Cosmic's ACLr - hmmm cat or gibbon graft??? Paper pants or commando?

[Cosmicsnuffle]

Jay -

.... och you're right about the cuff - ... I've lived in it today and it feels soooo good when you refresh the filling ...  aaaaaaaahhhhhhhh!


Mum stayed last night and was amazed at the tranquility of the morning routine here - my son gets up at 6:30 and leaves the house for 7:30 with very little input from me - I'm just around in case (usually doing packed lunch, and reminding him of al the things he already knows!). Daughter gets up after and just needs some encouragement to get out of bed and keep moving... she cycles to school.

Breakfast in bed - a gentle day with a couple of close friends (Mum's been good at manning the door - the day after my last op I had visitors from 09:00 to 23:00 and could have cried with tiredness) and am now sitting in the back garden in the evening sun with my leg up AND the cryocuff on :-).

This afternoon I had a visit from the local councillor about an issue with the skate park behind (he did call to check first!) - he's in shirt and tie, I'm in PJs (although they do look like T shirt and 3/4 shorts) -  made me chuckle.

Next visitors just arrived... ma- and pa-in-law!


xx

[Snowy]

Just catching up on your post-op journey...so glad that all went smoothly for you! I confess that I'm far more freaked about the general anaesthetic than any other aspect of the surgery right now (even the drilling through the bones) because I've never had one, and my family has a history of reacting really badly to them. I'm still hoping my OS will offer me a spinal tap option so I don't have to be knocked out, but stupidly I forgot to ask him about that on Wednesday.

Good words of advice on the cryocuff - I'm definitely investing in one of those. Am curious to hear more about the femoral block - what do they actually do for that? Fiddling in the groin area sounds slightly disturbing.

Very happy to hear you're out in the back garden already. How does the leg feel when you're moving around? How much weight are you putting on it?

Hope all continues to go well.

[tez27]

Femoral block and fiddling with the groin area I must have blocked that from my mind when I read it the first time!! selective blindness I think we'll call it, but Snowy mentioned it again and this time it penetrated into the brain so now I need details too.
Sounds lovely your Mum being there to sort out the kids and take care of you, enjoy being looked after for a while cos soon enough you will be the look after'er and not the look after'ee or something like that.
Snowy the general anaesthetic is not too bad at all I have had a fair few and have never had a major problem but if there is a history of sickness after one I think they can give you something to control that, the only problem I have is that it wipes me out for a coupe of days afterwords, saying that I did have another wee problem when I had my scope in Jan, the anaethsatis had a probem
finding a vein in the back of my hand [hands were freezing] and ended up damaging a nerve which resulted in numbness in the back of my hand, the morale of that story is make sure your hands are nice and warm before they start.
I think you lot are talking me into the cryo cuff or something similar, if it helps post op I can always sell it on e.bay after I'm finished with it, I will have a look around and see what I can find.
Take care all Tez

[Cosmicsnuffle]

The general anaesthetic is fine Snowy, a very bizarre feeling and before you know it you are awake and it's all over. For me being awake during the procedure and a spinal would be far more daunting!!

I went online yesterday to look for videos on femoral block on youtube - they used and ultrasound to identify the nerves in the groin that innervate the area they want to deaden, then use a small electric probe to stimulate the nerve and associated muscles to identify that it is the right one - then inject around the nerve to deaden the area directly. I wouldn't recommend you watch unless you have a strong constitution!

It was very funny as I remember really wanting to see the ultrasound screen, and was convinced that the anaesthetist was talking to me (not the trainee) about what he was doing. He was really surprised when he found me leaning my head on his shoulder to peer over to look at what he was doing! I remember trying to say "I don't mean to intrude but I'm just curious to see" as i realised he wasn't talking to me.... but I'm sure that's not what came out! Next thing I know is the ceiling is turning to liquid and flowing through the doors and a mask is coming over my face.... and that's it. I didn't even realise they'd started giving me the anaesthetic!

As for groin fiddling - you are past caring tbh!!! ...and that's where the paper pants come into their own. Just make sure you are neat and tidy before you go in if you know what I mean! 

As for the anaesthetic aftermath, my blood pressure tends to drop significantly and I spend a long time drifting in and out of semi-consciousness. It's not a bad feeling and I don't get sick like some people (my Mum does!), just disconcerting. I'm an extremely sensitive case apparently. Like Tez it takes a couple of days to shake off the feeling. All the anaesthetists I've had have been very sympathetic, very careful and informative... and we've had quite a laugh which is good for putting you at ease.


I'm trying to write realistically about the pain - but I don't want to put anyone off!!!
The bone drilling worried me too as it sounds so extreme - I can't really feel it - I thought it would feel like broken bones. The majority of pain/discomfort is from behind the knee and thigh - the hamstring...any nudge, twitch or tweak is butt clenchingly sore. The wound sites are somehow numb and sore at the same time, the graft site is still weeping slightly.
Weight bearing through the knee itself isn't painful unlike after the initial accident and scope in January. It feels very unstable. There's no way I could walk without assistance.
Movement is still restricted by swelling and bruising which is slowly emerging. I think the bruising is going to be in the pattern of the cryocuff where it has been applying pressure  . extension still looking good and flexion slow and tentative to 80o.

