Day 14

So today it's been 2 weeks since my acl surgery on Aug 18. I really have to wonder if it's going to take as long to recover as what I've read in other's blogs and in reference material on the net. Dr Anderson predicted the earliest recovery time of 3 months while most proclaimed more like 6 and some said as long as 9 months. I mean the swelling is still there and I can't bend it much, but really how long should it take to get those things in order? The muscle will come back in time; I'm not worried about that.

The swelling seems to be getting better everyday and the bruising is just starting to turn yellowish. The portals (the incision holes) are tender to the touch and knotty, but don't appear to be abnormally big.

I'm posting pictures of what my knee looks like now on the 14 day since surgery.

The pic on the left is my relaxed knee. The pic on the right I'm tightening both quads. See swelling looks better!

In this one (which was 2 pics) I'm tightening my quads. As you can see there is barely any definition on the right knee compared to the right.

Here you can see the bruising turning a bit yellow. I have my leg lifted and dangling and this is as far as it will bend on it's own. But I'm sure the little general PT guy will work on that today. Speaking of which.... gotta run hobble.

So physical therapy went ok. The first thing I did was to get on the stepper thing. It’s not really a stepper because you sit down and pump your legs in and out on the pedals. I did that for 10 minutes. Then Drew, the therapist, aka the Little General had me lay on my stomach and he pushed my heel toward my butt. Now like that didn’t hurt enough, he then held it there for like 30 seconds. This was the part that I read about before I had the surgery and everything I read about this torture was true. It hurts like hell! Afterward I did some leg lifts and decided to see how much it would bend after the General did a number on it. Well, as much as that pushing my heel to my butt hurt it did loosen up the knee quite a bit. I didn’t have protractor but it had definitely made a huge difference in my flexibility of the knee. I take back every bad word I said about the General. :) I finished my exercises then iced with the Game Ready icer and was good to go.

Day 13

This is getting tiresome already. I'm ready for the brace and crutches to go away. I am just about half way to being free from the brace and unless Dr Anderson says differently on Wednesday, I'll be free from the crutches (most of the time) by this time next week plus a day, but who's counting!

I fell square on my butt today crutching myself up the stairs at the back entry to my house. There are only 5 steps and it's so less complicated to just crutch up them backward rather than setting everything down and scooting it up with you while you scoot up on your butt. I also have no "aid" at the top of these stairs to help me stand up after reaching the top. Well, I got relaxed with the procedure and was going too fast and BAM! I slipped and fell. Fortunately my butt has some extra padding these days and took the brunt of the blow although I did put quite a bit of pressure on my boo-boo knee with the micro fracture in it. oops

I can bend it just a little bit beyond 90 degrees. Tomorrow marks the end of two weeks since my acl surgery.

Day 12

Today I noticed that I can bend my knee just a little bit more than yesterday without significant pain. I regress, once I bent it several times that little bit more than I bent it yesterday I was able to bend it to that point more easily on say the 10th bend. This is good!

The swelling is about the same; I wasn't very good about icing today as I've been on the computer rather than lounging on the couch. I could tell it wasn't happy about that, but after sitting with the compression and the cold water circulating around it, it felt much better. I think the bruising has ran its course.

The brace is becoming annoying though, I think the foam padding is not as cushy as it used to be and in order to keep the brace from sliding down my leg onto the top of my foot I have to cinch it really tight, which then causes a constriction of blood. I haven't come up with a good solution for this... yet.

Day 11 - 2nd day of PT - Shopping

When I refer to my PT I would normally be speaking of my physical therapist; however I'm thinking this PT guy I have now, Drew, is more like a physical torturist.

Now come on, I've done a lot of physical therapy over the last two years with 3 torn meniscus surgeries and I've never started out with 4-pound weights and leg lifts! Usually they ease you in a little bit and start with like 2 then increase up to 6. I've never used more than 6 pounds in any of the PT sessions I've ever had. Drew says 2 pounds is for old people; HELLO, I feel like I'm 75! So I survived the exercises, but barely and instead of doing 3 sets of 10 of each exercise it was more like 10 sets of 3! I'm usually the one trying to push it too fast, but even to me this seems just a little aggressive. He also informed me that he could remove my sutures for me; no thanks, I think I'll have a qualified medical doctor do that for me. Afterward, I was hooked up to the "Game Ready" device that provides compression and an icy cooling pad; it was like the machine I have at home, but much more intense.

The swelling looks way better today and I can almost tell there is a kneecap there! Ok so that was before the PT session with little Hitler. So I'm sure I've posted enough pictures of my swollen and bruised knee so I'll cease at least until the end of the first 2 weeks. The bruising my have stopped spreading.

