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Here is the long-awaited surgery update, for the two or three of you who were keeping track at home.

After seeing the ankle doc today, everything was made sort-of official: I'm going to have knee AND ankle surgery sometime in the next few months. My knee doc wants to do a cartilage transplant because I have a hole in my knee cartilage. The hole is behind my kneecap, so when I do anything that requires my knee to be bent around 90 degrees or so (like climbing stairs, or sitting/sleeping comfortably), I feel a lot of pressure and pain back there. The doc wants to fill in the hole with donor tissue, which would hopefully bring the cartilage surface back to a somewhat normal state.

While he's in there, he wants to do a meniscus transplant, because most of my meniscus on one side of the knee has had to be trimmed away. A quick (and hopefully somewhat accurate) anatomy lesson: the meniscus in the knee acts as padding between the leg bones, and it absorbs shock. When the meniscus gets torn, the easiest way to "fix" it is to trim away the injured part. The tissue doesn't have very good blood supply, so it usually can't heal on its own. After it's been trimmed, though, it's usually somewhat protected from further injury. Unfortunately, if you've had a large portion of the tissue trimmed, you're left without much padding in that spot, and it's susceptible to more injury. That's the situation I'm in now with my meniscus. There are some new-ish techniques to put some new padding in there, including a meniscus transplant. This is sort of like the cartilage procedure - my doc would put cadaver tissue in that spot and, if all goes well, it'll become my new meniscus.

As I mentioned, I saw my new ankle doc today (my last one moved away, so I was referred to this doc). Though my ankle surgery last year seemed to help, I still have a lot of pain and stiffness in the joint. Last year's surgery was done to address a cartilage hole, similar to the issue I'm having with my knee. During surgery, my doc poked some holes in the surrounding tissue in the hopes that scar tissue would fill in that spot and make a new cartilage-like surface. According to my new doc, it looks on the diagnostic images like the surgery helped, but there are still holes in the cartilage. The next option is to do the same thing that I'm having done in the knee - have donor tissue put in there to fill in the hole. Interestingly, the doc also noticed something that my other doctors haven't mentioned - I have some bone chips in the joint. My doc pushed on two specific spots, asked if they were tender (yes), and showed me on the MRI images that there are bone chips resting in those spots. That makes a lot of sense. I guess that "crunchy" feeling wasn't just the arthritis. During surgery, he should be able to clean up those areas.

So those are the three procedures that need to be done. They need to be done all at once, because the doctors would be using the same donor tissue, and the tissue has a short "shelf life". The surgery will probably help alleviate a lot of pain, but there's no guarantee that it will. If I don't have the surgery, though, my knee and ankle are not going to just feel better on their own. The tissue would continue to degenerate, and eventually I would need the joints replaced. I'll probably need the joints replaced even if I do have this surgery done, but it won't need to happen so soon.

I've had some fairly big surgeries so far, but this one will be major in comparison to the others. Rehab is going to take a very long time, and some of my academic work may end up being put on hold for a bit. I'm so frustrated that I need to go through this again. I don't think words can express how sick I am of having surgery. I'm lucky to be doing as well as I am despite the severity of my injuries, but seriously, I wish I could just take a break from it all.

Anyway. It's 10/16 again. Where did four years go? I wish I had something eloquent to say about it, but I really don't. Instead, I'll just say this: I miss them, and it isn't fair.

I'm thinking of everyone else who's having a hard day today. Hope you get through it and are able to remember all the good times. :)

more of the same

I need to have another surgery. I'm still mulling over what my doc said, and I'm waiting to meet with two other doctors to hear their opinions. When I have all the info, I'll post a longer entry. I will say this, though: while I was expecting that I'd need further surgery at some point, I didn't expect it would have to be so soon. And so extensive. To say I'm unhappy about it would be an understatement.

My balcony, on the other hand, makes me happy.

we are all on drugs

Last month, I went to see a pain management doc to help me figure out a tenable long-term plan for dealing with my chronic ankle & knee pain. My knee doc suggested I see this doc, and I thought it might not be a bad idea. I'm so tired of being in pain all the time. The pain doc had quite a few treatment suggestions, most of which I hadn't tried yet.

My new drug regimen consists of taking a muscle relaxant nightly, taking a nerve pain medication three times a day, using a topical medicated gel four times a day, and still using narcotics as needed. As you can probably expect, I'm feeling pretty drugged up. All of these medications (with the exception of the gel) cause drowsiness and dizziness. The muscle relaxants and the nerve medication have taken some time to get used to. The muscle relaxants pretty much turn me into a zombie. The nerve medication is really strange. It basically makes me feel like I have restless leg syndrome, but in my shoulders. It also tends to make me feel a little spacey. My doctor had me take one a day for a week, then two, and now I'm up to three, so my body has had time to adjust.

