# Destroyed Knee (Again....)



## Guest (Feb 7, 2007)

Well, today is my first day back on MTBR since Oct. of last year and was pleasantly suprised to see this new forum. :thumbsup: 

This is kinda a long post, but it may help some others knowing that no matter how bad things can get dealing with an injury, with alot of determination you can come back to the sport you love.

October of last year I was in the peak of my season. I had just moved from Chicago to Phoenix in June so that I would be able to ride year round. I had survived riding only in the early mornings, or nights in 106 degree temperatures, and had logged nearly 3000 miles in traveling around the state of AZ checking out every place I could to ride. I was riding 5-6 days a week and was in mountain biking nirvana. That all changed on one fateful Sunday in October.

I had planned on getting up and heading north to Flaggstaff to ride some downhill on real dirt, instead of sand but my friends all backed out. Not discouraged, I had my girl run me up South Mountain in Phoenix for a quick ride. I figured I would go do the trail I had been riding almost everyday for the 3 months I had been here. 

Mistake #1: Never ride ALONE!

I blew through the 5 miles of DH following the top ridge of the mountain and came to the point where you need to decide which trail you would like to come down off the mountain on. I made the bad decision to try a short, 2 mile techincal trail down the face of the mountain. I figured it would be a new challenge and would put me down only a mile from my house.

I started the descent and made it all of 100 yrds and it all went wrong. Coming off a switchback, there was an imidiate small drop, followed by another switchback. After hitting the drop, my front wheel got caught up in the rocks and over the bars I went. Had this been any other crash, I wouldn't have had a scratch on me, but as I was going OTB, my left foot got caught in the front triangle of my 45lb Dirtbag and as I went down, the bike went over me with my leg still in it. I instantly felt a "pop" and instantanious "white" pain. I had felt it before, too many times before, my knee had completely blown apart again...

I hit the ground, and blacked out for a second, but the pain was enough to bring me back to full awareness of the situation. I lay there for a minute completely in shock before getting sick from the shock. After about 10 min, I got myself up and relized I had to get myself off the mountain, there was no way any of my friends would be able to come get me, and rescues out there are paid for by the rescuee. There was no way I was going to make it back up that 100 yards to a trail which is much more traveled by hikers and other bikers. So I did the only thing I could do, which was try to ride 1 legged down a very technical trail, I had never riden before. I conceded that the bike was going to get the brunt of it at whatever cost. I only managed to ride maybe 20% of the trail down, the rest of the way I had no choice but to walk on a leg which was locked would not hold my weight. It took me nearly 2 hours to get to the trail head, where I called my girl and basically collapsed. 

Mistake #2: NEVER RIDE ALONE.

She came and picked me up and off to the ER for a 8 hour wait. They finally looked at it and took x-rays, which having been through this before I knew didn't do a thing and told me it was "SPRAINED". They referred me to a orthropedic specialist, which took a week to get in to see. He looked it it for 2 minutes and said I needed a MRI (Duh...) before he would know anything. He scheduled a MRI, which took another week to get in for. So 2 weeks post injury, with ZERO treatment to this point, I hobble in for a MRI. Anyone who has had one knows they suck, you lay in a very small tube perfectly still for an hour. With an injury like this it is extremely painful to stay still that long. The results of the MRI took another 5 days to get, on top of this, the orthropedic specialist was on vacation. So now, 4 weeks post injury, I finally have MRI's in hand and get back in to see the doctor. He takes one look at the MRI and report and turns to me and says "There is no way I am touching it. You need a Sports Medicine Specialist...." I was in total disbelief... I basically told him he had to be f'ing joking and stormed out of there, as fast as i could with my cane and gimp leg.

I got back home and started looking for the best knee surgeons in the area, and even considered flying back to Chicago to seek treatment. Fortunately I found who quite possibly one of the best knee surgeons in the country and is even the team doctor for some of the US olympic teams. I called and asked if they could see me and explained the situation, to which I think they were somewhat appaled. The got me in the very next morning, and after a thorough examination of my MRI's he basically told me my knee was totalled. I have had 5 previous surgeries on this knee before, the first being when I was 15 and the other 4 by the time I was 21, but this was by far the worst...

