ACL Four Month Update

It's been four months to the date since my little accident which left me with a torn ACL, meniscus, ligaments, and bone bruises. It's been a little over two months since my surgery.  So.... here's where we are!
I am in mobility transition. I am moving off of the walker, although I'm still supposed to use it at work, and transitioning not just to the cane but off of it completely, too.  That's right--today at therapy I was practicing walking on my own! It's not pretty at all. It's more like a step with my right foot and then a drag of my left up to meet it. But it's progress!

Yeah--not me....

The pain is pretty minimal these days. Most of the time, if I'm just sitting or laying in bed, it's probably just about a one. If I'm walking or driving, it sometimes gets up to a four. Today, since I was walking unassisted so much, it got up a little higher. And when I'm practicing stepping up onto something, it sometimes gets up to a five or a six.  It doesn't stay there though. I am having some swelling still, especially in my quad muscle above my knee.  I got a new brace a few weeks ago that is a lot less invasive, but when my leg is swollen, it rolls down, which is really annoying. So most of the time I don't wear it anymore.
I'm still using the bench to shower because I don't trust myself to step up and over into a slick shower, but I was able to get out of the bathtub by myself last week, which is definitely progress. I had tried a few weeks before that and needed help getting up, because it is essentially like sitting on the floor--a wet, slick, slippery floor with no grip. But this time I was able to get out by myself, which is even more progress.

Rub-a-dub-dub, I got out of the tub!

On Thursday, when I go back to therapy, we are going to start working on ramps. I need to be able to walk up and down a ramp to get in and out of my car at work since the curb is still too high for me to step up on. I can only step up about two inches right now and most steps are between six and eight inches (can you believe that?!?) The parking lot in front of my school is rocky and uneven, so I'm pretty concerned about walking on it without my walker. So for now, I'm supposed to use my walker at work and either my cane or nothing at home. It may take a while before I feel comfortable walking without my walker from my parking spot to the school.

Yes to the ramp--no to the wheelchair!

I can bend my knee almost completely. It's within one degree of my other knee. My extension is between 12 and 5 degrees most of the time.  Swelling keeps it from completely straightening, as well as my quad strength. I'm still working on it every day though. My knee is even more bent when I am standing up, unfortunately. I'm riding my recumbent bike a lot, and I think that will help.
The therapist I saw today said it's very possible I could be released from therapy by the end of September, which would be awesome. I know that it's going to be very difficult to keep going to therapy once school starts. It's already difficult since I'm back at work, even with the girls at daycare instead of school. I will hardly see them at all on nights when I have therapy once school starts.
That's where I am right now. It's not graceful. It's not pretty. But it's a form of walking. And I'm hopeful that I will continue to make progress at a good rate over the next two months so I can be dismissed.  (I will miss my therapists, though! If you need a therapist in the Dallas area, I highly recommend Baylor Wylie!)

ACL Recovery Six Weeks Post-Op

It's been a while since I updated my status.  It's been a slow but steady journey, and every day has its share of triumphs and defeats. I am still using the walker, but I am getting stronger, and I am hopeful to move off of it onto a cane within a month, though my therapist says it might be two. I am able to take my leg brace off now, though I sometimes still wear it, especially if I am walking on uneven surfaces.  I can step up with my right leg and then my left as long as it's not a very high step. I am still struggling with stepping up with my left leg first, which is frustrating.
I am able to ride a stationary bike now, which is good.  I can go all the way around--something I wasn't able to do last week.
My extension was at about a 12 last week, but I think it's better than that now because I've really been working on it this last week.  Not sure what my flexion is but it isn't as good as my left leg yet.
I was able to take a bath earlier this week, though getting out of the tub was a struggle. I am still using the bench to shower because it's just easier that way, though it's certainly not comfortable.
So... that's where I'm at six weeks after surgery, three months after the injury.  It's frustrating and often depressing, with glimmers of hope and occasional pride in mastery of a new skill.  The one thought I have to focus on is that I cannot compare myself to anyone else.  No one else has the exact set of circumstances that I do. When I see younger, more active people at therapy with the same injury walking around a week after surgery like it's nothing, it's hard to remember that they probably didn't spend almost two months in a wheelchair before the surgery.  Or maybe they didn't also tear their meniscus. Or... lots of other things that could be totally different.... For now, it's one day at a time, one step at a time.