I'm glad I went to see the pain doc over the summer, so I have time to get used to the new medications. I'm worried, though, that I won't get over the spaciness/dizziness before school starts next month. I've been taking narcotic painkillers regularly since the accident, which has always made me feel like I'm at a disadvantage compared to the other people in my classes since I'm in a fog all the time. When I speak up during seminars, I tend to feel like everything I'm saying is complete drivel, and then I get self-conscious about it, and I lose my train of thought. I have trouble concentrating on articles I have to read and on class discussions. Teaching is hard, too, because I always have to be on top of everything. But it's not like I can just ask grad school to take it easy on me because I'm on drugs, so I just buck up and deal with it. I can't imagine the spaciness is going to be any better now that I'm on additional medications. The new drugs do seem to be helping, so I don't want to make any changes right now. It's kind of catch-22 because I have a lot of trouble concentrating on school when I'm in pain, but the pain meds also make it hard to concentrate. C'est la vie. At least when I'm on the meds, the pain isn't quite as bad.

Anyway, life otherwise has been pretty good. August has been very busy. AV and I moved into an awesome new apartment. We were living in a house that was too big for just the two of us, so we downsized to a place that suits us better. The new place doesn't have much storage space, so unpacking has been an interesting challenge, but we'll get it sorted out. The view & location make up for the lack of storage.

After moving, two of my good friends from back home came to visit. It was really fun showing them around the city. Then I had a relaxing week-long trip back home. See Facebook for photos...

Here's one from my apartment:

been a while since i rapped at ya

(Jim Anchower, anyone?)

Not sure if anyone still reads this, but whatev.

So... like most students, I'm searching for a summer job, and having a tough time finding any work in our current economic state. Due to my ankle & knee problems, I'm restricting my job search to office work or anything else that doesn't require me to spend much time on my feet. Unfortunately, I have no experience working in an office. All of my high school and college jobs involved retail sales and customer service. I have most of the skills required to work in an office, and I'm sure I could pick up the rest quickly, but that doesn't matter. My BA and the work I've done toward my MA also don't matter. With so many people searching for jobs right now, my resume is quickly passed over in favor of applicants with experience.

After applying to dozens of jobs in the past month, I finally got an interview today. The interview was for a "greeter" job at a fitness club. This is a position for which I'm qualified: I have years of experience in customer service, and I know quite a bit about gyms. I think I could handle this. The interview went well, and I was pretty sure I would be considered for the job, until it came to the part where I ask questions. I mentioned that when I walked in, I noticed the greeter was standing up behind the desk. I told the interviewers that I have a bad knee and ankle, and asked whether I'd be able to sit while working. They said no, that this is a job that needs to be done while standing. I asked whether accommodations could be made in my case, such as having a stool behind the front desk so I could sit for a few minutes here and there. They mumbled "maybe", but by that point, something had changed in their demeanor. They were slightly cold to me then, and gave me the "don't call us, we'll call you" schtick and saw me out the door.

Assuming I won't get the call, I'm back to the drawing board, and incredibly frustrated. I finally got an interview for a job that I thought I could do, but as it turns out, I can't because of my ankle and knee.

I find that it's hard to explain to people how I'm feeling and why it limits me. Perhaps there were different magic words that I could have said - words that would have made the interviewers understand that this really is an issue, not just an unwillingness on my part to be a hard worker. I think I'm kind of in this no man's land between being able-bodied and being visibly disabled. Everyone likes to think of themselves as being sensitive to people with disabilities. We open doors for people in wheelchairs, or carry things for people who use canes, etc. People don't seem to realize, though, that not every disability is obvious. If you're not visibly disabled, you're assumed to be able-bodied, and you're expected to work hard. Our society values people who pull themselves up by their bootstraps, and wait tables to work their way through med school or whatever. Nobody wants to listen to a co-worker (or an interviewee, for that matter) say they can't stand for long periods of time because they have a bum knee/ankle. Everyone has a bum knee, right? How do I explain this is different? Instead of saying "I can't stand for long periods of time because I have a bad knee and ankle," I could say: "I can't stand for long periods of time because I was in a bad accident and had nine surgeries and I still go to physical therapy regularly and I take painkillers every day." But I don't want to, and I shouldn't have to. Or maybe I do have to. I don't know.

Anyway, rant over. I have an appointment in a couple of weeks with a pain management doc, so hopefully that will help me to deal with things from a different perspective. As far as the summer job search goes, hopefully I'll find something soon, and then the summer will be over and it won't matter anymore (until next summer). For the school year, I'm lucky enough to have funding, which is really exciting. I'll be teaching intro music theory courses to freshmen (or maybe sophomores, I haven't heard yet). I had a lot of fun when I was a TA a couple of quarters ago.