Basically the damage came out to be:
•I completely severed the ACL, which had already been replaced 9 years ago when I tore it last time
•75% tear of the PCL, a partial tear of the Medial Ligament 
•The Medial Meniscus tore into 4 seperate pieces which then basically were folded into my knee joint locking my knee at a 30 degree bend. 
•The Lateral Meniscus had been mostly removed in previous surgeries, but anything that was left was now gone.
•Several microfractures

The doc asked me when I wanted to fix it and I jokingly said "Can we just do it now?" The answer was no, but I was in surgery the NEXT afternoon. where he spent the better part of 4 hours reconstructing and cleaning up my knee. I went home that night and began what has been a long 4 months of healing.

Unfortunately things still were going to get worse before they got better... I went in 3 days post-op to begin my physical therapy, they had me doing some basic exercises, stretches etc. The therapist working with me asked if I had any pain, etc that was out of the ordinary, etc. I told him my calf muscle was sore, but I figured it was because my leg had been locked in one position for a month. He went and told my doctor, who examined me, left the room for a while and came back to tell me I had to go first thing in the morning for a Ultra-Sound. I thought nothing of it and went home for the night.

The next morning I went for the ultrasound, where they found why my calf hurt... I had a 131mm DVT (Blood Clot) in the vien in the back of my knee. They told me to drive myself straight to the hospital, not to stop anywhere, not to do anything except go straight there. At this point i kinda started to freak... I get to the ER walk in and they are waiting for me with a wheelchair, they sit me down and rush me upstairs straight to a room and admitted me. I spend the next 6 days in a hospital bed recieving shots of blood thinners in my stomach every 12 hours. I was not allowed to move, other than to go to the bathroom. They made me fill out a living will, and basically told me that if the clot moved and went to my lungs that it would drop me dead in a matter of minutes. It didn't, but small parts of it did break off and pass to my lungs, which burns like hell for 12-18 hours as the blood thinners disolve them. After a week in the hospital, my blood was thin enough they let me go, but I am still on blood thinners to this day, and will be for another 2 months before they can verify the clot is gone.

After al this, it was back to physical therapy to basically get a delayed start on my rehab process. Physical therapy is tough. If you ever have to go through it, remember it seems as though it isn't doing anything for weeks, and months, and then one day you realize you are doing things easier and easier everyday. You just have to stick with it, and not rush back to things no matter how much you think you are ready. If you think you can ride, ride a trainer, ride it sparingly and enjoy the fact that 10 minutes on the bike is 10 minutes more than you have had up to that point, even if your pedaling and going nowhere.

I am now 13 weeks post surgery and I went for my first ride on dirt since the accident last Sunday. I have lost everything I had up until that point, my strength, my balance and any agressivness I used to attack the trails when I used to ride. But I have come to realize it really doesn't matter. I can walk again, I am outdoors, I am back on the bike and most importantly, I have nothing to prove to anyone but myself. 

I have decided that the Dirtbag I took the fall on will never be ridden again by me, it is being retired and as a reward for even making it back on a bike I have ordered a brand new 07 Dirtbag. Lets just hope it has a little better karma than the last one

If you have made it this far, i appreciate you reading my story. I am excited to be back on the bike, and back in the MTB community.


Oh yeah, and just one more reminder... NEVER RIDE ALONE!!


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## pinkheadedbug (Aug 16, 2006)

Holy ****... that's a horrible story. But I pretty much always ride alone.


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## Arbuz (Aug 4, 2006)

The DVT episode scares the sh*t outta anyone 

Was the clot due to the surgery or the injury itself?
What was the pain like?

I'm hypocondriac so please bear with me 

I'm all freaked out now 'cause I gotta fly to Europe next week and those are looong flights


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## benzology (Oct 31, 2005)

Good story sixsixty...

I ride alone regularly and often think what would happen if I smashed myself up in the jungle!!

Secondly thanks for the motivation - I need to ride more often and your message made me realise what a lazy bastard I am...

Cheers and good luck with the full riding recovery...


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## California L33 (Jul 30, 2005)

And if you do ride alone, take a cell phone. 

I still wouldn't do anything technical alone. 

