Week 17 - Wish I had better News

Therapy has been going well in some respects and not so well in others. Since therapy is a roller coaster of ups and downs I'm hoping I'm just on a low spot. I started doing 1/2 squats on December 3 and 18" step ups to try to simulate the first step of the truck which is close but still not the 22" that is necessary to step up. I can't even imagine stepping down from that height... Yikes!

I'm not sure if I mentioned the horrible pop that I have going on too. It's next to the inner top part of the knee cap and is an awful feeling. It's like my knee gets tight inside especially when making a forward motion (sometimes sideways too) and I feel like I can't walk right unless it pops; which hurts of course. It's also audible and kind of has a slap type sound.

I saw Dr Anderson yesterday and tried to explain it to him. He keeps saying it's scar tissue. I keep telling him I don't think so. My PT has fortunately witnessed this several times now and has made comments about it in my file. Anyway, Dr Anderson said it could be that the micro-fracture is not doing what it's suppose to which is "fill in". The micro fracture is on the end of the femur bone which is where the pain and popping are coming from. I now have a script for another MRI to make sure everything is ok.

Now the bad part. I've mentioned that I was to have the other knee scoped for a meniscus tear on Dec 1. Well that didn't happen. I got a letter from the worker's comp people sending me for an IME (Independent Medical Evaluation) for a "second opinion" on whether or not the meniscus is torn, whether or not surgery is the best option, and to evaluate my right knee. Now common sense would tell anyone that sees me on a daily basis and knows what I'm going through with PT that there is no way I could possibly do my regular job in the condition I'm in now. BUT, the IME (being on the worker's comp payroll) has the final say in what my treatment should be if any. So this guy technically can say he thinks I'm able to do my job based on X,Y, and Z. It's so frustrating!

So now I'm waiting for the report to come in from the IME on Dec 10. I really have no idea what it will say. I did give him a 8 page report of sorts on how my PT is going and what my pain is like, but it was more on the left knee than the right since I didn't find out that he was examining my right knee until the day before. The report should arrive soon. It will probably come tomorrow since that's my birthday; just to add salt to my wounds.

In the meantime, Dr Anderson says no PT until he gets the MRI. Worker's comp probably will have a cow about authorizing the MRI. Although I really could use a break from PT for the benefit of both knees. Since I've been hobbling up and down the stairs for over a week now.

Yes, this sucks. If you are about to go through this yourself and are reading; I highly doubt you'll be dealing with the same popping and probably will have at least one working knee at the time.

I'll post again when I have the IME report.

14 Weeks - Still No Endurance

It's been 14 weeks now since the ACL reconstruction and while I am doing much better, I've discovered that I'm still lacking two things. 1. the strength and lack of pain to lift from a squatting position (I need this for my job) 2. I don't have endurance to walk for long periods of time without causing major soreness the next day. It seems that when I am walking it doesn't bother me, unless I'm mixing in running like at PT, then even walking is a bit uncomfortable. There is one part of my job that I haven't even come close to trying and that is stepping up and down from an 18-21" step, but I gotta imagine that would be extremely uncomfortable.

On Tuesday of next week I get to start it all over again with having the left knee scoped; I'm not even thinking about it really except that I'm trying to get a bunch of stuff done before to get ready for Christmas since I will be messed up again.... the story of my life for the past 2 years.

13 Weeks - I'm getting stronger

So its' been more than 3 months now. I'm feel like I'm feeling stronger. But I also feel like I lack endurance. Meaning? It's like I can do the exercises, but depending on which order I do them I feel like my legs/knee are fatigued and I then can't do the exercises. For instance if I do single-leg leg presses at the beginning of the PT session I can do them without much difficulty now at 90#, but if I do them after doing side steps with the rubber band, step downs, 30-second quick steps, and the like and attempt the leg presses near the end of the session there is a very noticeable difference in my ability to perform the single-leg leg presses to the point where my leg is actually quivering while extending. I'm sure it will come in time, but that's what I'm noticing the most right now.