I can tell when the meds are wearing off - I woke again at 3am and had my morphine, and then was feeling it again by 6am, so I'm just being unusually diligent and keeping on top of them. I usually hate taking painkillers, but can see this regime is really important.

I hope this is helping.... I hope I never have to go through this again - but wouldn't hesitate if I had to!!

If there's anything I'm missing that you want to know please ask!!!

Sunny shiny Saturday. Time to get a stripy suntan 

xx

[Mike Hough]

Hi,

As others have said, the general anaesthetic is fine. I was worried before mine (it was my first one), but all that happens is you breathe in some oxygen through a mask and there are a few seconds of everything going blurry - then you wake up in the recovery room. I knew nothing about the femoral block or the drilling. The pain was all around areas of bruising rather than near the bones.

Good luck!

Mike
   

[Cosmicsnuffle]

Day 4 Post-Op

The bruising is really starting to surface - at least it looks impressive for all the pain and hassle!! Bruising is mainly around the harvest site, down the front of the shin and in the back of the knee.... and OMG it's sooooo ITCHY under the dressings!!!!

All around the harvest site is still numb... hard to resist prodding it continually just to see if there's any change (I must be bored!).

Missed the 3am and 7am morphine today... resting pain is minimal, hamstrings and harvest site are nerve janglingly twangy if I over-do the flexion or knock my foot when walking. The extension seems fine - sat on the floor for ages last night with my legs extended... :-)

I can shuffle around holding onto things for support, but if I attempt any weight-bearing on a straight-ish leg the knee is freakishly wobbly - I have boingy cartoon noises going on in my head as it slinkys about!

Sat in the garden in the sunshine... not such a bad time of year to have an ACLr :-)

Hope you are all having a knee-free weekend!

[Raymond76]

Surprised that you have so much bruising. I guess it will vary person to person. I had no bruising and the same reconstruction.

As for the pain, I agree with you. The pains are all from the hamstring harvest site. In general all the pain and discomfort is from muscles and not the knee itself. You just have to be careful you don't do any movement that flexes the hamstring muscle much.

Keep it going!

[tez27]

Cosmic thanks for the update you have very discriptive way of explaining things that I appreciate sooooo much you make me laugh but I also get what you mean [if that makes sense]
Good for you not needing the mophine what a hero
If your anything like me any bruising is kinda satisfying its like you mark of honour or something like that,
your now prolly saying "what is she on" but I know what I mean
Sounds like things are going smoothley for you I hope it continues without ay problems.  what about physio when does that start?
Take care Tez

[Snowy]

Bruises are like a temporary version of your surgery scars - once when I was bemoaning the rather large scar I have on my right hand (fell through a window on a dairy farm in Cornwall at 3am in a thunderstorm) a friend told me that scars are just tattoos with better stories, and that's how I've always thought of them since.

Glad to hear that all is still going well. Have you been taking any other painkiller apart from the morphine? Pain medication was something else I forgot to ask my OS about - I meant to check to see what they'd be prescribing. I don't really mind taking anti-inflammatories, but I'm not a big fan of anything that makes me feel stupid - I still have about two-thirds of the T3s I was prescribed after my ACL tear. However, I'm quite prepared to check my natural antipathy at the door and take whatever they give me after surgery!

Interesting that the harvest site is more problematic than its new location. It does make me wish that allografts and/or synthetic ligaments could offer as consistently good results as autografts - somehow it seems so hard on the poor leg to have to heal up a graft site as well as the knee itself. Does anyone who's a bit further along know how long it typically takes the graft site to settle down?

Keep enjoying that sunshine, Cosmic!

[Raymond76]

For some people, they have issues with their hamstring even after a full year. Others say they have no problems at all. It varies so much. Just hope you are one of the lucky ones and don't have to many problems.

Even though I don't have thick legs but thinner legs (actually they are to thin in contrast to my upper body). My legs are pretty strong though, from years of hockey and soccer.  BUT I have always had tight hamstrings. I could never touch my toes.  I have a feeling that if I don't do some major hamstring stretches and weight training, I will have issues in the future.

To summarize, you need to know your body. Your strengths and weaknesses. If your calves, ankles, or hamstring need work, then give it 100% effort and work them. This is not a 1 time deal, its for life. You will need to create a new lifestyle. And if you haven't already, consider this ACL injury as a sign that your body is telling you that you need to.

Example. I was 33 when I tore my ACL in a soccer match. For years before, I was chasing down and keeping up with 20 something speedsters. Until one day my body said enough of that.

[Snowy]

I don't have any particular hamstring issues, but I do know they're a lot weaker than my quads (which are in pretty good shape from skiing). I've been working really hard on hamstring strengthening as part of my prehab, which feels a bit like fattening up an unsuspecting pig for the slaughter.

