A PCL Survivor Milestone ~ KDSI I Annual Gung-Ho Run 2013

I have always wanted to climb Mount Kinabalu to signify my personal accomplishment in surviving the PCL surgery.  Now 5 years later, the dream still hasn’t been realised, early osteoarthritis has begun to set in, both knees have deteriorated that now I’m surviving on gel/fluid insertion into these knees every 15-18 months, and I’m obviously getting older.  I’m actually in constant pain, but it is a condition I’m already accustomed to by now.

I had a chance to put my PCL knee to test recently, a consolation to my inability to make my way to the peak of Mount Kinabalu I suppose. It came in the form of a “Gung-Ho Run” held at my work place.  It comprised rowing for about 500m, running for 10km and finally climbing 303 steps to the top of an 11-storey building.  I was anxious to see if the knee would hold.  So far I’ve only run up to 5km, and have never attempted to exceed that (the regular jogging track around the base where I work makes it convenient for me to limit myself to just 5km).

Early riser

The day started very early for the Gung-Ho Run.  Already at my workplace for breakfast at 0530, Subuh prayer and followed by a warming up session.  Off to the boat house by 0700 and after a quick motivational talk by me (hmmmmm.......trying to motivate 90+ staff officers and trainees, including psyching myself up wasn’t as easy as I thought), we were ready to kick start with the first activity ~ rowing.

About to start

12 crew in each boat, and off we went.......... The heavily strapped pinky (link) didn’t bother me much....alhamdulillah.  Energy level was high, spirit was high.....but steering technique was totally off....hahahaha.......we were zigzagging to get to the marker buoy and were lucky not to finish last.........

The first boat to arrive....not mine

Now all pumped up for the gruelling 10km run...... After putting on my jogging shoes, and a quick warm up on my own to make sure I was ready, I lined up quickly with the rest at the starting point.  A blast of the horn and we were on our way.  The morning was beautiful, and the sun was shining brightly to lift up our spirit. Alhamdulillah the knee felt okay initially, but I knew I just had to maintain my snail pace and not be tempted or intimidated to keep up with the faster runners.  The agony of pushing through the pain barrier was the biggest challenge.  My aim was to complete the run without stopping at all.  Glad I have my wife and kids who drove along and waited at strategic places to cheer me on.  My pride and joy who have always been there for me.........I’m such a lucky guy.

The starting of the run

Still feeling good early on

Morale booster from the kids

At the first check point I was doing relatively okay.....by my standard that isJ  Still running, and maintaining my position just about the middle of the group.  However, after the one hour point, the knee started to bother me but I was determined to keep running.  My pace got much slower, a few runners behind me began to catch up and I was really struggling to keep moving.  A PCL survivor’s quest had to continue........so I just kept on going......”layan jer” as we say it here....

No pain, no gain 

The second check point finally behind me and I was enroute the last quarter of the run........by now drenched in sweat, and soaking wet with water I poured over my head at each check point,  coupled with a wobbly knee that felt like jelly.  Finally, the end was in sight and I could see my family and some of the earlier finishers cheering me on.  To complete the agony of this run, the last 500m was an excruciating gradual climb.  Huffing..... puffing..... sucking as much air as I possibly could and slowly inching my way.....still running all the way till the finishing line.  I was completely spent......... but the run was over.  And yes, I have managed to run the whole way.........

The last 500m uphill....with my twins cheering me on

Fliud replenishment before taking a crack at the 303 steps up the building

The route and my time

But wait......the Gung-Ho Run was not quite over yet.  I still have another 303 steps up the 11-storey building to be conquered.  The pain to complete the climb was obvious......every lift of the leg up each step was a challenge, every level reached made my chest tighter and my breathing faster.......the claustrophobic confine of the stairs did not help one bit as I was deprived of the much needed oxygen............. Then, finally I could hear the clapping and cheering signifying I was only about 20 more steps from completing my dash up the final stretch.  As I reached the peak......my time was read out to me: 1 hour 29 min and 35 sec.  Actually, I can barely remember now how I rang the bell to signify the end of my run.  But rang the bell I did, and this PCL Survivor has finally completed the Gung-Ho Run!!  My family was again there to celebrate this significant milestone with me.  At this point, the spectacular view from atop the building was second to the sensational feeling I had.  Alhamdulillah, I have finally reached the end of this.......running all the way, conquering not only the distance but also the constant pain I felt throughout the run.  Gung-Ho Run 2013 is now a history!!!!

