4 In 1 Operations And A Somewhat Unusual Ugly Knee

Today I had my 6 week post operation check up at Stanmore Hospital and I finally got to meet Mr Miles (my surgeon)... the famous squash player.. I sort of chose my own surgeon as I googled who was able to provide the surgery that I needed and was drawn to Mr Miles as his profile said that he played squash. Unfortunately, he doesn't play as much as he used to due to his dodgy knee😂 plus having to work some evenings. I did have a little chuckle to myself with my 2 dodgy knees and the fact that they have not ruled out playing squash in the future. Most people don't return to squash due to psychological reasons rather than the physical ability to play. I have already told myself... well when I snapped the ACL and cartilage in my other leg playing rugby that didn't prevent me from playing rugby or squash so now it is about developing the muscles in my legs so that I can get back to playing some form of sport.

Don't worry....... I know this is going to be a long and lengthy process as the graft sites are really vulnerable and I cannot partake in anything that is likely to risk the grafts moving and not holding.

I was asked how I was doing. Not too bad I told him, bit gutted that I haven't got the 90 degree bend that the schedule said I was supposed to be aiming for by week 6.... This is fast approaching as I am on Week 5 and 5 days... not though I am counting or anything. Don't worry he says I am not expecting you to be as you had 4 in 1 operations... Have I?? That's news to me I thought I only had 3. Nope I had to do some more work to your cartilage whilst I was there.. I think this is probably from where I tripped over my bag at work and twisted my knee just after my last MRI scan.. This may  probably explain why one of the holes in my bones was bigger than what they thought.

He looked at my knee and says oh we shall have a look at that.... referring to the last stitch that I have poking out of my knee... he gives it a little tug and says.. right I will be back in a moment, I shall just go and get somethings and we shall have that out today.. It's only been the last couple of days that that particular site has started to look as though it is healing. Previously you could see the hole opening up and closing whenever I have had to carry out my physio exercises.

Today's check-up is mainly about how I am feeling and how the scars are healing. I inform him that my bend is 56 degrees which he is happy with.. I am reminded that the operations I have had are quite big and that it will take a long time to be fully recovered and the exercises are gentle as he does not want the grafts to be displaced. There is no way of knowing at this stage as to whether they have been successful and I won't know until after 6 months. Due to the great progress I am making... I inform him my sick note runs out on 10.11.17 and checked that I could go back to work... This was short lived... No you will probably need at least another 2 weeks minimum. Actually what do you do for a living again. I explain what I do and then the blow comes... No you can't return to work. I do not want you to be put in any vulnerable or risky situations. Plus you can't drive yet or bend your knee enough...

Initially this came as a bit of a shock as in my eyes I am progressing really well and see the differences from the start of my physio sessions so thought I would be allowed to go back. It's costing me a fortune being off work as I keep buying 'things' online. However, I have made a good purchase... OK yes one of these is a work related book but it's perfect as I have loads of time to read it and now that I am no longer on loads of painkillers the information will actually be processed. I have also treated myself to Level 1 and Level 2 British Sign Language course... I have given up on Portuguese for the time being... sorry Jorge.

Mr Miles explains that he can't do the normal tests for the ACL reconstruction due to the grafts. I was asked if I had any concerns and I informed him I was worried about this big dent that I have in my knee. Oh yes... You will have that.. it's due to muscle wastage but we have to go slowly in building those up... yup you got it... due to the grafts. Don't worry he says you will get it back. Then he says... oh you are going to be left with a somewhat unusual ugly knee... Then he looks at the other one and implies 1 and a half!! Commenting that I am going to have a big scar... Mind you... I am not quite sure what good looking knee looks like.

I am not worried about the scar especially if it means that I am going to be pain-free and able to return to sport. I have missed it so much it's unreal. Sport for me has always been my form of relaxation. Squash has taken on a therapeutic role over the years. My job at times can be really stressful and when I was a child I remember my coach telling me pretend the ball is someone's head that has annoyed you. So at times of frustration I have hacked the ball on my own to blow away the stresses. At other times, I have gone for a run down the beach with Petra (my dog) and just 'dumped' the emotional baggage along the way.

