ACL pop, surgery, and beyond...

[Mtn Man]

Thought I should start my own thread about my journey. It started with this TR of how the ACL rupture and meniscus tear happened at K on 3/12/05 :
http://www.tetongravity.com/forums/s...4&page=1&pp=25

The MRI showed a total rupture of the ACL, torn posterior horn of the lateral meniscus, bruised tibia plateau bone, osteochondral impaction fracture of posterolateral tibial plateau, MCL and hamstring sprains, and lots o' edema all throughout the knee.

Almost two months out and a few weeks of pre op PT under my belt, the surgery is set for May 11th at 7am. This should be interesting since I've never actually had surgery or been out of work/school for 2-3 weeks in my life. I just put in for short term disability at work and have been stocking up on quick cook food, spill proof coffee mug, DVDs, and anything else I can think of for post op. The doc ordered an Iceman and CPM for home, we'll see if the insurance will cover them. Pretty freaked out about the surgery, but know that it's gotta happen. I already told them that I want to be knocked out cold. Huckwheat definitely has balls of steel for going through that awake.

The one confusing thing that happened so far is that my first ortho told me to go with the surgery. I went for a second opinion and the guy told me that I should just do a lot of PT and that I don't need the surgery. After a ton of deliberation, age factor, agressiveness in sports, research from people first hand, etc, I decided to go for it. I'm the last one who would want to have surgery, but I know it's a necessary evil to enjoy the white stuff that we love. I CANNOT WAIT UNTIL OPENING DAY!!!!!!

I'll probably update this while riding the couch, stationary bike, blades, and eventually sticks in Novemeber

B)

[Mtn Man]

Woo hoo! 1.5deg extension, 120deg flex aided, 95deg unaided. Last day of PT is set for Wed, then cut next Wed. I've got the free busted stationary bike all fixed this weekend and waiting downstairs.

Question about pain meds, what is the best stuff? Vicotin gives me a good buzz but doesn't really kill the pain. Tylenol w/ Codeine didn't do a thing.

Do you get a Anestesia hangover? Anything you can do to avoid it? I have Transderm Scop patches, was wondering if anyone used them for post surgery nausea?

Thanks!
B)

[Kellie]

Good luck on the surgery - just about to join the elite club. You're doc will likely prescribe whatever he's used to - I had percocet, but was only on them for a few days. You'll probably be similar, as that tends to be the case around here.

Some get the anesthesia hangover, I didn't. You're pretty much on the couch anyway . . . take altagirl's advice and keep the leg in the air . . . it's some painful swelling in your lower leg and knee if you don't . . .

Best of luck and keep us posted!

Kellie

[Plakespear]

Never had knee surgery, but the times I had anesthesia I didn't have a hangover. I had lots of pain in other places, like where I was sliced and diced...

But if you want a hangover, I'll take a trip to NJ with the beverage of your choice. And I've got some new Mtn. Bike DVD's to help pass the couch time (as well as Spinal Tap...)

[basom]

best of luck mtn man. i had no hangover. just woke up, hour later i took a leak and they sent me home. i say go for the epidural. it really helps to get home and settle in before you have to deal with the real pain. (my epidural lasted about 20 hours).

i got sent home with surgical stockings to help controll the swelling in my lower legs. they help a lot, so be sure to wear them for a few if they give em to you.

i'm not going to lie, its going to be wierd for awile. but you'll be stoked to be on the way back.

[Mtn Man]

Never had knee surgery, but the times I had anesthesia I didn't have a hangover. I had lots of pain in other places, like where I was sliced and diced...

But if you want a hangover, I'll take a trip to NJ with the beverage of your choice. And I've got some new Mtn. Bike DVD's to help pass the couch time (as well as Spinal Tap...)

May take you up on that, but I actually got Spinal Tap DVD for Xmas from my pop Ski porn, comedies and a lot of popcorn are ready!

Plakes, you never got a hangover or withdrawl from the Morph drip they had you on while at JH? That pic still haunts me. You gotta go back and beat the living shit outta that tree

B)

[Mtn Man]

best of luck mtn man. i had no hangover. just woke up, hour later i took a leak and they sent me home. i say go for the epidural. it really helps to get home and settle in before you have to deal with the real pain. (my epidural lasted about 20 hours).

Can you get the epidural and knocked out, or is it one or the other? I'm sure I'll ask this the day of, but thought I'd ask here too.

B)

[basom]

Can you get the epidural and knocked out, or is it one or the other? I'm sure I'll ask this the day of, but thought I'd ask here too.

B)

you can get them both, i did. and was glad. i hate pain, and watching myself get surgerized - so i minimized that stuff.

[Mtn Man]

take altagirl's advice and keep the leg in the air . . . it's some painful swelling in your lower leg and knee if you don't . . .

Best of luck and keep us posted!

Kellie

Thanks for the well wishes. Definitely learned the RICE technique worked the full week after it happened. My leg was a sausage when I didn't elevate it properly. I probably went back to work too early on it, because my leg looked like it was going to burst when I got home. Stayed home the next day, it was just too painful. Already put in for the time off, so it's a done deal, except for the occasional trips to the fridge, bathroom, and PT.