May your new Dirtbag never try to pass you


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## xcguy (Apr 18, 2004)

*Riding so soon?*

Hard to believe after all that destruction in there. Does your leg actually make a full rotation? How's the mental state as you approach anything remotely technical?


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## Guest (Feb 7, 2007)

Thanks for the positive comments:thumbsup: 

The DVT was caused from the injury,basically because my leg was immobile for so long. As for flying, they do call DVT's "Economy Class Syndrome" because they can happen on long flights. My doctor told me anytime you fly for more than 3hrs you should take a baby asprin to help thin your blood a little, that should help prevent them.

My leg 13 weeks out basically has full range of motion. I am within 3 degrees of my other leg on the flexion and 5 degrees on the extension. Basically my knees lock back to -7 degrees, and I cant lock the one that was injured back yet. Alot of it is the muscles needing to be re-trained. As an example, for the first month after surgery I could not consciously flex my quadracep at all, it was basically like it was disconnected. I had to use a TENS unit (electric stim unit) twice a day in order to even train my quad how to flex again. My knee is really really unstable because of the lack of muscle control. I have to wear my big hinged brace anytime I am doing anything other than walking to prevent it from slipping around, especially since there in no cartilage left to pad the joint, it is just bone on bone now.

As for approching anything technical when I ride, only time will tell. I have only been out riding 3 times now since the surgery and all of it was on some pretty simple XC single track. I am focusing more on training my leg to pedal a big bike again,and it feels like i am basically riding one legged right now. The first ride out though, I did manage to hit a little 3 foot drop which was a big confidence boost, since I was unsure as to if my knee would hold at this point even with the brace. My main concern isnt really falling again, its planting my foot and having it twist my knee, so I find myself trying to compensate by leaning to the right more and more.

As for riding alone, I too almost exclusively did it before this, and actually preferred it. No one to slow you down, cut you off and your alone with your thoughts. I may still ride XC stuff alone, but I will never ride the technical DH stuff by myself again.


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## Nostromo (Sep 22, 2005)

Wow, that is a awesome write up of your experience. I sometimes think about what it would have been like to get the injuries we give to ourselves - but 100 yrs ago. Imagine all that damage, you'd be just another cripple but for the miracles of modern medicine.
So whats the prognosis with not having cartilege in the knee? Is it gonna be OK to cycle but not run for example?
I ruptured my medial ligament yrs ago but luckily suffered no cartilege tears or other damage it seems.


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## Guest (Feb 8, 2007)

I was told 10 years ago that I would never be able to run or cut again without risking another blow out. Which is when I had to give up on playing hockey and skateboarding. 

Pretty much once you lose a substantial amount of cartilage the stability of the knee is gone for good when it comes to side to side motion. So this is why I got into cycling in the first place, I can still get my adrenaline fixes and not worry to much about side to side pressures on my knee. 

Now that all the cartilage is gone and its bone on bone, its just a matter of time before the joint wears out. When I was 22 after my 5th knee surgery they told me that I would be a prime candidate for a total knee replacement when i hit my 40's. Now that I am 30 and after this accident it looks like that is definetly going to be the case. So I figure I got 8-10 years to get the rest of my kicks before i need to have a artificial knee put in and "retire" from sports all together.


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## squealybrakes (Jun 3, 2005)

sixsixtysix,

I feel your pain man, I busted my ACL twice last year (same leg). :madman: It has been a rather long recovery: the leg is coming back little by little, but I still need to work on rebuilding my confidence. Way too often I find myself walking technical sections that I used to clear with my eyes shut.
Don't give up! :thumbsup:


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## Guest (Feb 9, 2007)

squealybrakes said:


> sixsixtysix,
> 
> I feel your pain man, I busted my ACL twice last year (same leg). :madman: It has been a rather long recovery: the leg is coming back little by little, but I still need to work on rebuilding my confidence. Way too often I find myself walking technical sections that I used to clear with my eyes shut.
> Don't give up! :thumbsup:


Thanks for the show of support.:thumbsup:

Giving up was never an option and I told my doctor that not riding again wasnt an option either. Its just a matter of not over doing it too soon. I have lived with knee problems for half my life and I figure between the 6 surgeries I have spent nearly 2 1/2 years in physical therapy. Each time the recovery gets a little longer... I am just glad I will be able to ride this season even if its not to my full ability. I am basically looking a total of 9 months of rehab but there is no way I can not ride to almost a year, I would go crazy. So I am taking what I can get this season, some is better than none


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## Tracerboy (Oct 13, 2002)

Wow 6sixty6, that's a painful story, but I'm glad to heal you're on the up and up.


