It has been 16 days since I had my knee cut open and got a 30 cm long nail hammered into my leg. 16 days of many small steps forward and a few ones back.
It is quite fascinating how fast the body falls apart if you don’t move around. It took one week to loose practically all my muscles in my right leg. According to the doctors, it will take 3-6 months to get them back… I used to have pretty sturdy calves (I won over nearly everyone when we measured our calf-index), now they look like tooth picks.
When I was still lying in my bed at the hospital, I was extremely motivated to start my rehab as soon and hard as possible. I kept searching the Internet for exercises and found several examples of athletes doing hard core stuff just 5 days after surgery. Of course I wanted to, and thought I could, be just as tough as them.
That didn’t really happen. I don’t know if its me being weak, or just those athletes having super powers, but it clearly doesn’t work that way for me. I find it hard enough to put one foot in front of the other. To give myself some credit (hrm, don’t really know if credit is the right word…) I actually did try to be tough. In my apartment, I have a stair going from the first to the second floor. Since one can stand underneath it and hang from the stairs, I thought that it would be an excellent exercise to do arm assisted squats. One legged squats. Splendid idea… or not really. Doing squats on a leg that has an intramedullary nail in it 7 days after surgery does not mean that you get a good workout, it means that your broken tibia moves in one direction while the nail moves in the other. It means that you create a hell of an internal bleeding in your already pretty traumatized leg. It hurts, and it means that you take several steps backward in your healing process… Once again, I seem to have proven that having a doctoral degree does not necessarily mean that you are smart.
I clearly have to learn to be patient, and accept that what I can do now to get better are (very) small things: wiggle them toes, lift one leg 10 times, lift the other 10 times, push one knee down and clamp the thigh muscle 10 times, then the other… the only rebel-tough thing I do now is that I do 30 instead of 10 repetitions… I hope that that will keep my muscles from going completely into oblivion. I hear hope is the last thing that abandons us.
But its not all about muscles of course. My rehab is mostly about my joints. Apparently, getting some metal in your body does not only mean that you are on your way to Cyborghood, but also that you start to feel and act like RoboCop. It feels as if that nail in my tibia goes straight through my knee and ankle. The ancle is slowly getting more and more agile, but the knee gets me very frustrated. If I use my hands and work progressively, I can get my calf to almost touch my thigh. But it hurts like hell, and every time I do it I have to re-start from square zero.
To be honest, I find it a bit scary since I’m terrified of chronic pain. I’m so scared that my body won’t work as well as it did before. Sorry, I know, I should just stop thinking so much. Keep the focus. Baby steps. Bend them knees. Over and over again. Patience. Focus on the good stuff. Ok, here are some good stuff:
GOOD THING #1
I can walk! Not far, and not fast, but I CAN WALK. I started out walking 50 meters. Then I went around the block, and now I can walk all the way to my parents (300 meters) to have lunch, and then go back home again. Today I did it all on my own (no back seat driver looking after me), wohoo!
The walking thing has several good things about it: 1) I get to leave the apartment and look at all the beautiful grey slush on the ground, 2) walking gets me completely exhausted and extremely hungry, and 3) once I get to my parents, I get to eat warm and delicious food, socialize and look at a very tiny and ridiculous dog. Happiness in a box.
GOOD THING #2
I have a dual color cast and I don’t have stitches! All hale the extremely nice nurses at NUS (who apparently all have some background in alpine skiing). I almost want to make up excuses for going back just to chat with them some more.
GOOD THING # 3
Mending broken legs appears to demand more energy than I can consume. In other words, I can eat all I want and more. That in combination with a bunch of wonderful, wonderful friends and family who keep coming by with fantastic food and pastry means that I’ve eaten more semmel buns the past week than I’ve done in my entire life. And I still have to eat more.
Now I only wait until I get off that damn morphine. Then I will drink wine. A lot of wine. And beer. Good beer. And bubbly. I think I may need a backseat driver then..
The Hungry Hen Report 
So I hope it wasn’t me encouring you to do the squats.
You know, they don’t open up peoples knees and put nails inside peoples bones for fun. The recovery time without the nail are insanely long, and you would probably still be in the hospital without it, to ensure that the bone grew together properly. But it is not magic, and you got to take it slow. But you already know these things :-).
As you discovered joints become almost locked up rather quickly. Moving them around is very important. The tissue under my shoulder become stiff 4-5 after i broke my collarbone. It took a couple of months for it to go away. Keep moving them.
I’ve had kneesurgery three times. It usually takes several months before the knee can be bend entirely together. However they (post surgery instructions) are usually very insistent on being able to stretch it fully. Usually light activity can be started way before though. If anyone at the hospital has said something that doesn’t match what I say, just ignore this.
You can look forward to regrowing your muscle mass, it is complete pain. 3½ months after my collarbone broke and my shoulders are still flimsy and weak. But I can ride my bikes now. The ability to recover also disappears. After a light 1½ hour ride I feel worse than I would do after an all-day effort. But there is progress.
Anyway. You are counting days. Recovery doesn’t happen in days, but in weeks, months, and sometimes years. Take it slow, and celebrate the small victories. Sorry to be the bringer of bad news here, but your recovery is probably going to take a long time. But hey, you survided an avalanche.
Don’t worry, most of the stupid things I do are a consequence of the stupid ideas in my own head. This squat thing was no exception :). Thanks for the tips! I have worked with my knees and ankles every day, and it has actually paid off already – I am now able to bend my titan leg almost as far as I could before the surgery. Wohoo!
But I know it will take time to get back to where I was before, a long, long time, and that it will take hard work. I’m sure I will get frustrated along the way. I guess that is why I focus on the days. Thinking about some small progress I did during the day makes me feel like I’m moving forward, even though I’m doing it in snail speed. Just like you say, thinking about the small victories makes me happy, and motivates me to keep up the good work.