Going my way...maybe? finally?

This past Wednesday I met with the hematology doctor to discuss my blood clots. Bottom line she said both clot incidents have been "provoked"...meaning I had good reason to develop them (c-section/pregnancy and traumatic injury). I have a return appointment in 6 months and plan to get tested in order to see if I have a condition that makes me develop them easier than the average Joe. I can't have all the tests done now because I'm taking blood thinners so I'm just going to wait and have everything done at once. Whether or not I have a clotting disorder does not affect my ability to have surgery now.

Although my clots are still there I'm no longer at risk for having them dislodge. She said after someone is on Coumadin for 4-6 weeks the vein wall starts to grow over the clot. It's been almost 8 weeks for me. So while it won't dislodge it's still causing some circulation problems. Every once in a while my left leg will still look more swollen than the right and occasionally it's a different color from my knee down (red or sometimes a little purplish). To help with that I have an appointment next week to get fitted for a compression sock. Hot stuff! And I've given up trying to conform and wear dress shoes at work...either I'm working in my running shoes or I'm not working. Rebel with a cause!

With regards to surgery... she wants me to finish out one more month of the Coumadin and then I am good to go! YEAH! As of my hematology appointment this past Wednesday my next scheduled appointment with the surgeon (just to check in) was not scheduled until June 25th! When she gave me the thumbs up for surgery in a month I went straight home and placed a call to the surgeon. My next appointment with the surgeon is now April 7th! Two months earlier! Hopefully we set a surgery date during that meeting.

On Thursday my physical therapist said she was happy with my leg extension for surgery. It is very close to being equal with my right leg and that's apparently one of the most important PT factors heading into surgery. If both knees can't straighten equally at the time of surgery then one ACL ends up being longer than the other. I'm still working on the flexion. I'm now able to bend it to 120 degrees during my wall slides. Not great, but not bad.

All in all it's been a good week and I feel like it's finally starting to work out. Hope it lasts!

Back to the ER

This morning I noticed some funky swelling in my left calf and ankle. My calf was looking really swollen and I had a lump on the inside of my ankle (think "cankle"!). I hadn't seen this type of swelling since I started the blood thinners over a month ago. Given that I hadn't hurt myself or changed anything in my activity level my hubby and I were pretty concerned about possible new developments with the blood clots.

After a call to my family doctor we went to the ER to have it checked out. I had another ultrasound done on my leg. One superficial clot has disappeared, but one remains and there has been no change in the DVT (deep vein clot). The doc said at this point the clots should be going away and he's not quite sure why they're not. His hope (and ours) is that I will learn more about why it isn't going away when I meet with the Hematologist doc.


In the end the ER doc said intermittent swelling in my leg is common and to just be aware/rest whenever it comes on. He didn't really have an explanation as to why it just happened and why I haven't seen it before this. He said I shouldn't consider this a set back and my body is just taking a little longer to clear the clots.

I'm looking more pathetic in this pic than I actually was. I was just really tired. My hubby and I joked around that we were in the "South Hallwa Islands" (the sign above me is missing the "y"). The nurse added that if you crossed your eyes and looked at the sign quickly it actually looked like "Hawaii". She was right. It sounded good anyway to pass the time. :-)

Perspective

One year ago yesterday my friend and co-worker, Jason, passed away after a ~2 year battle with leukemia. Jason was the picture of health before his diagnosis. He played college baseball and was a huge hockey player as an adult. He packed his lunch every day for work and it seemed to always be the same.... turkey sandwich (cut in half), pretzel sticks, yogurt and an apple. He worked out all the time and had the muscles to prove it. And then out of the blue he was diagnosed with leukemia.

There was never a doubt that he would beat it. This was Jason we were talking about. He was strong and healthy. It was only a matter of time before he was back to work and back to playing hockey. But sadly that never happened and he passed away on 3/13/09. Jason left behind his wife, 5 year old son and 1 year old daughter.

When I'm pissed about my knee or frustrated at not being able to do certain things I'm trying to think of Jason. My situation can be fixed and I can return to normal activity when all is said and done. That never happened for Jason. So while this does suck and I may complain I'm trying to keep it in perspective.

A Date

My hematology appointment is scheduled for 3/24/10! Yeah! I'm so happy to finally get this going. I'm not sure what's going to happen at the appointment or how many more may follow, but it's a step in the right direction.

Next appointment with the surgeon is scheduled for a week from today, 3/17/10. Right now I can bend my knee to 105 degrees. My goal is to have it at 110 degrees + by the appointment. At PT on Monday I was FINALLY able to straighten both legs equally. Granted I was really pushing down on the bad knee to get it straight, but at least it got there. The area around my knee cap is still swollen...it's been 49 days! My physical therapist told me most people are able to help the swelling by using compression wraps, but I'm not able to because of the blood clots. The swelling will have to go away eventually...right? All in due time.

