KNEEtalk

The OSTEOARTHRITIS DEPARTMENT => KNEE ARTHRITIS - Articular cartilage repair => CARTILAGE REPAIR - ACI & MACI (autologous/matrix-induced autologous chondrocyte implantation) => Topic started by: Room 101 on January 05, 2009, 08:19:46 PM

Title: Room 101's December 2, 2008 ACI (**January 31, 2011 update**)
Post by: Room 101 on January 05, 2009, 08:19:46 PM
I will be 5 weeks PO January 6. I am back to work after the holiday vacation time, and I'll give you my story, but I kind of want to know if not being able to do a SLR is normal at this point. It seems to be pain behind the kneecap that is stopping it and weirdly it's shutting down the muscles... I'll give you the scoop and apologize for it being long, but I have not had inet access... we're not wireless, yet ::)

I had AMZ, etc. in Feb. 2008 and ACI in Dec. 2008, so I've seen enough of crutches & a knee brace for a while.

December 2 was the ACI. It went really well. Patella lesion around the size of a 1/2 dollar or something. Surgery was more involved and took longer than expected, but I am fuzzy from the drugs and don't have pics yet so that part is a bit vague, haha. I was on vacation for 6 days and back at work (computer geek) at 7 days PO, although I saved 3 weeks of vacation and this will be my first 5 day work week since before Thanksgiving. We moved in November, thankfully a 15 minute commute instead of over an hour. It's nice on many levels.

From a post-op pain perspective, the ACI was nothing. I kicked the drugs after a few days, and maybe there-in lies the problem, haha... the only real pain was behind the knee making it so I could not lift the leg. My post op appt. was 9 days after and all was well. No infection or anything. I was told to open the brace to 45 degrees and move from 40 to 60 degrees on CPM starting at the 3rd & 4th week and begin weaning from crutches. I also cleared it that working out w/ my trainer brace on was fine as long as no weights were involved. I began training w/ him at 10 days PO doing massage table leg lifts & core and seated w/ my leg up resistance training for upper body. I can do anything on my side or my stomach w/ my surgical leg. Those muscles are actually really strong. I can also do quad sets on my side w/ my trainer manually resisting. Any position where I don't hit hyper works just fine. We do a lot of muscle activation and 6 second holds for exercises. Isometric holds and tons of core. I have even come to the point where we can do some modified cable work because I can fully put weight on the surgical leg. I still need to use one crutch due to some pain, but with one crutch I can go heel to toe and feel a good stride. My PT was on vacation over Christmas, so I have only had 2 appointments as of today (Jan. 5). Some great massage and manipulation and stim, but I cannot do an SLR to save my soul. The kneecap pain is bad, and I don't know if that is normal. I feel as if things are progressing, and I was actually really strong prior to this surgery which was good. The docs complimented that actually, even though I failed at phase 3 of ACI rehab. Kudos to my trainer and therapist for that because I still couldn't even walk a mile without repercussions before the ACI. I go back to the OS Thursday for a follow-up, so my questions will be answered then also, but what's the scoop from the experienced? Is the lack o fSLR ability while lying on my back normal? It seems so now, but who knows. It's just weird. I can sit and get myself in and out of the CPM or in and out of bed with the brace on, but as soon as I lie down and try it, things just don't function. I haven't pushed it because it seems to just make things regress a little. Maybe I need to try the pills again, but I just haven't needed them for anything else. Minus being sick of sleeping in the brace, I sleep well and on both sides easily. I am really stiff in the morning and the cpm takes a few reps to feel good, but all in all, that stuff is actually soothing.

So, the summary and Cliff's Notes version is at 5 weeks post op: Patella lesion around 1/2 dollar size. I am working out 2 days w/ my trainer, therapy 2 days a week. I am to move from 60 to 90 on CPM (I am at 75, and hopeful for 80 today). My PT RoM is at 70 easily, so only 5 degrees off the cpm. I am not supposed to push past that at all. That was very specific. My brace is open to 45 degrees and I walk w/ 1 crutch. I don't take any meds and see the OS Thursday. I cannot do a solid SLR supine w/out pain behind the kneecap, and I still have some trouble just lifting the leg up from being down, but walking and all is fine.

If there are any hints or suggestions, I am open to stories. I love the stories. I actually feel normal in this group rather than old & broken like "normal" people see me...

Hope everyone had a nice holiday & New Year!

Kim
Title: Re: Room 101's December 2, 2008 ACI
Post by: jonhark on January 05, 2009, 09:45:25 PM
I believe we had the same OS--Dr. Cole in Chicago, correct?

Anyways, take my suggestions with a grain of salt as I was told I could run my protocol as I see fit being that I had my other knee done and it was successful(verified with a scope on Dec 16th)

Half-dollar size patella defect is pretty large. In fact that is almost the entire area of the patella. Patella has approximately 25 cm^2 surface area. At your next visit try and ascertain the size of the defect (cm^2)

I had my last knee done separately for AMZ and ACI as well. I had an AMZ and microfracture that failed in Jan of 07. I had the ACI six months later.

Is it unusual to have pain under the kneecap with SLR's after ACI? I didn't when I started doing SLR's at week 2. But my defect was a little larger than a nickle.  My hunch is that your subchondral bone is pretty irritated from all the rehab you are doing.I wasn't nearly as aggressive as you have been. Things as simple as iso quad sets can irritate the patella. That being said, the first six weeks are the phase in which the chondrocyte cells proliferate...so it is good to stimulate them with plenty of smooth movement and motion.

Every surgeon has different rehab protocols. I generally used the most conservative one out there==Dr. Tom Minas out of Boston. He did my original AMZ and he has done more patella ACI's than anyone in the country. Here is the link to the rehab protocol:

http://www.cartilagerepaircenter.net/fileadmin/user_upload/pdf_files/Rehab_Templates/ACI_-_PF1.pdf

He keeps patients at 40 degrees in the CPM for six weeks. Brace is locked at full extension for six full weeks. Heel slides are fine. Strengthening exercises are good but shouldn't be causing any pain. I didn't attempt walking until week 8. I really don't think the graft or your leg muscles will be ready at week 5.

The first three months post op are critical in this recovery as the graft is at its weakest state (somewhere between water and yogurt consistency).

An e-stim machine or TMES is critical for early stage iso and SLR's. It forces you to fire your quad muscles...therefore taking stress off your graft.

Again, take my advice with a grain of salt. I know many that have been aggressive in rehab and just as successful as myself. Likewise, there are many that have been just as conservative and done well.

I'm at week three for ACI/AMZ done on Dec 16th. All I'm doing is CPM to 40, side leg raises and hip extension with straight leg in brace along with quad iso's with e-stim and ice.

This thing is a marathon and not a sprint. I really think you can do the majority of your knee rehab exercises sans trainer. Get a good routine that doesn't irritate the knee and stick with it. Increase duration and intensity every few months and see how the knee responds. You probably won't see your best result until 36 months post-op....

Let me know if you have anymore questions.

Jon











Title: Re: Room 101's December 2, 2008 ACI
Post by: Room 101 on January 05, 2009, 11:08:35 PM
Yes, Dr. Cole is my OS.  I know he is fairly aggressive.  I have not strayed from his protocol at all, but it is certainly good to hear others.  I will be going to check your link right after posting.  I have followed your diary, and I did catch up some today as I have been sans inet since the surgery.  didn't know what to expect w/ this, but honestly it's just different from the AMZ because after about 8 days that was nothing beyond flexion stiffness and once the bone healed you could be aggressive.  I think working with my trainer is mentally good, plus he has some great ideas on quad strengthening out of the supine/straight leg plain and I can get some reasonable upper and core work with him doing the resisting. Again, it is all brace on and mostly on a massage table, so it doesn't involve the legs at all.   It's also a 100% pain free environment.  I don't think pain is your friend after ACI, but maybe mistaken here as well.

One big difference is definitely the cpm degrees and walking.  Being that they told me to wean from crutches at 9 days post op.  I felt like I was behind or something was wrong, but it sounds like all is probably good, and that the SLR problem will resolve in time... even though that is weird.  I could do all that immediately after AMZ and got full extension back in days.  The lack of SLR strength is a surprise to me, but I'll try not to freak out any more until after Thursday, hahaha.  It's just bizarre how it shuts down.

The ISO quad sets were irritating, so I backed off.  I will definitely be asking about that this week when i go back to Dr. Cole. 

Jon, if I can ask, what made you go to Dr. Cole over Dr. Minas?  Was it a location thing?  (I don't know where Dr. Minas is out of, although I know it has been mentioned here.  I just have CRS I guess)

Thanks so much for your input.  I think you can't ever hear enough stories or talk to enough people about these surgeries.

Take care,
Kim
Title: Re: Room 101's December 2, 2008 ACI
Post by: jonhark on January 06, 2009, 01:24:55 PM
I chose Dr. Cole because I could get an appt and surgery date ASAP. Dr. Minas has a long waiting list. There also isn't much of a difference in how they do the procedure. The AMZ might differ slightly. Both of them are very competent and the top surgeons in ACI in the US. the actual sewing of the membrane and cell implantation is also fairly easy and they should have identical techniques. Chicago is also a lot closer to Denver and  outpatient instead of 3-4 days in the hospital which I didn't want to deal with. The rehab protocol is really what makes or breaks you in this surgery.

Couple more notes. You mentioned SLR's were attainable after AMZ. Keep in mind, you probably had some fibrocartilage left in your defect before ACI. They radically debride down to bone. The cells they inject under the membrane are viscous at week 6. Therefore, completely understandable to have increased pain compared to post-op. That is something I'm experiencing currently because I had 3-4mm of fibrocartilage in my defect. My pain levels weren't extreme before surgery but I was having catching and that nagging kind of aching after exercise along with some sharp pains on stairs. Without a doubt my nickel sized defect would have expanded to quarter and half-dollar size over the course of months and years given the level of activity. The larger the defect the more unpredictable the results.

Keep positive and you'll be amazed at how much better you'll be feeling ever 45 days or so.

Jon




Title: Re: Room 101's December 2, 2008 ACI
Post by: Room 101 on January 06, 2009, 05:59:07 PM
Hi, Jon.  Thanks for the insight.  I never really researched much beyond Dr. Cole when my other OS recommended him.  I wholly trusted my last OS as he had been my doctor since the late 90s.  I freaked some when he wanted me to see someone else, but then I researched Dr. Cole and went for my appointment and that was that.

I know the rehab is vital w/ this surgery, and it's amazing after reading Dr. Minas' protocol how different they are.  I only bend my knee in therapy or the cpm, but I am limited to a specific max.  I was told not to achieve 90 until 5-6 weeks.  But I was told to start weaning from crutches at 9 days.  Wacky.  I am doing their regimen to a t, but it varied from the papers he has online some.  I am sure it will vary more after Thursday.  They do individualize things at appointments.  You sound as if you go by your own routine, but you're and experienced person, haha.  -- I am a newbie.

The pain is definitely different now than pre surgery.  Not lingering or anything.  It's just when I move wrong, but it goes immediately away.  I try not to provoke that pain.  it doesn't feel good, hahaha.  But it isn't a pill worthy pain, if you know what I mean. 

I found it interesting reading about NSAIDs also.  No one had ever mentioned that to me to avoid them.  I assume Dr. Cole doesn't hold the theory that they are harmful to the cells.  But it's a good question to ask him for sure.

Thanks for "talking" to me, Jon.  You have been very helpful.

Take care,
Kim

Title: Re: Room 101's December 2, 2008 ACI (5 week Dr. update)
Post by: Room 101 on January 08, 2009, 09:26:52 PM
Saw the OS today.  All is well. Incision and knee look great and feel great.  Not much swelling.  Lots of muscle mass loss of course.  My leg looks stupid  :-[

 My concerns on SLR were overdramatic  ;D -- I am 5 weeks and 2 days post today.  I get to ditch the brace at 6 weeks when I ditch the CPM, although as of now I can sleep without it.  After that, I should be able to wean from crutches.

I have no pain except w/ attempting supine SLR or extension.  I was allowed to hang my legs over the table today and it felt soooo good.  Doc wanted me to do an extension, which I got started but failed.  He said it was muscle shutdown from the pain and was normal.   Make sure to get stim at therapy and just keep working.  I am strong in other planes like vertical or on my side, but not supine.  Just keep working the different planes and trying the supine but avoid the pain.  I am at 90 on cpm and doc said to not go higher. 

Meanwhile I will continue 2 days of PT and 2 days of training, which is also an extension of PT... or is PT an extension of training?  :P - I work out at a private training facility that has PT, so they work together and know each other.  My PT is more conventional and my trainer more new age, w/ muscle activation and functional training.  i call it wacky, but it works and I think the combination is killer.

Nothing was said about stationary bike, but I figure that will come in as soon as I get ROM back.  I was told that I could start working on full ROM at my PT appt. tonight.  I was limited to pain free before, which generally was 0 to 5 degrees off the CPM degrees.  I would hope to hit 85-90 tonight in PT as I am finally allowed to 90 on cpm.  Treadmill walking comes at 12 weeks, so right around my next visit.

On to the next step it seems.  I will see the OS again at 13 weeks.  Thanks to everyone for their help and for writing their experiences.

Take care,
Room 101
Title: Re: Room 101's December 2, 2008 ACI (5 week Dr. update)
Post by: dileigh on January 10, 2009, 04:53:35 PM
most of the traditional exercising doesn't come until about the 12 week mark, didn't even go to PT until then.  I wouldn't be surprised if you couldn't make it all the way around the first time on the bike, but it will get easier.

This surgery makes you be patient, even if you aren't a patient person......


Diana
Title: Re: Room 101's December 2, 2008 ACI (5 week Dr. update)
Post by: Room 101 on January 12, 2009, 06:03:44 PM
Well, tomorrow (Tuesday) will be 6 weeks exactly.  It is the last day for the cpm machine.  Woohoo!  I did kind of like it as it kept my knee moving and fluid.  I hit 85 degrees in PT Thursday last week and today was still only at 85.  My knee is really stiff.  I kicked in major heel slides added to all 4 ROMs & ankle work I was previously doing.  I still can't do a SLR.  In PT Thursday I could do them on the down, but not the UP & down.  Today at PT I couldn't even do one rep without some serious patella pain.  Not the wow I'm stiff kind of pain either... but the breath taking holy crap that is really uncool kind of pain.  We stopped that and worked on stabilizing in the brace and transferring weight with crutches without the brace.  Massage and stim.  I feel really good except for the supine SLR.  Man... frustrating!  Also, being stuck at 85 for flexion after 3 days of working ROM didn't make me happy.  I can  do an isometric quad hold for 6 second holds each rep totally pain free which I could not do a week ago.  So that's an improvement.   I'll feel better when I bypass 90 RoM.  I am sure the SLR will come in time.  I feel good quad contrraction but it still shuts down when the pain hits.

Oh, well.  Another day down in the books.

Take care,
Kim



Title: Re: Room 101's December 2, 2008 ACI (5 week Dr. update)
Post by: jonhark on January 13, 2009, 03:45:23 AM
Kim--

Some food for thought--when doing quad sets I focus on not hyperextending my leg and try to keep a small bend in my leg. This allows me to do quad contractions without putting too much force on the knee cap while contracting. Do the same when attempting SLR's. It is the opposite philosophy of doing quad sets with a towel under the knee and pushing against the towel.