I also mentioned the sharp ripping sensation I get in my knee every now and again. Mr Miles explains about the ACL graft and where it is and that this is the reconstruction stretching. A massive sigh of relief is given as this is the same sensation I used to get in my other leg when my ACL was ripping!!

So in all today has been yet another positive day and lots of reassurance was given. I have informed a couple of my team mates that I am going to be off work longer than I had anticipated. They have been really really supportive which is making it easier for me as I was feeling guilty that they are struggling as technically we are currently two members down. Both of them have told me not to rush back and to look after myself as it is not worth damaging my knee.... Don't worry I have no intentions of doing this especially after talking to one lady today. She has had two operations on one leg and one on the other. Both times she has damaged her legs after surgery. I was completely shocked that one of them she damaged 4 hours after her surgery. At times, it is scary when you have to go outside in the rain or worried that you are going to slip when you get up to go to the toilet during the night or get knocked by someone when you go out.. not though I have been out much.

I am just taking one day at a time and making steady progress everyday. 

Don't Be So Tough On Yourself!!

Over the last week I have had a couple of wobbles... Now I am not talking about wobbles on my crutches but emotional ones... My physio appointment was cancelled last week and I was worried as to whether I was progressing as much as I should be... I know that I am supposed to be aiming for a 90 degree bend in my knee... whilst remembering all the other things that I am not allowed to do even though my leg feels strong enough.

The lessons I have learnt is not to compare yourself to other people that have had their ACL reconstructed... I was already aware of this as I came to the same conclusion the other day but today when I had physio I was reminded.... Don't forget Louise we are not following the normal ACL rehabilitation plan as you have had 3 in 1 operations. I tend to remind myself of this but every now and again when I am struggling to bend my knee... OK.. sometimes this is because I forget to unlock my brace or I only lock one side.. but at other times it is due to the swelling in my knee and surrounding area.

Anyone would think I was auditioning for a part in 'Frozen' with the amount of ice that I go through to try and get the swelling under control. But you know what... I am getting there... it flairs up when I work through my exercises and sometimes when I am just walking to the toilet or sitting at a table and then the good old ice comes out and I elevate my leg and it starts to get under control again.

During the week, I have treated myself to a Bloccs waterproof cast cover.... OMG... it was so nice to have a bath. Well actually I had two baths and a shower first off! Getting into the bath was a sight for sore eyes... As I can't unlock my brace when I am getting into the bath and my knee on my other leg is also ACL deficient.. It was sheer bliss when I managed to get in. Then slight panic occurred... OMG.. How am I going to get out... I am not allowed to bend the knee as such in transit.. not allowed to fully weight bear... How on earth am I going to get out! I had visions of having to call the blinking Kent Fire and Rescue Services.... Oh the shame.. the embarrassment if I do have to do this... And why oh why did I not bring my towel closer to the bath just in case I was going to have to call them! Please please legs work and arms and everything else so that I can wiggle to the edge and then figure out what to do next...... MUUUUUUUMMMMMM....... don't laugh but can you help me!! Not something you want your mother to see is yourself in your birthday suit!! Mind you I did have a flannel covering a small part of my body!! 🙈 Thank goodness I managed to get out without having to call anyone else!!

I also treated myself to pimp up my crutches so that I am all set to go for West End Bares and to make my life so much easier when I am walking.......

I wish I had these from day one as it is goodbye sore hands and hello walking (within my limits!!)

The waiting room for physio is so entertaining..... everyone tells stories about their surgery and rehabilitation... One lady had injured herself horse riding and she has had numerous operations to fix her... I thought I was bad but she was just as bad if not worst! Then there was the lovely Erica... her and her husband were so nice and friendly. Erica was supposed to be on her final physio session today as she had progress really well recovering from a hip replacement but she has had a massive set back as she broke her femur after a night at the theatre! On a positive note... she got to see the show as it was afterwards and she thoroughly enjoyed the show! So it looks as though it will be more rehab for Erica.. I hope I get to meet her again to see how she gets on.

Anyway today at my physio session:- drum roll please.... my knee bent to 52 degrees... So it isn't quite the 90 but I am over half way!! I was pleased with this but also disappointed at the same time but this was when I was reminded I had 3 in 1 operations. (well after the physiotherapist did!).. so I then went back to be you know what Gregory.. You have done really well and it is more than the 2 degrees you had the last time you were here!

