One month later

now that I finally have my dragon taking dictation properly, i can fill in some of the gaps from the last long month.

the day of the surgery we watched a lot of curling. although the operation was scheduled for 130, I had to get to the grey nuns hospital by 1030 so they could clip on a hospital bracelet, get me changed into a gown, and... well, i'm not really sure what the rest of the time was for. mo was with me, of course, and we sat in the preop room with about five other patients and their partners watching olympic curling. those of us heading into surgery shared dehydration headaches. time passed quite slowly in that room, although as I think back on it it doesn't quite seem like three hours of curling (I did learn a lot about the game, however).

in a way, the surgical experience starts when they call your name. you give up the bathrobe and your eyeglassses, you get into the gurney, and they wheel you to the ER on the lower level. as the elevator descended, i said to the porter, "wow, it's all very symbolic." but he didn't understand what i meant. in the waiting bay, the surgeon stopped by to see me. i told him i had changed my mind about the surgery, that i was too scared to go through with it, that the shoulder hasn't hurt that much lately, and that i'd trade a little pain later for a drink of water now. he put a hand on the bedrail and said, nicely, "right. we want to do this surgery for your 70s."

they did five or six things. first, they sent in an arthroscopic camera and took pictures of the shoulder joint. at my first follow-up appointment, i got to see these pictures, which were stirringly beautiful. i had no idea what I was looking at, exactly, but the luminous white of bone against the milky backdrop of tissue made me understand, immediately, why someone would want to be a surgeon. they trimmed the labrum. at the follow-up appointment, the surgeon pointed to the photo of a fringe made of flesh, then to the after, all clean lines and absences, and said, "see? all tidied up." as I had known they would, they repaired the supra spinatus, which is to say they reattached that torn tendon to its bone. (i always think of chicken.) in addition, they shaved the bones and cartilage in my shoulder; they drained the bursa; and they repaired, repositioned, and stapled down the biceps tendon. i've been led to understand that this is rather a lot of work.

my first sensation back on the ward was in my elbow. i thought, distinctly, i cannot keep my elbow bent like this for 6 to 12 weeks. the second sensation was heat in the shoulder -- the inflammation. mo was there, which was enormously calming, and my parents too. there was a lot of morphine. morphine feels good, but not at first. the best hit is intramuscular, and it burns for the full 90 or so seconds it takes to empty the syringe. i was awake for most of the night, or at least I remember seeing nearly every hour on the clock, though it was difficult to connect those hands on the wall to anything meaningful. it's a strange way to spend time. you're aware of every hour passing, yet the experience has absolutely no narrative form.

everybody tells you to stay ahead of the pain, and this is excellent advice. for the first two or three days at home, I was taking 12 to 14 Percocet a day: an amount that astonishes me now, but which felt barely sufficient at the time.

when you dream about having time away from work, there is a lot of it: days stretch out voluptuously. in fact, i find the days quite short. partly this is because everyday life takes so much time. getting dressed takes the better part of 40 minutes; getting undressed and into bed a good half-hour; and then i have physio exercises that take about 25 minutes per set, and I do three sets a day. add in a walk, an iPhone game or two, and there's your day. i like being alone.

i have good days and bad days. on good days i feel jubilant, excited, triumphant: i am getting the better of this injury. on bad days i feel completely dismayed, convinced that it will never heal. the lesson is that i have good days and i have bad days, and i'm sure there's a wealth of wisdom in that.

there is a lot of frustration. simple things -- like pulling up yoga pants, or putting on a headset, or fixing a bowl of soup -- take astonishing amounts of time, and call on a patience that does not come naturally to me. bathing is extremely awkward and extremely painful. particularly before i got my stitches out, it felt almost impossible. i had to sit in 2 inches of water, and i washed my hair by bending over my knees. i cannot wash my left shoulder very well, i cannot dry my back, and things like hair product and eyeliner are out of the question. if -- heaven forfend -- something like this should happen to you, and you are my friend, here's what I will do for you: i will give you one hour a week in which you can ask me to do anything. i will clean your shower. i will drive you to the river valley and wait for you to walk. i will run errands. i will chop onions so that you can make soup. i will cull your e-mail if that's what you would like.

there is a lot of pain. before the operation we asked how the pain of shoulder surgery might compare to the pain of knee surgery. the guy we were talking to, the hospital's physiotherapist, fumbled for a few seconds and then gave up. "there is no comparison," he said. "it's super painful." i find the pain fatiguing, particularly at the end of the day, and four weeks later it is still hard to sleep.

