I cannot believe it's been SIX MONTHS since the ACL revision. I do realize that I haven't posted in a while and I do apologize to anyone that is sitting on the edge of their chair just waiting for the final chapter (what? that's not happening?).
So September 29, 2010 was my last appointment with my orthopedic surgeon, Dr. Kyle Anderson. I told him that even though after my last follow up he wanted to see me again in 2 months, but I made the appointment for 6 weeks knowing that the insurance company would have a cow if I didn't see him again for that long. About a week after making my appointment and informing the ins. co. I got a call/message stating that my appointment had been moved up as the big brown delivery company wants to try to get me back by Sept 1st. I told Anderson that I could almost squat on it, but really only for a split second. After hearing about the prospect of my returning to work, he lowered his head, crossed his arms and admittedly said, "No, I don't even think you should be squatting on it for two more months... have they seen your record?". Of course I had to giggle just a little bit, because it's a sad but true story of my "history".
I pretty much talked him into writing up a script for work hardening so it at least appears that I am taking bigger steps toward returning rather than continuing to do the same old PT and it would in the least buy me some more recovery time. Work hardening (aka occupational therapy) is kind of like physical therapy but in addition to strengthening with rubber bands and goofy little exercises there is focus on simulating your actual job and it is a program in which you will spend between 2 and 6 hours doing.
So off I went with a script for work hardening in my hand and a follow up card for an appointment I made 4 weeks later. It took about 10 days before workman's' comp called me to inform me that the work hardening had been approved and that would take me up to my next doctor's appointment.
I called Al at the work hardening company and we discussed what was going on. During the conversation he said, you do realize though that you're only going to have 6 visits until your next scheduled orthopedic appointment. Hmm, this is true... this will not do. So I called up my ortho and rescheduled my appointment for 4 weeks after the time that I would start this new therapy. Then I called my case worker for workers' compensation and informed her that since there was such a delay on their part in getting the therapy approved that I had rescheduled my ortho appointment for October 13. I haven't heard a peep from them. Good!
So the work hardening is going well, I'm gaining some more upper body strength and getting acclimated toward working with packages; lifting, lowering, using a dolly, stairs. I have had one set back and that is that the IT that was irritated at the previous PT place is still prevalent and really doesn't like weight bearing lifting. I don't recall if I mentioned that episode where I strained my IT. Basically it occurred because I really needed to do some lifting and lowering with the very realistic possibility that I would be returning to work in just 2 weeks; long story short there was a over use issue combined with an excessive strength test at PT that did it in. It's been 6 weeks since I strained it and it's still acting up. Bummer.
At 6 months, I can now squat fully on the knee and have ran a bit on it. It doesn't react well to extended walking/standing as I can definitely feel some swelling in it the next day after this. I probably shouldn't be traveling 7 miles at a time at this point, but I'm a little thick headed when it comes to common sense and fun.
STAIRS: The wonkiness I felt when going down stairs is pretty much gone; I do feel a bit of it after over doing it (see above paragraph about the 7 miles on foot).
SQUATTING: Yep, I can actually squat on it now without feeling the urge to just fall back on my butt because it hurts so much. I still favor it, but that's to be expected.
SENSITIVITY: This is about the same. It's not too bad, and honestly I really only notice it when shaving my legs.
SWELLING: See 7 mile paragraph above. Really though, it's doing much better in terms of feeling like I over did it. PT doesn't affect it too much. It's kind of funny though watching the assistant get a little scared when I set it to hill workout with a max incline of 12%. LOL. 40 minutes of hard up and down hills does make it feel a bit stiff (aka swollen), but it's not too bad and it doesn't linger. And a lot of lifting and lowing is a bit harsh too.
POPPING/PAIN: the popping has pretty much dissipated and I no longer have a lot of medial pain.
Wednesday, October 6, 2010
Wednesday, August 4, 2010
4 months!!
I think my PT people are just as happy and relieved as I am that I am doing well and on the way to recovery! I'm certainly doing well. I can walk and stand for a lot longer now before I feel bothered with soreness. It doesn't swell, but it does get sore.
Good things:
I had a follow up last week. Dr A recommended that I see him in 2 months. I knew very well that this would not go over with the insurance company so I scheduled it for 6 weeks (or until they send me to their lying IME doctor). I do feel that in 6 weeks I should be able to return to work. (crossing fingers)
When Dr A first walked in the room, he said "What happened?" I could only laugh, because most of the time when I see him I messed something up but not this time! So I laughed and told him nothing and that I was just there for a follow up... LOL. He'll probably be as glad to not see me anymore as I will!
Good things:
- Full flexibility (have had that for a while)
- Can stand and walk for prolong periods of time in ONE day, several days still bothers it
- Can swim long distances - I've done several long swims (1 - 1.5 miles) with very little soreness
- Can ride a bike (I haven't done this much, but I don't think I'd have a problem with long distances)
- Can walk briskly for over 3 miles
- Can walk 2 mins, run 1 min for a mile
- Squatting - I can squat for a brief moment, but not long enough to do my job
- Stairs - I still feel a little wonky going down. It's WAY better than before though
- Lack of sensitivity - The lower front outside area is still numb feeling. I don't notice it untill I touch it and then it reminds me of what it's like if you touch your cheek after getting novicane at the dentist. I can feel it, but I can't really feel it.
- Popping - This has gotten better, but is not totally gone.
- Full straight-leg weight bearing is WAY better, but I feel a bit of that sharp pain at the bottom of my knee cap.