So last time I wrote that I was running on the treadmill for two 1-minute sets with walking between. This week I started with a 2 minute quick walk (3.0 mph) then running. Last week I was running at a 5.2 mph pace and it was quite painful. So this week I decided to ramp up the speed and let my natural running style take over. Oh this was much better. Better than the walking for most of the 2 minutes even. My theory and the truth is that when I run my legs reach out more and and when I plod I bounce up and down which puts more pressure on my knee(s). So yes, I'm saying that running at a 6.3 mph pace is more comfortable than a 5.2 mph pace. For now I'm doing a 2 minute intervals of walking and running for 10 minutes or 3 times I walk and alternate with 2 times of running.

We started some new "fun" games today. One is stand with the bad leg on the carpet and the good leg on a slippery piece of fabric on like a waxed plastic board. Now slide the good leg back and the bad leg bends then slide back up to a standing position; I'm not very graceful with these.

Yesterday I started wall squats. Anna asked me how far I could squat. I didn't know because I hadn't done it yet. Then she wanted to know about squatting with work. I proceeded to demonstrate the 8 keys to l*fating and l*wearing (* would be my paranoia... fill in with i's). I actually did sort of squat during my demonstration with a wooden stand that I used as a package, but I cheated and had my right leg turned way out from the hip to avoid actually squatting down. I think she got the picture when I basically put my left heel on my butt to lift the box up with "smooth steady mot*n. Oh so anyway, yes, I started doing wall squats. With a big ball behind me and against the wall you lean on the ball with your lower back and move your feet out away from the wall then roll down the wall on the ball which of course makes you bend your knees while partially load bearing; this was a definitely a stinger and I was quite sore from it on Monday.

Today was one of those better feeling days doing the exercises. Unfortunately just when you start feeling like you can do it, you get new exercises that knock that feeling right out. But I am definitely getting stronger!

12 Weeks

So it's been 12 weeks now since the surgery. If I were a normal person I would be back to work, but I'm not. Dr. Anderson doesn't quite understand why work wouldn't bring me back in a different job while I heal. I reassured him that they don't want me back until I'm 100% and when I mean 100% I mean that they will want 110%. Since he's a football doctor too, I told him it would be like sending one of the Lions back in the game full speed ahead like nothing had ever happened. No easing in slowly... just BAM you're back and expected to perform the same as you did prior to the injury. Hopefully he understands this before sending me back!

PT is still challenging and since I've now been running on the treadmill for two 1-minute intervals I've been very sore. The only new thing that's been changed is now my "step ups" are on a step about 4" higher than the first "normal" step that I was doing; this happened after I had the "you do know what I do for a living" talk with Anna and told her how high the first step is into the truck.

My daily life is one piddling thing after another. Although I have been working on starting up an etsy shop online to sell my crap crafts.  I raked the leaves today for about 20 minutes, but that's about all I could do. Ok so I could have done more, but I really don't like pain. I've been going to the Y a few times a week to swim and do some upper body weight lifting which makes me feel better than I can do an activity without causing pain.

If you've read this from the beginning I'm sure I mentioned that I tore the meniscus in my left knee back in April after a slip and fall in the snow while delivering to a residential house. Well, I scheduled to have it scoped Dec 1. I feel that it's best to have it done now rather than wait. Most of the time it doesn't bother me, but then again I'm not doing very much. I fear that with winter sneaking up that the slipping and sliding in the snow will cause it to flare and believe me that is nearly an unbearable pain.

9 weeks

It's been a little over 9 weeks now since my ACL reconstruction. I feel like my recovery is going great, but I also have guarded feelings on "testing" it.
PT is PT. There's not much to say about it other than I was supposed to jog on the treadmill for 1 minute this week. At any rate, my PT person, Anna, decided to wait a week before starting the jogging... oops. She did start me on some side skipping things where I pick up a cone and do like a hopping side stepping thing and drop the cone onto a pile of cones 10' apart. Monday was the first day I did this and I was very hesitant! Wednesday I was I a little more relaxed with it.

