Stumbling Into Place

14 weeks ago today, I stumbled in my living room and ripped my hamstring clean off my hip.  Little could I imagine at the time how that unforeseen stumble would shape the next few months.  I returned to work 2 weeks ago to a new workplace completely different from any job I have ever had as a nurse.  I am pleased to say that after completing my first 2 weeks as a nurse case manager, I feel I have "stumbled" into the a wonderful work environment with collaborative and dynamic teams that permeate a culture of mutual respect.   It may be generous to say I am grateful for my injury, but without it, I don't know if my eyes would have opened so readily to this new opportunity for change.

Rehab at the bike/desk on my lunch break!

     This was not just any job change for me.  I found tremendous joy working as a Labor & Delivery nurse.  When I looked down the barrel of my post-surgical recovery, making the choice to leave was not an easy one; it was the result of countless hours weighing the values of joy, family, balance, health, recovery, and finances.  Believe me, I had countless hours on the couch, especially those first 6 weeks, to think about it!

     So here I am; a full-time working mom, juggling day care for a toddler and summer vacation for a 6 year old.  It is not easy, but it is a hell of a lot easier than running after a toddler after ripping off your hamstring!  When Michelle made me a mom almost 7 years ago, I felt a strong sense of duty that I, and not someone else, should raise and care for my child.  Why would I pay someone else to raise my child? And then Emily came 15 months ago and things got a bit more complicated. And then came the hamstring avulsion and things got a LOT more complicated.  Now I am the mother I thought I would never be: I go to work to make the money to pay other people to watch my children.

    But here is where my values have not changed. Even before the injury I was losing it.  Losing my shit. So burned out with the day to day grind of motherhood that I was not parenting anymore, at least not the way I envisioned.  I had over scheduled my kids, running around town as an under-paid chauffeur, short-tempered and reactionary. I had one day a week at work to enjoy stimulating adult interaction but was so exhausted at the end of 14 hours that I had nothing left for the girls...or my husband Barry for that matter.  When the injury happened and I could no longer run, chase, squat, drive, or actively play with my girls, something had to change.  It hit me.  Maybe, just maybe, if I work an 8-5 job and find daycare for Emily and after-school care for Michelle, I will actually be more available emotionally to my family and a more effective parent.  

    Ripping off my hamstring helped me realize that it is okay to recruit other people to help you with your children.  It is fair and equitable to pay someone to help you with your children if fulfilling your career goals makes you a more patient and effective parent.  Though it is heart-breaking to hear Emily's sad cry when I drop her off at day-care, I am happier and more patient with her sweet cheeks and toddler tantrums when I pick her up at the end of the day.  Michelle and Barry get a mom/wife who is not so quick tempered since she has been participating in meaningful and fulfilling grown-up work during the day.  Oh...and then there is the pay-check.  I'd say it's a win-win.

     I have 2 great perks with my job in regards to rehabilitating my injury: my office is next door to the orthopedic center where I have PT once a week, and we have a mini-gym at the office complete with treadmill /bicycle desks! Sitting longer than 30 minutes is still challenging for me, but our computers are adjustable so I can pop up to stand and still continue working effectively.  Stumbling in my living room has resulted in so many positive changes, it is hard not be a little bit grateful for the temporary set-back and inconvenience of it all.

Who knew? I'm a cubicle nurse!

     

10 Weeks, I See a Light!

I see the light (in Wyoming)

     Post-op protocols vary wildly for hamstring avulsion.  From brace vs no brace, early weight bearing vs later, early PT vs late PT, instructions are all over the map.  I have adhered to my surgeon's protocol diligently and as of last Friday, my surgeon felt I had exceeded expectations for healing and gait function.  I would say my protocol tends toward the conservative side, and for good reason.  Tendons and ligaments are slow healers without a lot of blood vessels to feed the healing.  Working a muscle before the tendon is ready to bear the load has a high potential for re-injury, or injuring other supporting muscle groups that are forced to compensate when the affected muscle/tendon group is not ready to play.  I am not terribly competitive by nature, but I admit extreme satisfaction to be told I was ahead of the curve!
     Over the past 4 weeks, I am astonished at how much my range of motion has improved. 4 weeks ago I was unable to flex my hip enough for the recumbent bicycle.  Today, I rode on the upright stationary bicycle for 20 minutes.  4 weeks ago, I could barely flex my left knee past 90 degrees.  Today, I sustained a comfortable "childs pose".  The scar tissue "tightness" I felt at 6 weeks is virtually gone today.

Emily slept, I hiked!

     Admittedly, I probably pushed harder than I should have over the weekend. We were in one of my favorite places near the headwaters of the Green River in Wyoming and I felt great.  I weathered the 4 1/2 hour drive with minimal discomfort and found walking on the dirt roads easy.  Barry was carrying Emily in a framed baby backpack carrier and Emily was a huge fan.  Emily has always slept well while being worn, and was badly in need of a nap. Since I felt so good, I popped 25 pound Emily into the pack and Barry helped her onto my back for about a 1 1/2 mile hike on a dirt road. It worked.  She slept, and I hiked...without pain.  I imagine that by  the fall, my favorite time to hike in Utah, I will be back to many of my favorite local day hikes that feed my soul. I was shocked at how strong I felt, but nervous because this is when I know I could overdo it and have a set back. 
    To get busy learning how to NOT overdo it while gradually strengthening my legs appropriately, I had my first Physical Therapy treatment today. Overall, PT went well.  I was able to perform all the exercises but was shocked at how weak my hips actually are.  After hiking with Emily on my back, I thought I was totally killing it.  But today, I could feel my legs shaking just doing simple bridging and hip strengthening.  My PT, Robby, was great.  Though he was not very familiar with my rare injury,  his skillful knowledge of healing tendons put me on a plan of treatment to gradually strengthen while protecting the repair.  Many people have been telling me how "great" my walking looks, so it was the reality check I needed for Robby to point out that my gait is still a "little wonky looking".  Oh yes, we have some fine work to do!
     There have been times I wished, mostly out of my own impatience, that I was on a more aggressive protocol.  But after my small hike this weekend, improved functional range of motion, and my PT session today, I am certain that I have been doing the right thing for my body.  As a recreational athlete, there is no race for me to win.  Only the intrinsic joy of moving my body through the activities I love.  A slower pace may actually be the key to winning my race.

My Baby Ate Poo

Too cute for poo! You see the problem in the
kitchen with keeping eye on baby while
engaging in food prep.

It happened.  Emily, almost 14 months old, ate her own poo.  Apparently when Michelle was a toddler, she engaged in this behavior once or twice as well.  With both girls, I was not present to witness such a milestone, but must rely on the account of Barry.  Perhaps they were showing off for daddy.

