Progress Not Perfection

Sooooo, some wishes do come true and I surely got mine. I saw Dr. Nicholas back in April for my almost FINAL post op visit. 6 months surely went fast right?! At that time, he gave me the okay to continue riding , but I had to wait until the middle of June to go back to racing. Yes, racing!! Before I get to that, I have to take a moment to explain.

Although, I had my last post op visit, I do have to see Dr. Nicholas a couple more times. I have to have the clip that is used to secure the ACL graft in place in the tibia removed. Unfortunately, some people get irritation from this clip and it causes pain, so the solution is to take it out. It’s basically like annoying mosquito buzzing in your ear. He offered to take the clip out back in April, but he explained I had to stay off the bike for 2-3 weeks after the procedure. There was no way I was prolonging racing and riding after having so much down time already. At this point I have actually gotten used to the pain, so I may opt to just leave it in. I do admit, when the pressure changes, or do agressive riding, I have a lot of impact and it can be really annoying!!! It even causes some mild swelling, but it’s nothing I can’t tolerate.  

So why did I have to wait to race until mid June? Well, when you have an allograft, it takes a lot longer for the body to go through the ligamentation process because it’s a foreign tissue. With autografts, it’s your own tissue so the body accepts the graft much sooner and begins to incorporate the tissue and heal. The allograft basically acts as a matrix for the body to build tissue and that takes up to 9 months, and for some even a year. With allografts there is also a much higher rate of rejection. With that in mind, Dr. Nicholas felt that racing is a much more aggressive style of riding, it was better to be safe, and let the graft to fully incorporated. I honestly did not mind waiting. It gave me some down time to enjoy the things I do outside of cycling and gave me some reassurance that the  graft would not fail like it did with my very first surgery. 

I also want to take a moment to thank Dr. Nicholas and his team. They are truly a special group and I am forever grateful. I received amazing care and guidance from them. I also recently saw that Dr. Nicholas was, by no surprised, named on the 2018 list, “Best Doctors in New York," published in New York Magazine. I can vouch for this as my previous teacher and now my doctor! Thanks Dr. Nicholas. :)

During the month of April and May I also continued to go to Center for Physical Therapy. Even though Dr. Nicholas technically cleared me to ride (not race), he encouraged me to continue my PT exercises. I technically could have done most of this stuff on my own, but I wanted the reassurance and guidance from Chris and Lisa to work on a few things. With this surgery being my third ACL surgery, I have been struggling with confidence. Jumping, planting, and stopping short were (and still) some of the challenges I was dealing with. We worked on these exercises as much as we could until my health insurance coverage ran out. With that being said, on my May 6th, Chris and I repeated the Cybex machine test and I CRUSHED it! Chris explained that all my numbers went up and that my leg was a rock. Although this was my last visit, he encouraged me to work on stabilization and strengthening at home after being discharge. May 16th was my last day at the Center for Physical Therapy. I can not thank these guys enough for their care, dedication, and kindness. This is literally the best physical therapy facility I’ve yet to go to, and surely in the Hudson Valley. They gave me the gift of returning to my normal life and helped me bounce back in to training and racing. I have made forever friends at this place and will be forever grateful. Thank you guys!

Side note: I think the confidence and trusting the graft has been the biggest barrier for me. I am nervous I am going to tear graft and re-injure my knee. I DO NOT want surgery again. I dont know how long it takes for this feeling to go away, but I will continue to work through it. I know it is definitely effecting my riding where I am not attacking technical sections at the same speed as I used to, but every day is a work in progress. 

Sponsor update:

Since Chris recommended to continue PT exercises at home, I did a little research and looked into some things I could do outside the gym. Thankfully, I stumbled across the Indo Board. First off, thank you Indo Board for hooking me up with my board. Holy smokes is this thing awesome. I totally recommend this product even if you haven’t had surgery because you can do so much with it. Core, balance, stabilization, and just plain good old fun. I have never surfed, but if it’s anything like using the INDO board, I cant wait to try it out lol. 

Now, on to the next topic, RACING!! Wow wow wow! My first race back was at Stewart and boy was I nervous. Unfortunately, I got really sick the week of the race (which I finally  kicked 2 weeks later) with tonsillitis, runny nose, and productive cough. The cough and sore throat sucked the most because it exacerbated my asthma and made me fatigued. Although it sucked, I fought through these symptoms and worked hard to hold a steady pace. After the first lap my fatigue caught up to me and I had slow the pace down significantly. 4th and 5th place actually caught up to me and passed me. Thankfully Katina shouted encouraging words to me and said, “come on Lindsey!!” Thank you for this!!! I put my body in overdrive and kicked in another gear. I managed to hold their wheels on the fire road, but once we got back into the single track, I took advantaged of knowing my home trails, stepped on the gas again, and took off. I pushed my way up to third place and held it until the end. I am so thankful for Katina cheering me on because I was almost ready to give up due to feeling like  crap. Never give up is my word of advice. We had an amazing women’s turnout and had a stacked field. It was definitely interesting starting racing half way through the season however, I think I did okay considering it was my first race back and I was sick. 

Lewis Morris was a a week away and my upper respiratory infection persisted and worsened. My asthma was still flaring up, my tonsillitis got worse, and I even got conjunctivitis. I know gross!! Right?  Luckily the conjunctivitis was almost cleared after being on Tobrex all week, but the foreign body sensation lingered. 

So Lewis Morris: Some more words of wisdom is when you are sick, REST!!  Unfortunately, rest wasn’t an option for me because I had my cousins wedding which was 2.5 hours away from my house  . . . and boy did I feel it the next day. I didn’t even drink!  The long drive had me home at 1:30am and the race had an early-ish start too. The race started at 10am, so that meant a 6:30am wake up call.  The gun went off 10am sharp and we were off. I felt every up hill ripping through my legs and my throat continued to burn. I still struggled from a slight cough which left my chest feeling tight due to my asthma flaring up. I overall felt exhausted. Kristine and Taylor shot off like rockets, were so far ahead, so I kind of just shut down. 4th place passed me on one of the uphills and I struggled to hold on. At that point I wanted to try catching her and hold on to 4th place until the end. Unfortunately 3rd place did not happen, but I went home with a sweet pay out for 4th and used the day as training race. I probably should have bailed on the race in general, but I have a limited season already and did not want to miss another race. Lesson learned from this race is:  pick and chose your battles and don't expect great results when you're sick and run down. 

