.d.e.w.e.y.c.o.o.t.e.r.

Getting the range of motion back

Well the last week has been pretty uneventful. I haven't been very diligent about the rehab, but I'm staying very active. In the last few days, I've even been doing a bit of walking around without the brace. Yeah, that's a no-no, but it's really feeling better all the time.

I went ahead and unlocked the brace to 45 deg flexion last week. This made walking a LOT easier - more natural. Then I cranked it open to 60 deg on Friday. I'll go to 75 deg tomorrow, then 90 per the schedule when I go to rehab on Monday.

The primary problem with the brace is the weather. It's getting warmer now, and it seems that whenever I move around, I start sweating, and the brace gets itchy. So it comes off.

So anyway, flexion is fine. I'm not supposed to go beyond 90 deg for a while yet, but I think I could get 110 or 120 right now. I think my primary areas of concern are extension and my quads. I get some pain when I extend it - though I expect that has to do with not doing the exercises as often as I should. I have, however, noticed that it doesn't usually hurt to sleep on my stomach. In the past, I couldn't sleep like that because it hurt to fully extend my knee.

The quads, I'm sure, will just take time. I'm considering getting on the stationary bike. I think I've got the range of motion to do it, and I need to start getting miles in this year. We shall see...

First rehab appt

Got a call about 9 am from the rehab clinic. Cool, time to get this started. Unfortunately, they said they didn't have an opening until Thursday. I politely told the receptionist that I was supposed to have my first appt at the end of last week, and now we're going to slip it until the end of this week?! I said that I can pretty much come in at any time and asked if there was any way to squeeze me in. She came back and asked if I could come in at 2 pm. That'll work!

The day couldn't go by fast enough. 2 pm rolls around and I head in. Buzzed through some paperwork and waited. Finally, my turn rolled around and the therapist called me back. As I got close to the table, I asked if I was still supposed to pretend to be using the crutches. That got a couple laughs. His primary concern was about the meniscus damage. If it had been repaired, I would be on No-Weight-Bearing for a month. Uh oh. I wasn't sure if mine had been shaved or repaired. He made a quick phone call and verified that it had only been shaved, which was in line with his assumption. He said repairs are typically only made on patients until their mid to late 20s.

He then went on to explain that my insurance coverage for rehab sucks. 12 visits covered w/ $30 copay. I'm not sure how long this is supposed to take, but 3 times per week on the order of 8 or 16 weeks means I'd come up pretty short. That means that I'll be doing a lot of this at home. What I didn't know was how would we split up the 12 appts - heavy up front, heavy at the end, or staggered out for the duration? His suggestion, heavy at the end. He said a lot of the range-of-motion exercises at the beginning can be done at home.

My doctor doesn't want me to go past 90 degrees of flexion for this month. He took a couple measurements to see how much extension and flexion I can get on my own. Pretty sure my extension was right at (or real close to) 0 degrees. Flexion was 90 degrees. Awesome! Already at my limit. But I think I'm not supposed to go past that for a month. The therapist agreed that I won't do any damage going past that limit - doc is just a bit conservative. He also measured both knees to compare the swelling, and he measured my thighs about 2 inches above the knee - I guess to get an idea of the amount of atrophy.

I did various exercises. The first was the only one that helped bend my knee in flexion. The main one he wants me to concentrate on is where I put a towel roll under my knee and try to press it into the floor. It's supposed to help my quads which have gotten significantly smaller. I'm to do -hundreds- of these per day. Fair enough.

In all I was there for a couple hours. He gave me handouts and prescribed sets and reps to do per day. I'm to pick up some ankle weights and start hitting it. My knee was a little sore that night (and my calf was sore from walking around this past weekend), but I didn't take anything for pain or inflammation before bed. All went well.

I plan to make a spreadsheet today and log all the exercises. The better I stay on top of it, the better off I'll be.

New hobble

So Friday came, and still no word from the rehab people. I call the doc's office - they put me on hold while they call the clinic. When she comes back, she tells me that they're looking into the problem and will call me back on my cell. I gave them my cell because I knew I'd be gone most of the day. More on that later. When I got home that evening (after not receiving a call all day), there's a message on the machine from the clinic - they have a prescription for me, please call. So not only did they not call my cell, they didn't call until about 2 pm. Whatever, not a big deal in the grand scheme of things, but still bugs me.

