Injury updates

I have been updating on my injury, surgery and recovery on Instagram --> annikameer http://instagram.com/annikameer
Soon I will take all those posts and write a post about it, in the mean time you can check over there.

Knee stress

After the news about my surgery last week I had a lot of strong emotions, I just wanted to go home crawl up in a ball under a blanket and cry, yep that was basically it.

But we (I went to the hospital with my mom) had a lot more scheduled that day, so I just had to suck it up, something that I’m pretty good at in general.

We went and checked out the rehab hospital in Amsterdam, I didn’t like it, but mostly I didn’t like the idea of it at all, all in all Amsterdam is a no go for those 6 weeks of rehab. Luckily I had 2 options. After that it was time to go to physio, I told her the plan and broke down and cried, I was mostly upset about the long period that I had to be admitted in a rehab hospital. She comforted me by telling me we would find a good place where I would feel okay.

After that we went to my grandfather and all in all it was a long day and I was exhausted by the time I returned home.

By that time I got in a state where I didn’t want to talk about at all, I just wrote my blog and that was it for a few days. I continued the prehab with physio, to get me in the best place possible for surgery. But my knee gave out again,….. it is getting lame, come on you can make it, it’s just 3 more weeks. I have been in an increasingly amount of pain and have been put on painkillers and anti-inflammatories to keep my knee happy and calm. Walking is not really happening anymore these days, well I guess I’m just easing into the stage where I can’t use my leg for 6 weeks. And it is harder than I thought since the other leg is of no use. So I do realize that those 6 weeks in a rehab hospital are extremely necessary, there is no way I could do it at home, safely.

I checked out the other rehab hospital this week and I liked that one better, so I guess I’m starting to feel better about the whole thing. Heliomare is near the beach and has younger patients, the whole atmosphere in general just made me feel better, and there are a lot more sporting options.

Wednesday I had my consult with the anesthesiologist, talking through my options and what I wanted. General anesthesia, that is clear there is no way I’m staying awake for this one, way to stressful considering what happened in 2007. They wanted to give me a nerve block for the postop pain but the surgeon doesn’t want that because he can’t test my nerves that way.

And that just makes me a little stressed, I have felt calm about the procedure itself, comforted myself by saying it won’t happen again. But the truth is that even though chances of it happening again are slim there is no guarantee. The doctor has been honest about that, even though they have an idea why it happened they are not sure. The surgery in 2007 left my right leg paralyzed, the surgery took approximately 100 minutes during  that period there was no blood flow in my leg, my muscles didn’t got enough oxygen got ischemic and died.

So 100 minutes of surgery can’t be done, but with a good planning that long won’t be necessary, but how long is safe for me? How much can my muscles take? A hundred minutes is considered long for ACL surgery, most ACL surgeries won’t take that long, it also is the maximum amount you can have a limb without circulation during surgery.

So in general 100 minutes is safe, borderline, but safe…. Not for me apparently. The thing is no one knows how long is safe for me, it is to be expected that I should be ok if they manage to drastically decrease the amount of time without blood flow. That’s why we chose for a procedure with a donor graft, they can prepare that graft beforehand and that way save a lot of time. Normally they will take a graft from either the hamstring or patellar tendon and prepare a new ACL out if it during the surgery, with a donor graft I save that chunk of time.

Doing the surgery without the tourniquet so with blood flow isn’t safe because the visibility is not good enough and I will lose a lot of blood that way.
I trust this surgeon a lot, and if anyone can do it he can. But there is no certainty and that makes me stressed. And I guess I started realizing that it freaks me out when they explained me that I couldn’t have a nerve block for pain control, because the nerve testing is more important than the most effective way of pain control in my case…

Well I will have morphine and be very enjoyable for other people.

Cathing up…. Injury update 

Never ever has there been a gap this big in my blog, oops.

I still owe you guys the story about my Whistler adventure in July, I have tons of pics, but that still has to wait.

Usually when there is a gap in my blog it means that I am either confused or injured or both…

Well I guess I am both.

All though it is not like I haven’t been blogging at all, I have been blogging on my Vancouver blog. So there are a lot of stories over there and a million pics, even the promised Whistler pics, just follow the link pictures at www.annikainvancouver.blogspot.com.

Injury

On July 18 I fell while free skiing slalom, I was just moving through a turn when one of my ski’s lost control, my left knee hyper extended and I fell.

The coach on top figured that this was a bad fall and worried, but I felt ok, no pain.