Gnar Weasels: The gnnnnnarrrr! I have a love hate relationship with this race, but I am so happy I did it! I have never been a great climber and I am struggling with that more than ever this year! As mentioned before, my ACL surgery set me back significantly because I have been having less power, fitness, and climbing has been a challenge, but this was the perfect race to work on that.  With that being said,  Gnar weasels did not disappoint!! A long hard uphill which had 850 ft of sustained climbing with some technical sections filled with rocks and root . . .  a true northeast course. It also left us racers with a fun fast single track all the way to the bottom with some switch backs. This race helped work on getting loose on my bike again and have fun. I knew I was not going to perform as well as I wanted because of all the climbing, but I managed to pull off top 10 with an 8th place finish. I consider every race I do this season a small goal accomplished with the mental and physical challenges I have faced since surgery and starting my season significantly behind everyone else. Did I perform my best? Probably not, but the take home message is to not give up, keep your head up, and take every day as a positive step forward in the journey of progression. Most of all I had lot of fun and enjoyed seeing my friends this weekend. I also will add that I am beyond grateful for my sponsors helping me through this season so far.  Thank you to TRT Bicycles for having my bike dialed for this weekend. Thank you Honey Stinger and Osmo Nutrition for keeping me fueled, Lazer for my light sweet helmet keeping me cool and safe, my MAXXIS Forkasters and DT Swiss wheels slaying the dirt, ESI keeping the vibration down with the amazing grips, FOX for having the best suspension you could ask for, and my INDO Board for preparing me for the balance on my bike. 

I am hoping to finish out the rest of the XC season on a positive note. I am heading to Mountain Bike Nationals this week and possibly doing the Eastern State Grind Pro XCT as well. As far as the fall goes . . . cross is coming!!! Stay tuned for more updates. 

Seeing the light at the end of the tunnel!

Sooooo I know it’s been a while, but I’ve have been crazy busy with personal events, physical therapy, starting work again, annnd riding bikes!! So yea so here are the updates: work has started again! Back to saving lives and trying to find my groove again. One thing I can say is when your surgeon gives you the option to take the full 3 months off from work,  definitely take the entire time(if you can). My first few weeks back were harder than expected. My knee had to adjust to all the walking and being on my feet all day while at work. If you have a desk job this may be easier, however, I work in the ER.  Walking and standing are huge parts of my day and put a lot of stress on my knee. I am kind of grateful because this actually showed me that that these are not good rest days. I used to use the days I work 12 hours shifts for rest days off the bicycle, but since my surgery, I now know how much walking I actually do. I referred to the pedometer on my phone and I actually  walk on average 3 miles during one shift! I realize 3 miles is not a lot to some people however, when you’re trying to rest in between hard training days on the bike, or even for the recovery stages of ACL surgery, being on your feet all day is not exactly ideal. While at work, I often take small breaks to do the good old RICE method. Rest, Ice, Compression, and Elevation. These 4 little things have been godsends to my work day. Like I said, in the early stages of returning to work, my knee started swelling and that god awful pain on the medial (inside part) aspect of my knee started to flare up. 

Good news though!!! Since the weather has become more tolerable for my knee I got permission to ride my bike outside! Yes! Yes! Yes !!!!!  Riding outside on my bike has been a blessing. I even started doing some training. Initially I had to ride my bike with flat pedals, however, I have progressed over the last few weeks to riding clipped in. The reasons for the delay on the clipless pedals: tendonitis, tendonitis, quad strength, and tendonitis. So here are some words of wisdom: Ease into everything!!! Between going back to work, continuing PT, and having my soul returned back to me . . . I mean getting permission to ride, HA! I developed patellar tendonitis.

     Patellar tendonitis is when the tendon that attaches the patella (knee cap)  to the tibia (shin bone) gets inflamed. This is commonly caused by overuse and stress on the knee. Surprisingly, this is  actually a pretty common overuse injury among cyclists, but is also a common complaint among people recovering from knee injuries in general. The continuous strain of regaining strength and muscle mass during PT aggravates this little tendon pretty bad, and produces a whhhhooole lot of pain. If any of you have had ACL surgery or have had tendonitis, you would agree with me that it is the the worst! Walking, running, jumping, and sitting hurts. Everything flares it up!!!! When I saw Dr. Nicholas back in February he adjusted my PT regimen. I was told no running at PT and no clipless pedals while riding. My PT, Chris, was already ahead of the game. We backed off running and jumping because Chris saw the signs and symptoms of the tendonitis developing early on. And trust me, I felt them! Ha ha! Chris also stressed resting more. Boy, was I glad I  listened. 

At PT we continued to work on strengthen exercises, balance, and core, but since a month has passed we slowly introduced running into the regimen again.  Chris also started to incorporate cutting and more jumping activities. Some of these activities include broad jumping, lateral jumps/hops, and alternating hops. Right now the alternating hops and single leg hops off of an elevated step are the hardest because it isolates jumping off and landing on the surgical leg.  Leg press, hamstring curls, lunges with weights are still done weekly, but my favorite exercise is now doing weighted squats on the bosu ball. This help you activate your core and intrinsic muscles which are crucial for balance on the bicycle. This also helps with power, strength, and muscle endurance. Another important exercise and test I have been doing at PT is the Cybex Machine. This might be one of the coolest parts of PT. The Cybex machine measures your hamstring and quadriceps muscle strength during flexion and extension. The physical therapist makes various adjustments to  resistance and speed accordingly. The computer then calculates and  quantifies the data so the physical therapist can analyze your specific deficits in comparison to your non surgical extremity. As you can see, I actually have a 15% quadricep deficit in my surgical leg in comparison to the healthy leg. This means I still have a little bit more work to do, but we are almost there! Progressssssss!! On the data sheet we can also see I have deficits in my non surgical leg.  The reason we see this  hamstring deficit in the left leg (non recent surgical leg) is because, as mentioned in the previous posts, I had ACL reconstruction with my hamstrings grafted a few years ago. Since then, I have had chronic weakness with flexion in that leg.  Unfortunately, this is something I have been struggling with since that surgery. The Cybex machine also has exercise programs that helps train your fast twitch muscles and build power. Let me tell you . . . this crap is hard. You will definitely be sweating during this.  Thankfully Lisa and Chris are like Mickey Goldmill from Rocky on occasions haha. They are always pushing me to reach the best numbers. 

Soooo back to the bike talk . . . as mentioned before, I have also increased my riding time!!!  I started focusing on endurance based miles and just enjoying riding again. Long easy rides with friends and relaxing on the bike has been so helpful. Sometimes we get caught up training for the race season  so much that we forget what it’s like to just ride our bikes and have fun. Fortunately, dialing it back a bit has helped me just chill on the bike again. I also recently visited my parents in Florida and was fortune to get some solid base training in as well. I managed to get a solid 21 hour ride week in on the road aaaaannnnnnnd the XC bike!! I wasn’t allowed to do anything too crazy, but luckily Florida’s trails are flat and non technical. I almost felt as if my cross bike would have been more appropriate  on them, but the xc was super fun!!! I definitely recommend the trails at Santos and Alva. They fun, fast, and fllllowwwy. The flat terrain also helps build fitness because you’re constantly pedaling. It's kind of like being on the trainer, but with a view and wind.  Oh, and don’t be fooled. Just because Florida is flat doesn’t mean it’s always easy! That place has tons of wind  which  often leaves you riding in a head wind frequently.  Occasionally you get lucky and  get a sweet tail wind that makes you feel like you’re flying!