After PT I met with a friend and we had breakfast. I've realized in handful of times that I've been out that handicap parking spaces are never available. It was raining and I wound up parking pretty far from the entry door. I can't hold an umbrella. The door is heavy and even though I've learned how to stick my crutch out to hold it after swinging it open I still have trouble getting through the door. Inside I encountered a mat for the first 5' then after that it was slippery tile. Normally I wouldn't have even noticed the tile, but once you've have a crutch slid out of control as you put it down and propel your weight forward, you become very leery of slipper floors. After breakfast my friend went with me shopping. I parked in the handicap spaces at each of the first three stores. The first one was Michaels. Yes, I'm a chick! The floor was slippery here too and there were several obstacles in the isles making it difficult to crutch my way through. The second store was Home Depot. Yes, I'm a chick that builds stuff too! Here I found an electric cart. I encountered two problems with using the electric cart. 1) There's no where to put crutches; it needs like a ladder hanger like you see on the side of some work trucks. I made due with putting the crutches in the basket albeit they stuck out to one side by at least 18". Fortunately I didn't take any one out or knock down a display with them. 2) There are a lot of obstacles in the isles! There are buggies with stuff that is being put away, 5 gallon buckets of paint jutting out on the floor, display bins in the isles and those huge rolling steps to reach the top shelves in the isles too. The isle I needed was tools and I was barely able to maneuver the turns. The 3rd place we went was a tiny hobby shop where in the last very small isle there were 2 stools on the floor to navigate in already very tight isles. I had to put one foot next to the stool and lift my other crutch over it.

Sure that was boring and painful to read, but these are the things you will encounter when venturing out. Actually finding something you want and getting it to the register is a whole other story! Good luck!

Day 10

So I did most of my home exercises given to me by the PT guy. I slacked a little bit on the "Quad Sets"; I tried to get them in when I thought about it, but seriously there aren't many times that I'm thinking about it and am in a position to do them. I did like 5 sets on the window seat where I did all the others so I probably only cut it short by maybe 1 or 2 sets I couldn't think of a place to do the "Ankle Pump" exercise since I can't exactly lay on the floor (cause I wouldn't be able to get back up) so I just plopped my bad leg on top of my good one while lying down which seemed to work just fine. The hardest and most painful thing to do is flex (bend) my knee. Yowie, that hurts!

The swelling looks noticeably better today. I'm still taking the Naproxen 500 twice a day.

On a positive note, I've figured out that not only can I butt slide down the stairs two at a time, but I can also butt slide UP two at a time! Whooo-hooo, less time on the stairs! (stairs are annoying)

Post Op - Follow Up - Day 9

Today was my first follow up with my orthopedic surgeon, Dr Anderson. He examined my knee and checked its stability and seemed pleased. He asked me if I was icing and I told him yes. He pointed out the bruising and I kidded with him about being too rough with me while I was under. I pretty much had just a few questions for him.

1. Weight bearing - I've been on "toe touch" only non-weight bearing status because of a micro fracture in my femoral condyle; can I walk on my right leg now without the crutches? Answer: No. But I'm allowed to release the brace now so my knee will bend when I "toe touch" walk with the crutches. I've tried this method now that I'm home and can't really say I get anywhere faster but then again my toe isn't used to being on the ground unless I'm standing still nor has my knee been bending with a walking motion.

2. The brace and PT - Part of the brace issue was answered with question 1 but also should I wear the brace when doing the PT exercises? Answer - It's not necessary.

3. What about the other knee - I'm not sure if I've mentioned this, but I tore the meniscus in my left knee for the 3rd time in April. Oops. I thought I might just wait it out and see how it does, but for one I know it will only get worse over time, I hate to take more time off work in say a year or two if I can avoid it and lastly it's been screaming something awful at me for several days now that I rely entirely on it (and the crutches) to get me around. So I asked him how long I should wait before having it done. Answer - At least 6 weeks otherwise the ACL reconstructed leg will have to compensate for the meniscus leg. I was thinking I'd maybe have it scoped again in mid November, which should be ample time for the ACL leg to gain some good muscle strength and enough time that I will recover from both about the same time. It might take a little longer, but less time cumulatively if I did them at separate times.

I told him about making a big bloody mess out of the one suture and he decided that I should come back next week and have the sutures removed then since they didn't look ready yet.