ACL Reconstruction Post-Op Days 8-10

Day 8 was pretty uneventful--it was basically a repeat of day 6 and 7. Things got a little better in the pain department, but I was still around a 3 or a 4 most of the time, with tiny spikes to 7.  Day 9, however, was a game changer.  Day 9 was the day I took control back over the situation and was reminded that I am the only one who can "fix" me.
I went to the physical therapist for the first time on Friday, which was Day 9. It was an early appointment and I took my medicine about an hour before it was scheduled to start so that if they decided to torture me, at least I'd have something to take the edge off. This is the first time since the accident that,when they've called my name at an appointment,  I've gone back on my own--Brian stayed in the waiting room. It was a little unsettling, but I knew this was something I had to do by myself.
I really liked the therapist right off the bat. He was very easy to talk to, seemed genuinely concerned about my injury, and definitely gave me the impression that we were going to get me all fixed up in no time. But after I finished telling him what had happened, and he'd asked me about my goals, etc., he said something that really resonated with me. He said, "I can't fix you--only you can fix you." I've known this all along, I guess. But hearing him say it really reminded me that whether or not I ever walk again is really up to me. I can go through the motions, or I can choose to ignore them altogether, and either way I end up in a wheelchair for several more weeks, months, years. Or I can give this everything I've got and get back to normal as quickly as humanly possible. Of course, I need guidance from the therapists, but at the end of the day, the results are all up to me.
I was there for about an hour.  We did measurements and I found out that my leg will currently extend 31 degrees. My left leg, the good one, extends to -5. He explained that I will need to get my right leg even with my left so that I can walk without a limp, etc. He also told me how far it was bending, but I don't remember what he said. I am definitely more concerned with extension at this point.
He showed me six different exercises that I will have to do several times a day. They are all designed to stretch out the ligaments and muscles in my leg and get it to extend and bend the way that it is supposed to. The worst one, by far, is the slow stretch, where I extend my leg as far as I can and then leave it that way for up to fifteen minutes at a time.   So, for me at this point, this would be taking it out 31 degrees, and keeping it stretched as long as I can.  He said I could start out at two minutes, but I needed to build up to 15.  This is one of those slow burn, no pain no gain type of exercises. Sounds simple enough, but it is pretty painful. He told me if it hurt above a four to stop, and if it really starts hurting I suppose I will, but a sustained pain at a four that you know you can relieve by changing position is almost as bad as a sharp seven that goes away pretty quickly.
I really liked my therapist, and I felt like he had a great plan in place. Unfortunately, at the end of the session he told me he wasn't going to be working at that location anymore. That was kind of disappointing, but I'm sure they have other therapists that are just as good and that will help me make quick progress.

My daily exercises!

