Jess Ong
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The Collision

3/29/2017

1 Comment

 
Ok so here's the story of how I hurt my knee. It happened during an ultimate frisbee game. A lot of people are surprised by this because they think ultimate is pretty chill (it can be, when you're playing pickup!), but high force contact actually occurs pretty often in games.  ACL's are probably just as common in ultimate as soccer, so it's not all that surprising that it happened to me while playing frisbee!
2014.03.22-23 MIT Women's Ultimate Frisbee (sMITe), Centex 2014 Highlights, Austin, TX
This is me (in blue) a few years ago taking a small tumble after catching the disc (I was fine). This happens all the time!
During the last weekend of February we traveled to Virginia for a tournament. The collision occurred towards the end of the first half of the first game.

I was defending a cutter, when a bladey disc went up. Since she was significantly taller than me, I knew my only chance at getting a hand on the disc was to get my body sideways and in front of her and jump before she did. When you jump, there's a point right before you start accelerating upwards where your legs are supporting much more than your body weight, and that force is doubled if you're jumping off one leg.  When I was at exactly that point in my jump to get the disc, some part of my opponent's body directly hit the outside of my knee as she tried to run through me, causing it to collapse sideways. I instantly felt the infamous pop that everyone associates with an ACL tear, along with the sickening sensation of my knee bending in an unmistakably unnatural direction. I landed a few feet away and facing a completely different direction. Replaying it in my mind still makes me nauseous. 

It was the pop that terrified me, and before I hit the ground I knew it was a bad sign. In shock and panic, I started to hyperventilate. Was that what I think it was? ​It took about 20 seconds to calm down, gather my wits, and slow my breathing enough to assess the knee. ​No, it can't be. It hurt when I was hit, but the pain isn't too bad any more so maybe it's fine. Nothing was clearly broken and I could move it, which was a good sign. I stood up and could put weight on it, great sign. I was able to walk off the field on my own...awesome sign! The thinking side of my brain kicked in and I started trying to convince myself that I was fine. 

Since there was a large amount of contact involved (and I knew most ACL’s happen in non-contact situations), I hoped the noise and pain was just from her leg slamming into mine. Maybe it would just turn into a bad bruise. Like when you stub your toe or get a paper cut and it feels like the worst pain the world but you know you’re going to be fine in 20 seconds. I thought, Surely if I can get up and walk then it must not be that bad, right? I decided I would walk it off that day and try to play on Sunday. 

I now know that I was wrong. Turns out it's possible to walk with a  very damaged knee, and a couple weeks later I found out that the ACL and both menisci had been torn. 

Here is a timeline of events and progress from injury to surgery. 
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Timeline since injury

3/28/2017

3 Comments

 
In order to provide some context as to when the injury occurred, what's happened since then, and where I'm at now, here's a brief timeline. 

Day -1 (Fri, Feb. 24):
Woke up dog-early to road trip from Boston to southern Virginia for a college ultimate frisbee tournament. 

Day 0 (Sat, Feb. 25) -- The injury​:
In the first game of the tournament, I was loading on one leg to jump for the disc (kind of like a lay-up) when my opponent directly hit the side of my knee, causing it to snap sideways and produce the dreaded pop. After 15 or so seconds of panic I realized I could move the knee and was able to walk off the field. The athletic trainer on duty couldn't definitively say what was wrong. She told me to take the rest of the day off and maybe I could try playing the next day. There wasn't much swelling or loss of motion, so I was hopeful that it was just a bad bruise or something like that.
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The swelling wasn't too bad on the day of injury
Day 1 (Sun, Feb. 26): 
Woke up to a very swollen knee. The swelling caused my quad to shut down, which amplified the instability. I could walk, but very slowly. At the fields I borrowed crutches from the athletic trainer, so I could get around faster when I needed to. ​

​Day 2 (Mon, Feb. 27): 
While the rest of the team flew back to Boston, I drove to North Carolina to hang out with one of my best friends, Faith, who recently started med school there. Lucky for me I hurt my left knee so driving myself was fine.

I probably should have been using crutches at this point, but it didn't seem worth it to drop $50 for a pair at CVS when I knew I had some at home. 
​
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Swelling continued to increase for a few days
I considered going to an urgent care place to get it checked out, but decided against it because I assumed they would just take a bunch of money, take some x-rays, tell me it wasn't broken (which I knew), and tell me to RICE. I figured the damage has been done so it is what it is, and I wasn't in excruciating pain so it didn't seem like an emergency. 
​
Day 3 (Tues, Feb. 28):
I had a blast hanging out with Faith! We didn't actually do much, but spent a lot of time catching up and goofing off. It was so encouraging to be able to pick up where we left off, and the visit was confirmation that this friendship will last through the distance. 
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That night I drove to the airport to go back to Boston. Getting from the rental car drop-off area to the gate carrying my backpack and duffel bag was slow and scary, but fortunately the gate was right past security so I didn't actually have to walk very far. 