So I got back up and skied down, before entering the line for the T-bar I went over a small bump and realized my knee acted ‘dodgy’. I didn’t think too much of it but decided not to ski anymore that day. I went home and iced the knee although there was no sign of swelling, I did have a limp and a small problem with full extension.

Later that day I went to the club cabin for dryland and after 45 minutes of cycling my knee was as new, limp was gone and extension was fine, I thought it was just a muscle thing and did the rest of the training with my group, no problem.

At the end of the training we did some balance stuff and walked the slackline, I had a lot of fun mastering the slackline.

I stepped on the slackline took a few steps but then realized that holding my balance was a lot harder than it used to be, I ended up losing it and jumping off…. To save myself from falling. I had jumped and landed on one leg, my left leg, a million times before, but this time something went horribly wrong. I landed and my knee totally gave out, there was a moment of full seperation (according to one of the trainers that saw it happen), I felt my lower leg move in sideways, my body move out and my knee sliding and separate. I screamed so loud and cried an rolled over the floor holding my knee, that was back in place again at that time.

After icing for a little bit the pain faded a bit and my muscle spasm kicked in, ultimately stabilizing my knee. I had it checked up but my muscle spasm was to severe to say anything concrete at that time, also I had a very limited amount of swelling.

So even though in that moment I was sure that my knee was completely blown I started to think that it still could be ok.

I could still walk, with my leg spasmed bended in something like 20 degrees, so I was limping badly, extending the leg more was impossible.

Three days later I returned to the city, Vancouver, and that was the moment my muscle spasm started to wear off. Walking became more difficult and I started to get some pain and swelling. The next day I was diagnosed with an ACL tear. Long story a bit shorter. The first month I was doing fine, I had a brace and used the wheelchair but still walked ok.

Then after about a month my knee gave out again, on the beach, even though I was wearing my brace and taking it easy. And from that moment on my knee was bad. A long discussion with my health insurance, because the doctor wanted to do an urgent mri. It was denied at first. Finally on September 9 I got X-rays, and they found an ACL avulsion fracture, meaning that my ACL broke out of the bone of my tibia, explaining my pain. And also putting me on a none weight bearing regime, in the wheelchair.

Still the insurance didn’t think I needed a MRI, after a long time with a lot of doctor’s giving their strong recommendations both in Canada and the Netherlands, the insurance said ok.

The MRI was done the next day (October 4), in a place with a 7 month waiting list that is quick. I got the results a day later confirming I had what they called an unhappy tried or blown knee, The ACL was broken off like I already knew but also sustained a full tear, the MCL was damaged just like the meniscus.

Looking back it is hard to say what happened when, but looking at the injury mechanisms the professionals have an idea. I probably sustained the avulsion fracture during my ski crash, it is explained by the hyper extension and high impact. Also this could have left my knee still reasonably stable if the fracture stayed in place, that’s why I didn’t notice too much problems.

But when I jumped on it, it couldn’t help but give out, ripping up the rest of it.

It was a long road so far but in November I took my first steps.

On November 10 I traveled back to the Netherlands in business class because of the knee.

November 14 I had my first check up with the surgeon in the Netherlands. We decided on a prehab period with a checkup after 6 weeks to decide on a plan for surgery.

Prehab; meaning pre rehab, before surgery to optimize outcome.

I started a 4 times a week physio schedule and made some great progress, starting out with Compex to get more control over my muscles.

But soon I moved to the real stuff, with leg press, squats and step up. I also started cycling and I even was able to do some track cycling, that went very well (but I’ll write a separate post on that). All in all prehab was going well, I am able to legpress 100kg. But balance, coordination and walking remained bad. I can walk about 200-300 meters with a very bad limp and a lot of effort, that used to be so much better and easier. Also the knee remained unstable, it gave out again damaging my LCL leaving me with 3 out of the 4 ligaments damaged.

So yesterday when I returned to the surgeon for my checkup we decided on surgery.

I will have surgery on January 27, during this procedure I will get a donor tendon in my knee for my ACL. The MCL and LCL will get checked and repaired if necessary, both meniscuses are damaged and will probably get trimmed.  I will stay in the hospital for the first 5 days and then move to a rehab hospital for approximately 6 weeks.

My situation is complex and with the other leg being paralyzed I probably won’t be able to take care of myself properly during that period. After 6 weeks the new tendon will be grown in and I will be allowed to walk a bit on it again at that point it is save to return home. I hate it to stay hospitalized for so long I really value my space and freedom, but I do realize that it is in my best interest to protect my knee.

That is the story so far, to be continued. 

