Monday, August 11, 2014

It's a post-op life for me... Two weeks out from ACL surgery (Week 1)

Slight preamble: in the next posts, I will be talking quite a bit about my recovery process from ACL surgery, but I will also try to reflect some about other aspects of life since, thank God, life does not revolve around our physical struggles.

As of two weeks ago, I can say I'm an official member of an elite club I never wished to join, the "Jock Joint Surgery Club", (yes I just made that up, which explains why the name's not particularly clever...).

Thankfully, week two has been nothing like week one... My friends who had been through the same operation and rehab warned me about the highs and the lows of the whole process. One moment you're flying high—not from the painkillers (an alternating combination of narcotics and ibuprofen)—and the next you hit rock bottom. I just hadn't expected to feel all those emotions during the first week of post-op.

Day 1, while I was conscious at least, I felt great, thankful to be out of surgery, thankful for a successful procedure, thankful for the amazing care I received from all the medical staff at the Texas Institute for Surgery. After returning from the hospital, I was still under the power of the anesthesia and spent most of the day sleeping. If it hadn't been for my mother waking me up every hour and a half or so to do the exercises which had been prescribed by the physical therapist at the clinic, I would have slept all day and probably all night.

Speaking of my parents, I cannot thank them enough for how they took care of me when I was unable to care for myself, bringing me food, water, and making sure I took my medications at the right times. They made sure I followed the doctor and the PT's instructions regarding the use of a couple interesting post-op machines, the ice-machine, which I had to use constantly, and the continuous passive motion (CPM) machine, which I had to have on for a total of 8 hours a day, though I had a love-hate relationship with each, but mainly love with the ice... My parents, however, didn't love the ice machine as much as I did since every four hours or so they had to change the ice in order to ensure that the water which flowed into my ice pack around my knee was cold enough to actually make a difference, which included waking up every night around 4 a.m. not only to add more ice but also to release me from the CPM machine and give me more meds. (Needless to say, both my parents and I were thrilled to return the machines to the clinic once the first week of post-op was over).

Day 2 and day 3 I was slightly more active. Though I still spent most of the day in bed with my leg elevated, I was able to do more exercises and also could notice progress in my quadricep strength, extension, and flexion—granted, I followed the PT's instructions "to a T" and tried to do as many sessions of my exercises as possible throughout the day, which included straight leg raises (SLRs, quad tightening to improve extension and activate my quadricep muscles, ankle pumps for increasing blood flow through my lower extremities to prevent clotting, and heel slides to work on flexion).

I was very blessed to have had very little post-op pain, only during the afternoon on day 2 did the pain become more than a dull throb and only lasted about a half hour. The downside to the pain management medications was the constant fight with grogginess and the desire to sleep in the moments I was not doing my exercises. That tendency to doze off was highly frustrating as I'm not a huge fan of napping and had been hoping to use the down-time in order to catch up on some reading. Let's just say that in the first 3 days post op I only made it 20 pages in to Tolstoi's War and Peace, which, if I hope to finish the great novel before I reach middle age, is not a reasonable pace. (I'm happy to report that after last week my reading speed increased significantly and am now about 300 pages through Tolstoi's masterpiece, though I'm still struggling to keep all the princesses, princes, captains, counts, countesses, and other characters straight...)

My first post-op week would not have been complete without a few mental breakdowns, which should be interpreted as depression accompanied by a river, or maybe more like a stream, of tears. After being so accustomed to independence and high activity levels, spending a week in bed completely reliant upon one's parents does not come without its frustrations. Walking around on crutches, verrryyyy slowlyyyy, transitioning to try to learn to walk normally again, the occasional twinge of extreme pain as one tries to move too quickly. At one point, I thought I had pulled my hamstring when I almost tripped on a chair, had to catch myself with my bad leg, and felt a nice little pop in the back side of my thigh. Looking back, it was probably more like the feeling the doctor had warned me about before surgery regarding a sharp pain in the hamstring which is nothing to be worried about as it is mainly the muscles trying to heal themselves around some of the post-op scarring, or something to that effect (since they used a hamstring graft).

My lowest moment actually came on the stationary bike around day 7, which, looking back, actually seems quite overdramatic and slightly comical. The frustration all started when I was trying to get on the bike, attempting to get the foot of my operating leg into the strap on the pedal, unable to control and bend my leg. Once I somehow managed to accommodate my foot, I began to try to pedal and was incapable of doing a complete revolution, something I never imagined I would go through. As I sat there, rocking the pedals back and forth, back and forth, reaching one extreme point of flexion and going back to the other, I began to cry, cursing everything that had happened, questioning why I had to get injured, why I had to be so far from my boyfriend for so long, why the dumb rehab process had to be so long... Luckily, no one walked in during my breakdown, and I was able to recover slightly before running into any family members (I say running figuratively, obviously, as I will not be allowed to run until 3 months after surgery). I am happy to report first that my feelings of uselessness and frustration have subsided since that moment and second that as of day 12, I have been able to do complete revolutions on the bike, both forwards and backwards.

I won't bore you with the details of the rest of week 1 as each day was fairly similar to the one preceding it, with only slight increases in activity and improvements in my knee's mobility. Week 2 was much better as I had my first follow-up with the doctor, who was very pleased with my progress as far as my extension and flexion were concerned (according to the PT, week 1 is essential for regaining complete extension, more important even than flexion which can be improved later on, but if the patient does not achieve complete extension in this period, it is very likely he will never be able to completely straighten his knee again and may even require a second surgery) and had my first two in-clinic physical therapy sessions.

Since this post is quickly becoming very long, I will leave details regarding week 2 for another post and end with some photos... Also, if you've been through ACL surgery and rehab, I'd love to hear about your experiences...


Right outside the clinic, not-so-bright but very early, I was the first patient of the day at 5:45 a.m.

Waiting to be anesthetized even though I'm so tired I already look drugged...

Post-op chillin' with the CPM and ice-machines

Not sure if I knew where I was when this photo was taken...

Hanging out with my buddy Charlie after surgery


Working on flexion with heel slides on day 3 (happy to report that I am already past 90 degrees)

CPMing, Mate-ing, and trying to read War and Peace


WARNING: THE FOLLOWING IMAGES ARE SLIGHTLY GRAPHIC...


Changing my dressing for the first time after surgery, since then all the stitches have been removed, except the ones from the longer incision which will dissolve eventually. (got some nice swelling going on there...)

Day 5 post-op, even more swollen and got some nice bruising going on in the shin area.

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