I'm Kirstie, the movie star. I will be your Speech Pathologist today.

So I haven't posted in a while...I've been pretty whiny lately and I thought you'd appreciate it if I kept the whininess to myself for a while. But, I've called a WHAmmmbulance and am feeling much more like myself today, so I will attempt to provide an update without too much whine.

It has been a tough few weeks in terms of knee pain. The last time we chatted, I explained how I really believe that  my pain is neuropathic - my brain is interpreting threat and sending amplified pain signals to my knee. It was enlightening to gain awareness and accept that my knee is likely structurally as good as it will ever get; however, it's frustrating when you understand why and where the pain is occurring, yet feel helpless to make it stop.

Anyways, I ended up taking some time off of work in an attempt to settle down this pissed off knee. It was ok for a few days, but by day 3, I was losing my marbles, ready to kill Dr. Phil and his messed up guests, and really eager to get back to the hospital - easier said than done. Because of some checked boxes on a form, I was told by HR that I could come back to work as long as I didn't sit, stand, or walk. Um? Ok? How's that gonna play out people? Speech therapy via stretcher?? Luckily, my family doctor is a very accommodating man and he was able to meet me in the operating room before he performed surgery just so he could uncheck those pesky boxes so that I could return to work. For real. Awesome system.

Although I am frequently experiencing pain at work, I find it much easier to distract myself in that environment. When you're dealing with people who've just suffered a stroke, or a family who is questioning how to keep a loved one comfortable at the end of life, you gain perspective and spend a lot of energy attempting to reassure and comfort patients. You also get to chat with families, hear about the patient's wedding in 1945, the new great-grandchild, and discuss current events. There is no doubt in my mind that I get my energy from people. I really need to be surrounded by people, especially when I'm struggling. I am also very lucky to work with really fabulous co-workers. They sense when I'm having a rough day (most of them are physios, so they can spot an "off" gait anywhere!) and are so supportive and kind.

One of my fabulous co-workers, Kelly, has begun acupuncture with me. Kelly is one of those people who is constantly observing, processing, and problem-solving. She came up with a great plan: we're going to pair my acupuncture session (in which I should feel relaxed and pain-free) with music. The idea is to classically condition myself, so eventually, if I am feeling pain, I can listen to a specific song/songs and instantly feel relaxed. You know, just like Pavlov's dog. If "Pour Some Sugar on Me" suddenly makes me excessively salivate, you'll know we've gone wrong somewhere. Haha. It's totally worth a try and I'm open to everything right now.  In addition, I'm trying a new medication that targets nerve pain. I'm crossing my fingers that this combination of therapy makes a difference for me. I just really want to be happy and pain-free again - consistently.  Fake it 'til you make it has some merits; however, it's exhausting to constantly be smiling through clenched teeth.

Yesterday, for example, around 2pm, I had hit my limits for the day. My knee was aching, the "shocks" were starting up again, and I felt old and disabled as I limped into my patient's room. My 75 year old patient with dementia, who had been in the hospital for over a month, was facing the wall in his wheelchair as I entered the room.

"Mr Smith? Hello! I'm Kirstie, the Speech Therapist."

Mr. Smith turned his head slowly and his eyes widened in surprise, "Wow! You look like a movie star!"

A huge grin appeared on my face and I instantly felt...well, I'm not gonna lie - I felt awesome.

"You have no idea how great that makes me feel,"  I responded, "Are you getting tired of being in the hospital?"

"I'm in the hospital? Jesus, when did that happen?" he responded.

Oh dear. He was definitely confused. He was confused, but man, did he ever make my day.

...And someone will mistake you for a movie star. 

Pain is Painful

"On a scale of 0 to 10, 0 being no pain and 10 being the worst pain you've ever felt, please rate your pain right now."

Ugh.

I hate that damn pain scale. I understand its merits. It helps patients think more objectively and rationally about their pain. It also helps health professionals determine the effectiveness of treatments. But, it kinda sucks. Whenever I'm asked this question, I go into a long complicated self-talk session before giving away my response, "Like 10 minutes ago, when I had a shock, it was a 9, but then the shock settled and it's a 5...so I do I take the average? I don't want to overestimate my pain, but I need my doctor to know that this legit pain. What do I pick? aggggghhhh!"

