Friday, August 31, 2012

3 weeks out of surgery

It's been three weeks since my knee surgery.  I began physical therapy this past Tuesday.  That was 18 days after surgery.  The swelling had greatly subsided and I felt ready to start working with the professionals.  I chose physical therapy office half way between home and work and plan on getting my sessions in after work 2 or 3 times a week.

I began my first session Tuesday afternoon at 12pm.  The first session goes a little longer and there were no other appointments, so I decided to go in and get it done.  My physical therapist (PT from now on) is a guy named Bob who as it happened graduated from the same high school as me a few years before I did and plays in the same Sunday softball league where I tore my ACL.  Strange coincidence.  The PT said he's had a handful of injuries similar to mine this summer as a result of playing in softball leagues.  That didn't surprise me much because I know I saw at least one or two other guys go down while playing in the league this past year.  I know one guy needed an ambulance for whatever happened to him.  A bunch of old guys trying to act young often times results in painful injuries.

We went over my goals, a timetable and I worked through I few basic exercises.  A lot of the focus at the beginning will be trying to get my leg to fully extend and also bend my knee as far as the other knee can bend.  I did a few exercises that worked on strengthening my quadriceps and also muscles up near my hip.  The whole session lasted about an hour and a half.  I was given some exercises to do at home on days were I don't have PT  and I left feeling good about where I was headed.  I went back to work and finished out the rest of the day.

I called Walgreen's late in the afternoon to get a refill of my prescription, thinking I better refill just to be safe in case there is some lingering pain after PT.  Walgreen's though, apparently had no record of my prescription and was unable to do anything for me until they heard from my doctor.  This was pretty strange since I had just been to Walgreen's days before to pick up the prescription.  I called my doctors office but was only able to leave a message with a nurse.

The next morning was pretty unpleasant.  Generally, mornings are the worst time of day for my knee pain because any pain medicine has worn off over night and my leg is just kind of in the same position all night and tends to tighten up.  I got up, took my last pain pill (usually i take 2 or 2.5), ate some high fiber cereal and went to work.

I began the day making a series of phone calls between Walgreen's and my doctor's office trying to get this all straightened out.  Hopefully, I thought, I'd be able to pick up the prescription around lunch time.  By mid morning, my knee and thigh were beginning to ache, at times there was this pulsating pain in my lower quad.  I felt like I was running a temperature and was told by a co-worker I didn't look so good.  I needed my pills, damn it!  The day after the first PT session was kicking my ass.

After another handful of calls, I was able to confirm with Walgreen's would be ready for pick up around 6pm, an hour after I normally get off work.  I hung around work for as long as I could but the place cleared out about 5:15.  I went out to my car, turned the key, and the son of a bitch wouldn't start.  I didn't really care about the car but if this episode got in the way of me getting to Walgreen's at 6, I'd just lose it.  Luckily, I had a friend come through and stop by and come jump my car.  I got to Walgreen around six, picked up my prescription, and was out the door with a smile.

The rest of the week was pretty uneventful.  I had my second PT session on Thursday.  It was very similar to what I did in my previous session, except it began with me doing 10 minutes on a bike.  The pain the following day, today, can't even compare to what I felt on Wednesday.  This morning, I woke up and took 2.5 pills and have been doing just fine.

Monday, August 20, 2012

10 Days After - Back to the Doctor

My first follow up with surgeon was today, ten days after the surgery.  My impression going in was that things were going pretty well.  I am able to walk around, albeit gingerly, I can get some good bend going in my knee, and the swelling has gone down noticeably.  To this point, I'm happy with my progress.

I got to the doctor's office for my 1145am appointment and waited until about 1210pm until my name was called.  The nurse told me she was going to take out the sutures and then the doctor would come in and take a look.  The sutures came out pain free and the nurse mentioned how the incisions look like they're healing well.

The doctor was in shortly thereafter and he basically wanted to see how far I could extend my knee and how far I could bend it towards my body while sitting.  He went through some still photos of the procedure, he showed me where my ACL was supposed to be but wasn't and showed me my new ACL which as it happens is some guy's old ACL.  You see, my new right ACL was harvested from a cadaver and then reattached inside of my knee.  Kinda weird but it's standard procedure in the world of ACL reconstruction.  I'll take this opportunity to thank the aforementioned cadaver for his body part that I will in the future find very useful.  Maybe a post dedicated to who it might have been one of these days.