Side note: As much as I wanted to go all out, it was extremely hard to dial it back. That has actually been one of the things I have been struggling with lately. When you get permission to do something you often want to go to the max with it. As stated above, listen to your therapist and surgeon. Tendonitis sucks and obviously the number one concern is your ACL graft. The graft is usually at it’s weakest at 12 weeks so its curicial to develop the proper strength and recovery before advancing your activities. Depending on the graft and the person,  some studies even say it can take up to a year to be fully recovered from ACL surgery. So the take home message is: listen to your therapist, be patient, take your time, and do the work. Every day you’re going to have to put the work in  to regain your strength!! Rest included!  

Some other updates! New sponsors for this year!!! Thank you Lazer Helmets, Honey Stinger, and Osmo Nutrition for helping me this year. I am pretty excited to represent your brand! Also, a special thanks to TRT Bicycles for always being  my shop  and at my backing call! Thank you to ESI Grips, Maxxis, and Fox for continuing to stand behind me this year as well. I am beyond grateful for all of you.  Thank you to Center for Physical Therapy for also hooking me up  when my health insurance did not come through as expected. You guys are a life saver and are all amazing!! 

I’m hoping to get some solid training in to bounce back the second half of the XC race season and for cyclocross!! Fingers crossed I get the green light from the boss man (aka Dr. Nicholas) next week.

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Patience and Progressions

I realize it’s been a while since I had an update so, I figured it was time. This week marks the  completion of the 8th week of physical therapy and being post op. Holy smokes has a lot changed since my last blog post! It feels like yesterday I just started PT and walking was a challenge.  Since my last post, I've ditched the god awful brace (thank god), have been focusing my gait, strengthening my muscles (which have shriveled up like prunes since surgery), and stabilization. I also have been working on having patience. I can't not even begin to tell you how much patience is key with this operation and recovery. Everyone wants to rush back to being normal and living our lives like nothing happened, but realistically the more you rush it and fail to focus on quality, the worse off you are in the long run. So, what the heck have I been doing these last few weeks? Well, I’m about to tell ya.

ROM (range of motion) Gait training, and Patience: 

Remember when I was referring to Captain Ahab in the previous post? Well peg leg is pretty much GONE! Although my gait is still ever so slightly off, my ability to bend and extend my knee while walking has progressed to a more natural movement. So my pirating days are  finally over lol. Honestly, I can’t tell you what specific thing I did to improve this, but overtime it eventually came back with progressing ROM. Over the last few weeks I struggled with getting flexion back as stated before, but this week I achieved full range of motion!!!  Chris was able to flex my knee to the point my foot actually touched my gluteus!!! I was stoked!! In side I was screaming with so much excitement and joy. I felt like the scene when Ace Ventura screams “ YESSSSS!! We have exercised the daemons!! This house is clear!!!”  If you have never seen this movie or don't remember this scene please view the video! It's pretty funny! Haha!  I know this may sound silly, but this is a HUGE mile stone for me.   

Since surgery, and even before, I have been struggling with pain on the medial aspect (inside part) of my knee. This pain was not a symptom  with my previous ACL surgeries and  has been a huge barrier for me this time around   In the beginning, the pain was significantly limiting my ROM, especially with flexion.  We still aren’t sure what exactly the pain is from . . . bone bruising? Scar tissue? MCL strain? Maybe all of it? It may even remain a mystery! Every PT appointment Chris continues to stretch and push my knee, but the pain improves with each visit. I still have a small amount tenderness over the joint line, but I see Dr. Nicholas this week for my second post op checkup.  I’m less concerned since it has continued to improve, but still something to address, obviously. One thing I learned this time around is not every surgery is the same and differences will occur. 

Swelling and pain are things you have to expect to have after surgery, but eventually you will get it under control. I religiously use ice and compression after PT and  anytime I do any exercising at home. Riding the bike at home has helped immensely, but what I actually found helped the most over the last few weeks was REST. As much as you want to push yourself to get better as soon as possible, you can actually be setting yourself back. I found I was doing WAY too much too soon. For example, Chris gave me permission to ride my bike for over 30 minutes 2 weeks ago so, I attempted to spin for an hour with some intervals. We started doing “hills” on the stationary bike at PT so, I felt it was okay to add resistance and intervals at home on the trainer. The following day I found I had more swelling and knee pain which set my ROM back at PT. I was not giving my body enough to time recovery from the intense sessions at PT while at home. Again, too much too soon. I backed off a little at home and noticed the  pain, swelling, and ROM improved again. This week being 8 weeks, I’m back to spinning on the bike with some intervals, but pain free! It’s amazing what a little rest can do for improvements. I will definitely be taking this with me when I get back to training for the race season in the spring. Fingers crossed this will be soon.

Aside from riding the trainer, I have also been working hard on walking and ROM at home. I have been slowly increasing the amount of time I spend walking Jake daily. This has been helping me prepare to return to work in January. My job requires me to be on my feet for 12 hours a day so, it is important I work towards that goal. Again, I have to continue keeping moderation in the back of my mind and staying within the allowed walking time prescribed by PT. This will ensure I don’t over do it and remain on track for proper rehabilitation. 

I also work on ROM by doing similar stretching exercises that we do at PT while home. One example is I use a dog leash to assist me with flexion. While lying prone on the ground, I can pull my leg towards my gluteus slowly. I wrap my dogs leash around my ankle and pull the leash towards my head increasing the flexion angle to stretch my quad.  Eventually it got easier and continues to get easier with time. Thankfully it doesn’t feel like Brody, from Jaws, is shooting my knee anymore lol. 

Strength:

During the first few weeks of this process, Chris and Lisa had me continue with the simple exercises. Every PT session they added modifications and adjustments to progress my rehab. Beatrix Kiddo in my subconscious has now graduated from “wiggle your big toe” to preparing for the ass kicking lol. What does that translate to in my world? I went from doing quad sets and non weighted straight leg raises (SLR) to: adding a 5 lb weight around my quad, to a 10 lb weight around my quad for SLRs, to starting leg press last week. We initially started the leg press at 40 lb, but now I’m up to 60 lbs on my surgical leg. I have also gradated from doing ball squeezes to using the weighted hip adductor and abduction machine. I am no longer doing TKEs(terminal knee extension) exercises with the band,  but now doing extension with weight on the hip machine. I realize I’m not doing back flips, round house kicks, and swinging a sword around, but I can say I am making gains and feeling stronger by the day.