If I am in quite a bit of pain, I usually go with a 7. It's a solid number. It gives me room to grow - you know, if the pain gets worse - In retrospect, 7's a good call. I have vivid memories of laying in room 406 of the hospital yelling, "It's a 10. The pain is now a 10 people. For real!"

Sometimes, I hear outpatients in our therapies department, patients who've dressed themselves, driven themselves to therapy, and participated in idle chitchat in the waiting room respond with outrageous pain claims.

"Oh the pain is terrible. I'd say at least a 15."

Ok. Wait just a minute. 15 is not an option. And if your pain was worse than the worst pain you could ever felt, than how the hell did you just scarf down that Tim's breakfast sandwich? Ya, I saw you. I call bullshit. Funny enough, that statement is usually followed by, "And I have a really high tolerance for pain." REALLY? And who decided that one?

But maybe that person actually believed his pain was 5 points worse than the worst pain he's ever felt? Who am I to say? Pain is personal. Pain is subjective.

This past week, I've been struggling with pain. "The shocks" came back with a vengeance. They caused me to drop my clipboard, grab my knee and yell, "SHIT!" on an hourly basis. Super inconvenient. I finally gave up on attempting to be a productive member of society and went home and laid in bed for a week. It sucked. When I began feeling a bit better later on in the week, I decided to sort out why the hell this is happening. After numerous knee inspections by both my fabulous ortho and my stellar family doc (both of whom I trust completely), it would appear that although my knee is swollen and slightly "angry," all the tests that indicate my cartilage is damaged, a tear exists, or anything really sinister came back negative. Which is a relief; yet, makes me question why I am feeling such intense pain, and how the hell do I ease this debilitating pain (other than drugging myself into that drooling, mindless state).

Then I saw a video. It was a really awesome explanation of pain and the brain's role in pain. You see, the brain is smart. Duh, it's a brain. When something is aggravated in your body, your peripheral nerves send a message to your brain, "Hey, brain, we've got a situation here. The knee is angry. Please advise." The brain's job is to collect all the information - it evaluates every piece of credible information including past experiences - to determine if you are in danger. In my situation, my brain would see that in the past, an angry knee indicated danger, typically resulting in ripped cartilage and surgery to repair. My brain immediately sends a message back to my peripheral nerves, "This is bad! I repeat, bad. THREAT!" (After all, it's in my brain's best interest to keep me safe and alive). My nerves respond by sending the message back to my knee, resulting in a sharp, attention-getting pain. My brain wants me to notice so it's amping up my signal!

So simple, yet so complicated. My brain is conditioned, given my past experience, to signal severe pain when my knee may just be slightly angry.

I'm not saying that the pain is "in my head." That's not the message here. Oh, I can tell you that the pain is real. It causes my teeth to clench and my eyes to tear. What I am saying is that although my brain is merely trying to protect me, it's a bit misled...and I have the power to help change that. And anything that puts the control back in my corner is music to my ears. But..it's easier said than done. I can't just tell my brain to stop, although awareness is definitely a good first step. My anxiety has definitely decreased simply by knowing that my knee cartilage is fine and that I do NOT require more surgery.

The literature recommends that you create a "safe" environment for your nervous system. Initially, it sounded like a bunch of hokey bullshit to me, but hey, I have nothing to lose. I determined that for whatever reason, heat eases my knee pain. So I've taken approximately 12 hot baths this week (sorry environment!) and constantly keep a heat pack on my knee. Basically, I'm telling my brain, "Heat helps. We're heating. We're safe."

Haha, you think I'm crazy, don't you? Ya, so the big question is: Has it helped? Is this helping?  Um....not, yet. But I'm gonna keep going with this. I'll let you know. I mean, the brain's not a dog. It can't be trained in 3 days, people!

Now when I receive "the shocks," not only do I drop my clipboard, grab my knee and yell, "SHIT!" but I also follow it up with, "Brain, we're safe. This is not a threat. I repeat, this is NOT a threat." Oh man, I'm gonna get locked up for sure.

