The Week That Passed

The past week went on as expected with daily therapy drills either done at home or in the clinic. In the clinic, Gimbo always looked to challenge me, which I really appreciated. It presented a new measure of progress by adding a degree of difficulty in some of my exercises. It also actually worked for me, as it was a good break from the monotony of the routines of my two-week extension.

I would still feel on and off pain especially when my knees are really tired. There is still a bit of swelling around my knee. And from time to time, stiffness in my knee and hamstrings would still bother me. This time though, I’ve come to accept that these are all part of the whole healing process. Plus in spite of this, I know that I go through my sessions with relative ease. And that for me is another sign of progress.

Complete Reversal

Wow! Yesterday, I did my drills with relative ease. My heel slides were easy and at certain points went beyond full ROM mark. I also went through with my other exercises with little difficulty. There was almost no feeling of stiffness other than the normal strain you feel when doing workouts. I was pleasantly surprised and feeling high.

I guess, just like running or biking, you go through good and bad days. I had a tough time days earlier, now it’s the complete opposite. So I figured, that should my mindset.

Just as Lance Armstrong said, “…Some days it hurts more than others. But it doesn’t mean I don’t do it. I deal with it…because not everything that is good for you, always feels good for you.”

Impatience Creeping In

Since starting on this two week extension, I’ve found myself struggling with a demon I know all too well…IMPATIENCE. It happens to me a lot specially when doing long runs. I get so impatient that I start breaking my pace and get unnecessarily exhausted. Then after my run, I think to myself, “that was stupid.”

Now, I’m only on my third day (of the two week goal) and already there’s a constant seesaw battle mentally and physically. There are moments when I feel I’m struggling do things I’ve been able to achieve so easily. For instance, my hamstrings seem so stiff that they are preventing me from reaching full range of motion (ROM) on my knee bends. I also noticed some swelling again and it’s driving me nuts. Plus, there are certain movements where I feel shooting pains on my knee. This feeling has disappeared a long time ago and now it’s back. It’s so frustrating!

Yesterday, I called the clinic and asked if I could do my therapy there. I knew I could do it at home. I did it the other day. But yesterday, I needed motivation or maybe I just needed company. Of course they were nice enough to accommodate me. Gimbo, patiently assisted me through the drills and although I struggled, I did everything really well. I was able to bounce back.

Today was bad again. Pain and swelling in my knee is back. My hamstrings feel so stiff again and so on. I’m beginning to feel that two weeks is so far away. I decided to just rest today and on hindsight am not even happy about that decision.

It’s difficult because I have no way of measuring any real progress because I’m able to do everything that’s needed. I just feel I’m stuck doing this boring routine until I finish the two weeks.

I’m going crazy. I know I need to refocus. But today, I just can’t. I just want to run or bike. Or I just want alcohol. Shit I can’t even have that. Oh well.

The Verdict (Part 2) – Nov 20, 2007

Today marks exactly one month since my operation. After 4 weeks of therapy, I was ready for the “next phase”. So I went to see Dr. George in his clinic today to get his GO signal. And the verdict was…too fast, too soon...two more weeks.

I did mention in my earlier post that there is a chance that George might just extend my sessions before allowing me to proceed with my gym workouts. That’s exactly what happened.

He explained to me that he wanted to give it two more weeks to ensure that my muscles and knee were strong to handle the workout regimen in the gym. He was concerned that I might push myself too hard, over do things, and injure myself all over again. I must say that George knows me too well and he’s absolutely right. I will push myself and push hard. Hey, that’s exactly what I was doing this past month. Oh well, as I said, he really knows best and I will follow everything he says to the dot.

So, with his instructions, my therapists gave me my program with slight variations on some of the exercises. By variations, I mean harder versions! Hahaha. I’m supposed to do these everyday in the house but I told my friends in the clinic not to be surprised if I pop-up and do it there some days. It’s nice having them around motivating you and laughing with you along the way.

So here I go. Not the “next phase” I wanted or expected but still a next phase. Two weeks, a new milestone.