Since I was supposed to be able to shower Saturday (but have been anyway since Thursday), I went ahead and pulled the tape off my incisions. Here they are:



So I was gone all day Friday because we checked Elliott into the hospital yesterday. Poor little guy got sent home sick from daycare on Monday, has been to the doctor all week getting shots and having blood drawn, and couldn't keep anything down. He was very dehydrated - when they took his blood, it only trickled.

He spent 2 nights in the hospital and was released on Saturday. Still had a case of the squirts, but at least he was able to keep things down and was playful.

So this past week has been pretty busy. And frustrating. I've been putting a lot of weight on my leg, and today I just kinda decided to stop messing around with these crutches so much and did a LOT of just walking around without them. Loaded Carson's motorcycle into the truck, took it to the track, and walked around the neighborhood a lot. It didn't hurt, doesn't seem to be particularly swollen now, so what the heck?

Gotta hit these goofballs up for some rehab tomorrow morning.

Stitch free

Meds: done. Haven't had anything since....Sunday night?
Pain: none. I'm not supposed to be putting any weight on it, but I can if I need to. I suppose I'm still a bit unsure of what my knee can and can't do, so I'm trying to limit the amount of weight I put on it, and the brace stays on the whole time.
Stitches: out.
Bandages: gone. I went into the doctor yesterday. I made sure to reiterate to him about the success of the femoral nerve block (at the suggestion of my neighbor, the anesthesiologist that recommended it). Doc asked right away if my neighbor told me to say that. Anyway, I let him know that I didn't feel as reliant on the crutches, but he stressed that it's important to let the bone heal around the graft first. A little inconvenience now, better result later. He removed the stitches, slapped some tape on the wounds, and said I could hop in the shower Saturday. That can't come fast enough - no more legs-propped-up-over-the-side bathtub time. He sent my info over to a local clinic where I'll begin rehab. Hopefully, they'll call soon, because I can't wait to get started. We'll start on range of motion. I believe he said we could start unlocking the brace in a week, ditch the crutches in two more weeks (?!), and follow up with him in a month.

Three weeks on crutches? Man, I didn't think that would happen - I was hoping for a few days. I really think that I could get around without them, but I'd rather get the t-shirt the first time around.

I can see that my thigh is atrophying. Not a good thing, probably means I'll have to work that much harder to get my strength back. :( Oh well. I'll update after the first rehab.

One week out

Ok, so procrastination has re-established itself. Whatever.

The appt Fri went well. I took a couple pain pills at 3 am as my knee was bothering me a bit. But it really looks like I'm on the downhill side of the pain issue. Went into the Dr. at 1:00. I was anxious to finally see what this knee looked like, actually vaguely wondering if they actually did anything to it since my pain has not been bad. At all. They pulled the brace off, took off the ace bandage, then started cutting away the cotton bandage that had been wrapped around and around. It was a bit bloody, but obviously nothing fresh. But man, talk about an ugly knee. Fatty McFat! Well, maybe Swolly McSwollen is more appropriate. I assume they didn't remove my knee cap, but you couldn't be sure just by looking.

Doc came in said everything looked fine. Scheduled me for a Tues appt to remove the stitches, then probably Fri at rehab. I asked him about the meniscus damage and the procedure. He mentioned that there was damage to the meniscus on the inside of my knee and toward the outside. Cassi and he had talked right after the surgery and he had said that the meniscus damage could be old. Hmm...I had know idea - I assumed it was only damaged when the ACL was no longer there to protect it. Wrestling? If so, I bet the left knee isn't looking so hot either. The ACL tear itself - he said usually he sees a bunch of fibers from where the ligament is still attached. Mine, however, appeared to be missing - much of it had been absorbed back into my body. I'm not sure what that says about the severity of the tear, or if it says anything at all, it was interesting to me that he made a point to mention it.

On his way out, he asked who was with me today (I assume he was going to talk to them). Since I drove myself (yep, bad patient), I just gave him a dumb look and he said, "oh, I won't ask that."

The assistant then changed the tape on the incisions - two small ones just below the knee cap, one about 1.5 inches long below. She put the brace back on and spent a few minutes adjusting it since it no longer had to wrap around the bulky bandages.

Took a pill before bedtime on Fri night, then one again in the morning. Spent the entire day outside - heck, we had nice weather, sunny, mid-70s. Even got a sunburn. Did some tweaking to the truck ramps - too long to fit in the bed of the truck, and sat around all afternoon talking with the neighbors, watching the kids play. Took a pill Saturday night, just in case.