Anyways, it's an interesting theory and worth a good 'ol college try (what does that mean? Did you try harder in college? I didn't.)

I highly recommend that you check out this video. Not only is it extremely informative if you are experiencing pain or living with someone in pain...but it's pretty entertaining as well (and I love a good Aussie accent!)

Frostbite? No thanks, had that for breakfast

Warning: this is an overly dramatic post because THAT's the kind of mood I'm in. As I write this, I am eating raw brownie batter from a bowl and drinking wine out of a box - I may have mixed a painkiller in there as well...You have been warned. 

So it's cold. It's so cold that it's completely necessary and appropriate to use the "f word" in all caps as an adjective to describe the cold. It's really FUCKING cold. For those of you who don't live in a bitterly cold environment, it's difficult to communicate to you just what -60 degrees Celsius with a windchill feels like. Let me try. Ever hear of frostbite? You know, where like your face or toes freeze, turns blue, and falls off. Frostbite is not even the main concern anymore. Frostbite is imminent. It's a daily occurrence. It's just a way of life, "Hey Bob, looks like you got a little frostbite walking from your car into work. Might wanna get that looked at. Frostbite amputations are at 10 this morning in the boardroom." You see, at -60 degrees what we should be worried about is the state of our internal organs. Don't they stop working when the temperature is no longer safe for human habitation? Like, humans can't survive on Jupiter, right? "Someone" deemed Jupiter unsafe. What makes us think we can survive this? Don't quote me on that one, but I swear to god, I felt my right lung freeze up yesterday when I attempted to inhale this so called "air" (Is it really oxygen anymore if it's frozen?) So you catch my drift - it's FUCKING cold and at this moment, I have NO idea why I make a conscious decision to live here. Obviously, I am an idiot.

You know who else really hates the cold (other than Dundee, the dog, who is now on a pee strike until the temp warms to -30)??? My knee cartilage. The poor cartilage is so traumatized that we are living in such an abrasive climate, that it has begun shocking me again with the tazer-like vibrations that run violently under my kneecap and almost cause me to pee my pants every 20 minutes. And I can't even blame the Biebs this time. Shitty. It's especially frustrating because the knee was so solid on our holiday in Bali. It loved the hot, humid weather. It walked, it swimmed, it climbed stairs, and I even took it surfing! It felt great and did wondrous things for my confidence. It has the potential of being a really stable, dependable knee. I just need to sort out the recipe of climate, activity, and diet (perhaps?), that maximizes its potential. -60; however, is not conducive to healing/functioning/thriving of any sort for man or machine.

To my fellow Saskatchewanians  Saskatchewanites friends from Saskatchewan: Congratulations on continuing to function - working, buying groceries, breathing, etc despite the fact that if NASA landed here, they would deem this arctic tundra "unfit for human habitation." Carry on. Good luck. Stay warm. Only 78 more days until the May long weekend.

Do NOT smile at the monkeys. Ever.

We're back from Bali! It was incredible. What an amazing place. The Balinese people are wonderful. I've never encountered such gentle, lovely people. I have tons of stories and thoughts to share, but to be honest, I'm currently not feeling too articulate. I'm definitely feeling the effects of the 40+ hours of travel and 12 hour time difference. My head is fuzzy, my tummy is upset, and it appears as though I've developed narcolepsy - I seem to fall asleep randomly and suddenly - while sitting on my couch, at the dinner table, on the toilet, and embarrassingly, almost at a work meeting yesterday. I suppose that's the definition of jet lag. So I'll take the next few days to sort this all out and try not to make any important life-changing decisions or share any deep thoughts until my head has cleared.

But, I have to share one memorable tale from our holiday ASAP - it's too sweet not to share.

When I was at my lowest last winter/spring, whilst heavily medicated and miserable, I had this sudden overwhelming desire to own a monkey. I know I know, it sounds crazy. I think I saw a picture of a monkey walking a dog on Pinterest and my effed up brain thought, "If only I had a monkey! My monkey could take Dundee for walks and fetch my pills! Brilliant!"I harassed my poor mom, sending her pictures of cute little monkeys daily - "Mom, I want a monkey. Can you find me a monkey?"