I was given new exercises to complete alongside my old ones and the ones for the dodgy ankle. I spent most of my day completing my rehab and icing but afterwards I feel great especially when I see the progress. I just need to remember not to be so tough on myself and only compare myself with myself rather than what other people have managed at this stage etc. Everyone is different and there are so many factors to take into consideration as to how people's progress will differ from one person to the next.

New exercises are simple yet so effective, I can feel my quads working hard. Every now and again I have to stop as my knee goes into some kind of spasm and then I think please hold me up!! I also have to contend with the other dodgy knee and hope that it does not collapse! I take longer completing my exercises as I actually do them on my other leg as well to build it up due to it having similar problems as my operated leg..

I will be feeling the burn in my thighs soon as I have to sit down and stand up, clench my the top of my leg and then sit down.. this is all with an unlocked brace. Obviously I don't just do one but I have to repeat this over and over again!

I then progress to mini squats and clench the thigh again. Burn Baby Burn... Think I may have to sort out a workout playlist whilst I carry out my new exercises.

As I sit back on the couch and bend my leg.. I said.. oh my leg feels easier to bend and not as painful now it is warmed up a bit... Let's measure it again.... BOOOOOOMMMMMM 56 degrees.... wahooooo getting closer to that goal!!

Progress and West End Bares

I am over the moon as to how well... I am progressing. My knee is bending loads more from my first physio session two weeks ago. I can actually see the bend myself!! ( I shall put up a photo soon to show you the bend!!) Walking on the crutches is a lot easier. More importantly I am pain-free until I have to bend my knee... This just tends to be a dull ache until I then push myself a little further to get the knee to bend that little be extra. It doesn't feel as tight anymore although it does feel as though something is still going to ping out of my knee and across the room. 

In the back of my mind, I still worry as to whether the grafts are OK especially when my leg goes into a spasm during the night and it feels as though my knee twists slightly and then a quick sharp stabbing pain but it is over within a second. I no longer get the red hot poker feeling that I used to get through the bottom of my foot anymore so overall I am mega pleased with how everything is progressing at this stage. Only time will tell if everything has gone according to plan. 

Today I booked tickets to see TheatreMAD's West End Bares.....

I would just like to say how helpful Katie Lydon; Deputy Box Office Manager at The Novello Theatre was. I was really worried that I wasn't going to make this years show due to not being able to bend my leg and have access to the theatre but she has given me all the relevant information that I need to make it possible and I have an aisle seat where I will be able to stick my leg out slightly if I cannot fully bend it behind the seat in time on Sunday 29th October.

My motivation is to continue to bend the knee further and hope that I will be able to fully bend it by the 29th. 

Weight-Loss/CM's Progress and Cancelled Physio Appointment

Today I woke up really looking forward to having my physio appointment as I wanted to see how much I had progressed from my last session. I am sure my knee is bending so much more than what it was at my last session. I have completed all of my exercises on a regular basis for both my operated leg and my dodgy ankle on the other leg! I was hoping that I would be able to progress to the next set of exercises and have my brace unlocked when I am walking. I didn't realise it was more difficult to walk with a straight leg then one where you can slightly bend it.

Unfortunately, I got a phone call at 8:50am informing me my session at 4pm today has been cancelled as my Physiotherapist has called in sick. Initially I was annoyed as I was worried that I may not be advancing according to my rehab plan but then I quickly had chat with myself.. You are doing great Louise... You are bending that knee more and you are doing all of the rights things, resting, icing my knee, elevating it.... So you are heading in the right direction. I was probably a bit annoyed as Saturday I went to London for a family meal which was great. It was really lovely catching up with all the news about the family. I also managed to have my leg bent on numerous occasions (train journey and during the meal) and for longer periods. Now this is definitely progress. It is so much easier to bend the knee when there is a distraction going on. I ensured I iced my knee throughout the day and when I got home.

Sunday I was supposed to be going to a birthday tea but I didn't realise how much Saturday was going to take it's toll on my body. Swelling was still up despite icing it but it was going down and boy oh boy did I sleep well during the night and there was still room for my sleep during the day! Although I really wanted to go to the birthday tea I was worried that I was going to be other doing it and wanted to be fully recovered so that I could have a positive session at physio today... but alas this was not meant to be.

