Ragemaster

Yesterday, as I went to the laundry room to put my clothes in the dryer, I went down a small staircase.  Since I still have issues going down stairs, I made a conscious effort to descend properly and use my left leg.  When I got to the bottom I continued towards the laundry room, I noticed something felt weird in my leg.  I looked down as I walked and noticed that with each step that it was bending the way it was supposed to.  Bam -- just like that I went from limping everywhere to walking normally.  It was completely involuntary.  Before the staircase I was still walking straight-legged and afterwards I was normal.

Since then I've been almost completely normal walking everywhere.  A few times when I start walking I notice that I'm goosestepping again, but now I know what it feels like to walk normally so I quickly change my gait.

I have a feeling that this process is similar to what Dilbert creator Scott Adams went through with his vocal disorder.  Though I would argue losing your voice in certain situations would be much worse than limping, the "remapping" of an area of your brain happened more or less involuntarily.  Adams figured out he could get his voice back by rhyming and once he knew what it felt like to talk normally, he could speak much more easily.  Now that I know what it feels like to bend my knee when walking, I can do it on a whim instead of trying to force it and look even weirder than with the limp.

Tomorrow I get to try the regular stationary bike instead of the recumbent one.  Range of motion hasn't been an issue for awhile, but I still can't bend my leg all the way back without it getting really tight.  I can get to almost 150 degrees.

I notice that I'm starting to do things more normally, like bringing my leg up to tie my shoes instead of awkwardly leaning down to do it.  Going up stairs is fine, but I still have that initial worry when I go down them.  In Raleigh, just about everyone asked me about why I was limping, so I definitely have more progress to make in terms of walking normally.

At PT they are adding in more rigorous exercises for my hamstrings and quads and increasing the weight each time.  My leg looks like it is getting better, but it still is pretty small.  Every day I still do my normal free weight routine in the morning and do almost 30 minutes on the bike and elliptical later.  I've been adding a couple minutes a week to the elliptical/bike routine and it seems to be getting easier.  The bike doesn't hurt my quads as much but it still leaves me more sore after 15 minutes than I would have been before the surgery.  I figure about Thanksgiving I can move to the resistance trainer for my road bike and soon after I'll have enough stamina and leg strength to hit the roads for real.  The only problem with the road bike is my habit of crashing into the injured body part, making it worse.  I really don't want that.

It's interesting to watch the progress of everyone else at PT.  A lot of people have had knee replacements or surgery on their knees and appear to be going through a similar rehab process as me.  Today there was someone I hadn't seen before on crutches and was using the same passive range of motion machine that I had used for the first couple weeks.  It made me think how far I've come and how that guy will go through all the stuff that I've done and eventually be walking again.  A girl that's been in there a lot when I'm in there went from not doing anything to using the stair climber and elliptical, and is now doing the walk/jog on the treadmill.  A lot of the older patients with knee replacements I see gradually do more on the bike, but haven't done the elliptical or the stair climber.  The physical therapist probably tries to match their rehab with their ultimate recovery goals.  Running probably isn't something you can do on a knee replacement.

At this point I think I could just do most of the machines and exercises on my own in the rec center after biking or the elliptical.  However, I would need some guidance as to when to try the road bike and start running again.  From those that have made it back running successfully, they seem to start back at four months at the earliest and usually five months or more after the microfracture.  I could go off that.  I do know that I'll have to do the old walk/jog routine and probably wouldn't do it every day either.  I would also have to get some idea of how far I could work up to runningwise until it would be considered risky.  These are all things to keep in mind as I progress, but I still have a lot of time left before I get to them.

Halfway to running?  Another ten weeks and maybe I can try.

Today at the PT, one of the assistants put me on the treadmill and said I should go as fast as I can -- even run.  I guess he doesn't really understand what I've got, especially since the doctor was adamant about me not running.

The daily increase in weights and the addition of the stairmaster, leg curls, and leg extensions have started to help my strength.  As usual, though, my leg doesn't look any bigger.  I still have a limp when I'm walking since it seems that I've reprogrammed the walking part of my brain to compensate for the brace.  Now I've got to unlearn that.  Walking back from the office today, I made a conscious effort to bring my leg up bent, almost marching to try to get rid of the limp.  I felt better doing that but it still isn't anywhere near natural.

