Sports Girl Runs Track to Strengthen Quads

Sports Girl running relay after MPFL surgerySports Girl continues to rehabilitate from her MPFL reconstruction surgery. She is now strengthening on her own rather than attending regular physical therapy sessions. She still has a ways to go to get her left leg as strong as it was before the surgery, or ideally, even stronger.

The doctor gave her the green light at the end of March to run some mid-distance races in spring middle school track, but he told her not to expect to have a stellar season. So her goal at meets has been not to finish last – which is a strange twist for my ultra-competitive Sports Girl. But I’m proud of her for knowing her limitations and pushing herself right up to them.

She is running the 800k and the 1600k and a couple of various legs in relay races. She is pictured above right getting ready to take the baton from a team mate in one of these races.

Overall, she’s had minimal problems other than a little muscle fatigue (which is actually a good thing), and a few instances of strange rubbing sensations and minor discomfort in her left knee while running. Sometimes she said both knees were actually bothering her, so I could chalk up those instances to being out of practice physically.

At first I was concerned when she said her left knee was bothering her, but when she actually fell on her knee recently while roller skating, I saw how worried she became when her knee was causing real pain. Thankfully, the knee felt just fine the next morning – so the pain was not unlike what any knee might feel after colliding with a tile floor.

I think she might just have to get used to some of these new feelings and learn how to read them. My hope is that she can grow confident on this newly stabilized knee and get back to her old aggressive self during competition.

Honestly, I believe the biggest risk facing her right now is incurring an injury unrelated to her previous patellar dislocation issues. With one weak leg, she is predisposed to injuries such as ACL and MCL tears.

As I’ve mentioned before, one key thing we’ve learned about how to protect the knee is to have strong muscles in the quads, but also in the hamstring, hips and abs.  So Sports Girl will spend much of her summer strengthening and conditioning.

After spending well over $100 a week on physical therapy, the fees involved for multi-week training programs in our area now seem like a bargain! I recommend all physically active teens should attend performance training as an insurance policy against a more expensive and time-consuming potential injury.

Sports Girl goes back to the doctor for hopefully the last time on June 2, and at that time she should get approval to start summer training/practicing for soccer and basketball, which start in the fall and winter respectively and require more sudden stops, turns and jumps. So there will be open gyms, skills camps and city leagues to attend this summer, as well. We’re looking forward to being busy with these activities – it sure beats being sidelined from them!

Our Sheep Are Baaack and Having Babies!

Black-Faced Ewe With Twin Lambs

With everything going on with Sports Girl and her knee surgery and recovery, I haven’t mentioned that our sheep came back to the ranch sometime around the first of the year.

The ewes had spent the last three months of 2009 at my brother- and sister-in-law’s place a few miles away getting bred. And then in the last week or so, they started lambing. Three of our five ewes have had babies so far – and all three have had twins.

Unfortunately, we did lose one lamb just 24 hours after it was born. Cocoa, the mother, was the ewe who lost her first lamb after giving birth in a snow storm last spring; I don’t think she really wanted to deal with two lambs for her mothering experience as I don’t believe she was letting the second lamb nurse at all. By the time we realized this, it was too late to save the poor little thing. Just another sad fact of nature, I guess. My girls didn’t cry, although there was certainly a feeling of sadness hanging over all of us.

So we have five baby lambs frolicking around our sheep pens. And they are really cute. Busy Toddler got the biggest belly laugh out of watching the little lambs when she went down to help feed this afternoon with Handsome Hubby.

My father-in-law has been very busy calving for the past month, as well. The winter weather here hasn’t really been very friendly for newborn calves and sheep, but somehow things are going all right.

In my naïve, younger years, I always pictured tiny baby lambs and calves laying with their mothers on a bed of bright green grass with the sun shining brightly down on them. I suppose that scenario would be more realistic if these critters were born in May rather than February and early March, but that schedule doesn’t work well for us.

My father-in-law calves in February and March so he has more time for farming later in the spring; we have to lamb as early as possible so the babies will be as close to grown/finished as possible when it’s time to show them at the county fair. So our babies have been born amidst snow, sleet, rain, fog and mud. If the critters themselves weren’t so cute, it would be anything but a pretty sight.

