# Back to the ortho?



## severine (Mar 6, 2008)

*Back to the ortho?-UPDATE post 17-UPDATED again post 65*

Alrighty, tomorrow will be 3 weeks and I still have pain in my left knee.  The orthopedist said it should be a couple of weeks before I was feeling up to skiing again, but if I was concerned, I could have it checked out again before our Sugarbush/MRG trip (which is now 2 weeks away).  I guess this was because while he didn't think there was ACL damage, sometimes it can mask itself pretty well and ongoing pain (or increasing pain) can be a sign.  When I saw the orthopedist, they did x-rays and he pushed my leg around in different manners to test pain, plus compared the injured knee to the non-injured knee.  I've since learned that most rely on MRI for more accurate diagnosis (versus x-ray)....

What do you think?

Pain started out to the left of my kneecap (outside of my knee), but now I feel it there, under my kneecap when my knee is really bent, and behind my knee in the middle when standing really straight (almost hyper-extending the knee).  Not crippling pain, just a constant reminder that there's something wrong, with the occasional "ouch" thrown in for good measure.

Experts want to chime in?

UPDATED in post 17

UPDATED in post 65


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## Paul (Mar 6, 2008)

A good ortho can tell just by moving the knee around. My acl was diagnosed this way and the tibial plateau and the top of the fibula were both fractured, so there was mucho swelling.

Honestly, I could never feel much pain from the acl tear ,but then again, it was masked by the pain of broken bones. Even after the bones healed, it was hard to discern. Of course, mine was a complete tear, I suppose a partial tear may react differently. The fact that you mention the left side of the left knee would suggest damage to the LCL. However, mentioning pain behind the kneecap could mean ACL or PCL. 

Get it checked. An MRI will tell what, where, if any damage is. Most likely if there is ligament damage, it is nothing too severe. 

Does your knee feel unstable, or is it just a bit of discomfort and pain?


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## severine (Mar 6, 2008)

Not unstable, just pain.  I figured the pain would be less by now, but it's persistant.  I basically am just wondering if I'm over-reacting or if it's a valid concern, having never been through this before.  I did injure that same knee back in December in a bad fall, but it was fine after 2 weeks.  I guess I expected the same this time, especially since the orthopedist said the same.

ETA: Some have questioned why I wasn't put in a brace or stabilizer.  Not sure myself.  I asked if I needed to do anything special or needed to brace it and was simply told to ice it and take ibuprofen.  That I would be the best judge of how much I could handle. :?  Then again, I'm sure many of his patients aren't stuck toting around a 20+ lb kid all the time, too.  Or lifting a 45lber into the car, out, onto the changing table, etc.


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## Paul (Mar 6, 2008)

severine said:


> Not unstable, just pain.  I figured the pain would be less by now, but it's persistant.  I basically am just wondering if I'm over-reacting or if it's a valid concern, having never been through this before.  I did injure that same knee back in December in a bad fall, but it was fine after 2 weeks.  I guess I expected the same this time, especially since the orthopedist said the same.



Its hard to describe, but when I blew my ACL, after the bones healed and I could walk again, I just knew. It didn't move or feel right. If you have any doubts, getting it checked certainly won't hurt (well, I don't know about your insurance, it might)


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## Paul (Mar 6, 2008)

severine said:


> ETA: Some have questioned why I wasn't put in a brace or stabilizer.  Not sure myself.  I asked if I needed to do anything special or needed to brace it and was simply told to ice it and take ibuprofen.  That I would be the best judge of how much I could handle. :?  Then again, I'm sure many of his patients aren't stuck toting around a 20+ lb kid all the time, too.  Or lifting a 45lber into the car, out, onto the changing table, etc.



Can't say much about the brace. Different docs, different theories....

I wore one post injury, but again, the leg was broken. Then I had one post surgery for, like, ever, but I had the ACL replaced with 1/3 of my patellar tendon. That was worse than the ACL graft.


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## RISkier (Mar 6, 2008)

Certainly not an expert.  They can't really see much regarding the ACL or MCL with an X-Ray.  At one time I had a micro fracture in my knee that primary care physicians couldn't detect.  The stability test would suggest that you didn't tear it, but sprains can take quite a while to heal.  So it's mostl likely a matter of ice and rest.  Standing in a somewhat hyperextended position puts strain on the knees.  If you don't feel like you're getting better an MRI seems to be the way to go.  It's pretty much the only sure way to see what's going on.


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## severine (Mar 6, 2008)

Mmmmm... insurance sucks.  We'll have to pay 30% and I imagine MRI is expensive. 

Maybe a few more days?  I had already decided that I was probably only going to put in a few hours at MRG during that upcoming trip, and skipping SB altogether.  It's not looking good right now though...


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## Dr Skimeister (Mar 6, 2008)

Radiographs are not able to detect injury to soft tissue structures, such as ligaments. There is often a "flare" in the joint space that is associated with an ACL injury that might show up on the xray, but I would hope an orthopedist would not solely depend on that sign to diagnose a tear. MRI is a much more useful diagnostic tool.

Another consideration has to be an injury to the meniscus, the "bumper" between the femur (thigh bone) and the tibia (shin bone). Meniscus tears are not uncommon with cruciate tears, but can also occur independently. 

If the pain has persisted despite the advised rest, use caution skiing on it as it is possble to make what may be a minor injury more serious that then necessitates surgery.