Anyways, the doctor was satisfied with my progress and said I can begin physical therapy this week.  I need to call the insurance company and a few physical therapy centers to figure out how I can manage rehab with my job.  There seems to be a physical therapy office / building / outfit on every other street, so I don't envision a problem.

One thing from over the weekend I found out was that's its probably best to have an ample supply of prescription pain killers at all times.  I ran out on Friday and figured the weekend would be a good time to try and wean myself off the good stuff.  I started taking extra strength Tylenol and it just was not the same.  I had trouble sleeping for more than a few hours at a time and I had terrible, cold, night sweats.  I got my refill for my pain meds today and what a huge difference it makes.  So as a piece of advice if in a similar situation: Stay ahead of the pain and when running low on your pain meds, its more than worth it to get the refill when you're only a week out of surgery.


Friday, August 17, 2012

One Week Surgiversary

Today, Friday, makes it one week since I've had my ACL surgery.  In one week I've gone from being a crutch-needing, constantly in pain, frequently puking disaster area to merely a hobbling, somewhat physically independent, somewhat opioid dependent maker of progress.  There have been a few unexpected pop / crack noises that kinda shook me up.. The noises weren't followed by much pain, just maybe a tingle, so I figure it was just my knee kind of re-adjusting to its new surroundings.  I've taken it pretty easy and haven't had any bad missteps.  At times, I'm walking with no cane.  When I do I'm sort of hunched over.  It's obvious there's a limp or leg dragging but I'm able to put some pressure on it and keep my balance, so I'm happy to be walking again.

Despite all the positives, when I walk, I can feel how weak my leg has become.  The thigh muscles began to atrophy shortly after the injury occurred, strengthened some in the month or prior to surgery, but now they're really starting to fade on me.  My right thigh has a consistency similar to that of a packet of Go-Gurt.  If I were a chicken and you were going to eat me I'd recommend the breast or the wing or the gizzard, the thigh and leg are just not where the good meat is at anymore. It'll all come back with the physical therapy and strengthening exercises and time, but that's just it, it's going to take some time.  It's just incredible how quickly  the muscle deteriorates compared to how much time it takes to get it back.  I signed up for it though, so I just need to be ready when the time comes.

Hopefully, the time is next week.  I see my surgeon on Monday and I expect him to let me know when I can begin the physical therapy.  I think he'll remove the stitches and let me know how he thinks my recovery has progressed so far.  I've followed all the doctor's instructions, nearly to a T, so barring any weekend catastrophes, I expect to leave there Monday with good results and a better idea of the game plan moving forward.

Wednesday, August 15, 2012

Back To Work

I made it back into work today for the first time since surgery.  I brought my cane (below) with me to get around and a pocket full of pain meds to make the transition back that much easier.

Work wasn't all too bad, everyone there was very helpful, offered to get me water, etc.  Gotta take a little help sometimes, and it was nice of them to give me a hand.  Had a Qdoba burrito for lunch.  I checked a couple weeks back but nothing has changed.  Qdoba is still not a cure for a bum knee.  I'll follow up on this in due time, just to make certain the situation hasn't changed.

I had work to do, and stayed fairly busy so the day went by quickly.  It can get a little frustrating when it feels like everyone is asking you the same questions, and asking you how you're feeling, and can they do anything to help.  It's not that I don't appreciate it, and I know people just want to help, but for whatever reason I get annoyed.  It's probably more just being frustrated with myself. Having to explain what the prognosis is just makes me think about how long its going to be until I'm back on my feet.  It's tough knowing there are a lot of really simple things I'm used to doing without a thought that I'm just unable to right now.  I just need to take it easy and accept the help when people are willing to offer it.

All in all, it was good to be back at work, not laying in bed and actually making myself useful felt good.  I got home around 5:30pm and was pretty exhausted. I iced up my knee again, laid in bed and got a short nap in.  I was more tired than I expected since I slept pretty well the night before.  Just a longer day than I've been used to catching up with me.  Tomorrow I get to take my first real shower since having surgery, and I'm actually looking forward to that.

Here's the cane I've been using to get around.  It was my grandma's before she passed away.  It had a Made in China sticker on it, which I promptly removed.  America!  I think it's either an eagle, a whale, or since maybe a dragon on the top of the cane, but I'm not really sure.






Monday, August 13, 2012

How It Happened

The day that will live in infamy, June 24, 2012.  The old high school alumni Sunday softball league played up at the local park.  The fields have always been shoddy. I played on them as a kid and really nothing much has changed.  Plenty of dips and divots, areas where there's too much dirt or not enough, I guess basically your average Little League field.

