Post-Surgery - Day 5

Day 5 is the exciting day where my bandages got to come off.  Which was a really good thing because they were half off by the time I got from the bedroom to the living room, and had fallen completely down to my ankle by the time I got to the kitchen to pick up a pair of scissors.  I was pleasantly surprised by how small my incisions are - I've seen some pretty substantial sized ones in my trips down the #aclsurgery hashtag on instagram.

The biggest thing thus far today has been swelling above my knee.  The irony of it is that this is how I was misdiagnosed repeatedly and played 4.5 years of hockey/football/strongman/etc. on no ACL and a couple meniscal tears.  It seems like overnight this swelling increased a bit, and it looks super funky when I do my flexion exercises.  I can also feel the tightness when I walk.  Hoping to make it recede a little with today's icing regime, but we'll see how it plays out.

Pretty much confirmed today that I react to toradol in much the same way as T3 in that I become emotionally irrational far quicker than I should.  Soooo...I'll be cutting out meds now and switching to advil, as I can't really afford to be crying over random problems when I go back to work.  Sanity...important!

My pain levels aren't high by any means, but I do find I'm feeling things more than I was the first few days.  It could be because I haven't been taking very many meds or it could just be general owie feelings.  I notice it most when I stand up and the blood rushes back down into my leg.

Pretty sure I was past 90 flexion today, so that's great.  I think my knee extension work is getting better as well.  I think my gait is going to be the hardest for me to fix in terms of the extension you should hit to start a stride - I have six months of really bad gait patterns to undo.

Post-Surgery - Day 4

Today has been the first day I actually felt like I had something done.  I woke up alert from my surgery, and have been pretty alert/no pain ever since.  Today I have been ridiculously tired and have slept most of the day.  Probably a good indication that I over-exerted myself yesterday.

Woke up and did my exercises.  Flexion is definitely coming along, and I'm fairly sure that I'm past 90.  Extension I think is coming, but it's harder to tell with these dressings still on how my knee is hanging.  I get to take them off tomorrow, so I'll be able to get a better view.  

Excitement of the morning was that things began moving again.  Thank you world!

Iced my knee twice and fell asleep for a couple hours.  Woke up, watched some TV, iced again, and followed tweets online about the football final from the other conference.  I'd been feeling a bit achy, so when that game was done, I took a toradol and promptly fell back asleep for another couple hours.

It's really weird to me to look down at my feet and have my left ankle be bigger than my right.  I don't think my swelling is excessive, but it's definitely present.

Looking forward to taking the dressings off tomorrow just because the big one keeps falling down/falling apart a bit.  Part of me wants to see the incisions, etc. but part of me doesn't.  Guess I better get used to them - they aren't going anywhere!

Post Surgery - Day 3

Slept slightly better last night - still not sleeping through the night, but there were less wake-ups.

Got my exercises done; I think I'm still around 90 degrees, warming up to past 90.

Feeling pretty good, I made the decision that I was going to go out and watch my football team play for the conference championship.  It's currently 30+ degrees in Edmonton so essentially I was making the decision to be outside for the vast majority of the day.

The team won so that was great to see, but I definitely paid for it in the form of some increased swelling through my knee.  When I finally got home I iced every hour for 20-25 minutes x4 to try and help bring it back down, which I think I did.  I was happy to note at bedtime when I did my exercises again that my mobility had not been impacted by my adventurous day.

No tramadol today; I had one toradol when I got him to try and help with inflammation.  I made the decision not to take another one before bed because I was really hoping for things to "get moving" again and both medications have constipation as a side effect.  I had the same problem after my ankle surgery and it resolved itself, but I wanted to help things along so I took some Restoralax before bed.  Sorry for the pun, but this is the crappier side of surgery.

Post Surgery - Day 2

I didn't sleep super great.  Not because of pain, but I just didn't sleep soundly (I normally sleep like a rock from the time I go to bed until the next morning).  Every time I woke up I was thankfully still pretty groggy, so I was able to switch positions as much as is possible when you have to sleep on your back, and get back to sleep.

My pain levels have been really low and I really don't like the way the tramadol makes me feel, so I elected not to take any.  Since the toradol is also an anti-inflammatory, I decided later in the day to still take that.  Ok, but "I decided" I mean one of my friends got mad at me and gave me the stink-eye until I took it.

The cryo-cuff is awesome.  The ice isn't quite lasting as long in the cooler as advertised, but it's also 30+ degrees right now and possibly warmer in my house.  It's a cooler, not a miracle worker.  I ran out of ice from the first bag in the morning, but my stink-eye-giving friend Sharon was nice enough to stop by in the afternoon with another one.  I iced five times for 20-30 minutes each time (10, 1, 4, 7:30 and 10:30).  I don't seem to have any of the bruising that I've seen on other people after their ACL surgery, so that's both welcome and interesting.

I did my exercises three times, with the exception of passive knee extension, which I did 5 times.  Flipping over to do prone flexion is by far the worst.  The actual flexion isn't that bad (I'm limited more by the spot where it gets super tight as opposed to painful) but trying to get in position to do it super sucks.  I'm trying to flex harder on my knee extension work to really try and get to 0 (and past it).  Hopefully it's coming.  Extension is my huge focus.

Marlies helped me wash my hair, so now I no longer look like a super creepy grease monkey.  I'm actually quite excited that on day five I'll be able to get my incisions wet, and because I'm not NWB like I was with the ankle, I can actually shower standing like a normal human!

