Sunday, September 18, 2011

Week Three

The week of the bike...

This week my physical therapist started me on the recumbent bike. At first, they make you just rock and back and forth on the petals to stretch out your knee. She told me to go all the way around if I could. After the first day, I was determined to go all of the way around. I pushed as hard as I could on the petal and went around twice. Huge accomplishment in my book! I found this article about rehabbing after ACL surgery on the bike. Cycling for Knee Rehabilitation

They also measured me at 120 degrees range of motion. I am very happy with the progress I am having thus far. I am only down to one crutch and the mobilizer brace when I travel. I can walk around without the crutches but my quad is not as strong as it should be to be completely off of the crutches. 

My next 1-2 week goals are to get off of the crutches and to DRIVE again! I hate not being able to drive myself places and rely on other people to take me everywhere. I did get a temporary handicap tag from my doctor. I think this will help a lot when I first start to drive, so I will not have to walk as far when in the parking lots. 

I took off the butterfly bandages this weekend since it has been 3 weeks. The incision looks pretty good (see picture to the left). There was a lot of dried blood but it all came off after I washed it.

I went to the Virginia Tech football game this weekend which was my first voyage outside of my house and work pretty much for 3 weeks. It was scary at first because so many people came close to running into me and also going down/up lots of steps. It was a great time though and had zero problems with my knee at the game. 

I am so eager to be walking/running/exercising again. The next week should be a big week because I have 3 PT appointments and also have another post-op appointment with my surgeon. 

How did your first outing go after surgery?


Monday, September 12, 2011

Week Two


I started Physical Therapy (PT) on Friday, September 9th. My Physical Therapist is GREAT! She was very pleased with the range of motion I already had. I measured at 90 degrees on the first PT session. I was concerned with the amount of bruising and swelling going down my leg and into my foot/ankle (see above picture). My doctor said this is normal it basically is just gravity pulling the blood down from the knee into the ankle.

My physical therapist gave me 10 exercises to do twice a day. I have been working on those every day. I have to go PT 3x per week. I am excited to go though because it is one step closer to getting off crutches and getting better. Here is a good website to see some examples of PT exercises they may give. Obviously do not try anything without the advice of a professional! ACL-PT Exercises

My second (2 hour session) at PT, went great. They stretched me out and worked on a lot of exercises. Because I have great strength back in my leg, I am only using one crutch now per the physical therapists instructions. I am SO happy because this is one step closer to being able to walk normal again/get my life back! She said I will start the bike next session which should be great for range of motion and strength.

As the weeks go on, I will continue to update how the rest of my PT appointments goes.


What is the best exercise you have learned at PT?

Week One

The Road to Recovery Begins...

I am 100% determined to get better ASAP. Without this mindset I think it would be very difficult to come back quickly from an injury like this. It is soooo easy to get down after a debilitating surgery. After all, I can't walk, work, exercise, drive, go see friends, attend VT football games, drive to see my boyfriend, walk my dogs, and the list goes on. The very last thing you need is any kind of negative thought.

I posted pictures of flowers that many loved ones sent to me after my surgery. I LOVE flowers and this kind of started the positive focus for me.

The sooner I get better, the more quickly I will get to do all of those above referenced activities again! It is amazing how each day my knee is getting a little bit better and better. I got the staples out exactly a week after my surgery. The swelling around my knee is still pretty bad but it's improving. I attached a picture of the knee without the staples. The doctor put butterfly bandages on the incision to keep the skin tight and continuing to heal together. After getting the staples out, I really started to concentrate on getting more range of motion in my knee.

I give credit to my Doctor for being so far along by the time I was ready to go to PT (a little over a week after surgery). She gave me several exercises to do before I started PT. The first exercise that I HIGHLY recommend right after the surgery is explained below:


  1. Sit down on a chair with your bad leg completely straight. 
  2. Take your good leg and pull the foot in towards you until you cant anymore. 
  3. With your good leg, push your leg back straight
  4. Repeat for 15 minutes 3x a day. 
Below is a picture of my knee bent 90 degrees!!! You all can do it!!! It is great gratifying. 



What did you find to be the most helpful exercise in getting a better range of motion in your knee?

The Day After...