We got up Sunday and went to Target for groceries and stuff. Cass recommended I ride the cart. Huh uh. I crutched around the store. Got nabbed again by the Sunday morning beer law when we checked out at 11. I never remember that. :| Spent a lazy Sunday doing next to nothing. We had picked up the 1st season of 24 and managed to watch 4 episodes before the day was out.

As far as the knee goes, it's getting easier all the time to get around. I'm not supposed to be putting any weight on it, but it doesn't hurt when I put a little on it. I'm not gonna do anything stupid, but I don't think I'll be putting as much weight on the crutches from now on. I do, however, notice that there's now some tenderness on the inside of my knee - there's bruising there and that's where the meniscus damage was.

Monday morning - one week post op. I can see a significant difference in the amount of swelling. My knee cap is becoming visible again! Here's a pic of my knee.


And here is the bruising on the inside and back on the knee.


I can't wait to get these stinking stitches out - that probably means I'll be able to shower again. I'll probably have to sit on something, but who cares? Showering is one of life's comforts that's easily taken for granted. And I think I'm gonna try to stay off the pain meds. Not sure how rehab will go, might need a couple then (?), but I'd like to close this chapter of recovery.

Rejoining the world

Ok, so it's only been 3 days. But being cooped up at home, or at least knowing that you're supposed to be cooped up, makes the cabin fever set in. Yeah, I know, I snuck out to the grocery store yesterday, but that was just for a few minutes. Today, I actually drove into Houston.

Had some coffee to get the day going after a GREAT night of sleep. For the first time, it seemed that I actually slept for several hours at a time. (Quite a contrast to the last couple nights - I remembered glancing at the clock on one of those nights, wondering if it's almost morning yet and seeing that it was only 11:30.) I could sleep on my left side, right side, or my back. Didn't try on my stomach, but it's a welcome change to be able to sleep pretty much how ever I wanted. The coffee this morning kept the digestive system in tune, no need for any other type of pill to keep things moving. I strongly suggest it to anyone on pain meds.

So I had made some plans to get out today. I needed to talk to some people in Clear Lake about a possible career change, and we needed to get some ramps for Carson's motorcycle. Lifting it into the back of the truck is not really an option right now, nor do I care to do that ever again. Northern Tool has a kit so you can make ramps from 2x8s.

The drive: kinda scary - my right leg propped up on the console, driving with the left one, and unsure how much the meds are impairing my judgment. Well, at least I don't reek of booze. But it went fine, though I was happy to be home when finished. I supposed it also helped reaffirm that there are still decent people in the world as I had people holding doors open and the dude at Northern Tool carried my stuff out to my truck.

Once I got home and got some lunch in me, I thought about picking up Carson from school. It's a bit of hike on crutches, but I decided to give it a go. After having to tell Cassi 3 different times, that yes, I was going to pick up Carson, she canceled the baby sitter. Overall, it wasn't too bad, but I was pretty tired when we got home. I might adjust the crutches - that might have helped some.

We sat outside for a bit and I put the ramps together. It only required a drill, a wrench, and a hammer. But since I couldn't find a hammer, the ratchet driver had to suffice. Craftsman tools, guaranteed forever.

Well, it's 8:00 now, 6 1/2 hrs since my last meds. I feel fine, but I'll go ahead and take a couple now anyway. Maybe I'll try 1 every 4 hrs tomorrow, and see if I can stretch it out further after that. Tomorrow at 1 pm - appt with the knee doctor. I hope to hear that I can start putting weight on this leg, hope to hear that it's okay if I have been putting weight on it (!), and hopefully I'm done with the crutches. I know that he's not as aggressive with the rehab as some stories I've read, but hopefully I can get back closer to real life quickly. I'm okay with the brace, but I really want to see the sticks go away. Wish me luck.

Sleeping stinks

Both nights so far have been long. It seems that I only sleep for an hour at a time before I'm tossing and turning. It just seems to be a very repetitive cycle of getting comfortable, dozing off, rolling over, going to the bathroom, and taking pills. I was able to sleep on my side as well, though.

I had zero pain most of the day today. Yes, zero. Which is awesome. The nerve block has almost completely worn off, just a little bit of pins and needles in my foot. Staying on top of the pain medication seems to be working - and I'll be sure to continue that.

