Skifanatics ACI Surgery - Nov 8 2010

[dishes]

Hi Ski,
I've been reading your posts and I'm so glad I came upon them.  I'm going in for ACI and upper tibia osteotomy on Feb 21st.  Dr. Gomoll is also my surgeon and I'm also going into the Faulkner.  Can I ask you, where are you getting your rehab done?  Dr. Gomoll said he refers alot of his patients to the Brigham up at Patriot Place, which is perfect for me since I live in the next town over.  I'm just wondering if you've been to the same staff, since you speak so highly of your PT and the regimen they have you on.  Also, when I booked the surgery date last week, Dr Gomoll's secretary told me 1-2 nights in the hospital, yet Dr Gomoll said one night due to the osteotomy.  Did you know ahead of time that it would be definitely 2 nights?  If not, what was the factor that contributed to the 2nd night?  I have a 10 and 13 year old who will stay with their dad that week (I'm divorced), but I'm trying to give my sister in law a time line for when I'll be home, since she'll be coming off the Cape to help me that first week.  Also, did you find paying for the Game Ready ice machine was worth it?  When I had the retrieval surgery on 12/3, they sent me home with the blue cooler with the cryo/cuff.  Dr G's physician's assistant told me I'd probably end up getting another one after the ACI surgery.  I really have no use for 2 of them!  Would you advise checking with my insurance company ahead of time to see if they'd cover the Game Ready system?  I'm going to set up my starter post tonight and explain my situation in a little detail, but I would still like to read your posts; they're informative and inspirational.  Thanks so much for sharing!
 

[kasia_ny]

Hi Dishes,

I had a very similar surgery to yours on December 15th.  I also had tibial osteotomy and cartliage transplant, not ACI though, but the Denovo NT, which involves a cartliage from a donor.  I was told that I was going to stay two nights in the hospital, and endend up spending three nights due to the fact that I had a bad reaction to anesthesia (I was very nauseaus) and also a urinary retention so they had to put the catether in. 

I had the Gameready and was told that most of the insurance companies do not pay for the rental.  I had to shell out $295 for a 21 day rental.  I liked the machine because it has a "cycle" function, it provides cold for 30 minutes and then takes 30 minutes break so that you do not have to think about taking it off.  However, if you have an alternative machine already it might not make such a big difference.

Take care,
Kasia 

[dishes]

Hi Kasia,  I'm afraid i'm not familiar with the procedure you had.  In fact, so many people have the medical terms and the sizes of their deficits listed on here; I couldnt tell you how big mine is!  Only that the doctor said it could not wait more than 6 months to fix because it was very big!  In the interest of saving money (I'll be owing my company money for health insurance when I'm out those months!), I'm not going to get the Game Ready.  It would be one more expense that I just cant afford right now.  Was your rehab similar to the ACI with osteotomy, as in NWB for min 6 weeks and extensive PT?  If so, how are you coming along?  I got great news today; I found a grant that I can use that will pay for a taxi to and from PT for as many times a week as I need to go, and for as long as I cant drive to PT.  What a load off my mind that is!  I'm single with a great man in my life, but he doesnt live close by and works full time, as does every friend and relative i have! For once, being a  social worker and knowing the resources actually paid off for my own self!  I suppose I'm going to need to thrive on these little victories to try to assuage the major anxiety and preoccupation I have with this impending surgery.  Did you have/need help the entire time of recovery or just the first week or two? 
Trish

[Melissa S]

Hi Dishes,
I am about 9-1/2 weeks out from a patellar ACI sugery.  I didn't get a Game Ready however, I am familiar with them since they use them on me at PT.  What I did get is called an Iceman.  It is a blue cooler with a hose and pad attached that you put ice in with water and wrap the pad around your knee.  I ended up purchasing it for $150.  That way you aren't paying a weekly rental and you are not on someone else's timeline as to how long you need ice.  I still use it about once or twice a day and I am sure I will use it alot still in the next 6 months since this rehab is so long.
Just thought I would throw out that idea for you.