I think SLR's are great once you build up the muscle to do the work. Otherwise it can be torture on the kneecap....as you are aware. Once your cells start to grow and mature youll be SLR's with no problem.

Using e-stim is huge as well. It really forces your quads to contract and has been a huge help to me over the past couple weeks.

Jon

Title: Re: Room 101's December 2, 2008 ACI (5 week Dr. update)
Post by: bsonday on January 13, 2009, 07:44:01 AM
Kim,

Keep up the good work, and thanks for your kind words.  I couldn't do an SLR until at least week 8, so don't sweat it at all.  And congrats on being almost done with that darn CPM.

-Ben
Title: Re: Room 101's December 2, 2008 ACI (5 week Dr. update)
Post by: Room 101 on January 13, 2009, 04:38:02 PM
Thanks fellas for the posts.  It's funny how every difficult part breeds some fear of doing something wrong or something going wrong.  Jon, I'll try your bent theory.  It's opposite of the usual, but clearly necessary.  I try so hard not to irritate the kneecap, but that's easier said than done, and when it happens, you just have to wait again until it subsides.  Unfortunately, I irritated big time in PT yesterday.  Oh, well, let's look on the bright side.  only 4 hours left of cpm!!  Sweet!

Takre care,
Kim

PS - it's so nice to be out here where people get it... really.  Thanks to everyone for sharing the stories.  It's not such a lonely road out here.
Title: Re: Room 101's December 2, 2008 ACI (Jan. 16 update)
Post by: Room 101 on January 16, 2009, 05:50:09 PM
So, CPM is gone!  It's so weird having time... mornings are no rush now and I'm not up until all hours finishing the time.  Plus, it's just more comfortable, haha.  I do miss it in the respect of movement though.  I reached 95 degrees last night in PT, which was 10 better than Monday, so that's good, but I'm a bit away from the bike.  i have full extension back, but I lack the quads to really do a proper SLR.  Based on previous comments I'm not even worrying about it (I just keep writing it  :P )

I discarded the brace pretty much and it feels good as long as I have some crutch support.  I don't sleep in it anymore, and that's gone well.    I still wear the brace outside in the ice and snow, but inside I feel comfortable.  We've mostly worked on ROM stuff in PT, w/ some beginning stability and basic walking w/ no brace, etc. 

It's not all that exciting, but for some reason it's such a milestone to say goodbye to CPM and the brace, hahaha.

I do a ton of heel slides and 4 way leg lifts (instead of supine SLR, I do them on my side or standing) -- are there any other suggestions for the even fluid motion the cpm gave?  I know the bike is great, but I am clearly not there quite yet.

I feel pretty good so far and have done a much better job of not irritating my patella this week.  In the long run I'll get farther along if I am nice to it.

The only other oddity is that I am getting a weird really quick nerve shot in my big toe... it started a few days ago when I do heel slides or bend.  It feels like it might be coming from the ankle or higher up.  Weird.

Take care,
Room 101
Title: Re: Room 101's December 2, 2008 ACI (Jan. 16 update)
Post by: dileigh on January 18, 2009, 05:18:40 PM
you might check if it's ok to rock the pedals back and forth on the bike, but I think it might be still to early.

It seems like only yesterday that I got rid of the CPM and strangely missed it afterwards.  Keep up the good work!


Diana
Title: Re: Room 101's December 2, 2008 ACI (Jan. 22 update)
Post by: Room 101 on January 22, 2009, 07:28:06 PM
Ok.  7 weeks post this week.  Things seem to be progressing.  We had quit trying SLRs, and I imagine we will try again tonight at PT.  I think it will be at least more successful.  I ditched the brace last weekend, and it has gone well.  We haven't had any more snow, so that is very helpful in being outside to/from work.  The doc's orders are to go a week w/ 2 crutches, a week w/ one and hopefully down to 0 at just after 8 weeks.  I feel strength improvements for sure.  2 crutches is very easy, so i think one is doable.  Around the house I use one, but I start in w/ some shin pain, so I then go back to 2. 

In PT, I did the bike 10 minutes doing 3/4 rotations pretty much.  I am still only just over 100 degrees ROM.  We'll see tonight.  I'm still really stiff, but it feels ok and no kneecap pain.  We didn't have to push hard to get 100.   I was surprised we didn't push more, but we headed more towards stability and some balancing.  I would expect to add some more items to the list during tonight's session.

It all seems pretty standard and boring I guess.  I'll take it  :D

Take care,
Room 101
Title: Re: Room 101's December 2, 2008 ACI (Jan. 22 update)
Post by: Gibbon35 on January 23, 2009, 03:50:27 PM
Oh the joys and pain of walking again. At 6 weeks i was only on 1 or 2 crutches as well. However i didnt get any shin pain. All my pain was in my damn foot. Literally i think the muscles in my foot just gave up during the 6 weeks nwb. And then when in started putting weight through it.....man oh man oh man. Little bugger!!!  :-X 
Im sure your physio told you but when you do the one crutch thing, remember heel first on the leg. Really work the quads when putting the leg forward and heel down. It will strengthen the VMO and quads and improve the limp im sure youll have to start with.

Title: Re: Room 101's December 2, 2008 ACI (Jan. 22 update)
Post by: Room 101 on January 23, 2009, 05:14:09 PM
Oddly, my foot has been fine.  I had foot weakness like that after the AMZ.  I am sure the shin thing is muscular, from working the ankle strength. I ditched one crutch last night in PT.  It feels good.  We worked on exactly what you wrote, Gibbon  8) - heel to toe and no collapsing internal rotation of the foot.  We did tons of balance & leg lifts for hip work and quad work.  Man, I actually got tired.  It was good PT.  No bike and still no SLR, although we are kind of going about it a little differently since I still get some kneecap flair ups w/ movement I'm not quite ready for.

I did do some no crutch walking w/ supervision, and it felt pretty good, but I fatigued very fast.  Fascinating really.  I had no pain at all.  It's really only straight leg supine exercises that nip me still.  We've been doing a lot of bent leg stuff, which is fine. 

Have a good weekend,
Room 101
Title: Re: Room 101's December 2, 2008 ACI (8 week update)
Post by: Room 101 on January 27, 2009, 10:30:34 PM
So... 8 weeks post today and 2 days crutch free.  I feel good.  This is one of those up days that can screw you later... I know I limp a little bit, but heel to toe is good and actually it feels nice to walk.  I don't get any giving way of the knee unless I do something too quickly. 

I was able to get full revolutions in PT on the bike yesterday.  I had to cheat w/ my foot ever so slightly  :P  that seemed to really loosen everything up.  10 minutes yesterday and 10 today.  It feels so nice!

The PT worked hard some some desensitizing and adhesions to the medial knee.  That helped a ton also.  I have really worked on balance and strength and (drum roll) 30 SLR yesterday and so far 30 today.   ;D  We haven't measure ROM for a while, and I need to massage the incisions even more than I have been, but I think we're headed in the right direction. 

I got freaked out yesterday when PT mentioned that I was having some nerve reactions, but he said it was normal and we just needed to desensitize.  It didn't bother me at all, but I do have stitch ends sticking out both ends of the incision.  I don't think my pain is nerve related, but I have been wrong before... it's just that I don't have pain unless it is in the straightening mode, like 45 degree terminal knee extensions (part of the 8 week rehab protocol) or the like.  It seems more like pain where the graft site was, but who knows... maybe the mild shin pain is related to nerves and there is something to it... I don't feel weak or anything either.  I guess it's good and maybe all this weird sensation stuff is normal. The tingling in my toes has almost gone away entirely, so hopefully it's just inflammation related.  I started back in the sauna last night.  I had held off for at least 6 weeks, but I missed it.  So nice and relaxing... and so good to really sweat hard.  I miss that.

So, 8 weeks has been pretty darn good.  Just the improvement over the last 4-5 days has been a lot.  I even climbed back into life and cleaned part of the house that didn't involve squatting or kneeling or bending and I cooked dinner and did the dishes, so my hubby is a happy guy   8)

hope you all are doing well.

Take care,
Room 101
Title: Re: Room 101's December 2, 2008 ACI (8 week update)
Post by: dileigh on January 27, 2009, 11:26:10 PM
Good job- I know you've been ready to get rid of the crutches.  Pretty soon you'll be running up and down stairs - well, maybe not running.....yet

Just don't overdo it.  There will be some down days, but the good days will outnumber them by a lot.


Diana
Title: Re: Room 101's December 2, 2008 ACI (8 week update)
Post by: Room 101 on January 28, 2009, 10:24:57 PM
It feels good to be crutch free.  It is also so easy to overdo when it feels good.  I appreciate all the help you guys give :)

Room 101
Title: Re: Room 101's December 2, 2008 ACI (Jan. 30 update)
Post by: Room 101 on January 30, 2009, 07:28:57 PM
So it's Friday.  Sweet.  Not having a great day today but I made a mistake in going to therapy last night.  I got a call a few hours prior that my therapist was not able to be there but they had someone else... my theory was, at least I can get massage, manipulation, ride the bike and get e-stim & ice & do leg raises, etc... silly me.  Everyone thinks they know what to do or that this isn't that big a deal, like an ACL would be  ::) 

It started out fine.  SLRs and ab & adductors & glute leg raises...   then i got about 30 seconds of patella manipulation ... and that was it.  We moved on to a bunch of stuff I wasn't supposed to do yet.  Standing from seated chair, step ups/downs... he thought I was just being a jerk when I said it (or lazy), but the rehab protocol was right there.  I don't even know what happened exactly, but i certainly did something to tick off the kneecap because i am walking like crap today and my knee hurts quite a lot  :(  - I am sure I didn't "break" anything, but I hate going backwards... this week has been pretty big for me as I am able to do tons of SLRs now, but I still can't do certain motions without catching in one part of the knee.  I'll be happy when that goes away... and hopefully it is soon!

The tingly sensations in my foot are gone entirely and the shin pain is gone also... I think I just needed to stretch good and do some harder ankle work.

Anyway, work has been brutal today and I missed my training session, although I didn't feel like doing it with the pain anyway.

Cheers to one of the depressing down days  ;)

Ahhhh, at least I have a nice place to rant it out  :P

Take care,
Room 101
Title: Re: Room 101's December 2, 2008 ACI (Jan. 30 update)
Post by: jonhark on January 31, 2009, 03:02:35 AM
TGIF!!

Your PT should be fired for having you do those exercises so early.....that's absolutely crazy!!!

I don't doubt you are sore today under the kneecap. Catching is normal at this stage--although it should be avoided.

I'm at 6.5 weeks and my major focus now is to do a ton of heel slides and continue with SLR's and hip stuff.

You'll be feeling better on Monday after the weekend.
Title: Re: Room 101's December 2, 2008 ACI (9 weeks post on Feb. 3)
Post by: Room 101 on February 02, 2009, 09:12:49 PM
Today is Monday and back to therapy, after a disaster last weekend.  I was quite stiff even this morning, but having my normal PT back was excellent.  I told him about the horrible day last week, and he was pretty ticked.  He said he had the protocol written down for the guy and was happy i still came to PT ... until he heard the experience. 

But we're back to "normal" now, and it went pretty well.  I hit a really easy 110 degrees ROM today, and I can feel my balance getting a ton better.  He made up for the lack of massage last week today.  My appointment was more about the therapeutic part and less about the exercises today which I needed.  I can do the exercises on my own... He really nailed the IT band (man is that sore) and worked hard on the muscles around the knee... it felt so good!  We did a lot of flexion because I was still really stiff, some balancing and core work.  I ended w/ 10 minutes on the bike, e-stim & ice.  I am already walking better.

On a good note, my trainer found me a slightly used stationary bike and got a heck of a deal.  He dropped it by on Saturday ;D
-- I love being able to do 10 minutes or so at home alongside the other exercises.  For some reason it feels like I'm doing more  that way :P

There are still some movements that hurt a lot, but for the most part I can see big improvements on things that were more difficult last week. 

It's definitely a very long road, and no matter how much I thought I was mentally prepared and comfortable with my decision to move forward... this is a much bigger animal than I even imagined, and I imagined it to be hard.  For me it's the patience that is hard... not the rehab.  I worked out as much as I could in spite of the pain & injury, so the work isn't hard.  It's the constant fighting to hold back and not overdo it, and the frustration when you do overwork.  It's also the fragility of the rehab as well.  But it's fun to see the improvements! 

Hope everyone had a good weekend!

Room 101
Title: Re: Room 101's December 2, 2008 ACI (Feb. 5 update)
Post by: Room 101 on February 05, 2009, 09:35:47 PM
It's Thursday, and not much has changed in the last 3 days, but I have PT tonight and then we're taking a break from this wonderful Illinois winter to go to Florida for a few days... I was bummed to miss that much therapy, but then my PT said not to worry... he'll give me a nice pool rehab to do.  I know I have access to a gym and a bike, so that's good.  I am just looking forward to some sun (hopefully)... covering the incisions, of course.

I worked out yesterday, and while on my back I can get into full extension easily and now failed SLRs are a thing of the past... I just need to progress through extension.  The knee still feels catchy and raw on that move.  I just try to keep on the bike daily and as normal a workout routine as I can get. 

I thought I was walking a lot better and more free... and then my boss says to me today "Wow, you're still really struggling"  :P -- oh well... can't impress everyone  :D  -- I actually ventured out to the mall for the first time since I got off crutches.  I needed some reasonable shoes to wear with dress pants in Florida... with no heel.  I actually found a couple pair, so that's a hugs bonus.  They were actually cute, too  ;)  - I was never a high heel wearer anyway... if shoes don't have the Nike stripe, I am normally unimpressed  ;D

I know there is no magic trick to get the extension back but time.  It's just one of those things that freaks you out and you wonder what's wrong  ???  -- keep icing and working and eventually that gain will come I am sure. 

I kind of dread the airport hassle and the flight for stiffness sake, but I am looking forward to heading south for sure.   We're staying with relatives and they were apologizing for it only being 60 degrees... I said compared to the -2 it is right now, 60 is ideal!  Let's see if I can control myself and not overdo it, like usual.

Have a great weekend,
Room 101
Title: Re: Room 101's December 2, 2008 ACI (Feb. 11 update)
Post by: Room 101 on February 11, 2009, 07:16:29 PM
10 weeks post yesterday.  We got back from Florida last night.  Ahhh, sunny and 75-80 all weekend.  It was so nice to be outside.  We walked a lot more than I thought I would be able to.  It was too cold for the pool, so I settled for my usual routine in the fitness center, but that was ok too.  I struggled a lot on the day we left.  We had to walk so far through O'Hare to get to our gate from the parking lot.  Then I got so stiff sitting in those seats.... it was great after that.  I walked the first day and by the time we were finishing my leg had started to give on me.  So I stopped.  I was sore and iced at night but I woke up feeling great.  Every day I walked farther than the last.  No pain unless I moved a little bit wrong.

I still don't bend great... really stiff, and I get grinding big time behind the kneecap when I try and straighten it from a bent position.   That concerns me quite a bit as it doesn't seem to be greatly improving.  We have been working on getting the hips firing, but it only helps a little.

Back to the routine starting today.  It was nice to be rehabbing in the sun, and I am walking so much more normal now, and pain free except when I first get up and need to get moving.

