Not the Knees (for Once)

So I haven't updated this thing in over a year, but I wanted to type about some injury related stuff, and I figured this was as good a place as any.

Anyway, last June I had my very first bicycle accident as an adult when I failed to properly navigate some curved railroad tracks biking home from work. My front tire got stuck in the track and I fell over sideways, catching myself on my left arm. The aftermath wasn't too dramatic: my hand, shoulder, and elbow hurt and I had some road rash on my left leg, but I was able to bike home on my own.

The following few months I had pain in both my elbow (mild) and my shoulder (more persistent), but it wasn't too bad, and I was able to just work through it. When I saw Dr. Trumper for my six month followup on my right ACL (about three weeks after the bike crash) I asked him to look at the shoulder (it was giving me trouble when I was swimming), and he said as far as he could tell (with the disclaimer that he's a knee doctor, not an upper extremity doctor) I'd probably separated it a little, and to go back in for x-rays if it hadn't gotten better in two weeks.

It got better, and I never went in about it. It took about six months before both the shoulder and the elbow were pain free, but I never had to let up in my training to accommodate the pain, so it wasn't a big deal.

You can sense where this is going, can't you?

Fast forward to four weeks ago. This spring I bought a hybrid commuter bike, and I'd gotten in the habit of biking pretty much everywhere. Traditionally on Fridays I go out to Happy Hour with some current and former coworkers, and I did that as usual with the plan of leaving after one beer and biking home. But my closest coworker (and friend/colleague of over ten years) was celebrating his birthday and some other folks were taking him out to dinner, and they convinced me to come along. And, since we were eating downtown, they also convinced me to have another beer.

Finally, about 8PM, I left to head home. I was in a slightly different part of town at the restaurant, and still a little tipsy from the alcohol (though not enough that I thought biking would be an issue), and for some reason I decided to take a different path than I'd taken before to get home. The road I biked down has a set of those curvy railroad tracks and again I didn't take them at the correct angle and got my tire stuck, went down on my left side again. I stood up immediately (I was in the road, and I knew there were cars around me), took one look down at my left arm and knew instantly I'd dislocated my elbow.

The next half an hour or so was a blur. A couple women from different cars pulled over, and one asked if I was okay (I said "no" as I was already in a lot of pain and really out of it). Someone said they were calling 911, and I made a weak effort to tell them not to (as is my custom), but they did anyway and an ambulance arrived pretty quickly. The EMTs asked me questions and I answered mostly without issues, though I kept calling my husband my fiance, and I couldn't remember the code to get into my phone so they cold call him.

I ended up strapped to a backboard with a c-collar (my neck hurt a bit, and they had to take that precaution), then loaded into the ambulance and taken to MCR in Loveland (about 25 minutes away) because my blood pressure was low enough to classify me as a trauma (even though the EMTs agreed that I wasn't really - my BP and pulse are just low in general). The downside of having such low blood pressure is that they couldn't give me any painkillers, so I was in quite a lot of pain all the way to the hospital.

Being a trauma, however, does get you in the door at the ER without any waiting, heh. Once I was in there they took off my pants and cut off my sweater (boo), then shot x-rays of my left arm while they stabbed me half a dozen times in my right hand trying to give me a second IV (I got the first one on the ambulance). Admire my obligatory x-ray photo!

The doctors knocked me out with Propofol (and gave me drugs for the pain, hallelujah), reduced the dislocation, and wrapped me up in a splint. I ended up only being in the hospital for about an hour, and was headed home by 10:30.

I had to wear the splint until I saw an orthopedist (Dr. Seiler) the following Tuesday. The good news is that I didn't need an MRI, didn't need surgery, and no longer needed to wear anything to restrict my motion. The bad news is that I'm not allowed to swim, ride my bike, or lift weights for six weeks.