I suppose things have happened since I last posted. I traveled a lot last quarter and I'm continuing to recover from the knee surgery. Haven't finished my MA yet, but hopefully by December. Danley got married in June - photos on Facebook. AV and I are thinking about moving to a smaller place, maybe downtown, maybe with a view! We'll see.

Okay, gotta go.

okay, it's been a while

I think I mentioned in my last couple of posts that my knee had been acting up. Well, that flare-up never really ended, and it got to the point where the pain was keeping me up at night. My doc tried a series of injections with a drug meant to lubricate the joint, but that didn't seem to help. My knee actually began popping more frequently (and painfully) after the injections. After exhausting all my other options, I ended up having surgery.

It's been three days since the surgery, and it's not feeling too bad right now. I can even walk on it already. My doc has prescribed a very aggressive rehab schedule - 8-12 hours a day on a CPM (or, as I call it, the leg-bendy machine), physical therapy 5 days a week (starting tomorrow), and 30 mins/day on the exercise bike (also starting tomorrow). My doc fixes up all the Seahawks, so I guess I shouldn't be surprised that he expects his patients to spend lots of time doing rehab.

Prior to surgery, my doc wasn't totally sure what he would see in my joint. The affected area was mostly behind my kneecap, which is a notoriously difficult area to see on MRIs and X-rays. During surgery, my doc found the cartilage behind my kneecap to have a few tears, which he expected. He smoothed it out, but evidently he had to walk a thin line - he didn't want to trim away too much, because I'm running a little low on healthy cartilage at this point. He also found and trimmed a few minor meniscus tears (on both sides of the knee, if I understood him correctly). The biggest problem he found was a layer of unhealthy tissue over the hole on the bottom of my femur where the rod went in (to fix my femur fracture). I had the rod removed back in 2006, but the hole never healed properly. The tissue that had formed was covering just the bottom of the bone. It was really soft and started flaking away when the doc touched it. Left to its own devices, the tissue would probably flake off into the joint (and it might have started doing that already). The doc cleaned out the bad tissue and had to make a quick decision to plug the bone with a cadaver bone graft. Luckily the plug went in a part of the bone that doesn't bear weight, so like I said, I can walk on it already.

So anyway, that was surgery. One of my physical therapists observed the surgery, which is pretty cool. I haven't talked to her yet, but I'm sure she'll have lots to tell me.

My parents and one of my uncles came for a few days to help me out. We went to the Mariners game the night before my surgery (minus my uncle, who hadn't arrived yet). The Mariners actually won! And we saw Ken Griffey, Jr. hit his 400th home run with the Mariners. Pretty sweet.

Everyone left this morning, and now it's back to school. I have a weird schedule this quarter. I just realized week four of the quarter starts tomorrow, which means the quarter is almost half done already. I'm in one seminar and in percussion ensemble, and I'm taking thesis credits. I only have to be on campus two days a week, at most. I missed a rehearsal due to surgery, and I'll probably miss the one this week, but I won't miss any seminar meetings. I'm not sure if I'll be able to finish my thesis stuff by the end of the quarter, so I might not finish my masters until December. That's not really a big deal, since I'm planning on staying at UW for my PhD. It would be nice to get everything wrapped up soon, but right now rehab is more important.

Since I'm finally writing on here, I should post some Cabo photos. I went on vacation a couple weeks ago with the boyfriend, his family, and some friends. Here are some photos (the rest are on Facebook). :)

two posts in four days? what?

Time for a shameless plug: I just finished working on my new website and launched it. Now I feel like I accomplished something over winter break. Check it out: http://www.amybowen.net

I started a new post for the shameless plug, but I suppose I might as well write a little more as long as I'm here. I just started teaching today. I'm teaching first-year sight singing on Tuesdays and dictation on Thursdays. There are two other TAs for the class - they both teach written and aural theory, but I just have a bunch of sections of aural theory.

It's kind of weird to be a TA for a class that I took with a prof when I was an undergrad. UWEC didn't seem to have many TAs, since they don't have many graduate departments. I only encountered TAs in some of the bigger departments (like history). They were usually undergrads also, and they only led study sessions. At UW, the professor teaches one big section of written theory, and then the prof and the TAs all teach smaller sections of written & aural theory. The students have class with the prof once a week and with the TAs all the other days. It's a lot different than what I'm used to, but after three hours of teaching this morning, I think I'm getting the hang of it. I'm also losing my voice. Three straight hours of teaching and singing is a little rough on the voice.