there is a lot of abjection. i was not prepared for how abject this experience would be. for one thing, it is very dirty. i am clumsy with my left hand, and so routinely spill food -- on me, on the counter, on the floor -- none of which are easy to clean. for another thing, it is hard to feel pretty when you rotate two pairs of yoga pants and can't pluck your eyebrows. the emotional abjection is of course the most difficult. last saturday I had a work party. my responsibility was to bring a course of Spanish cheese; everything else was done by others. buying the cheese was the subject of a specific excursion on friday; indeed, it was last friday's organizing principle, since I can only really do one thing per day. saturday morning I pulled together a serving tray, serving utensils, and laboriously printed little cards to identify the cheeses. (they looked like they were written by a four-year-old.) i planned my shower with enough time for a rest afterwards. mo did the laundry, but together we worked out how to organize the loads so that my best yoga pants would be clean for the event. the party was lovely, but it involved a lot of standing and honestly it was hard to talk to people i work with when i'm not in fact working with them. after one hour I thought I might faint. when i realized i had forgotten the damn cheese, i just lost it: burst into tears and fled out the back door, humiliated.

naturally, i feel guilty. it's a difficult time at the university, with budget woes and layoffs in the offing. i am acutely aware that the work i am not doing is being picked up by others, who are already busy. at the same time, the university is full of workaholics, and the place is redolent with stories about Prof. X., who took no more than a week off, and Prof. Y., who was back at work the day after his operation. i am not immune to the sense of obligation these stories entail, even though my best self scorns them.

whatever difficulties i may have, being insufficiently loved is not among them. friends have been wonderful: solicitous, generous, thoughtful, and attentive. i marvel at my great good fortune.

now my computer battery is running low, and it's time for a nap. believe it or not, composing this post has taken the best part of the day.

Full thickness partial tear

that's what they call what's wrong with my rotator cuff, and they're fixing it on 25 feb. they open up the shoulder, send in a little camera, and make a to-do list for while they're in there. might as well shave that bone. could check the bursa. and is that tendon what's causing the impingement?

the operation is done with me sitting up - "but they strap you in," said the pre-admission nurse, helpfully. it takes about three hours and requires one overnight in the hospital. then i spend six to twelve weeks with my right arm in an immobilizing sling.

let me repeat that: six to twelve weeks.

immobilized.

the awesome news is, that means no shoveling, no dishwasher-unloading and no email. i'll be off work for a long time. i'll read on the kindle. the medium-awesome news is, no chef's knives. the anti-awesome news is, no driving and, if internet stories can be believed, no sleeping. also no texting, no bras, no tidying, no shoelaces, no river valley, no shaving, and no making mo's lunches, for a long time. it's actually pretty staggering, when you think about it.

and i have been thinking about it - mo's insisted i do, even though she doesn't know that's what she was saying. she said, "practice with your left!" i'm glad i have because it demonstrates that i have no idea what i'm capable of. not in that character-building way; in that complete-absence-of-judgment way. brushing my teeth is messy but doable; however, i almost took out my own eyeball with the hairbrush. i can make coffee, allah be praised - but feeding the cats? i anticipated that it would be hard to open a pull-tab can with one hand, and it was, but the real poser was how to dish out the food one-handed. you stick a spoon in a can and then more or less chase the can all around the counter. on the other hand, so to speak, i can flip an omelet left-handed. who knew?

more than anything, after an hour of practicing i was mentally tired. it was incredibly hard to actually think about every little thing you do. how do you pull up a knee sock one-handed? (slowly.) how do you get coffee and the newspaper back up to bed with you? (two trips.) how do you grind pepper? (you don't.) it gives you huge respect for what babies must feel like at the end of the day - at the end of every day: hours and hours of trying to figure out the simplest little things, in a body that won't behave the way your mind says it should, turns out to be exhausting.

but what i anticipate to be really really tiring is being tolerant. as i'm fond of saying, i can only be who i am, and who i am is ... particular. fastidious. fussy. (some people use unkinder words.) post-op, i am going to be ridiculously dependent on mo, who is going to be working ridiculously hard managing - well, everything. here is a likely scenario: she will come home after a full day at work and start fixing us dinner, based on whatever she's picked up on her way home. in the course of unloading the dishwasher so that she can reload it so that she has room to make dinner, and with the cats yelling at her for their supper, it could be that she puts the bowls, or the cups, or the glasses, or (god help us) the plastic containers away in the "wrong" order. i will see it. i might have to actually watch it happen. and i will have to live with it.

i mean, consider the alternatives for just a second.

right? surgery will make me a more tolerant person, or it will give me a stroke.

my only hope is the painkillers, which i hope are strong and plentiful. 'cause i have a feeling i might have to share.