Kim
Title: Re: Room 101's December 2, 2008 ACI (Feb. 11 update)
Post by: Room 101 on February 12, 2009, 12:48:53 AM
So at what point were you all able to start biking "normally" again?  I still have to cheat, but I'm interested in how everyone progressed through this part?  I am still really stiff, and I don't feel much improvement in biking.  I still really have to turn my foot, but now I keep my hips & leg aligned.  I'm certainly not trying to do any real biking, but merely loosening, easy motion biking.

I'm just curious how others progressed and looking for some experiences with regard to biking.

Thanks,
Kim
Title: Re: Room 101's December 2, 2008 ACI (Feb. 11 update)
Post by: dileigh on February 13, 2009, 12:06:54 AM
Other than a few exercised the OS ordered, I didn't even start PT until 12 weeks.  At that point, it didn't take too long to bike normally - just a few days
Title: Re: Room 101's December 2, 2008 ACI (Feb. 11 update)
Post by: Room 101 on February 13, 2009, 05:01:07 PM
Thanks dileigh.  I appreciate it.   :)

PT was good last  night, for the most part.  I have noticed that I am seeing no improvement on the bike.  I can almost do a full extension but it starts to hurt behind the knee, so I stop a little short.  My knee swelling was down 8mm.  the calf was down about the same and I got 5mm bigger on the quad since the last measurements, so all of that is going well... I lost 7 degrees on flexion though.  I was 117 last week and 110 yesterday.  We worked and worked and it got no better.  There is no pain until it just stops and then it's like my knee hits a brick wall.  it's weird actually.  My stability was so much better and we kept progressing into this weeks new activities.  I was able to do things I couldn't do a week ago.  There has been clear improvement except for bending.  I fear adhesions, but will keep trying to work on it.  With the swelling down so much, I would have expected improvement.   ???

Oh, well.  One day at a time, right?   :P

Take care,
Kim
Title: Re: Room 101's December 2, 2008 ACI (Feb. 12+1 update)
Post by: jonhark on February 13, 2009, 06:36:47 PM
I started biking at 8 weeks. Start with no resistance then slowly increase starting around 16 weeks. it is an important part of the rehab as it promotes cell growth through synovial fluid. i didnt' experience any pain...maybe some really slight discomfort. After my first AMZ/mfx i did experience pain and biking wasn't feasible.

I can see how biking and walking is tough without full extension. One think I focus on with walking is to push through extension while walking and not keeping a bent leg. It makes a big difference. Put your foot at the end of a table and apply pressure to the thigh if you want to increase extension.

My experience from last time was to hold off on any exercises until there was no sharp pain. Dull pain is fine as that is to be expected until the graft matures.

I've also been sleeping in my brace. That keeps the leg straight and prevents you from bending the knee during sleep.
Title: Re: Room 101's December 2, 2008 ACI (Feb. 12+1 update)
Post by: Room 101 on February 13, 2009, 10:39:08 PM
Hi, Jon.  Thanks for the insight.  I always appreciate your input.  I should clarify (clearly I have Friday brain going  :P )

I have full extension walking, but I can't quite straighten my leg when I'm sitting with it hanging over a table... like doing an extension.  It hurts quite a lot.  The bike is ok.  I don't use much, if any resistance, but my knee is still really stiff, and while I can do full revolutions, I am definitely limited by the 110 degrees of flexion... the 110 used to be 117 a week ago.  I hope I just overdid the walking on vacation.  I don't have any pain at all... it's just super stiff.  I only get pain when i bend it too far, so I don't do that, but I do try to push past comfort to get more bend.

My walking has definitely improved, and I try to do what you are saying.  It works until I get tired.  I agree with the dull pain vs. sharp pain theory also.  I seem to go from no pain t sharp pain pretty quickly right now.

Thanks, and take care.

Kim
Title: Re: Room 101's December 2, 2008 ACI (Feb. 16 update)
Post by: Room 101 on February 16, 2009, 08:36:17 PM
Happy Monday.  11 weeks post tomorrow.  It's hard to believe it has been that long honestly.  It seems like the last week was a big one for improvement... even just over the weekend.    Certain movements just happen naturally now where they were impossible a couple weeks ago. 

I had a great weekend and a nice PT session today.  The weather finally broke for the moment.  The ice & snow melted off the drive & street, so I was happily able to go outside and take a walk on dry land.  That was very nice.  Sometimes it's good to live in the flatlands of Illinois!  I'd still prefer 80 and sunny, but I'll take 30 and flurries for February  ;) -- I rode the bike both days as well as walked.  I am getting stronger and more balanced for sure.  I dropped from 117 to 110 degrees flexion last Thursday, but today I reached an easy 125, so I think I got rid of some more swelling.  We worked mostly on balance and hip strength today.  I can tell I will be sore tomorrow, but a good and fun sore and not an uh oh sore. 

My next follow-up w/ the dr. is March 5.

Today is one of the good days, but I am definitely in that mental range of feeling better but stuck on the same level of rehab for a while longer... also known as boring phase, so I might as well write on here and bore you.  I am thrilled that this is mundane... I wouldn't want this rehab to be exciting  :P

Take care,
Kim

Title: Re: Room 101's December 2, 2008 ACI (Feb. 16 update)
Post by: hopalongjo on February 16, 2009, 10:59:56 PM
Sounds like you're doing really well! What do you mean you wouldn't want rehab to be exciting....getting out to physio is the one thing I look forward to with excitement each week...change of scenery and all that  ;D
Title: Re: Room 101's December 2, 2008 ACI (Feb. 16 update)
Post by: Room 101 on February 17, 2009, 06:43:04 PM
Oh, don't get me wrong, I look very forward to PT and training every week  :D  -- The exercises are still so limited in PT because I am still in phase 1 for a while longer... and by excitement I mean problems.  I am happy to be accomplishing phase 1 and seemingly "normal" at least in my rehab.

I seem to be very slow in things like terminal extensions and flexion, but I see dramatic improvement in other areas like quad strength and walking and hip strength and stability, so I am thrilled to be there doing the same things each day  ;D

I love to ride the bike with no resistance and I love doing all ROM leg lifts.  I really enjoyed taking a walk outside.  We're due for some more snow, so I am glad I got to enjoy a couple of outside walks for now.

Take care,
Kim
Title: Re: Room 101's December 2, 2008 ACI (Feb. 20 update)
Post by: Room 101 on February 20, 2009, 10:36:08 PM
11 weeks and 3 days post op... but who's counting  :P

Therapy was good last night even though I was sore and more stiff than usual.  I think I overdid the bike on Wednesday.... 30 minutes. We worked really hard on Monday in therapy also, and I think i was still sore from that which means I overworked the knee.  We have been adding some new drills which usually make me sore at first also.  Last night we went a little easy.  A lot of massage and IT band work.  I wasn't able to do a couple of drills that we had done multiple times before.  I guess that's the normal fluctuations with this surgery though.  I don't feel like anything is broken.  I am just sore.   I dropped from 125 to 121 in flexion.  We did hit 125 by the end, but it hurt more than Monday. 

As for the rehab exercises currently being done, I am doing 4" step ups with ease (not down but up only). We worked mostly on balance and hip & quad strength so some bosu balancing, mini wall squats (30 degrees or so), walking on toes and walking on heels, the usual 4 direction leg lifts, balancing on airex pad while playing catch, walking backwards on the treadmill (I think this made me really sore).  I feel good walking and can walk significant distance without pain, although today I have taken it easy because I am so stiff.  I was frustrated as I missed both my personal trainer workouts this week... one because a crown popped off my tooth and I ended up in the dentist chair and the other because we had potential clients come in for a meeting that lasted longer than anticipated.  At least it was a good meeting and might bring in some new work...

Maybe I'll be smart and only ride 10 minutes on the bike tonight  :)

I am bummed because we're due 6-9 inches of snow tonight & tomorrow.  I was enjoying walking outside, but I guess that will end the fresh air exercise for a bit  :'(

Have a great weekend!
Room 101
Title: Re: Room 101's December 2, 2008 ACI (Feb. 20 update)
Post by: momhanaway on February 21, 2009, 03:27:54 AM
Step ups at 11 weeks. That sounds great! 

You are doing awesome! 
Title: Re: Room 101's December 2, 2008 ACI (12 week update)
Post by: Room 101 on February 23, 2009, 05:39:28 PM
12 weeks tomorrow.  PT was good today, but I am still stuck on flexion... 120 with no "help" and 125 with "help".  It seems to be staying the same.  I can tell I'm really stiff, but it weirdly doesn't hurt.. just won't go any farther.  I am also still limited in extension... not straightening my leg as i measuring extension... in that realm I can go hyper just fine, but sitting on the table going from bent to straight extension.  That hurts some at this point behind the knee, although it is maybe a little better.  Sometimes I think it's me making it better because I want it better  ::) - I go back to the dr. on March 5.  I have to admit I am a tad freaked out over the lack of improvement regarding flexion.

Everything else seems to be progressing.  Pain is always our guide at PT or my workouts.  We added 3 lbs. to straight leg raises today... I couldn't even do one on my own a month ago.  We started some very light lateral walking, progressed the step ups to a little higher, did more backward walking on the treadmill, ball/wall squats to 45 degrees.  Lots of isometric holding patterns to increase strength.  I can walk quite a ways without pain or swelling which I could not do prior to surgery, so that's a major positive.

This weekend we worked around the house, organizing and moving boxes around (we moved to a new house right before surgery).  I know I did too much, but it felt pretty good until the end.  I quit when I hit the knee limit (well, just past it I am sure).  Even this morning I had no pain, only stiffness.  I didn't carry anything up or down stairs (that's just not worth even thinking about), nor did I carry anything heavy, but I did many trips back & forth from closet to storage room... mopped all the floors in the house (like a janitor, not Cinderella).  I finished off the working with a workout and 15 minutes on the bike.... and then the couch and an ice bag or 3.  It felt good for the soul as much as anything.  I felt like I really had joined daily life again, and that's nice  :)

It did snow quite a lot, though not nearly as much as predicted... but it was enough to keep me housebound.  All the working made the weekend go quickly though. 

Have a great week,
Room 101
Title: Re: Room 101's December 2, 2008 ACI (Feb. 27 update)
Post by: Room 101 on February 27, 2009, 04:02:42 PM
TGIF.  It's been a long week of work.  The knee is doing pretty good.  I am still sitting at 125 ROM, and I have been really stiff, but I seem to be walking really, really good.  Last night my PT told me if I walked in to a clinic for the first time, they wouldn't be able to tell what was injured... my stride and gait are very even.  No limping at all.  Once I take a couple steps after sitting, I definitely feel like I can walk really well and for quite a long time.  I feel really good walking.  Already more comfortable than before surgery.  Not other things, but walking for sure, which makes me happy at this point.  The kneecap moves easily in all directions, so that's a good sign also, I think.

We added some volume last night, increasing the amount we do but not changing exercises.  We're really trying hard to gently push the ROM, but not to the screaming painful point... just to moderate discomfort.    We did isometric quads and SLRs until i could lift the leg anymore.  Worked on some modified extensions, straightening the leg from bent.  I really struggle with that movement.  My kneecap just feels full, if that makes sense.  I don't know how to describe it  ???

We did 8" step ups easily, balancing w/ surgical leg behind "good" leg on a 1/2 foam roller while shaking a body blade.  All I know from that is I can't wait to get into better shape  because too much was shaking :P.  Slow lateral walks with careful pivot, backwards walking on the treadmill, balancing on airex pad, etc.  Not real exciting, but real exciting at the same time  :D

We definitely pushed the limits, and I am very sore today.  It's mostly muscular, so we''l see what tomorrow brings and if we did too much.  I work out with my trainer during lunch today, so tomorrow will be an off day, although we have to go finish moving out of the old house... my job is cleaning toilets and sinks.  Yippee.  Now, we just need to sell it.  Right.

I also think I need to back off on the bike.  I feel like I overdo it and get too stiff, so I'll back my time down from 30 minutes to 20 and see what happens.  Also I didn't think I was really doing any resistance, just enough to stop the out of control pedaling, but perhaps I'll back that down a notch as well.

I have to keep telling myself to slow down.  I can definitely be too aggressive.   That's the hard part for me.  To be calm and not get over excited  :)

Room 101
Title: Re: Room 101's December 2, 2008 ACI (Feb. 27 update)
Post by: Room 101 on February 27, 2009, 08:47:30 PM
[email protected]#$$&%# - only 112 degrees flexion today at my workout.  No pain at all.  Just stiff.  Clearly I am being overzealous on the workouts  >:(

Live and learn as they say... it just feels so nice to do stuff!


Title: Re: Room 101's December 2, 2008 ACI (Feb. 27 update)
Post by: jonhark on February 27, 2009, 08:53:54 PM
Sounds like you've made great progress....

It is a nice feeling to be able to do "too much".

Being able to walk normally again is a big relief....

As long as you avoid catching sensation and sharp pain you should be fine.
Title: Re: Room 101's December 2, 2008 ACI (Feb. 27 update)
Post by: Room 101 on February 27, 2009, 09:15:26 PM
Thanks, Jon... it's amazing what a confidence game this can cause  :P -- I appreciate the reply!
Title: Re: Room 101's December 2, 2008 ACI (Feb. 27 update)
Post by: dileigh on February 27, 2009, 11:30:15 PM
Yeah, it is hard not to overdo it when you finally start going good on the exercising.   You're doing just as much if not more than I was at this point, so keep up the good work  ;D


Diana
Title: Re: Room 101's December 2, 2008 ACI (March 2, 2009 update)
Post by: Room 101 on March 02, 2009, 06:10:43 PM
So this was a crazy weekend.  We moved 10 days before I had the surgery, and of course we are 2 folks who can't sell the house they moved out of now... so we were slackers in getting stuff out of the old house.  Well, I was couchbound post-op, and let's just say I am the motivator in the family.  I get the ball rolling so to speak... once the ball is rolling it's great.  Bottom line is we still had things to move out of the old house.  Saturday was spent moving the remaining items.  I was cleaning and vacuuming and doing the odds & ends.  It was a long day, but we are now officially finished as far as having items in the house to move  ;D

Sunday was to be the day to organize the new house with all the items we just brought from the old house.  I got out of bed, threw on sweats and went to the laundry.  Oh, wait, I need hangers.  Back to the bedroom which has a great wood floor... except it was apparently slippery.  I don't even know what happened.  I wish it was glamorous or at least entertaining... as I was thinking on the way to the laundry how nice it was to wake up and not be so stiff in the morning... that I could actually walk like a human almost immediately upon coming back to get hangers my foot hits the floor and I skate across it on my bad leg, run into the dog's  bed hear some gross popping and fall over.  After the pain sweats subsided, I got up and I think the knee is fine.  I was able to walk, but I could tell it was swelling.  But it didn't hurt too badly...  :'(

I went downstairs (after getting the hangers and doing the laundry thing) and iced and elevated.  The rub is that when I get motivated I am hard to stop... and I am so over sitting around all day  :P - So, I worked it out that I would stay downstairs and my spouse would bring the boxes to me and I would organize them.  Then, we organized the garage.  Once I sat down, I became extremely stiff and sore... but again, I am sure I didn't bust the graft or anything.  Just a minor setback.  I did manage my 15 minutes on the bike last night, although it didn't feel nearly as loose & flexible as it was before the hardwood skating incident.