I'm on the elliptical for 10 minutes each PT session as my warm up and end with a 10 minute walk on the treadmill. Most of the middle exercises are the same as I've been doing for a while now.

I do have to have the "you do know what I do for a living" discussion with Anna so that she understands what physical demands are required of me before returning. I also unfortunately have to schedule the meniscopy of the left knee too which I've been putting off. (sigh) On the positive side the extra time it will take to recover from the other knee being scoped will be built in time for my right knee to recover even more!

My next ortho appointment is on Nov 4.

7 Weeks and some

I feel like I've made big progress since my last blog entry. Obviously I'm no longer using the brace or the crutches. I've been swimming a couple of times. The first time aggravated my knee a little bit, but not so much after that. PT is going well now that I've switched therapists. Anna keeps an eye on me pretty much the whole time even if she's not right next to me. Yesterday I walked 10 minutes on the treadmill and for the first time I didn't hold on at all and my form was pretty good all the way through; the last minute I started favoring my right knee, but not like before!

Yesterday Anna had me try the elliptical. That didn't go so well. I feel pain on the downward stroke when the max of my weight is bearing down. I also still have some difficulty with stairs, but that is getting better too. I do hobble up them quite a bit after a hard session of PT like yesterday. I think the thing that aggravates my knee the most is full forward moving pressure like stairs. We've also been doing this exercise where I stand on a foam mat and dip my right leg and toe touch my left toe to 12:00, 9:00, and 6:00 while bending down slightly with my right knee. That causes pain and I'm thinking might be the culprit for my extreme soreness yesterday. I can't visually see swelling, but I can feel it. The Game Ready icing machine is awesome!

On the positive side I am walking better with minimal limp. Yeah.

5 Weeks and 2 Days - The therapist and Ortho Follow Up

I'm switching physical therapists. On Monday when I had PT I swear my pt guy checked on me once! I'm not saying that I need someone to watch over me the entire time I'm there, but good grief that is ridiculous. It's not as if the place was full in fact there may have been 6 patients there and 3 physical therapists. I was not told what exercises to do, how many reps and sets to do of the ones I took upon myself to do, nor guidance if I was doing them wrong. When I was done doing all the exercises I could remember I'd done on Friday I went over to the Game Ready to ice. I hooked it up but couldn't figure out how to get it to start. Alvin came by and I asked him if he'd start it since "it was a self-serve day". Alvin suggested that if I was aggravated with Drew to switch therapists. Well, I didn't want to piss anyone off; and I do think Drew is knowledgeable.... he's just never around! But at the same time it's my recovery and I don't need any more instances of things happening with unsupervised exercises. Like Monday when I pretty much fell off the treadmill when my leg did this catch/pop thing or when I'm doing that crane walk and a large woman with swaying hips knocks me over as I'm standing on one leg. Anyway, on my way out I stopped at the front desk and told the ladies I'd like to switch. They were very helpful and I'm being transitioned into Alvin's schedule.

Tuesday I saw Anna, one of the assistant therapists. I don't know if they know what went down and why I'm switching, but I'm sure if they did Anna understood what I was talking about by the end of the day. For instance at one point she said I was going to do the leg press next and said "You did 45 pounds yesterday, right?" To which I replied, "Um, no I didn't do those yesterday. I might have done them on Friday, but definitely not yesterday. There was no list of things I was supposed to do and Drew didn't tell me to do them; actually he didn't tell me anything yesterday."

I'm the patient; I chose to go to that facility. I expect at least some guidance from the therapist especially in the early weeks. I feel better having switched; actually I feel sore probably because I did things the right way for the first time since going there.

I saw my orthopedic surgeon today. Actually I saw him on Sunday as I lay on the couch watching Fox 2 News in the morning. One of the newscasters is being featured in Hour Magazine and when she held up the magazine to the camera there was my ortho on the front cover. Cool.

