate running in the rain. However, if rain (or snow) forced a serious runner to not run, then that would mean a lot of missed days. Sometimes, you just have to shove your body out there, and wear the best clothes you have. I have a Marmot synthetic top that works really well, especially under an old-fashioned 1970's era nylon vest. This shirt might qualify me as a "yuppie runner," but the fact that A) I'm running in the rain at all, and B) I'm not wearing a $500 dollar GoreTex rainsuit (the Marmot shirt was a gift), that point is wasted. Also, in my real life as an engineer, I make WAAAY too little cash to qualify as a yuppie.

I would also comment that, yes, I hurt my knee while running the rain. Conditions that night were vastly different than right now. It was 10 degrees warmer and drizzling. The rain was a non-factor - it was my fault that I attempted to long jump the stagnant pool [puddle not draining].

Phone Interview

2006-10-27T14:50:00.000-07:00

Even though the menisectomy is 2 weeks away, today I had the pre-op phone interview. They ask you a bunch of questions (history of heart disease ? any bad allergies ?) and answer any questions you might have. There were a surprising amount of mental health questions, including asking whether I was depressed as a result of the injury. Some questions I had involved the overall length (1 hour surgery, but 5 hours total), and the anesthesia. I've never had a "general" before and I must admit that even though I want to get this done, I'd be lying if I said the anesthesia didn't make me nervous. Someone else will be pumping drugs into me to force sleep and probably paralysis. Not to mention how much I.V.'s also stink. You get the point. On a lighter note, the nurse commented that I should write "27 SWM seeking SF" on my leg so the surgical nurses will know I'm single and available.

When I was initially evaluated, the doc suspected a torn palpateal tendon, which is in the back and connects to the top of the calf muscle. I'm assuming that a tear would have shown up somewhere, or someone would have told me if I had torn it, but that area is occasionally painful. Perhaps I strained it badly when I tore the cartilage.

This is the first post

2006-10-26T16:38:00.000-07:00

Let's set the stage here of what is going on. I'm an average runner, but I'm pretty serious about it and enjoy it quite a bit. I run competitively for a club (www.gbtc.org) and am still improving many years after college.

Last Tuesday something out of the ordinary happened. While running (or more accurate, leaping over a puddle while running), I landed awkwardly and tore my right lateral meniscus. Luckily, I didn't cream any of my ligaments, but the damage was done. I need an arthroscopic procedure to fix it (more on that tomorrow), and I am currently waiting for a time slot. Right now, I'm scheduled for two weeks from now, on November 9th, for a partial menisectomy. This means the doc will just clean up my tear and remove enough busted cartilage to give me full function. It takes all of an hour, shorter than most boring lunchtime sales pitches.

However, I cannot run. More accurately, before the procedure I can't really do much of anything. This is the point of this blog, as a healthy place to vent. Perhaps after it is all over, when I'm back to the track full tilt or swooshing down the ski slopes, I will continue this blog as a simple running blog. At the moment though, we're going to focus on my torn meniscus and the mental aspect of not being able to do the thing you love the most. Right now, its pretty crummy. To be continued en viernes.