Fall at Ivy Creek

Fall is settling in nicely, with cool days and changing leaves. Here's what we're seeing in the back yard this week...








Hope everyone else is also enjoying autumn and staying cozy in the cool temps.

2nd MRI Update

The second MRI was done last Friday and I met with the orthopedic surgeon today to review the results. No new results came out of this one. It did confirm the cartiledge damage on the underside of the kneecap which I already knew about. There's a small piece of cartiledge that is torn and is rubbing against the femur, causing some grinding and clicking but it's not painful at all right now. There was no explanation of why the outside of the knee has been locking up, although that has lessened a lot lately, so maybe it was just something that got a little irritated.

Basically, my knee will never be "normal" again - I'll always have some clicking and grinding, even if I were to have surgery, since the surgery would remove the damaged cartiledge but would leave a hole in the cartiledge, not a normal surface. So, surgery isn't a good option there unless it becomes too uncomfortable for me. Right now, it's definitely not that bad.

So, it's back to plan A, which is keep rehabbing, hoping to strengthen the surrounding muscles enough to buttress the kneecap and resist another dislocation. Day-to-day, I'm already able to do most things I want to do, so it's now about strengthening the knee for athletics. I suppose this is good news, although I do feel a little helpless about not knowing the cause of the lockups. Hopefully, those will go away with more rehab.

In daily activity, the knee actually feels pretty good. I did a lot of heavy yard work on the rocky hillside in the back yard this weekend with no problems, and I am definitely feeling more secure on it these days. So, progress, slow and steady. That's all for now!

September Knee Update - Another MRI on the Way

Well, the knee rehab was proceeding along swimmingly until about midway through the month. I was sitting down on the couch, and folding my bad leg under my good leg as I had been doing fine for weeks now. Pop. It was not a major pop like the initial injury, just the sort of joint pop that happens from time to time to everyone. But this one was accompanied by pain, and when I tried to stand back up, I could not straighten out my leg fully - it was painful and felt tight on the outside of my knee. I flexed my knee a while and walked around gingerly and after about 20 minutes it was fine again.

Didn't think much of it until it did it again that night, when I tried to stand up from sitting at my computer. When it happens, there is a lot of tightness and pain in the last 5 degrees of extension when trying to straighten my leg out fully. I flex the knee for a bit and let it relax, and in a few minutes the pain and tightness completely disappears, like it never happened, and I can extend my leg fully again.

This has happened now about 10-12 times this week, so I went to the doc this morning, and sure enough, as he was bending my knee every which way, it did it again. So, the theory is one of three things: the patella is subluxating (starting to dislocate), which I don't think is likely since the pain is actually well away from the patella tendon. Two, there is a lateral meniscus tear which the MRI missed (apparently MRIs miss 20% of those). Or three, there is a loose body, like a fragment of bone that broke off and is getting wedged into a space it shouldn't. I'm hoping for the third, since that's the easiest to fix.

Either way, I'm awaiting a call to tell me when the new MRI will be, so we can attempt to find the cause of the problem. Other than that, the knee is actually doing pretty well, it feels strong and rehab was going well. Now I have to scale back my rehab while still trying to keep the knee getting strong, so this will be a challenge. However, since I have no problems in any position other than full extension, I should be able to continue a lot of exercises that I have been doing, and keep the knee on track until we figure out the problem here.

Knee Rehab Update

Today I had my one month followup with the orthopedic surgeon, as well as my regular weekly PT session. The good news is that I continue to show improvement, and we're not going to even discuss surgery unless I plateau in my progress.

When I first started rehab, my left leg muscles had atrophied to roughly 50% of the strength of my right leg. Today, when we did the strength test, I am now at 76%. That's a lot of improvement for one month! I was pretty excited about that. When I start to get close to 90%, the therapist wants me to try skating again. Right now, that's a scary thought. There are still a lot of clicks and aches inside my knee for me to get used to first. Also, the kneecap is definitely still looser than my other one, so there is still some tightening of the ligaments that needs to happen.

