Knee Doc Visit Updates

[angelak]

Here at the office early because of a project.
The annoying co worker didn't quite finish up her part of the project first; so me being here early was pointless.
That is ok. I still get the comp time for it, so I'm not really worried.
I don't even really care.

Besides; doesn't this give me an opportunity to update on the knee doctor visit?
It was very bittersweet.
He is a great doctor, I've got to admit. He's experienced, has great bedside manner and is good at giving the not-always good, but not-completely bad news.

The news? I've been doing everything right. He didn't even bat an eye at the yoga, so I don't think I'll scale back THAT much, in fact after taking a hiatus from going as regularly this week (errr, much at all this week) I am seeing that the yoga does go a long way for pain resolution in the interim.

He did ask more questions, watch me walk with and without pants (I had shorts, because their shorts are blah). It is now decidedly so that I pronate a lot on each side – more on the left (my initially injured side.) My knees definitely go inwards when I walk (according to the doc) and that this is a biometric issue in regards to how fast this heals for me.

It means when I walk ANYWHERE it puts pressures on my tendons that some people may never experience. I've been doing it my whole life and while it won't prevent the injury from ever healing – it could explain some of it.

He said if I play my cards right, I could become painfree. But it's going to take more months.
He also wanted to explore running. He said that I shouldn't necessary stop. On a scale of 1-10, I rated my average pain at 2. 4 at worst.

He said he is comfortable with the notion that as long as I start out at 10 minutes a day, with 2 days rest time in between, that I should do treadmill only runs.

I hate treadmills for long term work, but I think he wants to make sure I am not putting ANY hills in there. He also said not to push the speed. At all. Which is really hard for me to hear as well.
So, while I do get to do some of those “short runs,” I'd wanted, it seems I'm stuck in the gym in a building.

Don't get me wrong, there is a part of me that is happy to have him (he brought up running, not me) the running part. I told him I'd quit running for 2 months. As daunting as that is to type.
It sounds like a less slow version of the return to run program given to me by my PT, because he said try 2 runs in a week first at 10 minutes each. If my pain level remains the same and doesn't get “pissy,” as he called it (which I entirely understand what he means, after having this condition) then to add 5 minute increments every week. Well, this is not a bad prospect to me at all. What disappoints, is the treadmill part. My damn outdoor body wants to be outside.

I am 100% because of how he stressed NO HILLS, NO INCLINE, NO PUSHING IT that he doesn't want me to inadvertently do anything. I think I understand this too much. I think at least one of my re-injuries were accidental. Well, okay – no one goes out and says, “My goal here is to train and accidentally run on a hill that pisses off my tendons!!!” or, “I'm going to crawl under too many desks with machine upgrades and fuck up the tendon!”

No, no. Point is, I think his treadmill advice is because on a treadmill, yes it's softer than pavement on tendons and joints, but also – there is no mistaking the incline. Outside, you can never really know.
Also – said this sort of overuse injury is something that creeps up on most people (I don't think mine did, but then again how the hell can you tell) and that it on some level permanently changes the structure of the tendon, but that doesn't mean I can't live a pain free life.

It does however mean that sometimes the graduated state of recovery is very. Very. Slow.
And so he said he is entirely pleased with a 20-30% improvement in pain on day to day – that this is really actually good news, and that I just have to wait some more.
It's almost what my Dad told me.

So, I'm left with bittersweet emotions about this stuff.
I was very good and handled the office visit with stunning cool. I didn't even turn bright red in the moments I described my life.

On the drive home it hit me what he had told me; “months.”
Hadn't I waited months? I asked myself. But he had said perhaps I pushed it too hard too early and that may have been why I experienced the 11 months already. Okay, I can see this. No one said “Hey! Don't try and run fast!” before.

Sure maybe that's logical.
And also the job re-injuries...

“If you play your cards right, you can live pain free again.”
This indicates if I play my cards wrong, I could live painful ...
This also indicates that if I'm not patient, I could fuck myself over forever.
So – the drive home was a bit of realization hitting me that – no, my journey is not over.
He also said, “there is no magic pill that makes this condition just leave.” He basically said the healing phases are just... well. I think I understand. It's clear to me he has experienced this condition enough. He also said, a lot of people just entirely give up on their sport of choice when they get this condition, and that is what is different about me than other people.

Okay. So I'm supposed to want to run after he said that?!??! lol, but he brought up the running, wasn't me pining to him. I think he is pretty good because I believe he entirely had me pegged on some level.
The sad part about this further visit to the doctor is that my current goals for life must wait and loom in the future, and they are not things I can any longer actively work on. I understand that I can do * other * things. I do. After all, my options are on the table. This is all I have. I must wait more months.

Gods know how many.

This being said, I have an apt with my acupuncturist on Saturday at 11. (Noting here so I don't forget the time). I will begin these therapies, my books should come in the mail today – and I will need to get back on my yoga practicing path because this temporary break doesn't really help my knee. This I can see. Also – I need exercise and at the very least this is a good stand in. The doc also said that surgically, there is nothing that can be done for this sort of condition with my severity. Sometimes if it lingers for years, they'll try and inject stuff into the tendon, but he said he was entirely sure it was way too early for that with me. He said it's a biometric problem more than a surgical problem.

Goody!!!! :P
The good news? My pelvis and kneecap are aligned well. It's just the way I walk. Just the way I walk.
And that makes sense to me why one would have gotten injured before the other one. It was the side I pronate most on.

I think I've summed it up.
The doc says I've got months to wait. But everything is going just as good as it could be expected. I think every case of patellar tendinitis is different.