B)

[milton]

Can you get the epidural and knocked out, or is it one or the other? I'm sure I'll ask this the day of, but thought I'd ask here too.

B)

Yep, I had both. As it was explained to me, i wouldn't actually be knocked-out and they could wake me if they had too. But about 2 mins after the drip started i was in la-la land, last thing i remeber is getting rolled on my side for the epidural, which i did not feel at all.

One mistake I made was not keeping my leg elevated on the ride home after surgery. I didn't get released until about 4 hours post op, but my lower half was still pretty numb. Unfortunately I had an hour+ ride home and didn't keep the leg iced and elevated. When everything wore off the pain kicked in big time. My percs did nothing for it, but at least knocked me out for a couple hours at a time. But you get through the first night and everything after that isn't so bad.

You may notice a deep bruise on your upper thigh about 2 or 3 days after, it's from the torniquet. Man that thing hurt worse than my knee did for a couple days. Dunno, maybe i was a bleeder and they had to crank it way down.

Goodluck to ya!

[basom]

^good point

when anticipating comming off your epidural be sure to be well medicated. do not wait for pain brfore taking drugs. managing your pain correctly for the first few days is important for your sanity. always stay ahead.

[Mtn Man]

I'll make sure to stay ahead of the pain, that sounds like a plan. Went to my last pre op PT session this evening. Got to .5 deg extend and 123deg flex aided, 105 unaided. I think that's about as good as it's going to get with the damage that is inside my knee. We think the damaged meniscus and ACL are partially blocking the movement inside. He gave me a few exerces to do right after surgery, which is in a week from now. So I just have to keep the knee mobile this week, I can't wait to get this damn thing over with. Been staying late at work just to cross train people and catch up on all the stuff on my desk so it doesn't sit there for a couple weeks while i'm gone.

T-minus 6.5 days...

B)

[milton]

>>T-minus 6.5 days...

Mt. Man under the knife today?

+++vibes, let us know how it went.

[spanky]

>>T-minus 6.5 days...

Mt. Man under the knife today?

+++vibes, let us know how it went.

he went in today. i'll try to call him tomorrow.

[Mtn Man]

Back from surgery, been in and out of conciousness a better part of the day. Percs are definitely my friend, no problems with hurling, although balance is a challenge. If I miss the 4 hour time on the meds, it REALLY hurts, so I have to keep up with them.

The docs and nurses were great there, made me feel comfortable. Although, waking up in recovery, the knee hurt a lot, so they gave me demerol, good stuff. I have a cold therapy machine strapped to my leg underneath my brace, so that's helping with the healing and pain too. They took pics of inside my knee, looks purty in there.

The good news is that I can put some weight on it already, I guess the meniscus repair went well. I'll start doing some of the exercises that they gave me tomorrow, just sticking to the gas pedal pumps right now.

A big thanks to all for the positive vibes today. All of the advice is greatly appreciated, made the whole experience much more comfortable knowing what I was getting into.

Now for the recovery, bring on the womens, booze, and ski porn!!!

B)

[Mtn Man]

Anyone get a lot of pain at first from the CPM? Doc told me to get on it right away and I did it for about an hour last night before the pain got to me. They told me I should be doing that thing for 6-8 hours a day when only an hour killed me. I have a call into the doc to ask about it. Barely slept last night, the percs only worked off and on. I could walk on it before the CPM arrived, but it hurts like hell when I get up now.

B)

[truth]

Is the CPM set up properly? I had some pain due to the sling not allowing my calf and hammy to move freely during fexion. They gave me a diff sling. I really had no pin in the CPM. The pain was really only bad when trying to stand up.

What ROM are you using on the CPM? Being on the CPM actually felt pretty good for me except the first 5 minutes after raising the ROM. A trick I used was to start with a lower ROM and add 1 degree every few cycles until I got to where I was supposed to be. Kinda like a warm up.

Get going on the quad flexes ASAP! It's all about getting the quads to fire again that allows you to be able to limp / walk without the crutches.

[Mtn Man]

Is the CPM set up properly? I had some pain due to the sling not allowing my calf and hammy to move freely during fexion. They gave me a diff sling. I really had no pin in the CPM. The pain was really only bad when trying to stand up.

What ROM are you using on the CPM? Being on the CPM actually felt pretty good for me except the first 5 minutes after raising the ROM. A trick I used was to start with a lower ROM and add 1 degree every few cycles until I got to where I was supposed to be. Kinda like a warm up.

Get going on the quad flexes ASAP! It's all about getting the quads to fire again that allows you to be able to limp / walk without the crutches.

Well, the CPM is doing better now, I've been using a lower setting. I was starting at 40 and it killed me in an hour. I've been doing 30 for about 2 hours and still going well. I'll try to ramp it up later tonight. PT starts tomorrow at 11am, have a feeling this is REALLY gonna hurt. We shall see. Starting the quad, hammy, and glut flexes today. Gas pedal pumps every hour.