4th week (12th session) Nov 19, 2007 – To the MAX

I did it! Yesterday, I completed the last session of my 4th week and as expected did all the drills to the MAX. My therapists required nothing less. I was doing maximum reps and maximum resistance on all the drills. I’m also able to reach full range on my knee bends.

My therapists and I feel I’m ready to do gym work already. Of course, the final say would be Dr. George. I’m seeing him this afternoon and hopefully I’ll get his GO signal! I was warned though that there’s a chance that he might extend my sessions. At first, I thought, that would be really upsetting. But I kinda figured he would know best. And, actually, I’m happy with what I’ve achieved so far. I’m ready for what’s next no matter what it is.


On a special note, I’m really thankful to all my friends at the SPRAIN and STRAIN clinic. Carmen, Ronnette, and Gimbo were really nice and they made the past weeks go by like a breeze. Thank you all, for everything!!!

Snapshots of Races with Mayi and friends

4th week (11th session) Nov 16, 2007 – Rollercoaster knee

Yesterday, Nov 16, was my second to the last session, GOD and Dr. George permitting. What I actually mean is, per my schedule, I’m supposed to complete a 4-week or 12 session cycle then George will examine me and hopefully allow me to start gym workouts with new programs. This for now is my latest milestone or my “major” short-term goal.

So, together with my therapists, I tried to max out all the drills. And, true to form I did everything they asked and gave every exercise 110% effort. I’m almost at full range with my knee bends/slides. I’m so ready for my last session and ready to complete all the drills to the max. Hahaha, it’s like I’m trying to prepare myself for a race.

Today though, I woke up with my knee feeling stiff. First I was upset thinking, setback again. But I quickly refocused and said, “I’m just tired from yesterday. It will feel better after I ice it.”

Yesterday was extraordinary. Aside from my maxed out session during therapy, I was also walking a lot doing errands the whole day. My son, Diego has been sick so I had to bring him to the doctor for a check-up. He was feeling so weak that he asked me to carry him. I know it was extra load on my knee but I really didn’t have a choice. I just thought, “hmmm….workout….hahahaha”. After, I moved around a little bit more to buy his medicines. Then, I dropped him home and went for my therapy. So, on hindsight, my knee has every reason to be tired.

But, it feels better now after the ice. I’m able to walk and do the stairs again painlessly. The stiffness is gone. I’m back on track.

4th week (10th session) Nov 14, 2007 – Pain vs. Progress

Today I was eager to come to therapy and begin the first session of what is supposed to be my last week. Actually, to be more precise, this meant last week in the clinic after which will be the start of therapy workouts in the gym. I think even my therapists were as enthused as they began by telling me that we were going to try to max out all the exercises. I like that. I like the challenge.

And true to form, I improved on all of the drills and managed to squeeze in new ones. This rounds up my accomplishments for this session:
1. Step-ups increased to 200 diagonal and 100 straight
2. Three and a half minutes on the wobble board
3. Added more resistance and reps on my hamstring curls and Legs presses
4. Wall squats were 60 and 90 degree sets plus an additional set of one leg squats on my bad leg (with elastics as resistance).
5. My ankle slides now reached 139 degrees. Only 6 degrees to go!!

I’m really happy with my accomplishments. But these didn’t come without the accompanying pain. I’ve come to realize that pain and progress go hand in hand. What motivates me through the pain though is another thing that Marianna shared with me which I realized was so true as far as all these aches and pain that come with recovery are concerned. She said, “Uncle Jam don’t worry, once the pain goes away, it will not come back”.

Now, I’ve cut down my goals to even smaller and achievable targets. It helps me cope with my impatience when I sometimes get hit with the realization that even the February seems so far away. It triggers a string of negative thoughts and a barrage of “what if?” questions. It drives me crazy. So, having smaller more attainable goals allow me to enjoy small victories that are enough for me chew on and move forward.
So even these tiny improvements during therapy are a big boost. This mindset actually works for me.

By the way, I was allowed to not use my immobilizer already! I've been waiting to achieve this milestone. Upon leaving the clinic, I cautiously tried walking normally. Although it felt weird and wobbly at first, I slowly got my groove and rhythm back. The feeling was ten times rewarding when I reach home and climbed the stairs normally. I looked crazy as I went up and down the stairs several times trying to shake off my disbelief. It was a great feeling.