- I experience some pain on the medial side (most likely the femoral condyle where I had the microfracture rather then the joint line). More activity = more I feel it. I feel it when I am standing on it with my knee barely bent (ie putting on shorts and when contacting step while going down) It's sharp, but not severe and debilitating. Again this is not even close to the pain I had before (yes, the pain I had when the IME doctor said I was fine to return to work)
I had a follow up last week. Dr A recommended that I see him in 2 months. I knew very well that this would not go over with the insurance company so I scheduled it for 6 weeks (or until they send me to their lying IME doctor). I do feel that in 6 weeks I should be able to return to work. (crossing fingers)
When Dr A first walked in the room, he said "What happened?" I could only laugh, because most of the time when I see him I messed something up but not this time! So I laughed and told him nothing and that I was just there for a follow up... LOL. He'll probably be as glad to not see me anymore as I will!
Sunday, July 4, 2010
THREE MONTHS!
You know this is going really well, when I have nothing to say about it!
Let's see. I'll start with the bad stuff. I was having a lot of pain when I would stand, straighten and put full weight on my ACL revised leg. That seems to have gone away after taking a week off and going to CA even though I did quite a bit of walking up some pretty steep "hills". It used to be a pretty sharp painful feeling on the lower side of the kneecap. I do still have a little bit of pain on the medial condyle from the micro fracture procedure. It is worsens with activities, but does seem to have settled down a bit. It's still better than before when I couldn't stand on that leg to get my pants on!
I've been doing some swimming and working out over the past month, which is not only good for my overall physical fitness but my mental fitness as well. It is very hard to go from being active to having dealt with so many problems over such a short time period. I've gotten a little more comfortable walking without the functional brace, but rely on when doing any kind of uneven surface walking. My right quad is still weaker than my left then again it's only been 3 months.
I'm in a lull with the swimming for now since I just had my left knee scoped to trim the torn meniscus for the THIRD time! Honestly though, if it weren't for the sutures you wouldn't even know I had anything done. I've had very minimal swelling; in fact I could see 90% of the definition of my kneecap right after surgery. Today is day 5 and it looks and feels absolutely normal (minus the sutures). I did have a lot of fluid inside the knee that I could hear slosh around when I walked the first 2 days which was rather gross. It's amazing though that in PT on the Friday after the Tuesday surgery that I felt better in my left knee than I had in over a year.... no pain on the recumbent bike, no pain doing rubber band side steps, no pain just bending it. Amazing.
My overall feeling about my recovery is a big smiley face.
Let's see. I'll start with the bad stuff. I was having a lot of pain when I would stand, straighten and put full weight on my ACL revised leg. That seems to have gone away after taking a week off and going to CA even though I did quite a bit of walking up some pretty steep "hills". It used to be a pretty sharp painful feeling on the lower side of the kneecap. I do still have a little bit of pain on the medial condyle from the micro fracture procedure. It is worsens with activities, but does seem to have settled down a bit. It's still better than before when I couldn't stand on that leg to get my pants on!
I've been doing some swimming and working out over the past month, which is not only good for my overall physical fitness but my mental fitness as well. It is very hard to go from being active to having dealt with so many problems over such a short time period. I've gotten a little more comfortable walking without the functional brace, but rely on when doing any kind of uneven surface walking. My right quad is still weaker than my left then again it's only been 3 months.
I'm in a lull with the swimming for now since I just had my left knee scoped to trim the torn meniscus for the THIRD time! Honestly though, if it weren't for the sutures you wouldn't even know I had anything done. I've had very minimal swelling; in fact I could see 90% of the definition of my kneecap right after surgery. Today is day 5 and it looks and feels absolutely normal (minus the sutures). I did have a lot of fluid inside the knee that I could hear slosh around when I walked the first 2 days which was rather gross. It's amazing though that in PT on the Friday after the Tuesday surgery that I felt better in my left knee than I had in over a year.... no pain on the recumbent bike, no pain doing rubber band side steps, no pain just bending it. Amazing.
My overall feeling about my recovery is a big smiley face.
Thursday, June 10, 2010
TWO MONTHS!!!
Have I mentioned yet what a difference there is in this recovery than last? Well, if I haven't; it's seriously night and day. Oh yeah, I guess it does help your recovery when you don't mess up the ACL the first day after surgery. I don't even want to look back at my log entry for 2 months out after the first reconstruction.
I now have the functional brace and it is working out quite well. It's rather lightweight and actually pretty comfortable. It's in Detroit Tiger colors; blue on the top and orange on the bottom. I feel for the Don Joy rep taking my measurements and order; you just can't hand a woman a brochure with 20 colors in matte and gloss with the possibilities of mixing and matching colors and expect her to decide on the spot!
Therapy is still going quite well. Two days ago I did my first "agility" exercise. I call them agility exercises because there is faster movement. The exercise was the cones. Place 8 small cones in a stack. Pick one off and shuffle sideways about 15' down and set the cone down. Then shuffle sideways back and get another cone. Repeat. I went back and forth 4 times (or two laps as we like to call it). I almost tripped on the last shuffle which I'll chalk up to a bit of fatigue. Hey, I even broke a sweat during this one! That hasn't happened in a long time from exercise. Oh how I long to feel the crustiness of dried salt on my face!
My quad is coming along very nicely. I was sore all last week due to a new exercise - lunges. It's certainly not up to par, but looking much better and able to take more lunging without intense soreness.
I have just a minor bit of pain with going down stairs; it's not too bad, but I'm not sure what an entire day of delivering packages will do to it. Most of the pain I have is from straightening my leg all the way while standing straight up on it. This is not something that I do even at home, only at PT, so I'm not foreseeing any real problems from this. My PT has been working over my knee cap though with stretching it in all directions to help loosen it up. He thinks the tight knee cap is causing the pain.
So all is going as planned if not better. In light of this and the fact that I'm sick of dealing with the insurance company, I've decided to go out to California with my husband who is running Western States.
Full force ahead!
I now have the functional brace and it is working out quite well. It's rather lightweight and actually pretty comfortable. It's in Detroit Tiger colors; blue on the top and orange on the bottom. I feel for the Don Joy rep taking my measurements and order; you just can't hand a woman a brochure with 20 colors in matte and gloss with the possibilities of mixing and matching colors and expect her to decide on the spot!
