Author: Jen Rios

It’s cold today and on the way to ATI, it was raining, the big splotchy kind.  There was a dull ache in my knee, not a throb but a constant ache.   My knee felt a little swollen. We  were early for my appointment and when Brad came over and asked how I felt; I searched for the correct word to describe the feeling in my knee.

When the words did not come to mind, I just said it was raining and kind of puffed my cheeks out a little bit. I told him that’s how my knee felt.   Once I was on the table, Brad squeezed a lot of massage lotion on my knee and began to work  standing up. I asked him how it felt and he  looked at my knee and pressed it with his fingers. He said it looked a little bit puffy.  Right around the incisions.

I asked him if that was normal, for it to NOT be swollen and then to get swollen. He told me that we are moving it a lot more so it might be from that.   He rubbed my knee for a long time and it felt better. Then he started kneading my calf.

It hurt a little bit and I winced. The tone in my legs reacted by twitching away from him. He asked me if it was tender and I nodded. I asked him if THAT was normal. He said it was and told me why. The calf muscles  run up my leg and connect at my knee so when the knee is worked on, it can cause the calf muscles to tighten.  (Basically, I think).

He sounds super smart when he talks about it because he knows exactly the reasons why my muscles behave as they do.  I think that was the gist.   He bent my knee a few times but did not measure and then he moved my straight leg out to ward toward him. I could feel the stretch  in my groin.  And felt good to have a different movement in my leg other than just being straight out in front of me all day!

Before he hooked me up for ice and stim,  my knee and calf both felt relaxed. The first time all day! With the cold and the rain, I was reminded that I have MS. I ALWAYS feel terrible in the rain! (Barometric pressure and stuff).   So today it was apparent that this is going to be a long recovery; and oh yeah, I have MS.

With a great report at my first post op appointment, I was feeling pretty confident! I’ve been consistently progressing well at physical therapy and reached my goal of bending my knee to 90°.   But then there are days like yesterday.

Days that serve as reminders for me that I DID just have knee surgery! I did not get approved to get my brace unlocked, therefore I cannot even put any weight on this surgically repaired knee.   My knee hurt a lot! It wasn’t the cracked-open feeling I had in my knee before surgery but it was an ache that I know will feel better eventually; but it does it right now!

I was on time for my appointment at ATI, I worked with Brad. As I was getting ready to get on the table, he asked how I felt. I told him that my knee hurt but it was a better pain than it was before but it still was in pain!  Once I was on the table, he rubbed my knee and pushed on it with his thumbs.

He kneaded my calf a bit and worked on bending my knee and it’s range of motion a bit, but primarily he rubbed my knee out. I asked him how it felt and he said there were some, “Tight spots.” As he did this, he had his, “thinking face” on.

I told him how I had seen the “thinking face” on Parker ( my MRT therapist who told me about Mike Barwis), Mike Barwis, Jesse (my first trainer), Phil, Michael, Sue, and Nick (among others), and everyone I have seen at ATI. I asked him if he sees “grids” on my body.

Like, Tron grids.  I always imagined that Parker saw them but he didn’t and Brad just laughed and said that he doesn’t either. I asked him if his hands hurt, he shook his head and  told me,”Not really.” He talked about tools that therapists use to save their hands.  (I am familiar with a few of them).

He told me that hands are the first things to go on physical therapists and they get their hands worked on  at physical therapy when they do.  My time was up and he hooked me up for stim and Larry put my ice on. That’s my favorite part!   My knee had started to feel a lot better!

Sean came with me and my Mom to ATI to help get me out of the car  since I still can’t put weight on my right leg.   Not being able to bend my knee so having to sit in the back of my car is really frustrating! Not to be responsible for the music choice  or temperature control in the car is even more frustrating!

I sit in the backseat with my back against the driver’s side door and my legs straight out. Given that I am only 5 feet tall, I fit just fine. I have 2 pillows behind my back and a pillow under my  right leg.  I told you it was it involved to get me in the car!   My knee was hurting pretty badly so I rested my head on the seat and tried to doze off.