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## severine (Mar 8, 2008)

The more I've read about it, the more I wonder if I tore or injured my meniscus.  Especially given the fact that it got better, then worse again.  Every morning I'm waking up with pain now, and it's getting progressively worse instead of better.  Should have called yesterday... now I'll have to wait until Monday. Possibly going to try the other ortho in town (specialty in sports med) as a sort of 2nd opinion.

In any case, looks like I'm out for the season.  Even if it miraculously does feel better in a couple of weeks, I'm not going to risk it in spring conditions.


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## o3jeff (Mar 8, 2008)

Personally i would try the second guy. It sounds like the first guy already misdiagnosed you already(doing an xray vs. the mri since it sounds like an xray does not shows ligament or muscle damage) and therefore has already wasted valuable heal time. But then again I really don't know enough about xrays and mri other than what I read in previous posts here. But it sounds like if they originally would of done the mri, you would be on your road to recovery.


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## Dr Skimeister (Mar 8, 2008)

Many meniscus tears are what are referred to as "bucket handle"tears. In that case, the flap that the tear created sometimes raises from the surface of the cartilage and in doing so exposes the nerve endings. Pain results when those nerve endings are exposed.


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## MR. evil (Mar 8, 2008)

severine said:


> Mmmmm... insurance sucks.  We'll have to pay 30% and I imagine MRI is expensive. ...



Ya, they are pricey. I had an MRI on my left hand a couple of months ago (torn ligament) and the bill was about $1400. But my insurance covered it. I was told that MRI's of the hand are the hardest and longest ones to perform (it took an hour) and I would imagine they cost more. So it may not cost as much to MRI the knee.


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## severine (Mar 9, 2008)

I just keep reading and reading and reading.  Looks like a good ortho should be able to diagnose just about as well as an MRI would assist.  But again, no medical training here... just going by what I can read and first-hand experiences of others.

That said, I woke up this morning with NO pain.  Sharp contrast to the last 2 days when it hurt more than it ever did before.  So as to maintain this no pain scenario, I have been vigilant about not carrying the baby on that side, icing periodically, and taking ibuprofen.  And out of the whole day thus far, I have only had a very mild discomfort a couple of times that did not last long.  Could it be a breakthrough?  

Calling the ortho in the morning... busy day tomorrow but hopefully they can get me in at some point.  If I don't _need_ to be out the rest of the season, then I don't want to be.  Especially with new boots and skis in the works... and MRG/SB next week.


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## severine (Mar 9, 2008)

Dr Skimeister said:


> Many meniscus tears are what are referred to as "bucket handle"tears. In that case, the flap that the tear created sometimes raises from the surface of the cartilage and in doing so exposes the nerve endings. Pain results when those nerve endings are exposed.


I have read about that.  Will definitely be asking about the meniscus tear scenario.


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## Paul (Mar 9, 2008)

o3jeff said:


> Personally i would try the second guy. It sounds like the first guy already misdiagnosed you already(doing an xray vs. the mri since it sounds like an xray does not shows ligament or muscle damage) and therefore has already wasted valuable heal time. But then again I really don't know enough about xrays and mri other than what I read in previous posts here. But it sounds like if they originally would of done the mri, you would be on your road to recovery.



MRIs are really expensive, and are only done after an x-ray. The x-ray won't show soft-tissue, but it does rule-out breaks etc... Like I said above, A good ortho cal tell a lot by moving it around. If he/she believes there to be ligament, meniscus etc.. damage, then an MRI would be done. Calling for an x-ray isn't a mis-diagnosis.


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## severine (Mar 10, 2008)

Appointment for tomorrow for 2:50PM.  Sticking with the same guy.  Knee is still pain-free (well, essentially) but feels a little weak.  Understandable since I haven't done much with it in over 3 weeks.  I'll see what he has to say tomorrow...


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## severine (Mar 11, 2008)

Just got back from the orthopedist and it was not good. The pain was starting to come back today and now post-appointment, it's pretty bad. He moved my leg around in various positions, pushing and pulling, pressed on the knee... and said he really thought it would have been healed by now. He doesn't think the ACL is affected, but said that it's possible I tore my meniscus. They're ordering an MRI for me. I'm waiting for the call from them on when I can go, but it's likely I won't hear back until tomorrow because our insurance is out of state and they have to get approval from the insurance first.


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## wa-loaf (Mar 11, 2008)

Ok, so I've been in denial about this for a little while, but I hurt my left knee almost two weeks ago in a collision with a snowboarder. I toughed it out for a week and made an appointment last week (on a really painful day) to see the Ortho. I just got back. First thing they did was hand me a sheet to go down and get xrayed. Got the xrays and came back to the office, the doc (actually NP) looks them over and checks out my knee. Looks like I might have chipped a piece of cartilage from kneecap and I'm going to get an MRI tonight to rule out an ACL tear. She also took about 15ml of fluid from my knee. I have a follow up on Thursday for with the NP and the Ortho. I also got a knee brace and I'm still optimistic about skiing Friday and Saturday. The NP though that was possible especially with a brace.


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## severine (Mar 11, 2008)

Wow, that sucks.   Though I guess it's good if the NP feels you can still ski with the brace on.  

I asked about a brace at my first appt and was told I didn't need one.  Didn't get to talk much at this appointment because my kids were trying to escape.  I appreciate that he didn't make it a long, drawn-out thing (though it didn't seem like he rushed, either).  I guess I just have to wait and see what the MRI says.  And hope for the best.  The sucky thing about meniscus is that in most cases, it can't repair itself - requires arthroscopic surgery.  I'm REALLY hoping that's not the problem.


