Thursday, February 2, 2012

More Than You Probably Ever Wanted to Know About ACL Surgery

I have survived surgery and am doing well and on the mend. Steve took the day off work to alternate my bags   of frozen peas on my knee, keep me fed and being an all round excellent man servant. I'm happy we bought a bed frame and desk two weeks ago or I would not have been able to get out of the floor bed and to the washroom when Steve goes back to work tomorrow.

The machine on our bed is a rehabilitation machine we rented called a continuous motion machine. I have it for three weeks. The company that rents them brings them to your house, instructs you on it's use and comes to pick it up at the end. They've already contacted me twice today to make sure I a) received it and b) have no issues or questions about it.

My recovery schedule for this week is as follows:
- 1 low dose aspirin daily to thin the blood to reduce the risk of blood clots
- prescription pain killers every 4-6 hours for yesterday and today. I was told not to be a "hero" and to take them on a schedule for the first two days and then medicate based on pain for the following days.
- toe touching is allowed but no weight bearing on my surgery leg - this means crutching around and bum shuffling up the stairs
- ice on intervals of 30 minutes on and 30 minutes off.
- 20 leg lifts an hour
- 100 foot flexes an hour (pretend I'm lifting my foot on and off a gas pedal)
- and I need a total time of 6-8 hours on my CPM (Continuous Passive Motion Machine) with the goal of having my knee bending to at least 60 degrees but not exceeding 90 degrees by next Tuesday.

Continuous Passive Motion Machine
For those of you interested in how the machine works since like myself most people responded with "that looks painful, you use that right after surgery" I had Steve take a video of me using it (don't worry my knee is still wrapped) .
I'm doing 0-30 degrees today and have turned up the machine's speed since this video was taken
It actually feels quite nice. 

Preliminary Surgery Results
My surgeon talked to Steve while I was coming out of anesthetic and gave him photos of my knee taken internally during surgery. The damage was more severe than the MRI originally projected and I'm fortunate to have chosen the surgery option because no amount of physiotherapy would have given me the results I will achieve with the surgery.

My MRI scan showed that my anterior cruciate ligament was severely bowed - think of a rubber band that's been stretched so much that it won't return to it's natural shape anymore. When my surgeon entered my knee he found more damage.

(Click for those wanting to see the inside of my knee - there's no blood in the photos)

He labelled the photos of note. What you will notice in them is that he also discovered and repaired tears in my meniscul ligament and damage to my meniscus. The bottom right photo also shows him checking the structural integrity to the  cartilage in my knee. My cartilage is soft and permanently damaged, he used the example of tire treads on a car, it will not grow back or repair itself.

(Click to see photos of the ACL tear and final graft)

These images show that an actual tear was found in my anterior cruciate ligament and the final ACL graft. With all these tears found, I'm glad I did not decide to continue trying physiotherapy without surgery because tears will not repair themselves naturally.

So what does that mean for the future of my knee? Well it all depends on how I heal and how well I keep up my physio. With regards to the cartilage degradation I need to be aware of it and restrict any high knee impact activities - no more running for me. I will inevitably develop osteoarthritis in my knee, which I was expecting eventually since my maternal grandfather had both his knees replaced. This just means I'll probably have developed some degree of osteoarthritis by 40 instead of 60. 

Pretty well-wishing flowers from the inlaws.

Plus side with a full recovery for the rest of my ligaments means I can continue to work with large dogs that have no manners that like to try to pull me in various directions with various degrees of force.  Steve and I will be able to continue our ballroom dancing activities, hiking, and ocean kayaking.

In the meantime I just need to make sure I follow my recovery instructions. Karen arrives this Sunday to help me out for four days since Steve will be back at work starting tomorrow. Shelley is coming for a week long visits in the middle of the month to escape the painfully cold Prince George, BC and get some California sunshine
(current view from the window behind me bed)
 with the added benefit of making sure I'm not starving (though Steve's doing fantastic so far and we did a lot of planning ahead to accommodate my dietary restrictions)

So far so good. No nausea from the pain medication and I bounced back no problem from the general anesthetic - it was just like having an epic nap. My throat feels like I was out shouting at a bar over live music. Actually I've had days when that felt worse than what I have from the breathing tube.

And I have the added benefit of an excellent recovery buddy.