Stairs have gotten better and I have a hard time believing that I can go up and down them without pain.  When I see stairs, I see fear.  It takes a lot of courage for me to go down them using my left leg.  Up isn't so bad, but going down, before the surgery, was when I had all the problems.  It seems to be a huge improvement.

Over the weekend I was heading towards campus when I passed a group of law students.  One of them was talking about her knee and how she had been running on it for months with it bothering her.  It turned out it was a torn meniscus.  It sounded a lot like what happened to me, before the surgery, but tearing the meniscus has a two week recovery time from the surgery.  You can walk out of the surgery and go right back to running after a few weeks without any serious problems.  With knee injuries on the brain, I pick up all kinds of stuff about people getting hurt that I wouldn't have even thought of a year ago.  Tons of football players get into trouble every weekend and you hear about it on the commentary.  Like the girl I overheard a few days ago, I overhear all kinds of conversations about people and their knees hurting.  And, of course, at PT, there are plenty of people with knee problems, lots of them coming back from knee replacements.

Lately, I've really felt unable to get away from everything, that no matter where I go I've got to share my personal space with other people.  The smallest things are starting to bother me.  In the office, there's at least seven or eight other grad students around talking about stuff.  Outside there are mobs of tourists and other students -- I get asked for directions at least once every few days and someone always stares at me because of the brace or limp.  In my apartment, I've got to deal with my roommate and his fiancee.  Yesterday, I realized what was missing.  Running and biking somehow alleviated that "walls are closing in" feeling: it's hard to get mad when you're tired.  On the roads or trails there isn't anyone to bother me and everything just gets zoned out.  An hour of running or biking feels like three or four hours of doing work or reading or just messing around on the internet. Without it, days just whip by and I don't get the same sense of accomplishment.  Hopefully soon I will be able to bike more and I won't feel like I'm going insane.

Tomorrow I'm off to Raleigh for a conference and I'll see how it goes in an environment other than school.  I'm hoping there are bikes or elliptcal machines in the hotel so I can continue to work on my range of motion, leg strength, and just get in some kind of workout.

Today it was back to the orthopedist to evaluate my recovery process.  The PT gave me a letter to take along and I voiced my concern that the brace I've had to wear is killing my gait.  I've been walking around the apartment without it, but it's really annoying being out and about with it on.  It's hard to bend my knee when the brace is on correctly and it's even harder when I've got long pants on and it sags down my leg.  Finally, they let me take it off.  The brace did give my leg a stronger and more protected feel and now with it off I can really tell the strength difference between my two legs.  Hopefully I should be walking without a limp within the next few weeks.  So many strangers have asked me what I've done to myself and I've got to tell them at least part of the story.  A lot of them think I've torn my ACL, but at least with that, they can reconstruct it in the worst case and you can go back to normal, but for me the damage is done and will never be completely repaired.

The doctor advised me not to run, but at this point it's still obvious that I shouldn't.  Again, excluding the problem of damaging the microfracture area, my leg wouldn't last five steps of running before my quad would erupt into an inflamed mess.  I'm really starting to get sick of all these appointments and long periods at the physical therapist.  I understand that it's so I can get better, bike again, and maybe run, but it's really tiring.  I adapt to the increased weights and more bike/elliptical resistance, but the recovery process is mentally straining.  I remember being fed up with previous long lasting injuries where my coach wanted me in with the training room every morning doing the same kind of stuff.  This is like that but on a whole new level.

The PT still wants me to continue with them on strengthening and returning to nearly full range of motion with my leg.  Yesterday I got to 140 degrees, so I am getting there.  I know my teammate said he still doesn't have full range of motion in his bad leg.