Stabilization:

Weights are super important to getting you strong, but stabilization and having good form are even more important in my opinion. At Center of Physical Therapy, Chris and Lisa are huge advocates for core and stabilization. We started off with me balancing on my leg for 30 seconds, to progressing to balancing on a piece of foam for 30 seconds, to balancing on the half  Bosu ball for 30 seconds. Last week we also advanced to a more fun activity, may I rephrase this, an ADD dream exercise. Haha!  Balancing on the half Bosu ball one leg at a time, while throwing a volley ball back and forth to one of the aids, is now a routine exercise at PT. Soooo many things all l at once!! HAHA! The first few times you feel like you’re going to fall flat on your face, but eventually you get used to it. I am also doing a lot of core exercises at PT as well. This is exciting because this will translate well over to training for race season

Keeping yourself sane:

Lastly, the most difficult obstacle I have been coping with is the mental one. Over the last few weeks I have been seeing Facebook, Instagram, and Strava updates of my friends riding their bikes outside and hiking. Last night it snowed so we can now add snowboarding to that list.  Even though it’s winter, the weather has been cooperating for cycling (aside from yesterday), for the most part. l Not being able to return to work, cycling, snowboarding,  or hiking leaves you pretty bored. I am fortunate to have an awesome dog to keep me company at home and on my daily walks. I am also thankful for my amazing friends who have been encouraging me and keeping me company along the way as well.  All this downtime has been occupied by doing CMEs (continued medical eductation)  to maintain my PA certification, watching Netflix, slowly learning Spanish, getting back into photography, and reading about cycling training. Again, I can’t stress the importance of finding a good physical therapy facility as well. You will spend a significant amount of time at PT so make sure you love it there haha. Chris, Lisa, and the rest of the crew at Center for Physical have become like family and are the best team for getting me back on my bike and work. I will leave you with this: if you’ve had ACL surgery or any surgery for that matter, stay positive, stay patient, work hard, but remember to rest, and surround yourself with good company.

Stage 6: The Long Haul! Weeks 1-3: Baby Steps

November 3rd marks the 3 week post op mark!! Yay to completing little goals that feel huge!!! It has not been easy, but it would have been A LOT worse if my Mom wasn't here.  My mother has literally been my life saver the first 2 weeks post op. I literally could not have done it without her. She cooked, cleaned, walked Jake, pulled me up when I felt defeated,  brought me to PT, went grocery shopping, woke up in the middle of the night to check on me, and even tolerated my dog waking her up a million times (we still haven't figured out why he kept waking us up. Lol). I love you! Thank you Mom! For those of you who anticipate having surgery, make sure you have someone at home to help you. You initially can not do this alone.

Week 1: The first day, the day I came home from surgery, was surprisingly the easiest! You're probably sitting there wondering, how is that even possible? Shouldn't I have had the most pain the very first day, the day of surgery . . . or even the day after? Well, thank goodness we have advancements in medicine and the nerve block was invented. The anesthesiologist injects a long acting anesthetic, like Ropivcaine, in the anterior and proximal aspect of your leg. In English, that means the upper and front part of your thigh haha! The anesthetic temporarily shuts off your femoral nerve so you don't  feel anything for 1-2 days. It’s awesome . . . until it wears off. haha. 

The next 3 days, I was non weight bearing, ambulating with crushes, and had my knee locked in extension in the  brace. The only time I took my brace off was to spend countless hours on the CPM machine. This machine slowly and passively moves your leg into flexion and extension. I started at 30 degrees, but this didn't initially hurt because of the nerve block. Also, in the first 72 hours (or unless your doctor tells you otherwise)  showering is not advised. I know gross, right? However, with that being said, when you do finally get to shower, it usually requires so much effort that you question if it’s even worth attempting. Trust me, it is. 

For those of you ACLers reading this, here are a few tips: I have a tub so, that created a barrier with taking a shower without putting my leg down. If you have a stand-up shower ( I had one in my first house for my first ACL surgery)  it’s a little easier, but still a pain. My advice: buy a shower chair. Sitting makes it easier to avoid putting weight on your surgical leg. It even frees up your hands so you don't have to worry about balancing with crutches.  Getting in and out of the tub even becomes easier.  The chair allowed me to get up and out, by pivoting and resting my leg on the edge of the tub. This also enabled me to keep my leg straight the entire time.  I then put my good foot down, grabbed a crutch or used my hands to push off the tub, then balanced on my good leg. After a few attempts, I got the  system down and it became easier each time.

I was fortunatly  allowed to shower after 48 hours, but was not allowed to get my sutures wet. Some surgeons are different and do not want your dressing changed / touched until they see you. One method I used to keep my surgical site dry was covering the sutures with Tegaderm.  We use this in the ER to secure IVs, but it also works wonders for keeping surgical wounds dry. For my other two surgeries, Saran Wrap and tape worked well too.

After finally taking a shower, I realized how much it was worth it. I felt civilized and refreshed.

On day 3, my nerve block wore off in the middle of the night. You know that scene in the movie Jaws, where Brody blows up the shark? Well, that’s basically how my knee felt. My knee was the shark. My tibia and femur were NOT happy.  I took a total of 3 Percocet tablets over 2 days, but called it quits.  I went from breaking into sobbing tears without triggers, to felling numb, then got severe nausea and vomiting for hours. Sccrrreeewwww that!! Ibuprofen for the win on the pain control! Luckily, for me, the ibuprofen worked well.

Day 4 was the first day of PT!! Back to Center for Physical Therapy! Yay! Aside from showering, this was the first time I was allowed to take my brace off. Chris and I discussed my surgery, he examined my knee, made sure I was neurovascularly intact, then moved to the ROM (range of motion) assessment.  The excitement of being at PT came to an abrupt halt. Here comes the pain  *cough* I mean the evaluation of passive range of motion. This is when the therapist bends your knee and tells you to relax (yea right haha). Well, needless to say, the tears ran down my face and the pain took over. Bending your knee for the first time post OP, might be one of the most painful things you will endure besides the nerve block wearing off. Oh, wait. That just happened only hours before this very moment!!  Wah!  However, it needs to be done, and marks the true beginning of PT. We didn't do too much this particular session because it was my first day. Also, my post op follow up appointment wasn't until Thurday. Despite the pain, the therapy session ended with good news!! I was given permission to partially weight bear, as tolerated, and  with crutches!! Yay!! This was huge news and unexpected. 

Day 6: Aside from regaining  ROM after ACL surgery, learning how to activate your quad is another major component to therapy. If you've ever seen the movie Kill Bill, you have a pretty good idea of how the process begins. “Wiggle your big toe” is a quote that Beatrix Kiddo, played by Uma Thurman, repeats over and over again. After waking up from a 4 year coma, she discovered she has severe generalized muscle atrophy. She spends countless hours attempting to simply move her big toe. It was a start for her, but then she eventually gets revenge and kicks major ass. You must watch this movie if you don't know what I'm talking about! In this phase of therapy I found myself feeling like Beatrix, telling myself to activate my quad.  "Move your quad. Move your quad. Flex. Flex. Flex," were repeated in my head. Activating your quad after surgery is pretty difficult, but just like Beatrix Kiddo, it gets easier with practice and every day.

