iainthinesward

[iainthinesward]

Two weeks down

Tomorrow, aka New Years Day, marks two weeks since my surgery.  I’m walking around the house with my brace unlocked.  Had my stitches removed on Thursday and can now shower and move around with out a lot of pain.  There is still a lot of swelling at the primary incision site so I need to keep elevating and icing. My physical therapy regimen is as follows:

- Quad sets, with and without a towel under my knee, about 30-40 with a few seconds of flexing

- Quad engaged leg raises (supine, prone and dorsal with recovering leg going up). 20 in each position.

- Ball squeeze with pelvis lifts. 20 or so.

- Knee flexion sitting on a raised surface 0-90 degrees and then use other leg to exceed 90 degrees. 30 or so.

- Sit ups (this is my own thing to keep my core strength).  Chin to sky, belly button to the ground. 30 or so.

- Raised knee extension using a foam roller, 10 minutes

- Hold onto a high-top with finger tips, balance on right leg with knee slightly bent (unlocked) for 10 seconds, repeat 10 times

- Hold onto a high-top with finger tips and stand on tippy toes, stand on heals, repeat 10-15 times or so.

I’ve been trying to do these 3-4 times a day and then ice, elevate, and compress.  I’ve been working remotely but my plan is to go back into the office on Wednesday and Friday. My in-laws will be driving me in, but at my current rate of recovery, I’m fully expecting to be able to drive by January the 16th - the day after they leave town. 

I feel like my PT will be expanding my repertoire this Tuesday since I am progressing nicely.  To date, I haven’t done a heel slide on a smooth surface.  The PT protocol is different from when I tore my ACL, but that should be expected since I should now have more stability, but stitches and a weakened hamstring to consider.

[iainthinesward]

One Week Post-Op

It has been one week since my surgery and it is a white Christmas Day here in Pittsburgh.  Luckily, this is a “stay in your jammies all day” kinda day, so no worries of slipping outside.  I’ve been doing PT exercises and icing in between opening presents and playing with new toys with my daughter.

I’m still walking on crutches with my brace locked at zero degrees, but I’m putting more weight on my leg and getting it bend to 90 degrees while sitting with the help of gravity.  We went to Phipps Conservatory yesterday and it was good to move around and be out of the house.  It definitely seemed to help reduce the stiffness.

I’ll be going to PT on Tuesdays and Thursdays on an ongoing basis and my post-op follow up is this Friday.  Looking forward to being released to the next step of rehab and mobility, whatever that may be.

[iainthinesward]

Feeling Good

Today I had my first Physical Therapy session with the same PT I had after I originally tore my ACL and injured my MCL.  He is a great PT, especially for an ACL patient since he has endured the injury, surgery, and rehab himself.

I hadn’t really bent my leg since coming home from the operation but I was able to get 90 degree flexion. I was able to get my leg almost completely straight (minus a degree or two) which is good progress considering I had my surgery three days ago.

The best part of the session was that my PT did a couple of tests on my leg and assured me that my graft had not failed (which I was worried about - see my previous post).

[iainthinesward]

Removed dressing, shower and a scare

This morning my wife removed the dressing that was put on after the surgery.  She put a couple of bandages over some of the incisions that were still a bit raw.  I have been able to control the pain by keeping my leg up, icing, and by using the TENs unit.  I’m sure that aspirin, Tylenol, and Advil had a lot to do with it as well.  

Entertainment has included podcasts such as Doughboys (current fav) and movies such as “Get Out” (amazing) and Pop Star (pretty good).

Everyone was out of the house and I took it upon myself to take a shower.  This might have been a very stupid decision but I was feeling dirty. I had to tape a bag around my wounds and use my crutches to get into the shower.  Everything was fine and I sat down on the side of the bath to clean my feet well and dry off.  I had dried off and was putting my brace back, buckling the bottom strap when my foot slipped a few centimeters I felt a pop in the back of my knee.

At this moment, I convinced myself that I ruptured my hamstring graft.  I screamed “Oh No” and the dog came to the bathroom to check on me.  I made my way to my phone and called my wife who told me to leave a message with my surgeons answering service.  They paged the PA and she called me and I explained the situation.

She explained that I might feel and hear all kinds of weird feelings and noises in the back of the leg due to the hamstring being used for the graph.   I got off the phone feeling a bit more at peace but still worried.  Dr. Google seemed to indicate that my graft is at its strongest right now.  Even though I’m reassured, I have my first PT session tomorrow so I may ask if there are any Lachman or Anterior Drawer Tests that can be done to see if my graft is still good.  Given that I can’t really bend might knee yet that might be somewhat difficult.

[iainthinesward]

Surgery and Day 1, Post-Operation

I was scheduled to arrive at the hospital at 6:30am on Monday.  The Friday before, someone was supposed to call me but I never heard anything because they were dialing the wrong area code (I need to get rid of my old 415 area code cell phone some day).  I had enough sense to call the hospital and I got my check-in time.  The weekend consisted of picking up our family (who are here to help after the surgery, and celebrate the holidays with us), dinners/brunches in which I abstained from alcohol, Holiday Pops with the PGH Symphony Orchestra, and final preparations for surgery/Christmas.

I took with me a bag full of books, magazines, my wallet, and cellphone.  I brought my brace and crutches from the original ACL-tear rehab.  The pre-operative staff were friendly and after taking my insurance I went to a waiting room where a very tired looking, elderly volunteer shepherded my wife and I to the pre-operative area, which was already bustling at this early hour.  There was no door to my “room”, but there was a curtain, a moving hospital bed and a TV.  I shut the curtain and disrobed completely, putting my clothes into bags and placing the rest of my belongings under the moving stretcher bed.  I tried to read a book but there were several interruptions.