I might post again after my knee doc appointment tomorrow. I have free time this week, which is kind of weird, but that will change soon...

P.S. I added a couple new links over there. ----------------------->

kicking around on a piece of ground in your home town

I got back to Seattle today, and other than the garbage cans on my curb that have not been picked up in three weeks, the snow storms of a couple weeks ago have been all but forgotten. Well, except for everyone pressuring the city to buy more snowplows, and the battles between everyone and the environmentalists about road salt, but those are stories for another day. Or not...

For now, let me back up a little. Amidst the blur of a week that ended last quarter and consisted of lots of Christmas shopping and packing, I had a follow-up appointment with my ankle doc. I was glad to have a chance to talk to him about the slow rate of progress I'd been experiencing. I wanted to ask him if this recovery rate was normal, and if I should be more aggressive with my transition from the aircast to shoes. The last time I'd seen him, he said I would probably be wearing regular shoes and driving within three or four weeks from that appointment. I figured it would be even quicker than that since I tend to push myself when it comes to recovery. My recent appointment was about seven weeks after the last appointment, and I was still wearing my boot most of the time. I'm still not driving. The doc reminded me that this was a big surgery, and I have other stuff going on in my ankle (like arthritis) that makes it difficult for me to recover quickly. In response to my question of whether or not I should be more aggressive, his answer was simply, "Not at all." He said that if I'm too aggressive, I run the risk of preventing my ankle from recovering fully from the surgery.

While I was there, I asked him whether he thought I should have my knee looked at by my knee doc. It's been giving me a lot of problems lately. It's painful, but the biggest issue is an increased feeling of instability. Also, my knee makes some new sounds when I bend it and straighten it. It's pretty loud when I'm going up and down stairs. It pops sometimes while I'm walking, which isn't usually painful, but it's uncomfortable. My doc took a look at it and said I should definitely follow up with my knee doc. I have an appointment to see the knee doc on the 7th. You know, in my spare time.

I think I'm starting to recover a little more quickly since that appointment (which was only a couple of weeks ago). I must have been at a plateau, and now I think I'm moving past that. It's a little more comfortable to walk with shoes, though I'm still walking really slowly and I've got a limp. It still hurts and I'm still taking pain meds regularly. My doc had said that it's probably going to hurt for a while yet, and I should listen to what my ankle's telling me. It still hurts more than it did before the surgery, but I'm finding that the pain is much more predictable than before. It's much easier to manage the pain when I know the routine - in the morning, I can't wear regular shoes until after my first pain med has kicked in. If I'm on my feet a lot, my ankle is going to hurt more. If my ankle hurts more than usual, it needs rest. etc.

Now that I'm making more progress as far as walking in shoes, I'm hoping I can start driving again soon. At this point, I've been unable to drive for longer than I was after the accident. I was on the road again four months after the accident, which is kind of incredible when I think about it. Now I'm four months out from the last surgery, and still waiting. If I were living in WI still I might be more eager to jump behind the wheel again. It's tricky here because traffic is so heavy, and if my ankle starts to cramp up while I'm stuck in traffic, my options for dealing with it are kind of limited. It helps that it's so easy to get around here by bus (as long as there's no snow in the forecast). I'm not so antsy to start driving again because I can already get pretty much everywhere I need to go. It will be nice, though, to be able to drive to physical therapy and back. I spend so much time busing there - from the time I leave my house for an appointment to the time I get home, it's usually about four hours. This quarter's schedule is going to be pretty busy, so it's going to be hard to squeeze in eight hours of PT and travel time per week.

Speaking of next quarter, it starts on Monday. That's too early. I wish I had another week of break so I can shake off the jet lag and get ready for teaching. I'm a little nervous about teaching, since this is my first quarter as a TA. I'll be teaching everyone's favorite class - sight-singing & dictation (or aural theory, if you're used to the UWEC lexicon, like me). It's exciting, but I also feel like I haven't had a lot of training or prep or anything. It's strange for a TA to begin teaching in the winter quarter, as opposed to the fall. I think everyone sort of assumes all the TAs know the drill already. There are some workshops and orientation sessions for new TAs in the beginning of the year that everyone conveniently forgot to tell me about. I seem to have fallen through the cracks since I'm starting in the winter. Oh well, I'm sure I'll catch on after the first week or so.

Anyway, break was nice. It was a little quiet, but I suppose that's a good respite from school. I went down to Illinois for the weekend to see the family, have jam sessions, and eat food (mmm, Chicago-style pizza). When I got back to WI, I spent the rest of the time hanging out at home and seeing people whenever I could. It was fun.

I guess that's about all. I got a Wii for Christmas, which is really awesome, so I'll probably get in touch with you other Wii users when I figure out the whole online thing. :)