I slept well last night with my legs on the elevation thingy I made. I did wake up a couple times to some pretty severe pain; some in the knee but mostly in my heel. I guess I need to put something down on the floor when sitting with my heel down for long periods of time. I had pain when I got up which located at two points: the upper outer part of the knee and lower inner part of the knee which isn't too surprising since that's where the tunnel was drilled through to thread in the new ACL.

I have to say that the swelling looks a little bit better today, which is kind of a surprise since I actually have more pain than I did yesterday. Go figure. There's no monumental change though so I'll skip the picture. :)

1st Day of Physical Therapy - Day 8

I had my first physical therapy appointment today. I used my handicap parking mirror hanger and parked 2 car spots from the front door which was totally cool since I have enough trouble getting in and out of the car as it is. Behind the front desk was a very large black woman that gave me the necessary paperwork to fill out. I have to laugh at these things because they ask questions "Like what are the top 3 things that you would like to achieve through your physical therapy sessions?" and "What functions are you having difficulties with?" Hmm well, let's see... I have difficulties with everything and I would like to be normal again. What stupid questions are those for someone who just had ACL surgery? Yeah, I know I'm being a little cynical; I'm feeling moody today. My phone number was hijacked and there were 7 additional phones put on my account and my phone number was changed without my knowledge and that just sucks!

The swelling is about the same, the bruising is spreading down my shin, and there's a strange lumpy bumpy thing on my shin that the physical therapist, Drew, says is probably just inflammation.

Like I said, I had PT for the first time today and Drew is my therapist. He seems quite knowledgeable which is more than I can say for the woman at the front desk. He took the usual comparison measurements between my right knee and my left and measured the amount of flexion by having me slide my heel towards my butt causing my knee to bend. It didn't seem like it was very far to me, but he said it was good.

Drew hooked me up to a stims machine. Stims is a machine that sends electrical stimulation into pads strategically placed to shock the muscles to contract. There were a series of 15 10-second shock seconds during which I was to contract my quads as hard as I could. It actually hurt more on the hamstring outer tendon. I survived and Drew gave me sheet with 6 exercises I'm to do at home. He also helped me get the brace on better and showed me how I should wrap the ace bandage I'm wearing under it. He wrapped it much tighter than how I was wrapping.

Tomorrow I have my post-op follow up visit with Dr Anderson.

Day 7

Yes that's right, I didn't post anything yesterday on Day 6. I had stayed up way too late the night before then slept in a bit. I had been working on a beer can holder (knitted) with a neck strap so I could "stand" around and socialize with my friends during the run and still hold my beer. Yep, that's right, this is a drinking club with a running problem otherwise known as hashing. Being my first day away from home since the surgery I had a lot to do. Plus I stumbled around the kitchen and made some brownies. At any rate, I did not take any photos on Day 6, but honestly there was nothing different between day 6 and day 5!

With that said...

Day 7: I survived the outing ok yesterday and never really felt like I was swelling, but the beer and camaraderie may have helped. Today will end the first week post-op and tomorrow I begin physical therapy so I'm sure I'll have something to say about that! The most I've bent my knee is 30 degrees in the brace and I've been extremely careful moving my leg when it's not in the brace. I know that the PT person knows what they're doing, but I'm still a little leery of de-braced movement.

Sooooo, let's see what it looks like today. Oh, that's pretty.

Well, you can see the bruising is spreading. In the picture of both legs I'm trying to tighten my quads. Yikes, even my good leg has lost muscle tone. Ok, so yes, I realize that the surgery knee doesn't appear to have a quad muscle at all. Later today I realized that my calf muscle is like Jello! Oh my!

Day 5

Ok, so today I have to be a little bit better to myself since yesterday I sat up way too much and didn't ice nearly enough. It's not like I was in complete pain, but I wasn't comfortable either. I blame my bad patient misbehavior on the new brace which allowed me to sit upright for longer periods of time than the first one. At any rate, I will be better today :)I'm getting around much better on the crutches, but still wish they were gone. My arms are sore from the crutches and from dragging myself up and down the stairs on my butt. My post op follow up appointment with Dr Anderson is Wednesday so we'll see what he says about bearing weight then. I'll probably still use the crutches some for longer distances, but it sure would be nice not to have to grab them just to walk around the coffee table to turn on the ice machine.

Almost the first thing I did today was ice... see, I'm already a better patient! Here's what it looks like today. Not much change, huh. Ok, so there's some interesting purple color developing, but the swelling looks the same... oh wait that's right... I didn't ice and elevate much yesterday!

Day 4

Here's the new brace... cool!