Overall I am pleased. I am slowly regaining the ability to do stairs pain free, thanks to the many exercises that are targeting the strengthening of the quad, particularly the VMO, which is the little knot of muscle just above the knee towards the inside of the knee when you contract your quad. To play along at home....put your leg completely flat out in front of you on the floor or bed, toes pointed up. Squeeze your quad down hard - like you are pushing the back of your knee down through the floor. A little knot of muscle should be visible just above and to the inside of the knee where your quad attaches into the knee. If your kneecap is a clock with 12 o'clock pointing up your leg, it's at about 11. That's your VMO, and in my bad leg, that part of the muscle had completely disappeared and turned to jello. I'm happy to report it has been sighted again!

A side effect of all this rehab is that I am at the gym many times a week and have developed an interest in a more general workout, so I've set a goal to lose 15 lbs. by our Disney trip in November. I want to reduce my weight in order to reduce the forces on the knee when I do get back to skating. So far so good, lots of exercise and lots of salads this week!

San Francisco, Part 2

I have been so busy since returning from San Francisco that I have not had time until now to blog the rest of the trip. Later in the week, I had more time to explore. Here are some of the shots I took.

This one is my attempt at an artistic composition from Little Italy looking towards downtown.


I took this while enjoying a latte from Cafe Trieste, which was started by Italian immigrant Giovanni Giotta 50 years ago, was the first place on the west coast to serve espresso, and is now a famous landmark in San Francisco. The people hanging out in there were very much authentic from the old country.

That afternoon I decided to walk out to the Golden Gate Bridge. I took the bus as far as I could into the Marina District, and walked the rest of the way. Here I am not too far into the walk...


...and here I am much closer, from Torpedo Wharf, which now is not much more than a pier jutting into the bay near the bridge.


This is a view back towards the city. I started near that orange domed building.


On Friday, I had the whole day to explore, so I took a guided walking tour of Chinatown. This building is the only freestanding building in Chinatown, since it doesn't share any walls with its neighbors. More interesting, this was at one time the only Chinese-speaking telephone exchange in the country. You would be able to call up and speak in Chinese to an operator, ask for "Mr. Lee on Grant Ave.", and she would plug the call into the right jack. The switchboard operators were required to memorize every name, address and phone number for all of Chinatown!


Just a street scene in Chinatown...


From Friday night through the weekend I went out to Pleasanton, which is on the East Bay side, over the mountains, to visit my friends Matt and Caroline. We went to the Pleasanton Farmer's Market...


We also went over to Livermore for mini golf, go karts, pizza and a drive-by tour of Livermore Nat'l Lab, where they both work. At some point during the weekend we were walking near their apartment when I saw this funny scene, so I will leave you with this...

San Francisco

I'm in San Francisco for LinuxWorld 2006 this week, but I have had some time before breakfast, at lunch and after the conference sessions to get out and explore, and I've walked over 10 miles through this town in the past two days! San Francisco's downtown is very compact, so I've covered a good portion of the city on foot, and then expanded my range today with a cable car ride.

I haven't been here since I was a young boy, so this is really a treat for me. San Francisco is truly one of the premiere US cities, and I've really enjoyed seeing all the neighborhoods, cafes, restaurants, shops and sights, as well as people watching since people from around the world are here! Here are a few of the photos from the sightseeing.

This is the view from my hotel, which is in an up and coming area called SoMa. This is looking north towards the Financial District.


My first walk was an early morning expedition for some coffee and breakfast. I had an hour, so I decided to just walk as far from the hotel as I could in half an hour, buy coffee, and head back. I made it through SoMa, across the western tip of the Financial District, through Chinatown and into North Beach (Little Italy)! I told you it was compact! To be fair, I was walking fast - it's doubling as rehab exercise for my knee.

I enjoyed it so much that I went back to the area for lunch, here's a shot of the Chinatown gate.


After the first day of sessions, I wanted to walk to this hot new area called the Ferry Building which is a renovated building with gourmet food stands and restaurants, basically a foodie's dream! I was in search of dinner but on the way I walked along The Embarcadero and got this shot of some public sculpture with the Bay Bridge in the background.


Today the exhibit hall at LinuxWorld opened. Compared to OSCON (my usual summer conference) it is huge! Hard to capture in a photo, this is just one corner of it.