     The incident had a suspenseful set-up.  Around 4:00 PM, my step-mom who had been watching Emily all day, picked up Michelle from school and joined me at the pool after I finished my aqua-exercises.  I met them in the locker room and my step-mom let me know with certain trepidation that Emily had not procured a bowel movement for her all day.  If there is anything you want to be sure of before getting your toddler into her swim diaper, it is that she has thoroughly emptied her bowels BEFORE getting into the pool. With two excited girls ready to swim, we took our chances and dressed Emily in her swim diaper, cover, and swimsuit, per pool regulations.

     At this point, you are probably thinking- and then she pooped in the pool! Right? She did not poop in the pool.  Giant sigh of relief!  With the poop bullet effectively dodged, we opted to dry off quickly and shower/bathe the chlorine off at home.  At home, I fed Emily some dinner while the tub was filling up.  This was a super bonus for her! Emily loves loves loves the water so to go swimming and then get in the water after was a huge win.  But alas, no poop.  With certain caution, I set her in the bath with fingers crossed that we would not end up with floaters.

     At this point, you are probably thinking- and then she pooped in the bath! Right? She did not poop in the bath.  I dried off her chunky delicious rolls and handed her off to daddy so I could get in the shower myself.  

     Apparently, from Barry's report, it went a little something like this; Emily waddles out naked-baby style with giggles of glee while Barry continues prepping dinner.  We do not have a kitchen island (something I plan to remedy once a few paychecks come in from my new job), so prepping food must be done with one's back turned to the naked toddler who is ramshackling her way through the living room.  Assuming she had probably peed in the tub and could happily use some 'free bum time', Barry opts to delay diapering until after the cauliflower is chopped.  As he turns to do a spot check, he witnesses 'the face' followed by a very worrisome deep squat. Emily stands up, pees on the floor, and goes back into her deep squat to procure a few well-formed rabbit turds.  In Barry's horror, he frantically goes to grab paper towels but by the time he turns back around, it is too late.  Quite interested in these little brown things that mysteriously appeared on the carpet, Emily promptly picks one up, like it is no big deal, and pops it in her mouth.

     All this is going on while I am enjoying my peaceful alone-time in the shower.  As I rinse my shampoo, the shower curtain flings open.  Barry thrusts the naked child into my arms announcing "You need to take her! She just ate her own shit! There is poo everywhere...and brush her teeth.  I need to go puke now."  Barry has always admitted an easy gag trigger and this moment was no exception!  Emily, of course, couldn't be happier. This was a big bonus day for her. Pool, bath, AND shower? As far as she is concerned, this is her lucky day. She smiles at me in the shower, plays gleefully with the water, and proudly brushes her teeth before bed.  

  I'm not sure what the score was, but Barry and I agreed that by default parental fail, Emily won big time.

Invisible Healing

   

Dr. Emily says: "It takes time to heal."

Doc Martin explains: "The patient may look normal on the outside,
but intense healing and growth is happening on the inside."

In the past week, a theme circulated through the Facebook group of hamstring injuries I belong to: a theme invisible healing.  As we move through the healing process, there comes a time when we wean ourselves from crutches, the limp gradually disappears, and we try to re-enter our world.  Though we appear "normal" on the outside, the healing continues and accommodations must still be made to decrease pain and continue optimal healing.  As my cyber-hamstring buddies relay, they experience sneers from co-workers, pressure from family, and misunderstandings from close friends when we look normal on the outside but have pain on the inside. Even people who work in wonderful team environments with a generally supportive workforce experience it. Why does she need a stand-up sit-down desk? Shouldn't she be better by now? I saw her at the mall last week, certainly if she can shop, she can come back to work at full capacity! You look great, when is your next race? 

     Sharing our struggles with returning to work, I know that this problem is not just limited to those with proximal hamstring injuries and surgery. This unfortunate judgment and misunderstanding applies for all "invisible" diseases or health problems.  People are silently suffering everywhere you look.  Whether they are healing from injury, going through a divorce, facing mental illness including clinical depression, processing through grief, or dealing with chronic pain or chronic health problems; these situations can appear very normal on the outside while intense healing is going on inside.

     The thing that got to me most about the stories of my cyber-hamstring buddies is that they are amazing people!  Active, dedicated professionals who have given themselves fully to their occupations.  Don't they deserve a little credit?  Are they REALLY just trying to get out of doing their jobs? Are the REALLY trying to get special treatment? Nobody asked for their injury to happen.  It has created an extremely inconvenient stop in the momentum of their lives.  Everyone wants to get back to work, and everyone wants to be able to perform at their prior level.  The nature of the beast is that it takes time to heal.  Our injury is quite literally a pain in the ass, and even sitting for long periods is difficult for quite some time. Everyone healing wants desperately to get back to it! Unfortunately, our intrinsic healing mechanisms determine how fast this will happen.  For the most part, there is very little we can do or think to speed up the process. We are all optimizing our nutrition, heeding our doctors' advice, and participating in reasonable activity for our timeline.

    When I go up to work next week to clean out my locker and say goodbye, my co-workers may wonder why, if I have come so far and look so normal, I felt I had to change jobs.  Maybe some will think I gave up, maybe some will think I abandoned my post...or maybe that is just the doubting-Thomas in my own head, projecting my own fears.  In the end, I am the only one who can judge the physical risks I am willing to take. Our disability laws in the United States require employers to provide "reasonable accommodation".  For me, "reasonable accommodation" meant changing jobs.  For others, it may mean a special desk, working from home, or adjusted work hours.   

     I implore to all the colleagues, managers, and supervisors out there welcoming back anyone from medical or family leave, that the best "reasonable accommodation" to ensure maximum efficiency starts with a healthy dose of empathy.  Whether we are coming back after physical injury, medical treatment, a new baby, the loss or care of a loved one, or psycho-emotional crisis, we are back because we want to be. I challenge our society to take a few breaths and withhold judgment.  Be kind to each other.  Assume the best intentions and know these healing individuals are doing absolutely everything in their power to get back to where they want to be!

A New Job

Today I officially accepted a new job as a RN case manager and said goodbye to my wonderful job as a Labor & Delivery nurse.  I was writing a much longer post, but decided the letter I wrote to my co-workers sums it up.  Read the April 7 post, The Athletics of Nursing, if you want a closer understanding of the physical demands of my job and what set me on this new path post-injury.

Dear friends and colleagues,

As I'm sure you heard, 2 months ago I sustained an injury that detached my hamstring tendons completely from my hip.  I required surgery to repair it and have had a great outcome, recovering as expected.  However, the reality of recovering a major tendon repair like this is that it is considered excellent if after a year, my hamstring operates at 80%.  Due to the physical nature of our jobs, I have had to think long and hard about the risk of re-injury at the bedside and how that would impact my family. Considering all factors of health, family, finances, and work-life balance, I have made the very sad decision to leave Labor & Delivery.  For the past 5 years, I have been so fortunate to work with such an amazing group of people. The dedication, team work, and camaraderie of our unit has made it a joy to come to work every day, even on the hardest days. Facilitating the beginnings of life is intrinsically rewarding and has provided me much joy!