Yes, that's right, I slept pretty much all night last night... much to my joy! Other than the mechanical difficulties of getting around I feel pretty good. Before I slept last night I turned off the pain pump to conserve it until today in case I need it. I started off my day with the idea that I would make coffee and sit on the lower deck and knit and watch the birds eat from the feeder. I'm also hoping that this first dose of coffee (albeit decaf) will umm loosen things up so I can have a "productive" morning. Marrian, Dr A's assistant warned me that the Oxy causes constipation, but um I haven't had a #2 since Monday afternoon!

There's nothing in the bird feeder so I'll have to fill it. First I tackled making coffee, which went pretty well. I put the coffee in a travel mug and set it into a coffee mug (I hate drinking out of travel mugs) then put it into a plastic bag and tied the top so I could carry it on my crutch handle. Filling the bird feeder was a little more daring since I had to exit the house; something that I had not done since entering post op on Tuesday. The filling of the feeder went very well and I only have maybe a teaspoon of feed now in my brace and in my morphine pack which I'm still toting around in case I need it. Finally I feel the need to "go". Thank goodness!

I sat outside and knitted for a little while, but this dang straight-leg brace really causes pain when you try to sit upright. The Lyttle guy is supposed to be coming at 11am to bring me the quick release bendable brace which I'm sure will be extremely helpful. I'm contemplating pulling out the morphine pump line since I'm not feeling any real pain and I hardly think a little discomfort is worth having the device strapped to me for "just in case". Maybe I'll wait until after I ice and it gets wiggle around a little without the brace on and then I'll decide for sure. Ok, I admit it.... I'm a little nervous about pulling the IV thing out of me.

9am - I suppose I should ice and see how the knee looks.

Doesn't look TOO bad. There's some nice bruising developing near the portal
by the band-aid. Is there still a knee cap in there?

11am - the Lyttle guy comes to deliver the new brace. Now this is more like it! It is SO much better. First off there's a quick click -in dial on the side to which you can set to maximum flexion (bend) and extension then there are quick releases on each side so that you can either move freely within the specifications of the flexion and extension or you can lock it in at a specific point within the allowed range. The other one has a dial which does nothing! Secondly, the straps have Velcro and buckles so every time you take it off you're not ripping Velcro apart and there's no tangled up Velcro mess! Just 6 quick buckle snaps and you're on your way! I feel like such an injured geek right now!

After the brace guy left I decided it was time to remove the pump. I'd been up and down and around all morning and I wasn't feeling any significant pain. I still had 50ml left, but what the heck I don't feel like I need it anymore. Getting the tape off was the hardest since I've never been a fan of home bikini waxing. I put a little "all natural" adhesive remover on it first then carefully and painfully peeled it off. It's not like I could see any hairs, but this is a very delicate area! Once I got the pad off I pulled out the IV. I really couldn't feel it, but it started freaking me out a bit because it just kept coming and coming. So maybe I exaggerate a little bit but it was a good 3" into the vein. Here's a pic of the tubing I pulled out.

With my new brace I was able to sit comfortably outside and watch the goofy squirrel and the birds while I knit. I have the brace set to 20 degrees, which is a far cry from "bent" but believe me just that little bit takes a tremendous amount of pressure off my knee.

Dave left to go run the Crim with some friends so I'm on my own for tonight and tomorrow afternoon. I'm sure I'll be ok. I might try to drive myself to the Secretary of State office and get that handicapped parking permit. I'm having my first beer since the surgery... yum.

Day 3

It's been a pretty uneventful day with the exception of dozing off and waking up to rain actually hitting me from an open window 8' away. Dave wasn't home so I had to deal with that. Most of the rain came in upstairs through the upper rear deck door and of course my office. I slid on my crutches on the wet floor in my office trying to get to the window to close it. Fortunately I don't believe I hurt anything, but it did startle me and upset me. I got all the water mopped up which is very difficult to do on crutches with one straight leg let me tell you.

I called the people that are supposed to be supplying me with a quick release brace and they should be calling me to set up an appointment. Something went wrong from the get go because I should have had it when I left the hospital. This brace I have now does not bend and that really sucks because it puts too much pressure on the knee when trying to sit up.

I have not taken any oral pain medication, but still have the morphine pump running. Right now I have 90ml left. I did take two doses of the Naproxen 500 which is an anti-inflammatory.

Other than the rain mess it's been another day of lounging in front of the TV icing and dozing off. At 10pm I went to bed. This was the first night I took my brace off to sleep since previously had to use the bathroom so much and it took so long to get the brace on that I didn't want to have any incidents of waking up in the middle of the night unable to go immediately downstairs to use the bathroom. It felt good to have the brace off while I propped my legs up on the elevation platform. I woke up once at like 2am to go then slept the rest of the night until 6:45am... my first good rest since the surgery.