3rd week (9th session) –Nov 12, 2007

Like a good soldier, I did all my exercises and drills during the weekend. I always think that if I slack, I will loose what I’ve gained so far and delay everything. I’m really paranoid. It’s my nature. Last night, in Pasay, Marianna told me that she doesn’t experience pain anymore. She goes through the drills with ease. She actually walks normally already. I’m so envious but I’m happy for her.

Today, during therapy, I did my usual 3rd week routine drills with slight variations. I did more reps for my step-ups (150 diagonal and 50 straight). I also added another 2 minute set, balancing on my bad leg, but this time using an uneven platform (wobble board). In addition, I used a stiffer elastic for my hamstring curls and increased reps to 150. Plus I did leg presses today and was able to reach 130 degrees already! PROGRESS! I love it.

3rd week (8th session) – Nov 9, 2207

I’m really happy because now I’m a consistent 120 degrees and I’ve been able to add weights and reps to my exercises. Still hurts like hell though. Plus my hamstrings are killing me. My knee also seems to be a little swollen. I’m guessing it’s from the extra load during therapy. Thank GOD for ice.

Start of 3rk week of therapy (7th session). – Nov. 7, 2007

Today, they gave me a new set of exercises. Heel slides were against the wall, squats against the wall (30 and 60 degrees), balancing on my bad leg, and diagonal step ups using my bad leg as well. They also increased the reps for my leg curls from 50 to 100 which is really the pits as my hamstring muscles really hurt. I feel like I have more than a dozen rips on my hamstring. It’s really painful. Although I take comfort from the fact that George says it’s normal and that my progress is actually so fast compared to others. So, I use that thought whenever I feel the pain and the anxiety of not being able to exercise. I just think to myself, “so much progress in two week...just think of how you’ll be at the end of the month”.

Oh by the way, I was able to reach 120 degrees on my heel slide today! Yahoo!

Setback?

One pain though that bothered me more than others were these stabbing pains on my hamstrings. I’d stretch at night and it happens. I’d reach for something and I’d get it. I was so sure I re-injured myself. I said, oh no, that’s it, the road just became longer. I felt so low. I asked Marianna if she experienced this too. She said she did so I tried not to make it bother me. Although it got to a point were it hurt really bad that I decided to see George and ask him personally.

George explained that these were normal as my muscles are slowly moving back into position and as I am staring to use them again in therapy. He also explained, in detail, what he did in the operation. It was a real eye opener and it put me at ease. The great thing about my visit to George was his observation that my progress seemed really fast. He was so enthusiastic about it but was quick to warn me to follow everything that they tell me to do as much as not try anything I’m not allowed to do.

I’m ok with that. As far as I’m concerned, George saying that I’m really doing well and better that expected was more than what I needed. My morale is recharged and my motivation is back.

2nd week of therapy (4th to 6th session)

Now I have my routine plus a mindset to go with it. My therapy, replaced my workouts and I was performing them with the same discipline and focus. That made it a lot easier to deal with. I’d still feel a lot of pain in varying degrees and places in my leg. I was constantly comparing notes with Marianna (GOD bless her) and communicating with my therapists. I wanted to understand that what I was feeling was normal and that I was not injuring myself further. I was pushing myself but wanted to make sure that I was not over doing it. I want to reach my goals and not through a monkey wrench and delay it further.

Start of therapy – October 22, 2007

Tuesday, I went to see George in his clinic so he can check on me and change the dressing of my wounds. It actually went well as George noticed that I didn’t swell that much as such did not required to be aspirated. Apparently, most cases swell really bad that they needed to be aspirated with needles to drain their knees of fluids and blood. Thank GOD. Trade off to my not swelling though is this huge blister (as big as a bottle cap) that George popped. To this day, the mark it left is far bigger than any of the scars I sustained from the actual operation. Oh well, you can’t have everything.

Since, I didn’t have swelling, George asked if I wanted to start therapy already (I could have also started two days later). But I thought, why delay? Let’s get on with it because I was really set on achieving those milestones. I really wanted to get back already.