Our team played two games that day, in the first we took a beating.  I think the score was 10-0.  It was ugly.  The next game was sure to be better though.  Our competition, a team named Travis and the Chimps was notoriously bad.  We were up probably 8 or 9 runs when I came to bat in maybe the 5th inning.  I hit a single to center field, the player bobbled the ball while fielding it and I decided to go for second base.  I was running hard and it looked like I was going to make it there safely, but as I put the brakes on quickly, my right knee gave out on me.  There was an extremely loud, dull pop and I went down in a heap around second base.  I knew immediately that something was very wrong and I instinctively grabbed my knee.  As players from the other team and teammates began to gather around me to see what had happened.  A person asked me if I wanted to get off the field; I most certainly did.  A couple of guys helped me up, and gave me assistance getting to our team's bench.

It was a hot day, so I parked myself under a tree in the shade.  A few people had extra ice so I bagged some up and began to ice the knee down, still mindlessly hoping that everything would be OK.  Maybe my knee just popped in and out real quick, with no real damage.  That would be great, but obviously it was wishful thinking.  As I sat there a few people walked by and asked how I was doing.  My friend's parents who came to the park to watch the game said that they could hear the pop from where they were sitting.  They were easily over 100 feet from second base where it happened, this can't be good.

Faced with the grim reality that something was seriously wrong, I did what most Sunday softball players would do at a time like this.  I drank.  I had a few at the park, I hobbled to my car, drove up to the bar and had some more there with the team.  It was beginning to get dark, I was beginning to get drunk, and my knee was beginning to swell up.  It was time to go home.  I limped out of the bar and to my car, a frustrated drunken mess.  I made it home safely, continued to ice the knee up and fell asleep.

The next morning I woke up to a grotesquely swollen knee (below) and called into work to tell them what happened.  I couldn't walk, was getting around the house using a baseball bat for a crutch and in quite a bit of pain.  Mentally and physically, that was a rough day for me, more difficult than the day of surgery or the day after.  I went into work the next day on crutches, I went to the doctor soon after and an MRI revealed that I had torn the ACL in my right knee.  I was headed for surgery, there was no way around it.

 





Day 4 - Monday

Another very early morning for me.  I was up at 430am with tightness / soreness in my leg that I was unable to sleep through any longer.  I went to the kitchen ate some shredded wheat, drank a glass of water and put down a couple of pain pills.  Not much to do at 430am so I went back to bed, put ice on my knee and laid there playing Words With Friends and reading some news articles.  

At about 630am my dad woke up, so I went into the kitchen and sat with him reading the paper and eating breakfast (more shredded wheat).  My mom came out shortly thereafter and I worked on the Chicago Tribune crossword before putting it down to walk around some. 

I have definitely made some progress in the past few days.  I am able to walk, with my knee brace on and without any crutches or cane as long as the knee brace is fastened tightly.  It keeps my knee from bending much when I walk, but it feels good knowing that I am able to put pressure on it and give it a bit of a work out.  I did a few laps around the house, some with brace on, no cane and some with cane and no brace.  After awhile though I could feel my leg getting sore / tired so I headed back to the bed to do some knee bending exercises followed by another round of icing.  It's afternoon now, though it feels later because of the early morning.  I expect the rest of my day to be similar to the beginning exercise, stretch, pills, ice, repeat.  Back to work tomorrow too, so we'll see how that goes.

Sunday, August 12, 2012

Day 3 - Sunday

Another early morning for me.  I got some good rest for the first time though.  I think I woke up half because of some pain and half because I was rested.  This is the earliest I've been up in three consecutive days in a long time.  I can't even remember when it might have been.

I got up and predictably went straight for the pain meds. They're a generic for the drug NorCo.  Anyways,  I had two of those with a glass of water and poured myself a bowl of shredded wheat.  I've been going for a high fiber diet as one of the known, common side effects of these pain meds is constipation.  Possibly more on this later.

After breakfast I decided it was time to take my original bandages off and replace with fresh ones.  But first I needed a shower.  The doctor told me not to shower for 5 days.  Now, I don't know if anyone follows this advice, but I couldn't any longer.  My hair was extremely greasy, it's August, I had been wearing the same shorts and underwear since Friday, the day of surgery.  I did change t-shirts one time.  I needed to keep the bandaged section of my knee dry so I got plastic garbage bag, had me mum tear a hole in it and slide it over my foot.  I tied it off with a twist tie and I was all ready to take a shower.

