Post Op Day 2: PT Nightmares

   When you mix exhaustion with pain and add a physical therapist into the mix, it's bound to end badly. But let's start with the good. 

   My calf pain is far less bad than yesterday. I can put slight weight on it, so I can get up and down stairs. Let me show you how I got up and down the stairs yesterday: 

Thank you tricep muscles! 

    I didn't sleep well, just due to general discomfort. I get an hour or so here and there at a time. Today PT was at 230 and it was pretty rough. I rode the bike, that felt ok. Then the bending started, and with the bending, the screaming and crying. I'm not much of a wimp but these surgeries have turned me into a complete little bitch. Working on my extension wasn't beautiful but nearly as bad as flexion. But by the end I could get myself to 120 degrees with a strap. 

   They're tossing some muscle relaxers into the mix to see if those help. I've been guarding my knee for so long, I have to retrain my brain and body to relax and trust it. I'm back at it again tomorrow morning, with orders to work on extension while icing and crank the CPM machine up to 120 degrees (I've been doing around 112, pass the pain pills). I'm also cleared for light stretching and sleeping sans immobilizer. I should be completely discharged of the immobilizer tomorrow morning! 

   Trying to stay hopeful, and ahead of the pain, so hopeful and high! 

How to force your knee into extension while icing! 

ACL manipulation and athrofibrosis Surgery

   So 4 months out from my ACL reconstruction and I needed a 2nd surgery. Why? Multiple reasons:

1. I still had a lot of stiffness. Think 85 year old woman stiffness upon waking. I'm 16. Not cool. 

2. My bones were forming funny since there's such little weight bearing force and I was setting myself up for pre arthritis. 

3. My flexion and extension STILL sucked regardless of daily exercises, dry needling at PT, constant stretching and quite a bit of screaming at PT. This resulted in a limp. 

   So they took me back under. Pre op was much in the same, I had a great care team at the University of Colorado Lone Tree Surgery Center. My PT, Evelyn Massey was there for my surgery and my surgeon, Dr. Armando Vidal, is pretty highly recommended. Having my pt there gave me a world of peace of mind. She knows my knee better than anyone in Denver. And she's a little bossy (in a good way!), so I had no doubt she would speak up and tell my surgeon "ok that's how far her knee can go so be gentle past there!". Bossy people love other bossy people. 

    So what did they do this second surgery? They went in through my portal holes and made one more small hole and scraped out the scar tissue build up that's been hindering my range of motion (ROM). They also cranked on my knee to bend and straighten it. It took just over an hour. I woke up about 30 minutes after, groggy with pain at about a 7 in the back of my knee where the nerve blocks didn't reach. My nurse immediately drugged me up and gave me pudding, tea, ice chips, and graham crackers till pain was at a 2. I left about 45 minutes after. 

    What's different about this recovery? Well for one I have a CPM machine, which is a constant passive motion machine. It cradles my leg and passively moves it through a preset ROM so scar tissue is prevented from building up and stiffness is decreased. It's not as bad as it looks, and I know it's for the best. I'm in here 8 hours a day, everyday, for 2-3 weeks. 

I still have an ice machine of course so I'm pretty much attached to one machine or another or at PT all day. I should get discharged out of my immobilizer today, rather than being kept in it for weeks. 

    I started PT yesterday, a mere 4 hours post op just for more mobilization. My knee bent to 121 degrees and I got to 2 degrees extension- much better! Today may be a little worse with no nerve block but I'll power through like I always do. 

    My muscles haven't been stretched that far in FOUR months, so yesterday my calf was super tight and sore. Ankle pumps and water is your best friend for this. 

The unraveling: 

Doesn't look nearly as monstrous as my first post op unraveling! I'm on crutches again at least through today and then weight bearing as tolerated. This week should be... Interesting. But I'm over the scary part and back to square 1 with recovery! 

2 weeks until surgery #2!

   Some people heal miraculously, some do not. I had a great surgeon, a great physical therapy team, and I used all my sports medicine knowledge to rehab myself too. I was the perfect patient! I moved to Denver and started dry needling to be more aggressive towards the scar tissue.

Dry needling with stim to activate my VMO: 

 It helped, but not quite enough. My new surgeon out here has decided I need another surgery to manually manipulate my knee into flexion and take out some scar tissue. 

   I'm nervous but also hoping this 2nd surgery does me good. I have a lot of stiffness in my knee, especially in the morning. I hobble around until it wakes up! I only have 104 degrees of flexion and I'm still 3 degrees in extension, which is enough to affect your gait. So I walk with a limp some days. NOT HOT FOR A 26 YEAR OLD! 