Therapy is still going quite well. Two days ago I did my first "agility" exercise. I call them agility exercises because there is faster movement. The exercise was the cones. Place 8 small cones in a stack. Pick one off and shuffle sideways about 15' down and set the cone down. Then shuffle sideways back and get another cone. Repeat. I went back and forth 4 times (or two laps as we like to call it). I almost tripped on the last shuffle which I'll chalk up to a bit of fatigue. Hey, I even broke a sweat during this one! That hasn't happened in a long time from exercise. Oh how I long to feel the crustiness of dried salt on my face!
My quad is coming along very nicely. I was sore all last week due to a new exercise - lunges. It's certainly not up to par, but looking much better and able to take more lunging without intense soreness.
I have just a minor bit of pain with going down stairs; it's not too bad, but I'm not sure what an entire day of delivering packages will do to it. Most of the pain I have is from straightening my leg all the way while standing straight up on it. This is not something that I do even at home, only at PT, so I'm not foreseeing any real problems from this. My PT has been working over my knee cap though with stretching it in all directions to help loosen it up. He thinks the tight knee cap is causing the pain.
So all is going as planned if not better. In light of this and the fact that I'm sick of dealing with the insurance company, I've decided to go out to California with my husband who is running Western States.
Full force ahead!
Sunday, May 9, 2010
4.5 weeks - I'm off for vacation!
A MUCH NEEDED VACATION!! I don't even want to get into what I've gone through over this vacation with the worker's comp insurance company. But, of course they lie and tell you things like.... "If you don't go to your therapy then you will be non-compliant to receiving treatment". So if I go I'm screwed is what the insurance company says. As I said, they lie. Two lawyers and the State of Michigan Worker's Compensation (WCA) department all say basically that the insurance company likes to think they own you, but there is nothing they can do if you go on vacation. Granted they can try, according to the WCA, and if they do I am to call and report it. Thank goodness! I've fretted over this for months since it's my one big vacation a year and a bunch of my friends will be there and my brother and my husband! Anyway....
I'm doing great! I know I haven't posted much because there hasn't been anything dramatic going on. It's now been a little over 4 weeks since surgery. The major swelling is gone and has been gone for a couple weeks. I do still have bulges over the portals. It gets sore and stiff (internal swelling) from being on it too long, but that is very normal. I have great flexibility. I do have some pain on the medial condyle part where I had the microfracture... I'm praying it goes away since that is what was so debilitating last time. My quad still look "pathetic" as my PT put it, but I have good quad control and am now free of the big immobilizer brace. I was fitted for a function brace at my last Ortho appointment on 5-5-10 just a few days ago. The brace is being shipped to my brother's in FL. In the meantime, I am very careful walking around and if I'm doing anything strenuous where I could twist it or step funny (aka cleaning the car for the road trip) I wear the brace.
I am relieved to be leaving; I definitely need the break from the injury - if only I could leave that behind when I go too.
Additional Tags: can I go on vacation when on worker's compensation workers comp leave town
I'm doing great! I know I haven't posted much because there hasn't been anything dramatic going on. It's now been a little over 4 weeks since surgery. The major swelling is gone and has been gone for a couple weeks. I do still have bulges over the portals. It gets sore and stiff (internal swelling) from being on it too long, but that is very normal. I have great flexibility. I do have some pain on the medial condyle part where I had the microfracture... I'm praying it goes away since that is what was so debilitating last time. My quad still look "pathetic" as my PT put it, but I have good quad control and am now free of the big immobilizer brace. I was fitted for a function brace at my last Ortho appointment on 5-5-10 just a few days ago. The brace is being shipped to my brother's in FL. In the meantime, I am very careful walking around and if I'm doing anything strenuous where I could twist it or step funny (aka cleaning the car for the road trip) I wear the brace.
I am relieved to be leaving; I definitely need the break from the injury - if only I could leave that behind when I go too.
Additional Tags: can I go on vacation when on worker's compensation workers comp leave town
Tuesday, April 20, 2010
2 Weeks Post ACL Revision
I'm going back in time and posting these two pictures from 2 weeks post acl revision. The surgery was on April 6, 2010 these were taken on April 20, 2010. Other than looking like it's been invaded recently for the 3rd time and that nasty little red circle where the blister was it looks good! LOL!
Sunday, April 18, 2010
12 Days since the ACL Revision
What a difference between the original ACL surgery and this one! First off I'm not frustrated as hell from being on crutches and all that goes along with having no free hands.
Here's what's up now...
Here's what's up now...
- Bruising - Minimal. Barely bruised up at all.
- Swelling - Minimal. Well considering it's really quite good. I can actually see some of the knee cap instead of a ball of swelling.
- Sensitivity - I do have more lack of sensitivity this time around. It's kind of like touching your cheek after getting Novocain from the dentist; you can feel the pressure of you touching it, but you can't feel the surface.
- Range of Motion - Great. I even impressed the physical therapist just 7 days after surgery. It's not 100%, but did bend to 130 degrees which is 30-40 more degrees than most people.
- Quad Muscle - What quad muscle? It's not as bad looking as it was after 5 weeks of crutches, but it's not pretty either.
- Calf Muscle - Again not as bad as the first time around. In much better shape than the quad. I can actually feel muscle mass when I flex it.
- Brace - I've barely taken it off. I AM NOT GOING THROUGH THIS AGAIN! I've had it on like 95% of the time. If I could shower in it I would. The first time I tried not sleeping with it I kept waking up because I could feel it. I did sleep without it last night, but I went to bed at 4AM so I don't think anything would have woke me up.
- Blister - That tape/surgery blister thing leaked 5 days after surgery. It was quite big. It had some blood in it and now it is this flat purpley-red scabby looking thing. It reminds me of those birth marks that some people have.
- Portals - The incision points look good from what I can tell. The tape kind of started coming off and then I was helping it out but on my first day of PT they put fresh ultra sticky tape over them again. But I want to see!