Today is exactly four weeks. I see Dr. Seiler again next Tuesday and I really, really hope I can get clearance to ride my bike again (though I'm not holding my breath for anything sooner than six weeks). My range of motion is very close to normal by now, though I can't fully extend my arm, nor can I bend it all the way. I am optimistic that I will get it all back (some people don't after dislocation).

Anyway, going from swimming four times a week, riding my bike everyday, and going to three strength training classes at the gym to, basically, riding a stationary bike was not working for me. I started going to my gym classes again after only a week off and just doing the lower body and core parts, then modifying the rest. My sister was running on Wednesday mornings, so I started running with her, and then we added Thursday mornings as well. For the hell of it I started running on my own on Monday and Friday, and quickly discovered that I didn't struggle with 3 miles like I always had previously. I decided that I was going to train for a 10K and ran a five mile training run.

It wasn't easy, but it wasn't as difficult as I was imagining either. I'd never run longer than a 5K consecutively, and the idea of running 5 miles scared the crap out of me. But I'd done it, and I had a lot left at the end. Clearly a 10K wasn't going to be enough, so I decided to train for a half marathon. I found one that had good timing (the Equinox Half on September 22) and I've been gearing up ever since. This morning I ran 10 miles for the first time, and it was challenging (particularly miles 8-10), but I never felt like I needed to stop. What I do need is to start carrying a water bottle (I ran into dehydration issues for the first time in my training), but I have a running one on the way. I'm feeling very good about my training and I know I'm going to be ready for this race in just over a month.

Having a goal has been huge for me this last month. I was really depressed the first two weeks after the injury, and have been off and on since, but I'm doing a lot better than I would be if I didn't have something to strive for. Running like this is something I never thought I'd be able to do, and going after it and succeeding is such a great feeling. I love training, I love being an athlete. I can't wait to be back on my bike, but in the meantime becoming a runner feels awesome.

Week One and Two Post Right ACL Reconstruction

I'm a little behind again, so I'm going to break this post into two parts.

Week One Followup:

Just like the followup from the first surgery, the one week appointment was getting my list of PT (same as before – mini-squats, heel raises, 10 minute extensions, straight leg raise, one leg balance, and biking 10-15 minutes with no resistance, all 2-3 times a day), turning in my CPM (thank goodness – I'd be happy to never see one of those ever again), and having my dressings changed (I was very thankful for that too, since they were disgusting this go around).  Here, have a lovely picture of what the insides of my dressings looked like after they pulled them off.  Mmm, dried blood.  It was like an enormous scab.

The guy who changed them didn't clean my leg off, though.  Just slapped some steristrips down and gave me my little compression dressing.  So I had the privilege of being crusty until I got home from work.  Ew.

I tried to make it through the entire day in the office (last time I only worked a half day, then went home, but that was mostly because I'd forgotten my work computer at home, so I just went to a couple meetings, then worked the rest of the day from my couch).  I managed to tough it out until four, then I couldn't take it anymore and went home for some narcotics and time in my cryocuff.

I did get a shower once I'd gotten home and sat for a while, though, which was glorious.  The first shower after having the dressings changed is awesome because you don't have to hassle with the stupid Saran wrap anymore.  Plus it meant I could finally clean off the remaining dried blood and gunk.

Again, I had the totally awesome fishing wire stitches.  That stuff is so cool.  When Erica takes them out (as she did today), she just pulls the bottom string and they all come out at once in about half a second with zero pain.  So neat.

The bruising was about the same as what I had on the left side, and the past week it's been itchy and annoying as it's healing. It's mostly faded in the middle and is just still dark around the edges. Unfortunately, some of the darker bruising that's lingering is on the back of my knee/upper calf, which makes my leg ache when I stand for too long.

I did range of motion tests last Monday and came in at 136º on the left (which is about 6º short of "back to normal") and 117º on the right.