We’re still watching the other two ewes, hoping to keep our lamb crop ratio as close to 200 percent as we can. And we’re hoping for warmer, drier weather.

Horse Lover Struggles To Get Time on Horse Back

Horse Lover's passion revealed itself early. Here she is at 3 years of age using our Welsh Corgi as her trusty steed. Note the saddle blanket and lead line. I'm sure she would have had a halter around the dog's nose if she would have allowed it.

Sometimes I think Horse Lover was born into the wrong family. While we do live in the country, and we actually have two horses at our disposal, Horse Lover doesn’t get to ride them near as often as she would like.

Honestly, she hardly ever gets to ride at all. That’s because Handsome Hubby is gone a lot for work, and my horsemanship skills are seriously lacking. Horse Lover actually knows a lot more about horses than I do, but unfortunately horses are just too large and potentially dangerous for a pre-teen to ride without some experienced help and supervision.

Even if Handsome Hubby was around more, I don’t know if Horse Lover would get to ride any more often. Handsome Hubby grew up riding horseback while working cattle, not for leisure. He might not admit it, but he really doesn’t get the intricacies of showing horses in shows or even understand the importance of certain skills such as proper “posting” techniques.

But Handsome Hubby does respect the knowledge Horse Lover has accumulated through reading and watching. He might even admit that Horse Lover may already know more about horsemanship and equitation than he knows.

I’m Not Interested in Horse Back Riding

Meanwhile, I must confess that I really don’t want to add horsemanship to my list of lifetime skills. I feel bad about that sometimes, but I have absolutely no interest in riding horses. That probably makes me a bad parent, but at least I’m honest!

I do feel some pressure to take up horseback riding for my middle daughter’s sake, but I don’t know when I would do it. As the old saying goes, “There are only so many hours in the day,” and I believe I am already trying to cram too many things into those hours.

Thankfully, Horse Lover is somewhat cautious in her horseback riding approach. So we don’t have to worry about her going off and trying to ride horseback without help. Yet her apprehension does have its drawbacks as it keeps her from improving her skills very quickly.

Horse Lover would like to compete in our county 4-H horse show this summer, but she is scared to ride Sadie, our horse with show experience. The horse is well trained, but she likes to test her riders, and she is a bit rusty. Both Horse Lover and Sadie need some training help, but that presents another problem – we don’t have a horse trailer to transport the horse nor do we have the extra hundreds of dollars at our disposal to pay for these services.

Would It Be Easier If We Didn’t Even Have a Horse?

Sometimes I wonder if it would be easier on Horse Lover if we didn’t have a horse at all. Wouldn’t it be easier for her to handle NOT riding if she didn’t even have a horse to ride?

The winter weather has given Handsome Hubby and I a bit of a break from Horse Lover’s pleas for lessons and to ride. After all, even the most dedicated rider can’t get excited about riding in sub-zero temperatures with 40 mph winds and drifting snow. (Did I mention that we don’t have an indoor riding arena, either?)

What Horse Lover lacks in experience, she makes up for in desire. And while I admire her passion and diligence, Handsome Hubby and I may well go crazy when spring arrives and Horse Lover resumes her begging. I’m not sure which will be harder to bear – a long winter with cold, snowy weather or a long spring with a pre-teen daughter persisting to ride her horses. I should know the answer to that question in a few months …

Sports Girl Needs to Strengthen Quads to Protect Knee

Monday was D-Day for Sports Girl – Doctor Day that is. She went back for her third follow-up exam following her MPFL reconstruction surgery back in mid December.

Except for being told she could immediately resume all her former activities without risk, the appointment couldn’t have gone better. The doctor did say that her left patella (kneecap) is now completely stable with less shifting than even her right. And the x-ray showed that the kneecap now sits straight on her joint rather than presenting with an outward tilt as it did before. The x-ray did, however, highlight the two metal screws she now has permanently implanted in her left kneecap, but these have left no lingering effects, thank goodness. If we hadn’t seen them on the x-ray, we might not have believed they were there!