The killer steps.....almost there

Your time ~ 1hr 29min 35sec

Are you okay sir?.....the expression says it all

The triumphant ringing of the bell!!!!  Yes, it's finally over

Looking back I’m glad I did it.  It encapsulates my own personal success in coping with the PCL surgery and the slow battle for recovery.  My life has changed forever as a result of the PCL injury.  This little feat of completing the Gung-Ho Run reaffirmed the belief that the change may not be so bad........in fact I believe being a PCL Survivor has given me a better outlook on life.  As usual, God’s plan is always betterJ As I recuperate from this experience.......ice packs on both knees, a long shower, a short nap and a dip in the base swimming pool; I can’t help to feel really blessed and fortunate.  Alhamdulillah atas semua kurnia Mu Ya Allah, I’m really thankful.  Life is great!!!!!

They are my pillars of strength....always

Nursing the hurting PCL knee

Iced-cold towel.......such a relief

The certificate

Medal for one of the Gung-Ho winners

My PCL Progress

There is life post PCL Surgery

I have not had the opportunity to see Dr Musa, my Orthopedic, for almost a year. He was away for a course and my past few appointments had been attended to by one of his staff who would just prescribe me with more Glucosamine (Viartril-S) to last me until the next appointment.

A life changing injury

Today I finally got to see Dr Musa for further diagnosis of my progress post PCL surgery. The good news is that the PCL surgery is a huge success (by my definition that is) as the range of motion (ROM) in my left knee is at its optimum with very little pain despite the strenuous load I subjected the knee to during recent activities (removing top soil from my little garden and replacing it with sand which I did in 5 days, followed by completing an 18 hole golf outing by walking).

PCL when it's fully singing & dancing

Now on to the not so good news. My other knee, on the other hand, is not doing very well as it has been affected due to subconscious ‘load shifting’ since the PCL surgery (which aggravated the existing wear and tear damages of my cartilage and further depleted my knee fluid). The knee is swollen a little because of my recent taxing activities, and the right knee has now become the ‘bad’ knee, limiting my movement at times due to pain. The medical term is ‘Osteoarthritis’ which is defined as “A form of arthritis, occurring mainly in older persons, that is characterized by chronic degeneration of the cartilage of the joints”. In older persons......hmmm. I guess I must accept that am an older person now:)

Dr Musa advised me to undergo a ‘scope’ to assess the damage but for now that is just not possible as I am scheduled to further my studies for a year beginning this January. As a stop gap measure, I have been scheduled to received 3 injections of fluid booster (for lack of a better term, will get the proper name next visit) to help augment the depleted knee fluid. I must say that after the first injection today, the right knee feels much better. I am scheduled to receive the subsequent two injections at one week intervals and hopefully the pain will be further reduced then.

I still have full ROM in both knees which is the bench mark for me to deal with this situation. There is pain in both knees, and this has limited a lot of my activities especially those that include running, but for as long as I have full ROM I am still very happy.

Dr Musa also explained at length the difference between the PCL surgery that I underwent which used‘autograft’ (not autograph) and the other version using ‘allograft’. Autograft uses replacement ‘parts’ taken from own body while Allograft uses those from a donor. Interesting!!! He said using allograft is more common in the US, while here in Malaysia autograft is more common as it is a cheaper option. Cheaper vs Better???? No idea.

Anyway, it has been an interesting day for me. As I recuperate at home tonite, I am thinking about Pam, Molly, Steven Chandra and the others who are facing their own battles in PCL recovery. Some are more successful than others, but this is life-long battle for us in the PCL Survivors Club. Today’s news about Osteoarthritis is just one of the many possible challenges that I have to face.  I believe I am ready......I really hope I am.

I must also thank Dr Musa for his tireless effort to help my condition, and after 4 years under his care, I must say that his dedication in doing what he does best as Orthopedic is extremely commendable.  Thank you Dr Musa!!!!!!

Well folks, that where I am with my PCL situation. All the best to all the PCL Survivors out there. May all of us come out on top in our struggle to get better, InsyaAllah. Amin.

PCL Recovery Exercises

This posting is my answer to Hamlet’s question in my previous entry. Since it’s longer than I’d expected (with pictures as well) and I’m now hoping that it could benefit other people as well, so I decided to put it as an entry on its own. Here it goes:

Hamlet said: .........do you mind sharing with me at least type of exercises u did during ur PT session? What did u do? Did u go to the gym? etc.

Hamlet (and other PCL survivors),

From your posting in Pam’s blog, I assume it’s been 6 months since your surgery. I hope you are progressing well. At this stage I was already mixing the Physiotherapy at the hospital with my own exercises at the rugby field.

Have you regained you full range of movement yet? Keep pushing, and ice it regularly especially after an exercise. I always knew my knee would not heal completely to its previous state prior to the incident, but one thing I really wanted was to regain full range of movement in my knee. I can’t imagine performing my prayers sitting down for the rest of my life. So despite the pain I kept pushing through till I finally regained full ROM, can’t remember when but after about 6 months I think I got enough bending in the knee to be able to perform my prayers sitting down (though not at full ROM but close enough, and with the associated pain that came while doing it).

