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Thursday, May 26, 2016

ACL Reconstruction Surgery and Recovery

It's all over now except the healing.... I had my ACL reconstruction/meniscus removal surgery yesterday morning, and I am now on my way to recovery.  I wanted to write about my experience because in doing my own research, I've found there are not a lot of actual accounts from real patients available, and the ones that are out there are kind of old. There are some YouTube videos, but I think writing can often provide more information because it's easier to go back and add things in. So, this may be a long post, but hopefully it will be helpful to anyone else going through this process.
My surgery took place at Methodist Hospital for Surgery in Addison, Texas. I was told to be there at 6:00 for an 8:30 start time, but when I got there, all of my paperwork actually said 6:30.  That's okay--it jut ended up being a little bit more of a wait.  There was definitely no one there when we got there, so there was no wait to get paperwork and bills paid, etc.
When we pulled up, Brian went in to get a wheelchair. We had mine, but they recommended we use there's, and that did end up being easier. It took a while for an orderly to bring it, but eventually he did, and I was able to go in and wait for Brian while he parked the car.  I waited in the lobby and watched the news for a few minutes. Before he even came back in, a nice lady from billing came and greeted me. We waited for Brian and then went back to sign paperwork and pay my portion of the hospital's bill.  Maybe it is tacky to discuss money, but I do see a lot of people wanting to compare how much surgeries cost, so I don't mind saying that our portion, 20% of the hospital's fee, was about $1500.
Next, we met a nice man named Eddy whose job was to keep Brian informed of what was happening while I was in surgery. He took me upstairs and into the pre-op waiting room. He got Brian's cell phone number, showed him where the cafe, vending machines, coffee machine, etc. were located. Then, a really nice nurse came out and got us and took us to the pre-op area.
Our curtained off area wasn't very big. It didn't have a window or a TV. I found out later that the one next to us did have both of these things, so I was a little disappointed. It would have been nice to have both of those things as we waited. It was just about 6:30 by the time I got back to that area. The nurse took my blood pressure, which was a little high, likely because I was nervous. She took my temperature, etc. and I had to do a pregnancy test. She said everyone who hasn't had a hysterectomy is required to do one.
Almost every staff member we met was extremely nice and helpful.