Sports Girls’ quadriceps, however, are still obviously smaller on her left leg than her right in spite of undergoing more than 15 30-minute physical therapy sessions over the past two months and completing exercises on her own almost daily. Rebuilding and toning muscle takes time, and the doctor says resuming physical activity now would put her at risk for other injuries such as an ACL tear. He recommends another four weeks of physical therapy and exercises to further strengthen her leg and better protect her knee before she starts working out or competing in any sports.

The doctor wants to see her again on March 29 after she completes four more weeks of strength training, so running in spring track is off the table at least until then. And we are all OK with that, including Sports Girls. She’s been through too much already to risk any unplanned setback. It’s more important that she get back into shape over the summer, so she’s ready to play high school soccer come August and high school basketball after that starting in November.

It will be equally important, I think, for her to strengthen her right leg, as well as her left. While the doctor says he doesn’t personally know of anyone who has required the same MPFL surgery on both knees, he has known patients who’ve had subluxation or dislocation issues with both knees. So Sports Girls needs to prevent this from happening on her right knee as much as she needs to rebuild her left.

Besides doing her exercises, these days Sports Girl applies Mederma to her scars daily and looks forward to the day when she can run and play ball without even wearing a knee brace and with no fear of her kneecap sliding out of place. That day isn’t too far off …

Sports Girl Recovers Quickly From MPFL Surgery

Knee After MPFL Reconstruction Surgery

Sports Girl's left knee is no longer swollen but shows some signs of scarring.

My posts about my 14-year-old daughter’s knee surgery where surgeons used a cadaver ligament to replace her MPFL and a lateral release have attracted lots of readers and several comments. I am happy to report that Sports Girl continues to have a quick and painless recovery.

She goes back to her orthopedic surgeon for a follow-up appointment on Monday, March 1, where the doctor plans to x-ray her knee and give her a post-operative evaluation. We should know more then about how well she is progressing, but by all indications, she seems to be healing as well or better than we could possibly have expected.

Sports Girl has regained almost complete range of motion in her left knee, and she continues with aggressive closed-chain physical therapy weekly with the therapist and daily on her own. This means she does weight-bearing exercises on her leg while her foot is planted on the floor, but no jumping or running or anything where she picks up her leg.

It is amazing to me how quickly her left quadriceps atrophied, and she still has work to do to get them built back up. But she is working hard at her therapy, and while hurdles and the long jump are out of the question, according to her physical therapist, running distance in spring track may be a possibility for Sports Girl at this point. We plan to discuss this with the doctor next week as track will start almost exactly 3 months after the surgery, and this was the short end of the 3- to 6-month recovery time frame we were given.

While she is doing very well now, the surgery wasn’t entirely easy. Sports Girl spent one week taking the narcotic pain reliever, Oxycodone. The little white pills made her queasy and light headed, but she needed them – especially at night when the busyness of the day didn’t keep her mind off the throbbing pain. She had many pills leftover at the end of that first week, but she gradually weaned herself solely to Tylenol. She found that she didn’t actually need the potent pain pills to be comfortable. She didn’t like the way they made her feel in her head and her stomach, and she didn’t like knowing that they are classified as habit-forming drugs.

Sports Girl’s knee swelled to at least twice its normal size, but we diligently kept it elevated and iced almost non-stop for at least the first week, maybe longer. As someone who normally sleeps curled up in a ball, I know Sports Girl didn’t adapt well to being forced to sleep lying flat on her back. There was just no other way for her keep her knee stable and elevated.

Sports Girl also struggled with the lingering numbness she felt in her leg, probably a prolonged effect of the nerve block she had for surgery and also a possible side effect of the long hours she had her leg elevated. But after a couple of weeks, she finally regained complete feeling in all of her left leg and foot.

I think some of Sports Girls struggles involved getting past her own fears. For example, my fashion-conscious teenage daughter wore the absolutely ugly white TED compression hose/leggings even longer than instructed. She also continued to bandage her incisions long after anything was draining, and she covered them with plastic wrap before taking a shower much longer than the doctor ordered. I believe she actually dreaded losing the pieces of tape that covered the incisions.