Well the nerve block has officially worn off and I feel every staple in my leg now. I had a Post-Op appointment at noon to check out the incision. It took everything I had in me to get up and get out of bed. (Note to everyone: Make post-op appointment at least one day after surgery). I attached a picture of what the incision looked like the day after. I had no idea what my knee was going to look like when she cut the bandage off. I actually think it looks pretty cool! But, I'm sure most people think it looks gross, I don't blame you.

The doctor appointment went really well. She said everything went very smoothly and hopefully this was the last time I would need a knee surgery. After I was leaving the doctor I fainted getting into my mom's car. I had no idea why... so I had to go back into the doctor. They did tests on my blood pressure and found that going from a laying down position, to sitting up, to standing my blood pressure would drop dramatically. Apparently this is very common in women and everyone should be very careful post surgery. If you fainted and hit your knee, you could mess up everything that the surgeon did. The doctor said to make the transition from laying down to standing up very slow, an almost 10 minute process. This way my blood pressure would adjust instead of just drop. The reasoning behind the blood pressure dropping is because your body is in shock from having a major surgery and its reaction is to get you to lay down to recover. By making you faint, your body is forcing you to lay down. It all made sense after the doctor explained everything and after two fainting episodes, I was okay!

I took another picture to compare my two knees in size and shape. It doesnt even look like I have a knee cap at this point. From this point on, I am going to share my experiences with therapy and positive focus :).


What did you think when you saw your "new" knee for the first time?

The Big Day... Dun Dun Dun


This is a picture of me right before the surgery. I was joking with my mom that I look like a lunch lady haha. Make sure that you shower the morning of the surgery!!! Showering post-surgery is very difficult and you most likely won't want to get out of bed for a few days.

Types of ACL surgeries:
1. Hamstring Graft--> My doctor refuses to do this surgery because she believed that you need your hamstring and doesnt make sense to do it this way.
2. Patellar Tendon Graft--> This is the surgery that I went with. It is the "golden" surgery for ACLs, longest used and most successful. This is the most common surgery on younger people as well. Here is a link of what the surgery actually entails. It is not graphic at all and very informative. Anterior Cruciate Ligament (ACL) Reconstruction Animation
3. Cadaver--> The cadaver is where they take the ligament of a dead person and use it for your new ACL. This was my second option because of the smaller incision. My mom also tore her ACL and had this surgery and it was very successful. They use this one on older patients because it is an easier recovery.

Before the Surgery the nurses will ask you to put the gown on with just underwear on. Make sure to take out all of your jewelry AT HOME! (I made this mistake for the first one and almost left all of my jewelry there). They will check your vitals and start to give you the IV. The surgery and anesthesiologist with come talk to you and ask you which knee they are operating on at least 15 times. The surgery will also initial her name on the knee they will be operating on.  They will then take you back to the OR (Operating Room).

The first thing they did in the OR is administer the nerve block in my right left in addition to the traditional general and localized anesthetics. In the surgery it doesn't really matter because I was out cold. However, when I was in the recovery room it is a much better experience due to the reduced use of general anesthetic. By the time I was to be discharged my head was clear and I felt generally great. My leg stayed numb until the next morning at my Post-Op appointment. The last thing I remember is them getting the nerve block and then I woke up in the recovery room. I was very aware and apparently was chatting it up with the nurse and asking about her entire life story. I stayed there for about an hour until I was ready to go home. I woke up with a PolarCare Ice machine on my knee (see to the right). Ask your doctor about this before the surgery, if your insurance does not cover it, I HIGHLY RECOMMEND GOING AND BUYING ONE! I use it all day every day. It is very important in getting better by keeping swelling down. Polar Care Coolers

After the surgery, I just went home and slept until the next morning. When the doctor says to take painmeds every 6 hours around the clock, DO IT!!! Don't sleep through the night, set your alarm and take them! You will regret doing otherwise.

Which surgery did you have and was it successful?

Pre-Operation


Before the surgery, you will have to have a Pre-Op appointment to make sure you are healthy, not pregnant, etc. They will do blood work, a urine test, and a physical exam to make sure everything is good to go.

Night before the surgery:

1. Do not eat or drink after midnight (including gum)
2. Do not take any kind of medicine one week before (unless otherwise directed)
3. Do not take aspirin one week before (very important)
4. Stock up on lots of fluids and bland food
5. Get a good night sleep!!