Week Two Followup:

I went in this morning for my second post-op appointment and got my PT bumped up again (same as the last time – leg press, hamstring curls, one and two leg squats, heel raises, skaters, standing hip abduction, gradually work up to 45 minutes biking or stair stepper). This means I can go back to the gym this week, woohoo! I'll be back down on weights again (was at 155 lbs double leg press and 75 lbs single leg, and 70 lbs double hamstring curl, 35 lbs single leg), but I get to EXERCISE. The hardest part is going to be working back up to 45 minutes on the bike, since I have to start at 5 minutes per session (OMG want 45 minutes NOW). If I go every day this week, I will be at 45 next Monday. I can't wait (I have a thing where plan it out so I get to the bike at 6:00PM so I can watch AC360º while I'm biking).

Range of motion today: 136º left (unchanged from the last visit, but I haven't been doing extensive PT on that side) and 125º right (not bad!).

They also shot x-rays again today, which I always enjoy (no really! I like looking at them!). I saw Dr. Trumper and he said that my knees were "freakishly symmetrical", and that usually they didn't come out quite so identical after double ACL reconstruction. I'm hoping my scars are equally symmetrical, because I'm OCD like that. Everything is aligned properly, and Dr. Trumper says I'm doing great.  :)

Additionally, he says I can get back in the pool in two weeks instead of three!!!!1 My incisions need to be completely healed (scars not scabs), but WOO FREAKING HOO! I'm still not sure I can swim at State (I'd have three weeks to train before the meet), but getting back in a week early is still fantastic, awesome news!

Anyway, here is the obligatory shot of the x-rays on the screens in the consulting room. My right knee is always labeled with an R tile, and left with an L (naturally).

Here's a better look at both knees together, front on.  Please excuse the crappiness of the photo demarkation, my software at work is pretty lame (yay freeware?). ANYWAY, these are my knees! This x-ray was taken with my knees bent at about 30º with my knee caps against the machine. The orientation is as if I'm facing the reader, so my right knee is on the left, and my left is on the right (yay confusion!).

Anyway, the blue circles are around the titanium pins that are holding the grafts in place through my femurs.  You can't see the plastic buttons that hold the other end through my tibias in the x-ray, but you can see the holes they drilled in there; those are circled in red.  The one on the right (my left leg) is harder to see because it's more healed.

That's about all I've got, I guess.  My next appointment is at five weeks (three weeks from now), and then ten (I never did ten on my left ACL because I had surgery again at week eight).  From here on out all my followups will be based on my right knee, with the caveat that my left is two months ahead in recovery.  Erica says I'll be getting strength tests in three weeks again. It will be interesting to see if my left leg has gained or lost any from my last five week test, since I've had two weeks of relative inactivity in the middle of my PT on the left side.

I Can Has ACLs!

I always start out writing these things with the intention of finishing the day after surgery.  But then the narcotics make me narcoleptic and I can't manage to get them done until recovery day four (which is the day I start reducing my pain killers). Today is day four, post surgery.

So, five days ago I had my right ACL reconstruction surgery.

Going in, I had no nerves at all.  I was actually feeling pretty laid back about the whole thing, since my last surgery was only two months ago and that went about as well as surgery can go.  And I was also excited that I got to go in at noon instead of after 2:00PM like my last two surgeries, because it meant I didn't have to fast for as long, hehe.

We got to the Orthopaedic Center at  10:30AM and ended up sitting in the waiting room for about 45 minutes before they took me back.  It was the same drill as the last time: change into my gown, booties, and cap, then go hang out in a pre-op curtain area.  That's where they gave me my thrombosis stocking for my left leg, and then went about trying to give me an IV.


I say trying because they had to poke me three times to get an IV started.  One of the two nurses had a decent vein in my left arm, but as soon as she injected the Lidocaine to numb it, the vein flattened out and she couldn't get the catheter in.  The other nurse tried to get it, then tried another spot higher up.  The second spot she got some blood to come out, but couldn't push saline in, so off to my right arm they went.  They did manage to get that one in pretty easily, and I was happy that I didn't have to have any more Lidocaine shots (the stuff burns).  I do have a fun bruise on my left forearm from the aborted attempts (made worse by the blood thinners I'm on now).

