10 DAYS ON

It is now 10 days since the operation to my left knee and today I removed the dressings and tape to reveal 3 small incisions healing very well. The picture above shows one of the small holes left healing.

The most important part now is that I allow the micro fractures to heal and that is why I have the crutches for 6 weeks.

It is only when you are put in this situation that you realise how restrictive it can be. Just doing small things that you take for granted becomes difficult. I can make a cup of tea then I can't carry it anywhere as both hands are on crutches and the same for any food I make, I have to eat it where I make it.

I have a cup with a lid now which makes it a bit easier rather than relying on help all the time.

Every day last week I carried out the 4 exercises 3 times a day and also iced the knee 3 times. The swelling has reduced considerably and the pain is only when I twist a certain way or accidentally put my left leg down with too much weight on it.

On Monday I went to the Physiotherapy Department at the Royal Infirmary and was given a new set of exercises and did 5 minutes easy peddling on an exercise bike.

No problems at the clinic and I have continued to do the exercises the last few days. I went back to the clinic today and continued with the exercises and the two measurements on my knee showed lots of improvement. I also did 15 minutes on the exercise bike with no adverse effects.

Last Saturday, using the crutches I went for a walk to the end of my street and back which is about 500m in total and my arms and hands were aching and I had to stop a few times.

I have been out each day since, gradually going further and I can now go a reasonable distance without stopping. I am not overweight and quite fit so using the crutches has been fine but if you were heavy and unfit it would be very difficult to go any great distance. Your hands and upper shoulders take all the weight and in the mornings I am aching in the upper body and my fists are sore to clench.

I have to use the crutches 24/7 and I am getting about fine with them now and yesterday I covered about 1 mile. That is the only exercise I do at this stage, but it allows me to get some fresh air.

On Sunday my golfing mates took me up to Tayport as it was the 3rd round of the winter golf tour I organise. I hired a buggy and only used my right foot to drive round watching them hack up the course. There are full reports and pictures on my other blog(link is at top of this site- hackers tour).

I am planning to drive in the next few days as the car is an automatic so I will only have to use my right foot to drive.

Anyway things are progressing along slowly but surely.

Not what was planned

WALK IN WALK OUT - NOT THIS TIME

Monday 7.30am I checked into the new Day Surgery unit at Stobhill for keyhole surgery to my left knee. I had a tear in my cartilage that needed to be repaired and at my initial meeting with the Consultant he said it would be a straightforward procedure lasting about 30 minutes. He also said that I would not need crutches and would be walking right away and back jogging in about 3 weeks.

However at 9 am on Monday, as I was waiting to go into theatre, he appeared to discuss the day and informed me that he was concerned about some thinning of the cartilage and he might need to clean up that area. I would still have the same recovery period and walk out of the hospital. Then he proceeded to say that there was a possibility he might have to do some more serious repair work and the recovery would be 6 weeks in full crutches and 3 months recovery.

Well, I was a bit taken aback at this and told myself that wouldn't happen and I was wheeled into theatre just before 12.00pm and the clock in front of me showed exactly noon as I went to sleep. I was wakened leaving the theatre at 1.30 pm a full 1 hour longer than I was booked in for. So I knew right away things had not gone to plan and I was told back in the recovery area that I was not allowed to get up as I needed to see the physiotherapist and get measured for crutches.

The Consultant came to see me later and gave me the news that it was a lot worse than he expected. The initial tear was no problem and was repaired but part of my cartilage was worn and had an indentation (he called it a divot) and was showing bone. He cleaned this area out and drilled small micro holes into the bone and into the marrow allowing cells in the marrow to make new cartilage over the damaged area. It is not as strong as natural cartilage but gives a coating over the previously bare area. He said due to my age he couldn't leave it as it was and this will hopefully strengthen and reshape the area but it will be 3 months recovery. The most important thing is that because of all the holes I now have a weakness there until the formation is complete and I am not allowed to put weight onto my left leg.

This is not what I expected and I left the hospital at 5.00 pm on full crutches. The first night wasn't too bad and I managed about 5 hours sleep but when I went downstairs to make a cup of tea, I realised that I couldn't carry anything as both hands were on the crutches. The reality of 6 weeks not being able to do anything for myself was now starting to sink in.

Yesterday evening I took off all the dressings as instructed and the above photos shows the 3 holes in my knee area and it is very swollen compared to my right one. I didn't sleep as well and this morning it was very tight and stiff but once I got up and moving it wasn't too bad.

I have 4 types of exercises to do and yesterday I could only do 2 of them as the 3rd was too painful, but today I managed to do them. I have been using an ice gel pack on and off today and Alison drove me to the library to get a few books and some fresh air.