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## Tracerboy (Oct 13, 2002)

*wow*

I thought only bad luck happen to people that work in the Medical field. Good luck get well soon.Ps I,m a nurse in the O.R.


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## Voodoosix (Mar 31, 2006)

Great writeup! I can't echo the "Don't ride alone" piece enough. On Nov. 5th I spent most of an hour laying paralyzed on a trail all by myself. It gives you a lot to think of when you are laying there helpless due to an injury. It can always go the other way too. Be careful out there!


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## 925hell (May 6, 2005)

*are you gonna brace this time*

sixsixty, glad you are getting back so quickly after such a horrific injury. It gives me some hope I am currently replying while sitting in bed after my ACL surgery. This one is my second. My first was due to over use (sports) and the second I did at work. I have ridden downhill for the last 5 years. When I spoke to my orthopedic surgeon after my first surgery, he insisted that I wear a knee brace for high risk riding. Are you going to wear one this time. I'm just wondring since some of my riding partners who also have had knee surgery do and don't wear bracing. Most of the time it's personal preference other times it's fear of worse injuries, like if the knee doesn't bend/pop the bone will. Thanks for the insight.
JK


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## Nostromo (Sep 22, 2005)

sixsixtysix said:


> I was told 10 years ago that I would never be able to run or cut again without risking another blow out. Which is when I had to give up on playing hockey and skateboarding.
> 
> Pretty much once you lose a substantial amount of cartilage the stability of the knee is gone for good when it comes to side to side motion. So this is why I got into cycling in the first place, I can still get my adrenaline fixes and not worry to much about side to side pressures on my knee.
> 
> Now that all the cartilage is gone and its bone on bone, its just a matter of time before the joint wears out. When I was 22 after my 5th knee surgery they told me that I would be a prime candidate for a total knee replacement when i hit my 40's. Now that I am 30 and after this accident it looks like that is definetly going to be the case. So I figure I got 8-10 years to get the rest of my kicks before i need to have a artificial knee put in and "retire" from sports all together.


Those knees are getting better all the time, e.g. http://www.jri-oh.com/jri_research_project.php#scorpio

I reckon 8-10 yrs the landscape will probably have changed and you may be able to get a decent mechanical knee that will allow you to continue riding, and prob without pain. Think positive :thumbsup:


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## Guest (Feb 12, 2007)

925hell said:


> sixsixty, glad you are getting back so quickly after such a horrific injury. It gives me some hope I am currently replying while sitting in bed after my ACL surgery. This one is my second. My first was due to over use (sports) and the second I did at work. I have ridden downhill for the last 5 years. When I spoke to my orthopedic surgeon after my first surgery, he insisted that I wear a knee brace for high risk riding. Are you going to wear one this time. I'm just wondring since some of my riding partners who also have had knee surgery do and don't wear bracing. Most of the time it's personal preference other times it's fear of worse injuries, like if the knee doesn't bend/pop the bone will. Thanks for the insight.
> JK


Healing Vibes! Good luck with your recovery, just remember that the therapy is going to suck for a long time, but it'll get you back on the trails.

As for the bracing. I am currently riding with my old brace which is a Donjoy Legend. Basically the standard brace for atheletes with ACL injuries up until the last few years. It is big, and cumbersome, but it works for now. I have a new one on order though called the Donjoy Extreme Action Armor, it is designed for Moto X riders, Downhillers and Skiers with severe ACL deficiencies. The bonus of it is that it has a removable knee/shin pad attachment:thumbsup: You can get them custom made with a RX from your doctor, or you can order them off the shelf and get the fit as close as possible. They run about $500 without insurance, but even then a well worth it investment.

Good luck on the healing!


