Home Alone

This week has been weird. I'm home alone, minding the "children" (ie: the cat and dog... who are acting like little brats. Apparently, they do that when my mom is gone). It's strange being in the house alone. I don't think I like it.

Studying... is going...

I start work on Monday at Children's. I'm pumped about that. Need to get off my butt.

Speaking of... Met with the Trainer on Friday. He kicked my ass. Full out, on the ground, thought I was going to faint or hurl, butt-kicking. I can run 10k, but I'm out of shape. So I chugged some water, sucked it up, and finished out the hour. I haven't been in this much post-workout pain since the suicide practice in high school basketball (our coach was pissed at us missing our free-throws during a game and he told us that we'd have to run a suicide for every one we missed in the second half... Our point guard had an off day. My shots weren't dropping either. And we had 45 minutes straight of suicides... Resulted in one girl with a strained hammy, 2 people puked, and I didn't want to move the next day... So SORE!) Anyway. I said "please sir, can I have some more." I have another round with the trainer in 2 weeks, and I fully intend to have it go much better (and I plan on having breakfast before I go to train). The yoga is going really well too... kicked my butt yesterday, but it was HOT in the studio.

I've also been icing my knee. It seems to be helping the pain issue. Not fully fixing the clicking, but I can deal with that if I'm pain free. So... only other thing to add is the final Summer Soundtrack for 2009. It's more chill than my recent stuff, but that's because I'm not running. Workout music tends to drive things a bit faster on my itunes. Studying slows it down. But... it's great music.

Summer Soundtrack 2009:

1. Paralyzer - Finger Eleven
2. Morning Nightcap - Lunasa
3. Fireflies - Owl City
4. Next in Line - Meese
5. Show Me What I'm Looking For - Carolina Liar
6. Look After You - The Fray
7. Somewhere Only We Know - Keane
8. Sweet and Low - Augustana
9. Say When - The Fray
10. This Town - O.A.R
11. Crack the Shutters - Snow Patrol
12. First Time - Lifehouse
13. Say Hey - Michael Franti
14. Say - John Mayer
15. Time to Go - Keane
    

The low down on the knee

So... Knee problem - not fixed, but in repair. Here's the blow-by-blow of the past 2 weeks. Please disregard my sarcasm. I'm a horrible and ungrateful patient.

1) After the MRI was reported, I got a call from my Ortho. He tells me the MRI is "clean" except for "beginning chondromalacia" and I'm welcome to run if I want and it doesn't hurt. Maybe some physio to make the clicking go away.

So... his job is done and I never need to see him again. Pro: No surgery. Surgery is a bad thing, right? Con: This doesn't explain the pain pattern (being quite consistent with a medial meniscus tear) or the fact that he could pop my meniscus back and forth during exam (something he ignored when we spoke about the MRI)

2) I schedule an appointment for physio therapy and make a call to get my own copy of the MRI (you know, just in case something happens when I'm in Dublin... then I'll have a baseline, right).

MRI Report (gist): Changes of chondromalacia along mid patellar apex and medial and lateral patellar facets, surface irregularity and tiny shallow chondral fissures (no instability). Small knee joint effusion with mild synovitis [NB: no mention of this in the phone call?]. No evidence of meniscal tear.

... Ok, so this still doesn't explain the pain. Does explain the clicking and grinding and small swelling.

3) Went to physio today. I like the woman I'm working with. She's sound. Her assessment is that the chondromalacia and pain is a byproduct of running a lot (well... duh), the injury to my left foot, and my built-in body mechanics. Apparently I have ridiculously high arches in my feet (this I knew, but it's surprising to other people). But those in conjunction with little to no internal rotation from my R hip (it's like 10* on the R and 25* on the L) and the bigger sacrolumbral lordosis... This stresses the knee.

She agrees that the pain and the instability I've had is a meniscal problem, and w/dye injection, it could be picked up on scan... but I'm not sure I'm willing to risk my kidneys and knee to confirm what we already know (plus, there's be little change to management) - that I have damage to my medial meniscus that's not a full blown tear (yet).

So... new plan... I'm working with a trainer tomorrow at the gym to put together a lifting/cardio routine (must emphasize glutes/core/hamstrings). I have a series of stability exercises I'll be doing to help with the hip and chondromalacia bit. I'll keep doing alternate yoga - gym days (for my own sanity). And I'll not be running...

I dunno how long I'll be able to keep off running. I miss it, even if I'm doing other things to stay in shape. But... BUT if the pain goes away (for a consistent amount of time), a little light running should be ok. I interpret this as no races or running-training until after new years at the ABSOLUTE earliest. I dunno if I'll train for something in 2010, but the option is there. Running once or twice a week over "short" distances (which I feel is about 3 miles) when I'm back in Dublin (provided I'm pain free) is ok. And I'll need to find a yoga studio in Dublin. Any suggestions?