And while Sports Girl was quick to ditch her crutches, she wasn’t as eager to leave her large black leg brace behind. She wore the brace for a few days longer than necessary, but that was fine with Handsome Hubby and I.  The roads, sidewalks and walkways around here have been covered in ice for much of this winter, and the brace served as a small insurance policy in case she fell.

The surgeon attached the cadaver ligament to Sports Girl’s femur with one dissolvable screw and to her patella with two screws that will not dissolve. According to the doctor, the dissolvable screws are too soft to be driven into the kneecap. The fact that the ligament will eventually be naturally attached to Sports Girl is reassuring and weird at the same time.

The surgeon could have used a piece of Sports Girl’s hamstring to replace the MPFL, but he wanted to leave the hamstring intact in case Sports Girl ever needed an ACL repair. Evidently the hamstring is the preferred tissue of choice for this type of repair. The surgeon assured us there was no risk of rejection using a cadaver ligament, and the recovery time is a bit less as the hamstring is not further weakened.

Sports Girl applies lotion with vitamin E on her incision sites daily as well as Mederma to reduce scaring. She will also need to wear sunscreen faithfully all summer as the surgeon said sun exposure in the first year makes scare appear more pronounced. I am picturing a tanned teenager with a white knee — similiar to how she looked last summer when she was wearing the black knee brace while playing sports.

The initial news of being sidelined from basketball and spring soccer was devastating for Sports Girl. But as she watches her former teammates wind down this basketball season, I think she has actually gotten a bit accustomed to her free time and has actually somewhat enjoyed this break from her sporting activities.

I believe Sports Girl’s biggest obstacles from this point forward could be overcoming her own internal fears as she regains trust in her knee – that and finding the strength and time to recommit to the sports she loves. So now we hope and pray that Sports Girl has the drive and dedication necessary to get ready this summer for high school sports in the fall. But first we need the surgeon to release her for full participation. I don’t think this will happen next Monday, but it might happen in March or April …

Winter Weather Leaves Thousands Without Power or Water

Even though the winter of 2009-10 isn’t yet half over, it has already been one to remember in South Dakota. Temperatures have been even colder than usual, inches and inches of snow have fallen, and even when the snow hasn’t fallen, fierce winds have blown around what was already on the ground. There is something seriously frustrating about shoveling the same snow more than once!

We traveled across our great state this weekend and got a belated glimpse of some of the havoc our extreme winter weather has caused.

There were livestock fences and wind shelters entirely covered in snow. Many large fields of corn stood unharvested after an unusually wet fall followed by the early arrival of winter. And even while there were areas of brown ground exposed in some places, just a short distance away there were mature shelter belts of trees with only branches poking out of enormous snowdrifts.

Repairing Power PoleBut perhaps the most striking blow the weather dealt was the large ice accumulations on power lines and poles, leaving thousands of people all across the Northern Plains without electricity for days, even weeks. The picture at right was borrowed from

We saw some of these downed power poles first hand. They looked like splintered toothpicks lying on the ground with lines sagging toward the ground or even snapped completely apart. And fixing these poles was obviously a daunting task. First crews needed to plow away the snow just to access the area for repair.

Entire communities have suffered from these extended power outages, and in these cases another problem has also arisen – a shortage of water. The community water towers drained quickly. And with no electricity to pump water or to run water treatment plants, residents were left without water not only for drinking and cooking, but also for flushing toilets, taking showers, or washing dishes and clothes.

Those living in the country have added challenges – they often have livestock to feed and water, and the power lines leading to their single-family homes are generally fixed only after those serving entire communities have already been repaired.

But country folks sometimes have it easier, too. Most have their own well and their own septic systems, making them more self-sufficient and generally taking care of any water shortage issue. Many also own standby generators to cover when the power goes out, so they are better prepared for the wrath of Mother Nature.

The plight of South Dakotans has gained some national news attention. An article will appear in tomorrow’s New York Times, for example. But generally our rural weather hardships are being rightfully overshadowed by the earthquake devastation in Haiti.