While they were stabbing my right arm, my anesthesiologist came in and we chatted about the spinal and I mentioned the back pain I had from the one in December. He said he thought that sounded weird and didn't think it was an issue (I think he thought I was being paranoid or something).  The spinal actually hurt less this time than last time, though, while it was going in.  The Lidocaine sucked, mostly because he gave it to me too soon after they pushed the Verced (and did I mention that Lidocaine is burny?).  I do think they gave me slightly more Verced, because I felt way more stoned once it finally kicked in.  I do remember that they stuck a drape to my back before they stuck me, and I tried to watch a bit more of what the anesthesiologist was doing with his little tray of goodies (there were a bunch of vials, but I only remember him opening one and pulling the liquid from that into the syringe).

Dr. Trumper finally came by about the time they were giving me the spinal and initialed my right knee (I was in fact sitting with my legs over the bed waiting to be stuck when he signed me), and so I was talking to him after I'd been drugged.  So I clarified that I would be getting "dead people parts" again, hehe.  Very classy.

Anyway, it didn't take long before my legs went numb and they wheeled me over to the OR.  I was introduced to the OR staff (I never remember the names of these people) and announced to the room that it was my right knee they'd be operating on.  I remember more about how they got me from my gurney to the table this time (they tipped me to the left, put a relatively short plastic thing under my bottom, then laid me flat and slid me across), and they needed me to move up on the table a bit and jokingly asked me to do it myself before grabbing the ends of my sheet and moving me themselves.  Then there was the fun dissociative moment of one of the nurses lifting up my right leg and propping it on her shoulder while she wrapped a tourniquet tightly around my thigh. I don't remember the tourniquet the first time. I was also glad that I couldn't feel my legs, because she really cranked it down, and I bet it would have felt unpleasant.

I woke up in recovery disoriented, thinking I was still in the OR. I had a ton of blankets on me, including one on my head like a hat.  And I was freezing. They actually put a heated bags of saline under each arm, and this weird heater that blew hot air directly into my blankets.  Even with all that I was still cold (but not shivering uncontrollably like the last time I had general anesthesia).  The oxygen canula they had in my nose was itchy and driving me crazy, and I kept adjusting it until the nurse finally took pity on me and took it out.  Again I set off alarms with my low heart rate (high 30s), and had to explain that it was normal for my resting heart rate to be so low.

Finally they took me to my room (I was in four this time, last time I was in room five).  The bad part is they took away my heat blower thing, but they did crank the heat up in my room to 80º (and it stayed that way the whole time I was there).  I also got my first dose of Vicodin, which I needed because I was in quite a bit of pain. My nurse, Jen, was amazing. Funny and sweet and she kept checking on me (mostly because I refuse to bother the nurses by hitting the call button).  She brought me lunch (turkey sandwich, but I took the turkey off and had a lettuce, tomato, and mayo sandwich :p) and coffee.  She brought me a second cup of coffee and I started to get really, really itchy.  Apparently that's normal when the spinal starts wearing off, but it was driving me bonkers, so she brought me some Benadryl.

About twenty minutes later I started feeling super groggy, and warm all over, and I thought it was the Benadryl kicking in.  But then I started to have a panic attack and went completely pale, so Jeff went and got Jen.  Apparently my blood pressure had dropped suddenly, which is another thing that happens sometimes when the spinal is wearing off.  She put the head of my bed down and gave me a ton of fluids via my IV (500 ml) and I perked back up in about half an hour.

I also learned that the very last thing to come back after the spinal (even after your bottom and your groin), is your bladder.  They had a pad underneath me in case I accidentally wet the bed (I didn't, jsyk, hehe).