I am remaining with the University Health System and have accepted a position in case management.  L&D will be a hard act to follow, but I am optimistic that I will find joy helping people navigate the healthcare system, all while being gentle on my healing hamstring.  Keep up the amazing work you do. You make an extraordinary difference for our community and I will truly miss you all!

Love,

Kelly Martin RN

 

Emotional Work

About a week after surgery, I was perusing the internet for chat boards and forums for other people who have injured, avulsed, or had surgery on their proximal hamstring.  After a long thread on "Runners World" or some other site, a woman indicated that she just started a Facebook group for those of us afflicted with this injury.  Since these injuries are rare, this Facebook group has accumulated people across the globe to share experiences, rehab protocols, successes, and set backs.  The group has provided post-op comfort measures, tips on managing activities of daily living, but most importantly, has provided an psycho-emotional outlet for a group of active individuals faced with a sudden disability and the ramifications of a lengthy recovery on an active lifestyle.

     As we share our experiences, we relate, laugh, cry, bang our fists against the wall, adapt, reorganize, and accept the new path our lives have taken.  I direct this post to these new found friends who may be surprised to find how a physical injury deeply effects our emotional well-being and psychological health.  The loss of function is akin to deep grief; suddenly, the way we defined ourselves prior to injury no longer exists.  Whether you define yourself as a long-distance runner, competitive cyclist, avid climbers or hiker, leisure sports enthusiast, or any occupation with significant physical demands, our mental health is intricately woven with physical loss.

     Here's the short of it: on Thursday, I lost it.  My left hip hurt, my right hamstring (the good one) was feeling the extra load of 2 months of compensatory work. My baby was needy, wanting to be held all day (which strained my lower back) and wouldn't nap unless touching my body.  The utter exhaustion of the day triggered the fear of returning to work (still over a month away). To top it off, my strong-willed 6 year old dished out the evening home-work challenge and my husband and I were on completely different parenting wavelengths.  I felt an inner rage and fury well up inside of me. My head was dizzy with anger and perceived helplessness. I had 2 options in the moment: completely blow my top with an angry outburst like a two-year-old, or lock myself in my bedroom and disengage.  I chose the latter, which though the better option, solved nothing and left me with a fitful night of anxious insomnia.

    Friday morning, the anger continued when I couldn't find the receipt to return a pair of $8.00 shoes that were too small for my 6 year old daughter.  Eight dollars.  My eight dollar temper tantrum.  My sweet toddler sat on the floor of the living room watching mommy huff around in anger looking for a stupid receipt and began to cry.  She was completely beside herself, a little sponge soaking up mommy's emotional state. If I could put words into that cry, it was a little like this: "But mommy, where are you? I am always safe with you and now you are gone. You are here, but you are gone. I'm sad because I don't know how to feel safe right now when you are so upset." I picked her up and cried with her. I nursed her down to a nap and promptly texted Barry that I was completely losing my shit.  He suggested I take the evening off and leave the house and he would take the girls, if that was what I needed to do.  It was exactly what I needed to clear the fog.

     Here's the thing.  I got through this brief emotional crisis with a combination of family support, shared experience of my cyber-hamstring friends, and my antidepressant medication.  It is so important to recognize the toll that physical injury can take on our mental health.  If there was anything lingering before the injury, such as a baseline clinical depression like I have, it will require twice the attention and effort with the stress and ramifications of physical injury. 

     As I confer with my cyber-hamstring buddies, I hear a common rationalization when talking about their injury.  I am have said it myself that "Others have it much worse than I do".  This can be a good tool to give us big-picture perspective, but it can also disallow us to experience the grief that comes along with a serious injury.  It is NORMAL for the marathon runner to grieve not being able to run.  It is NORMAL for the rock climber to grieve not being able to climb.  It is NORMAL for any athlete to grieve the unknown if, when, and to what capacity they will be able to return to sport.  It is NORMAL for the bedside nurse to grieve the inability to return to a physically demanding yet rewarding work environment.  It is NORMAL for a caregiver, now acutely injured, to feel overwhelmed and misunderstood if they are the one who usually cares for a loved one with chronic pain or other chronic health problems.  It is not self-pity to feel angry about the situation. We are not weak for admitting that life just got a lot harder!
     I would like to challenge myself, my cyber-hamstring buddies, or anyone facing a serious injury, to absolve ourselves of the guilt of grieving loss of function, even if temporary.  Discounting the emotional component of physical injury because "others" have it worse off doesn't help when it's your body it's happening to.  When we embrace the loss, we can begin to see that our identity is not what we do, but who we are inside.  This goes beyond the trite cliche of making lemonade from lemons.  It is more like realizing you were not necessarily a lemon to begin with.  Pardon the fruity metaphor, but if you see yourself as a fruit bowl and not just the lemon inside of it, there are a lot more possibilities than simply making lemonade!
   It is hard physically and emotionally. And that is okay. 

In Limbo

Not quite in, not quite out

Not quite broken, not quite healed

Not quite started, not quite finished

Not quite fulfilled, not quite empty

Not quite belonging, not quite outcast

Not quite loved, not quite despised

Not quite successful, not quite failed

Not quite strong, not quite weak

Not quite running, not quite still

Not quite going crazy, not quite sane

Not quite changed, not quite the same

Not quite enough?

enough!

In limbo is plenty 

stalled, yet moving somewhere

un-aware of where

Getting After It

This came in handy for yesterday's trek to the grocery store.

6 weeks post-op! With the blessings of by surgeon last week, I have been busy introducing my body to motion again.  The pool was closed last week so I did work on land with the recumbent bicycle and tried to get some cardio with the arm bike.  It is hard to get the heart pumping without full leg-use, but motion is lotion and over the past week, my range of motion is improving a little bit every day. As a normally able-bodied person, I feel a little guilty using a temporary handicapped parking permit. But it has come in handy, especially grocery shopping.  Yes, I am even grocery shopping this week!  Talk about celebrating the mundane!

Getting after it. Recumbent bike with no resistance.

The most challenging piece right now is the restriction of the posterior-lateral hip.  I assume it is scar tissue that is holding back the range of motion and that over time it will gradually improve.  Due to this restriction and a still-tender ischium, I have to slouch on my tailbone on the recumbent bike which only allows me to pedal for about 10 minutes.  I have weaned off crutches though and for the most part, I walk with slightly less of a limp every day.  