Getting in and out of the shower was a bit treacherous.  There is a tub, so having to step over that with one foot on the ground and a wet surface caused a little anxiety, but other than that good shower.  I got some fresh clothes on, brushed my teeth (also first time in while), and felt pretty decent afterwards. 

The bandage stayed dry in the shower and it was now time to take it off.  Here's a picture of how it was originally wrapped after surgery.




There was the Ace bandage on top, followed by some cotton wrap that tore off easily.  Under the cotton wrap was a thicker bandage seen in the next picture.  If you look you can see where my leg was waxed / shaved up to and in the inside of my thigh are the surgeon's initials (SC). 





Here's where it starts getting good, the final layers are coming off...getting closer to the potential gruesomeness.  Well here it is...








Obviously, lots of swelling.  The four cut marks are black, not because of the color of my heart and the blood it circulates, but because of an antiseptic called Betadine used to keep the incisions clean.  All the swelling makes it difficult to move or bend at all.  I've been doing knee bending "exercises" and trying to put pressure on while walking.  I've acquired a cane, which is great because waking up from sleep and naps has been getting tough.  Not my knee but just my entire upper body has been aching from using the crutches.  The cane helps me put pressure on the leg, gives me some balance and doesn't beat me up so bad.  I've decided to take the day off from work tomorrow and try to return on Tuesday.  I think by then I should be able to get around pretty confidently.

Saturday, August 11, 2012

Day 2 - The Aftermath

Day 2 started quite early.  By 2:30am I couldn't sleep, the pain in my knee was just too much to just sleep through.  I had probably yakked up the majority on the pain meds I took after dinner so I figured, despite the previous nausea I had to get some more.  I got up slowly, turned a few lights on and crutched into the kitchen.  I knew my stomach was near empty and since you aren't supposed to take this pain pills on an empty stomach I poured some water and grabbed some bread to make toast.  I nibbled at the toast, it didn't taste great and even smelled bad to me.  I drank the water slowly, refilled the glass and decided to go for only 1.5 pills this time.

I crutched back to bed, hoping this pills would kick in within a half hour and I could get some decent sleep.  As it so happened, this was not the case.  After about 15 minutes more nausea set in and I figured it was just a matter of time before that bread and water was on its way back up.  My dad had the foresight to put a 5 gallon bucket by my bedside for just such an occurrence.  I had a tough time even leaning up as my upper body, specifically my stomach muscles and back had taken a beating in the first round of vomiting.  I was sore all over but that didn't stop me from leaning over the bed and ejecting my recent bread and water. 

The rest of the night, I kind of just laid in bed  I had trouble getting comfortable due to knee pain and wearing a large, annoying knee brace.  I read some news articles on my phone.  It was just announced Mitt Romney named Paul Ryan from Wisconsin as his running mate in the 2012 Presidential Election.  So I read up on that and went out to the kitchen about 5am to try to drink some water and keep it down.  I had some strawberry Italian ice with it, and things weren't too bad.  I took my brace off and did some "walking" around with the crutches.

I laid back down and iced my knee, took some more pain meds and just let time pass while reviewing my fantasy baseball team.  I knew at some point I was going to have to try to keep some solid food down and I knew there were two leftovers pieces of pizza in the fridge.  I decided to go for it. I got up went to the fridge and got a glass of water and took down the pizza in no time.  Felt pretty good too, no immediate queasiness, no urge to hobble to the trash can.  Felt so good I decided to have a couple Nutter Butters that I saw in the fridge with some milk.  All this eating kinda wore me out.  I went back to lay down, fell asleep and woke up around 1pm.  I woke up feeling half decent, a welcome change.

I spent a lot of the day laying down, drinking water, and just surfing the Internet.  I started walking around more and putting pressure on my leg.  I was able to bend my knee and keep it flexed and then straighten it back out small stuff but you have to start somewhere.  The pain meds have been effective and I don't have any more nausea.  The knee itself it pretty sore, probably from moving it around throughout the day, but that's fine, it's to be expected.  Tomorrow, I have to change the bandage and I will get my first look at my new knee.  I know its going to be swollen as can be.  I'm interested to see where the incisions were made and I'm going to try to get some more direct ice on it.  Icing it through and a bandage and gauze just doesn't seem to have much of an effect, I don't think the coldness can get through.  Anyways, until tomorrow...