My ranching in-laws say this winter must compare to that of 1949, which has gone down in history as the worst winter of the 20th century for South Dakota. The only difference, they say, is that farmers and ranchers today have four-wheel drive tractors so they can still get the snow cleared to get out and take care of their animals in spite of the weather. Thank goodness for that!

Calving and lambing starts soon here, so hopefully we will at least get a break from the blustery weather. Even just a couple weeks of 40+ degree temperatures would help us better cope!

Ignoring my Pathfinder’s ‘Service Engine Soon’ Light

Three years ago I swapped my trusty 1996 Dodge Grand Caravan for a 2006 Nissan Pathfinder. I thought the Pathfinder would be better suited for driving our gravel roads and rough driveway. While I have appreciated the all-wheel-drive function on several occasions, I haven’t exactly been happy with my Pathfinder.

I’ve written about my struggle to find the perfect vehicle for country life once before. What I didn’t detail then was the service issues I’ve had with my Pathfinder – all supposedly caused by the six miles of gravel I drive on each time I travel to and from my home. It seems the gravel kicks up dust that gets sucked up into the vehicle’s engine and exhaust systems.

As a result, my “Service Engine Soon” light has been on almost perpetually for two years. The light first came on just two months after we purchased the vehicle, but thankfully the Pathfinder was still under factory warranty.

Initially, the light really bugged me; I promptly took the vehicle in for diagnosis and repair. Eventually my warranty expired, and I submitted a formal complaint to Nissan. Nissan tried two more times to fix my issue even without a warranty, but the light still came back on soon after every service. The last time I tried to have the dust issue fixed about a year ago, the service light came back on before I even made it home from the shop!

For those of you who are mechanically inclined, most of the issues I’ve had that required service involved the PCV valve and the oxygen sensors. And both issues are a direct result of the dust wreaking havoc with the emissions standards established to maintain clean air.

So now I just live with the “Service Engine Soon” light on all the time. The mechanics tell me the light will blink if there is anything seriously wrong with the vehicle. That’s sort of reassuring.

While I have my oil changed regularly, I have my tires rotated, and I’ve replaced my front brake pads, I continue to ignore my engine light. Speaking as the daughter of a diesel mechanic, this seems wrong. But constantly having the light checked and attempting to have the issue repaired was obviously a waste of time and money.

If only vehicle engineers would realize that some people still live in the country and that vehicles – especially SUVs and pickups – should be built to withstand this type of driving. Perhaps I should submit a formal complaint to them, as well … There’s probably too many of them to do that; so I guess this blog post will have to do.

Knee Recovery Goes Well So Far

Sports Girl's Knee 5 Days Post-Op

Sports Girl's left knee was still fairly swollen just 5 days post-op. It's still a little swollen even now, but not as much as this. Notice, too, how she wrote on her good knee with permanent market to ensure the doctor didn't make any mistakes.

Now at nearly 3 weeks post-op, Sports Girl is recovering quite nicely from her knee surgery. She has almost no pain, even when she’s worked hard twice a week by her physical therapist.

Her doctor told us that females tend to recover from these types of surgeries quicker than males and that young people tend to recover quicker than older people. So with two positive attributes on her side, Sports Girl seems to be bouncing back especially fast.

She still struggles a bit with mobility. She can just bend her left knee to almost a 70-degree angle; she says she feels a pulling sensation when she tries to go more than that. And she still wears the long brace to keep her leg straight almost all of the time. On the plus side, she actually can completely straighten her leg, which folks who’ve had this type of surgery often struggle to do.

Sports Girl is also able to support her weight on her left knee. She actually ditches her crutches quite regularly around the house and sometimes even forgets where she left them!

We had a fairly casual follow-up appointment with the orthopedic surgeon’s physicians assistant 10 days after the surgery. I think “casual” and “uneventful” are good qualities when it comes to describing doctor’s appointments. We go back to see the actual surgeon in 2 more weeks.