Hours 24 - 48

• 25 hours - I got up from a 2-hour nap and can say that the nerve block has definitely worn off. I had quite a bit of pain when I got out of bed so I upped my morphine pump drip for the next 30 minutes. If the pain continues like this I'll take a Vicoden since the Oxycontin doesn't seem to be making a difference. First I need to eat something so off to the kitchen for some oatmeal.
  
• 31 hours - The pain is pretty consistent now despite the morphine drip and the Oxycontin. It's a throbbing pain. Over the last couple hours I've had a twitch in the quadriceps muscle on the outside of my knee it doesn't last long. It's hard to tell if there is new bleeding or if it's old blood that's being re-wetted from the icing. The spot is much larger than when I left the hospital, but certainly isn't gushing.
  
• 34 hours - The pain has leveled off and isn't as bad as earlier. I'm taking an Oxy and turning the morphine drip off for a while
  
• 36 hours - My brother calls and wakes me up. I'd been asleep for an hour. I feel very loopy; way loopier than yesterday when I took the Oxy. I turn the pump back on and talk for about 1.5 hours. It's funny though, I feel like I can doze off, but that I can't sleep very long.
  
• 41 hours - It's 3am and I'm awake again. The morphine pump is still on. I so want to take the dressing off since it's starting to bother me. I went downstairs and collected the supplies to remove the dressing, but decide to wait a little longer
  
• 46 hours - Ok that's long enough plus I need a shower! I removed the blood caked ace and gauze. The incision points look like they normally do except that this time I have 3 rather than 2 as with the meniscus surgery. Showering wasn't as hard as I thought it would be. I sat on the edge of the tub and lowered my injured leg into the tub, removed the brace and turned on the water on the tub only. With the tub water running I shaved my legs... ahhh. Then stood up, hung my morphine pump outside the shower, pulled the curtain and turned the knob from tub to shower. It was a little awkward, but over the past 48 hours I've gotten good at balancing on one leg. To get out I just reversed the process. I feel much better! I had one incision that keeps bleeding a tad so I applied a Band-Aid and some gauze over it then rewrapped my leg with a clean ace bandage.

    

How I feel - First 24 hours

Since I got of surgery at 10am I'll count from there:

• 3.25 hours (1:15pm) - I'm home. My right leg is dead and when I touch my foot it just feels like a slab of warm meat. I cannot even wiggle my toes. It's difficult to raise my leg forward when using the crutches without dragging my toes; this is something I've tried to avoid since my toes will kind of stick then I lose my balance a little bit. I can't straighten my ankle; it turns inward. Like I said.... dead meat! I cannot feel my lower butt on the surgery side and the top of my thigh is numb all the way over to my hoo-ha. This is all because of the nerve block.
• 5 hours (3:00pm) - I finally get the energy to address the whole icing thing. I can't feel my leg and it flopped over like a dead fish when I moved it onto the icing pad; this was rather freaky. I can't feel the ice but I leave the ice machine running for about an hour. Of course I have to pee near the end of the icing and haven't put the brace back on before. I realize that I shouldn't have detached the Velcroed on foam from the metal bracing and it takes me way too long to get the thing put back together. Once I finally untangled all the Velcro straps I couldn't tell how tight to pull them since I couldn't feel my leg. Being pre-bucket I had to get down the stairs and to the bathroom without pissing myself. This was also pre-2-crutches time so I had to take the crutches down the stairs with me. By the time I made it back up the stairs with crutches in tote, I discovered that there was quite a bit of blood coming through the gauze and ace. I watched it for a while and after 10 minutes it hadn't spread all that much so I wasn't too concerned but am keeping my eye on it. I have not removed the sterile bandages and am not supposed to until Thursday.

This is the IV hook up to my pelvic area. That tape is gonna hurt coming off! I'll be using some goo-gone or something.

This is the pump that delivers the medication

This is the brace. There's another hinge dial on the other side

Oops, this is a bloody mess after that first emergency pee!