I walked to the nearby Sony Metreon's food court, picked up some lunch, and ate outside in the Yerba Buena Gardens. As you can see, it was a scenic lunch.


After the Tuesday sessions ended, I decided I wanted to ride a cable car. Here I am waiting in line with the rest of the tourists! :-) Only the tourists ride the cars now, because they're pricey. But, it was really interesting to see how they operate the cars - I think I want to check out the Cable Car Museum before I leave. Basically, there is a steel cable constantly running under the street, and the gripper (don't call them the driver!) uses levers inside the car to grab onto the cable and get pulled along. This gets to be hard work when you factor in San Francisco's hills! It was fascinating to watch them expertly pilot the cars through rush hour traffic, up and down hills, and gracefully navigating all the hazards of a big city.


My cable car route took me right through Union Square, the shopping heart of San Francisco. Note the ubiquitous iPod ad. EVERYONE here has an iPod. It's really amazing they even advertise any more - everywhere I walk, if a person is not with other people or talking on a cell phone, they have an iPod on. You can definitely tell this is Apple's homeland.


This is a view from atop Russian Hill while on the cable car.


The car dropped me off at Fisherman's Wharf, where I happened upon the Boulin Bakery and Cafe and had some clam chowder in a sourdough bread bowl. Seemed like an appropriate San Francisco experience for sure! And, the Boulin bakery was fascinating. They have an entire museum inside, which is free from 5-7pm, so that was a pleasant surprise.

I have two intense days of conferencing ahead, but I do plan to get some early morning and evening walks in when possible. I still have more to explore, particularly more in North Beach/Little Italy and in the parks. I also have Friday free before meeting up with my friends Matt and Caroline Friday night. Looking forward to it!

Physical Therapy

PT started today, and went better than I expected. I was able to ride a bike without discomfort for 10 minutes, and the baseline strength test showed that my left leg is at 50% of normal strength, so it's nice to have something to work towards. I got a new set of exercises to complete every day, including some with some resistance bands, all designed to strengthen the quad, which is the main muscle involved in patellar tracking.

I asked about the ultimate goal of the therapy given that I have a complete tear of the MPFL, and the PT said that in the case of the MPFL, where there is a lot of surrounding tissue that attaches to it and runs alongside it, you can sometimes achieve enough stability by strengthening up these tissues without needing surgery. The PT thought that the amount of stability and strength that I have now, six weeks post-injury, is very good. So, hopefully if I hit the therapy aggressively, I might be able to avoid surgery. He did not seem too concerned about the clicking and snapping inside the knee, since it is not associated with pain. He thought it might be related to residual inflammation.

So, the good news is I can go to the gym now, and do the bike and some strength training every day, and start to be more active. And I'll work a lot better when I have weekly PT sessions to measure my progress.

Fran's 31st Birthday

My 31st birthday was yesterday. We opted for a low-key celebration on Sunday night instead, which allowed for a more leisurely celebration than if we tried on a weeknight. Katie made me a phenomenally decadent chocolate cake from scratch!


The big present of the year was a total surprise: Katie got me the KitchenAid mixer that I've wanted forever! (She really coulda used it making that cake, too, but thought opening it, using it and packing it again would be tacky ;-)


I got a great haul of other gifts too! Lots of good stuff from the family. All in all it was a nice, relaxing birthday, and a good way to return home from my Portland trip. Thanks everyone!

Portland - Open Source Convention 2006

I recently returned from a week in Portland, OR where I attended the 2006 Open Source Convention. The convention itself turned out pretty well (as I documented over in my tech blog) but I had an extra day at the end to do some sightseeing.

Here's the view from my hotel room to the west towards downtown:


Our first stop was the Chinese Garden, in chinatown. It was built by 100+ craftsmen from Portland's sister city in China and modelled after a typical scholar's garden from the Ming Dynasty. It occupied an entire city block right in the heart of Chinatown.


After that it was off to the zoo in Washington Park. Washington Park has the distinction of having the world's deepest subway stop, at 770 ft below the surface. The elevator ride is a lot of fun (and fast!) I got a good shot of the hippos...


From the zoo you can hop on the zoo train which goes for miles through the woods of the park to the International Rose Garden (Portland is the City of Roses, after all...)