I had PT today and he confirmed that all the ligaments are fine.  I was at 125 flexion last Monday.  120 on Thursday and 112 on Friday.  Today was 110 when we started, and we were able to get back to 120, but I clearly didn't do my knee any favors with being a klutz  ::)  - I had more pain today doing exercises, so we backed off to a lot more massage and "nice" exercises.  I still worked up a good sweat and got very tired quads, so hopefully this step back will result in a nice step forward.

I have a Dr. Cole appointment on Thursday.

I figure I should look at the bright side of this and perhaps I burst through some scar tissue and when the swelling subsides, I'll have full ROM back  :D

Have a good week!
Room 101
Title: Re: Room 101's December 2, 2008 ACI (March 2, 2009 update)
Post by: hopalongjo on March 02, 2009, 10:44:39 PM
At least you've been told it's ok from the physio - now put your feet up!

I wonder if there are shoes you can buy with suckers on the soles  ;D

From a fellow klutz :-*


Title: Re: Room 101's December 2, 2008 ACI (March 2, 2009 update)
Post by: Room 101 on March 02, 2009, 11:37:59 PM
I am honestly mostly ticked about being such a klutz  >:( - I have been so careful, and every time I get up today and I'm back to the stupid limping, it's just more irritating.  I am getting very sore as the day goes on... looking forward to my couch and an ice pack or 3, and perhaps indulging in Hop's therapeutic remedy... Mmmm, beer.


Title: Re: Room 101's December 2, 2008 ACI (March 5, 2009 update)
Post by: Room 101 on March 05, 2009, 09:43:20 PM
So, the Dr. visit was today.  It went great.  Fast, which is good.  I think now that I ditched the swelling from my slip & slide on Sunday that things have improved.  All I had to show him was leg straighten from bent... he looked at it, barely any crackling, swelling is down, incision good.  He said my quad was great for this point and to keep doing what I'm doing... be smart and work it.

Cool!  I am interested in PT tonight because I finally felt more loose riding the bike last night.  It had been the same for a couple of weeks and i was getting a little frustrated... but I took a couple days off after I fell and it seemed to help... what that tells me is that maybe I need just a tad more moderation in my workouts.  I think I'll be better than 125 tonight.  I just feel it.

I asked for surgery pictures again, but they couldn't find them, so I'll email the PA again to see if I can have them mailed/emailed to me.  I'd love to see them. 

So, all in all, I feel great and seem to be making good progress.  The last 24-36 hours have shown a major improvement.  I am ready to settle in to this next phase of rehab, which lasts a very long time  :D

These dr. appointments seem to come at the perfect time... right after a nice improvement and just when you get all fed up & frustrated with how long it's been doing the same stuff, haha.

I'll post pics if I get them.  I just have to figure out where to upload them...

Room 101
Title: Re: Room 101's December 2, 2008 ACI (March 5, 2009 update)
Post by: Room 101 on March 05, 2009, 09:52:52 PM
Standard leg/scar picture... Man, I'm pale and out of shape!

Not sure if this might work...




http://www.facebook.com/album.php?aid=2010284&id=1491844604&l=4c47d
Title: Re: Room 101's December 2, 2008 ACI (March 5, 2009 update)
Post by: momhanaway on March 06, 2009, 05:42:56 AM
Wow, that's a bigger incision than I was expecting.  No wonder everyone talks about pain management.  So, do all ACIs look like that?  I'm just trying to prepare my daughter what to expect.  I've seen the inside pictures, but not the outside.

Thanks for sharing them. 
Title: Re: Room 101's December 2, 2008 ACI (March 5, 2009 update)
Post by: Room 101 on March 06, 2009, 04:54:10 PM
I think it's pretty typical... some are crazy! I know mine are smaller than predicted also.  I did find out that my patella defect was 1.8 cm x 3.5 cm as well.  Still trying to get the inside pictures.

Therapy went well last night.  We progressed through some different exercises and again stepped up the volume.  I worked well over 1 hour on exercises plus the 1/2 hour of manipulation, flexion and massage work... I was there around 2 hours, so i definitely got my money's worth.  I was at 121 degrees by myself and 125 with a little help and 127 with a lot of help.. so about the same, although I am sure overall it feels better.  very sore today around the knee, but it feels good also to have worked.

Kim
Title: Re: Room 101's December 2, 2008 ACI (March 9, 2009 update)
Post by: Room 101 on March 09, 2009, 05:27:13 PM
Happy Monday... man did it rain here all weekend.  It was crazy!  I will be 14 weeks post tomorrow.  Things are progressing well despite my malfunction in bending.  I was sup stiff today.  My PT didn't even tell me what the number was, so it must have been great  ::)  - Oh well.  All else is good.  The knee feels good.  We started some lateral movement drills, backwards exercises, some soft surface balance & stability exercises like airex pads and the rubber discs.  It feels good to sweat.  On Friday I worked with my trainer, and we did a series of bridging exercises and some more advanced matt work... some crazy new stuff he has been working on.  I was extremely sore in my hammies, quads and calves.  It was great.  Someone mentionwed my limping on Saturday, but it was from working out and muscle soreness  ;D

I really hit a breakthru at around 3 months (for me probably more like closer to 13 weeks.  I had read that and been told that quite a lot, and it was actually true for me.  I am getting more energy from being more active as well.  It just feels good to work hard enough to be tired and sweaty.  It seems like a lifetime ago.

Here's to another week of rehab & hard work.  Hope you all are progressing!

take care,
Kim


PS - I finally got some surgery photos.  Only 3, but it sums it up quite well.  I'll try and get them posted soon.  Hopefully tonight after work.


Title: Re: Room 101's December 2, 2008 ACI (March 9, 2009 update)
Post by: Room 101 on March 09, 2009, 11:14:56 PM
Here is a link to the surgery photos...

... had to repost farther down
Title: Re: Room 101's December 2, 2008 ACI (March 16, 2009 update)
Post by: Room 101 on March 16, 2009, 09:36:55 PM
Well, as nasty as it was last weekend w/ rain and cold, it is absolutely gorgeous here now.  What a great weekend.  Did a mile walk on Saturday and Sunday close to 2 miles, a half hour on the bike, my regular workout and then a sauna.  Fabulous!  the windows were open. 

I will be 15 weeks post tomorrow (happy St. Patricks Day!!) -- PT today went well, considering how much I did yesterday.  My range was 120 prior to really stretching and all.  I was 127 after that, so I seem to still be hung up at this point and quite stiff.  I feel really good walking, and I can walk without limping for a long time.  I can stand for quite a while before I need to sit down.  It just bugs me that I can't get the flexion back... I can tell I am getting stronger though.  Backwards walking w/ resistance is now quite easy.  We upped the resistance today.  Did more 8" step ups and those are much easier now.  We started doing some step downs off a 4" box.  It went ok.  We stopped when I got sore and lost proper form.  Short arc squats on the bosu are easy now, as is lateral walking w/ resistance.  I worked on balancing on an airex pad, which also is easier.  I can feel my glute muscles turn on now where before they were shut down completely.  It's amazing how using those muscles helps  :P  Besides that, my IT band is just tight as heck, and I also feel a slight strain in the groin when i walk far, so we did a lot of massage & stretching.  hip flexors, hamstrings, calves.  It sucks during and feels great afterwards  :o

I think things are going well, although a bit stagnant in big change/improvement over the last couple of weeks.  I can feel myself getting stronger, though, and that's always a good thing!

Have a great St. Patrick's Day!

Kim
Title: Re: Room 101's December 2, 2008 ACI (March 16, 2009 update)
Post by: nikkiluv on March 16, 2009, 09:58:36 PM
Room 101,

I just saw the pictures from your ACI...how did you get the photos of the inside of your knee that were taken in the OR? It's very interesting to see (I've seen some online and they are very graphic). Were you very suprised when you saw the photos of what it looked like?
Title: Re: Room 101's December 2, 2008 ACI (March 16, 2009 update)
Post by: Room 101 on March 16, 2009, 10:47:51 PM
I asked at my last appointment and the PA emailed them.  It is interesting, but I have to admit it was freaky to see my pictures.  I had seen other's pics either in articles I had read or on this site in another diary.  I did know the size of the lesion before I saw the pictures, but it was crazy to see the photos the first time.  Mostly, I was surprised at the rough edges, since I had just had it cleaned w/ debridement a few months prior.  It's amazing how fast you can damage the area.  I had been rehabbing the AMZ, so my activity level had diminished quite a lot over the previous year.

Kim 
Title: Re: Room 101's December 2, 2008 ACI (March 16, 2009 update)
Post by: nikkiluv on March 16, 2009, 10:59:40 PM
I wonder if they take pics like that of everyone's surgery. It is interesting to see but I think I would be freaked out to see the inside of my own knee, especially like that. Although I've never been given the choice of whether or not to be awake or asleep for all my other surgeries, that is one of the reasons I'd never want to be awake. Hearing them talk about what tools they're going to use, the condition, etc. I think would freak me out way too much. Also, with my next surgery I will be having a distal femoral osteotomy along with my ACI, and I totally know I DO NOT want to hear them sawing through my femur or screwing it back together!
Title: Re: Room 101's December 2, 2008 ACI (March 16, 2009 update)
Post by: Room 101 on March 16, 2009, 11:17:35 PM
That I understand.  I was only awake for one surgery... a shoulder reconstruction... and I don't remember any of it besides the fact that I know I talked the entire time... my surgeon just laughed when I walked in to the follow-up.  I wonder what i said.  I think I told a couple jokes... and asked a lot of questions.  I decided sleep was a better option for me, haha

I did sleep with both the AMZ osteotomy & the ACI.  I wouldn't have wanted to be awake, but I wasn't given a choice either.

Good luck!
Title: Re: Room 101's December 2, 2008 ACI (March 16, 2009 update)
Post by: Room 101 on March 17, 2009, 10:49:51 PM
So, here's a question to anyone... when were you able to do stairs comfortably?  Or really going up & down correctly, without going left foot, left foot, left foot?

I can do up sometimes now.. but I have to be very slow and deliberate, and some days I'm sore and just don't feel like it's the right thing to do.  Down is another story.  I'm not comfortable with that one yet.  I haven't tried anything beyond some step downs at PT, but I was curious when folks started doing stairs w/ alternating legs like normal people?  :P

Thanks,
Kim
Title: Re: Room 101's December 2, 2008 ACI (March 16, 2009 update)
Post by: dileigh on March 17, 2009, 11:39:59 PM
Wow, I had to go back to my diary for that one- somewhere between 4 and 5 months, but closer to 5. I haven't posted  in my diary in a few months and it's already on page 4.  Right now I'm just waiting for my 1 year appt next week.

 I have stairs in my house and work where my office is upstairs, so I just worked on it a little bit at a time, every day.


Diana
Title: Re: Room 101's December 2, 2008 ACI (March 16, 2009 update)
Post by: courtem10 on March 18, 2009, 02:59:30 PM
Kim- I tried to open the link of your surgery pics, but it wouldn't open saying the link had been closed. I think they were linked to your facebook profile. What is your name on facebook so I can try to find you??  I'm having my sugery in 2 weeks.  Thanks for your help.

Courtney Moore
Title: Re: Room 101's December 2, 2008 ACI (March 16, 2009 update)
Post by: Room 101 on March 18, 2009, 08:16:02 PM
Hi, Courtney.  I sent you my info also, but here is a new public link.

http://www.facebook.com/album.php?aid=2010284&id=1491844604&l=4c47d1a72e


Title: Re: Room 101's December 2, 2008 ACI (March 16, 2009 update)
Post by: Hathor on March 22, 2009, 06:41:28 AM
Hi Kim

I had a patella MACI 2 weeks after yours (13 weeks post op) and have not tried stairs yet. I am doing step ups in the gym no higher than 2 inches at this stage, with no step down.

Am also only doing squats in the pool, trying not to rush anything. Hope this helps.

Hathor
Title: Re: Room 101's December 2, 2008 ACI (March 16, 2009 update)
Post by: markld on March 23, 2009, 05:38:00 PM
I am about 2 weeks post op from aci my lesion was located in my trochlea and is 1.5cm2. rather small for aci, however I cant seem to manage to do a leg lift when lying on my back without some assistance. I definately cant do it on my own. It feels as though I cant activate my quad and hurts behind my knee cap. So basically I seem to be experiencing a lot of the same symptoms as you.
How are you feeling now? Any improvements lately?

Mark
Title: Re: Room 101's December 2, 2008 ACI (4 month update)
Post by: Room 101 on March 24, 2009, 08:54:31 PM
Hey!  here is a 4 month update.  I can't decide if it's gone fast or slow  :P  -- This seems to be the part that lingers, haha.  Phase 2 rehab that lasts for 3 months.  I do feel improvement, although my range of motion is still less than my other leg.  It must have been bad in PT today because my therapist didn't even measure.  He never wants to depress me on a Monday morning.  I feel pretty good though.  I can walk with no pain.  Sometimes it's a little stiff, but we have been consistently walking 2 miles and I could go more.  When it dries up just a little more, we might try the trails by the house.  I think they're pretty flat (we live in the midwest... it's flat!).  My recovery time after working it in therapy or with my trainer is much faster.  I don't get very stiff, but if we push it enough I am sore for 24 hours or so.  I actually get fatigue before pain now.  I still bike with very little resistance, but I can go easily 20 minutes and sometimes 30 before I get sore.  I only put enough resistance on there so my feet don't spin around uncontrollably.  I have started incorporating quarter squats back into my training sessions like when you do shoulder presses, etc.  There is lots of bridging and stability going on in my training sessions right now.  In therapy we are doing step ups 8" and adding more speed to the step ups making them a little less deliberate.  We do resisted backward walking (more like mini lunges) with no pain at all.  Balance and step ups onto the bosu, and step downs vary.  Once I could do a 6" step, but we have backed down to 4" step once a week because I had some pain.  We're working on walking faster and incorporating some turning in there going from forward to backward and so on as well.  I have no trouble at all with that. 

One thing that I think has helped me a lot is to focus on muscles that are stuck.  It had been so long since I walked correctly that my hip flexors and IT band are a mess.  My PT works on all that in therapy, but I have really worked with my trainer on accomplishing it at home with foam rollers as well.  I have noticed a significant improvement in stiffness since I started doing that daily.

I don't know where I expected to be (or if I had any expectations) at 4 months post, but to be honest, I think things are pretty darn good.  I can walk farther and with no pain than I could before surgery by a long distance, so that has to be a good thing.  It makes me look forward to summer and being outside.  I don't have any complaints right now... I just hope my flexion will improve and that I continue to progress positively.  I would think one of the next big improvement would be step downs.  I just feel pain and am not quite ready to go there yet.  i would also expect to see an improvement in stiffness.  I do notice when i sit or stand for any length of time that I get pretty stiff.  I am happier moving.

I must remember patience right now.  I can tell I am at a dangerous point where I forget about my knee when i am doing things like cooking or carrying things (or playing Wii  ;D ).  I have turned and twisted wrong a couple times lately getting into the car or turning to talk to someone. that is just a painful reminder to be aware of what I am doing.  My brain wants to run across the street to beat traffic, but my knee isn't anywhere near ready yet.

Room 101
Title: Re: Room 101's December 2, 2008 ACI (March 16, 2009 update)
Post by: Hathor on March 25, 2009, 07:06:52 PM
Hey 101

Great to read your detailed updates. You mention that you get pain when doing certain things. What sort of pain are you experiencing? is it sharp in some cases? Am curious as my patella is tender/bruised feeling when I do squats in the pool or step ups.