New View

Today I experienced something new... I joined the non-skiing/non-snowboarding parents at the bar and watched my kids on the ski hill all afternoon. I would have much rather been out there with them, but this was a good alternative.

I found a table on the deck and enjoyed the warm sunshine (should have remembered sunblock!) for 4 1/2 hrs. I came prepared with my book and iPod, but ended up not using either. I watched my kiddos the entire time and was completely wrapped up in their happiness and growing confidence. They loved it and I was so proud of them for trying something new on their own. I hope I'm able to ride with them at some point next winter. I know Dad is excited to get his "skiing legs" back and get out there next year too.

While watching the kids I also had the perfect view of the fateful jump that wrecked my knee. There were a lot of people out on that section of the hill, but oddly that jump was the least used (by far). Hmmmm... are other people seeing something in that damn thing that I didn't? Maybe it's just called common sense. It did look a lot bigger from the deck than it did on the approach.

As for the knee... after a few phone calls between all the doctors I'm starting to have a better understanding of what needs to happen and when. I still don't know exactly how long surgery will have to wait, but I should know at some point this week when I'll see the hematology docs (turns out there is a need to see them prior to surgery). After a quick conversation with the hematology scheduling lady this week I was told one doc was scheduling into June and the other had openings starting April 15th. But she said they may possibly be able to work with me if I was planning on having surgery sooner. It's all waiting on their clearance...so the sooner the appointment the better. She's going to get back to me this week and hopefully set something up sooner than April. Fingers crossed!

Same Page

I was supposed to hear from the Hematology group yesterday, but didn't. Squeaky wheel gets the grease right? I called this afternoon to get things rolling. The kind lady on the phone pulled up the referral and was confused as to why I was referred to them. She said that any blood screens they would be able to do would not affect my risk level for surgery and some of the tests can't be done while I'm on Coumadin anyway. She said those tests would have to wait until I'm done with surgery and completely done with my course of medication. She said the lady in charge of scheduling would call me regardless, but not to expect things to happen quickly. Only so many doctors and there was already a stack of referrals ahead of mine. In a more polite way she basically told me to dream on about seeing them before my next appointment with the surgeon (March 17th). Not sure that I need to see them at all right now. Errrr.

Going to make some phone calls tomorrow to my family doctor (who's monitoring my Coumadin) and to the surgeon. Hoping to get everyone on the same page! I don't think that's too much to ask.

And So It Begins...

January 21, 2010- Injury

It was a perfect day for snowboarding. The sun was shining, the snow was good, I was out by myself and had my i-pod...good stuff. I had been out for about 4 hours before I decided to head home. I was on my way to the lodge and hit one last jump about 3/4 of the way down. I went off the jump funny and landed off balance on a flat section of the hill. All my weight came down on my front leg (left) when I landed. My knee buckled and down I went.

Go figure...last run of the day.

I've read and heard tales of the noise that an ACL makes when it snaps. I'm sure I would have heard something had it not been for my i-Pod jamming away in my ears. Even without the noise I knew immediately that something was very wrong. I laid there for a second...trying to will away the pain. I started sweating, got shiver-bites (my daughter's word for goose bumps) and felt like puking. I was laying under the jump and was afraid of someone else landing on me and making a bad situation worse. And truth be known I was more stressed about laying there long enough for ski patrol to find me. No way was I going to get pulled off the hill on a sled. I had two main thoughts running through my head in a matter of seconds: 1. I'm screwed. This injury is going to impact everything and 2. pick yourself up and get to the car!

It took me a good 15 minutes, but I managed to get myself out of my snowboard and limped my way to the parking lot. It didn't occur to me that I should call someone to come get me. I wasn't thinking very clearly at this point. The pain was intense and I just wanted to get to the hospital. So I drove myself. 1/2 hour drive. My loving hubby met me there (we finally connected by phone when I was almost to the hospital) and wondered why I hadn't allowed ski patrol take care of me and why I drove myself. I'm still glad ski patrol wasn't involved, but I agree with him that I should have called for help and not driven myself to the hospital. I should not have been driving. I later found out my Mom was only minutes away at a local mall when it happened. Ooops. Lesson learned.

After a few hours in the ER and an x-ray they wrapped up my knee, set me up with crutches, gave me pain meds and a referral for follow-up. Off I went to do a whole lot of sitting still.

(The above photo is not indicative of my current skill level! Photo was probably taken ~18 years ago when I was riding almost everyday. I took a break from snowboarding when we had kids and was just getting back into it so I could teach my son how to ride. He's thinks Shaun White is the coolest ever and I kinda have to agree)


January 26, 2010- MRI

MRI. Not a fan. I'm claustrophobic. Thankfully I was in only up to my shoulders, but that was enough. Breathing exercises came in handy!