- PT - It is what it is. Nothing too drastic yet. Although I am leaps and bounds ahead of where I was last time and I really think I'm ahead of the game compared to most people. There was a young very athletic football player in there also with a torn ACL. He could not believe that I was just 10 days post-op! It was almost encouraging to see those young guys (there was another, don't know what he injured... also a football player.) They were jumping and pulling and squatting. Muscles were pumped, veins were defined, the sweat was pouring... shoo-wee, I better stop! But really, that was the most encouraging thing I've seen/experienced during this entire process. Just to think that I could maybe really return to my physical level I was at before! The first time didn't count since I had an issue that I didn't know about... yeah, that little ole re-tear thing that certainly prohibited me from excelling at PT.
Thursday, April 8, 2010
48 hours - The first look
It's now been a little over 48 hours since the surgery so I get to remove the ace and gauze and take a shower. I'm a little concerned that my leg is still numb because last time I'm sure it didn't feel like this; which is no feeling. I do still have the pain pump hooked up, but I did last time too. I' guess I'll know for sure when the pump is turned off and right now I'm just not ready to. As a quick side note before I forget, the pump people just now returned my last call to them which was Wednesday morning; 30 hours to get a call back is reasonable??
PAIN/NUMB: My leg is mostly numb from the upper thigh to just my lower calf. I have a lot of pain on the back outside area, but the anesthesiologist said that the block doesn't affect that area because the nerves don't go there.
I cleaned off some of the iodine with alcohol before showering and was delighted to find that I didn't have that nasty sticky stuff all over my leg too. If you encounter that, alcohol will remove it. The shower was without incident which is very good. I redressed the wounds with fresh gauze and re-wrapped it with the ace bandage, but not before getting in a few pictures.
I don't have nearly the bloody mess I did last time which is good if nothing more than a mental relief. I do have some sort of blister which I'm sure is just some pool of saline from the surgery. It really does look like a blister; I'm not going to worry about it. As for the incision points, they look normal. DH was informed that I will have a slightly larger scar on the lower inside. No big deal at this point! I'm sure he had to make the incision a bit bigger to dig out the old screw. oops. Otherwise the swelling looks normal even though I haven't been able to get in a good icing since I've been unwilling to remove the brace until I can feel my leg... up till now anyway.
Here's a couple quick pictures; hope I'm not grossing anyone out! :)
PAIN/NUMB: My leg is mostly numb from the upper thigh to just my lower calf. I have a lot of pain on the back outside area, but the anesthesiologist said that the block doesn't affect that area because the nerves don't go there.
I cleaned off some of the iodine with alcohol before showering and was delighted to find that I didn't have that nasty sticky stuff all over my leg too. If you encounter that, alcohol will remove it. The shower was without incident which is very good. I redressed the wounds with fresh gauze and re-wrapped it with the ace bandage, but not before getting in a few pictures.
I don't have nearly the bloody mess I did last time which is good if nothing more than a mental relief. I do have some sort of blister which I'm sure is just some pool of saline from the surgery. It really does look like a blister; I'm not going to worry about it. As for the incision points, they look normal. DH was informed that I will have a slightly larger scar on the lower inside. No big deal at this point! I'm sure he had to make the incision a bit bigger to dig out the old screw. oops. Otherwise the swelling looks normal even though I haven't been able to get in a good icing since I've been unwilling to remove the brace until I can feel my leg... up till now anyway.
Here's a couple quick pictures; hope I'm not grossing anyone out! :)
Wednesday, April 7, 2010
Broken Pain Pump
Anyway I guess this pump is more temperamental than the last because that yank must have done a number on it. I was sitting at my desk with the pump on the desk and I saw a drop of water on the pump face and once I felt wetness. At first I thought I spilled pop into the pump holder when managing the stairs with a pop and ice wrap in one hand while gripping the rail with the other so I didn't think much of it. After 20 minutes or so I noticed a puddle on the floor which threw the switch that something wasn't right. Upon examination, I discovered that the inside of the pump bag was quite wet and that the liquid certainly wasn't the color of root beer. Then the pump activated and I saw liquid drops forming near the orange connector to the pump. Uh oh. I got out a magnifying glass to further determine the extent of the damage and saw what looked more like a diagonal cut about 5/16ths of an inch beyond the connector and it appeared that the surface of the cut was red. The tube is clear and there is no red anywhere on the pump. I have red sheets on my bed, but the pump never leaked in the bed and it was on the floor the whole time I slept. This is strange. Like somebody started to make a cut when putting it together, stopped then cut a little further back. I'm thinking the cut was there already and my yanking on it opened it up. There is no way that I could have made a slice like that by yanking on it.
Ah, on to the story. By now the pump is literally squirting the medicine out. I had to stop it, but didn't know what to do so I removed the connection. Ok, I admit that wasn't the thing I should have done, but I was on oxycontin, vicodin, and was still fuzzy from sleep. There are actually directions on the pump to stop the flow, but it's written on the top and I was looking at it from the bottom. Ooops. I figured maybe I could just cut off the bad end and then reinsert the tube into the connector and it would all be good but of course once I removed the connector I could see that wasn't going to happen.