     The pool reopened this week after Spring cleaning and I plan to swim every day this week. Holladay Lions Recreation Center, my neighborhood pool, is kept at a therapeutic temperature and feels heavenly for rehabbing soft tissue injuries. Yesterday I was able to pull in a crawl stroke floating my legs behind with a bouey between my thighs for 20 minutes which was the first significant cardio I have had since the injury! I followed this up with range of motion work deep water jogging with a floatation belt. This mimics the same motion as the recumbent bike but without the pressure on the bum and more freedom in the hip without being tied to the specific range of the bike pedals. The pool also has a current channel with a grab bar which I was able to lap about 3 times against the current.  When I got out of the pool, I immediately felt less restriction in my hip. To my greatest surprise, I could reach my lower leg to put lotion on with little effort and no discomfort.  Lotion-on-the-leg milestone has been met!
     The bitter-sweet side of my improved mobility is that I am no longer dependent on my friend and neighbor Leann who selflessly gave her time and energy to help me with the baby during the first 6 weeks.  On most days, she brought her son in the morning before afternoon kindergarten. He is a super sweet boy and loved entertaining Emily.  The feeling was quite mutual as Emily's face would light up every morning when he came to play.  Good timing for Emily, she decided to crank out an ear-infection/ respiratory infection over the weekend so luckily I can care for her without exposing Leann's little boy to the copious amounts of snot pouring from Emily's nose.  Though there can be no doubt I am grateful for Leann's help,  the real gift has been the formation of a beautiful new friendship!

     Compared to what I could do before the injury, it is frustrating how far I have to go.  But compared to what I could do 2 weeks ago, I have made tremendous improvement.  I don't start formal PT for 4 more weeks so it is up to me to move my body safely and therapeutically.  Using pain as my guide has served my recovery well and will continue to guide me until PT gives me the word to go for it and push harder.  Stepping into the water, I finally feel like I am stepping up out of the clouds!

Phase II: Range of Motion

This morning was my 5 week post-op visit with Dr. Greis.  I have officially graduated to the next phase of recovery!  Hello phase II, goodbye phase I! Here is what I get to do for the next month:

This is WAY harder than it looks.  My leg was shaking.

1. Wean crutches!

2. Walk in the pool or deep-water jogging. May use recumbent bike with no resistance. 

3. Full knee flexion and extension permitted, but no full knee extension coupled with hip flexion.

4. No strengthening or load-bearing on hamstring yet. 

5. Drive...and yes, I get a temporary handicapped parking permit. This is the happiest news for Barry, who has been the house chauffeur for the past 6 weeks!

     

     Unofficially, I started weaning crutches this last week which is going well. I am hardly using crutches in the house at all except for stairs, but uneven ground outside will be awhile before I feel safe without them. 

The muscle-free, skinny-fat left leg takes a dip!

     Curious about how it would feel, I jumped the gun a little on Sunday and walked in the pool for the first time. I have always enjoyed swimming laps for exercise so after 6 weeks of doing nothing, I couldn't wait to get in the water, even if it was only to walk around.  

     Did I say "Only" walk around? Ha! Walking in water with a weak leg was extremely challenging! Pushing my leg through the water felt like I was pushing it through molasses.  Since the muscle has atrophied, my skinny-fat left leg wanted to float to the top of the water while my piddly little muscles had to push it back down; even just standing while holding onto the wall was tiring. Unfortunately, my neighborhood pool is now closed this week for spring cleaning, but my goal will be to get in the pool at least 3 times a week when it opens again.

     I think anyone who is faced with prolonged inactivity has some concern about putting on extra weight. I am pleased that after 6 weeks, my clothes still fit me the way I like. I don't have a scale in my house, so as long as I slip easily into my size 6 pants, I am satisfied. My appetite, which has always been hearty, dropped considerably with my inactivity; applying the the basic principals of calories in-calories out, I break even.  I have Emily to thank for some of this.  She continues to be a very good breastfeeder which burns around 500 calories or more daily, all while sitting on the couch.  The left leg has lost a lot of muscle: though it looks good and fits into pants, there is the element of skinny-fat that will only begin to remedy when formal PT begins in a month's time.

6 Weeks Since Injury

Today marks 6 weeks since that fateful morning in my living room.  Four and a half weeks post-op, I admittedly have jumped the gun on my weight-bearing which is not supposed to start until 6 weeks per my surgeon's protocol. Some doctors say 4 weeks, some say 6 weeks. So with the insight of a wonderful, though small, online community of people all over the world who have sustained this injury, I decided to listen to my body and give weight-bearing a shot.

6 weeks toe-touch weight bearing atrophy on left leg.

     Last Sunday was the first day I really started planting my foot on the ground and it felt wonderful. As I hoped, just the act of putting weight on my left foot improved my circulation and got rid of the prickly neuropathy on the bottom of my foot.  Monday, I was sore.  It was not my hamstring that was sore.  It was the other muscles and joints in my leg that had not been used since March 11.

     As you can see from the photo, the left leg with the sock has no muscle definition in the quads.  Compare to the other leg that has done all the work or 6 weeks and you can see what the left leg is up against.  Since the leg has not moved, the other tendons are also tight.  A mild case of drop foot has shortened the achilles tendon which places a stretch on the calves just by planting the heel on the ground.  The other muscles and tendons supporting the knee are weak so there is little lateral knee support with effort. My hip flexor is also tight, not allowing my leg to hang back in stride, so right now my gait is more of a penguin waddle from side to side.

    Monday I noticed my calf was sore so I rested most of the day.  Tuesday, the pain in my calf resolved so I advanced myself as tolerated. By Thursday, I crutched around the the block with partial weight bearing two times and felt quite accomplished.  Not to mention, baby Emily was downright thrilled that mommy was going on a walk with her while my friend pushed the stroller.  Today left me with some medial ankle discomfort. Weird.  Though I should be proud of my weight bearing accomplishment, it is a sobering reality of the commitment it will take to get my body to work with my leg in a functional way again. To keep things positive, I will leave this post with a list of small victories.

1. Reading lots of books with Emily. There are two things she knows a mommy on the couch is good for: breastfeeding, and reading books.

2. Michelle reading to her sister to keep Emily out of trouble...and they both enjoyed it!

3. Crutching around the block in the sun two times with Emily.

4. Crutching by the rock wall in my backyard to yank out some bindweed...ALWAYS satisfying!

5. Riding with my mother in law today to pick up Michelle from school. It was my first after-school pick-up since the injury 6 weeks ago.  Michelle threw her arms around me and said "Mommy!  This is the best news ever! It means you're getting better!"

     

4 Weeks Post-Op Progress?

Where I should be, on the couch reading books with Emily!

Today marks 4 weeks post-op and thank God it's Monday!  I am noticing a trend of over-doing it on the weekends when I don't have my hired angel to keep me out of trouble. I didn't even go anywhere.  Just hanging out at home, trying to be a mom was enough. I had some little victories that likely motivated me to push a little too hard. First, I was able to sit in a padded chair or reclined adirondack chair for up to 20 minutes without significant pain.  Hooray! Then I discovered I could partially weight-bear without much pain.  Hooray! Today, the back of my leg is achy and my hamstring is twitchy. Boo!
     Though I am excited to know that I am healing, it is equally frustrating knowing how careful I still  need to be. But now, I am grateful for pain. Pain is my friend; my warning system that activates when I am doing too much.  If I listen to the pain signals at the earliest point, I will avoid pushing myself too hard too soon.
     So while others may begrudge going back to the weekly work grind on Mondays, it marks the point where I get five full days with the help of Leanne and Donna to rest up before I hit my weekend grind!