Melissa

[dishes]

Hi Melissa, thanks for your reply.  The Iceman sounds just like the blue cooler/hose/knee wrap that they sent me home with after the harvest surgery.  I really wish I'd had that after the first surgery, since that one was much more invasive and painful than the harvest.  I was changing those plastic ice packs every 45 min for the first surgery; what a pain, no pun intended!  How's your recovery coming along?  Did you need an osteotomy with the ACI? 
Trish

[skifanatic]

Hey Dishes.  You should consider exchanging notes with Overdidit (look back in this topic), the two of you may be having phase 2 surgery around the same time.
 

Can I ask you, where are you getting your rehab done?

I live in central Massachusetts so I go to Ramsey Rehab.  If I had the option, I wouldn't think twice about going to Brigham though.  I suspect they see a lot more ACI than out here in the boondocks.  Ramsey is fine for me...I do most of my rehab myself under their guidance.

Did you know ahead of time that it would be definitely 2 nights?  If not, what was the factor that contributed to the 2nd night?

Not sure why I had the two nights.  I believe it is at the discretion of Dr Gomoll but not positive.

Also, did you find paying for the Game Ready ice machine was worth it?

Yes, as mentioned by others in here, I do recommend it....especially for week 1 and 2.  Dr Gomoll's admin can set you up with the Game Ready dude.  Especially for those first two weeks.  I also have a cryro cuff and use it now when I need to.  The Game Ready is good because you can just leave it on while you sit it bed and it deals with timing your icing sessions.  It does compression as well.  Here's a tip if you do get the Game Ready....Remind the nurses at Faulkner not to use ice chips in it.  Use ice cubes or blocks.  Small ice chips screw it all up.  In a daze, I watched the poor nurses fight with it on multiple occasions.

[dishes]

Thanks, Ski.  I saw in your week 7 post that that's the week you got your outpatient PT script.  Dr. Gomoll told me that I'd be starting outpatient PT after week 2.  I just found a grant to get transportation to get me to PT since I cant ask friends and family to drive me several times a week!  Did you delay outpatient PT or was this the doc's orders?
Trish

[dishes]

Hi Overdidit
On Ski's suggestion, I'm posting here to talk with you about your surgery.  Ski tells me it sounds like we're both going in for the same thing and may be right around the same time line. I'm going in for ACI and tibial osteotomy on 2/21 with Dr. Gomoll.  I have no idea how to send personal messages here!  So, if you'd like, please reply....it sounds like we may end up being laid up for the same time period!
Trish

[Melissa S]

Dishes,
My recovery is coming along pretty well.  I am pretty much out of my brace altogether and I am using just one crutch most of the time right now.  As my leg gets tired and sore at the end of the day I sometimes go back to two.  I am a little slower than some of the others on here who got off crutches and brace around the 6 week mark.  I think it depends on how strong your leg is before surgery.  I lost a lot of my quad muscle and my leg just wouldn't support me any sooner.  I do walk without any crutches too just around the house and short distances.  The thing I have been struggling a little with is the ROM.  I am kind of stuck around 120 and it took me a little longer to get there.  I am hoping when I go to PT tomorrow that I will have surpassed that mark.
I didn't have the osteotomy with mine because my alignment was good and my defect wasn't caused by that I had an accident.
You have found the right place for knee problems, everyone on here has helped me quite a bit.  If I can do anything else to help let me know.

[kasia_ny]

Dishes,
I believe our recovery should be very similar.  Where is your defect? Mine was under the lower half of my patella.   I was NWB for 4 weeks (until today, in fact), now I am 25% PWB for the next 2 weeks and then it is up to the doctor to decide to increase the weight-bearing.   I am doing pretty well.  Every day I feel like I can do a little bit more.  I am at almost 90 degrees ROM and this is considered "on schedule" by my PT.  I am doing all the exercises at home as advised by my PT and use the CPM machine for about 4-6 hours a day, in the morning and at night. 

After the surgery I have been staying with my husband's parents.  I was lucky that I had my surgery just before the holidays so it coincided with my sister-in-law with family being in town, so there was someone in the house at all times for the first two weeks.  Then my mom came for the next two weeks.  So I had someone with me for almost the whole time.  I would say that the in the first two weeks I really needed someone to help, later on I could do most of the things myself (getting dressed, shower etc. ) except for cooking and carrying food.