The original estimate for complete recovery was 3 to 6 months, so at only 3 weeks, it’s really too soon to tell much. I won’t prematurely declare that Sports Girl will be running hurdles in track this spring or that she’ll be playing striker for spring soccer, but we are feeling cautiously optimistic.

And even though this surgery has left Sports Girl sidelined from sports for most of her eighth grade year, we are at peace with our decision to have it done. Our hope is that she will recover better than she was before, that she will have a fun and successful scholastic athletic career and that she will lead a long and active life.

Sports Girl Is Recovering From Knee Surgery

All went well with Sports Girl’s knee surgery on Thursday. Things went so well, in fact, that the doctor said he wished he had been training a resident at the time; it seems she proved to be a textbook case for how and why to do this particular surgery.

I showed the doctor the diagrams I used to explain Sports Girl’s surgery in my previous post. Turns out I was spot on with my explanation — this is exactly what he did to Sports Girls. This and a “lateral release,” or the loosening of the lateral retinaculum, the tissue on the outside of the kneecap.

The surgery was done arthroscopically, so incision size was kept to a minimum. The doctor gave us some nice pictures of the inside of Sports Girl’s knee taken during the surgery. The good news is that her ACL and meniscus are in pristine condition. The bad news is that there was already some cartilage damage on the underside of her kneecap due to her kneecap sliding out of place. The doctor cleaned up the fraying and thankfully there weren’t any big  cartilage chunks floating around.

Besides pain and discomfort at the surgery site, Sports Girl struggles with nausea after taking her pain medications. She had a nerve block in her upper femur just prior to the surgery, and she 3+ days post operative, she is still experiencing some numbness and tingling in her leg and foot.

Sports Girls is wearing a long brace to keep her leg straight. She is to bend her leg 30 degrees during physical therapy exercises, but this isn’t much. She has her first outpatient physical therapy appointment tomorrow, and she has a follow-up doctor’s appointment next Monday.

Hopefully Sports Girl will write about her surgical experience from her point of view sometime soon. I’m sure her Christmas break from school is going to be quite boring as she spends the majority of her time either on the sofa or in bed with her left leg propped up on pillows and ice applied to her knee …

New Donor Ligament Will Support Sports Girl’s Knee

Sports Girl is not just having the surgery so she can continue to play sports. She is having the surgery for her quality of life and peace of mind. Each time the patella subluxes, cartilage damage occurs which eventually results in osteoarthritis. Cartilage cannot be replaced; knee replacement is used to correct the problem. We certainly don’t want Sports Girl to be looking at a knee replacement surgery at age 40.

Then there’s also the fact that each time her patella subluxes, it is very painful and frightening for Sports Girl.

Of course we are hopeful that Sports Girl will return to soccer and basketball and whatever else she wants to do in full force. We are told the recovery time will be 3 to 6 months, so we are planning for her to return in time for summer training. She starts high school next year, and the hope would be that she has a bright scholastic athletic career before her.

Why do kneecap dislocations become a recurrent problem?

Sports Girl’s left patella subluxes laterally – which means it slips out of place to the outside of her leg. Research I’ve found online explains that, “When the kneecap comes out of joint the first time, ligaments that were holding the kneecap in position are torn. The most commonly torn structure is called the medial patellofemoral ligament, or MPFL. This ligament secures the patella to the inside (medial) of the knee. When a kneecap dislocation occurs, something must fail to allow the kneecap out of the groove, and usually it is the MPFL.” I found this information on the Division of Pediatric Orthopaedics of Morgan Stanley Childrens Hospital of New York – Presbyterian web site.

So the doctor is going to go in and insert a cadaver/donor ligament to replace her MPFL – at least that’s how I understand it at this point. I should know a lot more about it after the surgery tomorrow, but the way he explained it last month in our office visit, I believe Sports Girl’s repair will looking something like the illustration below right. A normal MPFL is illustrated below left.

Normal MPFL Patellar LIgament

Normal MPFL Patellar Ligament

Reconstructed/Donor MPFL Ligament

Reconstructed/Donor MPFL Ligament

Sports Girl herself has contributed to my blog for the very first time. Read all about her pre-surgery anxiety here – from her point of view!