Adventures in sitting!

Our weekend backyard adventure.

Angels

I never knew how much I did as a mom until I had to assemble an army of people to take over my duties. Three and half weeks post-op, I could not be managing this without the Angels in my life who have swept in to help manage my household.  I will take this post to recognize those Angels.

Leanne.

Leanne is a neighbor and stay-at-home-mom of four kids who are all in school. She saw the paramedics outside my house the morning of my injury and quickly offered to be of assistance in any way she could. I had no idea at the time how important her offer would become.  

     It became clear after a couple of days that I would not be able to bend down and pick up my increasingly mobile 11 month old.  Emily turned one on March 29th.  She walked on her birthday. She is walking way better than me right now, but she also falls fifty times a day and like any toddler, she is into everything!  I cannot pick her up off the floor, put her in her crib (which happens to be downstairs...which is another hurdle), can't put her in her high chair.  All these activities engage the hamstring or offer a potential for injury (like stairs) that I cannot afford to take if I want to heal without complications. I cannot rescue Emily from herself which is necessary multiple times a day. You see, I cannot be alone with Emily. We both need a babysitter!

     On day 4 or 5 post-injury, I had a span of a few hours that my family was unable to fill-in and took Leanne up on her offer to help. She did more than I ever expected. Not only did her gentle, nurturing touch soothe Emily for naps and keep her out of trouble, but Leanne vacuumed, unstacked my dishwasher, cleaned my kitchen, and brought me books to read. That day ended up being somewhat of a job interview. She was so caring and attentive and wanted nothing in return. But her skills proved to be worth paying for. I offered her temporary employment until I can manage my sweet Emily by myself. Her companionship has also sparked a relationship of mutual support and friendship that will continue well past my recovery.

Donna.

Donna is my mother-in-law. My in-laws moved to Salt Lake City from Phoenix a year ago, just after Emily was born. The idea was that they would be closer to family in case either of them needed family near by for medical concerns.  Little did we know that it would be ME needing the help!

     Donna has stepped in wherever Leanne can't. Aside from watching the baby with me, she has prepared meals, bought groceries, baked muffins, picked Michelle up from school, and countless other tasks that we take for granted every day when able bodied. 

Barry.

Oh my, has Barry risen to the occasion!  My wonderful husband struggled at first. The stress of unloading my motherly duties onto him was overwhelming at first to say the least. He had to take over the nighttime duties when Emily woke up and was suffering sleep deprivation while she adjusted to the new normal.  The first nights after my surgery he woke me up every 4 hours to take pain meds so I wouldn't wake up in pain. He tirelessly cooks meals and has made my coffee every morning before I wake up! This injury has disrupted so many family processes, but last 2 weeks have improved greatly with the routine and he has not wavered to be sure that I protect my repair.

Tammy.

My aunt Tammy is the youngest sister of my deceased mother's.  She is 12 years younger than my mom was and 14 years older than me.  More a big sister than an aunt, she has stepped in selflessly just as I imagine my mother would have if she was alive.

     Tammy lives in Seattle and had already planned before my injury to come out for a visit to celebrate Emily's first birthday the first weekend in April.  When she heard of my injury, she immediately booked an extra trip to come and be of assistance for the few days before and after my surgery. She is a Physical Therapist turned Wellness Coach and kicked my butt into compliance. She was aghast the first day she arrived to find me hobbling down the stairs on my crutches and weight-bearing on my pre-surgical injured leg! She is also a lover of babies and found great joy in helping out with a giggly, sweet emerging toddler.  Her second visit 10 days post-op to celebrate Emily's birthday was equally helpful and I am ever grateful for her help.

Dave and Linda.

My dad is Dave.  Linda is my step-mom. My dad stayed with me tirelessly for 12 hours in the hospital the first day of my injury and has stepped in wherever he can in spite of his own health concerns.  He is 9 months post-op rotator cuff surgery and my voice of reason when I even think of doing too much too soon. Linda is the ultimate bookworm and baby-lover so she has provided me with a library of books for my idle time and taken the baby on Tuesdays throughout the first month of surgery.  My dad has also helped subsidize Leanne's help, insisting on paying her more than I could initially afford.  But he was right, she is completely worth it.

Irene.

Irene is my angel on the sidelines.  One of my best friends and mother of Michelle's friend Izzy, she has stepped in to help me manage Michelle.

    Michelle attends a charter school that is a 15 minute drive from our house. Irene lives a block away from school, an easy walk for Michelle, and has not only offered her home for Michelle after school, but has carpooled Michelle to various after-school activities and kept her for several mid-week sleepovers. It is painfully clear that I over-scheduled Michelle with after school activities now that I cannot drive, a mistake I won't make next year.  But as these activities prepare for spring performances and grand finales, Irene has made it possible for Michelle to continue participation.

The Cherubs.

The cherubs are my friends who have stepped in here and there to help where they can in the midst of their busy lives. My sister Cory and her husband Bill, my friends Taunya, Kim, Maysa, Ann, Sam, Izzy, and several others have brought meals, entertained Michelle, given me pedicures, and helped with the baby. 

Doug

     Yesterday I felt frustration and self-pity creep up on me. It kicked off after my shower when I was attempting to put my clean clothes away. When I carry anything, I have to hang my armpits on my crutches and move the crutch with my torso rather than my arms. I positioned my right crutch a little too close to center and crushed my right fourth toe (the good side) into my crutch while swinging through, which sent me to the floor.  I fell gently in slow motion and nothing felt tweaked or torqued on my left side at all. However, having a sore right foot now reminds me of how long I have to go and it is easy to slip into self-pity.  But pity is not active, nor a constructive emotion in any way.  So to draw strength from the experience, I think of Doug.

Mt. Rainer, October 2008

     

    Doug was a patient I cared for back when I was in nursing school in Seattle, working as a nurses' aid.  He was one of two patients I kept correspondence with when I moved on after graduating from nursing school. Though nursing school cautioned about blurring the line between therapeutic and personal relationship, it was impossible to avoid being Doug's friend![-] Doug was born with cerebral palsy, but inside his twisted body was a brilliant mind and absolutely the most caring, emotionally intelligent person you would ever meet.  Even while his body jolted in spasm, seemingly working against all his physical efforts, he maintained a playful sense of humor. He was realistic about his physical limitations but never let them limit him. He gathered the resources he needed to carry on practically, always flashing his warm and inviting smile along the way.