The rest of the night was fairly uneventful.  I had another super yummy dinner (cheese filled shells, again from Canino's), and actually slept fairly well.  I did have a lapse in my pain killers because of the nurse shift change, so I ended up being in a lot of pain again when my first dose wore off before the night nurse came and gave me my second dose.  I started my PT and that went just fine.

Jen was back in the morning and she woke me up at seven for my Advair, so I just stayed up.  Erica (my physical therapist that I've been seeing since I had my left ACL done) came in again at 8:00 AM and changed my dressings.  This time my incisions actually leaked (they've always told me that can happen, but I didn't have any drainage after the first two surgeries), so there was kind of a bloody mess.  The best part about this is that I've had considerably less swelling this time around.

The first full day post surgery is so strange. I felt stoned out of my mind on Wednesday, but the real nodding happened three or four hours after I took my Vicodin. It probably had something to do with the lingering effects of the anesthesia. I was still itchy that day, too, my arms, neck, and torso mostly. Apparently coughing can help clear it out of your lungs and stuff.  It's all very odd. Otherwise I felt pretty good, didn't have much pain because I kept up on my pain killers and my anti-inflammatories.

I fell asleep early and woke up at 5:00AM feeling pretty sore.  I ate a couple graham crackers and then took two Vicodin.  About half an hour later I started having a full on panic attack and began to feel quite nauseated.  When I'd start to fall asleep, I'd jerk awake because I felt like I wasn't breathing, and like my throat was swelling up.  Jeff came in about eight and I was feeling more calm, but still really sick to my stomach.  I was afraid to take any more Vicodin, or any of my anti-inflammatories, because my stomach was empty and I was feeling so ill.  Jeff called the OCR and they prescribed me some anti-nausea meds that Jeff went and picked up for me.

I took one with the hope that I'd be able to eat, but I threw it up almost immediately.  Jeff brought me some clear soda and dry saltine crackers.  I ate about three crackers, then threw those up about twenty minutes later.  I was in quite a bit of pain since I couldn't take any pain killers, so I decided to just try and sleep for a while.  I dozed off and on until about two, then tried eating again.  This time I had macaroni and cheese, and it stayed down, so I was finally able to take my meds.  I've been feeling pretty normal since then, so I assume it was just the last of the anesthesia wearing off that was making me sick.

I had a shower on Thursday, which is the first time I changed my dressings after leaving the recovery center.  By then I'd had a little more seepage, but it wasn't too bad.  The shower was kind of a pain in the ass because I have to wrap my leg in cling film to keep the bandages dry, and I seem to be failing pretty hard at it this go around.  I got the bottom of my bandages wet, and thus the dried blood underneath got damp and gross.  I think my incisions stayed dry, though.  Since then I haven't had any more fresh blood or drainage.

My bruises started to really come out on Friday, looking much more like they had on the left side.  They look pretty awesome, red and purple and all around my knee front to back.  They don't really hurt, but I expect them to be uncomfortable and itchy by next week.

I'm really starting to get sick of sitting in the same position, again.  Today is the third full day, and my hips and ankles have been pretty sore and irritated since Thursday morning.  I've been taking some breaks from the CPM occasionally so I can sit in a position that is more comfortable for my other joints and my back.  I'm feeling good enough now that being bedridden is starting to make me crazy.  I'm trying really hard not to eat my body weight in food, but that's hard too, since I'm so bored.  It's doesn't help that I've been watching the Food Network and the Cooking Channel almost non-stop since yesterday.  So much chocolate, mmmm.  I've gained about three pounds since Monday, on top of the three pounds I gained after I was hospitalized and had my last surgery.  I guess it just means I'll have to be diligent when I can start working out again.

That's about it.  I'm still doing my PT (same regiment as the last time) and sitting on my butt the rest of the day.  It's boring and I'm remarkably sore, but it's almost over (just a day and a half to go).  When I'm done with all this I'll have functional knees, which means I can be more active (once I finish recovering), and I hopefully can avoid total knee replacements in the future.