It's now about 9PM. I recalled seeing an instruction booklet in my release folder about the pump and there is a 24 hour number on there for technical assistance. I called them even though I had already began thinking of how I was going to fix the tube. The lady I spoke with said I shouldn't have removed the connector and that it is now contaminated. Ooops again; didn't think of that. She said I needed to call my doctor. After searching through a bunch of paperwork I found an after hours number to call. My doctor's answering service called Dr Anderson who told her to tell me to tell the pain pump people that they had to call Dr Anderson. So I called and left a message with the pain pump people telling them that they needed to call Dr Anderson's answering service so they could talk with Dr Anderson. Ah, once again I'm just the patient stuck in the middle of more protocol. At 5AM I haven't heard anything yet and called and left another message inquiring what was to be done. Honestly though I had already taken things into my own hands because I know the red carpet stroll that these companies do and nothing gets done and besides the more time I wasted the longer and sooner I would be in pain. It is now 8:30AM and I still haven't heard back from anyone. Now how Ms. McGyver fixed the pump. Materials: Duct tape (YES!), an oversized wide straw, and a tampon. First cut very thin strips of duct tape and while holding the slash/hole closed stick the duct tape on the opening leaving just a 1/8" tail on one side. Tuck that tail around the tube and press firmly, but try not to press so hard that you open up the slit! Continue wrapping that strip of duct tape then the next and so on until you have about 1/2" wrapped on both sides of the hole. In my case since it was near the connector I also wrapped the connector with duct tape to get a better hold and seal over the hole.
I decided to use the small pusher of a tampon applicator because of its stiffness; a regular drinking straw or two stacked would work too. Cut the applicator down to about 2" and cut a slit in it from one end to the other. Fold the tube over on itself so the loop is closest to you then thread both tubes into the applicator through the slit then secure it all around with duct tape. Next I took a large mouth 1/2" straw and cut it about 2 1/2" long and slit it all the way up. Again fold the tube over on itself but the loop will be furthest away from you. Holding the folded tubes together with the already duct taped mess slide the large straw over everything. Again wrap the entire thing with duct tape. The idea is to make it strong enough and stiff enough to withstand any future yanks and stress which is accomplished by having it fold over on itself so yanks are distributed to the folds and duct tape rather than the length with the hole that is now sandwiched between. If your hole isn't at the connector you can skip the large tube and just use the small one.
Tuesday, April 6, 2010
After ACL Revision
I never got a chance to see Dr. Anderson before or after the surgery because first they sedated me a bit to insert the pain pump line and after I was simply still out. Dave, my husband, did speak with him after though and he said that it went well. He said the condyle is in good shape (what a relief!!) and that the revision went as planned.
I did have a new cadaver ACL (the bone-tendon-bone of the gracilias aka hamstring) and the best news ever is that I DO NOT HAVE TO BE ON CRUTCHES! Ok, I need them a little right now, but it's day one!!!!
____________________________________________
So here are the events of the day:
6AM arrive at hospital
6:30-8:00 Q&A by Doc's assistant, the nurses, a couple anesthesiologists; surgery prep with clothing, socks, IV, pain pump, BP, heart monitor and all that other good stuff.
8-8:30 Sedation and into OR (don't recall this)
10:15 Wake up in pre-recovery room
10:45 Go to recovery room
11:30 Go home
The pain is pretty bad at this point but only on the back left (typical since the pain block can't reach that area). This time my toes aren't numb too, which will definitely make things way better-- my upper thigh down to just below my knee is very numb.
12:15-7:45 SLEEP
Right now, I feel pretty good. That back left pain areais gone matches the other pain, which isn't that bad.
At first I attempted the stairs with one crutch in an upright position, but felt too wobbly on the second step so decided butt scooting was a better option. Thinking about it now, I'm probably wobbly because the quad is numb and dead so my calf is doing all the work.
8PM I take my first oxycontin, which I'm beginning to feel now. I'm going to ice now WITH THE BRACE ON. :)
I did have a new cadaver ACL (the bone-tendon-bone of the gracilias aka hamstring) and the best news ever is that I DO NOT HAVE TO BE ON CRUTCHES! Ok, I need them a little right now, but it's day one!!!!
____________________________________________
So here are the events of the day:
6AM arrive at hospital
6:30-8:00 Q&A by Doc's assistant, the nurses, a couple anesthesiologists; surgery prep with clothing, socks, IV, pain pump, BP, heart monitor and all that other good stuff.
8-8:30 Sedation and into OR (don't recall this)
10:15 Wake up in pre-recovery room
10:45 Go to recovery room
11:30 Go home
The pain is pretty bad at this point but only on the back left (typical since the pain block can't reach that area). This time my toes aren't numb too, which will definitely make things way better-- my upper thigh down to just below my knee is very numb.
12:15-7:45 SLEEP
Right now, I feel pretty good. That back left pain area
At first I attempted the stairs with one crutch in an upright position, but felt too wobbly on the second step so decided butt scooting was a better option. Thinking about it now, I'm probably wobbly because the quad is numb and dead so my calf is doing all the work.
8PM I take my first oxycontin, which I'm beginning to feel now. I'm going to ice now WITH THE BRACE ON. :)
4 hour countdown
Actually it's less than 4 hours since I do actually have to get to Beaumont. Yes, that's right, I'm pulling an all-nighter. I won't even see daylight again before I'm all drugged up and braced up and being wheeled out with some horrific no weight bearing instructions.
Ok, maybe I"m jumping the gun. But standing in my shoes and feeling the way I'm feeling, I'm pretty darn sure there's going to be crutches involved. I do wonder how bad it is in there; it feels bad. I actually wonder if the meniscus isn't torn again too. Every once in a while I'll have that torn meniscus feeling, but never the severe stabbing pains.
Hey the positive side to having a revision is that I already know what to expect! I still have the sleeping elevation thingy I made. Yes, I'm quite aware that these things can be purchased, but 1) I don't want to buy one and I'd probably need a script for it and do you really thing worker's comp is going to pay for it? HA! Oh yes, and 2) I like to make stuff! In fact I decided that the basket of pillows was for one thing dangerous and it's just in the way too much so I came up with some new comfort/elevating/icing ideas.
I think the end result will work nicely. We have this rather crappy coffee table set and the only reason we bought it in all it's ugliness is that the top raises up to you and becomes a table. This is perfect for the couple that eats in front of the TV. Anyway the side table does the same thing. So I positioned that so I could swing the arm over and put my leg up on it. For comfort in this position I made a slant board for lack of something else to call it. The construction of the slant board is pretty much just like the sleeping ramp with foam.