Day 7 and Day 8: Post op follow up: This visit was filled with awesome news. Dr. Nicholas stressed how happy he was with the surgery. He also chuckled and thanked me for my kind words post op (Ha ha, you must read the previous blog to understand the humor in this statement). On examine, my anterior drawer test was solid, my incision sites were clean, dry, intact, and without signs of infection. So, sutures came out! Drum roll please!!!! This is  the best part of the visit!!!  Dr. Nicolas said I was able to walk without crutches !!!! This was totally unexpected because  for my last surgery I was non weight bearing for 6 weeks! The catch: my knee had to stay in the brace while locked in extension. I was totally okay with this news! Anything was better than not being able to weight bear for 6 weeks. 

First day on the bike!

Day 8: Milestone spoiler alert!!! My third PT appointment was, by far, the best day since surgery.  We worked on progressing my ROM with, yup, you guessed it, the stationary bike!!!!  My therapist told me that my objective was to rock my feet back and forth on the pedals. This meant starting at  3 o'clock and 9 o clock and slowly increased flexion and extension in my knee. I didn't care how much it hurt, I had to make it all the way around. I was determined, but holy smokes, did that kill!!! It took me about 15 minutes (in agony) to do it yet, I managed to make a complete circle TWICE!! Yes, a FULL pedal stroke TWICE, but twice was enough. Ha! I completed my first week of PT and was officially one week post op!! 

Days 11- 22: The second week of PT was pretty similar to the first week, but we made gradual progressions and tweaks to each exercise.  We went from quad activation to working on gait training. We  eventually worked on marching in place.  Initially, this activity required me to hold on to the wall the entire time for balance.  By the end of the week, I began touching the wall every few seconds to not at all. Baby steps to little rewards.

My ability to balance each day improves. On the  third day, I was scared to even place my foot down on the ground to attempt walking. I needed to hold on to Chris’s or Lisa’s arms the entire time. I overcame this challenge and progressed to avoiding  “the peg leg.” What the hell is a peg leg you may ask? Well, Captain Ahab, might be my best visual description for you haha. Basically, I walking with my leg  straight and with little bend. This is BAD.   After ACL surgery, you not only lose muscle mass, but you lose your range of motion. Complete flexion and extension are extremely difficult, and most of of all, painful to achieve    Each day my range of motion and  ability to walk and pedal improves. Less pain, more degrees, quicker cadence, and a gradual increase in resistance. Every day, with baby steps, there are progressions . . . and with progression come rewards. On Friday, I was given permission to set up my bike on the trainer!! I am riding my bike with minimal resistance, but it was the best feeling. Riding the bike helps with range of motion, decreases the pain in my knee, and helps push the fluid out of the joint space. Most of all, it’s treating my sanity. Even though riding my bike is easier than walking at this point, I will leave you guys with this awesome reward: an easy spin. 

Stage 5: The Surgery

On Friday October 13, 2017 at 0400 my alarm went off signaling that the big day has come. My surgical date.  I felt like I never went to sleep. I jumped out of bed and made my way into the bathroom to shower for the last time for 3 days (yea, I know grrrrooosss). After changing and brushing my teeth, Mom and I drove down to Manhattan and arrived at the Surgicare of Manhattan as scheduled for 0615. Oddly enough as we drove down to Surgicare, it didn't even feel as if I was driving to the have surgery. It felt as if I was driving to the airport, but this time the early flight wasn’t to a vacation destination.

Side note: I just want to say thank you to my brother's friend, Matt, for lending us his car. My mother unfortunately can not drive a manual transmission so, my car was unfortunately not an option for her to drive us to the city. Matt you're a life saver! Thanks!

My surgical appointment began with checking in with the welcoming, yet calming lady at thefront desk staff. I was pretty taken back by how awake and chipper she was this early in the morning. I never understood how morning people are filled with such enthusiasm before the sun rises.  After filling out the basic surgery paper work, Joe, the Breg rep, went over the instructions for my CPM (Continuous Passive Motion) machine and informed us that he already dropped my knee brace off to the OR. Joe was awesome. He carried the CPM machine to the car for my mom and even helped her find the nearest parking garage. I watched them leave the waiting room and waited for my name to be called.

Ready to go!

“Lindsey!?” My name was called by one of the OR nurses who lead me into the pre op area. I followed the nurse down the hallway passing several empty chairs behind curtains until we finally made it to mine. She asked me the standard pre op questions: confirmed my name, date of birth, allergies, past medical history, procedure, etc. She placed my identification bracelet around my left wrist, gave me my gown, the sweeeeet (sarcasm) hospital socks, you know the kind with rubber grips on the bottom??, and showed me where the bathroom was so I could give a urine sample. Then the waiting began.

Sitting in my chair for 5 minutes felt like an hour because my nerves started to run. Thankfully, my mom finally came back from dropping the car off at the parking garage. I was beyond relieved to see her. Having your mom by your side is the best company to have before you have surgery. My mom knew exactly what to say to keep me calm. 

As we waited, we were greeted by many faces. I met my anesthesiologist, Dr. Riegler, who was awesome and quite funny. I informed him of my previous anesthesia horror stories and he smiled and replied simply “I smell a challenge. Challenge accepted.” I loved the humor and confidence already,

    Side note: If you ever have any surgery, make sure you always communicate your concerns and previous experiences with the anesthesiologist. Obviously, the first time you really don't know what to expect, but just be up front and honest. Unfortunately, I do not do well with anesthesia, but Dr. Riegler  did a fantastic job considering my previous experiences. 

Dr. Nicolas and Shannon, one of his newer but awesome PAs, came by, said hello, introduced themselves to my mom, signed my knee, confirmed the procedure, smiled, and said they'd see me in a few. 

As we waited, Rocco, one of my orthopedic preceptors in PA school, came by to check on me as well. He asked, “ How are you doing? Are you ready? This is going to be good!!” Of course I replied with, “Yeaaaa, ready as ever but, nervous! Ha Ha.” “ You'll be fine!!!! You're in good hands!” he said. I knew he was right. What better people could you have around you?  My Mom,  Rocco, one of the longest practicing orthopedic PAs I know, and of course, Dr. Nicholas, one of the best orthopedic surgeons in the country! Now that’s what you call the “A Team!” You’re probably wondering why my preceptor from PA school is greeting me before surgery right? Well, prior to my surgery, I did a lot a research on ACL reconstruction.  I consulted and reached out to several surgeons, one of them being Dr. Nicholas. Both Dr. Nicolas and Rocco  were my orthopedic rotation preceptors. Luckily Rocco, and Dr. Nicholas remembered me from 2009 and got me scheduled right away for my appointment. 

Side note: Let me tell you how grateful I am to have picked this rotation. Rocco and Dr. Nicholas were my two favorite preceptors. They taught me how to suture, work the OR, how to be efficient in a busy office (which translated well to the ER setting I currently work in), taught me a crap load of orthopedics, and how to have a good patient- provider relationship.  4 weeks ago I met with Dr. Nicholas and Rocco in their office for my initial consult. We discussed my concerns and scheduled the OR date. The two friendly and warm faces greeted me in my room like my rotation was yesterday. That patient-provider relationship was now with me. We went over my options as to what kind of graft I was going to have. Initially we agreed on the patellar tendon route, but I expressed my concerns and we agreed to do the allograft route.  I think that makes Dr. Nicholas an amazing surgeon. He listens to his patients, he listens to their concerns, and he involves the patient into the decision making, but still helps guide them to the best decision for the patient. The anterior cruciate ligament reconstruction with a quadruple hamstring allograft was scheduled.  The surgery date was set and I knew Dr. Nicholas and Rocco were going to be the best team for the job. 