Thankfully, as I returned to my coherent self, I realized this monkey business was just...well...monkey business (See - I suck today.)

Well on our 2nd or 3rd day in Bali, Allicia and I were absolutely thrilled to spot a monkey on the side of the road.

"Pull over! Pull over!" we pleaded to our driver.

We quickly scattered out of the car (the boys remained inside) and began taking pics of this cute little guy, who sat quietly on a ledge scratching his belly and gazing curiously at us (likely thinking, "What are these little yellow-haired creatures with high, screechy voices?")

As we admired our cute little monkey, more monkeys began to congregate. Out of the jungle came 6, 7, 8 monkeys - all lining up on the ledge to inquisitively peer at us and scratch their bellies. Allicia and I marvelled at our little gang of monkeys - this was adorable! We beckoned to the boys to join us. This was more fun than a barrel of monkeys. Our boys remained in the vehicle, watching intently through the window.

Suddenly, a big, angry monkey joined the crowd. Sitting himself in the middle of the line-up, it was difficult not to notice that this giant, irritated monkey was sporting a...well...a boner. Yep, a big monkey boner.

Now, it's important to mention at this point in the story that monkeys come with warnings. Every website or book you will read about monkeys cautions you: "Do NOT smile at monkeys. Monkeys interpret teeth as a sign of aggression."

Tell me...how the hell do you NOT smile at a giant monkey with a big monkey boner?

Allicia and I burst into laughter. Oh my god! Do you see what I see?

In retrospect, it's quite apparent that a big, angry monkey with a stiffy is obviously going to be aggressive. Duh....and to be fair to the monkey, I can't imagine that any male would be thrilled with anyone mocking his boner.

As Allicia and I laughed hysterically, the big angry monkey did something utterly horrible. He scrunched up his little monkey face, opened his mouth, bared some major monkey fangs (I swear, there was still blood on those viscous monkey fangs from the last tourist he consumed), and hissed and screeched at us! It was like a monkey horror movie! He then raised his giant monkey arm and started waving it aggressively at us. If he could talk, I'm positive he would have been shrieking, "I'll get you my pretty!"

Allicia and I freaked! Screaming, we ran to the car, "Open the door! Open the door!" The boys, of course, were laughing hysterically at our predicament (which pissed us off - never bear your teeth at a terrified blonde).

Alarming. That, my friends, is what nightmares are made of.

That experience definitely put a monkey wrench in my plans of monkey adoption. Don't mess with the monkeys.

Bali and the Biebs

So it's all coming together now. I see a definite connection. My knee shocks are directly related to Justin Bieber's criminal activity. Obviously. There's a pattern. Biebs gets busted for throwing eggs - knee freaks out. Biebs gets arrested for drag racing - knee has a conniption. Damn you Justin Bieber. My knee aches, obviously mourning the loss of his innocence. I was just about to send out a tweet to the Biebs: "@justingbieber Stop breaking the law you little prick #kneekiller" but then I had an appointment with Dr. M, who confirmed that, no, it is not Biebs' fault.

As it turns out, I seem to have a piece of scar tissue that's rubbing against my meniscus and perhaps stimulating a nerve(s), causing, "the shocks." Not much I can do about it, but I do have piece of mind that my fabulous cartilage continues to appear intact. Dr. M reminded me that although we definitely improved the situation with the transplant, my knee will never be normal. Flare ups are going to always be a part of life. Bummer. I was feeling so awesome that a part of me thought that this was all over. I kinda expected to walk into my 9 month follow-up with Dr. M, hug it out, and break up for good. Nope. There is no finish line. We'll be seeing each other for a while. That's OK, I guess. He's the best and he gets me and knows exactly how to talk me off my ledge. He reminded me that I'm still "me." I've been striving to be the Kirstie that I used to be - the active and happy person of 2011. I'm still Kirstie, but I'm a new variation of "me." I've changed - physically, emotionally, and mentally - which is what we're supposed to do. That's life. We're constantly changing and growing. This experience just kicked it up a notch...but I haven't lost "me." I'm still here. I need to sort out what my daily activity level is going to look like. It won't be what it used to be - that's unrealistic. I need to determine a level that my knee can maintain, without continuously crashing.