Hathor
Title: Re: Room 101's December 2, 2008 ACI (March 16, 2009 update)
Post by: courtem10 on March 25, 2009, 07:27:08 PM
It's great to read your posts room 101. It's very encouraging for people like me who are getting ready to undergo this procedure. Hearing other people's success stories helps relieve my fears. Good luck with your recovery!!
Title: Re: Room 101's December 2, 2008 ACI (March 16, 2009 update)
Post by: Room 101 on March 25, 2009, 07:55:06 PM
Hi, Hathor.  Yes, I still get some pain.  Which exercises seem dependent on what I have done already.  Step downs still hurt quite a lot, although if I am fresh I can do a set or 2 on 6" step... if I am tired and at the end of PT, then I have had to drop to a 4" step down.  Also, lateral step ups hurt some, but that was better Monday than it was last week. 

In PT, we have started attempting some one legged work on the mini tramp, and that is so-so at best.  I still need help there, and it's minimal the bend I can get.  Full weight bearing on the surgery leg while trying to bend it still hurts a lot, but we try it each day.  I also don't squat fully, but I do a ton of short arc stuff completely pain free. 

My therapist is aggressive, as am I, and we will try things each day.  I know all is well and we aren't doing too much because I used to get really sore for 2 days after and very stiff several hours after PT, but now I am mostly just tired.  Swelling has subsided a lot and my calf & quad are growing, so all that looks good.

If I have any concerns at this point, I am starting to really feel the screws from the AMZ in my shin and I still have trouble ending which makes me concerned about scar tissue & adhesions... but we'll just keep plugging away, and at least the improvements are motivating.

Courtem10: I know it helped me a ton to read details, and if I remember correctly you are having this done April 1, right?  Best of luck to you!

Room 101




Title: Re: Room 101's December 2, 2008 ACI (March 27, 2009 update)
Post by: Room 101 on March 27, 2009, 07:54:03 PM
It's Friday.  Thankfully... the day started out with someone at the office eating my breakfast  >:( -- We woke up late and ran out of the house this morning.  I work where my hubby does, and he made his breakfast and set mine in the kitchen in back.  I was on the phone and when I went back a few minutes later, half of it was gone.  Seriously.

Anywho, at PT last night I was at 127 degrees flexion.  The goal was to fatigue the quad big time, so we did lots of reps, but not lots of bending (only short arc), like mini lunges onto bosu, lateral walks, eccentric one leg squats (like a 30 degree bend or so).  Both legs down and one leg up.  I can tell that motion is very weak with no opposite leg help.  Balancing on one leg.  Heel raises and lots of massage and patella manipulation.  I felt good when I lfet, and then we took a walk when we got home for somewhere between 1 & 1 1/2 miles.  I felt good, but woke up quite sore.  My quads are definitely very sore.

Today, I worked out with my trainer, and we did a lot of different bridging techniques, worked on some short arc dead lifts to try and start incorporating some power into those glutes when you come up out of it.  Backwards walking and balance activities.  Any short arc deal lifts are always 2 legged.  It's way too early for one legged stuff beyond straight leg balancing or matt related work.   

All in all, I feel really good.  Sore today, so I will likely forego the walk and maybe only bike for 10-15 minutes to loosen things up.  It's pretty mundane right now doing the same stuff for all this time, but it feels good to do stuff at the same time, if you know what I mean.  We try and put different twists on the exercises also.  I got some raging elbow tendonitis from crutching and supporting myself weird, so I struggle with that right now also.  After a while, you just get tired of always being on the lookout or being careful... like when you go to a busy place and someone stops short on you... you still have to be so careful of others because on the outside, you look normal, but on the inside the knee is still so volatile.

I am thankful for what I can do and look forward to progressing.  At least I have you guys to "talk" to  ;D 

Good luck to those going under soon, and to those who just got past the surgery part!

Room 101
Title: Re: Room 101's December 2, 2008 ACI (March 31, 2009 update)
Post by: Room 101 on March 31, 2009, 06:00:20 PM
Not a lot new today.  It's been 17 weeks.  We got 6 " of snow this weekend, so I was back to cooped up inside for exercise... I was getting really used to taking walks in the fresh air, but that will return soon enough.  Tomorrow and the weekend look promising :) - I stuck to riding the stationary bike and did a full workout Sunday.  I can go up stairs without any problems, as long as I go slowly.  I feel absolutely no pain, but when I get really tired, I don't push it and revert.  That is only usually if I've had therapy on that day.

We are staying within the 30 degree bend range limit and really starting to work on endurance and some more power.  The stability in my knee is fantastic, and it tracks really well.  My quad continues to get bigger, and the swelling is still subsiding from the knee, which are all very good things.  My flexion is comfortably at 127, which doesn't make me entirely happy, but it isn't extremely limiting at this point.

I can still really feel some shin pain, I'm thinking from the osteotomy screws... I never felt it before now, and it's when I stand on the leg for a while and then move.  Weird and wacky.  It hurts when I rub that spot also, but not tons.  All in all that is just a small gripe  :P

Good luck to the peeps having surgery soon or just having had surgery!

Room 101
Title: Re: Room 101's December 2, 2008 ACI (March 31, 2009 update)
Post by: Hathor on April 06, 2009, 11:15:48 AM
Hi 101

Just thought I'd give an update as I'm at the 4 month post op tomorrow and not far behind you. I've noticed a big improvement in my knee and every week it seems to get better. I've worked out what things irritate it and try and avoid those. My main daily regimen is SLRs with 5lbs ankle weights, wobble board, step ups and bridging. In the pool I have been doing squats and multi-angle lunges along with freestyle swimming with a pullbouy so that i don't kick.. I also ride my stationary bike going down the gears and back up. The most I have done so far is 1/2hr with very little discomfort and I even ventured out on my mountain bike the other day for a 20 minute very slow ride ! It was awesome to be outside 'exercising' !!

I have just started trying stairs in the house and have felt surprisingly good, ie no pain. I am a bit nervous so going easy. I am seeing my PT once a month now just to make sure things are progressing ok. I am seeing my OS in 4 weeks for my 5 month check up and hoping for a good review.

By the way, has your PT tried to get you on a rowing machine or anybody else used one at this stage of rehab?

Hathor



Title: Re: Room 101's December 2, 2008 ACI (18 week update)
Post by: Room 101 on April 06, 2009, 09:41:30 PM
Hi, Hath.  Thanks for the update.  You are 2 weeks behind me exactly.  I noticed significant improvement around 4 months also.  I seemed to really lose the stiffness after being dormant.  I work in an office, so i sit a lot.  I can't wait for the weather to straighten up so I can take walks at lunch.  We've gotten snow two weeks in a row now.  it's getting a little late for the cold & ice & snow I'll tell you.  We seem to be pretty close in rehab, although I haven't ridden a bike or anything outside yet.  Only taken long walks.

After 4 1/2 months, I am doing pretty well.  I think the improvements have slowed down, but that seems to happen.  We were overzealous in therapy last Monday and I was still really sore on Thursday.  We didn't do any different exercises, but we did step up the intensity and endurance.  So, we backed it down on Thursday.  My trainer was out of town, so I actually took Friday entirely off.  Saturday, I did between a 2 & 3 mile walk and the knee felt great.  I also rode the bike for 15 minutes. Yesterday, I rode the bike for 1/2 hour and felt really good.  I added a little more resistance, but still not a lot.

Today in therapy my flexion seemed better.  I am definitely getting more endurance also.  We've been basically sticking to the same program I've listed here in prior posts, so it's getting mundane   :P  -- The one thing I got out of today was a crazy dripping sweat.  Man, I miss those!  It felt good.  My leg is very tired and my knee is achy, but it feels really good considering the amount of work we did.  My knee actually looks like a knee.  Very little swelling.

I can go up stairs normally and pretty quickly now (not running, but a normal stair climbing pace) without any pain at all.  I can walk for what seems like forever without any swelling or stiffness at the time.  I may get stiffer after I sit down for a while, but I don't get swelling or pain with walking.  Walking hasn't felt this good for me in many years.

I still can't go down the stairs.  I get some patella rubbing, and it just feels wrong to try too hard at this time, so we'll keep getting stronger and patiently wait for the day that I can bend like that again.

I look forward to the next big improvement.  For now, I'll be happy with what I can do that feels good, and we'll progress as the pain allows.   

Room 101

PS - Hath, I haven't done any rowing.  My PT doesn't have a rower.  His office used to be in the facility that my trainer owns and trains out of, but in the last 2 weeks, my PT has moved to his own facility.  They are pretty bare bones as far as big equipment.  Mostly items like bosu & balls & steps & therabands and all.  Rowing would be cool.  He did have this new machine I'd never seen called NuStep.  I used it today for the first time... pretty weird, but it felt really good.
Title: Re: Room 101's December 2, 2008 ACI (19 week update)
Post by: Room 101 on April 13, 2009, 06:07:08 PM
Well, it was a weird week last week.  I didn't have therapy on Thursday due to the holidays, and my workout Friday was cut very short due to a project I was working on going nuts (on Good Friday nonetheless) and making me miss half the time slot.  We were at my Mom's for the weekend, so I had no access to anything, except some walking shoes and the road.  It was fairly cruddy weather, so I really did a lot of nothing.  I think it may have been a good break, though.

Therapy today.  My PT worked on some patellar scar tissue, patellar massage, IT band massage and when he measured I had increased 2 cm mass in my quad and gained 7 degrees flexion.  I was sitting pretty at 134  ;D today, and a week ago was fairly stuck around 122.  So, it seemed like the break really helped the swelling and even though I was stiff this morning, we worked it out and made some great progress.  I went through the "usual routine" of exercises.  side/forward/backward resisted short arc lungey/walkie things to comfort on the bend.  straight leg raises, short arc bosu squats. Short arc presses on his new K26000 (I don't know what it really is, but that's what we call it) and 5 minutes on the nu-step fancy elliptical/bike thing... another of his new toys, haha.    After sitting in my office chair a few hours, I feel really good and tired, but I am not stiff or sore in the wrong places.  That's very nice!

I don't even think about walking up stairs any more.  It just happens, and I do it normally... still walking, not running.  I still walk down the stairs one leg at a time... bad leg first and not bending, but I can tell I need to wait o n that part for a while still.  I am sure it will happen, but now isn't the time, so for now, I'll be happy with gong up stairs :)

So, today is one of the good and happy days.  I'll take it  :D

hope everyone had a nice holiday!

Room 101





Title: Re: Room 101's December 2, 2008 ACI (20 week update)
Post by: Room 101 on April 20, 2009, 10:40:54 PM
Ahhh, Monday.  Exhausted today.  We were in Vegas over the weekend.  Too much fun and a delayed flight due to weather in Chicago.  I don't have a ton to report in the last week.  I had 2 great therapy sessions last week where I dramatically improved RoM, and had a great workout with my trainer.  I am definitely getting stronger.

As for being in Vegas, it was the usual great time... the best part was that we walked and walked and walked, and I felt absolutely great.  by Sunday I was pretty stiff, but I didn't elevate or ice at all, and the only time my leg was up was when we were sleeping (which is not often).  I had no swelling and minor stiffness, mostly when we were at the shows and I was confined to sitting in the same position for a couple hours.  I kept to my flat shoes that I bought a few months back.. a pair of cute sandals and a crazy pair of pink shoes that have no heel and a great insole for walking, although it's a dressier shoe, so it worked.  My leg was stiff, but it was nothing like before the surgery.  It really walked off immediately, and I never felt like I was limping or hindered the entire weekend.  For once I kept up with the others!

I am glad to be back where I can ice and ride the bike some, but it sure was nice to be out and walking and the most painful thing that happened was a blister on my foot  :D 

My next follow up appointment is on the 30th of April, so I am interested to see what the OS says and to ask him a few more specific questions regarding activity.   I would figure I am about done with PT at this point.  I am looking forward to warmer weather and being able to enjoy walking around the trails by our house this summer... lucky for me that we live in Illinois, land of the flat. ;D

Take care,
Room 101
Title: Re: Room 101's December 2, 2008 ACI (20 week update)
Post by: courtem10 on April 21, 2009, 02:58:38 PM
Hi Room 101,

It's so great to read your updates and hear about the positive steps you are making in your recovery. I was wondering how often you were doing physical therapy at this point, as you said you may be near the end?? I had my surgery 21 days ago, and I am due to start therapy next week after meeting my doctor for a 3rd follow up appointment. I am so anxious to start because right now I'm basically just doing CPM for 8 hours each day plus a few ankle exercises that he gave me. Overall my muscles feel so week and limited, and I still have a lot of soreness and muscle spasms in my knee each day, not to mention the constant swelling that won't go down. I don't feel much improvements aside from less pain. I am still only doing 50 in the CPM, per instructions by the doc, but I'm not about to take any liberties and be overly aggressive. I'm just going to stick to the instructions he gives so that my recovery goes smoothly.

Courtney
Title: Re: Room 101's December 2, 2008 ACI (20 week update)
Post by: Room 101 on April 21, 2009, 04:52:14 PM
Hi Courtney.  It sounds like things are going quite well for you at this point, and that we are on a similar track, at least at the beginning.  I was limited to 60 degrees cpm for 4 weeks and the next 2 worked up to 90 degrees, but I was limited at 90 degrees for 6 weeks total, and in PT for 3 months. 

I started PT at a little over 3 weeks post op.  December 2 was the surgery and I started PT on December 26... the holidays did affect that by a few days for sure.

I have consistently gone to PT twice per week since then, and I work out with my trainer twice per week.  I never knew you could do so much good work on a massage table, haha  -- as for your spasms & soreness, I was very frustrated by that as well, and I think that is what prompted me to start writing here with questions, but it all seems normal.  I was also swollen for a long time.  It's honestly just been the last 2-3 weeks that i can see my kneecap again and my leg looks normal (discounting the lack of muscle and definition of course).  I was totally stoked that it didn't swell with how much I was on it over the weekend.  I just never had a chance to elevate, and i took that as a super sign that healing is going well.

Last night I realized just how terribly out of shape I am  ::) -- I rode the bike and I upped the resistance just to see how my knee would do.  I made 10 minutes riding hard enough where I had to push it, 10 minutes at one level lower and 10 minutes at the pace where I was just getting the motion and no work.  i was huffing and sweating like I'd run a 10k or something   :P ... but today the knee feels awesome and my legs are tired, so i did accomplish something, and it felt great doing it  :D

Take care,
Kim
Title: Re: Room 101's December 2, 2008 ACI (20 week update)
Post by: Hathor on April 23, 2009, 11:02:35 AM
Hey 101

We must be due for your 5 month update !! I was interested in your trip to Vegas. How did you go on the flight to and from Chicago. I did a 4 hour flight cramped in economy on Monday and really struggled with being able to keep my leg straight (I'm 6ft). I got stuck in the middle seat as there were no aisle seats left when I checked in. I was a bit sore for the rest of the day after that as I couldn't get my leg stretched out properly.

I also found a gym at the hotel where I stayed where I could at least do some exercise. I used a treadmill for the first time, power walking for 15 mins but then as it felt good I raised the incline on the machine for 5 minutes to max. It felt ok at the time but my hamstring on that leg has now been tight and really sore for 3 days ;D At least the knee feels ok.

I'm really looking forward to my second bike ride outside again this week-end...