June

June came and went, almost. The last couple of weeks I have been on my bike a lot more.

On May 27 I had a nasty accident in a bus here, after I got on the full bus as the last passenger, I asked the driver to give me a moment so I could sit down, because it’s hard for me to balance in a moving vehicle with my leg. He pulled out anyway and I fell backwards with my right arm, just above the elbow, hitting the fair machine. It was extremely sore and got swollen and bruised rapidly, check up in the hospital showed a small crack in my humerus and I was put in a sling for 2 weeks.

At the one week check up there where some concerns about other damage and an ultrasound was performed to check the status of the triceps tendon. Images were also sent to Amsterdam for a second set of eyes, long story short, I didn’t damage the tendon but damaged the muscle, luckily this heals better then a tendon injury and I have a grade 3 tear in my ulna collateral ligament, that last one is pretty nasty because it makes my elbow very unstable. So I got a big as brace and I am back to normal life again, can’t do weights right now or use crutches but other than that it’s ok.

So After I got the brace I was able to bike again J I have made some great bike rides around here, it’s beautiful. Vancouver is pretty hilly so my climbing skills will definitely improve here. I joined 2 different cycling clubs. With one club we train in Stanley park on Tuesday night, we circle the park 3-4 times (9k per loop), there is a big climb in there too. And with Lululemon Kitsilano cycling club I train Wednesday night, we usually ride up to UBC (last Wednesday twice) which is a though climb, other than just riding we also do a lot of different drills with Lululemon,  a good combination.

Both clubs have long rides during the weekend, so enough options. And I have made some good rides alone or with friends.

On the left side of this picture is UBC, Stanley Park is top right

 Thursday morning means 7am yoga, always tough to wake up but really nice once I have done it. Add some one legged squats and jumps and I have a nice training schedule over here.

Also I have been hiking a little bit, never expected that I would be able to do that but my walking has been pretty good lately.

 The next Whistler camp I will attend starts July 8 at the glacier, excited to ski again and get back in the gates, will see how that goes with the brace, maybe use one pole, don´t know yet. I will see how it works out. This is a short overview, there are a lot more stories in the Vancouver blog.

Whistler super camp #1

Returning to basics and fundamentals will be the focus of the May camp, utilizing much of the mountain, groomed and off piste runs. On-snow functional body movement, skills assessment and drills will create a strong foundation for building skills on. Campers will be divided into 3 groups by age/skill levels (I was placed in the highest group, performance level). Including fitness testing on Saturday.www.wmsc.info

So Saturday was the day for GS testing, it was raining, that added an extra challenge, the snow was so sticky, but hey it’s BC spring skiing. For testing we also used a wave track, with 6 waves, 1 meter high each and the tops where 12 meters apart. The goal was to absorb the waves at GS speed while making the turns. After a few tries I got the hang of the wave track and actually quite liked it. At the end of the day we also had to tuck the wave track, well that wasn’t quite as successful, I almost crashed after the third wave barely managed to keep standing but lost my pole and skied out of the track.

That afternoon we did fitness testing, which started with a beep test, that was the only test I couldn’t participate in. After the beep test they build all the stations with the different tests, penta jumps, both on one leg and on two, box jumps (ugh), 5-10-5 agility (‘running’ and touching the floor), high jump and planking.

Overall I scored pretty good better than expected and I was pretty happy with my results. Especially since I wasn’t allowed to jump for 12 weeks after my ankle injury (torn syndesmose) in February (when I broke my orthotic), this was my first time jumping again.

Sunday it was time for skills testing on slalom ski’s, we did the wave track again and hourglass skiing (I got a 7 out of 10). The group also skied on 1 ski without poles, quite a challenge from what I have seen. Since I’m not able to ski on one ski I did a different exercise to help me separate more, and it worked pretty well! Seems I have found the change I needed at the Whistler mountain ski club, I have made quite some progress and definitely stepped out of my comfort zone. Thanks to all the great trainers! It was awesome to get training from a girl who was on the Canadian national team last year.

After testing we went ‘free’ skiing, but as trainer Ryan said there is no free in free skiing, always work on something while having fun. We skied off piste, through the trees, this was definitely a challenge for me, but the camp motto was accept the challenge, and I did it!

After that run, it was the end of the day already and my good leg was so fatigued  that I just ‘fell’ it was more like sitting down in the snow, time to download.