As for doing the exercises, I was quite lazy to do it at home (with twins running around….very challenging). My therapy was mainly at the hospital twice a week and at the rugby field three to four times a week.

Exercises at the hospital (at about 5 month point) include:

~ Cycling. I gradually increased the resistance to develop my thigh and leg muscles which had shrunk significantly after the surgery. I normally cycled for about 30-45 minutes for each session.

~Steps. “Up & down” steps were very useful. How to describe this? It only has two levels of steps; let say you step up with your left, then up with you right and you are already on top of the stairs. Then you continue to step down. Repeat this for let say 5-10 minutes varying the way you step. It promotes bending of the knee and develops strength.

Steps similar to the ones I used

~Trampoline. I used to bounce on it with one leg on and the other leg off the trampoline.  I vary the bouncing going forward, side-ways and backward. I liked this exercise as it also made me sweat.

~Standing on a Half-ball. Standing on a flat surface suspended on top of a half ball helps especially to improve flexibility and balance.

~Standing on inclined surface. This is the easiest thing to do and you can vary the inclination based on your progress and tolerance to pain.

~Terra band. This rubber band may be used in various ways to provide resistance. I used it a lot. And they are colour-coded depending on their strength and elasticity. The strongest one is black, and I was taught to perform various exercises using them. You can do this at home as well, but unfortunately in my case, I didn’t do quite as often as I should (we are talking hundreds of reps for each type of exercise daily). I also bought a set of weights that can be wrapped around my ankle and I used it in similar manner as I would with terra bend.

The elastic terra rubber bands

~Water exercise. The hospital has a water therapy pool that generates waves at varying speed to provide resistance during the exercise. It was fun but I only managed to do it like 3 to 4 times.

~Gym sessions. I did a little bit of weight training, mostly doing “leg extension” (front and rear extension). Increase the weight gradually as your leg becomes stronger. I did this only for a short while (maybe up to 10 sessions) towards the end of my 9-month therapy at the hospital. Due to my work commitment, after 9 months I only did exercises at the rugby field while coaching my team. For exercises using weights, you’d better consult your PT staff as it involves a little risk depending on what exercise you perform. I think a gym rat like Pam may also give you some really good pointers on this one.

Leg extension machine

Exercise at the rugby field:

~Running. I ran circuits, varying the distance. Something like this: run 50m, walk 50m, run 50m and walk 50m. Increase the distance, the speed and the repetitions when you become more comfortable (never do sprint at this stage!! I have not done any sprint even today). I also ran sideways, zig-zag, backward, striding etc. I used to be a sprinter in secondary school and the knowledge did help me to be a bit more creative with the running exercises. I also used weights around my ankle and walk with them as I conducted rugby practice.  I eventually did hill exercises, climb a 1000ft+ hill and ran 5km with my players.

These exercises worked for me, but they are not the only ones.  Do consult the experts before attempting any of the exercises I mentioned.  You must know your body, your limit and your threshold for pain.

All the best to you Hamlet, and all you guys PCL survivors out there.

An Inspiring Blog - "My PCL Surgery"

I wrote an entry a while back about an injury to my PCL which occurred during a rugby practice (my blog entry titled My Posterior Cruciate Ligament (PCL) Surgery). I wrote about the experience and my strife towards recovery after I decided to undergo a knee reconstruction surgery. The surgery has helped to improve my condition tremendously, although the journey to get to where I am today has been nothing but a real challenge.

Not long after I jotted in my PCL story, I stumbled upon a wonderful blog about a lady who experienced a similar situation. The blog rightfully known as “My PCL Surgery” outlines in great details her personal journey to recover from a PCL surgery. Known as "Skinnygurl" in her blog, the lady has captured the attention of people from the world over through her inspiring stories about her daily battle to get better after the surgery. I consider myself as one of her many fans now, and I draw a lot of strength and inspiration from her stories to move me forward in my own struggle towards recovery.

She has been kind enough to feature my PCL story in her blog. You can find her blog entry about me here. But more importantly, please take some time to browse through her stories in the blog. Her effort to document in intricate details her progress is really admirable as it clearly portrays her utter grit and determination to beat the injury. Her stories have definitely inspired me and I am hoping to do my bit to promote her blog to others. So, if you know anybody who is suffering from a PCL or an ACL injury, please introduce him/her to this blog. I hope this blog, “My PCL Surgery” which belongs to a friend of mine “Skinnygurl” will benefit others the same way it has benefited me. Thanks.