Post-Op Appointment #1

Today was my first post-operative appointment as well as PT. As with over half of my pre-surgery appointments, the weather was snowy and icy and it was rough getting to the appointment. I didn't want to deal with changing so I still wore shorts and a t-shirt as this is what I had to wear to the appt and it was a short crutch to get inside.

When we arrived, my regular physical therapist was there to greet us (me, Jeff, and my mom). He got me up on an exercise table in the "examination room" of the PT area. He immediately started undressing the knee - I was nervous to see what was underneath.

First came the ace bandage. This was followed by the bladder for the ice-cold cooler water - no wonder I couldn't feel it - there was a ton of cotton gauze between it and my leg. Then came the cotton gauze, followed by (bloody) sterile gauze, and finally, steri strips on the actual wound. It looks like there are three holes and about a two inch incision for the ACL to go in.

There were three patients lined up on the exercise tables for my doctor and his PA to visit. Each was about 5 minutes long and I was last. While I waited, it was back to quad sets - my favorite - but I did get a compliment that the muscle seemed good.

When the doctor got to me, he took out pictures from the surgery - blech! I peeked a little and may look more - they're now in my possession. But all in all, it was a bit of a blur. He thought that my meniscus damage was old - to me, that means way old like over five years, because I don't remember having a hurt knee for a long time!

He gave me my goals: 1) Rest & Elevate, 2) develop the quad and be able to lift the leg 3) get 90 degree range of motion (yikes!). His PA said to call with any problems and I'd see them next week to get the staples out. Then, it was back to therapy.

I did a calf stretch (easy), range of motion exercises (hard), quad hooked up to the electronic stimulator (hard), leg lifts (hard), and practiced walking with crutches (not bad). I'm supposed to be doing these and more three times a day and going in two to three times a week. I have three appointments next week. Unfortunately, I need to get stronger to be able to drive, so that's something to focus on.

The appointment and PT lasted about an hour and a half. I got the go-ahead for a shower - yea! Things are looking up even though there's been a lot more pain with the movement.

24-48 Hours

The day after surgery was a little rough. In the afternoon, I got uncomfortable and didn't feel relaxed again for four or five hours. I think my leg started to feel uncomfortable in its elevated state. It wasn't really my knee that was complaining but more the quad and calf.

Eventually, the painkillers took over and I was able to calm down. I have been taking the painkiller every four hours and so far, when I've tried to reduce or taper the amount of time my body has protested. At the doctor today, they said to keep taking them regularly for at least another day.

I got a lot of sleep on Thursday (two days after surgery). I got two good three hour naps in as well as full nights of sleep before and after.

PT exercises are a necessary evil and I did them twice on Thursday. The ankle pumps and calf stretches were easy but the quad stretch seemed endless but I made it through 45 repititions with 10 seconds tightened quad.

Recovery - The First 24 Hours

When I made it home I was tired - the pain pills I'd been given made the ride home mercifully fuzzy. We had a wheelchair to get me in the house which was good. I went straight to bed and was out for about three hours.

We had the living room made into a "recovery room" with a pullout couch and lots of pillows. I would definitely suggest trying to get a sick room set up on the first floor of your house if you can.

I couldn't feel my leg for the first night due to the spinal block so didn't have a lot of trouble with discomfort. The painkiller did its job which was great. I have an ice cooler that brings cold water into my bandaged area. I had hoped I could actually feel the cold, but I just feel a little bit of cool every once in a while. I still think it's doing its job, though.

If you're a girl and having this surgery, stock up on nightgowns before you go in. I only had one but it's already been through the wash once and it's back on - definitely the most comfy way to go.

I didn't have any of the nausea problems other people have talked about in their diaries. Just a bit woozy once. I had to make myself focus on drinking water to stay hydrated which was difficult but necessary. My appetite was back that first night and I was able to have dinner. I'm glad I had to use crutches when I first got injured. I wouldn't want to be learning in such a weakened condition.

The morning after the surgery, I was still feeling good. Jeff was back to work, but a friend stayed home with me and my mom flew in Wednesday afternoon. I'm sure I could have handled the day by myself, but it was so helpful to have people around and I would definitely recommend getting helpers if possible.

I did my first PT exercises Wednesday morning - ankle pumps, calve stretches, and quad sets. It hurt a bit, but thinking about doing it was harder than it actually felt.

So far, so good.

Surgery At Last

The day for surgery finally arrived. I would say I was more nervous on Monday, the day before, than on Tuesday when I went "under the knife". We pulled out the couch in the recovery room (aka my living room) before we left to go to the Ambulatory Surgery Center. We arrived early (a rare occurence for me) and when we went into the brand new facility I could tell that at least Jeff would be comfortable. The waiting room was posh as far as I was concerned with a couple computer terminals, tables, and a lot of space.