Anyway, it was a brief encounter. He came in and looked at my knee and stated "I'm jealous". He had torn his ACL playing football 20 years ago and the surgery was way different back then plus he's a phenomenal doctor. I had written down some questions to ask him; most of which were to cma with the insurance company. Here's the list:

Q. I've been weaning myself off the brace; when can I ditch it?
A. Now. You don't need it anymore.

Q. What about the "sport" brace I've been told I'll be fitted for?
A. We don't get you into that until about 3 months out.

Q. Can I swim?
A. Yes and bike.

Q. So yes I can bike
A. Yes.

Q. Although it might be a little much now, but can I use the elliptical?
A. That might be a little much, but you can test it.

Q. Can I mow the grass once I start walking better?
A. Yes.

Q. Can I rake the leaves?
A. Unfortunately yes.

Q. So gardening/yard work in general is ok so long as I'm not causing pain?
A. Yes.

Q. Can I shovel the snow?
A. You're getting a little ahead of yourself aren't you. Yes.
(it is Michigan after all)

Q. I watched a youtube video of ACL surgery; do I have screws in there?
A. Yes, but they are naturally soluble.
Q. So I don't have to worry about airports or (knocked on wall) another MRI.
A. Nope, and let's hope you never need another MRI. (no shit)

That pretty much summed it up. It looks pretty good I think; although we both agreed that my quad is pretty pathetic looking. There is some mild swelling and it still feels stiff. I do have this little catch part that I hope will go away once the swelling is really gone. He tested the strength of the acl and seemed satisfied. I see him again on November 4.

4 Weeks - Off the Crutches

Yes, that's right. I'm now officially off the crutches! Thank goodness. Saturday was Dances with Dirt, a foot race, and my husband ran the 50 mile event for which I supported him. My hands were practically bruised the next day from crutching to all the aid stations from my car.

So I had left a message on Friday with Marian, my ortho's assistant about what I should be doing and should not be doing in regards to being off the crutches. While I think my PT has good knowledge he's led me to believe that he's not taking my best interest in recovering from the micro-fracture and I wanted to make sure that if he said "do 10 jumping jacks" that I would be able to do them. Ok, that's an extreme, but you get my point. Marian was helpful as usual in telling me what to expect and basically telling me that while jumping jacks may be a little bit much that I should be getting into some heavy duty therapy now. She said if I'm told to do squats to do them within my "pain limits".

I had already ditched the crutches Monday when I got up knowing that in PT that I would be without them too. So at home I could take it easy and get used to walking on my recovering leg at my pace rather than Drew's. It is very weak and I walked timidly on it.

When I arrived at PT we begun on a whole new plan; the acl recovery plan. First Drew watched me walk, then I went to the recumbent bike where I was instructed to pedal for 10 minutes. I had a hard time getting the first rotation around so I scooted the seat up a bit to give me more leverage. During the 10 minutes I moved the seat back a notch twice so that I was more in the position I should be. It felt rickety, but ok. There was no resistance.

Next I just stretched my calves on a slant board. This required stepping on to a slanted board with both feet and leaning forward 4 times at 30 seconds each. This was fine and it felt good to stretch my calves. I did what I like to call the "crane walk" where you take a step and lift the non-stepping leg up and hold it for a second then step with that leg and hold the other one and repeat down and back across the room which is probably a good 70'. Then I did the stool pull and pushes across the room there and back three times. For this one you sit on a stool with wheels and using your heels pull yourself forward then on the return you push yourself backward. My hamstrings were screaming pretty good on this one. Then I did some calf raises; 3 sets of 15. And lastly I did some "squats" on what is basically a padded board that travels up and down on a track at a 45 degree angle with a platform that you put your feet on. I did 3 sets of 15 on this. This felt ok.

I had gotten a little comfortable with walking around. Oh when I say walking, it's more like a baby-step, grandma look and I'm still wearing the brace for support until my quad gets stronger. Anyway, I was going upstairs and put my bad leg on the step before my good leg and tried stepping up. OH MY, that sent pain shooting up from my knee like mad. A move that I don't want to repeat!