I did sneak off to the grocery store this morning - had to get some coffee creamer and some pooping pills. It wasn't too bad, and I wouldn't be extremely hesitant about driving again.

Still dozing off and on through the day. Hopefully that'll change as I plan to step down the meds tomorrow. I'm on 2 pills every 4 hrs, I'll try 2 every 5 hrs and see how that goes.

The Journey Begins

All said - it wasn't too bad. We got up and around, and got the boys to school. I ran to Academy to get a pair of shoes as I really didn't want to bring my old raunchy ones to the hospital. When I got back home, Cass was in the drive getting ready to go - "leave it to you to be late to your own surgery." We headed out and walked up to the Day Surgery desk with 20 seconds to spare. Hrmph.

We get checked in, put on the gown, and a nurse takes my vitals. A little after 11, they started the IV - which was a bit of a shock in itself, watching this lady's shaking hand coming at my wrist holding a needle. Yikes. They put some sort of medication into the IV and the buzz begins. The anethesiologist offered a femoral nerve block - it would make most of my leg go numb in order to help post op pain. Meh, why not?

Around 11:40, they push me into the operating room and get started. They started fishing around for the nerve for the nerve block. It's a needle that they can run a current through - when they get the nerve and run a pulse of current, the muscles in your leg contract. Kinda weird. Shortly after, the needle doc told me he was putting in the good stuff. Whatever, that stuff won't knock me ou....

At some point I came to. They must have asked me something - I just remember saying something about going home and drinking beer in the driveway. Then it was sleep time again. I woke up again and started talking, but it was all pretty much auto pilot. I know it was about 3:10, they kept saying that they were surprised how coherent I was. They showed me pictures of the inside of my knee from the procedure. Apparently there was more damage to the meniscus than they expected. Cassi and Dr. Smith had talked and he felt that the damage was somewhat old. I'm to see him on Fri, so I guess I'll find out more then. They said everything was good to go, but it might arthritic when I get older.

The next 40 minutes or so were pretty hazy, and my stomach was a little queasy from the anesthesia wearing off. Wow, I hate that semi-burned plastic taste. Gah. At some point they wheeled me into my room. The nurse gave me a muffin and some coke. I had to go slow as the queasiness hadn't completely disappeared, but I was very hungry. I got most of the muffin down and about 16 oz of coke. She gave me some pain medication at about 4:30, and we checked out around 5:15.

We pulled onto our street just before 6 and a bunch of people were outside. After having been couped up all day, I wanted some fresh air. We stood around and talked for about 20 minutes, then I went inside and beached myself on the couch. I built a pillow tower to keep my knee elevated and had a couple corn dogs and mac-n-cheese. I watched 24, talked to my folks, and headed to bed.

Pain, so far, has really been a non-issue. After the surgery is what just a dull ache. Pretty much the same even now. I have made sure to stay on the medication - Norco, which I understand is pretty much the same as vicadin. I'm supposed to take 1-2 every 4-6 hrs. For the first 24 hrs, I'm going with 2 every 4 hrs. I'll slowly back it off after that.

The Night Before

Well, tomorrow is the big day. ACL surgery. (Quick history - tore it in Sept 06 playing softball. Knee buckled in mid Oct, then again at the beginning of Dec.) I'm just anxious to get it over with. I don't look forward to the recovery - pain, swelling, hobbling around - but after it's all said and done, it'll be good to not have to worry about my knee buckling when doing something as simple as throwing a frisbee.

I had a couple options for the procedure. The doctor could either use part of the patellar tendon or hamstring to make a graft, or he could use a donor graft (allograft). I really don't have a preference (I assumed that donor grafts were uncommon), but when the doctor mentioned using an allograft, I was surprised, but ready to go that direction. There's supposed to be less pain and faster recovery (since they're not harvesting the graft from me), plus it has the added benefit of freaking out Carson and the other neighbor kids. I told them to keep an eye on me, as having this surgery done might turn me into a zombie.

I'm also a little curious to see if he'll find any other damage while they're digging around in my knee. From what I understand, 50% of the time they need to trim the meniscus, and the doctor did say that he say what looked to be some tearing - hopefully nothing too serious there.

Blah blah blah. I've obviously thought about this too much. Only 3 1/2 more hours to enjoy food and water - I'm sure gonna miss that morning coffee.

First go...

Just setting up the blog s/w, making sure all is well...