Lastly, I made a video the night before surgery that documented the flexibility of my mostly "good" right knee, as well as the eight week progress of my recovering left knee.  Once I get that edited, I'll put that up on this blog.  It may not be very exciting, but I thought it was kind of interesting.  And my first video blog!  Woo!  Hehe.

Okay, I've got friends coming over (with Starbucks, bless them), so I should probably finish this post.  I'm sure I'll update again soon with my first post-op appointment and such.  Almost done with all this recovery stuff!  I can't wait!

Five Week Followup

So I had my five week followup at OCR today and have confirmed that I can go back to the pool now (YAY). So, I'll get to go to swim practice at lunch tomorrow!  I'm so excited, I can't even describe how happy I am!  Yay swimming!!!

So I was way off on my range of motion numbers from the other day.  It turns out that 142º is my GOOD knee in flexion, not my repaired knee.  That one's at 124º (normal range of motion is between 135º and 150º of flexion).  My knee's actually been bugging me today for some reason, but I'm not really swollen, and Erica didn't seem overly concerned about my degree of flexion or extension, so I must be on track there.

I had my strength tests repeated today (I did a set of these before surgery in December). The first test is that you get strapped into something similar to a leg extension machine, but it doesn't have weights; rather it has a computer system attached that records how much power you have by moving your leg against its resistance.  Because of the way it works, you have to fight against it in extension and flexion, so they can measure the strength of both your quadriceps and your hamstrings.  The readings are matched against your healthy leg.

As of this morning, my left quadricep is at 96% of the strength of my right one, and my left hamstring is at 73% of my right.

The second strength test is a leg press, but again you don't push any weight.  You do as you normally would (though this is single leg, not both legs) and push against the foot plate with as much force as you can for about ten seconds.  The results from that test show my left leg is at 64% the overall strength of my right leg, which I was told is "about normal" for five weeks post-op.

The tests I did today are also going to serve as my baseline going into my right ACL surgery in February.

Speaking of which, since I'm going to have to start my rehab all over in three weeks, I'm just supposed to continue with my current PT regiment with the addition of getting to add swimming and road cycling (spoiler: it's snowing today, so I don't see the road bike coming out before my next surgery).

Lastly, I did ask about the pain in my spine, and she took a look at it and said if something bad was going on I'd have swelling or redness or would be getting spinal headaches.  But she also said that lingering pain is something most people don't experience, and to talk to the anesthesiologist before my next surgery to see what they have to say about it.  As it is, the pain is getting less frequent, but I do still get it from time to time, and I'd like to know if it's something that needs to be checked out.

Two Weeks and Beyond

Okay, well, it's been a while since my last post.  Part of that was me being on vacation for New Years (I traveled by car from Denver to Dayton, OH, then drove with a couple friends to Cherry Hill, NJ to spend NYE with even more friends – it was a fantastic time), and part of that was that I had my luggage, my laptop, and my iPad all stolen out of my husband's car (the window was smashed and my things were taken from the back seat) the night before I left on said trip. So I've been spending a lot of time trying to restore my computer (I had a backup, but it was about 30 days old) and get my life back in order after a couple interesting/exciting weeks.

Anyway, just before I left for the New Years trip, I had my two week appointment at the OCR.  I got a fun new list of PT, so I'll list that first (from memory as my checklist was in the stolen luggage):

• Strength
• Full Squats (With Weights, 3 x 10, 3 times a week)
• Single Leg Squats (Affected Leg, 3 x 15, 3 times a week)
• Calf Raises (with Weights, 3 x 10, 3 times a week)
• Standing Hip Extensions (With Ankle Weights, 3 x 10, 3 times a week)
• "Skaters" (3 x 10, 3 times a week)
• Leg Press (2 x 10 both legs, 2 x 10 single leg with half weight, 3 times a week)
• Hamstring Curls (2 x 10 both legs, 2 x 10 single leg with half weight, 3 times a week)
• Cardio
• 45 Minutes of Stationary Bike or Stair Stepper, 4-5 times a week

I love the strength training, but the cardio is getting old already, hehe.  However, assuming everything goes okay with my five week followup this coming Monday, I can get back in the pool next week, woohoo!

