The Injured List: My Black Balloon

"Unless it’s a truly horrific, traumatizing event (for instance, being run over by a steam roller driven by all those girls that made fun of you in high school), the worst part of an injury/illness isn’t the physical pain. Sure, physical pain can be epic. It can nag and nag and nag. You can get to a point where you’d truly consider eating a rat poison smoothie if you thought it’d bring pain relief. But usually, once you get past the immediate event and the first few days of acute pain, the worst part of any injury/illness is psychological." -Krista Scott-Dixon, stumptuous.com

So. Effing True. So much of the pain was and continues to be in my head. No, I'm not suggesting that I'm imagining the twinge of electricity shooting up my leg when I move my knee in a way It Doesn't Like. But I certainly envision that twinge of electricity as a a full-fledged electrocution as if I just chomped down on a telephone wire before I even move. However, more to the point, I'm confident that what Krista is referring to is the jail of convalescence we shroud ourselves in when we incur a serious injury. The little black cloud that descends over our heads, coloring our every thought grim shades of gray, follows us around as though tethered to our necks like a child's balloon.

Backing up to address my last post: yes, I am walking normally. Well...almost normally. My last visit to the physical therapist began with a five minute "correction" of my gait. She was fairly pleased with the lack of noticeable limping but detected that I was still "swinging my leg around" more than I should and encouraged me to incorporate the "quick bend" that my right (healthy) leg was employing. Keeping my leg underneath me, even if it slowed my pace a bit is crucial to maintaining proper alignment in the rest of my body to prevent other muscles, joints and bones from compensating and causing imbalance. So, I'm walking as normally as can be expected, all things considered. All of this is to get my knee as healthy as possible before surgery. (More on this crazy concept to come.)

The worst pain lasted a week. I resented having to go to work and limp around with a single crutch. Luckily, I work in an environment that is highly sensitive to health privacy laws and an explanation (although curious colleagues surely wondered) was not expected. This was in stark contrast to the numerous inquiries on Days 7 & 8, however, which were spent at a local derby tournament. In stark contrast to my work environment, all consideration for health privacy decorum flies out the window when you show up sans skates to a competition weekend. The words on everyone's lips are "What haaaaaa-pennnned???" with more collective sympathy than you'd muster had you been born to a thousand doting mothers. This is something wonderful that speaks directly to the community aspect of our sport, however, and I met each and every inquiry with an honest explanation (as tedious as it threatened to become) and gratitude for the commiseration and well wishes.

Walking normally is the first step (see what I did there?). As you've probably guessed, I've agreed to ACL reconstruction and surgery is scheduled for next month. However, don't be fooled into thinking I didn't consider the alternative. Having full range of motion (ROM) and strengthening the leg muscles around the knee are crucial pre-surgery steps considering how much atrophy can set in during recovery. Being in the best shape possible will not only speed healing but will shorten the one-year-until-you-return-to-sports prognosis significantly. On Day 6, as I viewed the MRI results over my doctor's shoulder my worst fears were realized. (No matter how much you prepare yourself for the worst, you're never entirely prepared for the tears.)

The images made sense having undergone a meniscectomy in 2009 on my right knee but I had honestly never given my ACL a second thought and, frankly, didn't really know where it was! The doctor utilized a slideshow of sorts and first illustrated my PCL - a darkened narrow road running up and down between my leg bones - and he explained that my ACL should resemble it in color and thickness running perpendicular to it. However, the next slide presented showed something that looked a lot more like overcooked cauliflower than a ligament.

He gently explained the fraying quality when the ACL is ruptured due to its rope-like structure. Simply sewing the pieces back together is impossible. I imagine a seamstress trying to reconnect to a garment that was unraveled - it can't be done. She would need to add more fabric and smooth out the frayed edges. Due to the damage to my patellar ligament, it was disqualified as a candidate for grafting and I wasn't willing to agree to have my hamstring donate precious tissue. I have been working arduously on strengthening my hamstrings and I'd be damned if anyone was taking even a sliver of what I've built up! That left one option: cadaver graft.

Yum!

I weighed the options from my perch on the examination table while the words "one year before you can play competitively" rang in my ears. We discussed the no-surgery option, as well. People live relatively normal lives without ACLs. Many derby players finished their seasons and competed in tournaments ACL-less, postponing their surgeries until more convenient hours (read: off-season). I managed a similar feat after my meniscus tear, skating through the agony and competing in the 2009 Western Region Playoffs only to have the procedure shortly thereafter and then NOT complete my physio. (What followed was nearly two years of skating like a lame horse and only recently became 100% healthy. There's a lesson here, kids.) I knew his prognosis was conservative at best - my plan was to get back to skating competitively no more than six months after surgery. But there was more to consider:

Age.

I would be returning to roller derby at 41 years of age. Sure there are plenty of "older" skaters out there but I'm still coming into my own as a player and it's difficult to envision climbing back onto the horse that has thrown me off while still reaching for that brass ring of high-end competitive play. And besides, aren't I a little long in the tooth to be skating in circles wearing fishnets? (Okay, I haven't worn fishnets in ages but you get the gist.)

Cost.

Yes, I have "decent" coverage but the calendar year is young and I have deductibles yet to be met. The surgeon's office requires patients to pre-pay co-pays which my health savings account won't even cover. (I really should have opted for more money to go into the plan but who wants to be left with the possibility of losing cash at the end of the year if you don't have medical needs requiring it?)

Recovery.

I taxed the patience of my most valuable resource (my girlfriend) last summer when I underwent scar release surgery on my ass (yes, my ass). In short, several high-velocity falls caused necrotic tissue loss and severe scarring in two places that were hella painful and - worse - threatened my silhouette (oh, vanity!). My insurance originally approved the procedure and then changed their minds. I'm out of pocket dozens upon dozens of dollars. Not to mention how much fun NOT pooping for a week was due to the pain killers. The woman is a saint but can I really put her through more of my bed-ridden-ness?

Pooping.

Do I really want to run the risk of pain-killer induced constipation?

Could this injury be the universe's way of saying, "Hey, enough is enough. Why don't you ref or coach or something?" I mean, I could live without an ACL. Sure, I would probably have to eschew swing dancing, snow boarding and derby but I could live, right?

Live...without playing roller derby.

Huh.

That's about the time I picked up a stick and poked the universe in the eye.

Next up: Week 2 & the importance of positive thinking!