Sunday afternoon consisted of lots and lots of stretching, I was so sore, I couldn’t sneeze anymore ;). Sunday afternoon also means soccer, the team thought they had an actual Euro soccer player on their hands, unfortunately I had to disappoint them with that… J

I'm so adopting this Canadian lifestyle wearing running leggings and bright running shoes in public, being outside and active every day 

Monday was the last day of camp and we had the candy cup duals, this was so much fun!

Dual slaloms always helps you to push that little extra.

 After skiing it was time to say goodbye, until July because that’s when the next camps take place at the glacier by then. The whole team and coaches had drinks and nacho’s at Merlin’s bar. I had a great time thanks to all the girls and the coaches. A big thanks goes out to the Kepl family who took me in like I was family, and of course to topsport met zonder handicap who make these camps possible for me with their financial support.

The drive down from Whistler to Vancouver was beautiful again this time I could ‘enjoy’ it extra-long because of traffic jams, it clearly has been a long weekend.

Yesterday I started working again in the lab and my supervisor said ‘I see you have had some sun’ yep goggle face and helmet lines which is impressive with mostly clouded weather.

Now back to work and dryland until July, when it’s time for the next camp, more skiing, more fun times, more icebad’s and sore muscles ;) 

Whistler day 1

I’m in Vancouver for exactly 2 weeks now, to read more on those stories see my Vancouver blog www.annikainvancouver.blogspot.ca
Yesterday I made the beautiful drive from Vancouver to Whistler, taking me over highway 99, the ‘sea to the sky highway’ to view is so amazing that it actually doesn’t bother me that much that the speed is very limited. I have rented a car, and thanks to a little hand controlled car mix up, I got a free upgrade to a very nice car, I love it, I will miss it for sure when I have to give it back Monday night.

So today was the first day of skiing with the Whistler mountain ski club. I skied with the FIS group and had a good time. The conditions were very soft due to some high temperatures over the last few weeks, but there still is plenty of snow left J

We did GS drills today, and all the drills were new to me, the coaches mentioned that they saw a progress over the day, always good to hear, I felt it as well. I felt very confident on my GS ski’s in the soft snow. The motto of the day was accept the challenge, so I did moguls and off piste and tons of more drills. By the end of the day my GS turns felt really good and I was death tired in my good leg J. They have some high level coaches and a lot of their athletes have made the national team over the years. I’m so happy to get the chance to train with them, this might just be the change I need to step it up next season. So a big thanks to topsport met zonder handicap a great foundation who has made this possible for me!

After skiing we had dryland training, some athletes were mountain biking, some were running or spinning for 20 minutes. I was spinning after which we did some yoga and stretching. We also did some balancing, and I walked a bit on the slag line as well. With poles it was easy even turned and walked back,then I tried loosely holding another girl’s hand while walking, and I even took some steps on my own, nice project for this summer J
Tomorrow GS skills testing we will see, I’m looking forward to another day on the hill!

April Randomness

In march I skied my last international races of the season in France but my national race season wasn’t finished yet. This season they added an adaptive category to some of the national races in the indoor circuit. The first race I managed to win, which wasn’t that big of a deal considering a lack of competition but still nice.

Sunday we ski the second race and the third race is in May which I won’t ski…. Because in May I’ll be in Canada! This summer I’ll be interning in Vancouver general hospital for my scientific training period (as it’s called at the university) for more information about that see www.annikainvancouver.blogspot.com

But interning won’t be all I do when I’m in Canada, because off course I arranged for some ski training and I’ll be doing lots of other stuff. But this is the skiing blog J

I have arranged for ski training at the Whistler mountain ski club, they have 4 day summer camps during the weekends, I will do the one in May and 2 or 3 in July. Hopefully I can stay with a family during those weekends, that would be very nice.

These camps off course aren’t cheap so I’m happy to announce that I got the funding for these camp from a great organization in the Netherlands. They are called Topsport met zonder handicap, which means top sport with(out) disability. The foundation is founded by Marije Smits she used to be active in para-athletics and she is also a med student. Marije competed in 3 paralympic games (Athens, Beijing and London), and she has founded her own foundation to encourage talents with ambitions and goals. Just take a look at their website (it’s in Dutch) www.topsportmetzonderhandicap.nl

I’m also still training at the indoor slope in Landgraaf before I leave for Canada. Saturday I had a very good training, my skiing felt so much better, much easier in slalom, I have struggled a bit in slalom lately but things seem to go a lot better. I got a big help with this improvement because I was bootfitted by Patrick Rademakers from ski center edelweiss. He adjusted my boots so my feet are in a more natural position which means I can turn the ski easier, it takes less strength.

Well that’s it for now, will check back later!

My first Whistler camp is May 17-20