This is the cooling and compressing machine

This is the cooling machine wrapped around

• 9 hours - I take an Oxycontin
• 9.5 - I can just barely move my toes back and forth
• 10.5 hours - I can feel my right buttock
• 11 hours- I'm fading in and out of loopiness feeling
• 13 hours - I can move my toes back and forth a little more and am regaining some feeling.I go to bed
• 15.75 hours - I had to pee, I'm glad I slept with the brace on or I'd have never made it! I can now turn my ankle and am pretty much feeling all of my foot now.
• 19 hours- There's mild pain in the knee area; I can totally feel my thigh and buttock. I guess the blocker has worn off.
• 20 hours - pretty much feeling a lot now. Haven't been elevating though since I've been on the computer. Going to get in the icer :O
• 23 hours - Feeling sleepy; going to lie down in bed

ACL Surgery - The Hospital, the drugs

I report to the hospital for my 6:30am appointment. My surgery is scheduled for 8:30 and should last 1 1/2 hours. I sign in and verify that the right claim number is being used for this case by the anesthesia department. In about 10 minutes I as called and we went into the "blocking" room. There I undressed and redressed into my gown with the back open; my vitals were checked and I was asked some routine questions. I like looking at the heart rate monitor and seeing what my HR is under variable circumstances. Mainly my HR stays between 41 and 46 but will spike with laughter or concern. An IV was started with saline and an antibiotic. Dave came back for a short visit then was excused while the "blocking" team went to work and explained the procedure. First a sedative was shot into the IV. I was asked to roll on my side while one of the anesthesiologists arranged my legs properly for the ultrasound guided shot to a nerve on my right hip/butt. The last thing I remember though is the alcohol being rubbed where the shot was to go.

I wake up at about 11am in a post-op room wear a large non-bending brace with a lot of Velcro straps. They said I was pretty groggy. Once it became apparent that I was ok and awake I was taken to a recovery room which is more conducive for visitors. I was thirsty as all heck so the nurse got me some apple juice which I sucked down pretty quickly so she brought me a double next time. Dave came back after a bit and we talked about the procedure and what Dr Anderson had to say.

Dr Anderson said everything went very well. He did not do the double bundle and I'm sure he good reason not to. The meniscus was indeed torn so that was shaved. And the femoral condyle problem turned out to be a fracture not a tear so now I'm not supposed to bear weight on that leg for about a week. A week seems soon to me for a fracture to heal, but who am I to argue.

At about 12:45 outfitted with a pair of crutches, a straight leg brace and a morphine pump attached to my pelvis. My first challenge? Getting into the car with the straight leg. I totally could not feel my right leg at and when I touched my toes they felt like a slab of meat. I wasn't quite in the car and I told Dave not to shut the door yet because my toes were stuck between the rocker panel and the door as I tried to maneuver my dead straight leg into the car. If he had shut the door on them and cut them off I wouldn't have even felt it!

Off to home where the Lyttle guy was waiting for us with the cooling machine. Poor guy, this was my first attempt at stairs in this condition so it took forever to get in the house! The cooling machine is totally cool and I'm sure once I'm able to remove the dressing I will thoroughly enjoy it since I won't have to deal with dripping ice packs. The morphine drip allows me to up the dosage every 30 minutes and has a total capacity of 400ml; it is suppose to last for 2 days. I also left with a prescription for Oxycontin, vicoden and naproxyn with instructions on how to use each.

After the Lyttle guy left, Dave went to get the drugs filled. Filling the Oxycontin proved to be quite a challenge. The pharmacy we normally go to doesn't carry it because they don't want to encourage break-ins (I do live in Detroit). The second one said it would take 2 days to fill; Dave told them I just got out of surgery and the first two days is when I need it. Between that kind of junk and then being told that my workers' comp prescription card was not authorized for it really had Dave teed off. Better him than me trying to drive myself dragging my dead leg!

Getting Around - Things to make Life easier

First off you need to have prepared the area you will be spending most of your time relaxing. Most likely this is in front of the TV. Figure out how to elevate comfortable with a straight leg. Gather other entertainment supplies. Make sure there is ample room around your "nesting" place. Ok those things are obvious. Here a few tips and suggestions for making your life easier that I've discovered.

I'm live in a 2-story house with the kitchen and bath on the first floor (upstairs one is being remodeled). My bedroom, TV room and my office are on the second floor. I'm required to wear a straight leg brace for 4 weeks and cannot bear weight for 1 week. There are 16 steps. Yes, I have challenges.

