Patient spotlight: Zaak's last game

Physiotherapy, Integrated Health Clinic

“Play every game like it’s your last.” I cannot remember who said this or when I heard it, but it is a quote that has always meant something to me. As a very young athlete, it is something that has forced me to be better - to play harder, to run faster, and to never give up on any play. As a kid, it made me think I was super cool for remembering this quote, that I somehow had an advantage over everyone else because I kept this quote in the back of my head. Funny enough, as a kid, this quote didn't have quite the same meaning to me as it did when I grew up. A “last game” as kid for me usually meant the last game I could play in the hallway with my brother before my mum called us for dinner or the last game before the lunch bell rang. A “last game” as I grew up hopefully meant the finals of whatever competition I was playing; and if we got beaten before that, the last game came as an abrupt surprise and I was left disappointed, angry, and sad that there was no more soccer for the season.

As this quote stuck with me, I started to think about it in different ways. I would repeat it, and somehow the emphasis changed. “Play every game like it’s YOUR last - your last game ever.” That emphasis got me thinking. I started to understand a different meaning to this phrase. I started to play sports with the attitude that I might never get to play again. Call me crazy, but it drove me. For those that know me, I have always been competitive with everything. It doesn't matter if I am playing “21” on my mini-basketball hoop in my bedroom or a national soccer tournament - I want to win. Always. If it is any argument for that matter, I want to win it. Part of this passion came from my attitude to leave it all out there. IF it was going to be my last game ever, would I run a little harder for that pass? Would I jump a little higher for that header? Would I slide in for that tackle? Absolutely.

It is definitely not always easy to think that a game might be your last. Sometimes I would recall my injuries while I sat on the sidelines and sometimes I would pretend that I was getting cut from the team after the game. My nightmares were basically ones where I would have dreams about not being able to walk and that scared me. A lot. Just the thought of being permanently confined frightens me. But, it also motivated me to make the most of every situation. Regardless of any injury I faced, I always believed it was in my ability to become faster, work harder and come back stronger than ever.

October 17th, 2014. The day it all changed. This is a day I will never forget. I woke up in the middle of the night to a loud snap and pain on the side of my knee - I began panicking. I couldn't straighten my leg. It had locked before, but this time was different. It was frightening. This time I wasn't dreaming. I screamed. Loudly. I began to cry. Not because of the pain, but because I felt like this was the end. This was different that any other injury. In my mind, this seemed permanent. Unfortunately, little did I know that it kind of was…going to be permanent.

I was told I would be on crutches indefinitely until I got surgery. Waiting for surgery wasn't the worst part actually. I had been told that meniscal injuries were one of the fastest to heal and that they had a great prognosis. I was told the recovery process would be smooth and I would be back to walking anywhere between that day and a couple of weeks. I used school to take my mind off things, as well as studying and planning extracurricular events. I was really looking forward to getting the procedure done and was anxious to get going on the rehabilitation front. The day of my surgery, I was actually quite excited, I knew it was my first step to getting back on that field.

November 13th, 2014. I went in at 6 am and woke up a little after 1 pm and once again I began to panic - second time in a month.

I was wearing a cast. I couldn’t believe it. This was not supposed to happen. I had no clue why I was wearing a cast and no clue why my leg was confined to the bed. I kept asking the nurse why I was like this and she had no idea. Immobilization is scary. I was always taught that immobilizing a joint meant permanent issues. So yes, I began to panic. Not to mention, I was in a ton of pain. I’m talking pain that made me sick to my stomach. On top of everything, I was frightened to hear what had happened to my knee. The pain got worse along with my nausea, so they gave me a high dose of gravol to put me back to sleep. After a few hours, the surgeon came back and informed me that the first attempt at surgery was unsuccessful and due to this complication I had to undertake a second procedure that would leave me in crutches and a cast for another 2 months. I was also informed that my knee would never be the same and I would probably be limited to low intensity activity for the foreseeable future.

