Injury Update: The (Long and Winding) Road to Recovery
Ending 2015 with knee injuries was the bitter icing on what had already been a pretty unsavory cake. I spent all of 2015 struggling to come to terms with the loss of my brother, treading an unhealthy line between not caring about anything at all and obsessively worrying about my living loved ones. When I hurt my left knee early in the year (exercise related) I didn't care enough to deal with it or my HMO, so I powered on. But when I hurt both knees badly at the Avengers Half Marathon in November, I knew I would have to succumb to the horrors of my HMO and begin my physical recovery.
At the time I had a very low level HMO that was only accepted by one PCP (Primary Care Physician) in my area. I had visited his office twice before and on both occasions nothing came of the appointments. Poor care, no real treatments. I was dreading dealing with him again for my knees, but I had no choice. Allow me to take you through the maze of rejection I suffered at the hands of my former insurance plan:
- November 15 - Injured
- November 18 - Visited the only PCP who would accept my low level insurance. Diagnosed with most likely 2 torn menisci (1 in each knee) by a student, and was told it would take 10 days to get an approval for an x-ray. I repeat, 10 days for a useless x-ray.
- November 19 - I can't take the pain any longer. I decide to take myself to Urgent Care for the x-ray so that the PCP/insurance can move on to giving me a referral to an Orthopedic Specialist and an MRI. The Urgent Care doctor is floored by the lack of help I've received and prescribes a pain killer and tells me to get to a specialist ASAP. The x-ray is clear.
- November 20: I call PCP and send him my x-ray results. He says he will make a request for an MRI & Specialist referral.
- November 23: I apply for heath insurance through my work because clearly it's time to pay a higher premium for better care.
- November 30: I receive a referral in the mail for 1 physical therapy session from my PCP. No MRI, no specialist. Just 1 session on Physical Therapy at an office that can't see me until the end of December.
- December 1: I part ways with my old insurance and call to make an appointment with a new PCP to start the referral process over. It has now been 16 days since my injury. With no idea how to care for my injuries I am just icing and taking anti-inflammation medication. I am going crazy. I haven't exercised or done anything that can make it worse - or better.
- December 10: New PCP rocks. She immediately tells me it’s Patellar Tendinitis and definitely something else. For the something else, she writes me a referral to the Orthopedic specialist I had chosen. I go straight to his office with her referral and they make my appointment for the 23rd (their first available) and they make the MRI referral request on the spot. This is the way it was supposed to go down! The insurance will only approve one knee MRI at a time, so we start with the right since it hurts so much more than the left and is the "newer" injury.
- December 23: I'm sick with bronchitis. This is the third day I've missed from work, but I drag myself to the MRI appointment and the following appointment with the Orthopedic specialist. I am so thankful that after 38 days I am finally receiving the proper health care that I load up on meds and handle my business.
The diagnosis was so much better than I imagined. The right knee doesn't have a torn meniscus at all. In fact, he said my menisci look great! The bad news was the best possible bad news of all: I have a minor Tibial Tubercle Stress Fracture, Bone Marrow Edema and Patellar Tendinitis.
What does all of this mean and how long will it take to recover?
Tibial Tubercle Stress Fracture: So when I was zig zagging around other runners while running at Disneyland I caused an injury that occurred from "violent tensile forces on the tibial tuberosity. The force is delivered through eccentric contraction of the extensor mechanism of the knee from either of the following:
Violent contraction of the extensors without shortening (eg, springing off when jumping)
Forceful flexion of the knee against the powerful contraction of the quadriceps (eg, landing from a jump)" - via medscape
Bone Marrow Edema: A fancy way to say fluid inside the bone. Yes, it hurts. A lot. It's a terrible pressure inside the knee that I cannot explain in any other terms except that it is like the worst earache, toothache and headache all moved into your knee. Like my knee just wants to pop. "If you suffer a significant injury something may hit your bone, or the two bones might be crushed together. Either way, the bones will not be happy. They will develop fluid within them in response to the injury. Bone, in that respect is not very different from our other tissues like muscles which collect fluid after an injury." - via howardluksmd.com
Patellar Tendinitis: A giant pain in the ass. If you're a runner you may have experienced this. The patellar tendon works with the muscles at the front of your thigh to extend your knee so you can kick, run and jump. It's basically an overuse injury to the tendon connecting your kneecap (patella) to your shinbone.
What is the treatment and how long is the recovery time and can I run Star Wars?!
I was cleared to walk and exercise again as long I don't run or lift weights. No heavy lifting allowed as that just adds more pounds of pressure to the knee. I was also cleared to WALK the Star Wars Half Marathon later this month as long as I take it easy. Other treatment includes stretching, ice and wearing a brace to help with the tendinitis.
I left the office optimistic about my recovery despite the fact that I was literally so sick I fell asleep as soon I got home. The drive, the MRI and the appointment took a lot of out me. I was sad I couldn't immediately get out and walk or go to the gym, but I knew I had to rest first.
Finally, on Saturday, January 2nd, 48 days after I injured myself, I went for my first recovery walk. I tested a slow gentle pace while wearing my knee strap. It felt good. I don't care how slow I walk I am just thankful I am moving forward. Even happier that I am no longer sick.
November and December were rough months for me physically and mentally. I had so many fitness goals and plans that I had to let go of because I had no answers, but now I can see the very bright light at the end of the tunnel and I am looking forward to running again. Hopefully next month!