Physical Therapy #2

This was a fun appointment. I started to feel like I am making progress.

We added exercises to those assigned in the first physical therapy appointment. These are a lot of exercises and I am starting to realize that physical therapy is a real time commitment. But it is really important so I can't slack on this.

Especially because my extension is still at 0 and we are starting to get a little bit worried about getting my knee to hyperextend like my normal knee...

1) calf raises with equal weight on both legs
2) single leg raises (SLRs) with both legs. Left leg in all directions. Right leg (injured leg) just to the front and to the side. I can't SLR to the back because I can't work my hamstring yet.
3) roll in chair to bend knee. hold for 10 sec and push back (this is a good exercise for me to do in lab).

The best part of this appointment was that we UNLOCKED MY BRACE!!! I learned how to walk with the brace and the crutches but this time I could bend me knee!! Very cool. We also worked on walking up and down stairs in the bendy brace. I have to take one stair at a time and use a hand rail and a crutch to support myself. Not natural at all yet but it is nice to start to feel a little more independent and strong.

Next week, I am going to be working with another physical therapist because my person is going on vacation. This makes me a little bit nervous but I am sure I will be in good hands.

at the top of some stairs in a bendy brace
work it girl!

First follow-up with the Surgeon

This was a quick appointment. We did an X-ray of the knee. It looked great. Then, the surgeon and the intern quickly checked my flexion and extension. I started to try to make my knee bend as much as possible and the doctor stopped me and said "we don't need anything heroic". I laughed. They just wanted to see that I could bend my knee. They didn't even measure the angle. My extension was zero, meaning that my leg was able to get completely straight, which is very important at this stage. The intern removed the stitches from the incisions for the arthroscopic part of the surgery. These are two small buttonhole-like cuts on both sides of my knee. It didn't hurt. So far, so good.

Physical Therapy #1

I was really nervous going in. I didn't know what to expect and still hadn't really re-established a relationship with my right knee. I was timid and reluctant to touch my knee.

But at the beginning of PT, I was told to touch my knee and that it needs LOVE. So I felt bad because I had been so timid and scared of my knee.

So my exercises for the week are:

1) heel props
2) patellar mobilizations and also rubbing the scar tissue
3) quad sets
4) single leg raises
5) knee bending (with assistance of my left leg)
6) desensitizing knee with different fabrics

Also, I was allowed to put some pressure on my leg. Walking with the brace (locked into the straight position) and with crutches.

Finally, I was told to rely on acetominophen for pain relief because the one of the stronger painkillers makes patients emotional and constipated.

Day 5 Undressing

So I have been deliberating for a bit on what to show my readers when it comes to the actual wounds from surgery. I don't want to cross that line of TMI or show anything too gross. But also, I want to be informative and "keep it real", as was stated in my mission statement. So after discussion with some close friends, I decided to show you some pictures. A word of caution if you get squeamish easily.

Okay. So the nurses said to switch my dressings on day 5. This would involve removing the white compression stocking. Then the brown ACE bandage that was wrapped tightly around me knee. Then the white gauze and some large white bandaid-like things. Finally, butterfly bandaids. We were told that the butterfly bandaids would come off when they were ready. So since most of them didn't come off on their own volition, we left them there.

Figure 1. Removal of dressings. A) The ACE bandage was found under the white compression sock. B) Under the ACE bandage was white gauze. C) After removing the white gauze and some large square patches, I saw this. These bandages were not yet removed as them seemed very firm and not ready to be moved. 

The knee was not as gross as what I was expecting. But it was definitely swollen and had some markings on it. I could see one set of stitches out of three (two for the arthroscopics and one for the graft). This was a relief because I was most nervous about the wound left from the hamstring graft. My leg overall looking weird because my thigh seemed to lack all muscle and was just kinda floppy. My knee was big and round and my foot was also swollen and club-like.

I was happy to redress the wounds.

Figure 2. Replacing dressings. A) First we put back new gauze and the ACE bandage. Then I put the compression stockings back on. The left leg stocking just keeps my leg warm. B) The non-slip socks were added, as well as the ice machine. C) Finally the brace! And I am as good as new. Almost. Soon. Hopefully.