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## wa-loaf (Mar 11, 2008)

Considering my experience, I'm very surprised that they didn't send you in for the MRI sooner. Seemed like it was a routine step they do.


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## severine (Mar 11, 2008)

I don't feel that my ortho did a disservice by waiting.  He did seem genuinely convinced that I would have no problems healing in time to ski at MRG next week.  He was a bit surprised to see me back in the office today.  I appreciate that he didn't jump right to the MRI as they are expensive and I can't afford to be paying for anything that isn't absolutely necessary.  

I have confidence in him.  Here's his bio from their website:


> Sports Medicine / Arthroscopic Surgery
> 
> Dr. Brezenoff graduated from Union College and the University of Medicine and Dentistry of New Jersey. He then completed an internship at Albert Einstein Medical Center in Philadelphia, PA and a residency in orthopedic surgery at Montefiore Medical Center in Bronx, NY. In 2000, he completed a fellowship in Sports Medicine and Shoulder and Elbow surgery affiliated with Georgetown University, where he treated professional and Division I athletes. Dr. Brezenoff is certified by the American Board of Orthopedic Surgery, and is a member of the American Academy of Orthopedic Surgery and the American Orthopedic Society for Sports Medicine.
> 
> Dr. Brezenoff practiced in Bethlehem, PA for four years where he had an active sports medicine practice serving as the team physician for several area high schools, as well as DeSales University. He has vast experience in non-operative rehabilitation of sports related injuries as well as advanced minimally invasive arthroscopic surgery of the shoulder, knee, elbow, and ankle. He also performs ligament reconstructions, joint preserving surgery, replacements of the knee and shoulder, and the treatment of fractures.


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## Dr Skimeister (Mar 11, 2008)

Here's wishes for fast healing for both of you.


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## Paul (Mar 11, 2008)

Wow, hate to hear about all these knee injuries, looks like I was a year early to join the club.
Wa, What kind of brace? If he thought there was a real ACL issue, you likely would be in an immobilizer.
Sev, No disservice, I agree. These things can be tricky to diagnose. Best wishes to you both.


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## wa-loaf (Mar 12, 2008)

Paul said:


> Wa, What kind of brace? If he thought there was a real ACL issue, you likely would be in an immobilizer.



I don't think she thinks there's really anything major. In the x-ray it looks like I chipped a small chunk off of my kneecap (although that could also just be the way it is), but I did crash into the guy knee first and then twisted around him. So it's both an impact and forward twisting injury. The MRI is to check out the kneecap and to rule out an ACL tear. In checking out my knee she felt there was a little more movement than normal, but I didn't feel any pain from what she did, so any damage is likely minor.

Drawing the fluid off of my knee really helped my range of motion. I was having a tough time bending the knee too far. That was the most painful part of the day.

The brace I got is just a neoprene pull-on with plastic rods on the side and hinges.

My follow up is Thursday afternoon. So I'll know more then.


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## severine (Mar 12, 2008)

I'm having problems with swelling (fluid) affecting ROM now, too.  ROM wasn't bad up until recently.  Caring for and picking up after 2 small children all day isn't helping.

Have to call the office this morning.  I may not be able to get an MRI... need to see what they say.


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## wa-loaf (Mar 12, 2008)

severine said:


> I may not be able to get an MRI... need to see what they say.



Because your insurance won't approve it?


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## severine (Mar 12, 2008)

Because I have an IUD.  On WebMD that's listed under things that may prevent you from getting an MRI.


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## wa-loaf (Mar 12, 2008)

severine said:


> Because I have an IUD.  On WebMD that's listed under things that may prevent you from getting an MRI.



Oh right, I saw that on the check list. Eyelid springs are also not good for MRIs! Something I didn't know existed until I saw it.

Are there any other options?


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## severine (Mar 12, 2008)

I _think_ the only alternative is arthroscopic if x-ray wasn't decisive and they can't do an MRI.  Not sure, though.

They're supposed to call me today anyway so I'll wait for the call and see.  Some sites say it's a problem, others say it is not.  I think it has to do with how much they crank up the magnet, but I'm not entirely sure having never done this before.

Never heard of eyelid springs before either!  Wow!


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## drjeff (Mar 12, 2008)

severine said:


> I _think_ the only alternative is arthroscopic if x-ray wasn't decisive and they can't do an MRI.  Not sure, though.
> 
> They're supposed to call me today anyway so I'll wait for the call and see.  Some sites say it's a problem, others say it is not.  I think it has to do with how much they crank up the magnet, but I'm not entirely sure having never done this before.
> 
> Never heard of eyelid springs before either!  Wow!



Unless you have really, really, really short legs,  for a knee MRI, or for any "small body part" MRI for that matter, the radiation exposure field is quite small and limited.  I send folks a few times a year for an MRI of their sinuses, and the per the radiologist at the scanning center I send my patients to, the radiation exposure field for the sinus scan is basically from the patients pupils to roughly their lower jaw gum line.  Outside of that with images taken ona  modern MRI machine the radiation exposure is essentially nil.