• Ice Packs - If you don't have freezer gel packs or didn't get a cooling machine, you can make your own ice pack. Take a gallon size Ziploc bag (I like to use 2; one inside the other to prevent leaks) and add 1/2 rubbing alcohol and 1/2 water. Don't fill it too much because you want it to be pliable. Stick it in the freezer. The alcohol will prevent the water from freezing and you will have a nice slushy pack. Add water/alcohol to get the right consistency. I've heard a bad of frozen peas works well, but I've never tried that.
• Ask your surgeon/assistant for handicapped paperwork
• If you have wood floors, remove all slippery area rugs and make sure you wear the sock you got for your other foot during surgery or something with a non-slip bottom.
• STAIRS - Butt slide down and backward butt slide up. You put yourself at great risk of falling if you try to crutch the stairs.
• Having an extra set of crutches is a plus that way when you get to the end of the stairs there are crutches and you didn't have to drag them with you! Maybe borrow a pair.
• Put a milk crate or other low object at the top of the stairs. It's a b*tch standing after doing the backward butt slide up. A milk crate is a good height for getting your butt up on to. Watch for slippery floors though!
• When you take your brace off for the first time, pay attention to it's placement. If it's like mine with a foam wrap that the metal framing Velcros to, do yourself a favor and do not remove the frame from the foam! Also when you take it off it's best to stick each strap to itself rather than let them dangle and get all stuck to each other which is very frustrating. If you have the option of getting a brace with the quick release for flexion and extension... DO IT as this is well worth a couple extra bucks especially if you'll be living in it for 4 weeks like me.
• Have a cooler within arms reach for the first 2 days with water and other beverages (I'd recommend staying away from the beer for a few days until you're clean of anesthesia, Oxycontin and Vicoden!) Not the I would have ever had a beer the night after surgery or anything! ;-o
• Have some sort of tote bag/backpack nearby for moving things since you basically have not hands since they are on the crutches if you eat on the second floor you might want to find a handled bag big enough to hold a plate or bowl in. Seal or Saran wrap securely and drag up the stairs with you (another good reason to have more than 1 set of crutches). Eventually you're going to have to go buy beer bread.
• I know this is gross, but have piss bucket nearby in case you really have to go and there's no way you can get that brace on and make it down the stairs in time. Sometimes the drugs and anesthesia will make you ill too so it's a good idea to have a bucket nearby anyway. The day of the surgery you will probably have to go a lot since you're tongue will feel it has paste on it. Gals, don't forget the TP and rags for any misses. Fortunately I've made it down every time, so this is just a security blanket for me.
• Put your weight on your palms not your armpits when using the crutches otherwise your armpits will be screaming after a few days. You did read the recommendation for having a milk crate at the top of the stairs didn't you? Oh that one is a life saver!
• Keep some hard candy nearby for your pasty tongue because if you only drink tons of water you'll have to go to the bathroom tons of times.
• To remove the yellow iodine gluey stuff after taking off the ace and gauze saturate a towel with alcohol and wipe.
• Don't be ashamed to ride the electric carts; they can hold your crutches for you at the entrance
• A clean Ace to rewrap and maybe a band aid after you remove the original ace and gauze.

Preparing for Post Op Leg Elevation

I'm a creator, by nature, so I tend to make a lot of stuff. Since I've already been through knee surgery three times... YES THREE! I've learned a lot. And one of the most important things they tell you to do is to elevate; they just don't give you any advise as to how to elevate. No I'm not a retard and realize that pillows are nice and soft and elevate; however, until you've tried really doing it when you can't get around well you quickly learn that this is not such an easy task. For one thing, pillows weren't meant to be stacked and they sort of roll off each other especially if you are really elevating with your knee above your heart as it's suppose to be. In addition to the pillows rolling off on their own before you can get your leg hoisted and comfortably planted, while your laying there relaxing any sudden movement can cause your leg to cause those stacked pillows to roll away again. Pain in the butt! This is the most annoying thing ever so I decided I'd build something that would really give me elevation and be comfortable. Sooooo....

This is my latest "handy work"! This dandy was made from scrap materials around the house and will hopefully give me comfort while I sleep while elevating my leg after knee surgery tomorrow. The rise is 28 degrees or 15". It consists of a piece of plywood covered by 2 layers of egg carton padding and two layers of material. Sure one layer of material might have been enough, but I wanted to make sure it breathed ok plus the red stuff is a knit and stretches. The material is folded under at the corners and stapled in place on the underside. The legs are glued and screwed with a quick layer of hand rubbed polyurethane (mostly to prevent splinters and damage to the bed/sheets. As an afterthought, I decided that I didn't like the way the legs poked the bed so I added the flat platform that they sit on; again I stapled the fabric and screwed the legs to the platform. The blue flower-print box that looks like a brick is a floral foam brick and it pinned to the elevation platform. The brick is suppose to keep my right foot from falling outward while sleeping which will put pressure on the knee and thus wake sleeping beauty up. I did say I pinned it because I'm not sure how well it will perform. At any rate, I'm sure this will be way better than trying to stuff pillows under the knee and having my leg roll off it. Ya know I could probably make some money off this design!

