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.