Sounds like in your case, its good 'ol fashioned insurance company policies where personal health is often second fiddle to corporate profits 

A typical knee MRI scan:  (note the radiation exposure field extends maybe an inch above and an inch below the image)







Why though sometimes metal and MRI's can be a problem if the metal is in the  image fiels, is that the radition beam from the MRI "hits" a metallic object, you get on the image what is called "scatter" which is the star like "eplosion looking" streaks in the image belowNote the picture below is a CT scan, not an MRI, but I couldn't find any good "scatter" MRI pics online, you get the same results from both imagining systems though with respect to metal)






You can see how something like that *might* make it tough for the radiologist to properly interpret the image


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## severine (Mar 12, 2008)

I'm actually surprised ultrasound isn't used.  It shows tissues and bone.  Cheaper and can be done in office.

Like I said, I'm no expert here.  Just repeating what I read.  Could be a non-issue (and I'm hoping that it is).  I'd rather be informed than have the appt, struggle for child care (possibly even a ride because I'm claustrophobic and may need to be sedated), and then find out that they can't do it because of the IUD.

drjeff - Is it true that amalgam fillings can heat up during MRI?  That's another thing I read.  I believe I still have 2 amalgam fillings.

BTW, I'm typing this while sitting in my old pair of ski boots (new pair will be picked up this afternoon).    It's almost as bad as summer jonesing....


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## wa-loaf (Mar 12, 2008)

It's not the radiation that's the problem it's the magnet. Anything metal that's not tied down (or part of your body) can get yanked out of position: http://www.webmd.com/news/20010801/fatal-mri-accident-is-first-of-its-kind


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## severine (Mar 12, 2008)

Exactly.  Anyone who was watching NCIS last night could see that magnetic metal in the body issue in action. 

Besides, if it were radiation that were the problem, I'd already be screwed with all the x-rays I've had done since getting the IUD.

Still waiting on the call....


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## Paul (Mar 12, 2008)

No need for sedation, an MRI on your knee won't involve getting your head into the tube. You'll only go in, at most, waist to mid-chest deep. The tough part is laying still for 20 min with that damned racket. SRSLY, those things are loud! They'll give you ear-plugs.

Also, I have about a half-dozen metal-amalgam fillings along with a metal crown. No problems, I believe they are non-ferrous, so aren't affected by the magnet. They did have to give me full head X-rays first, however, because I had a previous eye-injury where I had a piece of steel embedded in my cornea for about 2.5 months. Needed to make sure there wasn't any left. :-o


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## drjeff (Mar 12, 2008)

severine said:


> I'm actually surprised ultrasound isn't used.  It shows tissues and bone.  Cheaper and can be done in office.
> 
> Like I said, I'm no expert here.  Just repeating what I read.  Could be a non-issue (and I'm hoping that it is).  I'd rather be informed than have the appt, struggle for child care (possibly even a ride because I'm claustrophobic and may need to be sedated), and then find out that they can't do it because of the IUD.
> 
> ...



The biggest difference between and MRI image and an Ultrasound image (even the new "4-D" ultrasounds that so many pregnant women get the pics of their babies taken with) is the degree of resolution that each machine can deliver.  The ultra sound can give a good image of larger structures generally speaking.  The MRI can give a GREAT image of both large and small structures.  If your Ortho-pod is starting to think of a small tear (and by small you very well may be talking a few millimeters), you're likely not going to pick that up on an ultrasound, whereas with the resolution of an MRI image, your chances are much better of seeing it.

As for heat and amalgam fillings and MRI machines,  as long as the radiation beam is focussed directly on the fillings for a LONG period of time (we're talking an hour plus), its of no issue whatsoever.  Even if there is a constant, extended MRI beam exposure(lets say for a full head imagining session in multiple planes - and MRI can produce images in both vertical and horizontal axis's(?sp) depending on what you tell the software to do), the risk of tooth damage from the residual heat exposure is EXTREMELY low (prolonged heat to a tooth with a live nerve in it can potentially lead to nerve death in that tooth - that's why when my type of folk pick up the drill and start working that all that COLD air and water are emmitted from it, so the nerve stays cool and healthy)

If claustrophobia is an issue AND you Orhto-pod wants an MRI,  many imaging centers nowadays have what's called an open MRI where the housing around the imager isn't as nearly "tube like" as the traditional MRI machine.  Plus as Paul said, if it just a knee their looking at, even with an old machine your head would be out of the "tube", unless of course your a midget 

An Open MRI machine:






and "old school" closed MRI:


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## wa-loaf (Mar 12, 2008)

drjeff said:


> An Open MRI machine:
> 
> 
> 
> ...



Wow, those are nice MRI machines. I felt like I was in the bat cave yesterday and that's not even the MRI machine. I had to cross over a little bridge and there were industrial looking rolling garage doors with some weird padding and bare cinder block walls. And then the control room with the MRI in another small room looking like it was just stuck in the wall.


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## severine (Mar 12, 2008)

wa-loaf said:


> Wow, those are nice MRI machines. *I felt like I was in the bat cave* yesterday and that's not even the MRI machine. I had to cross over a little bridge and there were industrial looking rolling garage doors with some weird padding and bare cinder block walls. And then the control room with the MRI in another small room looking like it was just stuck in the wall.


:lol:  That's quite the mental image! :lol:

Still waiting on their call.... I have to leave in about an hour to run some errands so I may miss them today.

On the upside, knee feels better today.  Yesterday's increased pain was likely due to the manipulation at the appt.  There's hope!


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## drjeff (Mar 12, 2008)

severine said:


> :lol:  That's quite the mental image! :lol:
> 
> Still waiting on their call.... I have to leave in about an hour to run some errands so I may miss them today.
> 
> On the upside, knee feels better today.  Yesterday's increased pain was likely due to the manipulation at the appt.  There's hope!