Day 1 - Surgery

I tore the anterior cruciate ligament (ACL) in my right knee playing softball on June 24.  I got a base hit was running toward second base when I tried to stop.  I felt and heard a loud pop, I took a tumble and immediately knew something was wrong.  I needed help getting off the field, went to the doctor soon after and was diagnosed with the torn ligament.  I debated bypassing the surgery because I was walking OK and didn't want to go through the extensive rehabilitation.  After speaking with doctors and a few friends whose opinions I value, I decided to go through with the surgery.

I was told to arrive at Christ Hospital in Oak Lawn, IL this morning at 6am.  I woke up at 5am and took a shower and drove over to my parents house.  I needed someone to drive me home after surgery and help with any other issues I might have at the hospital.  I'm lucky that they are around to help.  We arrived at the hospital right at 6am.

I checked in, signed a few documents and was brought to a pre-surgery room to change into a hospital gown.  It was about 6:20am at this point and the nurse told me that surgery was scheduled to begin around 8am.  With some time to kill, my parents came into the room to hangout and talk.  A few different nurses were in and out.  One hooked up an IV, another helped fill out some paperwork, others just stopped in to say hi and good luck.  Everyone was very friendly and helpful.

A young doctor, my surgeon's assistant / trainee / protege came in to say hello.  He fiddled with my knee a bit, asked which knee was being worked on, etc.  I must have been asked 7 times by 6 different people what knee was being operated on.  Better safe than sorry I guess.  By the third time, I wanted to have some fun with them and say "Knee surgery, no, no, no.  This is a gender reassignment."  But I chickened out and just kept saying, "right knee".

At about 7:40am a nurse wheeled me out of the pre-surgery room towards surgery.  They parked me in a room, gave me some oxygen and took my vitals.  My surgeon stopped by, asked what knee we were operating on, and initialed my knee just to be sure.  He gave me a run down about what was about to happen. I was going to receive a "nerve block" in my right thigh, which would numb my leg for about 16 hours.  After the surgery, I would have a knee brace and be able to put pressure on the leg as soon as the next day.  He told me to change my bandage in two days, not to shower for five days, and that we would have a follow-up appointment in ten days.  The anesthesiologist came by to introduce himself, explain the nerve block and just double check with me if I was taking any medications to avoid any complications.

It was go time.  I was wheeled into surgery, the room felt like it was about 50 degrees.  The doctors were talking about Ferraris.  Seriously.  They placed a mask over my face and I was soon out for the count.

When I woke up, I was in the recovery room, which I think was more of a hallway with a series of curtained off spaces.  I could be wrong about that though, this is by far the haziest part of my day and I don't have much recollection from here and up until I saw my parents back in the pre-surgery room in which I had began the day.  My leg was totally numb from the thigh down from the nerve block, it was a really bizarre feeling.  I was given some water, crackers, and pain meds and told to relax in the room until I felt a little less woozy.

Once I was ready to go, I got into a wheelchair and was wheeled out of the hospital.  Every small bump I hit in the wheelchair caused me to cringe.  I got into the car and it was worse.  Chicago area roads and train tracks can be pretty rough on people's cars.  They're even tougher on a guy with a recently operated on knee.  I couldn't wait to get home and lay down. 

When I got home, I got into bed and propped my leg under some pillow and just laid there.  This is the part of the day I was dreading the most.  Just home, big brace on my knee, big bandage, knee throbbing, and a long recovery ahead.  As I'm laying here I'm thinking this is exactly why I didn't want to go through with surgery in the first place.  The pain meds weren't doing much for me at this point, but I didn't want to overdo it with those, so i literally bit a rag on and off for about an hour.  I ate a turkey sandwich, we ordered pizza, ate some of that too.  Popped 2.5 of these pain pills in my mouth, took down some water and went back to lay down and ice my knee.

Within an hour my head was spinning, I was drifting in and out and really feeling nauseous (a side effect of these pain meds).  I had to get up.  I struggled to my feet and began to crutch into the living room where my parents were hanging out.  I saw a plastic bag on the dining room table and grabbed it just in case Cousin Ralph was coming over.  I just to the living and the feeling hit, not nearly enough time to get to the bathroom, so i puked right there in the living room.  I got the majority of it in the bag but there was a bit on the floor that my poor mother had to clean up.  Sorry Ma.  By now it was about 930pm and I decided to call it a night, I laid down probably falling asleep around 1030pm.