After that, I changed into the awesome hospital gown and some yellow socks with the anti-slip surface, transferred to the bed, and waited for the next nurse to come in and start my IV.  I had a warm blanket, but it was really, really cold in there. I almost asked for another blanket, but I toughed it out.
After about fifteen minutes, another nurse came in and started my IV. She also drew a few vials of blood, which she was able to take out of the IV prick so she didn't have to poke me twice.  She had me write on my knee. She said I could write whatever I wanted, so I wrote, "This one!" And then we waited, and waited, and waited. It was about an hour and a half, I think, before the next person came in.  Meanwhile, next door, a very animated couple took up residence. That woman was having back surgery which was also scheduled for 8:30, and she didn't arrive until 7:30, and had a constant stream of doctors and nurses over to discuss things with her. I know it was a totally different procedure, but I was feeling a little neglected, really cold, and wondering why they got a TV--and a window.
It was almost 8:30 on the nose when the first doctor showed up, and it was the anesthesiologist. By then, the entire bag of IV fluids had run out, so he had to get another bag going before he could give me the "happy" medicine.  As he went off to do that, a lady brought in the Polar Care cooler the doctor had arranged for and showed us how that works. I'd talked to her the day before and decided to go ahead and get it even though my insurance didn't cover it. I had read a lot about how this machine, which circulates cool water around the surgical area, does a lot for pain. So, I thought it was worth the $198.
As the Polar lady was finishing up, my ortho came in. He is a man of few words. He told me again what he was going to do, nothing I didn't expect, asked if I still had enough hydrocodone at home (to which I said, won't I need something stronger, and he said probably not) and asked Brian if he had any questions. I don't even know what it was I was supposed to ask, so I didn't have a lot of questions. I had been told earlier I would have to walk before I could go home so I asked if he thought that was going to happen (since I haven't walked in two months) and he said with help but I won't be putting weight on my right leg still.
The anesthesiologist came back in as my ortho and the Polar lady left.  They asked Brian to go to the waiting room now because it was time to do my femoral block. He would get to come back later to tell me goodbye, but things were getting real now, and I wasn't sure if I'd even remember if he came back in later or not.
The OR nurse came in and asked me my name and all of the questions about why I was there again--it's like a quiz and you have to pass it each time. She looked at my knee (my doctor also had to write something on it) and got on to me a little bit for not writing my initials. (The nurse said I could write whatever I wanted....) The anesthesiologist put something nice in my IV and I became very, very calm. I did hear him ask the nurse to go get him an anesthesiology tech at least three times before I started to drift into another dimension. He finally went out to get the other guy himself. I was still awake and semi-aware of what was going on, but not so much.  It took the two anesthesiologist guys a long time to find whatever it was they were looking for in my leg. They had an ultrasound machine and they were speaking a language that may as well have been foreign to me. I guess they were finally satisfied with what they had found and he put the blocker into my upper thigh.  I didn't feel it at all, although it must have been some heavy duty needle because I have quite the puncture wound now.
Brian did come back to say goodbye, though I barely remember it, and then I was wheeled back to the OR by the anesthesiologist guys and two OR nurses. When I got into the operating room, I was asked to transfer to the other bed, or table, and they helped me over. I remember thinking how everything looked so sterile and white, including the giant light hanging over the table.  I don't remember seeing my ortho in there at all. I don't remember being asked to count backwards or anything like that. I just remember moving over, and then the next thing I knew, I was in the Phase I recovery room.
I wasn't in any pain, but my mouth was incredibly dry.  The nurse offered me a pain pill, some water, and some crackers, all of which I accepted. My throat felt raw, I assume because of the tube that they probably put down it, but it didn't really hurt. I was having a hard time talking though.
My leg was wrapped in layers of gauze, ace bandages, and a huge immobilizer. I could tell the blocker was still working because it felt pretty numb, although I could feel my foot; I had my left sock on, but not my right, and my foot was cold.
I wasn't awake in Phase I for very long before the nurse wheeled me over to Phase II. Brian was brought back a few minutes later. I was really, really tired, but I also really needed to use the restroom because of all of that IV fluid. It took two nurses and Brian, but I was able to transfer into a wheelchair and go to the restroom before returning to my bed and falling asleep for about two hours. I found out later I was in the Phase I recovery room for about forty-five minutes.  So, all in all, I was in recovery for about three hours before I woke up, needing to go to the restroom again, unfortunately (because it was a real pain!)  and then I was able to get dressed and go home.
I wore some really stretchy, thin capri/yoga pants and a T-shirt, so it wasn't too difficult to get dressed, although the nurse and my husband had to help me.  My leg still wasn't hurting at all as they wheeled me down to the car, but my mouth was still incredibly dry. I wasn't sure how I would get into the car with the immobilizer on because it doesn't actually bend, but I was able to wedge it in by pushing myself up onto the console.
The ride home took about an hour, and the only time my leg hurt was if Brian hit the breaks a little too hard and I leaned forward on it.  I had to stop and get a tea on the way home because my mouth was so dry, but I definitely wasn't hungry, and the last thing I wanted was to end up nauseated or worse.
I got home and went to bed.  Brian hooked the Polar Care unit up, and it didn't seem to be doing anything at first, but it was cold--I just couldn't feel it because my leg was so numb.  Brian went to get my daughters, who had been at a friend's house. When they got home, they were a little leery of coming in because they were afraid that my leg was going to be gross.  Finally, they came in to say hi, but they didn't stay very long. I think they were happy to be home but tired from too much playing and afraid of all the stuff wrapped around my leg.
Brian went to get my prescriptions, which are an antibiotic and a pain medicine called Tramadol, which I hadn't heard of, but I have since read that it isn't very effective. I still have some hydrocodone, though, so I will probably be relying on that. I believe he prescribed the antibiotic because the tendon they used to replace my ACL is from a cadaver, and they want to make sure it doesn't cause an infection.
I didn't really sleep too much yesterday afternoon, though I did doze off for a few minutes from time to time.  I started to have a few aches later in the evening, but nothing too bad. I would say my pain was maybe a 3 or 4 at worst. The doctor had said I could take my immobilizer off to sleep, though I have read other doctors have said not to take it off, but then other patients also get some sort of machine that bends and straightens the knee, and I don't have one of those, so maybe every patient is different. So, when I went to sleep last night, I did take the immobilizer off.  I thought I would be more comfortable without it on, but in retrospect, I'm not sure it would have made any difference. I still had to basically sleep flat on my back because I can't roll onto my side with my knee wrapped in these bandages and gauze. I can bend it some but not completely, and I cannot completely straighten it either.
I didn't sleep well at all last night, despite having taken the Tramadol (I wanted to see how it compared to the hydrocodone.) My back was hurting from being in the same position, and my leg was starting to hurt.  I could tell the blocker was starting to wear off. I couldn't get my knee in a comfortable position.  I think I may have slept for three or four hours total, in half-hour chunks. Luckily, I wasn't going anywhere today.
The blocker was definitely gone by about 9:00 this morning, and my knee was really starting to hurt. Anytime the cold water started to run out of the Polar Care, I could really tell a difference. When it was time to take my pain medicine today, I decided to go with they hydrocodone. It seems to be a lot more helpful than the Tramadol.
Most of the pain I've been having is either in the back of my knee or in my shin, not too much in my knee itself, although there's been a little bit in the anchor site on the top, outside area of my knee.  I've also had a little bit of pain from the immobilizer digging into my leg and the cord from the Polar Cube digging into my foot. At one point, when it wasn't quite time for me to take my new medicine yet, my pain got up to about a five or six, and that's about the worst it's gotten today. I have had a lot of twitching and spasming, jerking, and cramping in my leg today. I decided to put the immobilizer back on because every time I fall asleep, my knee starts jerking around on it's own, which is painful and scary. I'm hoping the immobilizer will prevent any damage, though my understanding is there's not much I can do to re-injure myself at this point short of putting too much weight on it too quickly.
I go to the doctor on Friday to have my bandages changed and to see how everything is healing. Other than that, I'm planning on just doing a lot of resting this weekend.  I'm not supposed to put any weight on my leg this week, but when I go to physical therapy next week, they'll let me know when I can start bearing weight again.
That's where we are at this point, about a day and a half after surgery.  Does anyone have any questions? Anyone else whose been through this care to share their story? In my experience, every little bit of information is helpful, so please feel free to post in the comments or ask questions. I'll update again in a few days.

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