See, all you need to do is just hop around on your good leg all day and you've solved your problem without having an MRI either 

You'd even still be set for skiing!






On a side note,  just seeing any disabled person out on the hill enjoying the snow is awesome, but if you've ever seen the national/world class disabled skiers competing, WOW!  The majority of them would out ski about 98% of the skiing population!  They can really rip!


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## wa-loaf (Mar 12, 2008)

drjeff said:


> On a side note,  just seeing any disbleable person out on the hill enjoying the snow is awesome, but if you've ever seen the national/world class disabled skiers competeing, WOW!  The majority of them would out ski about 98% of the skiing population!  They can really rip!



I'd still want to ski if I (god forbid) lost a leg or even both.


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## Warp Daddy (Mar 12, 2008)

Got a guy at our regional hill  who skis with one leg and outrigger s on the pole  --this dude RIPS  and on the steeps -------AWESOME skier


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## drjeff (Mar 12, 2008)

Warp Daddy said:


> Got a guy at our regional hill  who skis with one leg and outrigger s on the pole  --this dude RIPS  and on the steeps -------AWESOME skier



I have the heli-ski show of Discovery Channel HD's "Living The Dream" series on my DVR at home, and they have one segment where the main skier is from the US National disabled ski team (1 leg using outriggers) just ripping the powder out at Mike Wiegele's Heliskiing out in British Columbia- really cool segment(and entire show for that matter!)


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## Paul (Mar 12, 2008)

wa-loaf said:


> Wow, those are nice MRI machines. I felt like I was in the bat cave yesterday and that's not even the MRI machine. I had to cross over a little bridge and there were industrial looking rolling garage doors with some weird padding and bare cinder block walls. And then the control room with the MRI in another small room looking like it was just stuck in the wall.



Most MRI machines are mobile units. That's why you feel like Mad Max in them.


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## wa-loaf (Mar 12, 2008)

Paul said:


> Most MRI machines are mobile units. That's why you feel like Mad Max in them.



Ah, that explains the bridge and garage doors. I probably stepped over into a trailer housing the MRI. :smash:


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## drjeff (Mar 12, 2008)

Paul said:


> Most MRI machines are mobile units. That's why you feel like Mad Max in them.



Yup,  the hospital that is practically across the street from my office has their CT scanner (too small of a hospital for both a CT and an MRI) in an 18 wheeler trailer that is attached to the hospital next to the ER.

On the flipside, the "imaging center" that's also in the town where my office is has BOTH there CT scanner and MRI machines in "radiology suites" that look like they could fit right in in the Taj Mahal!

The bigger issue here is why on earth does a small town of less than 10,000 people and and rural surrounding towns, need 2 CT Scanners and an MRI machine in it???  Especially when less than 30 miles away to the North, South, East and West there are hospitals that are at "worst" a level 2 trauma center with all the types of imagining machines that just about any Doc in the world could want for diagnostic purposes!


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## Paul (Mar 12, 2008)

wa-loaf said:


> Ah, that explains the bridge and garage doors. I probably stepped over into a trailer housing the MRI. :smash:



Yes you did. Watchout for ol' Luke, though, he can be pretty ornery...


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## Paul (Mar 12, 2008)

drjeff said:


> Yup,  the hospital that is practically across the street from my office has their CT scanner (too small of a hospital for both a CT and an MRI) in an 18 wheeler trailer that is attached to the hospital next to the ER.
> 
> On the flipside, the "imaging center" that's also in the town where my office is has BOTH there CT scanner and MRI machines in "radiology suites" that look like they could fit right in in the Taj Mahal!
> 
> The bigger issue here is why on earth does a small town of less than 10,000 people and and rural surrounding towns, need 2 CT Scanners and an MRI machine in it???  Especially when less than 30 miles away to the North, South, East and West there are hospitals that are at "worst" a level 2 trauma center with all the types of imagining machines that just about any Doc in the world could want for diagnostic purposes!



Do you work in Brooklyn as well? :blink:

I guess the answer lies in my post above....


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## drjeff (Mar 12, 2008)

Paul said:


> Do you work in Brooklyn as well? :blink:
> 
> I guess the answer lies in my post above....



Actually I need to head a couple of towns North to Putnam to head to the office.  Makes it fun since Putnam borders Marc's home town!


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## drjeff (Mar 12, 2008)

Paul said:


> Yes you did. Watchout for ol' Luke, though, he can be pretty ornery...



I want to nominate this for Picture of The Year!


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## Paul (Mar 12, 2008)

drjeff said:


> I want to nominate this for Picture of The Year!



I'd be honored. My wife caught me when I though she was out a-huntin'.


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## lerops (Mar 12, 2008)

Sorry for your injury, I feel for you. I am getting an ACL surgery in a week. I am absolutely not an expert, so I can only share my experience. 

I was sledded down and the doctor at the mountain said it was probably a sprained ligament. There was nothing on x-ray, so no bone issues. Initially it seemed to improve, then it got worse. I am not sure those swings say much.

Had an MRI taken and voila, ACL tear. Since then, I have been doing PT. Pain mainly has been under the kneecap. During the first couple of weeks it hurt if I was on my feet for a long time. Afterwards, there has been pain after long workouts and intense PT sessions. Excess straightening and bending did hurt, but straightening doesn't hurt anymore.

Hope this helps and hope it is just a minor sprain.


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## severine (Mar 12, 2008)

Paul said:


> I'd be honored. My wife caught me when I though she was out a-huntin'.