I shall just continue with all the exercises and ensure that I rest and get the swelling under control before my next appointment.

Great news was yet to come:-....... Hurry up mum, I need you to take my photos and do my measurements.... Photos were taken.. The normal front, side and back view.

Drum roll please.... Hurrah 1cm from my chest, 5.5cm from my waist and my hips have stayed the same. Very pleased with Week 1 as to how well I have done. I haven't weighed myself due to being on crutches but as soon as I can I shall start to record my weight.

I have sorted out a food plan for this week and factored in social events just like I did last week.

Rehab:- Going well so far

Yesterday, I had a physiotherapy appointment for my ankle. This is for ligaments that I have partially torn in my non-operated leg from where I have had to over compensate for such a long time. Mind you I was managing this really well until I had to increase my driving on a daily basis... This was not an option I had much control over. Initially I was angry that I had injured my body further as I have been so careful. I have carried on with all exercises that I have been given despite the 1:1 treatment sessions ending. I wanted to build up muscles in both legs so I had the best possible advantage of recovering from surgery as possible.

Anyway, I met with a new physiotherapist who is just as nice as all the other therapists I have met along my way of 'getting fixed'. I give the long history again about my legs.... ACL deficient, cartilage missing on my left knee, ligaments torn in left ankle (This is what is being treated today)... Right knee:- recent surgery to reconstruct the ACL, stem cells grafts x 2... Oh and  a Grade 4 stress fracture to the tibia. How is your health? Believe it or not... It is really good. Feeling great and really positive. Can't wait to get back to playing sport etc hence why I want to make sure the left ankle is strengthen now so that I do not end up over compensating on my operated leg. At the moment, the crutches are helping with both sides of my body.. taking the load off both my knees and ankle.

The task of personalising my physio exercises isn't straight forward as Emma (Physiotherapist) has to consider the protocol stages for the stem cells and ACL reconstruction as I am not fully weigh-bearing. The examination of the ankle was thorough. The pain levels in my ankle have decreased from the original 10 to a 2. This is massive progress and I am really pleased. My main concern is that I want to ensure that I strengthen the structure around my ankle to prevent the ligaments from tearing further.

I have been given 5 simple exercises that I need to complete on a daily basis. This will be added to my other exercises that I have to do for my knee. I have always completed my physio exercises and always ask if they are just a minimum and can I complete more if my leg is OK and pain-free. Some days I complete more and others I just stick to the plan as I listen to what my body is telling me.

Progress:- Today, I know it is such a simple task but I managed to sit in the front passenger side of the car. My knee is bending enough for me to get into the front. This was a struggle but WAHOOOO I got there in the end. However, after the struggle of getting in... I opted to have a little rest and then move into the back of the car with my leg up. I was worried that if my mum had to break suddenly my knee would really hurt and I may cause further damage to it or my ankle as it does not bend enough to sit comfortably in the car just yet. But, you know what? It doesn't matter as I look back as to what I could do last week and it's not as much as this week!

I also re-focused about losing weight and how to keep it off last week. This is something that has gone amazingly well this week, although I have no idea as to how much I will lose as I wasn't able to weigh myself... as when I did I was 4 stone lighter... bonus....Shame this was because that 4 stone was going through my crutches! Usually I see things as a challenge and once I have reached it... old habits tend to slip back in. So this time, rather than seeing the weight-loss as a challenge I have looked at the motivation as to why I want to lose weight..... all will be revealed soon!

London Marathon 2018:- Not to be

Normally I would be gutted about not getting a place in the London Marathon. Although this is something I already achieved in 2011, I had to defer my place until 2012 after a rollercoaster ride as to whether I would be able to run in 2011 or not.... Turns out it wasn't supposed to be due to a Grade 4 stress fracture during training... But fear not as this gave me the determination and focus to make sure that I was in the best possible position to complete it in 2012 despite limited running training as there was a risk that I could get a stress fracture up to a year after getting the original one. This is something I did not know about... It's amazing what you learn about your body and the healing process.

Anyway good new is I didn't get into the Marathon so I won't have to have a conversation with my consultant just yet about when I can run!! To be fair I do need to get off the crutches and bend my knee but there is nothing like a bit of forward planning and something to work towards.