H
Title: Re: Room 101's December 2, 2008 ACI (20 week update)
Post by: Room 101 on April 23, 2009, 06:21:18 PM
Hey, Hath!  Yep, 5 month progress appointment w/ Dr. Cole is next Thursday.  I figure I have about 3 more PT sessions left, unless he gives me more, but I think he won't.  You're a couple weeks behind me, right?

As for the flight, I am shorter at 5'5" so I can straighten the leg out some.  I was a little stiff on standing up after the flight, but it was worse coming home after being on it so much all weekend.  It walked right out though, and I really was no worse for wear.  The worst by far for me was going to a show on Saturday night and sitting in the middle of a row.  It was close to 3 hours with no leg room (and if I don't have any leg room, wow) and a really big guy on my bad leg side so I couldn't impede on his space... even if he was my friend.  There was no room!  I was sore during the show, but again it was gone as soon as I could move it some.  FYI, I did ask before the flight if i could get my seat changed from the middle, and they were able to accommodate that, which was great.

Wow, power walking.  I haven't gone there yet, and I haven't tried a bike outside either.  I am happy to hear it's going well for you  :D  - My protocol up to 6 months is slow paced walking & balance drills, w/ some very basic sport specific things... which we have done a lot of lateral movement, etc.  I will wait for my appointment to make sure it's ok to do more things like that. 

I have only tried to put some mid resistance on the bike once so far, and it was great, but I did get some knee soreness 2 days after (a day & a half because it was Wed. morning after I rode on Monday night).  I'll definitely push the resistance again on the bike, but it won't be until this weekend because I have PT tonight and my training workout tomorrow.  I am always sore after working it for 2 days.

I'm interested to see if I sustained my RoM or if it is less again.  I do feel a little swollen & inflamed, but most likely I just need the deep scar tissue massage again... somehow I have a hard time creating that kind of pain on myself  :o

I think this weekend is supposed to be great weather, so I am hoping to walk the trails by our house.  If it doesn't rain anymore, they should be solid enough.  The dogs will love it  ;D

Hope everyone else is doing well.

Room 101
Title: Re: Room 101's December 2, 2008 ACI (20 week update)
Post by: Hathor on April 25, 2009, 08:52:53 AM
Ok 101, maybe 'power walking' was a bit of an exaggeration...maybe more of a brisk walk, longer strides. As you know I'm on take-two so would never take an unnecessary risk at this stage. having said that it was really tempting to start running as I've never actually used a treadmill for anything but running!

The bike ride today was awesome, outside on flat road spinning mostly in the easiest gear for 1/2hr. All very slow but fun.
My PT has introduced pedaling with one leg last week by standing to the side of the stationary bike and turning the strokes with the injured knee. It's really hard work and excellent for inner range quad esp. VMO. I'm up to 5mins at a time and my leg feels like it weighs a ton when I'm done because the muscles are so tired. As it's only 5mins it doesn't seem to give me any soreness at all. :P

Hathor
Title: Re: Room 101's December 2, 2008 ACI (20 week update)
Post by: Room 101 on April 27, 2009, 06:16:16 PM
I think to a lot of us Knee geeks a brisk walk is a power walk  ;) -- Seriously, I know what you're talking about.  I actually did that for part of my therapy this morning for the first time.  A five minute walk as fast as I could go, no incline.  It felt weird.  No pain at all, but my body definitely was not used to that.  It had been a very long time since I could do that.  From the knee perspective it felt great.  It was my last exercise, so my quad was shaking like crazy.  I actually worked so hard today that my hair was soaked with sweat.  I don't remember the last time I could work that hard.  It felt really great to sweat that much, although I am not so sure my workmates are happy!  :P

Hath, I am so jealous to hear you were outside riding the bike!  I was hoping to get out on the trails by our house for a 3 mile walk or so, and we got rained out... all weekend long.   :'( Lots of flooding.  :'(  I was stuck indoors on the bike.  Speaking of bike, I am intrigued by your one legged thing.  That sounds sweet, but I have a recumbent bike at home, so I am not sure if that would work well.  I'd sure be willing to give it a go, though.   ;D

I have definitely made another leap for the positive with rehab.  My PT was off all last week, so I hadn't been to therapy in 10 days.  Oh, the deep tissue massage is so painful, but I sure felt good when it was over!  We did the same exercises w/ the addition of brisk walking, but we increased intensity.  My knee is starting to look great.  No noticeable swelling.  I could handle all the exercises and had minimal discomfort. I even tried doing a couple flights of stairs going down normally.  I have been going up normally for a month or so with no trouble.  Down was really good actually.  No pain at all.  I was very controlled and slow to do it correctly, so I guess calling it normally is an exaggeration.  :P  I can tell my quad needs work.  After doing it a couple of times, it was enough for the moment.  I was up & down stairs all weekend long.

3 days until my next OS appointment.

Here's to a week of nice weather and more hard work at rehab.  Hope everyone else is doing well and progressing!

Take care,
Room 101
Title: Re: Room 101's December 2, 2008 ACI (20 week update)
Post by: Peg Leg on April 30, 2009, 03:05:43 AM
Hey! That's great news that you are progressing so well.  It really feels good to work up a sweat after such a long, slow recovery.  I still can't go down stairs normally, so that's super that you are so close.  Keep up the good work and I'm sure your OS will be pleased, too!

peg leg
Title: Re: Room 101's December 2, 2008 ACI (20 week update)
Post by: Room 101 on April 30, 2009, 03:33:17 PM
Thanks, Peg Leg :) -- Most days it seems good.  My PT has really worked on soft tissue lately, scar tissue under the scar and the patells and the IT band.  It has made such a huge difference for my knee that I cannot explain, but it stinks at the time because it is very painful!  :o

I'll check in after the appointment today.

Oh, yeah... it's still raining (we had one day that it didn't rain since the weekend)  ::)

Room 101
Title: Re: Room 101's December 2, 2008 ACI (5 month update)
Post by: Room 101 on April 30, 2009, 10:55:37 PM
5 month OS appointment today.  I don't think it could have gone any better.  I had no swelling, awesome quad strength for this amount of time post op, great extension & flexion.  very little crackling and no pain.  He was really happy.

I was given the go ahead to progress as tolerated.   I can start riding a bike outdoors and have no limitations to training full weight bearing and bending and all.  The only limitations are pretty apparent.  No impact, twisting, stopping short or planting hard.  All else was fair game as my knee tolerates.  So, pretty much no running & no sports, but I am stoked that I can do some outdoor activities this summer... if it ever quits raining  ::)

I can't wait to pump the intensity on the bike and try riding outdoors.  I can already walk for miles and do things I couldn't do before the surgery.

I know there will be minor setbacks, but today is an awesome day, and I am going to enjoy it  :D

I have 3 or 4 more therapy appointments, so I will finish those, and then i am out of PT as well  ;D  -- I will actually really miss my therapist.  he is fantastic!

Take care all, and keep up the hard work!!

Room 101
Title: Re: Room 101's December 2, 2008 ACI (5 month update)
Post by: momhanaway on May 01, 2009, 07:02:01 AM
I am so happy for you!!! GREAT NEWS  :)
Title: Re: Room 101's December 2, 2008 ACI (5 month update)
Post by: courtem10 on May 01, 2009, 03:10:29 PM
Hi Room 101,

such good news to report, especially now that the warm weather is beginning and you will be able to enjoy outdoor exercise! I have been reading on your PT & how the massaging and other things may be really painful at times. That being said- did you ever find yourself taking pain killers or even over the counter pills before or after therapy?? I am starting PT this week & I'm a little nervous. I don't want to go overboard on the meds or anything, but I also don't want to be sucker punched with unexpected pain. Aside from that I have to say your posts are so encouraging to me, you have no idea. It helps to get through the diffiulties knowing other people have experienced such positive results. Have a great weekend!

Courtney
Title: Re: Room 101's December 2, 2008 ACI (5 month update)
Post by: Room 101 on May 01, 2009, 05:28:03 PM
Hi, Courtney.  Good luck with starting therapy.  It's a big help. 

I never had pain issues to be honest.  After the AMZ I had more pain than after ACI, but once I stopped taking the pills, I never took them again, and I had always stopped prior to PT starting.  Honestly, I don't want to mask anything at therapy because once I started doing weight bearing exercises, I wanted to know what hurt and where my true limits were.  Pain is/was always my guide to progression.  Others might do it differently, but that's kinda been my way.

I think you'll find PT will be very helpful and kind for a while.  You're so limited in what you can do at the start that most of the benefit is from desensitizing the scar and massaging the soft tissue, and working on passive ROM.  electric stim was my best friend along with ice.  The scar & soft tissue massaging sucks while he's doing it, and I am actually pretty bruised, but it stops as soon as he stops.  It's not lingering, and it shouldn't be.  He's honestly only gotten aggressive with that recently, but he learned some new techniques in a class.  It has honestly helped my ROM and stiffness far more than I can explain. 

Over the last 4 months, I have definitely done exercises that i wasn't ready for, but if you're direct with your PT and tell him it hurts in a bad way and you need to back it down a notch, it should go well.  I have always allowed a dull pain, but stopped anything that felt stabbing or harsh.  There is a definite difference for me, and everyone is different, so it is experimental.  Just don't be afraid to tell your PT you're uncomfortable with doing something. 

I have found PT to be very tiring, and I am always sore, but it never lasts, and it has let up considerably lately.  Last night in fact, I felt absolutely exhausted and awesome leaving PT.  We got home and took the dogs on a 2 mile walk.  I don't know if I've been able to do that much since I was playing softball in college... it felt great.  I followed it up with a hot whirlpool and then some more ice, but today I feel great.  No swelling and no stiffness.  I go to work out with my trainer in 1/2 hour.

 Have fun with therapy, and keep us up on your progress!

Kim
Title: Re: Room 101's December 2, 2008 ACI (5 month update)
Post by: Room 101 on May 05, 2009, 12:07:59 AM
Finally, a nice weekend of weather!  It was so nice to be outside! 

Had a productive workout on Friday.  I was actually muscle sore on Saturday.  We took a 2 mile or so walk.  our usual route.  The trails were still way too wet (and we didn't feel like washing the dogs afterwards).  On Sunday I took the inaugural bike ride.  We rode on flat ground for around 4.1 miles and it went well.  I was really weak pushing off on the right side, but once I got going it felt good.  It took a couple minutes to loosen up better.  When we got home, we took our dogs on the usual 2 mile walk, so i had a lot of exercise yesterday.  I had absolutely no pain, but I did have some swelling.  I elevated and iced and woke up feeling really good.  I didn't work out today, and honestly I'll see how the nightly dog walk goes before deciding what to do for my workout tonight.  I may just go back to some nice, easy recumbent bike.

I think there is a fine line of working well and working too much... and I am not sure I recognize it yet.  I tend to be a too much person by nature... so I know I need to be conscious of the way I feel.

Hope you all are doing well.

Room 101
Title: Re: Room 101's December 2, 2008 ACI (May 13, 2009 update)
Post by: Room 101 on May 13, 2009, 08:33:33 PM
Hope you all are doing well.  I am still chugging right along.  Today was my last official physical therapy, WOOHOO!!!   ;D Another milestone set.  But, in reality, I have been with my therapist now for pretty much 10 months out of the last 14-15 months due to the AMZ.  We both still believe there is benefit to working on the scar and soft tissue.  I have gained a ton of flexion with the evil massaging techniques, so I will continue to go see him one time per week for now... kind of on the sly.  I will pump up the workouts with my trainer.  We had been doing mostly core and upper body because I always saw him the day after therapy.  I have begun working dead-lift patterns, and man are my glutes weak!  I am looking forward to stepping up the gym workouts.  I have ridden a bike outside, and I continue to work the stationary bike also.  I have not yet tried elliptical, but it is due more to accessibility than anything else.

On average, I take a 2 mile walk every day with my hubby and our 2 dogs.  I work out with my trainer twice per week, and I do that routine once on my own.  I ride the bikes when the weather agrees that I should.  I have not done more than 4 miles yet.  I will ramp up the bike and treadmill now that therapy is over, but I will also continue to do the straight leg raises and some PT exercises on my own.  Most of the time, my knee feels really good.  I do occasionally twist it funny or it swells, but ironically it's when I am not doing anything but daily activities, but then that's when I'm not paying attention also  ::)

My left quad grew 1 1/2 cm in the last 2 weeks, and it is still 3 cm smaller than the right.  I had worked hard before the ACI, and my left quad was actually bigger and stronger, so I have lost a ton of mass.  It seems like such a big hill to climb even though gains are still coming frequently.  :P

I am going up & down stairs normally.  Down doesn't hurt, but sometimes it feels... odd.   I don't quite know how to describe it.  Perhaps I am just weak or tired at that moment.  I tend to then revert back to the old ways, but I am encouraged by the progress on stairs as well.  I think it's related to strength.  I know the cartilage is still busy growing and filling in also, so who knows.

I'm just trying to be careful but at the same time work as hard as I can.  it's a very fine line for me because I tend to be over excited...  :P

Hope everyone's rehab is going well, and Nikki, good luck next week!

Room 101 
Title: Re: Room 101's December 2, 2008 ACI (May 13, 2009 update)
Post by: Hathor on May 14, 2009, 04:40:34 AM
Hi 101

Thanks for the update sounds like you are going great. I am due to meet my OS next week (he had to cancel the last meeting due to an emergency) so I'm looking forward to hearing what he has to say. It'll be my 5 1/2 month check up.

My knee has been feeling good but definitely have good days and less good days. I am exercising most days alternating between bike/walking/rowing one day and SLRs/bridging/heel raises the next. I have a stationary bike and a rower at home so I have been doing 1/2hr bike followed by 5mins rowing (knee flexion to 90d only) on the 'active' days and loads of SLR/bridging/heel raises with weights on the non active days. I find that works well for me and it gives my knee a rest on the 'non active' days.

Stairs seem ok but still finding myself 'cheating' on the way down so will perservere with that.

Like you, some days the knee feels so good I feel like going for a run or going really hard on the bike but I'm having to hold back and be very patient. This is very frustrating !!

Will update some more once I've seen the surgeon.

H
Title: Re: Room 101's December 2, 2008 ACI (May 13, 2009 update)
Post by: Room 101 on May 14, 2009, 03:57:42 PM
Hi, Hathor.  It's great to hear from you :) -- It sounds like we are in pretty much the same place both post surgery and in our rehab process... it is pretty, um, uninteresting at this point isn't it  ;)  -- I am so thankful to be in this blessed uninteresting place in rehab though.  I hope your appointment is as positive as it seems it will be!  Looking back, it's hard to believe almost 6 months have passed.

The holding back is tough, but I am consistently working up an awesome sweat with my workouts, so that actually feels wonderful!

Take care, and look forward to what the surgeon says!

Room 101
Title: Re: Room 101's December 2, 2008 ACI (May 13, 2009 update)
Post by: Hathor on May 18, 2009, 10:17:13 AM
Hi all

Saw my surgeon today for 5 1/2 month check up. He was pleased overall and the fact that there was no swelling and the patella felt smooth on bending were really good signs :). He did say I had a mild case of bursitis in the fat pad just below the knee and gave me some inflammatory drugs to take, but said it was nothing to worry about and it would go with time.