I have two more scheduled physio appts in August to add to the stability exercises and make sure I'm actually doing it right (cause let's face it, I'll probably cheat). I can add another before heading back to Dublin if I want, wait and do one when I'm home in Oct for the wedding, wait till I'm home for Christmas, or just not go back... We'll see. But I do like my Physio, so it won't be because of a personality clash.

So... that's the story. Chondromalacia + effusion + synovitis + meniscal damage (but no discrete tear). ... so no Dublin Marathon 2009 :(

C'est la vie.

Head - Shoulders - EFF!

Let's play a game called "What's wrong with Liz's knee?"

a) chondromalacia
b) medial meniscus tear
c) lateral meniscus tear
d) all/more than one of the above...

[initial ortho asseessment done, MRI done... vote now!]

I'll give you a bit of background if you want to play with more detail than is possible on fb status updates.
1 - We're talking about my right knee.
2 - Yes, I've run 2 marathons, including the Dublin marathon back in October. I ran the Flora 10k June 1st and that's the last time I've been out for a run. (I may or may not have been injured following my left foot getting clipped by a cab about 2 weeks prior)
3 - There was never any specific trauma to the knee. BUT, I have played basketball for about 17 years, been running for about 15 years, played tennis for nearly 20 years, and was a catcher in softball for a number of years as well.
4 - My knee makes lovely crepitations (you can hear and feel - mostly just behind the patella) whenever I extend it, and it is loud enough to be heard going up AND down stairs over the sound of flip-flops.
5 - Pain is a transient thing, but it's mostly achy, about 3 hours post run, or after 3 days without running... Or for the past 4 days straight. It's both medial and lateral along the joint margins, and it's tender over my lateral and medial meniscus.
6 - Apparently, that little moving/popping thing all the way on the inside of my knee... That's my medial meniscus (as according to the ortho)

Other things I'll tell you: It was brilliant that on my first week back in the States, I was able to book an appointment with an orthopedic knee surgeon, have said appointment, book an MRI and have said MRI. I'll probably get the results tomorrow (Monday), about 2 business days following the procedure.

We'll see what the results are. Updates to follow.

Bit more from Donegal

On Travelling

First off, I'm no longer in my flat in Ranelagh (not now, not in the fall). I have moved! So if you need that new address, let me know.

I actually spent last week bouncing between 5 different places: Ranelagh, the new flat, the flat in Mullingar, Donegal with Sinead, and IFSC with Deter. Now... it's home in MN for the next 2 months. I don't like living in a bunch of different places at the same time (I've decided it's quite stressful), so I'm going to avoid that in the near future. But on the up side, I had some fun times travelling!So first stop: Donegal! After about 5 hours in a car to get there, a heaping pile of food from Lidl, and two bright pairs of leg-warmers... Ridiculousness ensued.

(I got stuck in a bog)

(We took over a castle)
(We ate a whole cow)

All in all, great times! Thanks Sinead... And to our credit, we did find Bloody Foreland eventually.

No sooner was I back in Mullingar when I had to pack up and move on out of the flat up there to head back to Dublin... And move out of my flat in Dublin. Big mega thanks to Deter for helping me move all my shmaz and Jim for letting me litter his room. Because ND is doing work on the O'Connell house flats over the summer, my stuff is split between Jim's room and the sacristy (It's weird to leave your stuff in a sacristy). Deter and I had a slumber party the last night in town (again, thanks for tolerating me).

I woke up around 4:30am to pane shaking thunder. I was 100% confused (not being in my own room, thunder and lightning in Dublin... what gives?!). It was the start to a very long day of travel. It continued to rain all morning, so I did have to walk across the tarmac in a white tee-shirt in order to board my plane home. Clearly, there was a delay and I was a bit strapped for time when I reached Chicago. I hit the ground running and managed to just make my flight to MSP. I love getting into the MSP airport. It's like once I'm there, I don't care if my luggage shows up or if the weather is crappy... I'm home.

We had a family dinner (minus Joe, plus Kirsten). Totally the best thing ever. I was nearly asleep at the table by the time we had dessert, but I couldn't care less. I love my family.

Last night (being the 4th), we went to the club for dinner and fireworks. We've been going there for over 20 years and I can't remember ever being rained out. It's brilliant.

So... It's good to be home. Time to get cracking on the work that's piled up lately. And for the time being, you can find me in Minnesota (and can reach me on my MN cell or my Dublin mobile).

~L