Day 5 (Thurs, Mar. 2) -- First doctor's visit:
​
Was finally able to see the sports med doctor (I'll call him Dr. F), who also happens to be the team doctor who took care of us when I played soccer in undergrad. 
He's worked with me with several injuries, so we know each other fairly well and I have a lot of respect for him.

He examined my knee, performed all the typical tests, and said "I can read you pretty well by now, and I know you're worried about the A-word." (He actually said "the A-word," haha.)  He was right. Anyone who has ever played cards with me knows I have no poker face. He had a suspicion that the ACL was torn, but couldn't say for sure because I had enough muscle guarding that the tests weren't effective. 

Dr. F also took some x-rays to make sure that there were no fractures (which I already knew and wasn't concerned about). 

Day 6 (Fri, Mar. 3) -- MRI and physical therapy​:
Got an MRI in the morning. I know most people hate the noise and claustrophobic environment of MRIs, but I actually find them oddly relaxing. It was nice to sneak in some mini-naps while the magic magnets created 3d images of what I would later find out was the remnants of my ACL. 

I have already been doing PT for my shoulder (which I had repaired a year ago), so it was pretty easy to sneak in a session for my knee in lieu of the appointment I already had for the shoulder that day. After this injury, I'm pretty sure my therapist wants me to burrito myself in bubble wrap every time I step onto a field from now on. But hey, she should be happy, I'm keeping them in business. Boy, was this the most painful PT session I have ever had! I went in with only about a 45 degree range of motion, which was apparently not acceptable. So she had me lay on my back, told me to take a deep breath (side note: not a reassuring thing to say to someone), and forced it to bend farther. She might as well have been trained in martial arts, because she had me writhing around on the table nearly screaming "mercy."

As painful as PT was that day, I did leave the office with a significantly improved ROM. Probably more importantly, though, that experience taught me that it in this instance it was okay to push through the pain in order to regain function. 
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Day 7 (Sat, Mar. 4):
The PT experience the day before inspired me to attack rehab pretty aggressively. I spent about 3 hours practicing walking back and forth along the hall in our apartment until I reached as normal of a gait as I could manage. I also started doing some hamstring, quad, and hip strengthening. My goals were to (1) Walk as normally as possible, and (2) Get to the point where I could commute to/from work on my bike again. ​
ACL/Menisci - Juggling 12 days after injury
Day 10 (Tues, Mar. 7) -- MRI Results:
​
By this time I could walk almost normally and straighten my knee almost all the way. I was beginning to wonder if maybe my knee was okay after all! The several-day interim between the MRI and results was excruciating: hoping with all my might that everything was fine, while at the same time knowing in my gut that all was probably not fine. I just wanted to know, so I could move on mentally!

In the afternoon I finally had the anxiously-awaited appointment with Dr. F to find out my fate. Alas, my knee was definitely not fine. Here's the list of injuries from the report: 
  • Completely torn ACL
  • Torn medial and lateral menisci
  • Grade 1 sprains of MCL and LCL
  • Grade 2 strain of gastric muscle (calf?) and popliteus muscle (never heard of this, but google says it's a small muscle in the back of the knee)
  • Bone contusions in tibia and femur (where the bones crashed into each other, I assume)
  • Joint effusion (swelling) -- duh! ​
Dr. F is awesome and spent almost an hour decoding the above list for me, walking me through the implications, and answering my abundant questions. Basically, the ACL is the biggest problem and needs to be reconstructed because without it the knee will continue to be unstable. The torn menisci (plural of "meniscus"), which act as shock absorbers for the bone and cartilage, were to blame for the sharp catching sensation that I was experiencing in certain situations. The menisci would also need to be dealt with surgically.  The rest of the injuries were minor enough that they would heal on their own. 

​We set an appointment and surgery date with Dr. S, the surgeon who would piece my knee back together. 

Day 11 (Wed, Mar. 8): 
I bought a basic knee sleeve from a local running store, and wow​! I always thought those sleeves looked useless, but the compression does wonders for swelling and stability. Since then the sleeve has been my best friend. It drastically decreased my limp and allowed me to walk faster. 