Here's a picture of my new set up. I'll be pretty much living on that one cushion for many days to come. The ice machine is more readily available. The icing pad should hopefully be tangle free. That extra cheapo table thing there will hold my crafts :)
Ok, maybe I"m jumping the gun. But standing in my shoes and feeling the way I'm feeling, I'm pretty darn sure there's going to be crutches involved. I do wonder how bad it is in there; it feels bad. I actually wonder if the meniscus isn't torn again too. Every once in a while I'll have that torn meniscus feeling, but never the severe stabbing pains.
Hey the positive side to having a revision is that I already know what to expect! I still have the sleeping elevation thingy I made. Yes, I'm quite aware that these things can be purchased, but 1) I don't want to buy one and I'd probably need a script for it and do you really thing worker's comp is going to pay for it? HA! Oh yes, and 2) I like to make stuff! In fact I decided that the basket of pillows was for one thing dangerous and it's just in the way too much so I came up with some new comfort/elevating/icing ideas.
I think the end result will work nicely. We have this rather crappy coffee table set and the only reason we bought it in all it's ugliness is that the top raises up to you and becomes a table. This is perfect for the couple that eats in front of the TV. Anyway the side table does the same thing. So I positioned that so I could swing the arm over and put my leg up on it. For comfort in this position I made a slant board for lack of something else to call it. The construction of the slant board is pretty much just like the sleeping ramp with foam.
Here's a picture of my new set up. I'll be pretty much living on that one cushion for many days to come. The ice machine is more readily available. The icing pad should hopefully be tangle free. That extra cheapo table thing there will hold my crafts :)
Saturday, March 27, 2010
ACL Revision
I'm scheduled for arthroscopy on April 6th to clean up the femoral chondyle and to assess the ACL for a possible ACL revision. The doctor's involved are pretty sure that the ACL will be "revised". Revised means re-done.
The saga continues with dealing with the worker's compensation insurance company. The latest news is that they don't feel that they can pay me for the 3 weeks lull in checks because I didn't get an MRI that I wasn't informed about. I've since called a mediator and am hoping that this will help. I wonder if they've approved the brace and didn't tell me or the left knee arthroscopy and didn't tell me. I hope anyone reading this is not also dealing with worker's comp; it's exhausting and very frustrating.
The saga continues with dealing with the worker's compensation insurance company. The latest news is that they don't feel that they can pay me for the 3 weeks lull in checks because I didn't get an MRI that I wasn't informed about. I've since called a mediator and am hoping that this will help. I wonder if they've approved the brace and didn't tell me or the left knee arthroscopy and didn't tell me. I hope anyone reading this is not also dealing with worker's comp; it's exhausting and very frustrating.
Wednesday, March 10, 2010
Follow Up with my Ortho
I had my follow up with Dr Anderson today. He asked me what happened. I didn't know. I told him I never felt a pop a twist or anything that even gave me an inkling of an idea that I'd hurt it. I told him about 3 instances early on in my recovery that could have been the cause, but even then I never ever felt any kind of injury! The first incident was when icing the first time with my dead leg from the nerve block. The second time was when I nearly fell off the treadmill in PT during the first week off crutches and the 3rd was when that woman knocked me over at pt while doing the crane walk. I suppose I recall those most because they freaked me out the most. I've kind of tripped a bit and stuff, mostly at PT doing goofy exercises, but still I never ever felt like I'd hurt it!
Dr. Anderson seemed a little disappointed. He asked me if I was running on it. I told him I couldn't run; I can barely make it down the stairs or stand on one leg and put my pants on. It's seems to be getting worse. He asked me about exercises; I told him that I've been swimming, but that aggrevates it.
He answered several of my questions regarding the MRI, I didn't ask about he the metallic artifact. I guess I forgot.
These are my notes from our conversation, more was discussed this is just some highlights.
What is causing the pain: Cartilage may have healed, but pieces may be breaking off. Cartilage not normal.
The knee is looser and under the sheer stress the micro fracture doesn’t do as well.
ACL tear: Torn at the superior attachment; apparently that's the other end of where I thought it was. Scar tissue may be the only thing holding the acl in place.
Pros/Cons: This combination is not easy to get over and frequently goes on to be arthritis. It is no good leaving it unstable.
Treatment: Clean up the cartilage and assess the ACL and be prepared to replace it.
Options: Looking at the MRI, doesn’t think there is another option.
Dr. Anderson seemed a little disappointed. He asked me if I was running on it. I told him I couldn't run; I can barely make it down the stairs or stand on one leg and put my pants on. It's seems to be getting worse. He asked me about exercises; I told him that I've been swimming, but that aggrevates it.
He answered several of my questions regarding the MRI, I didn't ask about he the metallic artifact. I guess I forgot.
These are my notes from our conversation, more was discussed this is just some highlights.
What is causing the pain: Cartilage may have healed, but pieces may be breaking off. Cartilage not normal.
The knee is looser and under the sheer stress the micro fracture doesn’t do as well.
ACL tear: Torn at the superior attachment; apparently that's the other end of where I thought it was. Scar tissue may be the only thing holding the acl in place.
Pros/Cons: This combination is not easy to get over and frequently goes on to be arthritis. It is no good leaving it unstable.
Treatment: Clean up the cartilage and assess the ACL and be prepared to replace it.
Options: Looking at the MRI, doesn’t think there is another option.
Sunday, March 7, 2010
MRI results
I always like to get my MRI results before seeing my ortho so I can look up terms that are used in the radiologist's impressions. I knew something was wrong, but I really thought it would be the micro fracture. Nope...
YIKES! Hmm. It doesn't particularly feel all that instable and what little bit of instability feeling I've had I've been chalking it up to lack of quad muscle. (Yes, it has atrophied quite a bit since I haven't done PT since December.) Let's see what else do we have in the Impressions part of the report. I'll add the meaning of stuff in ( ) as I go along.