Apparently I can massage the knee scar to prevent it from getting worse...but who wants to massage their own scar? I thought I'd enlist the help of Evs so I set the mood: you know, had a shower and applied smelly lotion to my legs and so on.

"Hey...Evvy. Wanna rub my....scar?" I inquired seductively (ha! As If I know how to talk 'seductively')

Initially, he may have thought that "rub my scar" was code for something sexy. It wasn't. I literally just wanted help breaking down the scar tissue in my knee. Needless to say, he was uncooperative. And disappointed.

So despite the continuation of the "the shocks," I feel ready to embark on our great adventure. We leave Sunday morning for Bali. It only takes about 39 hours to get there, so we'll have lots of time to mentally prepare. Yikes. We're also battling with a last-minute conundrum - how to import our booze to Bali?? The hard alcohol in Bali is taxed at a very high rate, so a 26 of vodka can cost about $80! They recommend that you don't buy mixed drinks in bars, as some businesses in Bali are concocting their own versions, sometimes with methanol, to avoid paying the heavy prices. The methanol drinks have killed a few tourists, so that's not ideal. At all. We want to bring our own, but are struggling with the decision to purchase duty free in Minneapolis and pay duty twice, or hope that a duty free is open in Singapore between the hours of 12 am and 5am (our last layover). So, you know, we have a first world problem in a third world country. Haha.

But, honestly, I'm so looking forward to life in Bali for a few weeks. Every one of my friends who has been there has described it as a peaceful, spiritual, magical place. It'll be nice to slow down, enjoy great company, and have lots of laughs. I'm also looking forward to being underwater again, consuming my oxygen at lightening speed. What can I say? I love breathing.

Cheers!

Fear: It'll make you sh*t your pants

Ugh.

What else can I say?

Ugh.

I had a shitty week. I crashed. That's the only way to describe it. I was flying high...and then I crashed. I can't pinpoint a specific moment, but my downward slide definitely began about 9 days ago. I had a crazy day at work - I was on my feet all day, pushing a poor man in a wheelchair around the hospital (long story, but I'm going to go ahead and blame a Doc for mistaking "Speech-Language Pathologist" for  "Porter"). I got home, laid on the couch, and haven't really gotten off of it since. I got Nancy Kerriganed. It started with all-over aches and pains in my knees and hip, and then moved to "the shocks." "The shocks" have riddled my knee since the beginning of this whole knee fiasco a year and a half ago. I've never been tasered, but I would imagine that "the shocks" feel much like someone is directly tasering my knee. Picture a dog, donning a shock collar, who has just left the boundaries of his yard. That's what I look like. I yelp, jump a bit, lick my butt, and then carry on. It's exhausting. The one thing I've found that reduces the intensity is Tramadol. Do you recall the Tramadol? That's that pesky drug I became addicted to last spring. Tramadol is effective in reducing my pain; however, it causes me to drool and lay lifeless on my couch. Yikes. Unfortunately, that's what my week looked like. I limped around the hospital, wide-eyed and screeching in pain occasionally, then crashed on my couch in a puddle of drool at 4:30....and the bad dreams returned. You know the frustrating dreams where Dr. M is my volleyball coach? This week he benched me and yelled at me in Afrikaans. I don't speak Afrikaans. It sucked. It reminded me of where I was. I thought I had this. I thought I was in control. I'm not. Perhaps I never will be.

Physio saw me pathetically limping around and suggested that I start temporarily using the cane until this "flare-up" diminished. The practical side of my brain understands why I would benefit from the cane for a few days. The practical side of my brain realizes that I'm not helping myself by limping around the hospital. The emotional side; however, had a very strong reaction to that suggestion.

"NO!"