Update on Bendy Machine Progress

My pain threshold significantly decreased when the nerve block ran out. I felt like I could feel so much more pain along the front of my knee that I had been blissfully unaware of before. As a result, the bendy machine hurts A LOT more. Not discomfort but actual pain. So I have been making progress a lot more slowly. But I am hoping not to regress again. I think if I continue to more forward I can still reach the goal of 110 degrees by my second follow-up appointment. 

Check it out this new chart. It is more simplified than the last. I simply want to convey that I am increasing the angle of flexion of my right knee overtime (slowly but surely). 

Sweet Inspiration

My incredibly sweet boyfriend had a present delivered to me today. It was a poster of RG3!!! For inspiration. We posted it over the TV so that now when I want to quit the bendy machine, I just look up and think "what would RG3 do?". Not only did the poster give me inspiration but it also made me laugh incredibly hard. 

Also, please notice the beautiful flowers on my mantel. The pink ones are from my awesome lab mates. And the yellow are from my very caring Mom and Dad. 

Thanks loved ones!

Bendy machine

Now it is time to describe the bendy machine. Its technical name is the CPM machine, which stands for "continuous passive motion". Misnomer!!! This machine is anything but passive! It is torture.

Here is a very boring video of me using the bending machine in the hospital. I was so pleased with my performance BUT it turns out it is easier to do the CPM in the hospital while under lots of local anesthesia.

So I have to track my progress. Below is my progress on the CPM machine since the surgery. It is not a perfect chart but you get the point. In pink are the time points from the hospital stay. In green are when I first got home and in blue are time points after my nerve block ran out. The size of the balls represent the length of time. The smaller balls are 1 hour and the larger are 2 hours.

Doctor's orders are to do the bendy machine 3 times a day for 2 hours each time, minimum. The goal is to get to 110 degrees by the second follow-up appointment.

Night of Day 1

Not good. 'Nuff said.

Post-op Goodies

So before the operation I got my brace and crutches. Basic tools.
But after the operation, I got more goodies that are so wild that they each warrant their own post.

1. the bendy machine
2. the ice machine
3. the nerve block

I think for many ACL reconstruction surgeries some of these gadgets may be optional but recommended. I highly recommend all of the them and if your surgeon doesn't provide them, change surgeons. Seriously. Change surgeons.

Day 1 Back home

smile is hiding grimace

Swollen leg with brace and ice machine

Day 0 Fuel for the Fit

Day 0 Drugs are Good

Before Drugs

Drugs

After drugs

Pre-op preparation

1. Stocked the kitchen with lots of water and gatorade. Soup and apple sauce.

2. Packed a small toiletry bag with toothbrush, toothpaste, etc for overnight stay in hospital.

3. Books and magazines. Including Mindy Kaling's book (present from David).

4. Crutches and brace.

Pre-op appointment

I was nervous about this appointment. But immediately felt better afterwards. I like my surgeon. Young but confident. High energy but not spastic. He gave his spiel and told me statistics about ACL surgeries in general and his practice, specifically.

Then he let me ask questions. He answered them all patiently, even the silly ones. Like, will I have to remove metal body piercings? Yes. Bummer. Oh well. He said some of my fears were "common but irrational". Okay. That makes sense. He was being honest with me.

Then my knee was examined again. Lachman test. Yup, still have a torn ACL...

Then I got fitted for my crutches and my brace. I got a cup of green antibacterial soup. And intern came in asked me if I drink or use drugs. (answers will remain undisclosed for the purposes of this blog).

I read some forms. Asked more questions. Signed some forms (the subjects I wish don't ever have to come into play).

Fingers crossed.

Sometimes Honey Badgers Care

I play defensive back for the Honey Badgers. And to say it nicely, "Honey badgers don't care".

So I stayed in the game and played as hard as I could after I stopped quickly to avoid a collision with my goalie and an the other team's striker. I had been running full speed when I went down.

My teammates huddled around me and when Jan tried to touch my knee, I scooted away anxiously. She said  I looked like a "dog with diarrhea". Which made me howl with laughter. Only Jan could make me laugh within minutes of destroying ligaments (yes plural) in my knee.

But I shook it off and finished the game. And the next one and the one after that.

I'm a honey badger, after all.

Or so I thought, until I heard that another player who was injured later in the same game had gone to the doctor and received some bad news. Torn ligaments. It was three weeks out from the injury and my knee was still swollen and still hurting. So I made an appointment with the sports med people.

Bad news and this time I care.