Side note: for those of you who are unfamiliar with the terms mentioned above. An autograft is a graft that the surgeon takes from the patient’s own body. An allograft is a taken from a cadaver. A cadaver is a  person who has passed away and kind of enough to donate their body to people in need. 

Finally the OR nurse arrived and escorted me to my operating room. I looked at my mom with last minute hesitation, gave her a hug and a kiss, and told her I’d see her in a few hours. Mom reassured me, smiled, and walked through the exit door. It was just me and the scrub nurse now. 

As we walked past the scrub station, I saw Dr. Nicholas prepping for my surgery. “ You ready?!”  He said. I responded enthusiastically, “ Heck yea! Let’s do this!!” With two thumbs up! “That’s what I like to see and hear! The recovery all starts here!” I knew this was going to be good! This is why I trusted and liked this man. He's extremely positive and enthusiastic. You can always tell that he is totally used to working on athletes. 

The OR nurse and I walked through double doors entering the cold sterile room.  The familiar clean smell of the OR brought me back to memories of assisting in the OR. We were welcomed by  the scrub nurse and Dr. Riegler who were both masked. The OR table was set up just for me. Dr. Riegler placed a 22 gauged IV in my right antecubital, administered fentanyl, placed the non-room rebreather over my face, asked me to breathe in and out, and finally started to admitted the propofol. I felt tired but, attempted to hold conversation. Then lights out. 

Seconds passed (which was really an hour)  and I woke up in the recovery room with my mom by my side. The familiar large, black, bulky, black knee brace was fixed on my numb right  leg. The nerve block made my entire leg from my hip down feel painless, for now.  This is the part where you wean off of anesthesia. I don’t want to scare anyone who has never had surgery before, however, I figured I’d share my experiences with you. 

As stated before, I am one of the few people who does not have good reactions to anesthesia. I became depressed, apologized to every staff member in the surgical center, my mom, and started to cry. Then depression phase finally passed, thankfully. This was abruptly followed by overwhelming feeling of happiness and  euphoria. My Mom told me each time Dr. Nicholas came by to check on me, I made everyone laugh.  I was shouting, “I love you Dr. Nicholas! You're awesome!!” As per my mom, he responded with, “I like that!!” LMAO. I don't remember saying this at all, but at least I can say I was happy. After all I did in fact have an awesome surgeon and he didn't seem to too upset about it. HAHA!  Followed by the overwhelming feeling of joy, the hell phase took over like a black cloud. The intense, sharp, dull ache, and pressure sensation of a vice grip clamping to my skull began. Here comes the migraines. Each wave of pain was accompanied by nausea and vomiting that lasted for 3 hours.  I don't know if any of you saw my Facebook post, but all I can say is I don’t know what I would have done without my mom. Not only was my mom being a mom, but she was a nurse extender. She wiped tears and vomit off my face every other second as . She kept the nurses up to date every time my blood pressure shot up! Especially when it hit 190/109. Yup, that was my BP and higher. The spins continued and the intermittent nuclear bomb going off in my head persisted. Finally, after 3 hours, my symptoms faded.

Side note: I know 3 hours feels like a long time, but my last anesthesia experience almost had me staying overnight at the hospital. So gold star and two thumbs up for Dr. Riegler!!  

Finally, I was stable and moved to another recovery room. This where my nurs offered me a warmed corn bread muffin and orange juice that literally tasted like heaven in my mouth. Eating was the best part of the entire morning because I couldn't eat anything after dinner the previous day.  Yay for food!!! Finally, my mom and I were allowed to drive home and the surgery was over.

Side Note: Surgicare of Manhattan is awesome!! If you ever need surgery, this place is where it's at! The staff and nurses are amazing and so attentive. You can really tell these people love where they work and have an amazing team!! Also, like I said before, the corn bread muffins are bomb. 5 Star review for sure!!

My first post op PT was scheduled for Monday at 0900 . . . 3 days after surgery. I couldn't wait to go! Let the recovery begin and on to Stage 6: The Long Haul!! 

Using my CPM machine!

Jake offering me his toy when I got home from Surgicare. 

Perspective: The last of Stage 4

Three days ago I found myself having a hard time getting motivated for physical therapy. Usually I am pretty pumped and excited to go however, that day I woke up focusing on my surgery date and the dreaded inconveniences to come. I couldn't stop thinking about how I’m going to be stuck on the couch on sunny days, wishing I was with my friends on group rides, the races I am going to miss, how I won't be able to go hiking with my dog, taking a shower without breaking my neck because weight bearing won't be an option, the challenge of simply carrying my cup of coffee to the table because my hands will be occupied holding crutches. The list goes on.  All of these things were on my mind while driving to PT. Perhaps the gloomy rainy weather had something to do with it. Who knows?

The moment I walked into the Center of Physical Therapy my mood started to switch. This place has become my second home and will continue to be be over the next 9 months.  I can't even express how grateful I am for this place. Sheri and DM Foster (thank you!!) highly recommended it to me a month ago so, I decided to give it a go. Prior to my first visit I read some reviews on the staff and facility, but the reviews don't do this place justice.  This particular day is the reason why. 

Immediately entering the building I was greeted by the friendly smiles of the staff at the front desk, who by the way, make it a point to learn your name on your very first visit. Then Lisa, fitness coordinator and PTA, saw me. She knew I was not myself today.     

    Side note about Lisa: Lisa and I have become friends over the last few weeks discussing health, fitness, books and exercises. She even took it upon herself to get me hooked up with a Game Ready device for post op home use!! Thank you! Thank you! Thank you!!

She immediately engaged, grabbed Chris, my physical therapist, and both reassured me that I was going to come out of this stronger than  before the injury.  The staff at this place have way to get your mind focused on the positive outcomes and directions you will go.

Besides enjoying the awesome pre op PT program, I have really started to appreciate the positive vibes you can feel flow through this facility. The staff working as a team, watching the progression of the other patients break barriers that they did not think were possible, and just talking to the other patients. 

Over the last month I've met several unique patients who really put things into perspective for me. I’ve had the privilege to watch a young girl, who was told she was never going to be able to walk again, do gait training exercises , march across the gym floor with ease, and use the elliptical machine along side of me. She was so humble yet unbeliavble. I couldn't stop thinking to myself how amazing her recovery has been. The fact that I was sitting there moping about my ligamentous injury an hour ago, was pathetic. Watching her power through exercises with the injuries that she is going to live with for the rest of her life was so inspirational.  