I started on the stationary bike (with no resistance). It was pretty painful and stiff at first, but felt pretty good after 10 minutes or so!

Day 12 (Thurs, Mar. 9): Juggling​:
I recorded this video a few minutes after discovering that I could juggle a soccer ball: 
ACL/Menisci - Juggling 12 days after injury
Though my knee was still too unstable to do any tricks (yes of course I tried), it was still a huge relief to realize I could juggle again. It made me feel a little more like myself. That night I went to the gym and spent about 30 minutes doing basic juggling, 

I also tried the elliptical at very light resistance and ramp, and almost broke a sweat. 

Being able to do these somewhat normal things was such a mental boost in the midst of a rough week of coming to terms with the reality of the injury. 

Day 16 (Mon, Mar. 13):
​
4.5 miles in 40 minutes on the elliptical, with decent resistance. This was one of the first real workouts, and it felt so great to be huffing and puffing on that machine that I used to hate. After this, I ended up doing an elliptical workout pretty much every day until surgery to try to maintain some cardio fitness. 

Day 19 (Thurs, Mar. 16) -- Back to bike commuting:
​I finally felt like my knee was stable enough and had enough range of motion to try biking on the road. I cleared this with my PT first, who helped me come up with a strategy for safely biking in traffic (e.g. walk up hills, don't put full weight on left leg while accelerating from a stop). There were still some painful and unstable instances like initially pushing off from the ground. But even though it was painful, once I was in traffic I felt totally comfortable and in control, so it was plenty safe.  

​Being able to ride a real bike again was a significant milestone for me because it provided physical, mental, and logistical freedom. It cut my time spent getting from place to place in quarter and made me much more mobile. 

Day 24: (Tues, Mar. 21) -- Pre-op with Dr. S: 
During every interaction I've had with any kind of medical professional since this injury (athletic trainer, sports med doctor, physical therapist, and now surgeon), they have all performed the same series of tests on my knee. The point of each of these tests is to either (a) reproduce instability, or (b) reproduce pain. It's pretty disturbing to watch and feel someone manipulate your bones into directions they definitely shouldn't be able to move. If the MRI wasn't enough, Dr. S was definitely convinced that my ACL was torn after he had the chance to twist and pull on my knee!
Lachman's Test
The most important order of business during this appointment was to decide which graft to use. The most common options  are hamstring tendon and patellar tendon. They are both great options, but based on the literature and articles I had read before the appointment, I had loosely decided to go with the patellar tendon. Dr. S confirmed that that was what he would recommend for me. 

Dr. S also gave me the low-down on what to expect with the meniscus tears, which were too large to heal on their own. Basically, there was potential that I would be on crutches for 6 weeks with the knee locked straight, based on what he would have to do to the menisci. However, he wouldn't know until he was actually inside the knee, which meant that I would have to go into surgery not knowing the recovery timeline. 

Day 26 (Thurs, Mar. 23) -- Day before surgery: 
Here is where I was at right before surgery: 
  • I could walk 95% normal and mostly effortlessly
  • Stairs (up and down) were fine
  • Biking around the city felt mostly normal 
  • Elliptical workouts same as pre-injury
  • I could jog around 200m (but with pain)
  • 90 degree squats with 25lb weight (but straightening out from the squat was stiff and mildly painful)
  • 40lb single leg hamstring curls
  • Single leg balancing 75% normal 
  • Single and double leg juggling felt great
  • Flexion within 20 degrees of good leg
  • Extension wasn't completely straight due to the meniscus piece lodged in the joint
  • I still had at least one painful buckling instability episode every day

They don't let you eat or drink at all after midnight before surgery, so in order to combat grumpy hangry-ness as much as possible, I had a feast at 11:55pm. I don't remember what I ate, but I know I savored it. 

Day 27 (Fri, Mar. 24) -- Surgery day!:
I'll probably outline the day of surgery in more detail in a later post, but I have a new ACL, yay! Dr. S said he ended up using my quadricep tendon as a graft because he measured my patellar tendon on the MRI and it was too short. I was a little bummed about that (quads are super important  right!?), but I trust that it was the best decision. He was able to repair the medial meniscus, but the lateral meniscus tear turned out to be larger and more "complex" than expected, so he had to remove ~60% of that one. 
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I was told to ice several times a day, but there's no way any cold was going to make it through the 1" dressing they put on in, so I stuck with just elevation until I could remove the dressing a couple days later
3 Comments

Facing Fears

3/26/2017

4 Comments

 
​My five roommates and I  host an open dinner at our house every Tuesday. In the past two years of doing this, I don’t think there’s been a single week where everyone knew everyone. So each week before we dig in to the chow, everyone introduces him or herself and answers an ice breaker question.