I have created this negative symbol in my mind. To me, the cane represents "broken." I know it's wrong. I'm a rehabilitation therapist for God's sake. I know better! But the thought of using that damn cane again freaks me right out. When physio suggested the cane for a few days, I felt my chin quiver and my eyes well up with tears. I HATE that cane. To be completely honest, it's mostly superficial. I hate the way people look at me when I'm on that cane. The "Awwwwww's" and pity in their eyes makes me feel this big (I'm gesturing teeny tiny with my thumb and index finger right now). On the other hand, the practical side of brain tells me that I'm not fooling anyone right now with that awkward limp anyway - the people who notice know that I am struggling right now...cane or no cane.

We leave for our big holiday in 1 week. We are going to Bali - definitely a "bucket list" trip. In my mind, this vacation was planned as a victory celebration - successfully making it through the most challenging few years of our life. This set-back is so disappointing but I'm presently glued to my couch, leg elevated and heated, pampering this knee to prepare it for a big adventure. I'm presently off of all physical activity - no physio, no yoga, no weights, and no drunk dancing. I'm worrying about this knee settling down - I honestly thought that I was over the worst and this whole challenging journey was coming to an end - an end with a fairy tale ending, of course :) I'm hopeful that this is just another minor set-back and learning lesson in this ride that I'm still very much on.

Finally, motivational posters are annoying me this week. I posted a few on my wall - you know "Never give up," "Stay strong," blah blah blah. They aren't helping. So I took some time to find a few of my favorite DEmotivational posters. Enjoy.

Firsts

2013 was a year of "firsts" for me - but not the kind of firsts that most peops would consider desirable. In 2013 I had my first major breakdown in a Doc's office (Sorry Dr. M!), went on my first anti-depressant, ended up in emerg with my first diagnosis of serotonin syndrome (oh, google it, it's a hoot!), depended on a cane to walk for the first time (UGH!), experienced my first legit 10/10 on the pain scale, suffered through my first drug withdrawal, and finally, received my very first knee cartilage transplant. I'm all for trying new things, especially as we age and complain, "I'm too old to experience anything new," but c'mon....those "firsts" sucked the big one.

Although it's only January 11, I've already experienced 4 major "firsts" in 2014 - good, solid, happy firsts. As my last post described, I rang in 2014 with a huge first - my new cartilage rocked out on the dance floor. That was definitely a turning point in my recovery. In addition, in just the last week, my new cartilage has participated in its first ever yoga class (I love tree. Solid pose), completed its first CrossFit workout (modified, but legit), began briskly walking on the treadmill, and officially entered 'Phase IV' of cartilage implant recovery. I recall laying on my couch post-surgery, reading the phases of recovery, sent to me from an Orthopedic clinic in New York who had some experience with patients like myself. I remember thinking that I would be stuck at Phase I forever: non-weight bearing for 8-10 weeks. It's hard to believe that I've made it all the way to the second last phase of recovery. This phase is characterized by strengthening the knee and building endurance. The thing that excites me the most about this phase of my recovery is that I'm only about 4-6 months away from Phase V: participating in regular sports and activities. Wow. A year ago I was struggling to accept that I may never be able to walk "normally" again and now I'm training with a goal of returning to the regular activities that I participated in pre-knee fiasco.

In addition to all those fabulous firsts, I also have another exciting announcement to make: I have chosen my fight entrance song! Yes! Can you believe it? Right now you're thinking, "What the hell is she talking about?" Well, I'm not really into watching the "fights," per se (like UFC, MMA or even boxing matches),  but I do really enjoy the moment right before the fight, when, tunes pumping, crowd cheering, the fighter enters the ring with his/her posse. Usually, the fighter looks super cool, and I always imagine the adrenaline rush that fighter must experience in that moment. I usually tune out once the fight begins and then contemplate, "If I was a fighter, what song would accompany my awesome entry into the arena?"

Well this week, it suddenly came to me whilst listening to Songza's, "Belligerent Party Rap" playlist. I have it...Ludacris. Obviously. It's badass. It says, "I'm about to kick some ass, in a super cool, I don't really give a damn, kinda way....so get back get back you don't know me like that." I imagine that my UFC/MMA entrance would look something like this (Warning: bad words. Lots of bad bad words)