I was immediately taken into the surgery prep area, given a bag for all of my stuff along with a gown and socks to change into. The nurse got my IV in and double-checked that I was me and went through some pre-surgery questions. I briefly saw my doctor and his resident as he walked out of his previous surgery. He initialed my right leg and that was the last I saw him for the day. The resident went over the gameplan and then I met the anesthesiologist and her resident. She asked if I wanted general anesthesia or a spinal - definitely general! She also told me that when I woke up I would have the option of a spinal block if the pain was severe when I awoke. This puts anesthetic in your femoral artery to basically numb your leg. She said about 20% of patients have severe pain and can use the block but they don't like to do it until after the surgery because it only lasts for 8 to 12 hours.

The resident gave Jeff a prescription for post-surgery painkillers and he gave me a sedative to keep me calm. Then it was time to say goodbye to Jeff and head into the surgery. I was pretty relaxed (with the prescription). I remember being wheeled in, confirming my name and why I was there and that's all, they put me under.

I awoke in the surgery room (I think) and I was in A LOT of pain. It's all pretty fuzzy but I know my leg hurt much worse than I expected. I was rolled into the recovery room. The nurse immediately increased the pain medicine in my IV. I was shaking, moaning, and having trouble communicating. The pain medicine was helping a little and I'm not sure how long this was going on, but they made the decision that the spinal block made sense and I was all for that!

The anesthesiologist and her resident used an ultrasound to find my artery and the nerves around the patella. They were great about getting the injection in around my groin and it only took a few minutes before I was much more comfortable!

Mercifully, they waited till I had calmed down to bring Jeff back. He had been updated by my doctor right after surgery - he said that the MCL was healing well and did not need any fixes in the surgery. They replaced the ACL and cleaned up the meniscus as expected. They are still concerned with some damage on the outside of my knee - something about bone spurs. I'll find out more about that when I get to speak with him on Friday.

Jeff waited with me in the recovery room for 20 or 30 minutes and then I was released to go. Jeff warmed up the car and I got wheeled out. Everything went smoothly and we were on to the next stage - recovery!!

Pre-Surgery Checklist

I have a list of instructions to follow before surgery:

• Take crutches with me to the surgery
• Wear losse comfortable clothing to the surgery
• Use an antibacterial scrub the evening before and the day of the surgery around the leg - this was provided by the doctor
• No food after midnight on the day prior
• No aspirin, Vitamin E, or herbal medications 10 days prior to the surgery
• No NSAIDS including Aspirin and Ibuprofin for a week prior
• Bring someone with me to the surgery
• No contact lenses - bring glasses
• No jewelry
• No nail polish or makeup

How it Happened & The First Week

Two months seems like forever ago. But here's how it happened. It was the day after Christmas and we were skiing for the holiday in Michigan's Upper Peninsula. I am neither experienced nor enthusiastic about skiing, but things were going well enough. I decided to take a lesson the last day so the next time we skied hopefully I wouldn't be such a novice.

The lesson went well and I didn't fall once...until I caught my right ski in the powder and snow while the left knee kept going. I've played soccer for 27 years without serious knee injury, but the most dreaded thing that I imagined happening for all these years is an ACL injury. When I felt the pain as I crashed into the mountain, that's what I immediately yelled "My ACL!" amongst numerous expletives. The pain was immense!!

I was carted off the mountain on a snowmobile and met up with my husband who ported me off to the ER. The diagnosis was that I probably tore my MCL based upon the the various knee examinations the physician performed. I was sent back to our rented condo with a bottle of Percocet and knee immobilizer. We had a 14 hour drive home the next day followed by a visit to my primary care physician the day after.

My regular doctor also thought the MCL was the probable extent of the injury. Because this damage needs a stable knee and time to heal, I was ordered to keep the immobilizer on the knee (see the photo above from the day of the accident for all its glory) and stay on crutches. An MRI was scheduled for a week from that appointment and I was referred to an orthopedic surgeon. The catch, though, was that I was not allowed to schedule an appointment until after the MRI was completed.

I figured out I could drive my husband's automoatic transmission car after a few days and he took mine with its manual transmission. I was able to return to work when my vacation ended and didn't need the narcotic painkillers after a few days. This was replaced by over the counter Ibuprofin and Tylenol. I was definitely sore and awkward and looking forward to the MRI!

About this Blog

Two months ago, I tore the MCL (Medial Collateral Ligament), ACL (Anterior Cruciate Ligament) and Meniscus in my right knee. I was taking a ski lesson while on vacation with my family in Michigan's Upper Peninsula over Christmas. I am an admittedly unskilled skiier, and won't be returning to the slopes. However, I want to aggressively treat my injuries so I can get back to the sport that I love - soccer - and also enjoy the active life that I've had leading up to the injury.

I have found people's blogs and diaries and the experiences of my friends who have had knee surgeries to be so valuable as I prepare for my surgery. There are so many questions that I have and everyone's experience is different. The more I've been able to learn, the more I've felt prepared.

The reason I want to record my experience relates to a desire to contribute something of my own that might be useful to others who go through this in the future. This in no way replaces medical advice or the knowledge of physicians, physical therapists, or any medical professional. Primarily, my focus is on providing my experiences that may help others know what they may encounter.

It's a week until I have surgery to repair the ACL and Meniscus. The MCL heals itself and usually does not require surgery.