First a PA came to take vitals and ask a few medical history questions.  I had been concerned about some high-ish blood pressure at my last PCP visit, but my vitals were pristine throughout the entire process (at least that is what my wife the NP told me).  I suspect lowering my caffeine intake allowed me to bring down my blood pressure. Next, a nurse anesthetist came to give me an IV.  All of the staff were friendly and kind, which is nice when you’re practically naked and getting poked and prodded.

My surgeon popped in and introduced himself to my wife and shook my IV’d hand.  He was very positive and upbeat and cut to the chase, “let’s get you out of here and start rehabbing”.

Soon, the anesthesiologist came into my room and remarked about my book choice (Harlan Ellison) and I corrected him when he misread autograph as allograph from the surgeon’s notes. He gave me options between a single-administration 12 hour nerve block and a pump that i could take home with me and administer over several days.  Given that the pain hasn’t been very bad since the surgery, I’m glad I chose the 12 hour block. 

The nurse came in eventually and gave me a cocktail of oral drugs including morphine, some calming meds, Celebrex, and I believe a stool softener.  Next a smidge of some anesthetic was pumped into my IV.  At this point I had articulated my name, DOB, and type of surgery at least 6-7 times and my perception of reality was starting to change.  My wife gave me a kiss and headed out to the outer waiting rooms.

Two folks introduced themselves and they lurked around for a while and then finally said “It’s show time” and I was wheeled down the hall.  I remember asking “What are those things?” and the staff explained that the red containers on wheels were suction receptacles. “Everyone asks that”, they said.  I relaxed knowing that I was just like everyone else.

The Operating Room was very bright and there were many people in lab coats milling around.  Some folks introduced themselves and I shifted myself from the moving bed to the operating table.  Then I remember a mask going over my face and everything went dark.

My next memory was gasping for air.  I could hear people rooting me on and eventually I had stabilized my breathing.  I think I was in and out of consciousness until I made it back to the non-operating room.  There, a nurse gave me ginger ale on ice and my wife came to greet me.  The surgeon had called her and reported that I had no evidence of arthritis or any other damage and it was a straight-forward ACL reconstruction.  Someone had attached my brace to my leg which is to remain on until my first physical therapy appointment at least.

I rolled out to the car with my crutches and I was informed by the transporter that a train crash in Washington had killed several people - so I felt even more lucky given my fears related to going under the knife.  In the back of the car, I propped my legs on two pillows and we drove to the pharmacy to pick up some a stool softener and Percocet.  I had already loaded up on over-the-counter Advil for pain and Bayer aspirin for blood thinning.

Since being home, I’ve been using the electro-therapeutic TENS unit (the pads were placed under my bandages before I left the OR) as well as an icepack compression pump.  I’ve been propping my leg up in bed and rotating between Advil and Tylenol.  I can get around on crutches and I can put weight on my operated leg, but I’m trying not to overdo it.  I still have my brace on and have been flexing my quad and doing leg lifts, but all the other physical therapy exercises from my discharge instructions look a bit ambitious at this point.

I was expecting the pain today to be unbearable, but it really hasn’t been bad.  I took the Percocet last night to sleep but i’m not sure that I really needed it.  The 12 hour nerve block may have extended into today or perhaps the pain will have a ceiling.  I did a lot of preoperative leg lifts and rode my bike for months. Since I had a year to heal my original injury, I felt physically prepared.  The original injury hurt way more than the surgery has, but maybe I’ll feel differently once we remove the bandages and I can see what my leg looks like.

[iainthinesward]

3 days until surgery

A year and 8 days ago, I was playing basketball and I tore my ACL and strained my MCL.  My thinking was that a 40 and over b-ball league would be less competitive that some of the leagues I had played in previously.  I was used to getting jammed fingers and pulled muscles and had taken a break to avoid injury.  The 40 and 50 year olds ended up being some pretty tough ballers.

5 days after my 40th birthday, in our 2nd game of the season, I caught the ball on the baseline and dribbled right and into a crowd, was double-teamed, lost control, stumbled and heard/felt a pop.  I lay on the floor screaming obscenities and my team helped me to the bench.  I made my way to my car, drove home and I knew that something really was wrong when the knee dislocated again when I went to bed.  When it dislocated a second time, the pain was as agonizing as the initial injury.

The next day my wife whisked me around town from an urgent care appointment to an orthopedic appointment and finally to an MRI appointment.  I was given a  brace and crutches and eventually made my was to seeing an orthopedic surgeon.

I rehabbed my knee with a physical therapist several times a week and eventually took over the therapy on my own.  The fixed brace was eventually allowed to bend and was downgraded to a heavy sleeve, which in turn became a light sleeve and eventually I weaned myself off of any brace. I put off surgery in order to go on vacation in the spring and enjoy the summer.  My ACL was gone but I continued to mow our hilly lawn, walk the dog, and as my physical therapist prognosticated “my bike was my friend”.

Here in the Steel City, the most-popular ACL-less athletes are DeJuan Blair and Hines Ward. Ward tore is ACL as a kid and didn’t even know he had until the draft combine.  Blair actually tore both of his ACLs and played in the NBA. I tried my best over the last year to do a Hines Ward impersonation but I was never able to return to anything more strenuous than riding a bike and lifting.  I ain’t Hines Ward and this blog documents the events that are to ensue after I coming to grips with that fact.

I was never much of an athlete.  I used to enjoy basketball and skiing, but my activity of choice over the years has become jogging.  Prior to my injury, I would regularly run for 30 minutes on the treadmill at the gym.  Since my injury, I’ve done some brisk walking and soft jogs for a few feet but my leg has never felt stable enough to run with, especially when running down hills.

So, I have one more weekend of health and rebooting this Tumblr is how I plan to document and regiment my recovery.  My goal is to be able to jog by this time next year or sooner.