Post-Surgery - Day 1

Today has been interesting as I've essentially been watching my leg and foot swell up a bit.  I'm thinking that the colour may start coming out tomorrow.  Pain is up a bit compared to yesterday, but it's nothing that I can't handle.  I've taken a single tramadol (I'm allowed up to two per dose) three times - once in the morning, once after lunch, and once around dinner time.  I'll probably take two when I go to bed, along with a ketorolac.  The tramadol comes with a warning that it may cause drowsiness/dizziness, and I'm finding that to be accurate.  I'll take a tramadol and then be playing on my phone or trying to catch up on some work on my laptop and find that the words start to spin a bit and I'm nodding off.  So I'm not the most productive, but I didn't really expect to be immediately after surgery either.

I'm trying to ice on a fairly regular schedule.  Today I've done I believe four sessions (9am, 12pm, 3, 7) and I'm about to plunk the cryo-cuff on for another one.  I've done two sets of exercises and again, will do one more before bed.

EXERCISES:

• Prone knee flexion (use non-operated leg for assistance; go until stretch, hold for 5s; lower slowly) x10
• Seated knee flexion/extension (use non-operated leg for assistance; extend until stretch, hold for 5s; flex until stretch, hold for 5s) x10
• Supine heel slides (slide heel of operated leg towards butt, hold for 5s) x10
• Isometrics (tense squad and butt, hold 5s; extend heel into bed, hold 5s) x10
• Ankle pumps (plantar and dorsiflexion) - I've been doing this every hour or so for about 10 reps to keep the blood flowing in my calf
• Passive knee extension ( heel up on a yoga block and letting the knee go into extension/hyperextension) x10 minutes

Surgery - Day Of

I was assigned the first surgery slot of the day, so we were up bright and early.  Thankfully I live about five minutes away from the hospital where I was having it done, so we only had to leave at 6:20 to get there in plenty of time for my 6:30 arrival time.  My surgery was booked for 7:45-9:30.

Pre-surgery was pretty chill - we went through all of my paperwork and then I got to write on my legs which one was being operated on and which was not.  I was then transferred downstairs to the day surgery ward.  Marlies came down with me, which was much appreciated.  I spoke to my doctor, who re-emphasized that I'm going to have to work my ass off to get my extension back after being locked for six months.  Game on.  From there, Mar took my glasses and it was off to get cut open.

The anesthetic hit me fast and hard.  They started my IV, I moved from the gurney to the operating table, I remember feeling a bit of burning through my hand, and then boom, I woke up in recovery.  When I came to, I turned to the nurse and explained I wasn't in pain, wasn't sad, but was about to cry for no reason.  She helpfully gave me some kleenex.

I felt a little bit nauseous but not too bad, and was alert enough that they bumped me back upstairs.  From there I drifted in and out of sleep and really had no pain.  I had several nurses come to visit and all were pretty impressed by my level of alertness.  One didn't want to give me a second cup of gingerale, but I finally convinced her that yes I was thirsty and no, I wasn't going to vomit it up.  Honestly, compared to how I felt after my ankle surgery (again not really in pain, but definitely a lot more drowsy) this was a walk in the park.  I had to prove I could stand up and walk around without falling over or throwing up and passed that.  After having been NWB for 7.5 weeks for my ankle, it was shocking to me how much weight I was able to put on my knee and how little it hurt.

Marlies came to pick me up and we stopped to pick up my medications (tramadol and ketorolac) and then headed home.  The rest of the day was a mix of napping and watching Scrubs.  My pain levels stayed really low - I took a tramadol sometime around 4:30 and then two before bed with one of the keterolacs.  I didn't sleep super well, but that wasn't really pain related - I just really hate sleeping on my back.

Three Weeks

I'm now three weeks away from surgery.  I actually back-counted today, and the time from MRI to surgery is just over six weeks.  My MRI requisition to MRI was just over three weeks.  It may have taken a ridiculously long time for me to get a proper diagnosis, but things have moved pretty quickly since then.

April 17 - Requisition
May 10 - MRI
May 11 - Results
May 12 - Discuss Results (and get sad)
May 21 - Appointment with sports med Dr.
May 21 - Surgical consult
May 25 - Called with surgery date
May 26 - Boss okayed date, confirmed with surgeon's office
May 28 - "Learn to Crutch" at the hospital (aka - 95% of people don't read this pamphlet so we made an in-person session you have to attend instead)

There's nothing really left in the next couple weeks for me to do other than wait it out and try not to obsessively google everything I can about ACL reconstruction.  Honestly my biggest question at this point is where on the pain scale this will fall in comparison to my ORIF surgery in January.  Mainly because with my ankle, I then proceeded to work from home for almost two months, whereas with this I need to be back to work pretty quickly.  Surgery is on a Wednesday, and Canada Day is the Wednesday after my surgery.  Ideally I'm back at work on the 2nd after my physio appointment.  I can probably get away with the 6th (the Monday) at the absolute latest, but I have to be back in the office that week.  I have to be on site for a tournament that week-end (July 10-12) which is going to be interesting to say the least.  My partner is coming along to act as my legs for the week-end and I will have to make sure I have a plan in place for icing/elevation.  Thankfully if I can get through this crunch, I get two weeks before I have to be on site again and hopefully at a month post-surgery I'll be at least doing ok.

Since I've been told to do no lower body work between now and my surgery, I'm really trying to push with my upper body work.  I'm doing a bench day based on 10/20/Life and then a shoulder day and a back day.  I'm hoping to be able to do the majority of this program post-surgery as well; I'm going to have to run it by my physio though as the last thing I want to do is screw up my reconstructed knee.  There's a couple exercises I think I'll have to modify further - I z-press on both back and shoulder day (one with a swiss bar) but I don't think I'll be sitting on the ground for this after surgery.  Seated press should be a decent and doable substitute.  I'll have to modify face pulls to do them seated as well, but that should be fine.  I'm going to have to play around and see if cable rear delt raises are something that I can do from a seated position as well.