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Saturday, May 14, 2016

MRI Take Two

The only way you don't know that I recently tore my ACL and meniscus is if you've never met me before and stumbled upon this blog post blindly.  This is because everyone who has ever met me in my entire life has had to listen to me whine and complain for the last six weeks.  (Note to self: check "unfriending" data on Facebook.) It's not because I am generally a "woe-is-me" type of person (I don't think) it's because having a torn ACL really, really stinks. I can't walk, I can't drive, I can't do much of anything. But... I can complain, apparently.
So, today's post ain't gonna be any different....
I went back to see my ortho a few days ago. Before the appointment, my husband (who is just as sick of this situation as I am) and I decided I was either walking out of there on my own power somehow or we were scheduling surgery.
Neither of those two things happened.
My doctor was shocked when I told him I hadn't been doing physical therapy for the last four weeks--because he never told me to do it!  He says he put it in my notes to have his people call the PT people, who were supposed to call me. None of those things happened. And so he determined that I couldn't have surgery yet because my leg was still too swollen and immobilized.  He didn't know why it wasn't bearing weight better or why it won't straighten, so he sent me back to get another MRI to see if my second injury about five weeks ago caused further damage to my meniscus which may now be blocking the ligaments and keeping my knee from bending. This injury happened after the first MRI.
I was so upset when he told me four more weeks that I almost lost it. I wanted to cry and punch him in the face at the same time.  I mean, it's one thing to say, "You're knee's not ready yet," but something else entirely to say, "Oops... we never called PT." The fact of the matter is, if he had told me I needed to do PT, I would have called them myself. But I'm almost positive that he said let's re-evaluate in four weeks, and if I needed PT later (like after surgery?) we could do it then, but he didn't know if he was going to order it or not because it's so expensive (guess I looked like a bum that day).
Of course I didn't punch him or cry, but I did take my toys and go home. Which translates to mean I immediately went home and started looking for another doctor.  I know this wasn't done intentionally, and there's a good possibility that he could have said no surgery, continue PT anyway, I just don't know how I feel about having someone cut me open after he's already shown himself a bit forgetful and/or unorganized.
So today I went in for my second MRI.  That probably needed to be done anyway.  I went back to the same place I went the first time, Preferred Imaging.  The first time everyone was unbelievably nice and attentive.  I felt like they went out of their way to make sure I was comfortable. Today was not quite the same.  The receptionist was nice enough but not particularly friendly. And the MRI technician was nothing like the last one.  Apparently, the guy right before me was very uncooperative, which put the technician in a sour mood from the beginning.  As he was walking the other guy out, I heard him explaining that he moved too much and that the image was not going to work. He would need to reschedule. The patient seemed pretty insistent that he didn't think that was necessary and he would just take in the blurry image, and the discussion went on for a while. So by the time it was my turn, the tech was about out of patience.  He was doing his best not to take it out on me, but I know how my knee works, and I knew we were in for a bumpy ride.
The tech pulled my wheelchair to a halt about twenty feet from the MRI machine because of the metal and told me I'd have to walk the rest of the way. (Um, sir, if I could walk, I wouldn't be here.) I explained that I couldn't do that, so he had to go find the MRI safe wheelchair. The transfer was anything but graceful, but eventually I was able to wheel myself into where the machine is kept, it's narrow white tubeyness all set up for my session of misery.
There it sat, like a portal to Hell, beckoning me....