I also had the pleasure to witness the progressions of a gentleman who is graduating from his ACL reconstruction rehabilitation soon.  Hearing Chris encourage him through the Cybex dynamometer machine, yelling “Go! Go! Go! Push! Pusssh!!!! You got this!! You got this!!!” was awesome. I couldn't stop thinking about how I wish that was me fast forwarded in 9 months. You could see the excitement flash across his face with the advancements he has made with each test result. This particular person gave me motivation to focus on the result, full recovery.

At the end of my PT session, I was blessed to make conversation with another patient while we were both hooked up to the Game Ready machines. By the way, the TENS unit and the Game Ready machine are my two favorite parts to PT. Anyway, before my ADD gets carried away, back to the topic. He was an older gentleman who started PT a few weeks ago to work on gait training and strength. The conversation started with a comicaltopic on how we were both using the stationary bikes earlier.  “Ha Ha! All that effort to stay in one place. They should at least give us something to power on those things” he said. We gradually got into the topics as to what we were both recovering from, but I really didn't want to tell my story after he told his. This wonderful man told me how he was diagnosed with metastatic cancer a few years ago and how the mets in spine weakened his body. He told me how amazing he used to be atdancing and that it was one of his favorite things to do. He got so joyously lost within his day dream ofdancing at a wedding he attended recently, but he quickly broughtus back to reality when he said, “ but then I had to stop. The pain slowed me down and I realized I couldn't dance any longer. The cancer is stable, for now, with chemo but, man I wish was recovering from what you young kids are recovering from.” He didn't know my story yet, and I honestly didn't feel my injury was respectable enough to tell him. I too, wish he was recovering from ACL reconstruction. 

What I learned from this PT session is, the importance of finding a great PT to build your recovery emotionally and physically, and to be grateful for the health you have. Keep things into perspective. My ACL reconstruction might be life altering in terms of not being able to ride and race my bike, hike with my dog, and not fall on my face to get into the shower in the short term, but 9 months of recovery is a lot shorter than  a life timespent by the people I've met at the Center of Physical Therapy.   Life will place obstacles that you can get through, hard and easy, but you can get through them. 

My surgery is tomorrow and I am growing a little nervous, but I will utilize the remainder of my time pre-op to enjoy the things I love the most. Today I will enjoy my last bike ride out side for a long time, bring my dog for a hike, enjoy the freedom of walking, and the little things I take for granted without crutches and my knee brace. Although these things are coming to a brief pause in life, I know my new family at the Center of Physical Therapy will get be back up and running (literally haha) in no time. Monday is my first post PT appointment and I can't wait to go back. 

My first Blog Post: The 6 stages of an ACL injury.

Someone once said to me that, “when you witness an athlete get injured, and see the tears pouring down their face during major TV sports coverage,  it's not due to the pain. It’s due to the disappointment and impending challenges they will face after the injury.”  These challenges include: physical challenges with recovery,  not being able to complete everyday lifestyle activities, post op pain, and most of all, the emotional stressor of possibly having their athletic career stripped from them in matter of seconds.

Unfortunately, I have had the privilege to experience this on 3 separate occasions minus the TV coverage. I have torn my ACL 3 times now; twice in my left knee and recently my right knee. 

I can basically sum up 6 stages of emotions with my experiences:  

• Stage 1: The Injury

• Stage 2: The Oh shit, this really just happened! Here comes the pain

• Stage 3: Depression

• Stage 4: Stop feeling sorry for yourself and accept help from others

• Stage 5: The Surgery

• Stage 6: The Long Haul

Stage 1: The Injury:

Description: You’re faced with a short intense burst of pain and shock that it just happened. You're body is overloaded with adrenaline making the pain not even an issue. Your mind does not even recognize the future emotional roller coaster ride you're about to experience.

My experiences: Stage one for me was a little different each time I tore my ACL. It was different because the knowledge base I’ve acquired over the years of being a medical provider, and let’s face it, you kind of know what to expect if you’ve had the same injury 3 times. 

The lift.

The first time was about 6 years ago and was filled with a lot of firsts. It was my first time at Diablo,  the first year I really got involved with racing and riding mountain bikes, and the first time riding with new guy friends from one of the local bike shops.   My technical skills were limited however, at the time, I felt really fit and just excited to be there.  I also felt pressured to keep up, ride the harder trails (that I was not good enough to be riding in the first place) with the guys, and not slow anyone down. We went down one feature trail where the guys were slowly creating a farther gap between us. I remember being blown away with the speed these guys were descending the mountain.  They were clearing table tops, hucking jumps, and railing berms at speeds I was not comfortable committing to at that time.  Then it happened. I went off one of the wooden ramps, fell 5 feet coming off the bike, and crashed with my knees taking the majority of the impact. The sudden intense sharp, aching, pain of my ACL ripping off my tibia, went off like a grenade in my knee. I held my knee close to my chest, fought back the tears for the few seconds while the grenade continued to explode. I rocked back an forth like one of those soccer players you see on TV after another player just took them out during the game. Then the pain slowly subsided. By the time the pain stopped, my friends realized I was not with them, and finally came back. They helped me up and then I attempted my first step. Big mistake. My knee felt like a noodle and gave out immediately. I realized I wasunable to regain balance and was unable to ambulate.  At that time I realized something was wrong . . . Stage 2.

Stage 2: The Oh shit, this really just happened! Here comes the pain:

This is the part where the adrenaline wears off. The overwhelming emotions of sadness and shock consumes you because that treaded ACL injury you hear ruining people’s athletic careers in fact, just happened to you. Yes, you. Like the nice slap in the face you just accepted into your life isn’t bad enough, that thing called pain comes back with a vengeance. 

My experiences: The thought of a ligamentous tear was in the back of my mind when it first happened, due to the instability of my knee. I've seen and treated a bunch of patients in the past with this injury, but I remained in denial. I refused it happened to me. Who injures their ACL while riding bikes anyway, right? Well, even though it’s not the most common injury in cycling, I later learned I was predisposed for this lovely injury due to genetics and being female. . . which will get into in a later blog post.  After going to the orthopedic surgeon days later, I got my MRI results, and became another statistic. The MRI confirmed I tore my ACL.

The second time I tore my ACL, was kind of a mix between Stage 1 and Stage 2. Due to the second ACL tear following my reconstructive surgery, I did not experience the same intense pain. Your native ACL receives nerve fibers that are branches from the tibia nerve. When the ligament is injured, they are disrupted on the initial tear causing pain. After having a graft done, you really don't experience that intense pain because the nerves are gone unless, it’s accompanied by bone injury. It’s more of a sudden pop. With that being said,  I immediately knew I re-tore my ACL. I was 2 weeks out after being cleared to ride again and being discharged from PT. I was greeted by the familiar instability while walking again.  The devastation had a quicker onset because I knew I had to have revision surgery, go through the gruesome 6 months of rehab that I just finished, and to do it all over again. 

The third time, which happened a month ago yesterday, was much more devastating. I just bought a new bike, just completed my first full year in Elite/Professional Class for cross country, was looking forward to the upcoming cyclocross season, and was feeling awesome again. I say again because of the side note mentioned below.

