UPDATE May 15, 2011

Okay, so for any reader who's perhaps been awaiting an update or two--my apologies! Been busy with work and physical therapy, and no news is good news kind of thing.

So, I finished up 6 weeks of physical therapy (in fact, I ended up doing 8 weeks as per my PT Jason's recommendation). How is the knee, you ask? The knee actually has improved dramatically in terms of range of motion, movement, and strength. Or should I say the leg has...I am able to run on the treadmill at 7 mph or 11 kph (did two minute runs with one minute interval walks; last Friday did 7 minutes non-stop...slow and steady as she goes), I have been hitting some tennis balls against the wall and that mobility has been coming along better each time (I've been out twice, and am hoping to move better each time).

Strength in the legs has been a major aspect of the physical therapy work. I'm leg pressing 300 lbs, which feels good and gives me confidence. The down side right now is that I still have a bit of a limp...haven't gotten rid of that yet, so that's a bummer.

Anyway, I've also been playing golf on the weekends, and haven't felt anything bad while swinging the club or while walking 18 holes for about 5 hours. So that's also positive.

Now, I'm AM going to get an MRI soonish, and will definitely post the result of that test for you to read. that's kind of the point of this blog, isn't it? To see if Dr. Jatin Chaudhry's treatment had a healing impact on my torn ACL.

The other thing I have discovered is that the MCL is a pretty major ligament, and while it has been healing on its own, that process is still not completed. So there's weakness in the MCL even today.

But, the good news, at least temporarily, is that I'm NOT getting surgery over the summer. I have improved so much in 3 months and a half that I want to wait it out, and see how I feel say six months since the injury happened. Which would be the end of July. I also want to see what the MRI says. My gut feeling is that there has been some healing to the ACL, but that might just be hopefulness talking.

But, in the meanwhile, I don't see why I should traumatize my body with reconstructive surgery if I am able to pretty much do what I want to do in terms of quality of life activities.

So, to recap: feeling much better, moving much better, not getting surgery over the summer, will get an MRI and post the results on the next entry.

American doctor = surgery!!!

Okay, so I met up with the good Dr. Shell in NYC. I tell him I'm feeling better, stronger, walking better, etc. "However, Dr. Shell, I just wanted your opinion on an MRI I got on India. The doctor over there said it's a partial tear that can be managed with rehab."

Sure, let's take a look. actually, let's do some physical manipulation first.

Why not? So I lie down on the bench, and he tests my knee. then he tests my right knee. Then he tests my left knee pretty forcefully, yanking and tugging on it. Even I can tell that the left knee has some "give" compared to the good, right knee.

"Yeah, there's definitely some looseness here." says he. Well, sure, I'm thinking, but isn't that more like an 70-80 percent tear?

Then he takes a look at the mri scan. Doesn't spend too much time scanning the scan, as it were. "there's nothing here," he asserts. For a one-hundreth of a second, I grow hopeful thinking he means there's no tear here. But what he means is that there is no ACL here. Damn.

Then he shows me a couple of panels. On one, he says, you would see the ACL right here, but there's nothing. On the other one, he says, "you would see...well, you do see something here, but it's useless, it's not functional."

Case closed. After that, we have a nice chat about my options for surgery. He seems really confident and competent, so part of me is already resigning itself to surgery at the end of June. But, another part of me thinks back fondly to those days of acupuncture needles. Did they really have no effect.

The Indian doctor, Dr. J, did say that the MRI I have in hand shows improvement from a complete tear, and if his system works, he expected 80% to a full healing of the ACL in 6 weeks of physical therapy. According to that timetable, then, I should be doing another MRI at the end of April or early May.

So that's what I'm going to do. Wait out another month. Get another MRI. Show it to another doctor, just to get an opinion that is unbiased from any previous reports. Now, while I feel better, I am nowhere near feeling like I can start running or playing tennis. But in a month, I am hoping to feel more inclined for sporting activity. I think that will be a telling sign, even before the mri.

So I'm going to post (4) weekly updates, until the next MRI report. Cheers to one and all!

NYC Session 1

Columbus Circle, view from Time Warner Building

Quite a change...from Hakkikat Nagar, Delhi to Columbus Circle, Manhattan, from Jatin to Jason. Jason's in his early forties and has a ready smile. The best part is that he's a tennis afficionado like myself. So the second I tell him what I really want to rehab for is to get back on the tennis courts, his interest is peaked and he guarantees me that I'm in the best hands possible for this endeavor. Of course, I don't tell him anything about a possible regeneration on my ACL. Simply, that Dr. Schell in NYC as well as Dr. Jatin in Delhi feel that I should give 6 weeks of rehab a chance before taking stock of my option for reconstructive surgery.

The therapy center is located in the back of Equinox, a high end gym in NYC. It's probably a nationwide chain. Wouldn't surprise me. What does surprise me is that "high end" for a gym still only gets you basement real estate. Of course, the location is prime--Columbus Circle, with the Trump Hotel right across the street and the Mandarin Oriental hotel adjacent. The reason I'm there, other than the fact that the therapy center takes my insurance card, is the easy commute home after I'm done.

I get a new set of exercises to do at home, similar though different. I do them at the PT center as well. My MCL is still problematic and it turns out that my leg isn't quite as straightened as it should be when straight. Ergo, says Jason, the limping walk. So now I really have to concentrate on striking my heel firmly in the ground before continuing with the rest of my stepping procedure. Even without surgery, it's a long road to rehab. But Jason's confident that he might be able to get me back to playing tennis without surgery.

Let's see. He wants me to step out on the court in about a month's time. By then, I'll know one way or another what the situation is--If am am mobile and don't need immediate surgery, or if I am shaky and need surgery by the end of June.