Because, if you've never had an MRI before, here's the deal--you can't move. At all.  If you do, it blurs the image. It's kind of like in the olden days when people went to get their pictures made and they had those rods up their backs to keep them from moving and ruining everything.  So he asked me to put my leg in this little positioner that was designed to isolate it, but my leg had to be fairly straight, so you can see how this might be problematic for a person who cannot fully straighten her leg.
I warned him ahead of time that my leg likes to spasm, and that there is nothing I can do about it. He kind of sighed and instructed me to do my best not to move.  Have you ever tried to stay perfectly still for thirty minutes? Not a twitch, not a spasm, nothing? It's really hard. And seeing how upset the tech was with the last guy, well, that just made it even worse for me, because I am a rule follower, and I really didn't want to mess it up and have to come back, and get yelled at for moving too much.
I am lucky that it is my knee that is injured because they don't have to put my whole body in the tube.  It stopped around my waist, so no claustrophobia. I got to listen to the radio, which was also helpful, because those machines are really loud. They sound a lot like a jackhammer.  They vary in loudness and intensity; sometimes it's a constant hum, other times it's pulsating. It's never pleasant.
And so about two minutes in, I realized my leg, which was hurting due to the straightness and the position I needed to hold, was starting to tighten up. Tightening muscles equals movement.  And then the twitching began.  It started in my thigh, and I tried to keep it there, but soon enough it moved to my calf, and then, inevitably to my knee.  Now, this happened last time, too, but the sweet tech lady whom I now love even more came over the speaker and asked if it was involuntary, and when I told her yes, she said not to worry about it, and I was doing great.  This guy said nothing. I knew he was probably swearing and cursing my name. I continued to do my best to keep from moving, but my leg was uncooperative, and it was especially agitated by the jackhammering, pulsating noises the machine made every once in a while.  I knew any minute he was going to yell at me to please hold still, but he actually didn't say anything at all for about 25 minutes.  I know how much time had passed not because there was any sort of clock or timer but because he told me it would take about 25 minutes and because of the average length of songs.... So he finally says, "Are you doing alright?"
I hesitantly said, "Yes, but I know it's spasming. Is it okay?"
There was a long pause during which I mentally envision myself going out and telling my husband and two cherubs who are patiently waiting in the lobby that we have to come back again because Mommy is an MRI failure before he finally says, "It's okay. Just do your best. Some of the scans are bad, but some of them are okay."
Now, I have no idea what this means--I don't know how many scans he is doing, how many have to be good, if a bad scan means extra years in purgatory, or what, but I am at least a bit relieved to hear that some of it is working... to some degree.  He told me it would probably be another seven minutes, and that it is taking longer because I CAN'T STAY STILL!
I suddenly know how those impulsive five-year-olds with ADHD must feel when teachers such as myself tell them to stop jiggling their legs. I apologize, my little friends. Never again.
I don't think it was seven more minutes. I think it was seven more hours. But eventually, he comes back through my headphones and says, "This is the last scan. It will take about two minutes."
And then I started counting. Slowly. To 120. As I concentrated on not moving. By the way, when you are trying not to move, the worst thing you can do is try not to move.  And I counted past 120. And on. And on. Maybe I was counting too fast. Maybe my wiggly leg is prolonging the torture. By now, my leg is burning and screaming at me. It wants to bend so, so badly.  Finally, somewhere between 300 and 400, he says, "Okay. I'm coming to get you out."
Hallelujah!
Once I was out, however, it was almost impossible to stand up and get off of that table. My leg refused to go back to its favorite bent position. It was so stiff and painful. It was all I could do to lift it out of the positioner. I thought Brian might have to come back and help me up. But I made my way off the table, into the chair, transferred to my own chair, and finally out into the waiting room, where the five minute wait for a CD of the experience turned into a fifteen minute wait, and my leg was furious and screaming at me the whole time.
When I finally got home, I immediately took my "good medicine" (it's only hydrocodone, which is nothing to a lot of people, but it puts me to sleep almost immediately) and took a two hour nap.
It's been about seven hours since MRI #2 was completed, and my knee is still angry. I think it might take a few days for it to stop screaming at me.  But hopefully this MRI will give the doctors what they need to decide whether or not my inability to bear weight and straighten my knee is mental or muscular.  I don't know if it's because I haven't been moving it enough or if it really is incapable of being straightened and/or holding me up. I hope to know soon so we can get on with it already.
If and when my knee is strong enough for surgery, it will ultimately be up to me to determine whether or not I want the surgery.  It used to be a given that if you tore your ACL, you were having surgery, especially if it was torn in two, like mine is. It cannot repair itself. Now days, however, unless you're an elite athlete, you may be just fine without getting it surgically prepared. It won't ever heal, but you should be able to do day-to-day activities with no problems. Your ACL stabilizes your knee and keeps your bones from moving too far away from each other. I can't walk, but I have practiced taking steps, and the sensation is very strange. It's hard to explain, but I feel like the bones are moving, like my knee is fuzzy or asleep in the middle, and most unsettling of all, I feel like it could just fold up at any second. I honestly think that, if it is truly my decision, I want to have it repaired. Not because I know without it I'll never fulfill my dreams of becoming a professional soccer player, but because I am so afraid of it sliding out of place again. I can't ever tear it again if I leave it the way it is now, but other things can re-tear, like my meniscus and the other tendons and ligaments, and I'd like to avoid that at all costs. I know the surgery is very painful and the recovery is long and pretty awful.  I just don't know if I can walk around on a bum knee that feels like Jello for the rest of my life. I do realize that, no matter which way I go, I will have to be extremely careful for the rest of my days not to injure it again.

I know several people who have had ACL reconstructive surgery.  If you're one of them, what do you think?  Would you do it again?

2 comments:

  1. YES yes I would and I've left a comment on this thing twice i keep pushing the wrong thing to publish it. You don't want your knee wobbling around and dislocating all time , do you? Just stay ahead of pain pills and do therapy and you'll be able to get around sooner than I did. I wanted to get back to playing ball so took me 6 months before playing but I was back to work and driving sooner than that.

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  2. I really think that surgery is probably the best option. I think this first surgeon disagrees. Hopefully, the second one will see things my way. Thanks for the input!

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