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!!!!

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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 is 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. :)

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 :)

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.

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.

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...

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.

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.

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.

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)

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.