From the Rose Garden, you can get great views of downtown.


After that we hit the trendy Nob Hill neighborhood for dinner and then headed to the airport for a long redeye flight home. Portland is one of my favorite cities and I am happy to be able to make it there each summer. This year I'll get a bonus visit because I'm going to tag along when Katie heads there for her neuropsych conference in February!

Knee Update

I went to see the orthopedic surgeon today and he wants me to try some physical therapy first, to see if the ligament and other structures might tighten up on their own. He mentioned that it is hard to get an exact picture of the MPFL from the MRI, and that it appears torn but beyond that he couldn't be sure. Four weeks of physical therapy and a different brace for now, and we'll re-evaluate later. There appears to be at least a chance of avoiding surgery, so that seems to be positive news.

In other news, from the shameless promotion department, happy birthday to me! :-) Pics of birthday fun as well as my trip to Portland will probably go up tonight.

Minnesota Cabin

Katie and I recently spent 4 days in a cabin near Nisswa, MN with Loren, Sally, Ben, Steph, Ellie and Ada. We had a great time meeting our newest niece Ada and getting lots of playtime with Ellie and catch-up time with the rest of the family! I never had the Minnesota lake and cabin experience prior to this, and it was everything that was promised. The cabin was on a small lake, with a dock and a small beach, as well as a campfire pit.


The sunsets were gorgeous!


While we were there we opened Ellie's birthday gifts. Aunt Katie made her this princess dress from scratch, and she sure seemed to appreciate it!


We also rented a pontoon boat on a bigger lake nearby, which allowed us to get out on the water to do some fishing and swimming, and Katie even took a shot at tubing.




We also shopped in downtown Nisswa during an arts and crafts fair, cooked lots of yummy meals at the cabin, played games, roasted marshmallows, and had an all-around great time!

MRI Results

I got the results of my MRI today, and what it boils down to is two significant findings:

1. Dislocation and relocation of the patella (kneecap) with an associated complete tear of the medial patellofemoral ligament (MPFL).

2. Grade I sprain of the MCL.

So, the good news is that the MCL, ACL and meniscus are all intact. The bad news is that the MPFL is completely torn. The MPFL is the ligament that keeps your kneecap from sliding too far towards the outside of your knee. My kneecap is not way out of place or anything, but it does feel like there's some instability in there.

I don't want to speculate any farther other than to say it's a fairly common injury and if surgery is required, it looks straightforward and with a very high rate of success and happiness post-op. However, I still have to consult with an orthopedic surgeon before I know what my next steps are, so I don't want to get ahead of myself.

The hope is that the knee will remain stable enough over the next few weeks to allow me to complete this busy time I have with work the next month or so, with two business trips, and then I will have plenty of time to correct the issue on a more long-term basis. I've been able to get back to work and get around with minimal trouble in the last week or so, and if it stays that way, this should be an ok plan. That's all for now, I'll post more info as it comes available.

The Knee is a Tricky Joint

On, June 21st, round about 8pm, I was on the ice doing a warmup drill with our goalie. I was standing still in front of him when a teammate sent a puck towards me but behind me and to the right. I twisted around to receive the pass. Funny thing is, my left foot decided not to follow me, I think because it was caught in a rut in the ice. So as I pushed off the inside of my left foot to propel myself to the right, my knee was faced with a choice.... and the choice it made was not good. I heard and felt several loud pops as the knee gave out, and down I went.

Now, the first thing you think when this happens is, "I know that's not a noise that my knee is supposed to make", as you lay on the ice looking upward. A few seconds later, you start to feel the pain, which actually is not that bad at this point. After laying there for a minute and gathering my wits about me, I had some teammates help me to the bench where I removed my equipment and assessed the situation. At the time, I knew something was wrong because my knee didn't really want to move, but from the outside it looked well, more or less like my other knee. I hobbled around the rink gathering up my stuff, and (very) slowly made it out to my car.

Being my left knee, driving was not really impaired, and I drove home and hopped into the house. By that point, the swelling had started. I never got to the "grapefruit sized" swelling that many people experience, but the inside of my knee was quite swollen and sore. I immediately started RICE therapy (rest, ice, compression, elevation) and actually slept comfortably that night.