     As a classically trained singer, I participated casually with a group of singers that put on concerts a couple of times a year when I lived in Washington state. I invited Doug to one of these concerts when he genuinely showed an interest in coming to hear me sing. I asked if he had a way of getting there and he wrote saying "Of course, I'll take the bus!" The concert was at a church in Bellevue which was across the lake and in a place that seemed a little obscure to get to by car, let alone by bus.  I had doubts that he would make it. I never should have doubted him! As I looked around the audience just before the concert was about to start, there was his smile, cruising in on his electric wheelchair with his caregiver. Of all my friends who came, he was the only one who took 3 different busses and wheeled 1/4 of a mile on an electric wheelchair to get there. And he acted like it was no big deal. That was Doug. He transformed any potentially frustrating circumstance into a practical problem to solve without an ounce of self-pity.

     Doug and I were Facebook friends which became our primary form of communication when I left the pacific northwest in 2010. He was a fan of the Facebook "poke", which was playfully fitting for his sense of humor. Sometime around 2012, it occurred to me that I hadn't been "poked" in awhile and hadn't seen his posts in my feed. I knew it was not possible for him to "unfriend" anyone. When I went to stalk his page, it now read "Remembering Doug". In 2011, Doug was tragically killed in a hit-and-run accident while driving his electric wheelchair on the side of a road. The driver was eventually apprehended, but that is very little consolation to those who had been infected by his positive attitude, goofy sense of humor, and gleaming smile.

     In memory of Doug, I dedicate my recovery to banishing self-pity and addressing each problem with practical resolve; to solve what I can, and accept what I can't. 

In Sickness & In Health

Barry and me at Jackson Lake in 2012.  Michelle just turned 3.
This was the first trip we took alone together after her birth.

The power of partnership is using your differences to your advantage. When people fall in love, there is an element of projection they place on each other. We seek sameness to fulfill the fantasy of romantic love. Over the past 9 1/2 years, Barry and I have become more aware of how different we truly are. Learning to appreciate those differences as our romantic projections dissolve is the challenge of every marriage.

     When a disruptive event occurs in a marriage, we have two choices: adapt or deny. Denial is the monster that keeps us holding on to the illusion. Even with the best efforts, old patterns are extremely sticky and difficult to vanquish, even when those patterns disrupt the family system.  It often takes a disruptive event as the catalyst to change those dysfunctional patterns. If we let it, the event can be a powerful opportunity to adapt to a healthier state of normal. My therapist told me once that it takes 30 days for change to solidify into habit. Today marks four weeks since the injury and I am finally beginning to see a positive difference.

     Aside my injury which was spontaneous and unplanned, over past year and half we had two other planned life-events that are known to be on the top of the list for "most stressful": we bought a house, and had a baby. I'll be totally honest that the past year and half has without a doubt created a significant amount of marital discord. Though my postpartum depression lifted after resuming my anti-depressant medication, I watched moodiness and negativity take over Barry in a way that felt impossible to break through. 

    Then the injury happened, suddenly the man who was already the main bread-winner and family chef found his responsibilities double. The first couple of weeks were a challenge.  He is an introvert and prefers to keep emotional discourse to a minimum, but his non-verbal language was abundantly clear: "This sucks for me. My life just got that much harder. Kelly is why my life got so much harder." Physically he was picking up the slack by taking care of the baby, taking Michelle to school, and cleaning up where I couldn't. But emotionally, he struggled. He would ask me to do things he knew I wan't capable of and fall into a slump when I couldn't or wouldn't do it.  

    I noticed the change about a week ago. Barry's head began to lift above the fog of denial and begin the process of emotional adaptation and acceptance. Instead of coffee in the morning, he was juicing.  Instead of pouring a cocktail when he got home from work, he prioritized exercise. He stopped falling asleep in front of the TV at night and started reading until he felt drowsy. Over the past few days, I have finally seen the resentment melt away. He is falling asleep in our bed instead of the couch. He is patient, interactive, and proactive, facilitating opportunities for me to bond with the girls. His parenting with Michelle is more effective. And this morning, he was downright cheery! With his wife disabled, the strength required of him has left no room for unhealthy choices or habitual resentment. Silver linings everywhere.
 
     

The Athletics of Nursing

     On Monday, my brain activated the worry button when my surgeon updated my medical leave paperwork, changing the length of my estimated incapacitation from May 17th to June 20th. That makes sense. May 2 marks the point when I can begin weaning crutches and start gentle activity like walking in the pool or a recumbent bike with no resistance (as tolerated). 4 weeks later, I may begin PT.  So maybe that gives me 3 weeks of PT before returning to work for an injury that is known to take months to return to 80% of previous function.  With many jobs, this would be adequate. But there are days when my job as a Labor & Delivery nurse is an outright athletic event.
     When I was pregnant last year, there were days I could barely walk at the end of the day as my hips were expanding.  Just bending down to plug in a bed felt like a monumental task. And who designed those IV pumps we use? It was not a nurse who designed an IV pump that weighs 10 pounds plus up to four 2 1/2 pound pump modules added to make a 20 pound piece of machinery that you have to hold up isometrically with one hand for a solid minute or two while screwing in an extremely slow mounting clamp onto a pole...for almost every patient!
     Nurses are people movers. In Labor and Delivery, we move women with spinal anesthesia after a c-section, help women up to the bathroom the first time after epidural anesthesia, provide endless hours of counter pressure for labor support.  We twist, we turn, we bend, we lift, we sprint to emergency c-sections. Every once in awhile when I hear a colleague say "I really need to get back in shape!" I think, well, it can't be all that bad; you did just leap onto the bed pretty quickly to relieve that shoulder dystocia! And these activities go on for a 12 hour shift.
     To be clear, I am not complaining.  I am active. I love to move my body. I have loved that for the past 11 years (5 in Labor and Delivery), I have a job where I get to move my body in dynamic ways. I have worn the intensity like a badge of honor. I have kept myself fit so that I can effectively execute the demands of the job.
     The physical demand of bedside nursing is no secret. If you do a job search for nursing jobs at my hospital, any bedside nursing job states that you may have to do all kinds of physical movements including lifting 100 lbs.  Yes, it says that specifically: 100 lbs, though we move patients 2 to 3 times that weight! This is not like lifting 100 lbs at the gym. This is 100 lbs (or 250 lbs) that drops suddenly in a tight cramped space on a floor that maybe wet and slippery, as you are twisting your body around, banging your knee on a cabinet trying to figure out what the hell just happened.
     For the first time I have to worry that my body may not be able to meet the physical demands of a job I love and remain whole enough to keep up the other meaningful activities in my life. I cannot afford re-injury. When I went back to work after Emily was born, I cut back my hours substantially to 12 hours a week. How wonderful to spend more time raising my baby! But a 12-hr work week was the minimum my family could bear to keep our household a-float. As a part-time employee, that left me with no PTO (paid time off) and no disability insurance to help float us through this.  Add the medical bills to the mix and I am faced with a reality that I may need to go back to work full-time to recover from this injury financially.
     On the positive side, my hospital has a decent medical leave policy that does support keeping my job while incapacitated, even for part-time employees. My manager is supportive of my recovery and would love to bring me back when I am able. The questions is, can I afford to wait that long?