Recently I have been watching two great programmes on BBC iPlayer.... How To Stay Young and The Human Body: Secrets of Your Life Revealed. You will need to hurry if you want to watch How To Stay Young as the first episode is only available for another 13 days. It's amazing what our bodies can do and how we can slow down the ageing process by simple lifestyle changes. The motivation has to be how much do you want it? How would you feel when you get to your goal? What would it look like? Seeing how people have aged due to either poor diet, lack of sleep or stress has really made me think. Luckily I am in a group that has previously completed Scott Baptie from Food For Fitness 30 Day Challenge and as previously mentioned in another blog.... the group has decided to re-start it as a Christmas Body Challenge. I am currently on Day 3 of this and it has been amazing.... Why I stopped doing it I have no idea.. Well actually I do... It's because it was sold as a 30 Day challenge! Anyway.... I have got rid of the 30 day idea out of my head so that when the 30 days are up, I can move onto the next stage. 

I also reviewed the stresses that I have in my life and how I can prevent them from slowly re-entering my life and if I cannot avoid them I have looked at techniques to how to manage them more appropriately. So I am now equipped with a variety of tools in my took box. Normally I have used sport or running to elevate my stresses but for obvious reasons I have not been able to use my normal methods so I have turned to mindfulness and relaxation. So with a combination of healthy eating and mindfulness I am sleeping so much better and I feel great within myself. In other words, life is amazing! 

I pushed myself a little too far with physio exercises yesterday as I was hoping that I would be able to bend my knee enough today so that I could go to the theatre to see Labour of Love but alas it is not meant to be. So today I am resting up and icing my knee whilst carrying on with the exercises but taking it a bit easier with them. Progress is being made on a regular basis.

It is amazing as to how far research has enable different treatment plans from those 13 years ago. In 2004 I snapped my cartilage and ruptured my ACL in my other leg. At that stage I was only offered to have my cartilage repaired and was advised to build up the muscles in my leg to support the lack of the ACL which I have done and have continued to do so ever since. This time round, I was offered stem cell graft in the hope that this would repair two holes that I have in my bones. I am also part of a research project which I can opt out of at anytime but I have no intention of doing that as if it means that there could be further opportunities to progress with medical advances whether this would help me or not, I am all for it. Hopefully it would mean that someone else in the future will benefit from it. 

I remain ever hopeful that the grafts will work and will be able to fully return to sport when I am allowed to. It's not until something is gone do you realise how much you miss it. I have made some amazing friends over the years via sport whether this was playing squash, rugby, running, cycling, swimming, people at the gym, BootCamp with Kelly or workshops with Stuart Amory and Mark Raynsford. I am determined that I will be back having fun!!

30 day Christmas Challenge

Hurrah..... I have a new focus whilst carrying on with my physio exercises.....The  Food For Fitness 30 Day Challenge started today.

Today I have remeasured my stats and taken my starting photos. I am not going to lie but I am disappointed that I let things slip whilst waiting to get my leg fixed but hey at least I have drawn a line in the sand and moving on.

I know the Christmas top is on the tight side but you know what.... it won't be by the time Christmas comes...  So here I am braving it out by actually showing my starting photos....

I didn't weigh myself as when I did I was 4 stone lighter but this was due to me putting too much weight through my crutches!! Now it would have been nice if that was real but alas it is not to be at this stage!!

So after measurements were taken..... I started the day with an omelette and greens. I completed physio exercises throughout the day but somehow I managed to go back to bed and I had a 3 hour sleep!! I hope I will be able to sleep tonight! Obviously my body was telling me I still need to rest up so that was exactly what I did!

Feeling all refreshed I continued to do my exercises. I know it is going to take time to bend my knee especially after seeing the surgery again on YouTube... I have also read other people's experience of their ACL reconstruction. Everyone's rehab is going to be different from one person to the next. There are so many factors to take into consideration, people's healing abilities, physical strength and also mental strength to continue with rehab and more importantly what the surgery involved. This is the second lot of surgery I have already had on my leg as in January 2017 I had an arthroscopy to repair a complex tear of the posterior meniscus horn. At this juncture, I had a bucket handle tear - partial meniscectomy.