1. The patient has evidence of an apparent re-tear involving the anterior cruciate ligament at its superior attachment (the spot where the screw was put in to hold everything in place), with grossly abnormal morphology residually present. (This one is a little disturbing, but I believe it means that the attachment point has morphed into something really abnormal looking... that doesn't sound good no matter what it might really mean).
2. There is a focus of osteonecrosis (dead bone) with some associated marrow edema (swelling of the bone marrow - very painful) involving the posterior (back side) nonweightbearing surface of the medial (inner) femoral condyle. (The knobby part of the bone at the bottom of the femur.)
3. Degenerative (deteriorates over time) narrowing of the medial joint space (space normally occupied by the meniscus) secondary apparently to prior meniscal surgery. (That makes sense). Truncation ( shortening) was seen, most likely iatrogenically induced (as a result of treatment). No definitive recurrent tear is seen (speaking of the meniscus); however, delineation (the outline) is suboptimal because of metallic artifact present. (Sounds like there's a piece of metal that's not supposed to be in there and so the MRI image shows a bright white spot because it can't "see" through it? I asked Dr Anderson if I had any metal in my knee from the reconstruction and he said no; perhaps this is just some tiny shaving? Still not keen on it whatever it is.)
So that's pretty much it. I see Doctor Anderson tomorrow.
There is an apparent re-tear of the anterior cruciate ligament repair; its superior attachment is disrupted.
YIKES! Hmm. It doesn't particularly feel all that instable and what little bit of instability feeling I've had I've been chalking it up to lack of quad muscle. (Yes, it has atrophied quite a bit since I haven't done PT since December.) Let's see what else do we have in the Impressions part of the report. I'll add the meaning of stuff in ( ) as I go along.
1. The patient has evidence of an apparent re-tear involving the anterior cruciate ligament at its superior attachment (the spot where the screw was put in to hold everything in place), with grossly abnormal morphology residually present. (This one is a little disturbing, but I believe it means that the attachment point has morphed into something really abnormal looking... that doesn't sound good no matter what it might really mean).
2. There is a focus of osteonecrosis (dead bone) with some associated marrow edema (swelling of the bone marrow - very painful) involving the posterior (back side) nonweightbearing surface of the medial (inner) femoral condyle. (The knobby part of the bone at the bottom of the femur.)
3. Degenerative (deteriorates over time) narrowing of the medial joint space (space normally occupied by the meniscus) secondary apparently to prior meniscal surgery. (That makes sense). Truncation ( shortening) was seen, most likely iatrogenically induced (as a result of treatment). No definitive recurrent tear is seen (speaking of the meniscus); however, delineation (the outline) is suboptimal because of metallic artifact present. (Sounds like there's a piece of metal that's not supposed to be in there and so the MRI image shows a bright white spot because it can't "see" through it? I asked Dr Anderson if I had any metal in my knee from the reconstruction and he said no; perhaps this is just some tiny shaving? Still not keen on it whatever it is.)
So that's pretty much it. I see Doctor Anderson tomorrow.
Wednesday, March 3, 2010
A new MRI
FINALLY after months and months of waiting, I had an MRI today 3/3/10 on my right knee post ACL reconstruction. I don't have much more to say about that until I get the results, I didn't like the facility as much as the one I normally go to. They didn't have free coffee and donuts... LOL. Ok, on top of that it's a mobile MRI unit which means it's in a big truck trailer. It was kind of cool, but kind of uncomfortable.
I pulled up the images on my computer at home and I have to wonder about the quality. The pictures weren't as clear as what I get from the other place. Then again I'm no radiologist and I was told that the MRI machine was very powerful.
I'll get the results before seeing Anderson so I can ask educated questions.
I pulled up the images on my computer at home and I have to wonder about the quality. The pictures weren't as clear as what I get from the other place. Then again I'm no radiologist and I was told that the MRI machine was very powerful.
I'll get the results before seeing Anderson so I can ask educated questions.
Monday, March 1, 2010
Where's my check?
I get a "paycheck" from the insurance company since this is a work related injury. The checks arrive on Tuesday. Well this past Tuesday the check didn't come. This isn't the first time this has happened they get delayed because of holidays usually and even though there was no holiday we did have a lot of snow so maybe that's why it got held up.
I called my claim rep on Thursday 2/25/10. I didn't even ask her about the check but asked her what the situation was with all the back and forth commenting. She then told me that they had approved the MRI back in January. January? WTF? I told her I didn't know the MRI was approved. She told me that she sent the approval to my doctor's office and so she "guessed" that was my notification. Guessed? Hmm. This doesn't sound right. I didn't get hysterical or anything so I was good, but I did forget to ask about the check in my state of shock.
Seriously, I've been waiting for a call from her regarding some result from all this bantering of comments back and forth between doctors while I gimp around and waste away. Yeah, you should see the quad on the ACL reconstruction leg. It's looking pretty skinny.
Ok, so I'll call Anderson's and get the ball rolling.
Friday comes and goes and no check then Saturday no check. It must be lost in the mail. So I call claim rep on Monday 3/1 (she was out of the office on Friday, but I left a message.) She tells me that since I hadn't gotten the MRI or scheduled an appointment with Dr Anderson that my checks are being held! Held? Um, yeah, you didn't tell me that you ever approved the MRI! About now my slight paranoia with dealing with these people sets in and I begin wondering what her angle could possibly be for not informing me of the approved MRI? She even told me that she called my doctor's office last week and they told her I hadn't had the MRI. So why didn't she ever call me? Maybe she wants enough time to go by and then I would be in default for not complying and not getting the tests or making doctor appointments that were approved. Seriously though, if YOU were paying someone to sit around and do nothing wouldn't you let them know right away of something as important as this?
I hadn't made the MRI appointment because doctor Anderson's office hadn't called me back yet from Friday.
WOW, I wonder if this woman will have a job by the time all this is over.