There have been periodic arguments on LetsRun about the different articular cartilage repair methods, none of which are extremely robust.  It seems that most people on the message board and other boards that I've seen get microfracture for deep cartilage tears.  It's the go-to method for an attempt at repair since it's minimally invasive, has a moderate recovery time, and a good success rate compared to the other two techniques.  Autologous Chondrocyte Implantation is a new method where a small sample of your cartilage is taken out in an initial surgery, grown in a lab, and implanted over the defect in a second surgery.  They open up your whole knee to put the new cells back in and there is a ~2 year recovery time.  Apparently the cartilage is much stronger than fibrocartilage so it's better for long term results.  Most insurance companies don't cover it since it's considered an experimental procedure.  It seems that if this technique was improved/matured so that the recovery was shorter and became more mainstream so insurance would cover it that it would be a good option.  In the case where my microfracture doesn't hold up, maybe in ten years there will be a solid procedure to replace missing cartilage.  I've also heard of stem cell injections into the knee to help repair, but that seems almost completely unheard of and there aren't any proven results.

I finally got hold of my teammate who had microfracture on his knee a few years ago.  We talked for over an hour and I got an idea of what his take was on the whole injury->surgery->recovery process.  It was good to actually talk to someone that I knew that had this done to get an idea of where I stand.

I knew that he had some kind of knee issue that required surgery and a long recovery but I wasn't sure that it was microfracture.  It happened to him during the summer after my junior year of undergraduate while he was a freshman.  I remember talking to my coach over the summer about how everyone was doing and he mentioned my teammate as having some kind of major knee issue that had to do with the cartilage.  I remember returning to school and practice in the fall and seeing him do his therapy in the athletic training room.  Every time I went in there to get some ice or stretch, he was in there on the bike or doing some kind of exercises.  There were plenty of times I remember being in there and he wasn't having a good time or something was hurting and the trainers were telling him to take it easy; that there were good days and bad days.  Finally, I don't remember seeing my teammate doing workouts again until March of my senior year -- he started having issues in April or May of the previous year, so it was quite awhile before he was back to training normally again.

I didn't really think too much of it -- when I was healthy and running well I tended to forget about those on the team that were injured.  They went to the meetings at the beginning of practice and then I didn't see them until I was stretching or in the shower.  Usually I only really paid attention when someone I ran with regularly on maintenance runs or as part of a workout group suddenly disappeared one day.  I would be aware that they were injured for a few runs or workouts and then it would kind of slip my mind as I got used to them not being around.  Of course, when I was the one that was injured, which happened at least once per season, I always seemed aware of everyone else that was hurt.  We all spent plenty of time in the training room trying to get better.  Overall, I spent most of my worrying about trying to stave off or heal my own injuries. It seemed that some tendon or muscle was always about to take me out of the lineup, was in the process of keeping me from running, or trying to blow up again as I restarted training.  Of course, once one problem was on its way out, something else was desperately trying to start up.

Unlike me, my teammate said there wasn't anything that he remembered as the cause of his cartilage defect.  His doctor said he probably ran into something, but he didn't remember doing anything like that.  One day he remembered running a steeple race and being fine, and the next day on a long run the pain started.  It slowly got worse for awhile as our coach told him the problem was an IT band injury.  After a lot of stretching and no improvement he went in to see a doctor at home, which eventually led to his diagnosis.

His defect must have been more weight bearing than mine, as he said that it hurt when he walked, whereas mine didn't.  Like me, my teammate also had a lot of popping and locking in the joint with every leg extension.  Before the surgery, his doctor told him that the microfracture-induced fibrocartilage would most likely last about three or four years, enough to get him through his college career, but after that it might break down.  My doctor didn't really say this, but this short-term success seems to be the general assessment on the Internet.  He (and my PT) have said that the tissue will break down faster if I return to hard training, so I'm not really inclined to do that.

During the surgery, the doctor had to move my teammate's patella so that it wouldn't rub against the microfracture area.  The idea was so that bending the knee wouldn't scrape away the fibrocartilage-forming clot.  I was kept in a motion-limiting brace to prevent this from happening for the first couple weeks, but I didn't have my whole patella adjusted.  He said the defect area was about the size of a thumbnail, which seems to be smaller than the area I had that was more like two thumbnails.  My teammate said that he didn't have any pain in the microfracture area after the surgery but he could feel something in there sometimes.  Following the surgery, he was on crutches for about five weeks, biking at about two months, and then started running at about five months.  It was about seven months before running seemed more normal.  He also remarked that his leg strength didn't come back until nearly a year after the surgery and even today, four years after, the bad leg still seems smaller.  He still can't squat on his bad leg either.

