Tuesday, September 25, 2012

#777 I'm against manipulation

I met with my surgeon today for my six week follow-up after surgery. Basically, he just wanted to check my range of motion. The goal we've set is 125 degrees of bend and zero degrees (flat) for the flex when the leg is straight. I'm currently two degrees short of flat, which means that I have a teeny, tiny two degree bed in my knee when I'm trying to have it lie flat. My bend, though, only measured at 110 degrees today, prompting Dr. F to say, "I think manipulation could really benefit you."

Let me tell you what I know about manipulation. The very first time I met Dr. F and we talked about the surgery and the post-surgical care and physical therapy and the goals for recovery, he told me that if I did not reach the goals in a reasonable time, there is a procedure called manipulation. It is an outpatient procedure where the patient (me) is put under general anesthesia. A shot of cortisone and pain-killer is injected into the knee, and while the patient is out, the surgeon bends the knee very aggressively, causing all the scar tissue to tear, thus enabling approximately ten to fifteen degrees more of bending. Almost immediately after the patient wakes up, the patient does some intensive physical therapy to keep the scar tissue ripped up and the knee bendy.

At that time, the end of July, Dr F told me it was pretty unpleasant and something I should try to avoid.   But here we are, about two months later, and he thinks manipulation could be beneficial to me.

What I heard in that sentence was that all the physical therapy I've been doing, all the bike riding, all the walking, all the stretching, hasn't been enough. I felt like I failed. I've been sad all day.

Dr F and I have another appointment in two weeks. If he doesn't see significant improvement in my bending measurement, he's going to recommend manipulation.

Tonight I had an appointment with Lance, my physical therapist. I told Lance what Dr. F said, and Lance said, "Ooh. You don't want that. The first day will be fine because you'll be on morphine. The second day you will question your will to live. The third day you'll be ok with living, but you'll wonder why you ever had knee surgery in the first place. The fourth day you won't want to move. The fifth day you'll feel better and start to see light at the end of the tunnel." (Or something like that. I may have embellished his words, but that's what I heard.)

So basically between today and October 9, I have got to get this knee bending like it hasn't bent in five years. I have got to push it nearly to the point where I am in agony, then go a little further.

We did that tonight in physical therapy, and I got to 115. The thing is that Dr F doesn't push me until I'm nearly in tears. He just bends it until it stops and then he measures. I gotta get my game face on here. Lance says that if we can at least show Dr. F steady improvement, he'll probably back off the manipulation talk. Lance told me that if I was older, he'd be happy and satisfied with 110 or 115, but because I'm "in my prime", both doctors push me harder to get good results.

Plus Lance said that the fact that Dr. F is talking about manipulation doesn't mean I have failed. He knows that I'm doing what I need to be doing. He said that sometimes scar tissues forms more quickly and more strong in some knees, like mine, I guess.

So next time you sit down and your knee bends without pain, think of me and wish me well. I'm going to be pulling and bending like a bad ass for the next two weeks to avoid The Manipulation.

1 comment:

Kteach said...

I really feel bad for you, you have been trying so hard! Kepp on pushing yourself, be positive and everything will work out!!!
I am sending lots and lots of hugs and good thoughts your way :)