The next morning was a different story. As I got out of bed, the knee -really- did not want to support any weight, and I hobbled to the restroom 10 feet away. It's a really strange feeling to have a joint and a limb that you are used to walking, running and skating around on be completely useless. I think my brain had a tough time reconciling this, as my body was then overcome with an intense wave of nausea, the worst I'd ever felt. Good times! Thankfully, that lasted only 2-3 minutes, but enough time to convince me that a trip to urgent care was in order.

After a lonnng wait at the urgent care center (not so urgent, I guess), the doc took a look. An xray showed no fracture, so he sent me home with an immobilization brace, a followup appt. in a week, and a promise to have someone contact me about physical therapy.

Over the next week I went back to work, and with the immobilization brace it was pretty easy to get around. After a few days, the swelling went down, and what remained was a lot of stiffness and tenderness on the inside of the knee, indicating an MCL (medial collateral ligament, runs along the inside of the knee) injury. Day by day I gained a little movement back but still did not develop any "trust" in the knee - it still feels like it might give out, especially when not bandaged.

I was not impressed with the urgent care doc, and when no followup call about PT ever came, I cancelled my appointment with him and scheduled one with my regular UAB doc. Saw him on Friday, and he did another x-ray, which again turned up no fractures, but was interesting nonetheless cause my kneecap was out of place due to the swelling. The doc's comment was, "Hey, what's your kneecap doing way over there?" Just kinda interesting to see.

He ordered an MRI for me, which I completed this morning. As my first MRI, that was an interesting experience. It was easier since it was my knee and my head did not need to be in the tube. The noises were interesting, and LOUD... while laying completely still for 30 minutes I had lots of time to think about them, so I decided they broke down into three groups: sounds like machine guns, sounds like grinders, and sounds like futuristic laser weapons. Not sure why it needs to be so loud, but not really disturbing - the earplugs that were provided were a big help.

With the holiday, I won't have the results until sometime Wednesday, but what I suspect is at the very least, an MCL sprain. A sprain is when you stretch or tear one or more ligaments, and judging from the soreness right over my MCL, this seems like a likely outcome. The concern I have is that with the number of pops I heard, there may also be damage to the ACL and/or the meniscus. MCL injuries don't generally call for surgery, but ACLs often do, and meniscus injuries generally don't heal by themselves either, due to lack of bloodflow to the area. So, I'm not sure what's in store quite yet. The good news is that I can support weight and walk around with very little pain or discomfort, and the knee overall feels like it is becoming more stable. But, the knee is a tricky joint, and sometimes other ligaments or muscles can compensate for injuries.

In the meantime, I've also been fitted for a sports brace, which will allow me to ease myself back into hockey as the knee heals. I will wear it for at least the first year after the injury. I'm in no hurry to rush back, though. I'm looking forward to doing some PT to increase the strength and flexibility of the joint first. Right now, I'm just hoping to avoid surgery. I should know more later in the week.

Ada Mae Richards has arrived!

Katie and I are aunt and uncle once again, as Ada Mae Richards made her debut today for proud parents Ben and Stephanie, and big sis Eleanor!



Ada Mae Richards
7 lbs 6 oz
19 3/4 in
June 5th, 2006
1:33pm

Road Trip!

10:30am - "That show we watched last night about Big Bob Gibson's BBQ was good. They won all those BBQ awards. It looked tasty."
10:31am - "Yeah, we should take a trip up there someday and check it out."
10:40am - Katie and Fran are on the interstate headed toward Big Bob Gibson's BBQ in Decatur, AL!


We arrived at Alabama's mecca of BBQ just over an hour later...




12:30pm

Katie: "Maybe you didn't need the three meat sampler."
Fran: (Stuffing himself back into the car) "Oh yeah I did. That was awesome. Now roll me home."

That was the best BBQ I've had in a long time. One of the things Big Bob Gibson's is famous for is their white barbeque sauce (vinegar/mayo based), but I had no idea how good their red sauce was too. Everything I had was awesome. If you're ever passing Decatur, AL on I-65 in northern Alabama, you owe it to yourself to stop in for a meal. We'll be going back again soon. Check out their web site at http://www.bigbobgibsonbbq.com/

After the feast we headed over to nearby Huntsville to meet up with our friend Hari and hit the local mini golf course.