My teammate remarked that I should really focus on abductor and adductor exercises which the PT really has me focus on.  It's one of the things I work on during my morning routine.  He remarked on this because he had a lot of tendinitis issues as he returned to running that would have been lessened with more leg strength.  Other than that, my teammate made it through the last two and a half years of his college career successfully and wasn't held back by his knee.  His mileage was high and he did all the workouts and raced well.  I remember running with him through some of the more treacherous trails around here last year, so I know his knee could definitely tolerate trail running.  He still ran 50 miles a week through the summer and is still doing well today.  It's great to hear that his microfracture procedure and recovery were a complete success and it's a good motivational tool.  Since I don't have to worry about burning eligibility or missing races, I can take it easy during my recovery and not force anything.  As I've mentioned before, just being able to run again to some degree will make my surgery a complete success.

Yesterday marked over two months since the surgery.  I've come a long way, but there's a long way to go too.  I'm now allowed to bike and elliptical on my own, so I took advantage of that today and went to the school rec center: 15 minutes on the bike, and ten on the elliptical.  This I did in addition to my usual morning weight routine which takes nearly 45 minutes.  It would be great to bike outside, especially since the weather is nice today, but I don't think I'm ready for that and won't be for awhile.  My leg still shakes with weakness after 15 minutes.  Also, it seems that my good knee has been hurting and popping some, which must be some kind of compensation problem.  I'm hoping it's nothing serious and just a mild consequence of putting most of my weight on the good knee, since the pain started when I was on the crutches.

Last night one of my old teammates who goes to dental school in Richmond came down to see the team massage therapist.  I dropped by while he was there since I hadn't seen him since the summer.  The massage guy, who punished and tortured me for so many years, had an interesting comment about leg strength that I hadn't heard before: your quads should be 20 percent stronger than your hamstrings.  That is, if you are on a leg press that works your quads, you should use 100 pounds if you are using 80 pounds on a leg curl machine for your hamstrings.  No wonder runners have so much trouble with knees: quads get very little action compared to hamstrings and calves.  Biking can change that, though.

My teammate's got knee issues like I do and has been out ever since dominating the Boston marathon last spring.  He really hasn't been able to run since then and an MRI indicated grade 1 or 2 damage to the articular cartilage.  That's where the cartilage is bruised or has a small divot in it, but not like my grade 4 where it's chipped out all the way to the bone.  He seems so motivated to run again and get back into regular training, but with permanent damage like that, it may not be possible.  Since his damage wasn't as severe as mine, the docs say surgery wouldn't accomplish anything, which leaves him out in the cold if the pain persists.  Hopefully most of the pain is caused by some inflammation from whatever he did and once that subsides he'll be able to run again, but if I were him I would change my mindset.  Right now, I would consider my recovery a success if I am able to run 20 -30 miles a week.  It's so bad because he was running so well and even got some sponsorship offers.  Maybe it's not as bad and he'll be out there kicking butt again soon.

It begs an interesting philosophical question: would you like to run the race of your life knowing that you would never be able to run again?  You would sacrifice everything to blow the field out of the water.  Your time and place would be so much better than you ever hoped it would be, but when you finished, you would never be able to start again.  Would that be worth it instead of having a lifetime career of running but only making modest personal gains?  I don't know for sure, but I do like running just to be outside and to feel like I accomplished something.

I'm finally making some headway on the latest school project.  It should be an interesting experiment since we will get to wear some sensors for awhile to test our model.  Since we are going to use human test subjects, my advisor blindly checked off some box about it when sending in the research proposal to the school.  Now they are making us fill out all this liability stuff and explain our exact test procedure when we aren't really finalized on everything.  And, we, the researchers working on the project, are the only ones who are going to be the subjects, so I think we are completely aware of any "dangers" that go along with wearing some sensors.