He now wants me to start pushing the patella harder to ensure the cartilage gets all the right signals so told me to start introducing squats, more cycling, stairmaster/elliptical trainer and leg press. He said to stay away from hamstring curls and OKC leg extensions for a few more months. My OS just got back from some big conference overseas where he said they talked about MACI success in the patella and the consensus was amongst surgeons that it was important to put more pressure on earlier than previously thought to get better success rates with the quality of the cartilage  ???. Who knows ???

Anyway, good news so far and fingers crossed for the next 12 months....

Hathor

Title: Re: Room 101's December 2, 2008 ACI (May 13, 2009 update)
Post by: Room 101 on May 18, 2009, 05:24:49 PM
Sounds like great news, Hath!  Congratulations!  Interesting news on the rehab front, although it sounds similar to what I was told also. 

I was pretty much told to do anything that avoided stopping hard or twisting quickly or high impact.  No sports yet or running, but anything my leg was able to tolerate lifting was fine along with biking and walking and elliptical, etc.  I don't squat yet.  I do deadlifts instead right now.  Mini squats I guess on certain exercises...

Keep us updated Hathor.  When do you go back to the OS?  at 12 months?
Title: Re: Room 101's December 2, 2008 ACI (May 13, 2009 update)
Post by: Hathor on May 18, 2009, 08:57:10 PM
Hi 101, thanks for the encouragement.

My OS doesn't want to see me again specifically but asked that I call him in 3 months with an update. He also said that patella defects tend to overgrow and will require debriding at some point around 12 months.

Here's to the next 6 months of rehab. I have to say that the last few months seemed to have been slow coming although I was wishing the time away to get over the initial stages of this op!!

Hath
Title: Re: Room 101's December 2, 2008 ACI (May 29, 2009 update)
Post by: Room 101 on May 29, 2009, 11:36:02 PM
Hey all.  Haven't updated in a while.  To be honest, no interesting news is good news.   :D

I am done with formal PT now and strictly working out 2 days a week with my personal trainer and on my own the other days.  I pretty much do my weight routine 3 days a week and calmly ride the bike.  On off days, I push the bike harder, and I have ridden outside twice.  It's been really rainy here, so I haven't been outside as much as I want t be.  I did 5 miles last weekend and had no swelling or pain.  The first try I did swell some, so I held back.  I continue to be able to walk without limit, although if I am on my feet all day then I notice that I want to stop after about 1/2 our normal walk.

The bad news is I have been on a very tight work deadline and had some days I was at the office until 2:30 AM... so no rehab gets done, and that isn't something that makes me happy... but a job is a job, and most days it's very good to me.  It's just frustrating to fall out of the routine I was getting so good at following.  But I am back now, hopefully with no more 17 hour days  :P

My workout routine hasn't changed much.  I was doing deadlifts w/ around 30 degrees flexion, and we have improved that to 75 degrees or so with no pain or no swelling after it's done.  My glute tends to be very weak, so we really work on strength there.  My quads are quite tight, so we have been concentrating on that as well.  I do a ton of bridges, and we have begun some very simple and light reverse lunging.  Just enough to activate the group of muscles.  usually done with one leg on a slide board for fluid motion.I am excited to eventually get to the progression my good leg does.  That will be a nice day.

Hathor, I read your post in the other thread, and it's great to see you on the bike and doing well.  Thanks for the update!

Hope you all are doing well with your rehab.

Take care,
Room 101
Title: Re: Room 101's December 2, 2008 ACI (May 29, 2009 update)
Post by: Hathor on May 31, 2009, 10:34:12 AM
Hey 101

Good to get an update on your progress. Sorry to hear work is getting in the way of your rehab routine. I've been getting up at 5.30am to get my workouts done before I head to work but it makes a long day.

I've also started to look at doing some Romanian deadlifts too as my OS was against the hamstring curls. Are you doing any weights for the quads? Other than squats not sure what else to do that is CKC to start building the VMO etc. up? Any suggestions welcome.

Take care

H
Title: Re: Room 101's December 2, 2008 ACI (May 29, 2009 update)
Post by: Room 101 on June 01, 2009, 10:20:01 PM
Hey, all!  What a fabulous weekend of weather we had!  Saturday we were gone all day watching our niece play softball and then a family gathering.  She's 10.  So fun! 

Sunday was as perfect as weather could get, and you know what that means...  Overindulging in outdoor exercise.  Yep.  Nothing like pushing it... 5 miles on the bike (we would have done more, but my hubby's bike chain broke  ;D ) -- So, we took the dogs on a 4 mile walk after that.  So I did 9 miles of exercise, and by the last 1/2 mile walking I was so tired.  We did a pretty good pace, except for all the trail sniffing the pups enjoyed at the start, haha.  It was probably a tad too much all at once.  I did break out the ice bag last night, which helped.  I didn't swell, but I am sore.  If I am sore tomorrow, I'll know I overdid it and need to back off.  I am sure it'll all be fine.  I felt great biking and walking, until I did get tired.  We are walking a charity 5K this Thursday which I am looking forward to.  That has been my goal all along, not knowing exactly where I'd be in rehab.  I am farther than I thought to be honest.  Even though I was sore after all the exercise, I was still doing stairs pain free.  My quads were shaking, but I didn't have any pain there.

Hathor, as far as quad strength, I do not use hardly any weights at all, unless I am doing SLRs, and then I add ankle weights.  I walk backwards on the treadmill which is good for VMO, and I do tons and tons of bridges.  Romanian deadlifts (which I do hold weights), regular deadlifts (also with weight) but the weight sits on a step so I am not doing more than 75 degrees flexion at this point.  I am still accomplishing the power of the deadlift though, and I have improved, dropping from 12 inch step to 6 inch step for a deeper deadlift.  I do the reverse lunges I described in the last post, with the back leg lifting off the ground once it gets back.  That is very hard for me to do, and I need 'help' by holding on to a bench while doing the lifting.  At first I had to grab to get the lift, and now I have improved to only need to touch the bench for support while doing the lifting portion.  Some days are better than others. 

I also work on the kettle bell Turkish get-up... but I only do half of it.  I found a sample on youtube, and you must understand that when I do it I stop *prior to any kneeling*.  I can't emphasize that enough.  I do the first half of this video.. through the straight leg lifting part (exactly 2 minutes into this video), only I don't even lift the leg.  it rests on the floor.  There are a variety of different get-ups, and I do 4-5 different ones alternating every workout.  I was really surprised that I could do these with the knee flexion, but I have no limits in bending and when I tried it I had absolutely no pain, and this is a fantastic exercise... although I would only learn it with someone who knows what's what as it's pretty intricate.  It is a core exercise that benefits lower body stability.  I love doing them... even halfway  ;)

Besides that, I bike like you... stationary throughout the week, and weather pending outside on weekends.

I do not even do real squats at all.  No old fashioned leg extensions or hamstring curls.  I guess the only other thing I can think of that does help me is we incorporate a lot of lower body stabiility with upper body lifting.  For example, I do chest press while on a stability ball, in a bridge position.  When I first started, I did two dumbells, both arms at one time, but now that I am stronger and more stable, I do one arm at a time, which throws off balance to make it harder to stabiilize.  We work *a lot* on balance.  Split stance on a lot of pushes and pulls for stability, etc.  Or square stance with mini (30 degree) squat and power zip up to straight leg while doing a shoulder press, etc.

If I think of anything else or do anything fascinating tomorrow at my workout, I'll let you know... but that's it in a nutshell.

Here's the turkish get-up link.  There are many, but this one was the best and slowest progression.
http://www.youtube.com/watch?v=RqyIuFIdgRk&feature=related

Take care all,
Room 101



Title: Re: Room 101's December 2, 2008 ACI (May 29, 2009 update)
Post by: Hathor on June 02, 2009, 10:37:41 AM
Thanks for all the info 101. You are very busy with your training. My routine seems pretty boring by comparison.

I can't believe how most rehab protocols (Hambly et al.) talk about getting back to sport at 6 months, cycling, inline skating etc. What a crock ! Based on what I read on this board getting back to 'sport' has a completely different meaning to us M/ACIers...

I'm having a few days off altogether as I hurt my traps and neck muscles doing a workout with heavy weights 2 days ago. >:(

H
Title: Re: Room 101's December 2, 2008 ACI (May 29, 2009 update)
Post by: Room 101 on June 04, 2009, 05:49:31 PM
Hey, Hathor.  Yeah, I do things on a lot of days, but I think you seem to be more aggressively hitting the bike.  I kind of ride for the motion, but it's not really pushing gears or anything or levels if I am stationary.  It's very casual. 

On Tuesday I did mostly straight leg exercises since I went so many miles riding & walking on Sunday.  Nothing much beyond 1/8 to 1/4 squat position prior to deadlifting (or what we call zipping up) to straight legs.  We really started hitting the dorsi flexion.  Mine is bad.  I worked on it a lot in PT, but then kind of got away from it after.  So we started working that out again.  Wednesday night we went on a smallish walk.  About 1 1/2 miles.  An easy day.

We are going to a charity 5K tonight for our neighbors boy who died of a brain tumor.  It's such a sad and good cause.  I hate to miss it.  It kinda puts some knee discomfort into perspective, that's for sure.   I am actually a little sore today, so I am unsure if I'll walk it all or not.  It was my goal to walk the 3.1, but if I'm sore at all, I will take it down and walk maybe a mile.  We'll see.  i don't have to decide for a few more hours  ;D

Anyway, I was talking to my trainer Tuesday about VMOs and such, and he reminded me that even though it's a hip/glute exercise, that resisted lateral stilt walks were also really good for vmo training as the stabilizing leg has to work pretty hard also.  We did multiple sets for a see what I mean kind of lesson, haha.  I use the colored tubing around my feet, sitting where it's comfortable right at the arch... I started with yellow and now moved up to green tubing.

Hope everyone is having a good week.  We are having a beautiful day today.  It's finally warm enough to ditch the coats.  I think we were hitting 70 today.  Yeah!

Room 101


Title: Re: Room 101's December 2, 2008 ACI (May 29, 2009 update)
Post by: Hathor on June 05, 2009, 08:45:22 AM
Good luck with that walk 101, you are absolutely right, our knee issues are small compared to what some folks are going through. They had a young guy on tv last week who was born without arms and legs but he had a fantastic outlook on life, he was funny and a real breath of fresh air!!

Glad to hear the weather is improving for you, here we just went into winter so coats are going on instead. I may give those stilt walks a try as well, without the instructions on how  :-\

H65

Title: Re: Room 101's December 2, 2008 ACI (May 29, 2009 update)
Post by: Room 101 on June 08, 2009, 09:42:15 PM
Happy Monday.  Well the walk was a success.  They had the largest number of people ever (over 1100).  this town is around 3000 people and the way they come together is awesome.  I walked the whole thing.  I actually felt good and the worst things was fatigue at the end.  I did the walk in 57 minutes... I actually stood by the finish waiting for exactly 57 minutes because I am a dork.  But I didn't think that was too bad.  The worst part was walking down a pretty big hill... I slowed down and really watched it at that point, but I had no pain at all.  I did ice that night and honestly felt really good the next day.

It's really cold here again.  back to the coats, the rain and the storms.  Ehhh.  June should be hot and humid... but it feels more like March.  I despise cold weather  ::)

Anyway, hathor... the lateral stilt walks are really easy.  you can use the colored tubing or even a theraband would likely work (until it breaks) - Tie it up so it has a diameter of a foot or so (maybe a little less... is that around 26 1/2 cm?).  I put it around the arch of my foot because it's comfy there...  standing tall, one leg is the stable leg, and one kicks out (keeping your legs straight) to the side.  Do 5 reps one way, 5 reps back the other way where the other leg stabilizes... 3 sets or 15 reps each way.  The butt dimple and adductors should get tired, but the stabilizing leg also does a lot of work.

I'm excited to go back to therapy this week (I didn't just say that, did I???  :o ) -- My PT got some new tools for soft tissue manipulation... Gaston technique, I think... and were going to get back to work on the IT band, the knee scar and the horrible elbow tendonitis I gave myself by being on crutches for 5 months out of 12.  I notice some extra stiffness since I haven't been in PT and haven't been getting this work done.  I'll be interested for him to take my knee measurements also to check calf growth, quad growth and swelling (which I would hope would be non-existent).

Take care,
Room 101
Title: Re: Room 101's December 2, 2008 ACI (May 29, 2009 update)
Post by: courtem10 on June 09, 2009, 05:25:29 PM
Room101- congrats on finishing the walk!! I was wondering what you have been doing for your IT bands?? Mine feel super tight & I want to know what the best stretches are for them. I keep forgetting to ask my PT guy

thanks,
courtney
Title: Re: Room 101's December 2, 2008 ACI (May 29, 2009 update)
Post by: Room 101 on June 09, 2009, 09:13:52 PM
Hi, Courtney.  I hope your rehab is progressing well.  IT bands are interesting.  You can't stretch them.  Mine are a definite trouble spot, and I think it goes back to years of doing things wacky because I always walked with a limp and tried to still play sports... I have worked on them ... or rather had them worked on by my therapist and my trainer. 

The therapist does some seriously deep tissue massage, which leaves me quite bruised.  If you mention IT band to your therapist I would guess he would work on it the same way.  My PT goes across the grain, rather than lengthwise up & down the leg, and it really cleans it up nicely.

With my trainer and on my own I use foam rollers.  They come in different diameters and softness.  At first I am sure you would go really light, and I am sure you want to wait until it's ok to put pressure on the side of your thigh.  But you lie with your leg on the foam roller, IT band down on the roller... support with your other leg and arms.  You can control the amount of pressure nicely.  At first I dragged my foot on the ground to ease the tension.  I use a 6" diameter roller and I started with a mixed blue/white color which was softer than the black one I now use.  You just roll up and down 15 to 30 times on each leg's IT band, concentrating on the tender spots.  You can do this a couple times a day, every day.  I have seen a lot of improvement.  If my PT does the deep tissue massage then I give myself a day to recover and don't use the foam roller.

The foam roller goes lengthwise up & down the leg and the PT goes sideways.  It was a nice mix and really has helped me a ton.  I rolled them out at my workout, and they were very sore today, but we did tons of spring cleaning chores this weekend... I was painting and planting flowers and didn't do the rolling this weekend.   I hadn't done it since before the 5K walk actually.  I noticed, too  :P

Take care,
kim
Title: Re: Room 101's December 2, 2008 ACI (May 29, 2009 update)
Post by: courtem10 on June 11, 2009, 04:13:19 PM
Hi Kim,

thanks for the IT band info. I figured foam rollers would be the best option. All my muscles just feel so incredibly tight and week at the same time from a combination of not being used and then abnormal movement due to the brace & crutches for so long. I am going to try out those suggestions and see how things go. I know it's just patience at this point. I'm on schedule it just doesn't feel normal to not have complete freedom with regard to your body movement.

Also- one general question to the group- what did people out there do to minimize the scar or to protect it from the sun?? I am going to be going to the beach fairly often this summer, and I want to make sure I dont get any sun damage.

Hope everyone is having a great day- we are having another rainy cloudy one here in Connecticut :'( Where is summer??

Courtney
Title: Re: Room 101's December 2, 2008 ACI (May 29, 2009 update)
Post by: Room 101 on June 11, 2009, 05:38:44 PM
Hi, Courtney.  I hear ya on the tight & weak part.  Things just work a little differently for me after the osteotomy.  I am much better balanced, but my IT band is soooo tight and my dorsi flexion (pulling my toes toward my shin) is also very tight and weak.  It's all getting better, but I am diligent about foam rolling and stretching my calves & shins.  It's also why I am going to go to PT and let someone who knows dig in there and work on those sore parts.  It really opened up my movement and I fell great when it's loose!