Whole

when i think about the university's gems, i think of the glenn sather sports medicine clinic. the people there -- physicians, surgeons, physiotherapists, students, technicians, massage therapists, and clerks -- are all so very, very good that i feel lucky just to walk through the doors. even limping through the doors, i feel like i'm entering the hallowed place where knowledge, experience, discipline and hard work synthesize to make everything better. and honestly, i thought that even before nancy declared my ACL whole, even before she called ian in to concur, even before i got the x-ray ruling out other serious injuries, even before she signed the alberta health care forms with the diagnosis "left knee sprain."

when i die, i'm leaving all my money to the gssmc. so there.

and i'm probably not going back to nikki's shop. eh, anyone can make a mistake. but why settle for the mazda 6 when you could have the audi r8?

Torn

i twisted my knee in a soccer game last friday night, my first game of the season. it was a perfect night for soccer: calm, clear skies, not too warm, no wind. the ground was soft after a few days of rain. the pitch had give. i was wearing new cleats, adidas' latest magic with a weighted last and supple calf leather. "i'm overcompensating," i joked to my teammates before the game, "letting technology make up for the fact that i haven't played much lately." not a lot of soccer, but i've been working with a personal trainer and i felt fit.

the game was humming along, a good match. i was making a play, not a particularly spectacular play, just one of those moves you make from the midfield wing, when the injury happened. thinking back, i believe i was changing direction, but it was such an unmemorable moment in the overall flow that i can't really recall the details. had i already kicked the ball? was i going after it? had the play moved infield? my left cleat was planted, my body moved right, the knee complained. just one of those things. i jogged a little, tested it. it seemed fine: tweaked, but okay. at half-time i stretched. the knee kept swelling until finally, with ten minutes left in the game and another slated for sunday, i came off the pitch. no point overdoing it.

by the time i got home it was really swollen. saturday i couldn't bend it at all. couldn't walk, couldn't really drive. but that's the way with knees: once they swell, they're hard to bend, and it's hard to tell what's going on. i did what we all do, an internet diagnosis. collateral ligament strain? maybe something where the hamstring attaches -- that left hamstring has been iffy of late. could be a tear in the meniscus. i was pretty sure it wasn't ACL. i contracted my quadriceps again just to be sure.

what with aunty jo, it's been a busy enough week that only yesterday did i make time for a physio appointment, and even then it was just so that i could give my team an answer about tonight's game. by yesterday, the knee wasn't that painful. still swollen, but only with these comical little goose eggs. sure, it buckled occasionally, and it was awkward to get in and out of the car. the pain keeps shifting, but it isn't serious -- nothing a little naprosyn and ice can't handle. i was smart enough not to try running, but i went to pilates monday, yoga wednesday, and tuesday night did a long bike ride through the river valley. sure, everything made the knee swell more, and there were certain poses i couldn't do, but it was a positive relief to have an alibi against one-legged planks, to have an excuse for not getting up the hills faster, not holding my lunges longer.

for all these reasons, i was totally unprepared to hear the physio say the fatal three-letter word. "i just don't feel an end point," she said apologetically, after manipulating my knee this way and that. "how does it feel to you?" "weird," i said, "hollow, empty." and then i burst into tears.

see, i've been down this road once before. i tore my right ACL in january 2002. i know something about the wait for surgery and the two-year rehab, not to mention the catastrophic personal consequences. i just don't know that i can do it again. i know, i know, it's too early to make such a call -- i've barely absorbed this news, and still feel dismayed. but none of the options look good to me.

on the one hand, there's the surgery. which is amazing, from a purely scientific point of view, and, for most people, from a personal physical point of view. the surgery is arthroscopic. the surgeon makes four small holes in your leg, grabs a little hamstring tendon with a crochet hook, folds it over a few times and strings it through your knee, thereby building a new anterior cruxiate ligament to connect your upper leg to your lower leg. over time, your body accepts the makeshift ligament as the real thing, and builds blood vessels and neural pathways along the new ligament. it's an incredible process, when you think about it. it's also a long and painful one. for me, the knee was strong and stable within a year, but the hamstring has never fully recovered. when i'm doing a hamstring curl, you can still see the gap where the tendon used to be. when i think about the surgery, i remember lying face-down on my bed trying to straighten my leg, crying and crying in agony. it took four months? five? to straighten my leg after i had surgery. post-surgery rehab was a lot of work -- and i was six years younger then.

on the other hand, there's no surgery. what that means long-term is still opaque, but some things are certain: no soccer. no downhill skiing. no surfing. longterm knee instability leading to higher potential for other knee injuries. it means wearing an ugly brace at least some of the time. what about running through the river valley in a perfect summer morning? what about my goal of running from canmore to banff this summer? what about swimming? how will an unreconstructed knee age; what will it be like when i'm aunty jo's age? nikki the physiotherapist said, "don't worry, you'll be active again." what does that mean: when, and how? and in what ways?

i feel numb, dumb, not even angry or upset anymore. just a gloomy sense of should-have-known inevitability. a formal feeling.