Side note: This past year was extremely challenging for me. I started my first full year racing in Elite Class at the Sea Otter Classic battling a severe episode of vertigo (which I was nearly sent to the hospital for treatment). The middle of the season was also paused because I sustained a grade 3 concussion. I had a bad crash after practicing the drop at the Julbo Eastern Grind PRO XCT MTN Bike Race in Vermont. I was diagnosed with a severe grade 3 concussion at The University of Vermont Medical Center after being knocked out unconscious for 25 minutes. I also have no memory of about 2-3 hours of my life. Not only did this scare the life out of me, it absolutely crushed me emotionally.  Not only was I not able to race the following day, but I was forced to skip nationals,  stay off the bike for two weeks, and my face was a hot mess.  This was suppose to a big year for me.

So where was I? Right, the feeling awesome part. Well lets just say that came to an abrupt halt when my knee gave out yet again. This time it was my right knee. I was riding downhill at Mountain Creek on my amazing new Trek Slash having a blast with friends. The fun stopped when I didn't see the small drop in the inside part of trail coming around a sharp turn. I put my foot out to prevent me from crashing and boom! There was that grenade feeling again, followed by the instability as mentioned with Stage 1.  I knew I tore my ACL the second it happened however, this time I was oddly more calm during Stage 1. I knew I tore my ACL, but I kind of just said it out loud like it was a matter of fact statement. I was not even upset. Thank you, adrenaline. 

The injury.

Well, like mentioned before, that wonderful thing called adrenaline eventually wears off. This time it was when I was driving home (sorry I didn't listen to you Cory). I initially didn't feel the need to go to the hospital, because I really didn't have pain unless I attempted to walk.  I just told myself, “ so, I just won't walk untilI get home. I can drive home and deal with this later.” And lets face it, it was my third time around.  I’ve seen this a bunch of times now treating patients in the ER too. I was an ACL veteran right?  I remember telling myself,"I had a positive Lachman's and and anterior drawer test at Mountain Creek.  I know my ACL is torn. Why the hell should I go to the ER? It’s going to be a waste of time.”  Then my knee started to throb, but this pain was unlike the very first time I initially tore my ACL. The pain was much more intense this time.  I felt every single bump in the road that my car hit, any movement of my knee, and the pressure of pushing down the gas pedal exacerbated the pain. At this point I have not straightened my knee out. I already know what you're thinking. Yes, I was stupid for driving home. I called my brother and asked him to bring me to my job, the ER. 

Side note: Going to the hospital was an experience it self. Thank you Jack, Mark, Elyse, Amanda, Mike, Beth Ann, Adam, and everyone else at work. You guys were amazing.  The excruciating pain of my two friends/co-workers straightening my knee out was horrible, but I wouldn't have picked anyone else to do it.  I was blessed to have my friends and brother, Jason, by my side. Also thank you to the pharmaceutical companies for creating IV Toradol. That stuff is awesome haha.   The anticipation of getting an MRI days later to see the additional damage, wasn’t exactly ideal. I wanted the answer right, then, and there.  Don’t forget we are in Stage 2. Here comes the rush of emotions. I called my Mom and the words came out of my mouth,“Mom, I tore my A—.”  I couldn't even initially finish the sentence. The tears of sadness and realization consumed me. My cycling career was over. . . so I thought.  

Well here comes Stage 3.

Stage 3: Depression:

 This is the stage where you realize that you're no longer able to participate in activities that you love to do. Life stops. You lose motivation and quit. 

My experiences: the first time wasn't as bad because I really didn't expect what was coming. I didn't believe how crappy it was to recover from this injury and thought it wasn't going to be as big of a deal.  The first and second times also didn't have a big impact on me because at that time, I also wasn't taking cycling too seriously. Racing and riding was just a new hobby. I was more upset with the inconvenience of not being able to complete everyday lifestyle activities as easy. Going to the store, taking care of my dog, and doing house chores were once simple tasks. Now they were difficult challenges.

The Slash.

My MRI.

I think this time was was more devastating because not only was I faced with a third surgery and the inconveniences mentioned before, I realized that everything I worked towards the last three years to get to the elite level was crushed. I also have a more complicated ACL injury this time around. I have significant bone bruising with microfractures of my tibia plateau and femur, sprained every ligament in my knee, and even managed to sprain my IT band. The pain was more intense and I walked with crutches for about week. I was also forced to take several days off of work.  Calling out of work was never a thing.  This was my first time missing work due to an injury, ever. Not only was I freaking out about my job,  I was unable do the things I love the most: hike with my dog and ride my bike. Those things are my stress relievers. They're critical with keeping my sanity and provide happiness. They were yet again, removed. As some of you may have seen, I posted a dramatic post on Facebook stating I was selling all my mountain bikes and quitting racing. I even went through with posting my bicycles for sale on Facebook and Craigslist.  On most days following the injury,  I had zero motivation to do anything. I even lost interest in eating. And if you know me well enough, that's completely uncharacteristic of me.  I love food. HA! All I wanted to do was sleep, and sleep more. Lucky for me I had amazing friends, family members, and people from the cycling community reach out to help me. Even my dog was even a motivational factor. They all helped me reach Stage 4. 

Stage 4: Stop feeling sorry for yourself and accept help from others:

This is the stage where you kick Depression's ass.  You stop feeling sorry for yourself. You realize you have amazing friends and family members that want to help you through rough times. You realize the end of the world has not come knocking on your door just yet, and things aren't that bad. You remember all the sick people in the world. There are people suffering way more than you. They have long term terminal illnesses, life threatening injuries, and permanent life alternating injuries.  Get over yourself, things are going to be okay.

My experiences: I'm only going to elaborate on Stage  4 of the third and current ACL injury. The reasons  are, this first blog post is becoming way too long, and I really want to focus on what I learned this time around. I do want to thank Amanda, “Twin,” for taking me grocery shopping when I couldn't walk after my ER visit. Also, thanks for documenting me riding the scooter in Hannaford!  That was definitely a classic. Bill, thank you for taking Jake, my dog, to the Catskills. He definitely needed to  burn up the pent up energy while I could not walk that week. Chris, thanks for coming with me to the doctors appointments and help keeping my spirits up. You guys rock. 

The remainder of my blog posts will be focused on the help I got to reach Stage 4, ACL pre-op rehabilitation, my surgery which is scheduled on Friday, October 13, 2017 (yes, I picked that day LOL), and my experiences with post-op rehabilitation.

Intermittently I will be posting educational blog posts about the ACL topics such as: how I chose my graft, the research I did to do so, and what I learned along the way.

My goal is to share my experiences with other people who may be going through ACL reconstruction, other traumatic injury recovery, or people who are just simply interested in hearing my personal experiences with recovery and getting back into the race scene stronger than last time. This is also going to give me something to do while I'm stuck at home on the couch.  HA! Thanks for reading along this far. I look forward to telling you about stages 4, 5, and 6 here on out.