I have followed the plan for today. The main meals were:- Egg and veg, Cajun Chicken Jambalaya and Turkey Bolognese.

Day 1 Menu

Cajun Chicken Jambalaya.

SMART GOALS v DUMB GOALS???

I spent most of yesterday in bed asleep in-between icing my leg and doing my physio exercises. Friday had taken it's toll on me but it's all good as I am listening to my body and not pushing it too hard despite being desperate to bend my knee.

Today Sunday 1st October..... Tesco delivery has arrived....... This is great news as now I am all set to go for Food for Fitness 30 day challenge starting tomorrow.... I have already undertaken this challenge and it's not a tough challenge as the food is great and life is made so much easier as you have your dinner meal the following day for lunch. This makes it so much easier for those that will make the excuse.... I haven't got time to cook etc.

It's great when you surround yourself with others that are taking a similar journey as you as no doubt there will be highs and lows along the way..... The Food for Fitness Group is a great place for this support. It is so motivational to see how well others are progressing. The support offered when you have gone off track or lacking motivation is incredible. The banter is always great too and I just love the competitive spirit especially when it comes to who is going to be crowned King or Queen of the Pancakes!

Preparation is key for me..... My kitchen becomes like a little military operation during the prep stage.... I am not sure my mum and sister think the same... Through their eyes it's more like a war zone! I already prepped some meals in advance once I knew when my operation date was but the Food For Fitness 30 day Facebook group have decided that we are going to refocus for Christmas and  to make it easier I am going to follow the original plan. I won't be sticking to it 100% as I had already a few social events booked in but I shall make smarter choices about what I will eat during those social gatherings.

Anyway.... I have started to look at goals that I want to work towards. I haven't broken these down yet into short, mid and long term goals yet. What goal setting format do I use? 

• Specific
• Measurable
• Attainable
• Relevant
• Time-Bound

The above I am using as a guidance for my physio as I don't want to risk progress to quickly and damaging my knee or the full potential of the graft from working. I have read the protocol for Stem Cell Grafts over and over again to make sure that I am within the guidelines. It clearly states 

"The repair site is most vulnerable during the first 3 months after grafting."

My goals will be to work hard and hit all of my physio progression targets...

• Dream-Driven
• Uplifting
• Method-Friendly
• Behaviour- Driven 

Not everyone is SMART or DUMB... so I am going to go with a combination of the both for setting my goals.

It is my dream which isn't a big dream as such but it's to get to the theatre on Wednesday night.... If I was going with the SMART driven motivation... I know this is an unrealistic goal  as it is may not be attainable within the time-frame but you know what each day I am going to give it a go and if I don't get there my next goal would be aim for 29th October. If I get there..... It is going to be totally awesome... as it will be West End Bares 2017.

In order for me to get to the theatre, I need to be able to bend my knee enough so that I can sit comfortably in a seat. Although I managed this on Friday whilst I was out for dinner my leg was not bent enough and it was stretched out over the other half of the table but it was such a massive improvement from where I started on Tuesday with only 2-3 degrees bend!

As everyday goes past it is getting easier to bend the knee to previous days but just bending it a little bit more is so tiring. The muscles surrounding the knee feel so tight and every now again it feels as though something in my knee is going to ping off across the room like an elastic band when you pull it back across your finger and thumb like a trigger. My knee swells up so much when I do this exercise I have to spend 15 minutes icing my leg and then 15 minutes off/on/off/on... You get the picture.

So my other dream is to get back to playing squash... this is going to be at least a year away if I am allowed to return playing but I have been told it isn't ruled out yet....

I want to get back into this dress........

Goal Dress!!

I managed to get into this dress when I broke my leg through kettlebell training and changing my eating habits. I can't workout yet other than my physio exercises so therefore I will be focusing upon lifestyle changes via my eating habits. 

I have also given myself a focus of learning British Sign Language whilst I am on sick leave. So far so good it has been really enjoyable. I need to keep the brain active and remember to slow down my body with pushing to reach targets and have breaks so that I can ice my leg and recover etc. I think I have this under control as I was hoping to go to a food festival over the weekend but I opted to stay at home with my leg up other than doing my physio exercises. 

Just remember you can do anything if you are motivated enough to achieve your goals.