Folks, you can't teach this kind of talent and form...


After that it was back on the open road. See, we were due home at 6pm for.... that's right .... a BBQ at our friend's house.

Dana's Spring Visit

My sister popped in for a nice visit at the end of May. The goal for the trip was as much relaxation as possible, so we spent lots of time lounging on the deck and around the house, eating, reading and planting in the garden. Very relaxing. Dana even mowed our lawn, claiming that she missed doing that - not my idea of relaxing but she appeared to enjoy it (Dana, just so you know, any time you get another urge to mow the lawn, come on down...)

We did take a picnic over to Aldridge Gardens to enjoy the botanical park and check in on the hydrangeas right at the peak of their season. It was really hot that day, but we're doing our best to hide it...



Back at the house, we took the annual "here's the Fabrizio kids on the back patio with the flowers, so that mom has something new to put on her desk" photo shoot. Katie's zinnia patch is off to the right, and has become the star performer of the entire garden this summer!

Loren and Sally's Spring Visit

Loren and Sally drove all the way from Arizona for a visit and a delivery in April. They brought all of Katie's childhood stuff and a treasure trove of great tools for the workshop! We had a great visit while they were out here.

Here's a nice shot on the deck in front of the sweet gum tree.



Sally opened birthday gifts while she was here.


Sally also spent lots and lots of time looking out into the greenness of the Alabama spring. She doesn't get treated to this much green out in the Arizona desert, so I think this was a highlight for her.


During the birthday gift ceremony, we got sidetracked trying to teach Sally how to do the "floating hot dog" trick. We're still waiting to hear if she has seen it yet! (Sepia for dramatic effect....ok, I was just playing with settings on the camera)


This watermelon got shockingly high ratings on the RWS (Richards Watermelon Scale). I believe I heard some scores in the 9's! This early in the season, that's big news!


And so another wonderful visit came to an end. We're meeting up next month in a cabin in northern MN for the next Richards family gathering, where the newest member, Ada, will get to meet her Aunt Katie and Uncle Fran! (Of course Ada wasn't born yet at the time of this visit, so this is a giveaway that it took us a while to make this blog post!)

Changing Birds

My new hobby is bird watching. We are fortunate to have a great environment for the birds- lots of trees, a running creek, and an endless supply of birdseed. It has been fun to see how the birds have changed over the past month. All of the birds have started to change from their drab winter feathers into their bright feathers that are attractive to mates.

Here is a picture of a male goldfinch. He's so bright! Just a month ago, the finches looked so different (see the backyard birdcount post for a comparison).


I was sitting outside today on the deck. I didn't think the birds would come to the feeders with me sitting so close, but they got used to me being there in about 3 minutes. Here is a shot of a Carolina chickadee, our most frequent feeder visitor.



We were very lucky to see a female Eastern bluebird today! They are rare in neighborhoods and quite shy. We looked into what it takes to keep them around- it's very complicated. You need to provide them with housing and at least 100 mealworms a day. But the rewards sound like they are worth it! They will become so tame that they will eat out of your hand! We are looking into putting out some bluebird houses.

It's been so much fun watching the birds! We even got Fran's mom hooked on the birding when she was here.

Mom's Visit

Fran's mom came for a visit last week! After picking her up at the Atlanta airport and spending the afternoon in Decatur shopping at the farmer's market and walking around downtown, we enjoyed a relaxing and leisurely-paced week in Birmingham. The weather cooperated with highs near 80 (unlike the low 50s of this week!) and mom got some quality time with the garden and the birds. We also did lots and lots of cooking, leading up to the highlight of the week, the meatball feast! Our friends joined us and laura set the new record, eating 5 meatballs with dinner.

Here's a photo of one of our "latte moments" - mom got hooked on Fran's lattes from the latte maker ($5 garage sale find, go Katie!)...



Since mom left, Fran has caught, recovered from, and recaught a cold, Katie has been hard at work studying for the licensing exam, the tulips have started to bloom and the weather has returned to winter! March is in like a lamb and out like a lion this year, apparently.