You're so high-brow.

No call from the ortho. :angry:  I was busy getting my boots today and then the kids ... well, all hell broke loose.  So I will be calling in the morning to find out what's going on.  I'd like to get this done and over with, but it's quite possible that the hold up is my insurance and not them.  Lousy insurance...


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## severine (Mar 13, 2008)

We are a go for the MRI.  IUD will not be a problem.  Appt is Monday at 2PM and then I'll go back to the orthopedist Tues at 8:40AM to follow up.


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## drjeff (Mar 13, 2008)

severine said:


> We are a go for the MRI.  IUD will not be a problem.  Appt is Monday at 2PM and then I'll go back to the orthopedist Tues at 8:40AM to follow up.




In all seriousness bring some ear plugs, while completely painless,  MRI machines aren't exactly quiet!  You might actually want to call the imagining center you're going to and see if it's okay to bring an ipod or something similar. (Some centers would let you bring 1 for a lower body image and some won't)

Good luck, and hopefully the image read will be just imflamation!


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## wa-loaf (Mar 13, 2008)

*Done*

Blown ACL, bruised bone, sprained mcl and possible small tear in meniscus. :-x

Need to do 4 week PT to stregthen leg and wait for swelling and bruised bones to heal. Then have surgery. Should be up and running for next season.

Funny thing is it doesn't hurt. Doc was suprised.


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## Paul (Mar 13, 2008)

wa-loaf said:


> Blown ACL, bruised bone, sprained mcl and possible small tear in meniscus. :-x
> 
> Need to do 4 week PT to stregthen leg and wait for swelling and bruised bones to heal. Then have surgery. Should be up and running for next season.
> 
> Funny thing is it doesn't hurt. Doc was suprised.



Aw, shit. That sucks. I'm really sorry to hear it. Cripes, that makes what, 4 acls this season? Jeebus, we're gonna have to start an AZ support group.


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## wa-loaf (Mar 13, 2008)

Paul said:


> Aw, shit. That sucks. I'm really sorry to hear it. Cripes, that makes what, 4 acls this season? Jeebus, we're gonna have to start an AZ support group.



I started a poll. http://forums.alpinezone.com/25510-got-acl.html


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## drjeff (Mar 14, 2008)

wa-loaf said:


> Blown ACL, bruised bone, sprained mcl and possible small tear in meniscus. :-x
> 
> Need to do 4 week PT to stregthen leg and wait for swelling and bruised bones to heal. Then have surgery. Should be up and running for next season.
> 
> Funny thing is it doesn't hurt. Doc was suprised.



That totally sucks!  Hope your PT is atleast easy on the eyes as they're having fun manipulating your knee in a whole variety of directions!


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## severine (Mar 14, 2008)

wa-loaf said:


> Blown ACL, bruised bone, sprained mcl and possible small tear in meniscus. :-x
> 
> Need to do 4 week PT to stregthen leg and wait for swelling and bruised bones to heal. Then have surgery. Should be up and running for next season.
> 
> Funny thing is it doesn't hurt. Doc was suprised.


I'm so sorry to hear that.   At least you should be fine for next season!


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## GrilledSteezeSandwich (Mar 16, 2008)

So why are you probably done for the season???  Did you end up tearing your ACL/MCL??  It sucks that Brian gets to have all the fun..


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## severine (Mar 16, 2008)

You're right; it's not fair.

I think I'm done because my knee is still swollen and sore over 4 weeks after my fall.  I'll know more after the MRI tomorrow, but it's not looking good so far.   Thank you for asking though.


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## wa-loaf (Mar 17, 2008)

severine said:


> You're right; it's not fair.
> 
> I think I'm done because my knee is still swollen and sore over 4 weeks after my fall.  I'll know more after the MRI tomorrow, but it's not looking good so far.   Thank you for asking though.



How'd the MRI go?


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## severine (Mar 17, 2008)

MRI wasn't bad.  My head was out the tube, but that's it.  I did freak out a little bit at first, but they put headphones on me and let me pick an FM station to listen to (though the volume was nowhere near loud enough to make a dent in the MRI noises).  I've had a cold since Wed and was really worried about my nose staying clear, but I wasn't allowed to keep my cough drop.  Did a lot of deep breathing when I panicked a few times, but got through it... and ended up in a coughing fit I couldn't stop.  Fortunately, it was right at the end (though I didn't realize it and they came in right after I started coughing - the lady said, "I bet you thought I was coming in here to yell at you." )

Follow up is tomorrow morning with the orthopedist.  The MRI tech told me it would be a couple of days until the doctor got the results (and they didn't tell me anything, unfortunately), but his office scheduled the follow up for tomorrow so he better know then.  Less than 12 hrs til I hear more....


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## wa-loaf (Mar 17, 2008)

severine said:


> Follow up is tomorrow morning with the orthopedist.  The MRI tech told me it would be a couple of days until the doctor got the results (and they didn't tell me anything, unfortunately), but his office scheduled the follow up for tomorrow so he better know then.  Less than 12 hrs til I hear more....



They should know. I got films 5 mins after the MRI and delivered them to doc at my appt. They looked at them for 15 mins and had a diagnosis.


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## Paul (Mar 18, 2008)

wa-loaf said:


> They should know. I got films 5 mins after the MRI and delivered them to doc at my appt. They looked at them for 15 mins and had a diagnosis.



Same here, I left with the films in hand.