Gratitude

A friend of mine stopped by yesterday for a quick visit around lunchtime and made me a sandwich.  A little gesture that went along way.  I believe I illustrated the difficulty of taking things in and out of the refrigerator with 2 hands on crutches in a previous post.  As I told her my rehab plan and the length of time that I have to let the muscles in my left leg waste away, she commented:  "If your injury had happened to me, I don't know what I would do.  I have one tenth the support and close family network that you do!"
     It is true that a good chunk of my family lives in Salt Lake City. My sister, my parents, step-siblings and my husband's parents are all here. I have an aunt from Seattle who has flown out twice to help.  I am immensely grateful for the time and resources they have all pitched in to keep my household afloat!  But then more support popped out of the woodwork.  Friends brought meals. Since I can't be alone with now 1-year-old Emily, some have offered to stay with me for a few hours here and there. Friends and twice-removed family members have offered to transport Michelle to her various activities. One neighbor was so helpful to me one day, I actually hired her to help me for the next 6 weeks or until I am able go up and down stairs, perform light housework, and chase after my baby. All of these gestures large and small have accumulated into a network of support that was unimaginable the day of my injury.
     There is no doubt this injury is a great inconvenience to me. But I will make a full recovery. Four months from now, I can expect to be participating in all the activities I did before with little accommodation.  I credit the wonderful patients I have cared for as a nurse for the past 11 years for giving me clear insight into this.  New quadriplegics, stroke victims, pregnant mothers with cancer, babies with significant birth defects; the list is endless for people who have had to muster up more courage, strength, and perseverance than I could even fathom. These people have given me the gift of gratitude.

Grateful for the sun and this 1 year old cutie!

Overcommitted

A couple weeks before my injury, I shared a piece of writing with my sister. She liked it and asked if I had considered blogging. Well, since I'm blogging now, I'll post it here.  If I was having trouble figuring out how to simplify before, the universe has answered robustly since this injury why overcommitting is, simply put, bad for you.

I am writing this because I need to find sanity in motherhood. I need to free myself from the urge to compete with elite child-rearing. I need to stop the insanity that is driving me, my 6 year old daughter, and my husband into an emotional tailspin. I need to stop the fear that if I don’t over-schedule my children into several “enriching”, IQ-increasing, service-enhancing, athlete-making, music-virtuoso-making, activities that I will have failed them to provide the opportunity to excel in life. 
     This is my own failing. What is this personal regret despite my deep satisfaction with my career, unconditional love for my family, and general happiness with where I have ended up in my life? Why is there this this nagging belief that it is up to me to create and control what my children turn into? 
     The other day, I found out several of my friends are giving their daughters who are friends with my daughter Violin lessons. Another friend spoke of her daughter excelling in ski lessons. Bam. There it was. That feeling of failure. Even though I make the conscious decision NOT to bring the excruciating sound of a beginning violin player into my home, or spend money I don’t have on extra ski lessons, I must be failing my daughter by denying her the experience. I felt a frenzied failing come over me that since I did not enroll her in early music experiences, that perhaps I have already missed the boat with her! It’s craziness! I see that many of my daughter’s friends do possess a certain talent that lends them to excelling in many of these activities. But I need to be honest here. My Michelle is just a kid. My daughter is not a virtuoso, she struggles with reading, as much as she loves to move her body creatively, she does not seem to carry a “gifted” athletic ability nor does she possess an innate seriousness to perfect a talent. She won’t eat a vegetable. Michelle works hard in school.  She has to work hard. There is no hidden genius in her little 6 year old brain, and like her mom, she will have to work hard, likely very hard, to meet her own high expectations of herself.     
     I'll tell you what she is. Michelle is an unabashed extrovert who will make friends with anyone.  She is sensitive to the loner and has a stronger tendency to be inclusive rather than exclusive of others. She loves to paint, draw, engage in elaborate imaginative play with puppets and dolls. She has no desire to tease, only play with and love her baby sister.  She is strong-willed, emotionally sensitive, and extremely high-energy. These are the traits with which she was born. I had no say in the matter, and ultimately, I will have little say in what she ultimately finds fulfilling in her life.  
   So I say to myself, stop it!  Stop the guilt! There are limits to my financial and emotional commitment to ballet, tumbling, piano, basketball, theater class, art class, kung fu, girl scouts, soccer, swim lessons, ski lessons, trips to Disneyland, PTA,  and that is okay! My girls will be fine, and my husband and I will be fine without it. But I won’t be fine blazing down the road of over-committed insanity. And if mommy’s not fine, the trickle down effect leaves everyone sad and frustrated in my house.  
   So, here’s to knowing what I must do to feel “fine”. That by saying “no” to over-committing my child’s life, I am saying “yes” to a happier, healthier me. And if there is anything my kids could use more of to excel in life, it is a mom who can deal. My pledge to my kids is knowing my limits.  My commitment to them is to be present.

Phase I, Rest and Heal

I had my first post-op visit Tuesday which was mainly a wound-check.  The good news is, I am healing as expected.  The bad news is, I am healing as expected.  Though I have researched post-op rehab protocols for hamstring avulsion online, I asked to get Dr. Greis' protocol printed out to see if he had the same guidelines.  Yup.  Pretty much.  The only big difference is that Dr. Greis did not put me in a bulky brace for which I am undoubtedly grateful!
     Phase I, weeks 0-6. Rest and heal.  Ice incision.  Toe-touch weight bearing with crutches.  No flexing or stretching hamstring.  No formal PT until 8-10 weeks post-op.  As I write, I am only 10 days out.
     The irony with injuries like these is that they happen to relatively "active people" and I am no exception.  If something needs to be done, I do it.  But I can't right now and absolutely shouldn't be trying to!  It is a huge challenge overcoming that nag in my brain telling me "If you throw one crutch down the stairs, use one crutch on the left and hold onto the wall on the right, you could probably hobble downstairs and throw in a load of laundry!" That would be crazy!
     The urge to ignore "rest and heal" is also fueled by guilt over the burden this shift of responsibility has placed on my family. On Tuesday evening when my husband Barry got home from work, he looked at the dishes in the sink and remarked "Would it be too much to ask if you could just do the dishes?"  Both girls had been at grandma's all day and were not home yet.  The dishes were from breakfast and the sandwich I made for lunch.  Trying to remove food from the refrigerator to make a sandwich and then put it away again is really a simple task...that is, if you don't have both hands on crutches trying to keep the weight off a weak leg. I did manage to put the sandwich fixings away which was a real accomplishment.
     Standing at the sink for any length of time on one leg with armpits resting on crutches is again challenging and though I can manage hobbling items to the top rack of the dishwasher, the bottom rack requires a sophisticated balancing act.  To avoid active flexing or stretching my left hamstring, I must position the right leg in a deep 1 legged squat (left leg loosely dangling behind me) with the left hand on a crutch reaching down and out with my right hand to place a dish between the slats.  I know this because despite my precautions to "rest and heal", I have tried it.  Once. And it sucked.  I nearly fell over.  Never again.
     So to Barry's request for me to do the dishes, I replied "Yes, I'm sorry, but is too much to ask right now.  It is extremely hard for me."  A few minutes later he huffed out the house and announced that he was going on a drive.
     "Where?" I asked
     "I don't know."  He said.
And then I felt guilty. I should be trying harder, I thought. And remember that thing I said at the beginning of this post about how crazy it would be for me to try to hobble downstairs to throw in a load of laundry? I did that crazy thing.  And VERY fortunately, I did not fall, stub my toe, or tweak my hamstring. But every time I ignore my instructions to "rest and heal", I put myself at great risk for prolonging my recovery and perhaps permanently sabotaging the return to prior function.
     Those first few days post-op when I was in a lot of pain, my limitations were abundantly clear.  Barry and Michelle were incredible those days, commanding me to rest, setting the alarm every four hours at night so that I would keep my pain control steady. I am sure as my pain improved over the first week, I began to look less like a recovering post-op patient and more like a wife/mother just lying on the couch all day. Despite the looks of it on the outside, there is some remarkable healing going in there! A complex matrix of tissue is growing and gluing my tendon back to the bone.  Only I can protect that.
     So in the spirit of committing myself to "rest and heal", I have been more forthright about what I can and cannot do.  I have also enlisted Michelle's help with a lot of simple things. One night when she grumbled and stormed off because I asked her to help me put my pajama bottoms on, I put it to her like this: "I am asking your help because I am physically unable to do it myself.  I can't do this without you.  If I don't ask for help and hurt myself, it will be even longer before I can run and play with you."  I think she got it.  The next night when she retrieved something from a low cabinet for me I said "Thank you so much Michelle!  What would I do without your help?"  Very proud of her important role in project "fix mommy", she replied "Oh, you would probably die."