    I still cannot run and I'm almost 15 weeks out. I should be much better than I am, but I'm not and its frustrating beyond belief but I keep on keeping on! 

I go to the gym everyday to ride the bike and I can do the elliptical now also. I've gotten back into yoga, I modify many poses but it gives me a sense of accomplishment. I foam roll, I stretch, I yell through physical therapy.

Doing yoga last week. Yes this was hard, but putting my life on hold wasn't working for me. I had to at least try, and I succeeded! Yoga has helped my knee quite a bit actually! 

   Every body is different, so take your recovery at your pace, research, get opinions! No slacking! If you have questions or concerns bring them up and get answers. Take your health into your own hands. 

11 Weeks Post-Op

   Just a heads up; the knee has become it's own entity. It runs the life. So don't be surprised if I refer to it in the 3rd person!
   We have a few new things that have happened since my last blog. My flexion is now to 103 degrees, painfully. BUT I can get to 95 degrees myself. Extension is only lacking about 3 degrees. As of right now, I don't have to go back under for manual cranking and manipulation. I may have to get scar tissue scoped in 3 more months, but that's still up in the air. Physical therapy has gotten slightly better. The bending still hurts, I still scream but I stopped crying through it! I also get to do a few more exercises which I am always happy for! I'm still icing and using compression, and doing daily stretches but I went ahead and made this crazy decision to move across the country last week! My cousin and I drove 1,700 miles to Colorado!
   While PT is on standby since I was getting here, and then had to acquire new insurance and doctor appointments, I have been vigilant about at least stretching. I was kinesiotaped before I left to give me a little extra help too! The kinesiotape helped "wake up" my quads to remind them to fully extend. Don't mind all the bruising- we also started foam rolling and using pressure point rolling therapy. Hurts so good!

The kinesiotape stayed on for quite a while too! Ask your physical therapist if they think it could help you too.
   Today was the first day in 6 days that I was back on the bike, and it felt good. I don't think I've lost any range of motion, but I'm interested to get a second opinion on how my recovery is going. I love my original doctors, but they just weren't willing to make this move with me. I'm looking into trying new things (Dry Needling and Acupuncture) and am remaining hopeful that I'll have a full recovery soon!

Thanks to my 3rd flood apartment, I do a lot more stairs and can even start to get down the stairs like an adult! I have to hold on to the rails and I'm going slow, but I'm getting places!

I can touch my foot! Stretchhhhh!

Recovery Roadblock: 7 weeks post ACL surgery

   So I haven't written lately, since there hasn't been much exciting to write about. It's been 7 weeks post op now (well, technically Tomorrow). I'm doing fairly well but I did hit a minor roadblock. I met yesterday with my Orthopedic Surgeon, and he said I'm having all the trouble bending my knee due to inflammation. Here's the kicker... my knee isn't abnormally swollen, or even sore. But I'm no doctor and I know for a fact how much my knee hates bending. I was prescribed a steroid anti-inflammatory and I see him again in 2 weeks for hopefully what will have been progress.

Good, New changes:
* I can do leg raises, I even do weighted leg raises
* My balance and strength are returning
* I got a performance sleeve, which keeps my knee from swelling and I can put ice sheets directly into the sleeve which has been wonderful.
* Swelling has gone way down! I no longer have a monster knee
* I'm out of the immobilizer and off crutches! I've been out for about a week, and during work I wear my compression sleeve and my pre-surgery ACL brace. I still move slowly and cautiously but I'm moving.
* Pain levels aren't bad at all... except a few times at PT have been uncomfortable.
* I'm rocking on the bicycle, can't bend enough to get all the way around just yet.

Forcing my Knee to bend with light weight

This is about how much bend I can get on my own; muscle tone is 

slowly returning!

My incisions look great, and it's almost a normal knee again!

   I've been vigilant about going to Physical Therapy, and doing my home exercises. I was even cleared to get back into the gym and do upper body. I've started noticing the little things in my recovery; I can walk upstairs like an adult, still have to go down like a small child because I don't have the eccentric control. I sleep better at night and don't wake up every time I need to readjust. I can clear the bathtub so I don't have to maneuver myself into it. I have progressed in physical therapy well and my strength is slowly returning. While the past 7 weeks has passed, it's hard to believe it's been almost 2 months since surgery. Honestly, I had been hoping by now I would be a little further along, but every person heals differently.
   I knew this recovery would be a long road, but it often feels like time is at a stand-still. It's very frustrating to feel incapable of the smallest things. Not to mention, I deal with pain fairly often due to a physical therapist forcefully bending my knee. I know it has to be done, and it's in my best interest, but damn is it painful some days! There are good days and bad days, and yesterday was a bad day. While I have increased flexion from 40 degrees to 80-85 degrees, I should be at 90 degrees easily. I have two weeks to get to 120 degrees. I am trying to keep my hopes high that this roadblock won't be a serious one!