I noticed, five minutes until my appointment  time that we were still on I-96.   I called ATI and told them that I was coming but I would be late. Then, traffic completely stopped FOREVER!  I remembered a couple of years back,  when I was training at Barwis with Mike Rhoades,  and traffic was brutal. It was because of an accident. I was pretty sure this was an accident too.

I couldn’t really see out of the front window, and my knee hurt a whole lot, but traffic was not moving and I was frustrated because I was late for my physical therapy appointment!  Then, we all saw it. It was a garbage truck who lost all of the garbage out of his truck so there were like four other garbage trucks picking up that garbage  that was strewn across the highway and police were directing traffic.  It was a huge mess! I just wanted to hurry up and get into ATI!

I finally get into ATI and Brad began working quickly once I was on the table.  He bent my knee and was able to get it to the 90° that was my goal! Then, kneaded my calf vigorously and my MS reaction was to  jerk my foot away from him. He kept a tight hold on my ankle and  I could feel my calf relax.

He kept looking at the clock behind me (because I was close to a half hour late) and said he wanted to save time for ice and stim so he worked quickly on my calf, it didn’t hurt as badly as it did before but it didn’t feel good!

Once Brad was satisfied with the work he did on me, he hooked me up  for stim and placed the ice pack on my knee. I let my breath out and closed my eyes because it felt so good! My mom stood by me by  this time.   My mom suggested that I cancel my appointment the whole time we were in traffic.  I told her that even though we were late, I needed to come to therapy for this exact moment!  The combination of the stim and ice is the best feeling in the world for my surgically repaired knee!

My brother came with me and my Mom to my first post-operation appointment. It is quite involved to get me into the car because my brace is still locked at zero  so I can’t bend my knee and I am not supposed to put any weight on my right leg.  After this operation, this was the first time I have ever sat in the backseat of my car. It’s not comfortable!

Once  I checked in and the three of us were in the office, my brother took a seat in the far corner and I rolled up to him and put my leg on the table. I feel pressure when my leg is not elevated and the table was a good height. It made my knee feel a lot better!

I was called back and my Mom accompanied me. Once in the room, I extended my leg on a stool  without wheels and my mom helped me to open my brace up and pull my compression sock down to expose my knee.   I met with Dr. Frush!s P.A.  I met with her before   surgery. She looked at my knee and thought it looked great!

The Friday before, I had a reaction to the pain medication I was given  after surgery and had to discontinue it. Two weeks after surgery, I am only on extra strength Tylenol so it feels like I’ve had surgery!   She pulled the Steri-Strips off and  cleaned up the dried blood and pulled the stitches out of the sites, cleaned them, and replaced the Steri-strips. I explained to her how I’ve been keeping it elevated and constantly icing.

She was very pleased to hear this and told me, looking at my knee, it looks like I haven’t even had surgery! That felt great! I was doing a good job with tons of help from my Mom!   I felt like we were getting A pluses and gold stars!  I thought for sure she would unlock my brace. However, this was not the case.

She explained to me that I would  need to  only put 50% weight  on my right leg. She further explained that having MS and I am wheelchair-bound this  would mean anytime I transfer from my will chair elsewhere.  She said that transferring is twisting the knee  and it would be impossible for me to make sure I was only putting 50% of my weight on my right leg.   She said, because of this uncertainty, she was not going to unlock my brace and I  needed to continue doing what I have been doing.

I didn’t really LIKE hearing that but I understood it. It is for the best!   This really makes me feel limited and dependent on other people.but, this is what’s best for my knee. I will do whatever is necessary because I do not want a THIRD knee surgery!

Once I was in the car, I told my brother about pulling the stitches out of the sites. That kind of hurt but my brother and I laughed when I told him that I had“one stitch” in each site. We repeated the line from the 1987 movie, Adventures in Babysitting  , just like the doctor did when Brad got stabbed in his foot.   We laughed and laughed.