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## California L33 (Jul 30, 2005)

sixsixtysix said:


> Healing Vibes! Good luck with your recovery, just remember that the therapy is going to suck for a long time, but it'll get you back on the trails.
> 
> As for the bracing. I am currently riding with my old brace which is a Donjoy Legend. Basically the standard brace for atheletes with ACL injuries up until the last few years. It is big, and cumbersome, but it works for now. I have a new one on order though called the Donjoy Extreme Action Armor, it is designed for Moto X riders, Downhillers and Skiers with severe ACL deficiencies. The bonus of it is that it has a removable knee/shin pad attachment:thumbsup: You can get them custom made with a RX from your doctor, or you can order them off the shelf and get the fit as close as possible. They run about $500 without insurance, but even then a well worth it investment.
> 
> Good luck on the healing!


I just Googled the Donjoy brace. It looks like you'd have trouble moving in the thing, let alone ride a bike. Is it comfortable? Does it interfere with a natural pedal stroke?


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## 925hell (May 6, 2005)

Sixsixty,thanks for the healing vibes definitely gonna need it

I have also used the legend, defiance and defiance III. You are gonna love this I blew out my knee the second time because I, according to the doctor had the wrong stops in my brace. Not to hijack the thread but to pass on some info that I think you might find interesting. Check out this brace, if you are interested http://www.isports.com/productsKnee.htm, It's called the CTi2 I just got measured or it a day before my surgery. The measurements, over 20 took close to 30 minutes. To answer

Cali L33 riding in the braces is not bad its strapping armor over them them that causes the bulky feeling.


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## Guest (Feb 13, 2007)

Wow, those braces look beefy and ultra high tech.

I will have to ask my doc about them once I get a little closer to being fully healed. The Donjoy one I am getting isn't custom, its just off the shelf, but made for ACL deficient folks like me. Hopefully in the next year or two I will be able to get my ACL replaced, as the prognosis for not having one isnt so good, but my doc wouldn't do it when he did the first surgery since my knee was locked and doing them in a knee without full range of motion is just asking for them to tear again during rehab. Not to mention since they already harvested the tendon from my hamstring on that leg the last time it tore, they will have to use it from my other leg. (my doc won't use cadaver ligaments) I was going to have it done 4 -6 weeks after the first surgery but then the DVT popped up and now they won't touch it for at least a year.

Oh well , its the price you pay for playing hard, I did get some new incentive to get back to healthy asap yesterday though....










As for riding in a brace, it really isnt that bad, I played Junior A hockey in one for 3 years with no real problems.


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## 925hell (May 6, 2005)

Oh my, sweeeeeeeeeeeeeeeet ride woth the roco.


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## akashra (Dec 30, 2006)

This story serves as a reminder to me why I don't do downhill :/ ouch.


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## BLS439 (Jan 16, 2004)

I messed up my ACL and some lateral meniscus while at work. I was prescribed a CTi2 Vapor brace and it rocks. It's a bit tight laterally, but I think it's cause my knee is still sore/numb. My injury was June 6th and after several misdiagnosis I had reconstructive surgery on July 25th, 2006. Coming up on 7 months and I feel "okay". I'm running on a treadmill and using a stationary cycle. My knee stills clicks and pops every once in a while and I still do my quad sets (concentrated quad contractions)to keep my quads up to snuff.

I feel your pain and hope both of you to a speedy recovery. I've lost around 10* flexion and 5* extension. I can't sit on my knees due to the pain and the pressure in my knee. I haven't even tried side-to-side cutting sports yet. I plan to go for an easy off road ride this weekend...I've been jonesing with my Blur LT just hanging in the garage.

Good Luck and fast healing!


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## Guest (Feb 22, 2007)

wow, 7 months and your still having pain and numbness? 

I was through the pain phase about 7 weeks post op, and am already able to kneel on that knee. But then again, I don't have a ACL or either meniscus any more, so there isnt alot left to heal. Last weekend I managed to take my new rig out for a 15 mile ride and had no pain while riding, but my knee did balloon up pretty good afterwards. I was told to ride the stationary as much as I could tolerate as soon as possible after my surgery, and it seemed to help alot with getting my range of motion back.