Also at my two week followup I had x-rays shot.  Dr. Trumper says everything is lined up perfectly, and healing fine.  I snapped a couple pictures of the x-rays on the light box, and I love this one here, because you can see the titanium pin that's holding the top of the tendon in place.

Everything is still healing at a pretty good pace.  My extension is perfect, and the flexion is getting better all the time (my last measurement was at 142º, but that was at the two week follow up).  My bruise is mostly healed at this point (and doesn't itch anymore, hallelujah), but the skin there is still darker than normal.  This is exactly how I healed when I had the hematoma from my blood clot, so I'm not sure if it's just big bruise related, or if it has something to do with being on blood thinners (I am off of those now, but only as of just yesterday).  I have been having more stiffness in the joint in the last week or so when I sit in one position for a long period of time.  When I get up my knee aches and I have to walk around a bit to get it back to its full range of motion.  This is something I was told about when I got surgery, so I'm not too worried about that.

One thing that does concern me a little is that I occasionally have weird, localized back pain right over my spine.  I'm used to having lower back pain, but that always feels like muscle pain (because it crosses my entire lower back), and this feels like a golfball sized spot immediately over my spinal column, and the location seems to coordinate with where the spinal injection was placed.  I haven't asked about it yet, but I'm going to check on Monday to see if this is normal or something odd is happening.

In other news, the steristrips finally came off last week and I was able to see the entirety of all three incisions. The scars are still pretty purple right now, but if it's anything like the last arthroscopy, they'll all fade to nice, light white lines in a couple months.

Lastly, I made the decision about two weeks ago to go ahead and get the right ACL replaced as well.  That surgery is scheduled for February 7.  I'm going to have to pay more for this one as my health insurance has rolled over and I have to hit my deductible and out of pocket max again, so I assume I'll be paying right around $2000 for this surgery.  I do already own my cryocuff, though, and insurance does cover the rental on the CPM and everything else (minus copays), so now's not a bad time to do it (before I switch insurance in April – just in case it gets worse).

Assuming this surgery goes as well as the last one (knock on wood and such), I should have two completely functional knees by this fall.  I'm not sure when I'll start getting back into impact sports (hockey and softball), but it will be nice to be able to run and bend without my knees going out from under me.  And hopefully this will enable me to avoid having to get total knee replacements when I'm older as well.

Finally Out and About

So this past Monday morning I finally was able to get out of bed and haul my friend the CPM back to the Orthopaedic Center of the Rockies (with help from my wonderful husband). And I was glad to be rid of it; I don't normally sleep on my back, so six nights in a row of being forced to sleep on my back with my leg elevated was really starting to take it's toll on my lower back and neck.

When I got over to OCR, Erica (my lovely physical therapist) put me on the stationary bike immediately.  Let's just say it was fairly unpleasant, because I hadn't been bending my knee that much in the PT I was doing before.  It did loosen up pretty quickly, however, and though it still hurt, it felt mostly manageable.

After that we went through the rest of my exercises, which are identical to the set I did after my meniscus surgery in June.  Those are:

• Heel Raises (30 reps, 3-4 times daily)
• Squats (30 reps, 3-4 times daily)
• Straight Leg Raises (Injured Leg, 30 reps w/5 seconds hold, 3-4 times daily)
• Straight Leg Extension (Just like I was doing right after surgery, 10 minutes w/5lbs weights, 3-4 times daily)
• One Leg Balance (Injured Let, 30 seconds at a time, 4 reps, 3-4 times daily)
• Stationary Bike (No Resistance, 10-15 minutes, 2-3 times daily)

These are all feeling really good so far; even better than they did this summer, somehow.