Session 20 - the verdict

A view of Dr. Jatin Chaudhry's Clinic, SHARNAM HEALING

I decided not to take a second MRI today. Told the doctor so. He seemed disappointed. I told him I'd take it in 6 weeks from now, in the US, when the ACL should have become healed and functional. This according to his timeline, of course. He said that's a good idea, send me the results so I can look at them.

Then, the doctor advised me to forego the last needle session! You can imagine that he didn't have to tell me twice. According to him, the body would naturally accomplish in 4 days what the needles would have accomplished in thirty minutes. I'm not going to argue with the calculus, I'm kind of relieved that Dr. JC believes so strongly in the fact that the ligament is doing its healing job now.

So what's the verdict here? The verdict, according to Dr. Chaudhary, is that the healing has accomplished the needful, that the ACL has begun regenerating itself on the femoral joint, and that in six weeks of care and exercise, I should be able to return to sports.

That's a pretty fantastic verdict!

The question is how do I really feel right now? I feel that today is my best day so far, in terms of stability and strength. There is still swelling around the knee, but that has been there unchanged for the last few days. Do I feel sanguine that by six weeks I'll fully functional/recovered? At this point in time, I'm willing to believe. Let's see what happens six weeks from now.

I'll definitely be getting another MRI done at that time, to confirm what exactly is going on in my knee. Of course, by then I'll also have a pretty good feeling as to my walking, running, and sports playing capabilities.

I'm going to update this blog, not daily but frequently, up until that 6 week period is over. By the way, I've added some pics here and in some of the other blogs, so feel free to treasure-hunt, as it were, for some interesting visuals.

I've got to say that I've truly enjoyed working with Dr. Jatin Chaudhry and his amazing staff. Thanks Doc, and thanks Manoj, Lochan, Sashant, Anwar, Urvashi, and Sumit.

Session 19

Arjun Atwal, PGA Professional, got some Sharnam Healing

So one down, one to go. Or, to be more precise, 19 down, one to go.

Today was needles, as was yesterday and as will be tomorrow. Today, I managed to download a program called Osirix on my Mac. This allowed me to view the MRI scans on it. I took my laptop to show the doctor and get his opinion. He was pretty certain that there was practically no ligament attachment on the femur in the first MRI. Hence the "high grade to complete tear." So, in his opinion, the news is good...I've got 40 percent regenerated, and he assures me that by tomorrow, it will be close to 70-80 percent regenerated.

I hope he's right. So I'm going in for yet another MRI, expense be damned, to see if his prediction bears fruit. If it does, that means that surgery should be definitely be avoidable. So let's just say that I'm excited for the second MRI. I just hope that the MRI machine is an open machine...not a tunnel thingy. I'll find out tomorrow.

Well, it's been quite an adventure. Thanks for sticking around! Check in tomorrow for the final verdict on the Delhi treatment.

Session 18 - MRI results

Some squash player got Sharnam Healing

The MRI was an "open MRI," which was a relief. No imaginary tunnel suffocation. So I did the MRI in the morning, and had to return in the evening to get the results and chat with the doctor.

The MRI showed that the part of the ACL joined to the femur had a tear in it. the part joined to the tibia seemed pretty much okay. In the words of the report, "there is a tear of the ACL, near its femoral attachment." There are ligament fibers there, according to Dr. Chaudhry, but it is a weak bond, likely about 40 percent of attachment.

He didn't seem too pleased about this. I guess he was hoping for more. He asked me how many days I had left in Delhi. This being Friday, I told him I'm leaving on Sunday night. Good, he said, that gives us three needle sessions. We'll bring the tear up to 70-80 percent attachment. After which, you'll be able to rest it, and gradually move back into exercise and sports.

Three more days of needles? How nice. I thought I was done. I asked him when the results of the three extra days of needles would show up. He said, by Sunday itself. In fact, why don' t you do another MRI on Sunday afternoon, and we can see the difference before you leave.

Hmmm...Well, I agreed. In for a penny, in for a pound. I figured that might as well give this treatment its due, and what's 3 more days anyway. So he poked me with the needles, I lay down for the requisite 30 minutes, then came home.

Saturday is a morning session, and so is Sunday. Sunday should be interesting, what with needles in the morning and an MRI in the afternoon, and long non-stop flight back to USA in the night.

More importantly, let's see what the scan on Sunday reveals.

Session 17 - winding down

Went in for all the nice things today: Magnet machine, Electromagnet on the knee, exercise, currents, vibrating thingamajig, laser thingamajig. The doctor was away today so the clinic was really empty. There was a relaxed feel to the entire session, and seeing as it is most likely my last one, it was a nice way to wind down my experience at Dr. Jatin Chaudhry's clinic.

My MRI is scheduled for 10 am tomorrow morning. I'm anxious more than anything else. Lack of healing will necessitate surgery in a few months. So there is quite a lot at stake. The MRI technician asked me if I had any previous MRI (I do) and to bring it along so that he could compare the old one with the new one (I said sure).

But then at the clinic later this evening, Manoj told me: Don't tell them you had an MRI, don't show them anything, don't tell them anything about your condition. Let them come up with their MRI report without any help. I said, Uhmm...I already told the technician I do have an MRI and will bring it along. Manoj shook his head. Tell him you were confused, that it was an x-ray, that you know nothing about nothing.

Okay. Sure thing.

So, dear reader, if you've kept up this long, or perchance happened on this entry non-sequentially, then make sure you check out tomorrow's news--I am pretty sure I will have the report and Dr. Chaudhry's prognosis in hand to share with you.

Keeping 'em fingers crossed...