​Sometimes the questions are weird, for example: If you were a vegetable what would you be? Sometimes the questions are related to a nearby holiday: What is your proudest Halloween costume? or an upcoming birthday: What is something you appreciate about [insert birthday boy/girl’s name]? Sometimes, when we can’t think of a unique question, the ice breaker is more standard, like What is your biggest fear?
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House dinner back in the day when we all fit in the kitchen
​A quick google search of biggest fears reveals a list of the top 10 most common phobias among Americans: 
  1. Flying
  2. Public speaking
  3. Heights
  4. Darkness
  5. Intimacy
  6. Death
  7. Failure
  8. Rejection
  9. Spiders
  10. Commitment

When the question of greatest fear came up at house dinner, we turned out to be, for the most part, a pretty good representation of the general population. However, though many of these fears did resonate with me, none of them were quite as frightening to me as my Greatest Fear: tearing an ACL.

When you play cutting, pivoting, contact sports for long enough, you inevitably see and hear enough ACL injuries to develop respect for that little ligament that holds your knee together. People in the sports community might not know what the acronym stands for or what its function is in the knee, but they pretty much all know that a snapped ACL is guaranteed to be a season ender. Throughout the years I've had plenty of teammates who have torn an ACL. A handful of them returned to soccer stronger, faster, and more coordinated than before their injury. However, more often than not they struggled through rehab and never made it back to pre-injury levels.

Because of the notoriously long, grueling rehab associated with recovery (6-12+ months post-surgery) and the long-term effects of the injury, tearing an ACL has been one of those slightly realistic fears that has hung over my head for the past few years. Almost 75% of ACL tears are non-contact pivoting, cutting, or landing injuries. Available literature (read: both legit-and non-legit google results) pretty much unanimously agrees that the rate of non-contact knee injuries can be reduced by focusing on things like hip and hamstring strength, single-leg balance and control, and landing mechanics. With that in mind, for the past year or so, I've been fairly intentional about incorporating various exercises into my weekly routine in order to prevent preventable injuries. 
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A collection of my mobility and light strengthening tools: PVC roller, foam roller, stick, various bands, lacrosse balls, and agility ladder
However, the reality is that contact still happens, and all the focused strengthening and training in the world isn't going to defend against a large enough force. 

UnfortunateIy, I found this out the hard way. 

I will probably post a more detailed description of what happened, but to make a long story very short: I was fully planted on my leg, loading to jump, when a direct blow to the outside of my knee caused it to buckle sideways and tear my ACL and both menisci. (Edit: Read the full collision story here.)

Now I get to face my Fear.
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Kudos to you if you read this far! Thanks for sticking it out. I know I'm leaving this story as somewhat of a cliff-hanger, but there is more to come, I promise. 

​I tend to process things best through writing. It helps me collect my thoughts and allows me to reflect back and see progress/trends through time. Since I usually keep my writing private, I'm a little hesitant to share this story. But I'm hoping that sharing this blog with friends and family will allow you to see different layers of who I am that I may not be so good at showing on a normal day. 

I will be adding thoughts and updates here and there, so check back if you're interested. (Edit: Here is a timeline of events and progress from injury to surgery.) I am going to try to be vulnerable and honest (things that I'm often not very good at) about how this injury has affected me mentally, emotionally, spiritually, physically, and logistically. Some of the posts might be pretty raw, but in general I will try to be entertaining and humorous! 
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  • HOME
  • PERSONAL PROJECTS
    • MACHINIST'S CUBE
    • MACHINED RESIN CANDLEHOLDER
    • LASER CUT PROJECTS
  • RESEARCH
    • MOBILE-ENABLED DIABETIC FOOT ANALYZER
    • BLOOD PRESSURE IMAGER
    • ROBOT FLOWER GARDEN
    • HYPOSURFACE
  • PROJECTS
    • DESKTOP LATHE
    • ANIMATION WHEEL PUZZLE
    • SOCCER JUGGLING ANALYSIS
    • DELTA LINEAR 3D PRINTER
    • GALAXY YOYO
    • "OPERATION" ROBOT
    • FIREFLY FOOTBALL
  • SPORTS
    • SOCCER FREESTYLE JUGGLING
    • ULTIMATE FRISBEE
  • CONTACT