The reaction I had on the way home; Very sad. I wasn't sure how to talk about it because I felt a bit emotional about the notion that nothing is going to change right away - the my current new living situation will be perpetuated for an unknown amount of time STILL. I did get to talk to Jim about it, and really it does suck on many levels. BUt I really have no choices but to just keep doing the same things I've been doing. No options. The choices here are the kind that I just have to accept. And of course, it also behooves me to think perhaps he mentioned "months," so that I will not try to rush it and end up right back where I've been at for the last months. If that makes sense. I opt to believe he told me longer rather than shorter to ensure that I don't (seeing as he seems pretty observant) try and power on ahead too quick and regret it. I am hoping this is true, and hoping with more research and self treatment annnnnnnnnnnnnnd acupuncture, that I can make headway in fewer months, rather than like - 11 more. My brain heard the worst case scenario on "months," but Jim did point out, he didn't say HOW many even remotely. That could be 2, 3, or 18.

I feel though - the trip was worth it, (Jim was disappointed like I was with the answers) and after a few healthy and non-depressive tears, I feel like I can handle moving on from here with a new plan of action.
Jim was very impressed at my "non over reaction" to the situation. When I am depressive, the reactions become less and less logical and more and more over-stated. What he noticed was a far different thing than depression.
The tears are 2 different varieties entirely.

I cried for the hikes I cannot do, I cried for the runs I miss, and I cried for the limitations on my training still - and the frustration of having to keep on keeping on. Just like I've been doing. But it isn't so bad.
I've got the Yoga. I've got the go ahead from the doc to work on SOME form of running. And a lot more tools than I've had in months. I feel like I can formulate new plans so my life doesn't make me want to drop kick people or spend my life bawling in my tower of misery. I can re-evaluate and maybe prepare in other ways.

The plan?

Wait. Yoga. Wait. Run slowly. Wait. Try my best with diet and not rely as heavily on my exercise. Wait. Yoga. Wait. Also accept that any of my private goals will have to wait and that it just isn't the right time or this stuff would not be happening. The universe will give me what I need, when I need it. Now is not the time.
I need to work my best on the Sharepoint project, and possibly next year my position will move into a more sedentary sort of job that could also help keep me strong. :P

And other things.

There are other variations, but for the time being this is all I can swallow until life shifts again. That may be a month or two, or less or more. Who can say? :)

And now work is needing to be done :P


More perhaps when the work doesn't need to be done. At least I got a lot of the details that are likely to pass through my brain onto the screen.

Good, and Bad. But damn is the doctor good at being mister positive.
Well - I think as Jim said, if he didn't believe it could get better, he would have discussed options for coping with the forever-pain.

-Angela

Comments

[herongrrrl.livejournal.com]

Did he discuss orthotics to correct the pronating tendency? That runs in my family, and whenever I've asked a doc about it I've been told that as long as I'm *not* experiencing pain, they aren't necessary, but that they can go a long way to correcting pain from that. I do notice that the gel arch-support inserts I wear in my hiking boots (read: walking shoes, don't do a lot of hiking these days) make a huge difference. They aren't technically orthotics, since those are custom made from molds, but they do make the difference between aching knees/back or not if I have to be on my feet a lot.

He did

[ithisia.livejournal.com]

He did discuss this.
I have SuperFeet - and stability shoes. He asked about my PT and what she had suggested.

He asked if they relieved the pain. They probably helped, but didn't do anything dramatic.

-Angela

[herongrrrl.livejournal.com]

Well, at least they will help prevent further damage to your knees. My grandma (from whom my mom, grrrly and I each inherited the tendency to pronate) never had them and wound up with terrible arthritis in both knees...I can't help but wonder how it might have gone differently if she had had the extra support from them. Sorry they aren't helping more with the pain, though!

[everlastinggoo.livejournal.com]

I'm glad to hear that your appointment was good overall and that the doctor is pleased with how you're progressing. I know running on the treadmill will suck for you, but hey, at least its running! Keep your chin up and follow that plan of yours...eventually this will all just be a memory. :-)

I agree

[ithisia.livejournal.com]

With the running.
The fact he told me I didn't have to stop, even though this time around I figured I should, is very encouraging. Any tidbit? I'll take it! Thanks for the support.
You know every little bit helps!

-Angela

[eneogei.livejournal.com]

Good on ya for keeping up the yoga. I don't have serious knee issues like you do, but I'm double jointed and the yoga has really helped build strength around my knees. I can't hyperextend backward anymore (thank gods!), so if I trip on something, I have enough stability to not bend my leg the wrong way and pull something (that sucks a lot). I definitely go through periods of yoga-angst (I'm leaving one now), where I'm all at odds with myself for a few days, but then I go back for a couple days or so in a row and am reminded of how good it makes me feel and of how I felt before I got into it. I think it's a good sign that my 'low' periods have me in class 2-3 days a week, and not 0 days (kind of like all my previous exercise/diet attempts)- it does so much good that it will always be in my big picture.

Yoga!

[ithisia.livejournal.com]

I am so glad, this may be just my first real "low" period since I started practicing. I felt bad for only hitting class 2-3 days last week - but I had the same rationale. 2-3 days is better than 0.

The strength can only do good, and frankly - I don't mind the Yoga torso at all. It also has way too many mental, physical, and everything benefits. I'd already decided to keep Yoga in my life in some level no matter what. Because it is such a balanced ordeal.

I am thinking that adding other stuff in alongside will help make sure I stay motivated with the yoga too. Thanks for all your advice though and comments. A Yogi pal is handy. And it is nice to know my low period is just a cycle that we all have from time to time.

-Angela

[nobodyberry.livejournal.com]

Good stuff. It sucks to have to keep waiting, but it sounds as though you're right where you need to be.