I go back on Tuesday, which will be post-op Day 13. By then, my goal is to have my extension to 20 degrees. That seems like a big jump to me, but I'm ready for the challenge.
My next stop on Day 9 was back at the ortho's office.  There's a nurse there who is very nice and she always stops to speak to me even when I'm not her patient. I was really happy that she was the one to remove the tape from my wounds!  I thought a man would probably just come in and pull it all off, but of course she didn't. (Most of the other nurses in the office are men, including the guy who insisted I fully straighten my leg last time, even though I can't.)  She cleaned it off with alcohol and the tape all came off pretty well. It actually looks a lot better, although it's still a bit misshapen and there will likely be some scarring.
My doctor checked it, forced me to fully extend it, even when I told him the PT said I couldn't, and checked how far I could bend it. Then, he showed me some pictures from the surgery. Apparently, I had completely severed my ACL from my femur. There was just a scraggly little stump left, like the roots of a weed holding on for dear life. He showed me pictures of my new ACL, too.  It looked very sturdy and fully capable of doing its job!
For some reason, I think the doc was under the impression he had already given me a brace with an adjustable locking mechanism. I explained that I haven't had one. He asked a similar question at the hospital, so I think he that we had done this already. Well, I got one yesterday and got it fitted. They locked it in at 20 degrees. I was confused and explained that my extension was only 31 and they said okay. I don't know if these two things are related--I thought they would be--but when they put it on, it wasn't uncomfortable (I mean, not anymore than any brace would be) so I guess it doesn't matter that I'm at a 31 and it's at a 20.  I like it--it reminds me a bit of Luke Skywalker's arm for some reason.  I hope I don't have to wear it for long, but I appreciate the fact that it has a lot of support for my knee, which should be helpful once I can start walking again. Speaking of, he told me to wait until next Wednesday, two weeks from the operation, before I start putting any weight at all on it and then to start off with 20 to 30 pounds tops. We are going to have to get that number up pretty quickly for me to be walking on it anytime soon....
Today is Day 10, and I started my exercise full throttle today. Sure, I went through as many as I could yesterday afternoon, but I didn't really have some of the props I needed, and I didn't have time in the day to do all of the reps.  Today, I have all day, and I'm almost done with them, though there are some I'm planning on going back and re-visiting.
As anticipated, that slow stretch has been a killer. The first time, I couldn't hold it for more than two minutes. I have now worked my way up to 10 minutes, but I don't think I can do 15 yet. I have to have at least an hour in with this stretch each day, which doesn't sound like a lot, but I can't tell you how many times I haven't been able to fit an hour long workout into my day (or have thought I couldn't anyway) which tells me it's a bigger chunk of time than it sounds.  Still, it's the most important thing I can do to help myself get better, so I'll definitely get that hour in each day. For now, I don't have a lot of other things to do anyway....
I do think I am making progress. Even right now, my leg is pretty straight. I usually keep it as bent as possible, but I'm just naturally keeping it straight with one pillow under it right now, and I think that tells me it isn't as insistent that it has to be bent as it has been in the past.
I will go to PT twice a week for the next two months, and then we will see where we are. They said the first two months are the most critical to my recovery.  The doctor still thinks it is possible that I could be walking (assisted) in another two weeks. I hope that I can walk by the beginning of July when I go back to see him.
So... that's where I'm at on my journey right now. It's been two months and two days since the incident. My pain is getting better each day, my leg is starting to cooperate a little more, and I really feel like I have more control over this than I have in a long time.
If you have questions, or something you would like to share, please feel free to leave a comment!

ACL Reconstruction Post-Op Day 7

I slept pretty well last night, once I finally fell asleep. I woke up a few times, but I slept from about 12:00 midnight until 6:00 AM. Then, after my husband and kids left, I fell back to sleep for another four hours.  That's probably the most sleep I've gotten since the surgery and maybe since the accident.
My pain was very manageable this morning. Until about 3:00 this afternoon, I wasn't in much pain at all. I'm not sure what happened at that point, but that was three hours ago, and since then, it's been pretty bad. Maybe a six on a scale of one to ten. That's about the worse it's been in the last three or four days. I took my meds about thirty minutes ago, and that's helping, but I am disappointed that the pain didn't stay mild all day. I had hopes that today would be the day I'd turn a corner and be on the downhill slide.
I'm wondering if the refill on my hydrocodone has anything to do with it. It's the same prescription, according to the bottle, but I got it filled at a different pharmacy. I doubt that is it, but it's the only thing I've done differently. Of course, I realize that pain ebbs and flows, and it could be any number of things that have caused my rough afternoon.
Something else interesting about my refill is that this bottle says to take 1-2 tablets every 6-8 hours whereas my original prescription says 1/2 to 1 pill every 6 hours.  If I had known I could take two pills right after surgery, I definitely would have been doing that. I don't need that now, but I did last week. I have no idea why the directions are different. I'm sticking with the original plan--one pill every six hours with a Tramadol about halfway through if needed. And ice. Ice has been my life saver. When the ice melts in the middle of the night or I run out before my husband gets a chance to fill it, I can definitely tell the difference.
I am worried about straightening my leg. I can't do it, and I am too scared to really work on that right now without specific instructions. I'm afraid they will make me do it on Friday at Physical Therapy and that it will hurt like a son of a biscuit.  I'm also concerned that they might make me straighten it at the doctor that day because the nurse made me do it last week--as in he picked up my leg and straightened it, and even when I told him it was excruciating, he kept it straight anyway so he could put my immobilizer on.
I decided to take my ace bandage off while I'm sitting around this afternoon. I know the doctor said I could take it off last week, but I was a little scared to leave it off, especially with two little girls. But it's off now, and that's a lot more comfortable. I really hate the feeling of having something bunched up behind my knee, so I was constantly straightening it, and it was constantly scrunching up again.

Not planning on using this too much anymore.