Let's Talk About Hamstring Avulsion

Hamstring strains are common sports injuries. 

Complete hamstring avulsions, where the tendon tears completely off the bone, are uncommon. 

Water skiing is the most common sport where this occurs because it sets up the mechanics just right.  Hamstring muscle contraction coupled with hip flexion with a straight knee and tremendous force & load placed suddenly to lurch the body forward is the recipe for disaster.   

Hamstring strains and avulsions are the most common yoga injuries.  Michelle and I were doing morning sun salutations about an hour before the injury, though I am sure that is incidental and not contributory to my injury.

Rehab protocols vary a little bit but all have one thing in common: do nothing but rest and heal with toe touch weight bearing with axillary crutches, pretty much just up to the bathroom for the first 6 weeks.  Gradually, I can increase weight bearing at that point.

It takes about 3 weeks for the incision to heal, but it takes 12 weeks really for the tendon to completely heal back to the bone.  After 6 or 7 weeks, the tendon is healed to the point where full weight bearing is allowed.

The process of strengthening the muscle again to a functional level will be a long and arduous task.  At around 9 months, it is considered excellent if my strength on the left side is 80% of the strength on the right. 

The literature supports repair and outcomes are much better when repaired early.  Amazingly, some people hobble along for months (14 months in one instance someone reported on a “runners world” internet forum) with a diagnosis of “hamstring strain” when in fact the muscle is avulsed.  Eventually, when PT fails to bring back function, an MRI is performed and the avulsion confirmed.  These are harder to repair as the muscle has retracted so far with so much scar tissue that harvesting tendon from other areas, usually the achilles tendon, is required.  There is more risk of sciatic nerve entrapment in delayed repair due to a pseudo sheath of scar tissue that may form, which sounds horrendous.  What is my takeaway? Glad I had the early repair!  Dr. Greis did excellent work putting it back together, now it’s my job to protect it.

Patience

After being farmed out for sleepovers 3 nights in a row surrounding my surgery, Michelle finally had an evening at home on March 23rd.  Hauled up on the couch, helping with homework was at least something I could do.  Michelle, who was strong willed and challenging before my injury, had notably reverted a lot of the limit-testing behaviors that were finally becoming manageable.  Nothing to set off a parenting lesson in patience than helping a kid with homework!

She opened her homework and got busy on a worksheet until she came to an activity about matching compound words.  There were 2 columns of words and she had to draw a line to match the compound words together.  Work to Shop, Ice to Cap, etc.  The first column had the word “Birth” which would correspond to “Day” in the second column.  She stopped and asked me “Mom, what does that word say?”  “Birth” is a word I knew she had read before and certainly had the tools to sound it out phonetically.

“Michelle, you wouldn’t be learning it yourself if I tell you the answer.  I think that is a word you know but if you don’t know the word, let’s try sounding it out.  I can help you that way.”

Immediately she launched into a dramatic display of wailing and tears.

“Mom! Just tell me the word so I can match it to the other word!  I don’t want you to tell me the answer!  Just tell me the word so I can get my homework over with!!!” 

I stood calm and firm as she escalated, her face red hot with anger and frustration.  After a couple minutes, I calmly said “I am unable to help you when you are this upset.  You need to find a way to calm yourself down before I can help you.  You can take some deep breaths here or calm down in your room.”  As expected, she continued to test with one more protest. 

“Since you can’t seem to calm down next to me, it’s time to calm down in your room.”  I said.  In the past, when she fights time outs, I have often had to physically escort her to her room.  I was stuck on the couch with a bum leg and no ability to physically enforce a time out.  There was no choice for me but to stay calm, hold firm, and remain patient.  With a couple of hyperventilated breaths, she started to calm down.  She wiped her tears and with two more breaths, she relaxed enough to ask with a sniff  “Now can you help me?”

“I am here to help you.  I won't read it for you, but if you do your best to sound it out, we’ll go from there.”

“B-eee-rrrr-th…be-earth is not a word I know!  It makes no sense!!”  I had a suspicion that she was feigning the difficulty of the word in hopes that I would just tell her the word, but I played along.

“It’s one of those words where the vowel doesn’t quite follow the rules.” I said.  How many times had I seen her drop the vowel that goes before the “R” in her spelling words?  If she was not faking this challenge, removing the vowel could be the answer.  So I said “What if you took away the ‘I’, how would you pronounce that word?”

“Birth.” She said hesitantly.

“There you go!  You got it.  Now which word would you match it to in the next column?”

“Day.  Birth-Day…Birthday!”  And she finished her homework in 3 minutes.

With this small, but notable parenting victory, I breathed a sigh of relief. I have no choice right now than to surrender to patience.  Exploding will do nothing to improve my situation or accomplish anything.  If we are going to get through the next 6 weeks as a family, I need to find that place in my being that is patient and calm with myself and those around me. 

Pre-op/ Post-op Photos

 Pre-op photos.  After hobbling around for 10 days, surgery day finally came March 21st.

Post-op glamour shot.

Pre-op and post-op couch selfies with Emily.  I will be spending a lot of time here.