Reclaiming Independence- 3 Weeks Post-Op

   The knee and new ACL are doing good! So now that the stitches are out and the incisions are healing, there's not as much going on. The pain is minimal, if there is any. Most of the pain is incurred at Physical Therapy. As the title hints, I'm slowly starting to be able to do things on my own again. I decided to write this blog when trying to find information about ACL recovery was so scarce; I could find plenty of doctor protocols but I wanted true life testimonials. Of course the doctors hope you have the simplest of recoveries, but that isn't always the case. Not to mention WebMD is vague. I had no idea what to expect, and what I did expect, was way off the mark.
   Now that I'm 3 weeks post-op, I'm more optimistic but I still have a very long road to recovery! I've been in PT for 2 weeks now, and it's helped tremendously. The first few sessions were just very minor range of motion movements, ice, and stem to start activating my quad muscle. Now that all my steristrips are off and my incisions are healed, scar tissue massage started and the ROM exercises got a bit more involved.
   Scar tissue massage may be one of the worst pains I've ever felt. I got home from PT, curled up on my couch, and cried like a baby for a solid five minutes. Unfortunately, crying didn't help my knee feel better but some pain meds did. It's similar to what I would think a small dull saw would feel like. Keep in mind, I had the patellar tendon graft, so the front of my knee is extremely sensitive without being touched and rubbed. It's a necessary evil; you don't want scar tissue to build up or they have to go back in surgically to remove it. Rub away, I'll just be gritting my teeth and trying to pass out from refusing to breathe. Luckily, the first time was the worst. The second time seemed much more manageable. 

As you can kind of see, my incision was a bit bruised and swollen. It's also oily from [gently!] rubbing Bio Oil on it. I'm hoping the scars will heal as close to invisible as possible, and I fully intend to help them do so. Every day I use shea butter moisturizer and bio oil on them, twice a day. I started doing this AFTER my week of neosporin was up and Lindsay (my PT) gave me the go ahead and said they were healed up. It's only been a few days, but I figure it can't hurt. If I start noticing real results, I'll of course blog it :)
   Another milestone I finally reached was being able to do leg raises! I've had no success at this until yesterday, when Lindsay decided to try the stem treatment first and then do leg raises. The woman is a miracle worker. Stem treatment sends small electric impulses to the muscle, to wake it up. Meanwhile, you contract your muscle too. It helps recreate the neural pathways. I'm proof this works.

   I can also now walk with one crutch! And I can take 1-3 baby steps without but I don't unless I'm near something sturdy to grab. I'm still using 2 crutches at school, but Towson is huge and why not have as much help as a girl can get?! At least at home though I don't need to depend on my mom to do everything, I now have 1 free hand! This makes a world of difference. So, things are definitely looking up!

And here is a little video of my leg raise glory!

Phase Two: Rejoining the Real World

  I'm 13 days out from surgery and a lot has changed!
* Stitches came out yesterday! It was an interesting feeling... but the pain doesn't last. I'm still in my huge brace, with an ace bandage wrapped lightly, mainly to prevent friction. The bandages were pretty gnarly!

Bandages coming off, and it's free!

* I started Physical Therapy (PT). I can only do quad sets and heel slides for now, and the rest is manual. My PT, Lindsay, forces my knee to bend and straighten so we can get that range of motion back. I'm only bending 50 degrees, which means there's a lot to improve upon.
*I can shower! I'm a little unsteady but I take it slow, and hold onto my handy pre-installed by my houses former owners, handrail. My skin had a slight rash after all the bandages came off, but it's clearing up quickly and I control any itchiness with benadryl.

Stitches are out!

* I'm allowed to sleep without the big brace, which means I can slightly bend my knee. This is wonderful.
*I can drive a car! It's a struggle and I drive like a gangster, but I'm going places... mainly just school and PT.
*I can walk, a little bit. I move at snail pace, but it's much more energy efficient than keeping my left leg up the entire time. Especially at Towson, where I do a lot of crutching.

    Overall, things are looking up. I'm learning how to be crippled with a bit of independence but when people offer help, I take it. There's not much pain, unless I move it funny on accident but a lot of the skin around my knee is numb, similar to how your face feels after novacaine. The swelling isn't too bad, and once the steri-strips fall off on their own, I can start doing damage control on the scar with neosporin once a day. I have PT twice a week for now, and I'm doing a few things at home too to help speed it up without overdoing it. I'll keep you all posted as I continue to see improvements and accomplish new things!

Normal knee. Monster knee.