B)

[truth]

Focus on the gas pedal and the quad flexes...do them whenever you can. I mean like every commercial break. My CPM protocal was started at 30 degrees and called for me to increase by 10 everyday until 90. I was able to bump that up by dialing in 1 degree at a time every couple cycles until it felt like it was just enough. You'll know when cuz yer knee will feel like it's gonna rip open.

With the CPM, the most important part is actually extension. Make sure the straps are snug enough that when the machine goes down your leg goes with it. Serioulsy bro, getting your full extension will be the toughest part of rehab. It took me 4 weeks to get to a real 0 degrees. Sounds like you're hanging in there, keep the faith, it does get better.

[Mtn Man]

Got in about 7-8 hours of CPM yesterday and 2 more hours this morning before PT.

First PT was pretty rough today. Got there at 11am and we took the gauze and cotton off. It surprisingly didn't look that bad. It's definitely not from the horror show that I've seen from some ACL surgeries. I'll take a few pics the next time I take the stuff off. Swelling itsn't too bad either. So we did a few exercises, electric stim on the quad, then ice and stim. It was good to get out of the house for a while, the sun was shinin' today. Then the problems came. Got back to the house and had subs to eat. Just after that, I got bad chills and weak all over. So I just rested in bed and tried to stay warm. I was back to normal after about 2-3 hours. My only guess is that I went through slight shock from all the electric and stress on the knee from PT. Still going strong with the Percs, but may try to go down to one every four hours and see how it feels tomorrow. Next PT is Monday, just chillin' with TIVO through the weekend.

B)

[Kellie]

I had the same shock response to my first PT - only it happened at the office, and I was dizzy and nauseous for awhile afterwards. It sucked royally.

All I have to say is that the others are right. It does get better soon (esp after the first week), although the mind games start soon, which are a challenge in and of themselves . . .

Best of luck, keep your chin up [kellie <-- feels like a hypocrite], and keep us posted!

Kellie

[Mtn Man]

One week down, post op......

Went through 2nd PT on Monday and 3rd today. Getting 80deg flex and 11extention. They seem pretty happy with that, especially the strength in my ankles, calves, and pushing and resisting them while applying pressure to the bottoms and sides of feet. Did the stim, many exercises, had a good work out today. That surprising considering that I had a pretty good fever going the entire day before, where everything hurt, either extremely hot or shivering, and my head felt like it was going to explode. Talk about a 180, I feel so much better today. Pop came to help me out with a few things, it was good to get out of the house for a while.

First post op doc appt tomorrow at 10am, can't wait! I think they're going to take the stitches out, will be soooo cool to actually take a real shower. Keeping up with the home exercises and CPM now, trying to make up for yesterday's set back with the fever.

B)

[Mtn Man]

Post op doc appt #1 today:

They seemed pretty happy with the results. Had an xray, they showed me the bio screws in my leg and explained the ortho pics they gave me the day of the surgery. Looks like they cleaned up the knee quite well, inside out out. They took out the stitches. they actually only had a stitch on each side of the knee, then one long subcutaneous stitch down the middle of the knee (about 2") and that was it. They said that they've become less invasive over the years, and that they stitched it up so I wouldn't even have a scar I was actually looking forward to having that scar/badge of courage on my knee, I guess I shoulda told them that before going in

So they told me do as much CPM and Cold Therapy as possible before they take the machine away (1-2 weeks more of it) and go to PT twice a week. PT is trying to sign out a stim handheld for me so I can use it on off days. They ordered a Donjoy knee brace(hinged) that prevents your knee from going past a certain angle that you preset. They told me that once I get on that in about a week, I shouldn't need crutches. I've heard that before, so I'm not holding my breathe just yet. The knee is still a little unstable when I put my weight on it and there is still a little pain involved in that too. No percs today though, just hitting the Advil and Naproxen now.

I guess a general question to all, how long before you were off crutches, how long on the CPM and Cold Therapy? Anyone go through this less invasive procedure (two small incisions on each side of knee, one port up top on quad, and 2" incision down center of patellar)?

B)

[dbldmnd]

I have got a similar set of incisions and I had the hammy procedure.

I was off crutches on day 6 and haven't looked back. No crutches and no brace. They wanted me to do full weight bearing asap. At my first PT I was around 115 deg. I've been trying to walk more normal, I'm still gimping but getting better. I still do the cold therapy every few days when it really hurts.

Just keep moving...

[Vinman]

Cruthes: average crutch time is about a week-2 weeks or so. Depends on the doc, depends on what was done to the menisci and depends on the person. I was off them in 3 days after my second.

Ice as much as you want as many times a day as you can. The faster that swelling is out the better.

A little pain with weight bearing at first is normal. That should go away.

Work on extension first, don't stress about flexion. Flexion will naturally come back as the swelling reduces. But if you can't extend your knee fully you won't be able to walk without a limp.