Last night I was sore feeling from the PT and my knee felt a little swollen. I also had that mystery bump off to the right of my shin appear again which is just where some swelling/fluid has pooled; it's just sort of a weird little bulge that normally isn't there. My calves however are very sore, but I was happy to carry a cup of coffee upstairs without having to set it on the steps while I butt slid up.

The swelling is looking good and the knobby portals are starting to settle down. The bruising is now gone. I still have several tender spot that hurt to rub, but I guess that's to be expected. I'm still not sure how long the recovery will be. Obviously it will be longer than the average Joe since I don't sit behind a desk. I should ask Drew next time. Of course these guys don't get it when you say you're a delivery driver; they all think you literally just drive. Oiy. I took some pictures, but they sucked. Honestly there wasn't much to see anyway. No bruising.... no muscle. LOL. I did take a picture of the brace thing just in case anyone wondered what it really looks like. In the photo, I have the brace unlocked since I'm now able to walk on it. It's quite huge isn't it!

3 Weeks!

It's been 3 weeks now since my surgery. I feel like I'm ready to walk on it, but am still on restrictions for "toe touch" only. I've had a few slips where I've had to put my foot down pretty hard, but other than that the most pressure I've put would be about as much as you want to put on the chest of your Lab. I don't have any dogs anymore, but I think you get the picture of the amount of pressure I'm talking about. :)

PT was ok today, Drew only mentioned the non-weight bearing once and at least this time he wasn't going against doctor's orders by wanting me to walk on it. He said something like, "Now we just need to get you weight bearing." I agree that this has got to be an awful set back to my recovery; but it is my recovery, not his and I want to do it right.

I talked with a young guy at PT today that was easily cycling on the bike. He said he had acl surgery just two weeks ago! TWO WEEKS? And he looked liked it had been maybe 6 weeks. Ok, so he didn't have the trio of the acl, meniscus, and fracture and he was probably 20 years younger. Anyway, I was impressed with his moves!

I hardly did anything today at PT; I wonder what was up with that. I did the sit and step for 10 minutes, slid my foot back toward my butt while sitting up, did the leg extensions with the 8" blue roll under it (which didn't hurt this time...yeah), the usual leg raises in 3 directions, and some body planking with my heels on a Swiss ball. The Swiss ball move was the most painful. It didn't hurt so much while I was doing it rather when I released; it was pretty excruciating. Drew looked over at one point over the leg of another patient he was working on and asked me what that face was for. LOL, I was probably grunting too. :)

So as you can see the bruising is nearly gone. I'm still pretty tender below the knee on the outside of my lower leg. I still don't know why it's so sore and why there was a bruise there. My knee definitely looks better as far as swelling goes; it's mostly concentrated above the knee and on the outer side. You can sort of see the lack of muscle in the pics. Yeah, that slope above my knee is where my quad used to be. And lastly, I have to point out the protruding bumps where the incisions were made. They are sore to rub, but not so sore to touch anymore; although hitting them on accident really smarts!

So I'll be toughing it out for another couple weeks on the crutches until I see Dr. Anderson again. I'd rather wait just a few more days and have his blessing before ditching the sticks. They've all been a little wishy washy about how long I should be non-weight bearing. I'm thinking "better safe than sorry". 

Day 18

Again at physical therapy Drew asked about putting weight on my right leg. "This is getting old" I thought in my head. "No, the doctor said 4 weeks. Even you said it takes 6 weeks for a micro-fracture". He left it alone at that. The thing is with the micro-fracture that if I don't let it heal properly, it can lead to arthritis and that's something that I don't need on top of all the problems I already have; I told this to Drew as well. I'm beginning to wonder if the insurance company didn't call him and offer him some incentive for getting be back to work earlier.

Today my knee feels sorer. It could be from the PT, it could be from sitting around at my brother's all day too. I iced a couple times when I got home especially since I could see a little more swelling now than I've been having.

