Days 4&5

Things are still on the up & up.  I'm off the perc's entirely except for when i go to bed. (Note: After reading other peoples experiences, I'm well aware of the fact that after I really start making progress in PT, I might need more perc's even though I do not need them now.)  Since I have nothing but time, I've become very regimented in rehabbing this knee over the weekend.  I alternate ice & elevation, CPM usage (now up to 80 degrees), and at home PT. 

My PT Protocol basically calls for quad sets, heel slides, and single leg raises (only in my brace, with leg fully extended).  My advice to anyone out there would be to try your hardest to find that happy median of not over-working the knee (this sometimes happens, especially in allograft patients), yet not under-working it.  

I've learned my way around the shower.  I found what works best is wrapping my leg, with the brace on, in a trash bag, placing a bath towel on the bottom of the shower for stability, then sitting on a stool or chair with my legs facing away from the shower head.  It's silly looking, awkward, but for me, it works and keeps my incisions dry.  

That's pretty much it for now. I'm looking forward to Monday as it's day 2 of PT for me.  Also, I'll post more pics in the days to come.  

Day 3

Best day yet.  Very little pain. I'm still taking the perc's, but if push came to shove, I could probably do without them.  I've done a few more quad sets today, more walking, and feel great.  I SLOWLY make my way up the stairs and into the shower. ( I was told not to shower for the first 2 days, then to wrap the leg in some sort of plastic bag going forward)  Afterwards, comes the moment of truth....taking all my gauze off.  I'm not necessarily expecting the worst, but from what I hear, bruising up and down my leg should be no surprise.  Fortunately, my leg looks great.  Little swelling, virtually no bruising. Very clean.  I'll attach a pic I took with my phone.  I took some peroxide, dabbed up and down my leg, replaced the gauze with sterile pads over the incisions, and wrapped myself back up in the ace bandage. 

Day 2

Like the doctors warned me, the second day post-op was pretty painful.  I followed the same routine as I have been;  an hour or so of CPM, followed by keeping it elevated for around 2 hours.  Every so often, I'll get up and do a little walking around.  When I walk, there is more pain and pressure towards the front of my calf and shin then there is anywhere near my knee.  When I'm laying down it's the opposite, pain near my kneecap, but nowhere else.

I start Physical Therapy today.  As per my surgeons orders, I do very little today at PT.  It's more of an examination than anything else.  My leg gets a little massage, I do some electronic stem., and some light quad sets. I'm told by the following Monday I'll get a little more involved.  The therapists are happy with the way my leg looks. Although we can't take the gauze off till Friday, there is minimal swelling in my leg, and the leg as a whole seems rather strong for essentially being 36 hours out of surgery.  I'm told this is in large part to my "prehab" of my leg.  I had a full 3 months to get my leg as close to 100% as i could before surgery, and I made the most of it.  I cannot stress enough how useful this will hopefully prove to be in what I hope is a speedy recovery. 

After I arrive back home, i spend a better part of the evening in some pretty moderate pain.  The best way i can describe it is, I feel like a child having severe growing pains up and down his leg. All i wanna do is stretch it out in any way I can, but I'm obviously SOL.  Thankfully, by the time 10pm rolls around, the pain starts to subside.  I pass out and sleep in intervals closer to 2 hours as opposed to 1 last night. 

Day 1

I arrived at the hospital nervous, anxious, but ready for surgery.  The surgeon came in first, and had a few words with me. He pretty much gave me my prescriptions for pain killers, an antibiotic, and an anti-inflammatory.  I was to have 3 incisions, all rather small, on the front of my knee, and the operation would take approximately 1 1/2-2 hours.  The Dr. also informed me that besides being under general anesthesia, I would be given a nerve block.  The nerve block was an injection into my upper thigh that would essentially rewire the way my Central Nervous System sent pain signals to my entire leg, thus numbing it for about 12 hours.  He handed me some printed out, post-surgery directives, then left while a team of nurses took my vitals, gave my an IV, shaved and cleaned my knee, and wheeled me down to surgery.  Besides that, the rest of my pre-surgery time is a blur, as I was out within minutes.