The Facts before Surgery

On June 2, 2009 I hurt my knee. I was stepping on a ledge and sort of slipped/fell backwards while trying to catch myself from falling. I felt a massive pop on the way down and another on the way up. It hurt like mad for about 3 minutes then was just sore. Then I fell... twice! Yup, without notice or anything; one second I was stepping the next second I was on the ground. This is not good. My knee swelled up to the point that the knee cap was unidentifiable and it would bulge on the top inside and the lower outside of my knee when I bent it. I had full range of motion.

Since I did this on the job it is workers' comp so that means I had to see the clinic doctor. He's a nice guy, but an idiot. I didn't see this doc until June 5 after doing a desk job and the swelling still wasn't gone. I was diagnosed with a "sprain of an unspecified site of knee and leg". Sooo, in other words he didn't know or just didn't want to say in case I decided I felt fine and it never slipped again and therefore it could assumed that I did this at some other time in my life and not at work; yup, I know how it works. After treating for the required 10 days with the clinic doc, who remained "clueless" as to why my knee was instable, I was able to go see my own doc. I went back to see Dr Anderson on June 22 because he is now "my ortho guy" since I've had my elbow and 3 knee incidents treated with him.

Dr. Anderson grabbed my knee and did one of those push pull tests while manipulating my leg just so and I immediately felt some wonkiness. "What did you do? You tore your ACL!" he proclaimed. Oh that's not good! He sent me for an MRI.

The MRI Impression: "A normal anterior cruciate ligament is not identified and appears to be chronically torn. There is a chronic tear of the posterior horn of the medial meniscus which may have been partially resected and there is a small tear in the articular cartilage of the posterior medial femoral condyle. There is a moderate size joint effusion.

Meaning of the Impression: The ACL is completely torn. I tore my meniscus again. And I tore some cartilage covering the knobby part of my lower femur. The ACL is a ligament inside the knee. The meniscus is sandwiched between the joints of your knee. Joint effusion is swelling within the knee. Condyle is the knobby protrusions at the ends of bones.

Injury - June 2, 2009
Clinic - June 5
Clinic - June 8
Clinic - June 11
Dr. Anderson June 22
MRI - July 7
Revisit Dr Anderson for MRI results - July 15
Schedule surgery - August 18
Physical Therapy to begin August 25
Post-Op follow up to be August 26

Surgery Plans: Dr Anderson will drill a hole through where my ACL was and thread in a new ligament. He'll do a partial meniscopy (again) to the torn meniscus. And I totally forgot to ask him about the torn condyle thingy but he'll address it when he's in there.

Ligament Options: There are several options on where this ligament comes from. First off there's an autograft which involves the medical grafting of bone or tissue from the patient's body then there's an allograft where the use of bone or tissue from a donor's (typically a cadaver's) body. I'm having a gracilis allograft. Here's some more specific information on the types of grafts.

Patellar Tendon Graft - The patellar tendon connects the patella (kneecap) to the tibia (shin). The graft is taken from the injured knee. The middle third of the tendon is used, with bone fragments removed on each end. The graft is then threaded through holes drilled in the tibia and femur, and finally screwed into place. The disadvantages of using this graft include: 1. Increased wound pain. 2. Increased scar formation as compared to a hamstring tendon operation. 3. Risk of fracturing the patella during harvesting of the graft. 4. Increased risk of tendinitis. 5. Increased levels of pain with activities that require kneeling years after post op.

Hamstring autografts are made with the semitendinosus tendon either alone, or accompanied by the gracilis tendon for a stronger graft then threaded through the heads of tibia and femur and its ends fixated with screws on the opposite sides of the two bones. A brace is often used to immobilize the knee for one to two weeks to help eliminate motion to the hamstring tendon's fixation to the bone in the post-operative phase. Evidence suggests that the hamstring tendon graft does just as well, or nearly as well, as the patellar tendon graft in the long-term.
The main surgical wound is over the upper proximal tibia, avoiding the typical pain sensation when one kneels down. The wound is typically smaller than the patellar tendon graft and hence less pain after the operation. There seems to be some controversy as to how well hamstring tendon regenerates after the harvesting. Most studies suggest that the tendon can be regenerated at least partially, while still being inferior in strength to the original tendon.

I chose the allograft because 1) I don't need any more problems as associated with patellar tendon graft. 2) That hamstring was torn a few years ago and needs all the ligaments possible. 3) It's less invasive which means quicker recovery 4) After 3 months the recovery playing field for all grafts mentioned are equal 4) Dr Anderson recommended it and how can I argue with a superb surgeon and a past patient of this procedure himself.