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## severine (Mar 18, 2008)

The verdict?  Fluid behind the knee, bruised bones, and a partially torn ACL.  Meniscus appears to be intact.  The orthopedist was quite surprised.  Since it's only partially torn, we're going with PT for now.  He's had good luck in the past with similar injuries and therefore has high hopes that will be all I need, especially since I'm not having instability issues.

The earliest I could get in for my first PT is next Wed.  Then I'll go 2-3 times a week for 4 weeks, with a follow up in 6 weeks.

I did ask about skiing (because it's been 4.5 weeks now).  He laughed and said that if I felt up to it, I could try some easy stuff.  Didn't feel I needed a brace since I haven't had instability but I'm to call him right away if I have any problems.

Could have been worse, right?  I'm just happy he's not jumping to put me under the knife.


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## wa-loaf (Mar 18, 2008)

severine said:


> The verdict?  Fluid behind the knee



That's all pretty good news. Did they draw any of the fluid out of your knee? They took a bunch out of my knee and it felt much better afterwards. It relieved a lot of the pressure and improved it's flexibility.

I start PT on Thursday, doing one standard and one pool based session per week.


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## severine (Mar 18, 2008)

No, he felt the fluid would go away on its own in time.

Pool-based PT sounds nice.


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## 2knees (Mar 18, 2008)

sorry to hear that severine.  

I really wish i hadnt read this thread though.  I'm starting to have some serious questions as to just what i did to my knee on sunday.


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## bvibert (Mar 18, 2008)

2knees said:


> sorry to hear that severine.
> 
> I really wish i hadnt read this thread though.  I'm starting to have some serious questions as to just what i did to my knee on sunday.



Bummer Pat!


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## severine (Mar 18, 2008)

Pat, I'm really sorry to hear that.   Don't keep reading.  I read way too much info out there while I was waiting to find out what was wrong and it only made things worse mentally.


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## wa-loaf (Mar 18, 2008)

2knees said:


> sorry to hear that severine.
> 
> I really wish i hadnt read this thread though.  I'm starting to have some serious questions as to just what i did to my knee on sunday.



Damn that sucks. Regardless it's probably worth it to have it checked out. It took me about a week to realize (or accept the fact) I needed to see someone.


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## drjeff (Mar 18, 2008)

wa-loaf said:


> Damn that sucks. Regardless it's probably worth it to have it checked out. It took me about a week to realize (or accept the fact) I needed to see someone.




That's one of our standard guy reactions!  Nope, not me, I'm not injured, give an an advil, it will be fine, it will go away by itself, etc, etc, etc.  That response is pure genetics, and I'm convined is located on the "Y" chromosome right next to the gene that makes us guys superior channel surfers and all knowing in the directions department!


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## Paul (Mar 18, 2008)

drjeff said:


> That's one of our standard guy reactions!  Nope, not me, I'm not injured, give an an advil, it will be fine, it will go away by itself, etc, etc, etc.  That response is pure genetics, and I'm convined is located on the "Y" chromosome right next to the gene that makes us guys superior channel surfers and all knowing in the directions department!



Agreed. Pat, you've been through it before, you know the drill...

Sev, That's a bit of a relief. Great to see you should be able to recover sans surgery. It was hard enough to handle with a then six-year-old. I can't imagine it with 2 curtain-climbers.
Good-luck!

Wa, Lucky bastich, pool therapy is a great way to re-hab. Wish I had had that option...


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## 2knees (Mar 18, 2008)

Paul said:


> Agreed. Pat, you've been through it before, you know the drill...



I know i probably should but i'm trying not to panic this time.  2 years ago, i did something to my left knee and freaked out.  It was worse then this one. all swollen and really couldnt bear any weight.  went through the whole drill with dr. appts, mri and follow up visits.  All for nothing, just a very very bad sprain.  My insurance sucks since my work switched over so i want to be rational about it.  I didnt feel a pop, my knee didnt give out, which considering the force with which i landed, i'm sure would've happened if i blew the acl.  and i finished the run till i tipped over at the bottom.  that had nothing to do with my knee.  PLUS, i skied one more semi-fast bump run and one easy bump run after that and it never wavered.  Based on those facts, i gotta believe the acl didnt blow.  

right????


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## Paul (Mar 18, 2008)

2knees said:


> I know i probably should but i'm trying not to panic this time.  2 years ago, i did something to my left knee and freaked out.  It was worse then this one. all swollen and really couldnt bear any weight.  went through the whole drill with dr. appts, mri and follow up visits.  All for nothing, just a very very bad sprain.  My insurance sucks since my work switched over so i want to be rational about it.  I didnt feel a pop, my knee didnt give out, which considering the force with which i landed, i'm sure would've happened if i blew the acl.  and i finished the run till i tipped over at the bottom.  that had nothing to do with my knee.  PLUS, i skied one more semi-fast bump run and one easy bump run after that and it never wavered.  Based on those facts, i gotta believe the acl didnt blow.
> 
> right????



Probably. I hear you on the insurance thing. Luckily when I blew mine, I still had decent ins. Now it sucks. No need to rush into anything, but it wouldn't hurt to take it easy for a bit and keep an eye on things either.


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## severine (Mar 18, 2008)

drjeff said:


> That's one of our standard guy reactions!  Nope, not me, I'm not injured, give an an advil, it will be fine, it will go away by itself, etc, etc, etc.  That response is pure genetics, and I'm convined is located on the "Y" chromosome right next to the gene that makes us guys superior channel surfers and all knowing in the directions department!