Lastly, I got home to vote absentee at the city municipal center when I was on fall break.  I got that taken care of since I'll be at SenSys on election day.  Really, I don't think either presidential candidate matches my choices.  Obama's tax plan raises marginal tax rates for those who make under $45k per year (poor grad student). McCain plans to freeze all research spending for a year after he enters office.  Obama hasn't even finished a full term in the Senate; McCain is going to be 80 if he gets elected for two terms.

Both have the wrong idea on the economy.  The problem goes beyond government regulation or lack of it.  It starts with individuals.  A lot of people today are lazy and want everything for nothing. They want the car and house they can't afford, so they go into credit card debt and default on their mortgage.  They want the college that puts them $40k in the hole only to graduate and bus tables.  They want health care and retirement benefits without lifting a finger.  These people purchase what they can't afford and then expect everyone else to pay for it when the repo man comes knocking.  It's a sense of entitlement and it drives me mad.  Here's a hint to fix this mess: stop buying stuff that you can't afford or shouldn't be, get off your ass, and start contributing to society.  The same mindset of the CEOs with enormous golden parachutes and corrupt politicians taking enormous sums from lobbyists is present in everyone.  If this persists, we'll be in a barter economy real soon.  The problem is that the candidates and government can't blame the constituents without taking heat for it and risking their own jobs and re-election.  The solution starts from the bottom up, with you and me, not from the top down (government).

The physical therapist suddenly increased my activity level.  Until this week, everything was pretty easy, but this week was different.  I do the bike with hard resistance -- it feels like going up a steep hill for 15 minutes.  Since my legs are so weak, it probably isn't that much resistance, but it sure seems like it.  Then, they had me get on the elliptical.  That was about the highest my heart rate has been since before the surgery.  If that wasn't enough, there were tons of step and stair routines that they started me on.  Until now, I avoided stairs as much as possible and always put my weight on the good leg.  Not anymore.  Plus they increase the weight each time I come in for all the weight machines and free weights.  This, combined with my free weight routine in the morning really wears me out.  It's probably because I'm not used to it. 

The PT thinks the pain I'm having is coming from where my IT band attaches to the tibia, which is good because it's not in the joint.  He said a lot of pressure was offloaded onto my IT band after the cartilage tear as a "protective" measure.  It seems to explain the shockwave of pain I had that went up from below my knee when I had the tear and when I had occasional pain during the two or so years leading up to it.   Now, it kind of makes sense since I haven't bent my leg much and everything has tightened up.  Stretching more should help this and I've already noticed it feeling better towards the end of the week.  Overall, my leg strength is getting better but I still have trouble walking correctly and it's still going to be awhile before I can bike for a prolonged period of time.

No more crutches.  I gave them up last weekend and it's been great ever since.  I have a great deal of trouble bending my knee properly when I walk which is going to take awhile to work out.  The therapist shortened the brace which helps, but everything will come in time.  My range of motion is better too, at about 120 degrees, but at that point it feels like my leg is going to break off.  Until that improves, I won't be able to use the regular stationary bike, much less the road bike.

I think my leg strength has improved significantly in the week that I've been walking and I no longer feel like I'm about to topple over.  At PT they have me using the leg press and this hamstring machine with actual weights instead of the spring machines I was using before.  Hopefully that will help me get back to normal more quickly.  My leg still looks like a stick and it takes an incredible amount of effort to stand on my right leg and lift the bad one.  15 minutes on the recumbent bike is getting easier and my leg isn't shaking when I finish.  I can't imagine what would happen if I tried to bike with real resistance or even run at this point.  I wouldn't last two steps.  Again, it will take a few more months to really get everything back.

The physical therapist thinks that the popping and pain that I get occasionally is scar tissue.  "Scar tissue" seems to be the catch-all explanation for pain that I've received from my past coaches, multiple massage therapists, and athletic trainers while on the team.  What is scar tissue, anyway?  Why does it cause pain?  Is it really "scar tissue", or is it the kneecap digging out the formation of fibrocartilage?  I couldn't really find a definitive answer on the internet, so I'm not really sure.  I know you get scars from really bad cuts, maybe the scar is swollen and gets in the way of other stuff that moves around, which is what causes the pain.