My mom thought there were two stitches in each site but saying that there was only “one stitch” was so much more funny!  On the ride home from the doctor’s office,  my knee really begin to hurt and I realized AGAIN that this recovery is going to be a VERY long road!

After I was home, and my son came home from school, I told him the same “one stitch” story.   I made him watch the movie with me when he was younger so he knew the reference. It was definitely more funny than  saying “two stitches.”

I worked with Luba on Friday.  Just as I got on the table, I asked her if she was going to move my kneecap around like Brad did. She said she wouldn’t if I didn’t want her to but I told her to do what has to be done and I will deal with it. She is very impressed that my knee is not swelling very much at all!

She worked primarily on my range of motion. She was able to bend my knee to 86°  And I liked the progress that my knee was making! She started kneading my calf just like Brad did and she saw me wince a bit. She asked me if it hurt and I nodded. I asked her  why it hurts so much and she said, “You DID  just have surgery!”

Oh yeah, I did! I still can’t bear weight on my injured knee so I have to be carried to the bathroom, otherwise I am in a recliner with my feet up.   It seems that I am making good progress but this is a very long road!  I go back to see Dr. Frush for my first post op appointment and I’ll see what he says. Hopefully he will unlock my brace so I won’t be so restricted and have my leg  forced to be straight with my brace that is locked at zero.

I worked with Brad on  Wednesday. My Mom and my brother Dave got me onto the  table and Brad pulled his rolling chair right up to my knee. The table was kind of high, at about Brad’s chest, and he started moving my kneecap around. Methodically, toward the top, and then toward the bottom, pressing his fingers in the middle.

It hurt. Not like “excruciating pain” hurt  but the kind of pain when someone is tapping on your arm or your leg or your hand  and you push their shoulder and tell them to “stop!” because after a while, you realize it kind of hurts! It was like that. He obviously knew what he was doing, but it kind of was the “annoying pain” after a while.

He was deliberate in his movements so I asked, “what are you doing?”  I explained that he was ensuring that there was no hypomobility in my knee. My kneecap specifically.   I told him that the top of my kneecap hurt right after surgery and the nurse in recovery said that she read that Dr. Frush had shaved it a little.   Brad nodded his head.

I remembered telling Brad at physical therapy, before surgery, that I just wanted Dr. Frush to open up my knee and pick out the bits that were hurting me  on the top of my knee toward the outside. I guess the “shaving”worked because even though my knee hurts, it’s not the kind of hurt I had before surgery with the “bits” hurting.  Brad told me that he didn’t want my kneecap to be “stuck.”   So, it all made sense for him to move my kneecap as he was. Then he started bending my knee.

I told him that Luba got my knee to 65° and her intern, Will, told me that it was 66° to him.  The first time Brad measured my knee, it was bent to 62°.   After he measured, he kind of rocked my leg  back and forth and the second measurement was 78°! I think I let out a,  “Yeah!”  Or something like that. It felt good!

He slightly bent my knee and pressed on the outside of my calf and I kind of winced a bit and he asked if that was a little bit “tender.”  It was! He continued to work on that spot and I continued to wince but I know that “Its got to hurt if it’s to heal”  so I just dealt with it.

I told Brad that I am almost out of narcotics. This fact concerns me a bit but that is how it is. I still will have my ibuprofen but would no longer have the hard-core stuff  so I am anticipating it to hurt a lot, like it did before. I still am not weight-bearing which is bothersome but I will see the doctor on Monday  and see what he says.

 I started working out at Barwis Methods July 12, 2013. I would go there three times a week. I was injured on September 21,  2016.  At my subsequent appointment with Dr. Frush, he explicitly told me NOT to go back to Barwis Methods (he knows Mike Barwis and all the wonderful work he does with the First Step Foundation,  he knows that I am a First Stepper) until my knee stopped hurting.  I never thought that I would NOT be going to Barwis Methods for eight months and counting.  I previously wrote about it being heartbreaking and it absolutely is!