Tomorrow should be another non-eventful day of catching up on DVRed shows. I'm sad that I won't be with the girls at school on their last days of kindergarten and third grade. I'm sad that I won't get to tell the student and staff at our school goodbye. I am happy that the girls will be here next week though. I've really been missing them these last few weeks. I am used to spending a lot of time with them, and they've been coming home from school and playing or going upstairs, a place I vaguely remember.... I think we are all ready for summer vacation to officially begin, and I would love to think I might be walking again by the end of the month.
If you are undergoing ACL surgery and you have any questions, please feel free to comment or email me.

ACL Post-Op Day 5 and 6

The last few days have been filled with firsts for my post-op life, which is a good sign that there is a light at the end of this tunnel, and soon enough, this whole experience will be over with!
Yesterday, I took a shower for the first time since my operation. I know that sounds pretty gross, and it would to me, too, if my interpretation of life was anything like it was before this happened.  Now, the fact that I spend 99% of my day sitting or laying in bed because I can't do anything else makes the fact that I haven't showered far less significant than the fact that I have no where to go, couldn't get there if I wanted to, and don't really have anyone to talk to about it (except you fine folk and my immediate family) or to even notice if I did shower. So, while I desperately needed a shower, I had no idea how it was going to go, and I certainly wasn't looking forward to it.
When I saw the doctor on Friday he said give it a couple of more days before I got my surgery sight wet. I still did everything I could to keep the wounds from getting wet, but it didn't quite work out as I had expected. I left the bandages on and wrapped them in plastic wrap, but I didn't tape it, and it didn't hold. So my bandages got wet, but because I was sitting on the bench in the shower, my knee didn't really get that wet anyway, and the wounds didn't even get damp.

I can't wait until taking a shower is no big deal again!

It was a pretty quick process, but I did need my husband's help.  If I hadn't dropped the soap on my knee, I think things would have been pretty uneventful. So that hurt a little bit, but it's fine now. Getting in and out is always scary because everything is slick. I highly recommend using the bench that sticks out of the shower because you can just sit down and slide all the way over and there's no climbing over anything.
Another first for yesterday was sleeping on my side. I hate sleeping on my back, but I have been trying to do it because I think it's the best way to ensure I don't bend my knee all the way up. Last night, I slept on my side with a pillow between my legs and my left leg on a different pillow. I had the ice machine pad wedged in there as well. I think this worked pretty well. My knee was possibly even straighter that way than it has been when I've been on my back. I also put some pillows behind my back so I could flip over a little onto my back if I needed to. So, in this position, I actually slept for about six hours, which is the longest I've slept since before the surgery. This meant that I slept through my pain medicine though, so when I did wake up, my knee was starting to hurt. Once you get behind, in my experience, it takes a while to catch up, and so I've been in pain most of the day, though it's been tolerable. It's been at about a three or four all day, maybe getting up to a six for a little while.
It's getting a little worse now because I don't have any ice on it, and we are within the two hour window of when I need to take my medicine again.  The reason I am out of ice is because of today's first--first day at home by myself. My husband went to work for the first time since the surgery today, so there isn't anyone to refill the ice machine.  I'll be okay for the next couple of hours until he gets home, but it does show just how much this $200 investment has paid off.
Being at home by myself today has been a little different than I thought. I expected to sleep most of the day, but I really haven't much.  I'm hopeful that tomorrow will be more productive! Either I'll sleep or write the next great American novel... or catch up on the shows on the DVR.
This is where I'm at almost a week after my surgery. Let me know if anyone has any questions!