I called my claim rep on Thursday 2/25/10. I didn't even ask her about the check but asked her what the situation was with all the back and forth commenting. She then told me that they had approved the MRI back in January. January? WTF? I told her I didn't know the MRI was approved. She told me that she sent the approval to my doctor's office and so she "guessed" that was my notification. Guessed? Hmm. This doesn't sound right. I didn't get hysterical or anything so I was good, but I did forget to ask about the check in my state of shock.
Seriously, I've been waiting for a call from her regarding some result from all this bantering of comments back and forth between doctors while I gimp around and waste away. Yeah, you should see the quad on the ACL reconstruction leg. It's looking pretty skinny.
Ok, so I'll call Anderson's and get the ball rolling.
Friday comes and goes and no check then Saturday no check. It must be lost in the mail. So I call claim rep on Monday 3/1 (she was out of the office on Friday, but I left a message.) She tells me that since I hadn't gotten the MRI or scheduled an appointment with Dr Anderson that my checks are being held! Held? Um, yeah, you didn't tell me that you ever approved the MRI! About now my slight paranoia with dealing with these people sets in and I begin wondering what her angle could possibly be for not informing me of the approved MRI? She even told me that she called my doctor's office last week and they told her I hadn't had the MRI. So why didn't she ever call me? Maybe she wants enough time to go by and then I would be in default for not complying and not getting the tests or making doctor appointments that were approved. Seriously though, if YOU were paying someone to sit around and do nothing wouldn't you let them know right away of something as important as this?
I hadn't made the MRI appointment because doctor Anderson's office hadn't called me back yet from Friday.
WOW, I wonder if this woman will have a job by the time all this is over.
Wednesday, January 20, 2010
The IME Report and Dr Anderson's response
I was going to enter a different post when I noticed that I never posted on the IME report. Put simply, it's crap!
WOW, this my friends is why you record everything! On top of the IME guy getting a lot of little details incorrect; he must have forgotten that he didn't actually do 12 of the 20 or so tests that he actually did do, but his report says he did and that I was fine in all tests. He lied and he reported falsely. I called him out on it and WILL be reporting him to whomever I can.
He reported that while I have pain in both knees upon squatting that in his opinion I have reached maximum medical improvement and can return to a "very strenuous activities". His recommendations for my left torn meniscus is home exercises. Interesting.
While I could really rant on and on about how Independent Medical Evaluations work and about how the doctors are as crooked as they come, I won't.
Normally a report like this would trump anything my ortho has to say regarding my restrictions and work status. But, since I called him out on his lies and discussed it with the head of workman's comp at my job, I was granted an extension on my current status until I saw Dr Anderson again on January 11 and he commented on the IME's report.
See the red tape rolling out?
So I waited. No more physical therapy had been approved during the waiting time... When I saw Dr. Anderson on the 11th we discussed the IME report and I asked him some more technical questions about the possibility of the micro fracture not having filled in.
Dr Anderson's response and comments about the IME report went something like this as he told me. "I 100% disagree with the IME doctor's report". He asked me if this guy even practices which I got a chuckle out of. In regards to the left meniscus he pretty much stated... "There is no pill you can take, no amount of time you can take, and no amount of exercises you can do that will ever heal a horizontal meniscus tear." Of course I knew that... gee I wonder why the IME guy thinks I just need to do some home exercises?
So the saga continued and now the ball is back in the hands of the insurance company. Will they deny me medical treatment based on the IME report when a highly reputable doctor completely disagrees with his findings? Will they risk a lawsuit since I have documented everything and even recorded the evaluation? I don't know.
The last I knew, before what I'll put in my next post, is that I was waiting for my claim rep from the insurance company to get back with me after they got with their vendor who was to get a response from the IME doctor regarding Dr. Anderson's response to the original IME report.
Everybody got their @ss covered now?
(this post was a recollection of events up to 1/20/10... in case someone cares)
WOW, this my friends is why you record everything! On top of the IME guy getting a lot of little details incorrect; he must have forgotten that he didn't actually do 12 of the 20 or so tests that he actually did do, but his report says he did and that I was fine in all tests. He lied and he reported falsely. I called him out on it and WILL be reporting him to whomever I can.
He reported that while I have pain in both knees upon squatting that in his opinion I have reached maximum medical improvement and can return to a "very strenuous activities". His recommendations for my left torn meniscus is home exercises. Interesting.
While I could really rant on and on about how Independent Medical Evaluations work and about how the doctors are as crooked as they come, I won't.
Normally a report like this would trump anything my ortho has to say regarding my restrictions and work status. But, since I called him out on his lies and discussed it with the head of workman's comp at my job, I was granted an extension on my current status until I saw Dr Anderson again on January 11 and he commented on the IME's report.
See the red tape rolling out?
So I waited. No more physical therapy had been approved during the waiting time... When I saw Dr. Anderson on the 11th we discussed the IME report and I asked him some more technical questions about the possibility of the micro fracture not having filled in.
Dr Anderson's response and comments about the IME report went something like this as he told me. "I 100% disagree with the IME doctor's report". He asked me if this guy even practices which I got a chuckle out of. In regards to the left meniscus he pretty much stated... "There is no pill you can take, no amount of time you can take, and no amount of exercises you can do that will ever heal a horizontal meniscus tear." Of course I knew that... gee I wonder why the IME guy thinks I just need to do some home exercises?
So the saga continued and now the ball is back in the hands of the insurance company. Will they deny me medical treatment based on the IME report when a highly reputable doctor completely disagrees with his findings? Will they risk a lawsuit since I have documented everything and even recorded the evaluation? I don't know.
The last I knew, before what I'll put in my next post, is that I was waiting for my claim rep from the insurance company to get back with me after they got with their vendor who was to get a response from the IME doctor regarding Dr. Anderson's response to the original IME report.
Everybody got their @ss covered now?
(this post was a recollection of events up to 1/20/10... in case someone cares)
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