I've struggled with chronic knee problems (severe PFS and mild arthritis) for years punctuated by a variety of acute injuries, so I don't take much about my leg function for granted. I've made a lot of compromises - giving up running and martial arts, for example - to save my knees for skiing, which is my big obsession. My real concern with this injury is making sure that I can get back on the slopes at the end of it. I'm far less afraid of the hard work of prehab and rehab than I am of not being able to do the things I love, which I guess is a pretty good starting point.

I'm 33 too, and blew my knee crash-landing a jump at Whistler. It wasn't in any way a typical ACL-busting fall, and my PT and doctor both think the culprit was actually a kickboxing injury I suffered four years before. My knee was never the same after that injury - I had persistent instability and it remained much weaker than the other side - and the consensus now is that I suffered a partial ACL tear that went undiagnosed. The fall I had this time was a straight backwards tumble without the twist that usually characterizes an ACL tear on skis, but it was enough to finish off what was left of the ligament.

I agree completely that this is a lifetime deal. That's why I'm so concerned about getting it right. From an objective point of view, it's actually an interesting opportunity to re-evaluate what's really important. I've been pretty career-driven the last few years, and if you'd asked me a few months ago how I would respond to a major injury my main concern would have been getting back to work as fast as possible. Now it's happened, I'm far more concerned about making sure I give my knee the attention it needs to give it the best chance of healing. I'm actually asking for two months off work, which would have been inconceivable to me before this injury. Now, my only worry is that it won't be approved!

[Raymond76]

Life is more important than work...

I always thought if I would have a bad knee injury it would be something like you had, an awkward fall or a big collision where your knee gets banged hard with someone. Never would I have thought it would happen during a light jog. For me it happened during an indoor soccer game. The ball was kicked  past the goalie, I was jogging to get it, stepped around the goalie...POP, down I went. No one touched me
It could happen anytime anywhere I guess. So enjoy life as it can change in an second.

[Cosmicsnuffle]

To summarize, you need to know your body. Your strengths and weaknesses. If your calves, ankles, or hamstring need work, then give it 100% effort and work them. This is not a 1 time deal, its for life. You will need to create a new lifestyle. And if you haven't already, consider this ACL injury as a sign that your body is telling you that you need to.

Great words of wisdom, Raymond. TKD has been my passion for 10 years - I was a late starter but was completely committed (as always- I can't half do something!). Some of my fellow students and Instructors are finding it hard that I am so stoical about my future in MA, they feel I am giving up. It's not that - if I have to move on to pastures new then I will, and without regret. The first thing my GP said when he saw me post injury was "your body's been trying to tell you to slow down for years, it's finally made you listen".
 

[Cosmicsnuffle]

Here - hopefully is a pic of my knee of many colours :-).




Had a call from Poole Hospital PT today with an appointment for tomorrow.... can't see the gem of a PT I saw previously but they have booked me in with a senior PT  .

Daughter got off safely at 07:30 for her school activity week in Wales - lots of help packing - I think we had everything on the kit list ticked    ... all in all the timing is pretty cool. She's no trouble but it just means there is one less person to worry about here for a few days.


Father wheeled me out to a country pub for lunch - 20 steps to the car, a short very slow potter into the pub garden to sit in the shade of a tree on a bench with my foot up, and the reverse to get home. Overtaken by old lady on a rolator going back to the car LoL.

No cryocuff until 8pm - . Knee, shin and foot are hot and tight with swelling, bruising still emerging - it's like a colourful civilisation is slowly taking over my leg (been watching too much Dr Who).

Brother and family (wife & 3 youngsters) visited and stayed for (and cooked  !) tea - I have to admit I had just fallen asleep on my bed when they arrived. Sitting in a pub garden eating good food was surprisingly hard work (or maybe it is the 6am mornings and uneasy nights). Sister-in-law gave me a foot and calf massage - OMG that was so good.

I managed one day without morphine 'til the evening (was that yesterday?), but did restart as pain was increasing. I've missed the doses in the middle of the night - but keep up during the day. Aside from that I am coming to the end of 75mg diclofan every 12hours.... paracetomol and ibuprofen.

I'm not usually one for taking painkillers but am sticking advice of keeping ahead of the pain (it's just that sometimes until you stop taking the drugs you don't know how much pain there is!).

Anybody sunburnt?

[tez27]

Hey Cosmic
Bruising is pretty spectacular as seen on F.B, I wonder as there is so much bruising your physio will get you to do much in the way of excersises as I would think that could make it worse, good luck anyway it must feel like moving onto the next step of recovery
Sounds like your starting to get out and about a bit more aint it surprising how much a wee jaunt out totally wipes you out, I guess its a matter of taking things slow and easy to start with.
How long did your doc suggest the use of morphine? I know what you mean about not knowing what the pain is like untill you stop the meds, but its still early days for you and with that amount of bruising I would think you will need something strong for a while yet.
Raymond I didnt rupture my acl doing anything dramatic either mine was not even sport related, I blame this predicament I have been in for the last 2 years on killer heels and the inability to walk down stairs in said killer heels 
Take care Tez