So we began our first set of exercises, which apparently was going to be my routine for the next three sessions (1st week of therapy). I actually did really well. I responded well and was able to perform the drills faster than expected. It made me realize though that what they were asking me to do were such simple leg and knee exercises. For example, I was only expected to bend my knee to 90 degrees 50 times. They were a far cry from the workouts I was used to but the effort level was comparable. I thought, this is going to be a long 4 months but at least I’m on my way.

D’Day – October 20, 2007

The day finally came. Mayi accompanied me to St. Luke’s Medical early in the morning. George managed to squeeze me in and gave me a slot. I was really grateful; I was 1st of 3 ACLs he was going to do that day.

The operation went smoothly. For some reason, I woke up and got a chance to watch what George was doing through a monitor. Actually I couldn’t really tell what was going on. I looked pretty much like watching a show on National Geographic. Anyway, George was done in 30 minutes plus another 20 minutes to sew me up. I was brought to the recovery room for what possibly was the most boring 3 hours of my life. Luckily, they allowed me to have my cellphone so I had some for of entertainment, a distraction of sorts. It didn’t distract me though from the pain I was experiencing. It felt like someone was twisting my leg, trying to break it again. And to add to that, it also felt like I had a heavy cabinet on top of my leg.

At around lunchtime, they wheeled me in a room where Mayi met me with my Burger King lunch! Yahoo! I was so hungry. It was perfect, Mayi was beside me plus a TV to entertain me. I begged the nurse not to bring me back to the recovery room. Fortunately, she agreed and I stayed there until I was given the GO signal to go home.

Before going, George gave me final instructions, most painful of which was NO ALCOHOL for the next two months. I thought at first that he was joking. But after asking several times if he was serious, it figured he was. Oh well, I can live with it. I thought all I have to put in my head is that, if I don’t follow his instructions, it will delay my recovery. And I didn’t want that. Besides, it’s just another milestone to aim for and I will be able to drink in time for Christmas and New Year!

The next 24 hours were not any less painful. The feeling I described earlier was consistent and sustained. Ice offered some sort of relief. And thank GOD for pain killers.

My family would call and text me. Telling them how painful it was offered some sort of outlet for me. GOD bless all of them for their support especially Marianna, my niece, who acted as my support group. She also just tore her ACL and is on the road to recovery. I must say though that I could not have done it without Mayi. She was my nurse, my secretary, and the constant ear for all my complaints. Thank you so much Mom.

Oh well. First step is done. However painful, I happy I’m on my way! Now, on to therapy!

The Verdict – October 18, 2007

Thursday came and as soon as George examined me, he immediately determined that it was a torn ACL. We went through a long discussion of what options I could take. He said that if I wanted to continue with my active lifestyle, he would recommend that I go through with the operation to repair the damage. I told him, that I definitely want to be able to still do my triathlon and play badminton as well. I just felt that even if I don’t do it on a competitive level, I’d still want to be able to set and achieve goals as I train and keep my fitness intact. That’s essentially how I train, I only recognize one competitor, myself. And in that sense, I still am looking to compete and succeed.

George added that if we operate, I can be back doing triathlon in 4 months and badminton in 6. I just put in my mind that for now these will be my new goals, my visible milestones. So with that, I decided, LET’S DO IT!!!

I happened in a "Snap".

A day after my 42nd birthday, I tore my ACL (Anterior Cruciate Ligament). I was playing badminton with my wife, Mayi, and my brothers on one of our routine weekly games. We were just on our first game when I instinctively (short of saying…What the hell was I thinking?) decided to jump and smash the ball. Upon landing, I felt my knee buckle and twist. I heard a popping sound and instantly felt the pain. I fell to the floor as Mayi, Joel, and Kwi ran towards me to see what had happened. They thought I’d sprained my ankle but I told them that it was my knee as I winced in pain. Shit, it hurt like hell and it’s a feeling of pain I will remember for the rest of my life.

Joel called our good friend Dr. George Canlas right away to tell him what had happened. I was advised by George to immobilize my knee and see him Thursday in his clinic. He also prescribed medicines for the pain and swelling.