My newly revised knee is doing beautifully, thank you! Incision pain is minor to the point of near invisibility. Comfort in movement is much increased. Clearly, the hardware was providing much structural interference that was no longer required for bone stability. Once the stitches and surgical dressings are removed (this coming Friday), I look forward to resuming careful but much increased activity.
I got a little too enthusiastic about moving yesterday and stubbed (broke!) my middle left toe. This is annoying rather than devastating, but slows me down, which was likely the point of my wiser self. My use has to be even more attuned to weight bearing without reaction to pain yet respectful of pain. Upon advice from my sister (former track star and current track coach), I taped the broken third toe to the uninjured second toe and have been only hobbling in a minor fashion.
To be on the ground and springing up with an overall elastic response is slightly more challenging, but not overly demanding. An aching toe seems like nothing much of any consequence compared to a constantly excruciatingly painful knee. And, since my knee is now quiet and more fully functional, I will accept the instruction to proceed with care and attention, to refuse to narrow or shorten, request overall length and width, and have confidence that healing and mobility progress continues, on many levels.
One of the biggest challenges for me in the entire long sequence of recovery from injury has been enforced inactivity. The initial emergency surgery for patella repair required me to live with huge daily pain and a fully extended leg for months, as well as re-learning to walk with a severely atrophied leg and very unbalanced use of my entire self. The recent surgery recovery is much simpler, as pain is quite minimal, and I can bend my knee, within limits for incision healing, and can walk with relative ease. Still, my surgeon recommended a week off to reduce inflammation and allow healing. Restlessness, boredom and frustration ensue. Without pain to stop me, I am likely to push myself beyond recommended notions of activity.
Inhibiting the urge to move and to return to teaching and full activity is a constant project. Anesthesia and post-surgery pain meds have made me very cranky, and my typical crankiness solution is physical activity. The internal landscape of noise has thus become louder and more insistent. The only “activity” that assists me is Whispered Ah, an Alexander procedure that requires dynamic non-interference and overall quieting. Whispered Ah reveals more layers of internal noise, and a necessity for further quieting. I don’t want to be quiet, but I have to just now. I want to run around the block, see to the garden, clean the house, go see some art, find external distractions galore. Instead, I will breathe. Damn, but this is hard!
So, I sit with my leg iced and elevated, allow reflexive respiration, watch the crows play in the wind, swallows swoop for insects, rain clouds gather and disperse. I reflect, with gratitude, on the great care given to me by surgery nurses and doctors, the kindness of loved humans and animals. Perhaps I can allow a drift from movement urgency to momentary being, and return to cherished full activity with new skills and awareness.
Surgery for removal of pins and wire from my patella went well yesterday, according to my surgeon. (As I was in the land of general anesthesia, my awareness of proceedings was nonexistent.) Once in the recovery room, pain became a thundering crescendo. The skilled and kindly medical team thus gave me a combination of big-time pain drugs until discomfort became manageable. Upon release to home, I was wobbly and a little goofy, but only in minimal pain.
Any pharmaceutical intervention has its side effects, however. Pain was reduced, but my stomach went wild. A night of extreme nausea and vomiting ensued. Since the prescribed anti-nausea medication wouldn’t stay down, I ceased fighting and just rolled with the punches, so to speak. No good use of myself was really possible except choosing productive areas of battle.
Today, surprisingly, my knee hurts less than it did prior to surgery, with only a slight incision pain. The ache that I associated with the hardware is gone. Of course, knee movement is limited by the dressing that protects the wound and stitches, and by the tenderness of the area. Nausea is gone, thankfully! I can’t say I have a voracious appetite, but at least the idea of food is no longer repugnant.
The temptation for me, of course, is to push back to full activity. I will apply inhibition and pursue rest instead, with ice on my knee, and sleep as my sport.
Although there are few projects less appealing to me than surgery, the potential future ease of living without metal pins and wires in my knee, and the possibility of being able to kneel with ease (gardening, Gyrokinesis, looking for cat toys under the furniture) trumps surgery and recovery distress. Thus, surgery to remove the pins and figure 8 wires on my fractured patella (all initially necessary for bone healing) has been scheduled for May 25.
In contrast to zero preparation for emergency surgery post injury, I have time now to prepare in organizational fashions (loose pants for surgery day, food prepared at home, a planned week off from teaching), and also to un-prepare. The temptation is to end-gain by pushing strength limits prior to surgery, increasing activity levels, and an overall attitude of pre-figuring a condition of self. However, since I can’t possibly know how I will be after surgery (the prediction is that mobility will only be affected by attention to incision healing), I am choosing to dynamically un-prepare. The condition of self, and my manner of use in that condition of self, will benefit most from more indirect means and approaches. Instead of working out more, walking further, and attending to strengthening in any specific fashion, I am calming, quieting and attending with happy curiosity to the use of myself. I am doing the time tested and effective Alexander procedures of Hands on the Back of the Chair (to increase an overall balance of tone and connection to the ground, as well as a brain state condition of dynamic non-interference) and Whispered Ah (to re-set respiratory support for invisible effort in breathing and co-ordination) so that I am hopefully in a good condition of self for surgery and recovery.
And, I am going for my morning faux-runs with a bittersweet awareness that this experience might not be available, temporarily, after surgery. Thus, the morning Spring light, the myriad birdsongs, are sweeter, the rhythms of walking with relative ease more precious.
I may go backward in recovery after surgery, but hope for further future possibilities in movement and ease.
When I fractured my patella in February 2009, I would never have imagined how lengthy recovery would be. Now, of course, I know differently than the relatively immediate recoveries I experienced with previous injuries and surgical hernia repair. A patella fracture and necessary surgery for patella fracture has involved over a year of dedicated rehabilitation, a new use of self, and patience that has challenged my entire being.
I recently travelled to NYC, my very favorite city on the planet. Flights impact my knee in a very painful manner; I book extra leg room (so I can wiggle and extend the injured leg). I endure the cabin pressure and the long hours of sitting with great discomfort, even with extra leg room.
However, once I can walk and move upon arrival, the pain diminishes. I am far more able to ascend and descend stairs and walking distances with near to my pre-injury ease. Movement in a symmetrical fashion has become more accessible, and weight bearing of luggage is no longer such a huge challenge as even a few months ago.
I walked on an average of 9 miles every day, according to my trusty pedometer. This mileage was easy for me in NYC, as walking there includes so many views and experiences, and the city is primarily level in footing. Attending to the larger view than my challenged knee improves use. I could joyfully attend to the rhythm of the city and be part of the flow of the city from a global sense of my entire self in a wider attention.
The result was that I returned home with far greater strength in my injured leg, much less inflammation, and a renewed confidence in my mobility.
Of course, I had booked lessons with John Nicholls while in NYC with the intention of improving my entire condition of self. The lessons expanded my respiratory support, enhanced connection to the ground, and generally reduced my interference in overall response.
All we can do, truly, is reduce interference. This may sound passive, but is truly the most active means of improving use in recovery from injury. We go from undoing to doing without doing too much. Undoing becomes an active state that can inform all activities. It is simple, but not easy, and a joyfully lifelong pursuit.