I recommend getting a walker for the house, I find it much safer to use than the crutches for trips to the bathroom and kitchen. 

You can read more about my recovery in my diary.
Take care,
Kasia

[skifanatic]

Thanks, Ski.  I saw in your week 7 post that that's the week you got your outpatient PT script.  Dr. Gomoll told me that I'd be starting outpatient PT after week 2.  I just found a grant to get transportation to get me to PT since I cant ask friends and family to drive me several times a week!  Did you delay outpatient PT or was this the doc's orders?

I believe I had the 6 weeks of home PT because of my remote location and also because I could not drive.  It would have been a huge inconvenience to seek rides twice a week.  For those first few weeks, I was very limited what rehabilitative activities I could do.  I really didn't need much assistance to perform the trivial tasks.

You can preview Dr Gomolls rehabilition protocol here...
http://www.cartilagerepaircenter.org/rehabilitation/aci-rehab-protocols.html#c63
http://www.cartilagerepaircenter.org/rehabilitation/rehab-exercises.html

[Overdidit]

Hey Everyone, I got my surgery date - February 7th.  So started cooking and freezing dinners this weekend.  Panic mode is setting in.  I'm a planner.  So let's talk about the Game Ready device . . . .do you think I can do WITHOUT this if I already have the cuff cooler machine?  So how does everyone feel about my kids having school vacation two weeks after my surgery?  6 and 5?  Do you think I should set up play dates everyday for them?  Will I still be on the pain meds most of the time?  Any input would be helpful.  Thanks, Wendy

[Overdidit]

Hi Trish,
First thanks ski for getting us in touch.  Trish my surgery is February 7th with Dr. Gomoll.  I sent you an email as well.  I am  in the panic mode.  Doing cooking and freezing this weekend.  Getting a bit nervous now . . . .trying to prepare our kids for this . . . ..6 and 5 . . .sigh . . .never mind work . . .a ton to do . . .

Hi Overdidit
On Ski's suggestion, I'm posting here to talk with you about your surgery.  Ski tells me it sounds like we're both going in for the same thing and may be right around the same time line. I'm going in for ACI and tibial osteotomy on 2/21 with Dr. Gomoll.  I have no idea how to send personal messages here!  So, if you'd like, please reply....it sounds like we may end up being laid up for the same time period!
Trish

[skifanatic]

WEEK 11
Lots of things going on this week.  Last week/weekend was a bit frustrating.  I wasn't making much progress with weight bearing despite the constant, relentless exercising.  When I tried to increase load on to my leg, the area around the lesion was quite painful with each stride.  I began to doubt my progress.  Well, this week things have turned around quite a bit.  The pain with walking is getting better and am officially down to using one crutch.  What a liberating feeling that is!

Also on a positive note, I've been consistent enough with my daily workouts to the point where my PT has dismissed me for a couple weeks.  There's not much else they can do until phase III starts.  At this point I perform 25 various leg/mid-section exercises daily along with recumbent biking.  I've increased resistence with the biking to the point where I can work up quite up a sweat.  In addition, I'm now starting three days of treadmill activity (holding on the railings to offset weight) to the weekly regimen.  I'm thinking I'll be able to walk with a cane for my 12 week follow-up appointment with Dr Gomoll in a couple weeks.

I spoke too soon about the lack of snow in the Northeast.  Since I wrote that here, it's done pretty much nothing but snow around here.  Doesn't make for getting around very easily.

[cdubb]

We've had a bunch of ice in the midwest/Chicago area.  It's so thick in parking lots that salt and other deicing agents aren't working too well.  It just melts the top and refreezes.  You literally have to chip away it and remove it to get rid of it and have salt work.  I've had 2 near miss slips. One really jammed my op leg hard and it hurt.  Haven't taken any paid meds since 3 weeks post op, but I did take one Norco that evening and had some increase in swelling the following day.  Seems to be okay now.  Scary stuff though!