One thing though, from expierience, watch it with overdoing the quadracep workouts, with a ACL injury you want you hamstrings to be as strong if not stronger than your quad so that it helps to hold the knee in place. Basically a normal person is 60% quad 40% hamstring, with post ACL reconstruction you want it to be at least 50-50% if not 40-60%. With ACL deficient people like me they want it to be 25% quad and 75% hamstring.


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## 925hell (May 6, 2005)

Man I wish I was even able to bend my knee more than 90 degrees, as I found out at my post op appointment, they had to do a lateral release because my kneecap wasn't tracking properly, basically if you looked at it wrong it would dislocate. So that gets to heal while 1st while my acl heals more slowly, they say that's a good thing because then I can't over extend my new acl causing "complications".

BLS after my first surgery I still had a occasionally had a errant pop and click, it suck that yours seems more pronounced, I'd say go see your doc again, as for sitting it took me a while to be able to, is it when you sit "indian style" or knees down if it is knees down you might be forgetting about your bolt if you have one I always did until I hit my or tried to kneel down, also as I was told my bolt will eventually "dissolve" but will remain sensitive for up to 1 year after. This as we all know is purely speculation, because I'm not a doctor, just a repeat patient.


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## JJGNC (Dec 25, 2006)

That's a pretty horrific story. I'm surprised that after blowing your knee a number of times, you would get back on a bike again. I'm not sure whether to commend you or ask if you're crazy. LOL. But anyway, if I were you, I would never again try to ride a trail aggressively. Ride easily...and no jumps! Knees are NEVER the same again after an injury, much less after what you've been through. Too many more incidents like that and you won't even be walking again...or you will have to get an artificial knee.

As to your advice about not riding alone. That's probably a good idea, but I almost always ride alone. I like the serenity when I ride alone on a trail. I just make sure I have my cell phone with me and some bandages, etc. I know it's a bad idea, though.


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## Guest (Mar 20, 2007)

I must be somewhat crazy, because I am ready to go at it again. I hate being idle. I had to give up a promising hockey future when I was 18 because of this knee, and had to give up any sports involving cutting or running or jumping when I was 22. Mountain biking was my replacement for my adrenaline rush. At least with this sport the bike takes most the shock....

As for now, PT is done, been released by my doctor, DVT re-eval ultrasound came back negative so I am basically as good as I am going to get without a ACL with the exception of rebuilding strength. Just joined the gym, got a personal trainer to help me work off the 30lbs I gained sitting on my butt for the last 5 months now I am starting to get excited about riding again.

I just got my new braces Fed-Ex yesterday so now I should be good to go on that front too. Hopefully I can get through the season riding, having fun and enjoying being back on a bike and outdoors again before getting my ACL done again.

I am very fortunate to have come through this one as well as I have, even though I am 30, my body is still able to recoup pretty quickly. I am sure the scenario would have been different if I were 40. As for the knee replacement, its inevitable at this point no matter what I do, I was told when I hit surgery #5 when I was 22 that I could count on a total knee replacement by the time I hit my 40's.


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## Gonz (Feb 8, 2004)

*Phoenix medical support?*

Hey six ... thanks for sharing your story. that's gotta hurt. just wondering why it took so long initially to get treatment. Is that characteristic of Phoenix ?


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## Guest (Mar 22, 2007)

Gonz said:


> Hey six ... thanks for sharing your story. that's gotta hurt. just wondering why it took so long initially to get treatment. Is that characteristic of Phoenix ?


The initial hospital network I went to was TERRIBLE! 8hr wait in the emergency room, completely overworked/inept doctors. The "specialist" they referred me to was a total joke, it took a week to get in to see him each time, and he would come in the room for 5 minutes, then come up with another excuse as to why he couldn't do anything. After 5 weeks I finally got fed up with it and found my own doctor, who is the BEST. Super nice, extremely caring and concerned about your well being, just as all doctors should be.

Unfortunately as the networks buy up more and more hospitals and doctor affiliations, it seems that their care just gets worse and worse. I don't want to say the name of the hospital network that I will NEVER deal with again, but they are one of the largest networks in the Western U.S. and have several hospitals in Phoenix. Lets just say, from here on out I will be making the drive up to Scottsdale.


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