My operation was at 10 AM, and when i awoke, it was sometime around 1.  My leg was in a brace that ran from halfway up my ankle to about halfway up my thigh. Under that, my leg was wrapped tightly in gauze and bandages, and under that was a wrap-around device that went over my knee.  I'm not sure what the name of the device is, but what it is is essentially a wrap with tubing that circulates ice water around my leg at all times. The tubing is secured underneath of the bottom of my bandaged ankle and connected to a cooler with a tiny motor in it that is filled with ice water.  

I hung around the hospital for another hour or so before being discharged.  Basically, I was advised to keep the ice-water-cooler-thingy runnng for as most of the day. On top of that, I was given a Continuous Passive Motion (CPM) machine to wear at home.  The CPM is an electronic machine with a remote control that you rest your leg on top of.  It slowly bends your knee for you at a degree set by the remote attached to it.  In my case, the doctor recommended working my way to a 60 degree bend the first day, then increasing it 10 degrees each day until i reach 110.  I'm to wear the CPM approximately 4 times a day in 2 hour intervals.   The Dr. also advised me to spend 1-2 weeks using crutches, but to put weight on my foot from the get go.  

So off i went, crutch-walking out of the hospital, pretty numb, but pretty pain free.  I remained pain free the entire day and part of the evening as my entire leg was still rather numb from the nerve block.  I started my CPM at a 20 degree bend, and by the end of my first 2 hour interval, attained a comfortable 50 degree bend. As for that ice machine, I basically kept it running for a good part of the day.  It's not quite like having an ice pack directly on your leg, so theres no real risk of nerve damage, and from what I'm told, the more I use this comfortably, the less swelling.  

By around 8-9:00 I felt the nerve block start wearing off, and immediately popped 2 5mg Percocets.  I've got a pretty good tolerance for pain killers, and I must admit for only taking 10mg of Percocet, the pain was rather low...maybe a 3 on a scale of 1-10.  Sleep was the only real problem for me that night.  While the pain was rather low, the bandage and gauze around my leg is rather tight, (RICE - rest, ice, compression, elevation), and is to remain so for the first 3 days.  Being so, I found it difficult to sleep with my leg elevated, tightly wrapped, and not being able to move.  All in all though, I'm pleased with how Day 1 went; my pain is low, i can bear weight on my bad leg (maybe a 65-35 ratio of weight, good leg to bed), and sleep eventually came, just in 1 hour intervals.  I'd wake up, wish to shift around, realize i couldn't, and eventually drift back to a not-so-deep sleep.  

A little background

My name is Jay. I've never quite had a good enough reason to blog, but after looking for as many personal stories about ACL recovery as possible prior to my surgery, I felt compelled to share my story.

I completely tore my right ACL, as well as partial tears both of my meniscus', on January 1, 2009 playing football. I didn't take a hit on my leg, just went to make a pivot and it was downhill from there.  Due to several different factors, i had to wait a full 3 months for surgery. For a better part of those 3 months, I underwent physical therapy 3 days a week, as well as rehabbing the leg daily at my local gym.  From what I gather, the stronger you can get your leg pre-surgery, the further ahead you'll be of that proverbial 8 ball. 

A few details about my scheduled surgery.  After consulting with my surgeon, and doing as much research as possible online (finding online medical journals proved to be very educational and insightful),  I opted for an Allograft surgery, which is an ACL from a cadaver.  Allografts are becoming more and more popular as more and more evidence is showing that long term, they are just as strong and efficient as the other two options, taking an autograft of your own patellar tendon from your knee, or taking a piece of your hamstring.  

Some pros of the allograft:

*  Using someone else's tendon means no extra incision.  No extra incision usually means less pain after surgery.

*  As well as less pain, it usually means the patient returns to Day-to-Day activities quicker than patients who opt for autografts. 

Some cons:

*  While more and more studies are showing the allograft is just as strong as an autograft, most any surgeon will still tell you the patellar tendon is still the most "tried and true" method of surgery, simply because it is.

* Also, while the allograft allows for quicker return of Day-to-Day activities, it usually takes a little longer to return to 100%.  From what I'm told this is because it is not your own tissue, so it takes a longer to graft itself onto your Femur and Tibia.