I started going to ATI for my physical therapy needs because it was inside of Barwis Methods. I met many of the physical therapists while I was working out at Barwis. ATI moved and now they are the office space next to Barwis Methods. They have a door in the back that leads  directly  into Barwis’ gym.

 Mike Barwis had referred me to Dr. Frush a few years ago when I tore my hamstring; he was the doctor I immediately wanted to see when my knee was hurt. When I first started physical therapy for my knee, I would have my Mom park in the back of Barwis Methods so I could get a glimpse of the guys or Megan before going into ATI; now, it’s too involved to get me out of the car to take the time to go in through the back, and that would REALLY hurt!  I just look at the Barwis window signs with longing as the car passes.

Yesterday, as I laid on the table talking with Luba, Dan Mozes walked in, stood over me, waited until I smiled once I recognized him, leaned over, and shoved his fingers into both of my ears!  I grabbed his hands and laughed. I was SO happy to see him in his Barwis Methods hoodie!  He walked over to greet my Mom and get some candy from the dish by the door.  Seeing him, satisfied my Barwis craving for a bit!  It served as my Barwis fix for a while.

I  texted Mike Barwis awhile back and told him that I cried because I miss going there so much.  Luba asked if he answered (he’s kind of a BIG deal) and she was surprised when I said, “Yes.”. I started working out at Barwis BEFORE he got as big as he is today.  I remember years  ago when I first started working out at Barwis and heard Jesse refer to Barwis Methods as just Barwis and I thought it soumded weird. Now, it couldn’t be more comfortable!

So, surgery went well! My knee hurts but it is going to get better.  Two days after surgery, I saw with a physical therapist who specializes in neural-therapy.  I was pointed in this direction – OBVIOUSLY because I have a neurological disorder.  But, that didn’t work out. I went home feeling NOT GOOD so I called ATI. They could help me with my meniscus therapy and could see me on Friday which was the fifth.

I am STILL not weight-bearing (meaning that I cannot stand) so my brother Dave accompanied me and my Mom to both of these therapy appointments (to help pick me up). My Mom came back with me with the neural physical therapist. I wasn’t very comfortable in the facility, it was much different then a ATI or even Barwis.   But, I think what made me most uncomfortable was the therapist (who was obviously a lot younger than me) but he kept saying, “I KNOW MS!”   I talked to Luba today about that and I couldn’t figure out why that made me so uncomfortable but she agreed. Perhaps if he had said, “I know a lot about MS” or “I’ve studied a lot about MS” or “I’ve worked with a lot of people with MS”  I may have been more comfortable but I was fighting the urge to tell him that I know more because it is raging inside my body and it has been for the past 16 years.

Friday, as soon as I got in to ATI I was greeted by a number of people and my brother said it had a more welcoming feeling then the first place. He didn’t know that everyone at ATI knows me.   I worked with Brad on Friday and he bent my right leg to 48° the first time and 38° the second time. The previous therapist did not even really try that hard to bend my leg.   He half-tried once and put his hands up and told me that he could not break my tone. I thought, “Brad never gives up, Luba never gives up.”   And felt defeated.

Luba bent my right leg to 65° today. Her intern, Will, told me  that he thought  it was 66°.  I’ll take it!  After I told Luba and Will about my experience at the first physical therapist’s office, I told her that at ATI feels like home. She smiled and said, “Welcome home.”   Brad gave me stim. and ice on Friday.  Luba just rubbed my knee and bent it the whole time. She told me as she snapped my pants to keep doing what I’m doing.

Last night, as I was about to fall asleep in the recliner in my living room, I cried a bit because I know how LONG this road to recovery is going to be before I can even get back on my road to walking and it just seemed a bit overwhelming!   I saw this earlier in the day on Facebook:

thought of that, stopped crying, and fell asleep. This is all I’ve been doing for the past 16 years.