I've continued to do leg strengthening and upper body exercises in the morning and going out for walks in the afternoons.  It's better than nothing, but now that I'm walking again I suddenly have the urge to go out and run and bike.  Nobody had better ever again bother me about being obsessive about running every day.  I went every day because I could, because I enjoyed it, and I knew that I might as well "get while the gettin's good."  Because on a day like today, I might not be able to run and I don't have to regret any days that I was too lazy to go.  Lots of guys on the team would give me grief about running every day during the active rest phase of our training.  I knew that I was healthy and in shape and I wanted to make the most of it.  It's a waste if you don't, because there will be days when you are injured and can't go.  So, I say to those with good knees: make the most of every day and don't waste your talent or effort: get out there and run.  Enjoy it.

Today while doing one of the leg exercises at the therapist and then again when I moved my knee at my desk, I felt the unmistakable pain I had before the surgery.  It was just as sharp and pronounced as ever.  I wonder if there is any new tissue at all where the microfracture was, or if there was, I've destroyed it.

It's the pain I always felt for the first minute or two on the bike, but it would go away.  When I ran the pain seemed different, almost duller and deeper in the joint but just as uncomfortable.  Before the surgery, I don't really remember having that kind of pain when not running or biking.

I know what I do that causes it: extending my leg when it's off the ground.  I have to try to avoid doing that.  I didn't think much of it when it happened the first time today, but the second time really got to me.  I'll say something to the PT about it on Friday.  Until now, I didn't have much pain at all in the knee, especially where the microfracture was.

It could be a sign that I've been a bit too aggressive coming back since I did do a few minutes of biking and I'm almost off using one crutch.  The doctor wanted me off the crutches soon and the PT seemed to think my progress was fine.  Maybe if I go a bit easier on things I will have spared my knee.  I know almost everyone has pain following microfracture, but I wonder if the pain they get is the pain they had before the surgery.

Hopefully it's okay, but I've got a feeling otherwise.  I'm really afraid of being a cripple for the rest of my life.

Yeah, that's progress.

This week at the physical therapist was good from a flexibility standpoint.  I can now sit on the edge of a table and let my leg hang down without any tightness.  I couldn't do that at the start of this week.  Because I can now bend my knee to 90 degrees -- and move the brace that much, I can now get my left shoe on without using a giant shoehorn.

I've progressed to using one crutch for a lot of my getting around, but when I go longer distances, I still stick to two.  My knee feels a lot more stable than it did and it seems to tolerate the weight bearing more without getting sore.  Slowly, I will try to walk farther with only one crutch and I am already going short distances without anything at all, but I feel kind of like I'm on stilts.

Yesterday, the weather started taking a crap and it's been terrible outside.  While I was headed to and from the office in the miserable mess, at least five people asked me if I needed a ride or help getting around.  I did have to go farther than normal to get to my parking space since it seemed everyone drove.  Nobody ever said anything to me before.  Maybe that says something good about human nature when stuff gets tough. 

I need to go to the grocery store but I don't feel confident enough to go by myself since I can't really carry much with only one crutch.  When I do, it throws off my balance.  The Trader Joe's is open that rose out of one of the new vast swaths of clearcut woods.  I thought about going in there after my appointment today, but it was a complete mob scene, since today was the first day it was open.  I figured it would be bad when everyone at the physical therapist was talking about it.  People were almost parking along the highway to get in there.  I'll go back after some of the hype dies down and when I'll be able to get around better on my own.

They finally gave me my diploma today and for the longest time I thought I hadn't done something that I was supposed to in order to graduate.  I was supposed to get it in August.  Finally, this morning I got an email and I went over to the registrar and picked it up.  No real ceremony this time.  It looks just like my other one except that the president has changed and it reads "Scientae Magistrum".  They didn't give me a cover for it either, so I've got to get something to protect it.

Next week I'll get to ride the bike.  Of course, the therapist's idea of riding the bike is probably a lot different than mine at this point.  It will still be good to start back, though, even if it's just ten minutes of slowly turning my legs around.