ACL Post Op Day 4

Just a brief update on day four after my ACL reconstruction/meniscus removal surgery.  I have read in a few places that day four has been like a brick wall, but that hasn't been my experience at all. I haven't been in too much pain today, and I have a lot more strength in my leg. I can get up and down off of the bed now with very limited help, and sometimes I can do it myself. Before, I was using my hands to lift my leg, and my husband often had to help me lift my heel onto the bed.
I have been exhausted today, however. I think it's that lack of sleep catching up with me. Last night, I think I slept about two hours in a row a couple of times, which is better than the ten or so minutes I had been sleeping in a row the nights/days before.  Today, I have fallen asleep dozens of times but haven't slept too long any one time except for a two hour nap. I am still jerking around quite a bit, and I've read that might be due to the opioids. So, I'll fall asleep and then have a muscle spasm or some sort of a full-body hiccup type of reaction and wake myself up. Sometimes it's my hurt knee, but lots of times, it's another part of my body.  It's not any fun at all, and it will be interesting to see if it tapers off as I stop using the hydrocodone.
I've stayed ahead of my medicine all day today, and I've used my ice machine all day.  My pain hasn't really gotten above a four or five, and that's just been when I've returned from an activity, like getting back into bed after using the restroom. That's basically been the extent of my activities again today. I know some people are allowed to walk around, etc., by now. But I'm not. My doctor made it pretty clear he didn't want me putting any weight on my operative leg at all and he mostly wants me resting and elevating with ice. I also am supposed to do ankle pumps and quad exercises, which I am doing.
So, that's been day 4.  The swelling seems to have gone down quite a bit. I am having some itching around the bandage site. Tomorrow, I am allowed to take a shower so long as I keep the incisions covered, so we'll see how that goes.
Questions? Comments? Concerns??

ACL Post-Op Day 3

I wanted to update this quickly without writing too much. I'm on some pretty strong pain medication (hydrocodone, which is strong for me) so you just never know what I might be inclined to write.  But I think it's important not only to update my family and friends but to also leave more information for those to come....
Yesterday was really rough. I went to the doctor to have my bandages removed and just getting in and out of the car, etc. was exhausting. The wound looks fine, and it's nice not having all that bulkiness wrapped around my leg. But the nurse who took the bandages off was a little rough, and if my leg wasn't straight when I went in, well, it is now, for the first time in about two months.

Here it is in all of its glory! Just a tad swollen....

I came home and went back to bed. I think the best advice I've gotten so far is to stay ahead of the pain, so that's what I've been trying to do. I have pillows behind my back and shoulders, and my leg is propped up so that it's above my heart when I'm laying down, which is most of the time. I have the ice machine on it at all times. The doctor said I could take the immobilizer off as long as I'm not up, so it's off almost all of the time. I have read a lot of other posts where people say they are supposed to leave their immobilizers on basically all of the time, so I clarified this point a few times with my doctor. It is a lot more comfortable to have it off, and sense the doctor said I could take it off unless I'm on the crutches, it's off. I have an ace bandage wrapped around it, as well as the "dust covers" he put on the wounds, a towel, the ice machine pad, and a blanket.
Last night, I was able to sleep a little bit more, but only because I took my medicine exactly as prescribed. I didn't wait for it to start hurting. I am taking the hydrocodone six hours apart. He also said I could take the Tramadol two hours after I take the hydrocodone.  I've read that Tramadol can be pretty addictive, so I'm not taking it every two hours, but I am taking it every four if I feel like the hydrocodone isn't as effective as it could be.  I am also still on antibiotics. My mental state is pretty fuzzy most of the time. I think this is more due to the exhaustion than the medicine, though the medicine makes me sleepy. I haven't gotten more than a couple of hours of sleep in a row since Monday, and it's Saturday now. I am even having a hard time writing this because it keeps getting blurry.
I only get up to go to the bathroom. I have rails installed on the toilet still from when I originally injured myself, so that helps, but I still require supervision. My husband always gets the fun jobs! Just getting up out of bed is hard.  I can't really lift my leg yet, so he has to help me get it off of the pillows and then slide it out of bed. Then I have to transfer to the wheelchair, to the toilet, and then reverse. By the time that's all done, I am very lightheaded and exhausted.  It's very painful. It hurts on the inside of my leg especially, shooting down from my knee through my shin. So I wait until the very last minute to go to the bathroom--and I'm really hoping I don't end up with a UTI because of it. It's just that painful. Hopefully, in a day or two, when my leg is stronger, getting out of bed won't hurt so much.
I am doing ankle pumps and quad tightening exercises designed to strengthen my leg muscles.  I think this is helping with regaining the strength in my leg.
My leg is still pointed out a bit. The doctor said this is due to swelling and not to worry about it.  I'm having a hard time keeping it from laying down on it's side on top of the pillows, so it's rotated out, and I'm hoping this is okay.  The doctor said it was fine yesterday....
I go to physical therapy next Friday. Hope to have a better timeline for recovery then. I also go back to the doctor next Friday.
That's all for now.... Please feel free to leave a comment if you have any insight. Your prayers and well-wishes are always appreciated!