 After doing all my exercises, she checked my extension (pretty close to normal with a little guarding) and flexion (102º), then one of the nurses came over and pulled off all my dressings.

So my sutures are actually underneath the surface of my skin, which is really cool.  In the picture over there you can see the two ends where the blue string is sticking out.  The red line between them is the incision where they inserted the new tendon (and drilled the hole through my tibia and femur).  The nurse actually trimmed the top string off, and taped the bottom one down with a steristrip.  When they remove the sutures (next Monday), they just grab that one end and pull them all out.  The nicest part about that is that you don't get the railroad track scarring you can get with external sutures.

You can see the two arthroscopic incisions on my knee cap in this photo as well. 

The best part about getting the dressings off is now I can shower without wrapping myself in clingfilm! And I think they'll just let the steristrips they put over the incisions come off as they like, so as soon as they're gone, I'm all done with that stuff.  I think they'll still make me wait five weeks before I swim (boooo), but at least by then my small incisions should be mostly healed, as well as the two puncture wounds I have higher on my leg (I know one was for the saline they put in, and I think the other one is where they pulled the top of the tendon through and secured it with the titanium pin).

Monday I felt pretty terrific, but then I also forgot my work laptop at home, so as soon as I finished my meeting, I went home and worked from my couch with my cryocuff on for the afternoon.  Tuesday was a completely different story; sleeping on my side was great for my spine, but not so much for my knee.  Every time I moved I would overlap my legs and irritate that giant bruise on the inside of my knee.  I woke up feeling exhausted and sore, then managed to get the mother of all headaches in the afternoon.

Finally, by about 7:00PM I'd had enough and took a Vicodin.  Best decision EVER. I slept great Tuesday night and felt wonderful on Wednesday.  I got a headache again last night (the weather is very cold and nasty here in Colorado, so I think that's what's doing it), so I took a Vicodin again with similar results.  Same thing is happening TODAY (headache, ugh), so again with the Vicodin.  Hopefully tomorrow will be another good day!

Okay, signing off for now.  :)

Post Surgery: Day 5

And the last day of the PT sheet:

• keep your extension perfect (of course)
• your flexion should be at 100 degrees
• pain medication should be used only as needed

So far I haven't had a Vicodin since yesterday afternoon. I still don't have any pain when I'm just sitting, but walking hurts a lot more today. PT is about the same, pain wise, as it was on day two (3-4 on the pain scale).

I steadfastly refuse to take any Vicodin today, though. Not unless I happen to get up to a five or something. Because I'm a tough girl, and I can handle this! Or something.

By the way, for me a 1-2 is something like, okay, ouch that doesn't feel good, but I can live with it. Like when you whack you shin on the bedframe and it aches a little. 3-4 is more like this hurts enough that if I could stop doing what I'm doing (i.e. leg extensions), I would, because wow, uncomfortable. A couple times it's gotten to the point where I've been punching my other thigh toward the end of my ten minutes of weighted extensions because I really don't like how it feels.

Also, starting yesterday I've had kind of an odd popping behind my knee when I go from bent to straight leg. Not behind the knee cap, but the back of my leg, right below the surface of the skin. I don't know what that's about, and it doesn't hurt, but it doesn't feel pleasant either. I'll have to bring that up with my physical therapist tomorrow morning.

Oh! I keep forgetting to mention, but my GP called me before I went into surgery on Tuesday and told me by blood test came back normal, so I don't have a protein deficiency. Which means I don't appear to have a clotting disorder, yay! So as soon as I'm done with my three weeks of preventative Coumadin, I'm done with blood thinners for a while. Woo!


I'm so glad that I'm done with the hourly PT tonight.  It feels like I'm just a life support system for my knee at the moment.