Today I did the 55+ mile Williamsburg road race course. I hadn't done the whole thing in a long time and it was a good way to spend the last day under my own power. It was a great day and the sun was out with very little wind. I should have topped off my water bottle since it was kind of hot. There were tons of other cyclists out, way more than I've ever seen out there -- I saw probably 30 or so the whole trip. All were going the other direction and most I saw early on, probably doing the same loop in reverse, except that they started a lot earlier to avoid the heat. I was pretty wiped by the end -- when I've done the loop before, I usually start to get tired about two hours in and today was no exception.

A lot of the roads farther out were really torn up and desperately needed repaving. It's funny there is a huge transportation stalemate in the state legislature because of road funding. The urban representatives are facing off against the rural ones since the urban areas want more funding to help ease gridlock. The rural roads definitely need some help. I guess it doesn't matter when you have a massive F-350 with 40 inch tires, but today I felt like I was being shaken apart in some places. The bike was skipping gears like mad and the water bottle cage was coming loose and rattling around. Anyhow, I made it back in about 3 hours, which wasn't a record by any shot, but I'm glad I did it. Towards the end I could feel the soreness building up in my knee. Hopefully I will be able to ride again without knee issues in a few months.

Tomorrow I go in at 7 AM to the hospital for the surgery as long as I don't get sick. You can't have any breathing problems for the anesthesia. On Friday, a nurse from the hospital called me and asked a ton of questions that were probably related to the anesthesia. Curious, I did some research on the Internet and now I wish I hadn't. It's about as close to lethal injection as you can get. In some cases, it is -- people die from it, but it seems it's mainly due to airway obstructions more than allergic reactions. They put an IV into your arm (I always thought they made you breathe in some kind of gas). Apparently for awhile after the IV fluids enter your system you are still fully conscious, but you will forget most of what happened after you wake up following the surgery. Then you go into some kind of convulsive state where you have all kinds of uncontrolled movements and then you finally pass out completely. After reading this, I'm wondering if they make you wear a diaper, just in case. Just like lethal injection, they put some kind of muscle relaxant in there to make it easier to operate on you. If reading about this part was freaky enough, it gets worse.

Apparently, less than one percent of general anesthesia patients experience some kind of "awareness" during the operation when they are supposed to be unconscious, and a large number of those report feeling pain. From the sounds of it, awareness during surgery, especially when accompanied by pain, can have a lasting affect on people, even driving them to suicide! Since there is a muscle relaxant in the drug cocktail, the patient can't tell anyone that they are awake and the surgery goes on, leaving them in pure pain and suffering. This is what they say about lethal injection, that the muscle relaxant keeps the patient from communicating that they are feeling any pain. Supposedly, there are recent methods to try to detect when a patient is awake, but it still happens. Hopefully I'll be okay, but this really makes me apprehensive about tomorrow. They had better let me get on a scale so that they give me enough drugs to keep me from waking up.

All that aside, then there's the recovery to deal with, but I'll cross that bridge when I get there. In all likelihood, that will be much, much worse than the surgery.

Aside from that, I've got to try to finish up some stuff for school, but I don't know if I will since I've been kind of unnerved about this whole deal over the past couple days. Yesterday after I left the office, I ran into a few old teammates, who are now going to be seniors. I hadn't talked to any of them in awhile and it made me feel a little better. It sounds like everything is going well for them and our team is shaping up well for the fall Cross Country season. My coach said to stop in after the surgery to talk about the recovery, so I'll probably do that after a week or so, whenever I get back to Williamsburg. I'm going to need as much guidance as I can get for the recovery process and slowly returning to activity. I don't want to do too much too soon and screw up the healing process. I'm sure there will be good days and bad days, and most of the days in the next few weeks will be bad ones, but as I get better, the tide will begin to shift and things will get better. And then, like injuries I've had in the past, you wake up and realize that you're all better and that, once again, all is well with the world. Right now, all I can think is that if I don't go through this, it will be much worse for me down the road.

I feel like an astronaut strapped into a rocket about to be blasted into space. Hopefully I'll be able to say everything went well this time tomorrow.