Never before in my life had I needed surgery and never before in my life was I told that my injury would leave permanent damage. I want to tell you all that I was determined in spite of this, that I was strong enough to overcome any difficulty set in front of me. But that didn't happen. Month after month, despite training nearly every day I couldn't get that spark back. The pain slowly diminished over time but the more I pushed myself, the more my knee wouldn't let me. It just wasn’t working. There was something blocking me – to this day, I still haven’t figured it out. Maybe it is the uncertainty and the fear - the uncertainty that my knee has not healed fully, and the fear that it could happen again. Of all the things associated with the recovery of a serious injury, the uncertainty is by far the worst. If there is anything I wouldn't wish upon anyone reading this article, it is that. It consumes me. I think about my knee all the time. Sometimes, I take hours out of my day just to research my symptoms to make sure I'm okay - reading through pages and pages of blog posts until I find someone with the same symptoms. Even more time consuming, I am on the phone with doctors, surgeons and physiotherapists begging to be on their waitlist, hoping for openings. I am constantly travelling from Victoria to Vancouver just to see certain specialists. The moment there is a gap in my hectic schedule, I'm on the phone pleading with receptionists to squeeze me in. I turned into someone who needed assurances, opinions, and results that proved to me that everything was okay.

In the past year I’ve seen 5 different physiotherapists, 8 different medical professionals, and 3 surgeons. I’m crazy right? If by crazy you mean I have an obsession to get better, then yes I am. And ultimately, my need for assurances led me back to a surgeon who finally said that he would go back and check if everything was okay. Option one, he finds nothing and I require about a week of rehab and option two he finds something wrong and I’m back in crutches for another 6 weeks.

I can tell you with certainty that my heart, my passion, my desire to play has never wavered. But what I’ve learned over time is that the mind probably plays a larger role than we would ever think. My mind is afraid. It won't let me get to my top speed because I am afraid that I will lose the control I have on my situation. I cannot play my hardest because deep down I am afraid to go through what I’ve already been through. It is almost like I am waiting for it to happen again, just like its been happening over the past 5 years. What probably frightens me even more is that I am scared I won’t be as good as I used to be. I know that is unrealistic given the point I am at in my life and yet, it still gets to me.

I started writing this article 2 months ago. My intention was that it would help me express myself, explain to people what sport and soccer meant to me. Explain all that I was feeling and the emotional whirlwind that comes with an experience like this. People know that I am a sports guy – I am watching soccer in almost every class and even when I'm not in class. But with this article, I wanted to share more than just my passion for sport. Being on the sideline sucks. Big time. I hate being subbed off - you’ll usually have to scream at me or pull me off before I come off willingly. I hate not playing. But being on the sideline knowing you can’t work harder or push it in the gym to change your circumstance sucks even more. My intention is that after reading this, you would know why it sucks so and why this matters so much for me.

While all these thoughts were running around in my head, something interesting happened. Maybe it has absolutely nothing to do with this article, but maybe it has everything to do with it. As I continued to write this article and come back to it every few days, I started to have second thoughts about my surgery. I started to re-live some of the moments in my life where I was on the field. This truly sounds crazy, but as I would write this, my mind would wander and I would be visualizing myself playing. I could see myself scoring goals, making moves, running past defenders. This really helped. I had to feel what I felt in those moments again. I had to. Finally, a couple weeks ago I said to myself that I couldn't live this way: in fear, in doubt, in uncertainty. I couldn’t live without at least trying to play, trying to get over my fears - so I decided I would start.

January 20th, 2016. A Wednesday - exactly 460 days after my initial injury - I decided to play again. It was one of the best days of my life. Yes, I was apprehensive. Yes, I was scared to make tackles. I am still scared to get tackled. Currently, to quote Kobe Bryant “I freaking suck.” I know what I have to do and how I have to play, but I can't execute it. I’m so busy making sure I don’t lose the ball at my feet that I’m missing what’s happening around me. Seriously though, I’m awful. But there are a few seconds each game. Maybe 3 seconds at a time, maybe 5 seconds, where I’m able to forget. Chasing that ball down the sideline brings me more joy than anyone knows. And when I'm chasing, I can forget everything around me. So I’ll learn - I’ll keep playing, I’ll keep trying. I’ll make sure in the coming games, there will be more and more moments where I can forget until I’ve forgotten about it completely. And I know I’ll succeed because I’ve already taken my biggest step. And that’s onto the field. Everything that happens now is dependent on how hard I work, how much I train, and how badly I want it. Now it is on me. I got to want it as bad as I wanted that last goal before that lunch bell used to ring. The thing is, I do. So now it is just a matter of when, not if, I get back to my best.

