Anniversary of the Iron Leg

Almost after one year of the mishap that forced me to stay away from my college for many months, here I am, once again, away from all studies and classes (Yipeee!). But this time, its nothing as serious: a bout of Jaundice. Can't say how or where I managed to get it; must have been hostel water, what else!

Its been one year since I had the accident, riding my bike, on 18th September last year and which forced me to undergo two operations, the second one being the product of the dreaded Scar tissue. The accident hurt my right knee, causing the AC ligament (the center most ligament and consequently, the innermost out of the 12 ligaments that the knee has) to detach from the lower end... from the Tibia, the thick bone below the knee upto the ankle.

The injury was not apparent for a few days... local doctors thought that it was a bone fracture. An MRI showed that the problem was much serious, requiring an operation as soon as possible. I was pretty jovial upto that time, because I had absolutely no knowledge of the seriousness.

Off we went to Delhi to have it fixed. An operation was conducted on 25th September, after a week of the injury, at AIIMS. The surgeons first did an Arthroscopy, using small tubes to look inside and try to fix it without opening the knee. But it wasnt possible to do so. So they decided to open the knee... as in opening it completely to reveal everything inside. And I was awake all the time!! Only my leg was anaesthetized... I was even asked whether I wanted to see the operation on the TV screen next to me!! I refused politely, and went to sleep for the two hour process.

After opening the knee, it was akin to a carpenter's job to fix the ligament back to its position. The docs took a piece of fibre, like a thick string, wound it around the lower end of the ligament, put the ligament in place and took string a few millimeters below, and tied it to a screw drilled into the bone. They then sew up the skin, with metal staples, put a plaster cast around the whole knee, upto the thigh and ankle. That was it... their job was done, and I was wheeled into an observation room.

After that it was a painful time. It felt as if someone had gripped my leg with an extremely tight grip. Even though I managed to pass that time with painkillers, I can still recall the time... sheesh!

I remained in the hospital for the next 15 days, suffering endless hours of boredom, broken only by visits of my cousins, nieces, nephews (yes, I had neices and nephews at an age of 4!!) and other near and dear ones. It was a time of daily improvisation in exercises of bathroom visits and daily ablutions! With the long plaster cast, it was difficult to move about and I could not put any pressure on the right leg. So after some days of experimentation and frustration, me and my parents finally had a smooth set of steps to take me to the bathroom!

2 days before getting discharged, the plaster was cut, and staples removed. My knee didnt bend at all at that time, sending sharp pain up and down the whole leg the instant I tried to bend it. In the doctors opinion, it would be okay with time... and they asked me to exercise the knee as much as possible. I didn't know how much was "as much as possible". Within 2-3 days, I 35 degree bends were possible from the straight position.

The next month was spent in physiotherapy visits, where the physio would try and bend my knee using her own strength. Initially, I gained about 4-5 degrees of motion a week, enough by their standards. I was not concerned, for they were not either.

But it was in late December that the trouble started... my knee refused to go beyond 90 degrees. My leg would go straight (not even completely straight) and then bend only half way, not an iota more. I came to know from the doctors and physio, that it was the result of "scar tissue", the tissue that forms when the body recovers from a trauma. In this case, the trauma was the surgery... the opening of the knee. The scar tissue is a living piece of tissue, supplied with blood as all tissues are, with the only problem that it is not flexible. And with the scar tissue bang in the middle of the knee, it meant the knee became inflexible.

By this time I had come home for the new year. So, in the first weeks of 2005, we again went to Delhi.

I cannot remember a time in my life, as worse as that month of January. In order to bend my knee more, I was subjected to what easily qualifies as 'torture'. The next few lines are not for the weak-minded. The physio originally treating me, took me to a new room in the hospital, where I was literally tied down at the waist, with roped attached to the ankle of my right leg, going over a bar above the bed, and tied to another bar at the side. The doc would tighten the rope to the extent I could bear... which was the 90 degree bend of my knee. Then she would tighten it more. Just 5 degrees she would say, and leave it fixed that position. The pain would become unbearable enough for me to cry out loud in that room filled with other people. Just a few minutes, the doctor would say, and go away while I was crying and crying, not able to move to ease the pain. The process was repeated every second day for a month.

What was also repeated everyday of that month was the visit to another physio, who was known to parents for many years. There I was forced to try and sit on my haunches, the way Muslims pray. Again, the pain would be unbearable, but I was forced... threatened even, that I would be pulled down if I dont sit. Understanding that it was for my own good, I tried to comply. But simply couldn't.

The crying went on for a month, either at the new physio's place or at the hospital. But I can remember waking up everyday, and going into depression immeditately at the thought of what lay ahead that day. Only my mom was with me at the time, and I can't imagine what she must have gone through, watching me like that everyday.