I think if the Consultant had told me 2 weeks ago at my meeting with him that there was a possibility of this being the outcome, I would have asked him to postpone surgery until the beginning of January and get the holidays and Christmas out of the way. Still it is done now and I have to get on with it and the main problem for me is the minimum of 6 weeks on crutches and I now have to rely on help for everything at the moment.

I also have to attend physio twice a week starting on Monday and the stitches should be out next week also.

The doctor said it was maybe time to consider a non impact sport once I am fully recovered. He said it was my call and to continue running if I wanted, then deal with the consequences whenever the areas deteriorate to a state where there will be more work required. He said it could be years away but there was significant damage for someone my age. If I hadn't got the tear then I would have not been any the wiser until it would have been even further damaged. I have ran now for some 35 years and I would be very reluctant to just stop.

I will get back on my feet, complete my recovery and I will continue to run as the enjoyment and health benefits for the rest of my body far outweigh the possibility of a knee replacement. We will see.

An Unexpected Letter

Before I explain the unexpected letter, I think a brief explanation is necessary.

Mid December 2009

While playing golf, my left foot slipped backwards and my knee twisted underneath me. I knew immediately something was wrong. Intense sharp pain and my knee buckling as I tried to walk never mind run. The pain gradually got less but I tried running every 2-3 weeks and even as late as May I was struggling to go any further than half a mile and the sharp pain and buckling would return.

So a decision was made at end of May, no more messing about with a run here and there it was needing a longer recovery period so complete rest from running.

No running at all in June and July and by mid August I decided to try some walking and jogging. The pain wasn't too bad and I gradually increased the distance and number of runs.

Just prior to starting back in August, I went to my doctor and he wanted me to see an orthopaedic doctor as he wasn't happy with the knee. A number of weeks later an x ray and meeting with the Consultant resulted in him saying he was concerned and he wanted an MRI scan to be booked. I was in two minds whether to bother as I was now running 3-5 miles a few times a week and telling myself it was okay.

At the beginning of October I went off for my MRI scan thinking this is a waste of time and I nearly never went. I had the scan and continued to run up to 5 times a week now and a few runs up to 8 miles. The knee was not 100% but most of the runs were not too bad and afterwards I had no real discomfort, but sometimes playing golf resulted in me limping as it would start to ache. I was out running 5 miles last Wednesday and over the last 3 miles my knee was locking and quite sore. This was the first time since mid August that this had happened.

After the run it was fine and then the post arrived with a letter confirming I was booked in for an operation on the 15th of November. There was also a second letter advising me that I had to attend for a pre-op assessment on 3 November. First reaction was what the **** was the operation for as there was not a word in the letter saying what I was going in for! I had no idea what was wrong and I had yet to receive any results from the MRI.

I phoned the Consultant's secretary and she said I was sent out a letter a few weeks earlier telling me that I have a tear in my cartilage (meniscus) and I would require keyhole surgery to repair it. Well the letter must have got lost and I received another one the next day. I was asked to come in and speak to the Consultant and he would discuss the surgery and recovery period.

I was not expecting the results from the scan to result in me needing surgery and I have swayed back and forth all week about what to do, but I am only 46 years old and after talking to the doctor today I have decided to get it done. He said to continue running if I wanted as long as I was not in pain - which I am not, but sometimes if I turn or twist the wrong way I can end up limping around with my knee throbbing like toothache. The thing is running has not been too bad and my knee has improved so much since January, but that might be it as cartilage doesn't repair itself very easily. So November the 15th at 7.45am key hole surgery to my left knee.

The recovery period is not too bad and I was told today that I can drive in 2-3 days and start jogging in 2-3 weeks. Golf is going to be 2 months due to the strain and twisting motion. So that is not what I planned but that is the way things go and on the other hand I now know what has been causing all the pain for months. Today I attended a pre-op assessment clinic which I passed with flying colours. Pulse was mid 50s, very good blood pressure, good results for an ECG. The Consultant also said that the scan showed no other damage and all other parts of the knee looked good. He said that due to my fitness and muscle bulk around the knee that my recovery would be quick. So I am going to continue with a few runs a week up to the 15th and get on with it.

When I left the hospital today I went to the Marie Curie Hospice to visit my friend who is terminally ill. He was drugged into a sleep with pain relief and it was very sad to watch him lying there looking so ill.

That visit brought home just how insignificant a sore knee is and that sometimes we all get too wrapped up in our own world and lose sight of other things and people about you.

For those who are not too squeamish, below is the procedure to fix a tear in a meniscus.