Special Thanks to:

Thank you for reading this article. It took me almost 3 months to finally complete it and I believe that it finally gets my message across. A friend of mine asked me to write a sports article for his website but ultimately, I ended up writing this article for myself. I came to understand that without expressing my feelings, I couldn't hope to get over the mental block that I faced. And while I did write this for myself, I would be thrilled to hear if anyone else was helped by this. And with that being said, I have to thank 4 individuals in particular for helping me through this journey.

Julia Lichtenstein: One of my best friends and a classmate of mine in medical school. Someone who probably met me less than 10 times before my injury and yet, none of my recovery could have happened without her. Upon being rejected at two separate hospitals (despite a locked knee classifying as a medical emergency), Julia asked her parents to help me get my surgery as soon as possible. They connected me to a surgeon who brought my wait time down from 6 months to 2 weeks. I was in the office on the Friday and had my surgery on the Monday. The timing couldn't have been better as I ended up being ready to come to Victoria just in time. She really saved me - not to mention all the notes she took for me and assignments she completed on my behalf! Thank you!

Dean Kotopski and Thomas Wan: Two brilliant physiotherapists at Performax Health Group who I had the pleasure of meeting a year before my injury. Honestly, Dean has changed the game when it comes to physiotherapy. I can guarantee that you won’t find someone in Vancouver like him. He is constantly researching, constantly coming up with new methods to help people and you know that when you’re seeing him, you’re seeing the best. Incidentally, I walked into his office for the first time with Travis Lulay (quarterback of the Lions) right behind me. Enough said. Of course, as soon as I got my cast, I didn’t even have to ask - he had me in whenever was convenient for me and he spent the entire Christmas break working on me and making sure I could walk again. That included Christmas and New Years Eve. That is the type of guy he is. We worked for 2 weeks straight. Everyday - on the bike, on the shuttle, you name it. At the end, I was able to walk without crutches the day before I moved to Victoria. I owe him big time. While I came home on weekends, I needed a physiotherapist in Victoria. Before heading out, I was introduced to Thomas; someone who Dean claimed “would do everything he could.” I’m going to let you all know that Thomas can do that and more. He is an absolute lifesaver. I could text this guy at 2 am on a Friday night and he would make sure there was an appointment for me Saturday morning. I was in there every Saturday, for a month, working with Thomas on range of motion, lateral strengthening, VMO stimulation, etc. Another individual who was absolutely instrumental in terms of my recovery and a great friend.

Brad Jawl: I met Brad by a stroke of luck. A good friend of mine was doing her clinical rotations for physiotherapy at Tall Tree Integrated Health Centre in Victoria, a clinic run and owned by Brad. To allow her to practice, Brad gave her the freedom to treat her friends in the clinic. She saw me for about 30 min and then called Brad in. He spent an hour and a half with me that day, no questions asked. In one session, this guy showed me what he was all about - he had no obligation to help me and yet he seemed to know that I needed his help just by looking at me. I continued to see him weekly and I have never left his office without feeling measurably better. While Dean and Thomas got me moving, Brad got me playing again. I would go as far as to say he is the smartest, most knowledgeable person in his field that I know. When I said earlier that Dean keeps up with the latest research, Brad is doing that on another level. Not only that, but he is the definition of someone who truly believes in his profession and believes in helping others. He helped me break all the barriers I faced and trained me to get past the excuses I was making. He gave me confidence in myself, in my ability, and most of all he taught me how to trust my body. There hasn't been a day where this guy spends less than 2 hours with me, listening to everything I have to say, no matter how crazy it seems. He is the only person that could probably read this article and say “I already knew that about Zaak.” Sure enough, two months after my first appointment with him, I was back on the field. When I say I met him by a stroke of luck, I truly mean it. I am the luckiest person in the world to have met him. Brad has changed my life and I am forever in debt to him.