Day 16 - out come the sutures

Today the sutures came out and I got to talk with Stacey, Dr Anderson's assistant. We discussed the puffiness which is mostly located above the knee now. I asked her about the hole on the outer side of my knee above it. I was pretty sure it was from the guide thing that is used to thread the new acl in since it seemed to be in the right alignment and sure enough that's what it was for; Stacey assured me that Dr Anderson wasn't drunk and that was just a slip. LOL.

I asked her about the soreness on below my knee on the outside too. She didn't know why that was sore and bruised. Hmm. Ok.

I asked her about using the crutches for only another week and she said that with micro fractures that they'd like to have the patient on no weight bearing for at least 4 weeks so the fracture scars over. If it doesn't scar over properly it can lead to arthritis. This was enough to convince me that I'll have to hobble along for just a little longer than originally anticipated.

As for the brace, I'm following the instructions correctly. Locked straight when up and about and ok to let it bend when just sitting around. Once the quadriceps get going better the PT people will advise me on opening up the flexion and allowing me to toe touch and walk with it on while using the crutches or even just one crutch. The reason being that they don't want to risk slipping of the acl if the quads don't fire correctly. Ahh, ok. I told her about the PT people wanting me to have it open and walk on it. She asked me if they knew I have a micro-fracture. I told her they did and that I have to remind them of what I can and can't do. I told her that they were pretty aggressive.

My next orthopedic appointment is September 23, which is 5 weeks post op.

Day 15 - Don't *^(@ with me today

I got into it a bit with my PT guy. I was late. Sure it was technically my fault, but he did say see ya Wednesday when I left on Monday; not see ya tomorrow. Needless to say, I didn't check the schedule Monday to see when my next appointment was. I was pissy and he was less than understanding. When I arrived there were no clean tables and I swore Drew saw me. After sitting there for about 5 minutes without anyone saying anything to me or even cleaning a table, I figured I'd go use the sit and step machine for 10 minutes since I did that yesterday. I finished and went back over to the tables which still weren't clean. I asked where Drew was. When he came out he spoke to me like he was scolding a school child, "Why are you two hours late?" Hmm, well. I see. Sure it messed up. They told me to come in anyway at the front desk when I called. They said you were waiting on me, I sat here for a bit, and did the stepper thing; so technically I wasn't 2 hours late! I offered to leave. Did I mention that I'm a little pissy now. It's not easy to "rush" around while on crutches to shower and eat and drive 1/2 hour to PT; plus in my rushing I took a dime size chunk off the enamel on the side of my tub with the brace... I am not happy about this!

Drew made another comment about how he was going to work me hard since I was two hours late. I informed him that it wasn't my intention to be late and that I'll make sure I get my schedule adjusted to fit ME. Ok, I'm venting. I'm annoyed with my situation already and I still have 2 more weeks of dealing with the crutches and brace.

Enough of that.

PT was painful. Anna was helping me today since Drew apparently didn't have the time because he had to leave at 12 even though it was only 10:30 (oh, sorry, I'm doing it again). So Anna wants to strap on a 5lb weight for the leg lifts, "sure, why not, even though I've only done 4lbs so far." She puts the 4lb on. The painful part was doing leg extensions with my knee resting on about an 8" round tube and 5lbs on my ankle. I managed to do maybe 3 and then I kept feeling a sharp pain in the back of my knee. So Anna took the weight off and I extended without it and it still hurt like a SOB. Later she massaged the area and informed me that I will feel different pains in different places at different times. Hmm. Ok. There were two other new exercises introduces today too. One was where I had my calves on a "Swedish Ball" (those big plastic/rubbery balls) and I would extend my hips up so that my body was in a flat line while elevated between my shoulder blades and calves. The other exercise was to stand with a strap behind my knee which was attached to one of those exercise bands. The idea was to allow the band to pull my knee forward then resist against the band and straighten my leg and basically lock my knee straight for a count of 5. Near the end these caused pain too, but around the kneecap. I iced while there then happily left.

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.