Finally, when February started, without any improvement in the movement, the doctors suggested another operation. This time, to break the scar tissue, and not immobilze the knee for even a day. Since the bone and ligament had healed normally, movement wsa possible without fear of damaging anything.

So the operation was scheduled and I was wheeled again into the Operation Theatre. With my parents and lots of my relatives waiting outside, I was anaesthesized completely this time. When I woke up, there was news waiting for me. This operation had gone on for more than 5 hours!! I was the first one to be taken inside and the last one to come out. My parents told me later that they had been worried sick.

The doctors told me that they had never seen so much scar tissue inside. In fact, when they put there scopes inside, (i.e., Arthroscopy) they were literally lost!! It was the fibre and screw they had put in earlier that had enabled them to know their exact position. When they set about to cut the scar tissue, their instruments failed to cut it! In the middle of the operation, they got a new instrument worth 15000 rupees. Using this laser equipped instrument, they were able to cut away the scar tissue. In the process, the instrument was 'used up'... it could not be used again after my operation was over.

The exercises started the very next day. The doctors told me that they had cut away the tissue to give almost complete Range of Movement to my knee. As time would pass, scar tissue will form again, unless I kept moving my knee in order to prevent it from getting jammed again.

It was easier said than done. I did the exercises religiously for the next 16 days I was in the hospital. With some help from others and some techniques to enable bending with lesser pain I was doing exactly what I was told to do.

Cut to the next few weeks... I came home, still doing bending exercises 3-4 times a day. Each session lasting 30 to 45 minutes. 30-45 minutes of fighting and struggling with my own leg. To prevent it from jamming again. Sometimes the pain would increase and I would cry. T other times the knee would comply and it would be easier to bend it.

My parents had fixed up a physio to come everyday and help with the exercises. The guy had helped me earlier also, before the 2nd operation, but my knee did not oblige then. This time though, since I had been exercising and there was no immobilization, it was easier to bend it.

Slowly but steadily, the range came with less and less effort. What took 45 minutes earlier started to take 20-25 minutes now. Even though the best I could do was touch my hip with the ankle.... thats just a couple of degrees less than normal. So it wasnt much of an issue. But the straightening still left some desirable degrees. Another complexity was that some fluid had started to build up in the knee. Upon showing it to a renowned knee surgeon in Mumbai, where my parents shifted recently, he promptly asked me to have it operated upon by him, wherein, he planned to wash the knee and maybe even remove the screw, since it could be irritating the knee. I promptly refused... I was in no mood to cater to the whims of a doctor who wants me to undergo another operation at a day's notice. Maybe he was right, but I simply would have none of the hospital stuff again... I hoped the swelling would go on its own.

Now, after one year, I dont have to do the exercises that way anymore. Bending the leg completely hardly takes a few minutes of effort... and the normal range, without exercising, under the power of the leg's own muscles is just a few degrees short of normal... nothing that troubles me even a bit... no problem now sitting in a cramped car or any place with low legroom etc. The bending part is quite good... sitting crossed leg is also no problem. And the swelling that arose due to the fluid is also gone now, thank god!

The straightening part is not as good as I would have liked it to be. The normal leg undergoes hyper-extension. That is, the normal knee goes beyond being merely straight. It actually makes an obtuse abgle (more than 180 degrees) when the leg  is fully stretched out. My knee doesnt do that to the normal extent. Though standing and running are no problems at all, but sometimes, when I am lying on my back, the lack of that extra couple of degrees nags me. I try to straighten it more, achieve it sometimes, but mostly shrug it off and go to sleep in another position.

Thank god that I can do everything normally now. No one who knows about my accident says that any sign of a problem is there... though it becomes a bit apparent once in a while, but I can live with that. And others, who have no idea of what I went through or what my knee underwent, dont even think that there is something wrong with my stride, my walk or my running. The steel screw is still there inside. Some people say that I should have it removed. But the doctor who did both the operations said that unless it causes a problem, why fiddle with it? So as of now, no plans to visit the hospital again!! Touchwood!

I thank God that he's enabled me to recover fully. A little bit of itsy-bitsy issues dont really bother me, because it just doesnt matter.

I think when I look back now, that I have learnt some valuable lessons, and I have learnt a few things about human psyche and human perception and attitudes, which is the positive side of the whole affair!

Now I am not riding a bike anymore. Dad has given me his car to keep in the hostel and use it. (Muhahaha!). Sold my bike some months ago for a decent sum. But once in a while the urge to ride a bike becomes strong. So I take a friends bike and ride it for a couple of minutes... thats it! No more for me!! This aversion is also due to that fact, that the doc warned me that another injury like this could be more complicated and mean more trouble! So theres that... no more bikes for me.