Side note: Many people ask how much work you should take off. DO NOT QUESTION THE DOCTOR!!! I will go through this in more detail later.


How to prepare your home:


1. Tidy up for convenience and safety

There’s going to be a time after your surgery where you’re trying to get to the bathroom in the middle of the night on crutches and under the influence of some pretty powerful drugs. But even in less trying conditions we need to make sure that our home is going to be a safe place for us in our new condition.

When you’re crutching your way to the bathroom in the middle of the night the last thing you need is to set your crutch tip down on a sock or piece of paper. Take the time before your surgery while you’re still fairly mobile to clean up and organize. Concentrate on walkways in particular, but also on the areas where you’ll be performing delicate maneuvers: near the bed, in the kitchen and the bathroom.

Cleaning gets a whole lot harder when you’re in crutches and feeling lethargic from the drugs.

2. Prepare your nesting area

In the hours and days immediately after you get home from surgery you’ll be spending a lot of time sitting still in one place. Whether you’re strapped in to a CPM machine, icing the joint or just resting this nesting area will be your daytime home.

Take the time now to get this space ready for your return. In my case I concentrated on our couch which is in the main living area of our home near the TV, between the kitchen and the bathroom. It’s in this space that I’ll use the ice machine, work on my laptop, watch TV and talk to visitors. My focus was on creating a flexible and comfortable space that caters to these concious activities, I figure if i’m going to sleep I may as well crutch over to the bed.

3. Healthy, Convenient Food

Your body has gone through a lot when you get home from surgery and in my experience, it’s not uncommon to have a healthy appetite. My focus is on healthy foods that are tidy and convenient to eat. They should have as little left over as possible to prevent my nest from becoming a compost bin.

4. Sleep Area

Between the stresses of surgery and the effects of the painkillers you'll be wanting to sleep a lot after surgery. To make your bed as safe, comfortable and convenient as possible I recommend three things:
  •      Have extra pillows to support and pad your knee while you are sleeping
  •      Limit the number of times you have to get in and out of the bed.
  •      Make it as safe and easy to get in and out of bed. (Keep crutches close to bed)
5. Entertainment

While you are laid up you'll need something to keep your brain engaged or you will go crazy! I find that having a couple of good books, a handful of good movies and a laptop will give you plenty to do. 


What are some things you did or wish you did to prepare you for recovery?

Background


Hello everyone! My name is Kelly and I am a very active 23 year old. I recently had ACL surgery on August 30, 2011. As I was prepping myself for the surgery, I notice that there was not a great blog or source to find out information from a personal experience online, especially of a female. I am not saying this is going to be the BEST out there, but I wanted to share my personal experience and thoughts with others who are going through this journey.

A little bit about myself...

I played three sports in high school, volleyball, basketball and lacrosse and have always been very active. I graduated from Virginia Tech in the Spring of 2010 and since then I have been going to the gym, training for a marathon, playing beach volleyball, p90x, and so on. Although I cannot pinpoint exactly when I tore the ACL (yes, I know this is very bizzare), I did notice my knee was not right on several occasions. First, I noticed while doing a stretch in p90x that my knee was swollen and couldnt stretch a certain way during one of these exercises. I thought nothing of it, so I continued to do my daily routine. It wasn't until I went white water kayaking that I found my knee was completely messed up. I had zero strength when trying to roll the kayak on my right side, while my left side was completely fine. Since I am right hand dominate, I was supposed to be stronger on my right side.

I knew something had to be up so I went to the doctor and got an MRI. On the MRI it showed that my meniscus was torn. My doctor recommended that I have surgery and that something else might be torn that was not showing up on the MRI.

I scheduled the meniscus surgery for the first week of August.  I got ready, took off work and had the surgery. When I woke up out of the surgery in the recovery room, the doctor said "Everything went well, BUT your ACL is also torn". My mom said I asked "Wait, what?" at least 5 times probably from the anesthesia and the shock. Completely torn by the news (long recovery, intense surgery, more time off work, not being active longer, etc) I began to research ACL surgeries online.  It was tough to find a good and informative personal experience of the surgery so I thought I would document mine to help others out.  So here I go :)

How did you tear your ACL?