It's not just a guy thing.  I do that all the time.  This whole injury started with me continuing to ski down the hill and try 2 more runs after falling.  And earlier in the season, I fell flat on my back at work.  Continued to work 3 more hours (sans pain meds) even though I was in severe pain because I didn't want to lose face in front of the guys.  I cried getting into the car and the whole ride home, it hurt that much.



2knees said:


> I know i probably should but i'm trying not to panic this time.  2 years ago, i did something to my left knee and freaked out.  It was worse then this one. all swollen and really couldnt bear any weight.  went through the whole drill with dr. appts, mri and follow up visits.  All for nothing, just a very very bad sprain.  My insurance sucks since my work switched over so i want to be rational about it.  I didnt feel a pop, my knee didnt give out, which considering the force with which i landed, i'm sure would've happened if i blew the acl.  and i finished the run till i tipped over at the bottom.  that had nothing to do with my knee.  PLUS, i skied one more semi-fast bump run and one easy bump run after that and it never wavered.  Based on those facts, i gotta believe the acl didnt blow.
> 
> right????


I hear you on the sucky insurance.  But sometimes you have to just suck it up.  Give it some time, go easy, and see how it feels.  FWIW, I didn't feel a pop and my knee didn't give out-I even skied down the rest of Canyon Run (I was at the top of Nor'Easter avoiding the skiercross course), plus 2 more runs down Lil Joe to test my knee-but I still have a tear.  Doesn't have to be textbook.


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## wa-loaf (Mar 18, 2008)

severine said:


> I hear you on the sucky insurance.



I don't use my insurance much, but I'm so glad I've got a good plan right now (PPO). I don't need referrals so I just look up who I need to see and go.


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## severine (Mar 18, 2008)

wa-loaf said:


> I don't use my insurance much, but I'm so glad I've got a good plan right now (PPO). I don't need referrals so I just look up who I need to see and go.


We have a PPO, too.  But compared to our old PPO (when I worked for the local municipality) it's sucky.  We pay A LOT more now than we did before.


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## Paul (Mar 18, 2008)

Went straight from an HMO to an HSA. Company made no contribution. Basically, we pay for everything right now until we hit 4k.


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## bvibert (Mar 18, 2008)

Paul said:


> Went straight from an HMO to an HSA. Company made no contribution. Basically, we pay for everything right now until we hit 4k.



Wow, remind me not to get a job at AT&T...


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## wa-loaf (Mar 18, 2008)

severine said:


> We have a PPO, too.  But compared to our old PPO (when I worked for the local municipality) it's sucky.  We pay A LOT more now than we did before.



I don't pay anything except $15 copays in most situations.


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## Paul (Mar 18, 2008)

bvibert said:


> Wow, remind me not to get a job at AT&T...



I can give you many more reasons not to. 

Actually, when AT&T switched, we went to my wife's insurance. Then they switched. Its like Death and Taxes...


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## MRGisevil (Mar 18, 2008)

Paul said:


> Went straight from an HMO to an HSA. Company made no contribution. Basically, we pay for everything right now until we hit 4k.



That sucks. We have HSA here but it's an option... and if you opt to choose it the company contributes 1K. Then again, if we choose HSA we pay everything until we hit 5k so I guess it's just as sucky...


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## Paul (Mar 18, 2008)

MRGisevil said:


> That sucks. We have HSA here but it's an option... and if you opt to choose it the company contributes 1K. Then again, if we choose HSA we pay everything until we hit 5k so I guess it's just as sucky...



Once you've made your contributions, and your account is "full" they're not bad unless something major happens. The upside is the savings each month. 

Man...when I started at SNET, I had Connecticare HMO. Full coverage. Didn't cost me one cent. The last year they offered it (2003, I believe) it cost me $360 a month. Now we're back to less than $100 a month, but we get creamed if another injury occurs. :sad:


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## MRGisevil (Mar 18, 2008)

Paul said:


> Once you've made your contributions, and your account is "full" they're not bad unless something major happens. The upside is the savings each month.
> 
> Man...when I started at SNET, I had Connecticare HMO. Full coverage. Didn't cost me one cent. The last year they offered it (2003, I believe) it cost me $360 a month. Now we're back to less than $100 a month, but we get creamed if another injury occurs. :sad:



Jeebus! I guess you weren't kidding when you said they were the evil axis...


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## Paul (Mar 18, 2008)

MRGisevil said:


> Jeebus! I guess you weren't kidding when you said they were the evil axis...



AT&T is teh suxorz!1!!!1!!1


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## MRGisevil (Mar 18, 2008)

Paul said:


> AT&T is teh suxorz!1!!!1!!1


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## Paul (Mar 18, 2008)

Talking about work makes me all stabby



Get those feetsies fixed, y'all!


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## wa-loaf (Mar 20, 2008)

Had my first pool session today. Lots of kicking of the legs while floating and walking funny in the water. Didn't think it was doing much, but when I got out my knee did feet a lot better. The therapist was pretty cute too, but she wasn't in a swim suit.


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## Paul (Mar 21, 2008)

wa-loaf said:


> Had my first pool session today. Lots of kicking of the legs while floating and walking funny in the water. Didn't think it was doing much, but when I got out my knee did feet a lot better. The therapist was pretty cute too, but she wasn't in a swim suit.



She'll be impressed when you show her some re-hab tricks like this one...


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## wa-loaf (Mar 21, 2008)

Paul said:


> She'll be impressed when you show her some re-hab tricks like this one...



That's actually not too far off the mark.


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