Monday, February 24, 2014

(Weird) MRI Results

No one is good at waiting. I don't think I am especially impatient, but I am certainly not Zen about it. Waiting for two weeks to find out the extent of  my knee injury has  been exceptionally unfun.

There was just so much time for predicting what the MRI would say. Every new bruise that appeared, each new 'tweak' I felt, any glimmer of modest healing gave rise to another cockamamie idea of what I had done to myself. From "I'm just a wuss and it's fine, really, if I'd just put on my Big Girl pants" to "I will need a total knee replacement... and possibly a liver and transplant."

Following each theory, of course, comes recovery scenarios from A - Z: "I'll be running again in March" to "I'll be one of those people on the Scooter at WalMart any day now."

Okay, even I'm not prone to THAT extreme thinking, but you get the idea.....
I sported this shirt, just in case the Doctor was not clear on my objective.
FINALLY, this morning, I got to see Dr. Barton, the orthopedic surgeon. This story starts pretty bleak, but stick with me....

As I sat and waited, I made an outline of information I needed filled in. The paper I was using had a fancy-fonted "HOPE" written at the top. I deliberately chose it because it is my mom's name and because it was what I was clinging to. I traced over the word hundreds and hundreds of times in the waiting room. The fancy HOPE slowly de-volved into a sloppy HOPE as my mannish handwriting covered up the curlicues.

I was teary, literally, waiting and waiting and waiting to be seen. To be fair, he wasn't really that late. I was a bit early and he was about 10 minutes behind. It felt like a century.

When I got into the exam room for more waiting, I sat on the table and did crunches and V-seats and leg lifts and any other strength training moves I could think of. Had to feel like this waiting had some purpose, other than making me weepy.

When he walked in he immediately asked if I had been made aware of the results. I think I earned a gold star for not screaming "NOOOOOO! I HAVE NOT! I HAVE BEEN WAITING FOR YOU!!" Instead, I (relatively) calmly informed him that his office said I needed to wait for my appointment. He was horrified how long I had had to wait and apologized, saying he could tell that I wanted to get things in motion. The results of the MRI were, to put it mildly, not what I wanted to hear:

ACL: Grade 3 (complete) tear
MCL: Grade 3 (complete) tear
Meniscus: no damage

While it's true, it could have been worse, this was bad, bad, BAD news. I have experience with ACL repair surgery, as you may recall, and it was so very hard. And I was so very much younger then..... So, I took this information badly. Very badly, in fact. I laid back on the exam table, not hiding my crying, and said, "Shit. This is horrible. This is the worst news.... (Deep breath). Okay. I want the surgery tomorrow."

It will not shock you to learn that, in fact, I am not having surgery tomorrow....

Dr. Barton reminded me that not all ACL tears require surgery. (And I thought, "Yeah, but I am an ATHLETE. I want the repair!") He said that too many people rush into surgery after something like this and it might not be necessary. ("Right. For geriatrics who only want to shuffle to the mailbox and their bird feeders everyday....") He said even if surgery was the right course of action, he would not touch my knee until the range of motion had vastly improved. (I cannot quite straighten it and can only bend it a tiny bit beyond 90 degrees.) His reasoning, irksomely solid, is that operating on a knee with poor range of motion means that knee will pretty much always have poor range of motion. To go under the knife I will need to be able to go from 0 - 140 degrees flexion.

He then proceeded to do a clinical exam of both of my knees, and this is where things got more interesting and HOPEFUL. He thinks that my knee has healed vastly since my exam by Tim O'Brien a week and half ago and since the MRI five days ago. He thinks, in fact, that I do NOT have a complete tear of the ACL and MCL. His manipulating of the knee leads him to believe that a better guess would  be a grade 1 tear to each of these. There is, he believes, some tissue connecting all the parts together.

I still don't fully understand how the 'picture proof' of an MRI can be wrong. If it's torn, it's torn, right? And I asked him that. But he said something I will never forget:

"I don't treat MRIs. I treat patients."

Well, that works out pretty well, seeing as I am a patient and not an MRI. I like this doctor.

And that's when I remembered the info about the meniscus. "And, not having meniscus damage is really important for a runner, right?" He agreed. A meniscus problem is far worse than ACL or MCL strains and sprains when it comes to running. Okay. Breathing.

Whatever the future decision about surgery is, I need to get into PT quickly, improve my range of motion,and maintain some semblance of strength. I asked specifically for Kevin at Action Sports, the PT I used for a knee overuse injury last spring, and he said "That's perfect. That's who I would want for you." Another big "Yes!" moment. The doctor made the call and the appointment is set for 9:45 tomorrow morning. (Blessedly, this is February Vacation week for us, so making these appointments is not too much of a problem.... come next week it may get dicey.)

Better notes than I took at any of my appointments with my Midwife.
(Well, after kid #1, anyway)
I don't know what I really thought I was going to hear today. I guess I should not be surprised that I am still, somewhat, in no-runner's-land as far as surgery is concerned. I am feeling very confident about the medical professionals who are advising me, exceptionally thrilled with my PT "handler", and -once again - very lucky to be surrounded by people who are supporting me in this. Thank you.


Yup. He totally signed my tights.


  1. What a journey, Phoebe.. hugs, prayers and much HOPE right along with you.
    It's the SLOW part that's so hard.... but you WILL get there!

  2. Oy, that's heavy. I once thought I had a meniscus tear but thank goodness it was not. I wish you a quick recovery but most important clarity for the right decision about what to do.

  3. You are my hero and you shall overcome - WHATEVER it may be. Carol

  4. Sniff! When the med professionals are on your team, you got it! Yay!!
    Off to ask my ACL tear researcher what he thinks about all this!

  5. Hi Phoebe -- came to your blog from the AMR Challenge page, and following and hoping for the best for you! Just wanted to share my two bits from my ACL injury a while back. My experience and circumstances might be totally different, and I am absolutely no medical expert, but I know how it's always interesting to hear similar stories, so for what it's worth ... I tore my ACL playing tennis about 10 years ago. I don't remember the term (grade X) but it was just completely gone from the MRI. I was on vacation at the time, and, like you, completely frustrated that I couldn't find out answers IMMEDIATELY. Once back home, trying to schedule the MRI, they actually wanted to wait until the swelling was completely gone because they said they can see things better that way (sorry -- should've posted about that while you were waiting!). Anyway, I was completely surprised also that just NOT having surgery ever was an option -- that there are completely normal, active people walking around without ACLs! I remember my doctor saying that it would come into play if you were really doing something that involved lots of side-to-side action, and then there was just the chance that the knee could give out (couldn't really make it worse), but that "average" people might be just fine without. I opted for surgery, but waited quite a while. I tore it in July, and didn't do surgery until Dec. During that time, I wasn't doing anything OVERLY athletic, but did see a personal trainer (not even "medical" just a trainer at the gym who was knowledgeable etc). I also trained and participated in a 60-mile charity walk, no problem. I golfed. I did avoid radical side-to-side stuff, and I wasn't a runner at the time, so I can't speak to that, but if it didn't involve twisting, it was fair game. Long story short, my surgery went great. I can tell this knee is better/faster/stronger (cue the 6 million dollar man anthem!) than my other "regular" knee. Given the circumstances, it sounds like you have everything going for you -- great doctor, great attitude. I will be sending good vibes your way!