January 29, 2010- Follow Up Appointment/Blood Clots


Initial follow-up appointment with the surgeon. My ACL is completely torn and I have a grade-1 injury to the MCL. I also have some pretty good bruising on the bones surrounding my knee...not uncommon for an injury like this.


As the doctor was moving my leg and knee around he noticed that my calf muscle was very tender...not normal. He expressed concern about possible blood clots in my calf. I'm not new to blood clots. I had one 8 years ago after my c-section with my son. So, off we went to the Cardiovascular Department at the hospital for an ultrasound on my leg.


The ultrasound found 1 DVT (deep vein thrombosis) clot and 2 superficial clots in my left calf. Same location as my clot 8 years ago. Off to the ER to start a course of medication. Several hours later and refresher course on self injections of Lovenox we left the hospital. Back to the couch with my bum knee, Lovenox, Coumadin and growing frustration. Now I really have to sit still! As if I wasn't still enough before.


Thankfully my coumadin levels became therapeutic very quickly and I only had to give myself the shots of Lovenox for 3 days. I'll continue on the coumadin for a while with weekly finger sticks to check the medication level and make sure it's therapeutic.



February 4, 2010- Start of PT

Starting physical therapy 3x a week. My knee is really stiff and I'm not able to bend it very much...maybe 60-70 degrees...and straightening it is already a challenge. It hurts. I'm sent home with basic exercises, but I'm cautioned that we are going to take it slow because of the blood clots. Sweet. I'm ready to do whatever it takes to get surgery done quickly. Going slow is not what I wanted or envisioned. I was told to let pain be my guide and not to press anything too much. Ok...I'll play along and be the good patient.



February 15, 2010- Crazy Lady Therapist

The crazy Canadian lady substituted for my regular guy. She wanted to know why I was still wearing the monster leg brace and using crutches. I thought I was being the good patient and was doing exactly what I had been told to do. She said that if I don't push it it's never going to move. Good point. 2 hours later my knee was more swollen than when I started the session, but I felt good. I felt like I was getting somewhere. Thanks for giving me the green light to start doing more. I definitely felt like that day was a turning point.




Mid-February, 2010- Help at Home

I have a really hard time sitting still! This injury has forced my family to adapt. Everyone is stepping up and taking on new rolls...and I'm stepping back. Thanks to my husband the kids now have chore lists for after school, they've learned to vacuum ("learned" certainly does not mean they've mastered it....it's a work in progress) and they help with laundry. I realized just how much work I was doing before. It's not as if my family refused to help...it was self induced. I either didn't ask or didn't allow others to help. I have a bad habit of wanting things done a certain way so I just do it. Needless to say this is something I've been forced to work on because of the injury, but I think something positive can come out of this....a more balanced household and sense that everyone is contributing.



February 24th, 2010- Back on the Taekwondo Floor


Taekwondo has become a major part of my life the past 3 years. I am usually at the studio ~3-4 times a week training and assisting with classes. I love the sport, the people and the atmosphere. Being laid up at home and not being around the studio bummed me out the most. I missed working out and seeing everyone. I knew that the rest of my tournament season was done (ending in June). I already had plans for 2 regional tournaments (Feb and April) and was just starting to plan for one national tournament in Las Vegas (Mar). See ya...it was fun while it lasted.



After my doctor determined my coumadin level was therapeutic I started going back to kickboxing. Kickboxing...sitting on my butt. Not the same, but it's something. I was also going to our taekwondo leadership/instructor class on Wednesday nights and just listening. It depressed me watching everyone out on the floor, but it was worse not being there at all. After a few rounds of that I began to realize that I could still assist with instructing classes. I would obviously have to modify my teaching style and rely on verbal instruction a lot more. In the long run I know that this will benefit me. I'm sure there will be a learning curve associated with it, but I know what to do and now it's just a matter of getting it done. My instructor has been supportive...he went through the same thing a few years ago. So last Wednesday (24th) I assisted with a class for the first time in more than a month. It felt so good to work with the kids again and to be involved. I'm going to do what I can.





February 26, 2010- Check Up Appointment

Not good. I went into it too optimistic about having a surgery date set by the end of the appointment. Instead I was referred to the Hematology Department for blood screens/tests etc because of my blood clots. They want to evaluate the risk level for surgery and to see if I have a clotting disorder. I am glad this is happening for my kids sake. If it is some type of disorder it may be genetic and may be a concern for my kids later in life. With that being said I am beyond frustrated with these damn clots. Surgery may be put off for a while until the clots are settled and the medication has run it's course. No one will give me a general time for how long that may take...1 month....6 months? I am goal oriented. Give me a time frame so I know what to expect. I was pretty down this past weekend about the whole situation.





I plan to use this blog to write about my ACL journey. I've looked at some others and it helped to read what others went through. This will help me just writing about it and getting my thoughts out. If it helps someone else in the process that will be a bonus!