As for the covering of the scar, I always went way overboard and covered the scar with band-aids.  I think zinc xide works, but I felt better with bean-aids.  I'm past the magic 6 months mark, but I still protect it.

Take care,
Kim

Title: Re: Room 101's December 2, 2008 ACI (May 29, 2009 update)
Post by: Hathor on June 13, 2009, 07:45:15 AM
Hi Courtney

I'm also a big fan of the foam roller for the ITB. My roller is white, was not aware they came in different colours! I use it most days and have done so for a number of years. I am a keen cyclist and the ITB's can get really tight when I trained too hard. Can't say that's a problem at the moment as my 'training' is very limited being 6m post op. There is also a stretch I use to help and that involves bending your leg at the knee under your chest as you lie over it (if you can picture it with you leg in an upside down L shape) with the other leg straight out the back.

I have only just been able to start doing those in the last few weeks as my knee was not up to it before. It stretches ITB and glutes.

Hathor
Title: Re: Room 101's December 2, 2008 ACI (May 29, 2009 update)
Post by: Room 101 on June 15, 2009, 08:49:33 PM
Hi, Hathor.  Thanks for the stretch.  I was always told by my trainer and PT that there wasn't really a great strecth, but perhaps they meant that it wasn't good enough on it's own.  My IT band got really tight after my osteotomy and then I went right into the ACI, so it hasn't been "loose" for a while. 

As for the foam rollers, I have a white one that is pretty soft... the blue & white is stiffer, and the black one hardly gives at all , and I had to work up to it.

All I can say is I went back to PT, and will be going again once a week for a while.  He took some classes on the Graston Technique for soft tissue injuries and scarring.  He finally got the tool kit, and after one visit I was totally changed for the better.  he spent about 45 interestingly painful minutes, but I was a new person when I walked out.  It blew the foam rolling away.  When i worked out Friday after having this done Thursday night, I could do things without support that i could not do on Tuesday.  I'm quite sure I wasn't stronger since Tuesday, haha.  It is worth asking your PTs about for sure.  I can't wait for Thursday's torture, and to try this new stretch!

Take care,
Room 101
Title: Re: Room 101's December 2, 2008 ACI (May 29, 2009 update)
Post by: slyguy1 on June 18, 2009, 04:27:21 AM
Any post-op update yet? It sounds like you have a great PT....what are you doing for cardio these days?
Title: Re: Room 101's December 2, 2008 ACI (May 29, 2009 update)
Post by: Room 101 on June 18, 2009, 03:59:41 PM
Hi, Slyguy.  I am 6 1/2 months post op, and for cardio I ride the bike, both outdoors and stationary.  I walk on the treadmill forwards and backwards (backwards is definitely for vmo strength and not cardio work, haha).  I lift weights 3 times a week, but mostly I have kept it calm and walk several miles or bike several miles or both in a day.  I have no pain doing 3-4 miles walking or 5-6 miles biking.  I like to mix both into my day.  I have not done elliptical very much yet.  I just don't have access to one and since it is summer (or supposed to be summer) I have enjoyed being outside more which is walking & biking.

It sounds very basic, but I am very happy that I can walk and bike that much with no swelling or pain.  It's a step in the right direction.

Take care,
Room 101
Title: Re: Room 101's December 2, 2008 ACI (May 29, 2009 update)
Post by: slyguy1 on June 19, 2009, 04:27:21 PM
Wow, that is great after such a short time post-op. I went to a new OS this week and the first thing he said was just by looking at my legs that he would have to break them to reallign them (osteotomy). I am thinking breaking of bone structure later on will lead to osteoarthritis and further complicate the matter. Any thoughts on this? Are you able to kneel on the floor and hold a yoga position for 90 seconds pain free? Is doing that not recommended by protocol? Thank you everyone for keeping these posts going....very inspirational to read. Have a great weekend...hope all this rain out here in the eastcoast is going to stop.
Title: Re: Room 101's December 2, 2008 ACI (May 29, 2009 update)
Post by: Room 101 on June 19, 2009, 06:31:26 PM
Hi, Slyguy.  I had an AMZ (osteotomy) as well.  I still have the screws in my leg.  On very few occasions I will notice a dull achiness in my shin, but I think it's from muscle fatigue more than anything else.  My shin and calf muscles still get very tired. 

I was shocked at how much more balanced I became from the osteotomy.  and my patella finally glides smoothly and properly.  I finally walk on a balanced foot and it cured some other issues I was having like plantar fascitis and the like.  I had the osteotomy 10 months before ACI due to the fact they thought they were going to do micro-fracture and AMZ, but my lesion was too large.  After failed therapy we just went right for ACI.  I don't have any problems after the osteotomy.  I was able to kneel carefully afterwards, but now I am not allowed to put that direct pressure on the ACI.  I don't know what my kneeling future might be now, haha.   One day at a time.

I know not everyone has these positive results, and I consider myself fortunate and blessed to thus far have had success.

Take care,
Room 101

PS - it has been storming like crazy for 12 hours in the Midwest... bleh.  Hail and downpours and lots of thunder & lighting... I understand several tornado warnings also, but 30-60 minutes from where we are located.  Good luck East coast  :P
Title: Re: Room 101's December 2, 2008 ACI (May 29, 2009 update)
Post by: slyguy1 on June 20, 2009, 05:30:26 PM
Hey room 101.....it is inspiring to read your success. Did you investigate the AMZ procedure before getting it? What was the reasoning for doing it? Looking at myself i am slightly bow-legged....they took out most of my meniscus (i think it is easier to just take out then to repair and save it). I never realized the importance of the meniscus and how it supports the stability of the knee and if torn or compromised (partially missing) it will lead to degeneration of the whole knee later on. I wish they had tried to save it...the os does whatever is easier for him so he can just get out of there and move onto the next one. He was gone when i woke up after my microfraction....i did not even get a chance to ask anything >:( I'm sorry i am venting here....i don't even know why they even do microfraction anymore when they know it is a temporary fix. A few people that succeed with microfraction are the ones that have the lesion in the non-weight bearing area where there is some bloodflow going there. Did they do anything in your meniscus area? I am thinking if your meniscus is healthy and not compromised it adds to your overall success of the aci and amz in achieving that balance you refer to.I have to see this new os again this week to see what my options are....i am trying to come up with questions i should ask if he lets me that is.

           On the AMZ and shin pain....could it be that you still have the screws and maybe when they take them out it may get better? Did they say when you get them out? I am still trying to get as much info as possible about success rates...prior to surgery did you ask what the success rate was? Having a partial menisectomy and a failed microfraction definitely lowers any chance of success on AMZ @ACI....and to be away from work for that long (not counting the fact that i work on my feet all day) all going against it. A lot to think about....i better ride the stationary bike and try to think positive...thanks for letting me  vent...enjoy the rest of the weekend....hope it's pain-free:)
Title: Re: Room 101's December 2, 2008 ACI (May 29, 2009 update)
Post by: courtem10 on June 22, 2009, 02:31:11 PM
Hi Slyguy,

I was reading  your questions to room101 & wanted to add in a little input. I also had the AMZ & ACI on my patella about 3 months ago. I know I asked my doctor many times about the osteotomy & the screws. He said achiness in the shines is typical following the surgery and even for months after as this is a major procedure. However, he did not recommend ever removing the screws unless there was a major complication or the patient was under extreme pain. He said the screws should remain in there to stabilize the knee & they cause no harm, nor should they cause any additional pain on there own. Also, going in to remove the screws means another unecesarry surgical procedure with more recovery and rehab.

room101- have you ever done stairmaster following your surgery?? i am pretty much pain free going up and down regular stairs, and i was wondering how soon i could transition to that workout.

Courtney
Title: Re: Room 101's December 2, 2008 ACI (May 29, 2009 update)
Post by: Room 101 on June 22, 2009, 08:08:52 PM
Hi, Slyguy.  I had done a ton of reading prior to the first visit with my new OS, a cartilage specialist.  My previous OS had done a bone scan to confirm what MRIs did not.  I think we had known for some time what the real problem was, but proving it tended to be complex in my situation.  I loved my previous OS.  He was wonderful, and when he said my problem needed a specialist I was very sad and freaked out... then I read about Dr. Cole, and I read all the material on his web site.  Nothing was a surprise to me when i went for my first visit.  He did a series of x-rays to check Q-angle etc. and that determined the need for AMZ along with  other items, like the dislocations etc.  I don't think my alignment issues were visibly noticeable.  I believe by reading a lot of items on www.cartilagedoc.com or Dr. Minas' web site, a lot of questions can be answered.  I also read a lot of diaries on this site.

As for the screws, Doc & I talked about it prior to the ACI, but neither of us thought that there was a reason to remove them.  He is basically in the school of thought that Courtney talks about.  It's better that they stay if they are not troublesome.  I even had the perfect opportunity for removal with another open surgery, but he wanted to leave them.  -- I think the shin achiness is just a result of the osteotomy.   I am tender if you push on it where they took the bone on lateral tibia.  I actually haven't felt achiness for a month or 2, so it may be subsiding.

Hi, Courtney.  It's so good to hear how well you're progressing.  I wasn't really able to go down stairs until 6 months or so. I could go up well before that.   It hasn't been all that long.  It's great that you can do both already.  We have stairs at our house, and I am up & down many times in a day... my workout room and laundry are upstairs.  I just honestly don't push the stairs thing beyond daily use, so I haven't done any stair master.  It's not currently in my plans.  I ride the stationary bike hard now in intervals, and I ride a bike outdoors (I was given permission at 5 months for that).  I guess I go for increasing intensity and endurance right now on the low impact items.  Walking 3-5 miles or biking for 5-10 miles.  I'm in no hurry to push stairs as a workout.  Maybe that's being super conservative, I don't know.  I guess what muscles I don't get with walking & biking I hit with weights and lifting.  it seems to be working.  I am getting stronger and my quad is getting bigger and I'm staying pain free with no swelling... so I'm happy right now.   We'll see where the progression takes me.

Take care,
Room 101
Title: Re: Room 101's December 2, 2008 ACI (May 29, 2009 update)
Post by: Room 101 on June 22, 2009, 11:49:05 PM
So, since these posts were fresh on my mind, I remembered to talk about them at my workout today.... just got back to work.  Sweaty sweaty sweaty!  I asked him about Courtney's question, and he said he wouldn't recommend getting on the stair master because you can get really good quad stimulation from walking backwards, either on the treadmill or resisted with a Cook band.  I figured I'd bring it up inquisitively since I don't do stair master by choice.  I work the cook band at my workouts with him, and I walk backwards almost daily, either while we're out walking the dogs or I jump on the treadmill.   For me, I feel like I do enough stairs in daily life I guess. 

Today's workout was great.  Straight leg isometric single bridging on a ball, hanging leg raises, kettle ball d2 (sword pull) patterns, kettle bell cleans, cook bar pushes, kettle bell swings, single leg cable power up thingies, and a stability exercise I can't explain...

It was short and intense... got caught on a work call so I was late by 15 minutes, and my trainer had a baseball game to play...

Have a great week,
Room 101
Title: Re: Room 101's December 2, 2008 ACI (May 29, 2009 update)
Post by: slyguy1 on June 22, 2009, 11:57:23 PM
Thank you courtney....yes i certainly agree that it is major surgery that you've had....and it sounds like you are making great progress. Are you in the northeast? Are you still with a PT or are you doing workouts on your own?

  Room 101....did you have a set of questions on your first visit with Dr. Cole who i'm told is the best in the country if i'm not mistaken. Strange how Dr. Cole did not jump into conclusion and ordered those tests before diagnosing your particular situation....i think that was professional. I need to find out success rates not just how many surgeries they have done. I know that some doctors are super book smart and graduated with top honors but the practical on hands surgeries may be a different story. Do you remember asking how many of his surgeries were successful or maybe he was honest and right out told you. I know the outcome can be totally different even with the best of surgeons but at least you have peace of mind going in. In reading these posts do you know of anyone who was one of the first to get this surgery and how they are doing? I know in europe, they have done these since the late 80's....just curious if any of them failed 10 years later. Great to hear such positive support here...hope to hear more good updates from you both....thanks again

Sly
Title: Re: Room 101's December 2, 2008 ACI (May 29, 2009 update)
Post by: courtem10 on June 23, 2009, 03:31:11 PM
Hi Sly,

I am in Connecticut, and I had my surgery at UCONN Medical Center. I am still working with a PT bc it's pretty early in the rehab phase- I only started rehab like 4 weeks ago. Being only 25 with hopes of returning 100% to sports & running, I figure I will be in PT for a good while to bring me back up to a competitive level. I just wanted to also add in that I did ask my surgeon about his prior success with ACI & I deffinitely factored that into my decision. I actually got opinions from 3 different ACI surgeons- 1 of which was Dr. Minas out of Boston who is a leading industry expert on cartilage repair. And honestly I felt most comfortable with the doctor I choose, it was totally a gut feeling, obviously combined with confidence that he would do a god job. But it ended up going perfectly- surgery was a breeze and everything so far is running smoothly. I am so happy with the choice I made, and it really is important that you trust and have a good rapport with the surgeon you ultimately choose. Case by case everyone is different, any doctor can have a failed ACI because all patients circumstances are so different.

Anyways, on a side note- has anyone out there experienced any pain and swelling behind the knee??? I have noticed that area to be super tight and restrictive lately to my movement. It is causing me decent pain. I also have noticed a section in the middle of my scar recently popped up. I immediately freaked out that  a screw had gotten loose & come to the surface, but I'm sure that is just an overreaction. However, I didn't think scar tissue could still be developing at this point bc I am constantly working to break it down. Any thoughts??

Courtney
Title: Re: Room 101's December 2, 2008 ACI (May 29, 2009 update)
Post by: Room 101 on June 24, 2009, 09:23:10 PM
Hi, slyguy.  I certainly asked questions, but the kind that i think are typical... when can i go back to work?  How long on crutches and brace?  I had many technical answers after I read all his articles and was crystal clear on the procedure and it's success rates.  I understood the risks of patella damage and I talked to him a bit about what helps with success.  In my opinion, I think once the surgeon successfully does his job, the patient has to then do their job.  I don't know how the numbers get skewed by patient doing things too soon or not soon enough, etc.  I only ever went to Dr. Cole and his knowledge and the recommendation from my previous OS were enough.  I scheduled surgery on the first appointment day. 

I don't find it strange that Dr. Cole did his own tests.  One thing that was perfectly clear the first day was that he had his protocol and it was followed.  Those tests were part of his protocol and provide valuable information to the extent of damage and the scope of the surgery.

I did not ask him his success rate.  It kind of goes back to the above statement of did the patient do their job afterwards, or did they have some immune system issues that caused rejection?  Enough hours on cpm, diligent about PT, working out enough, getting strong enough before progressing... there are so many factors involved, and honestly his background spoke wonders about him.  Bottom line is the guy is awesome.  A lot of times I think the reason for a failure isn't quite clear.  Bad luck?  I don't know... I just don't always think it's a botched job.

I don't have any info on long time past patients.  I started reading here after the bone scan results in 2007.  I'd be interested in that info also... as well as if anyone has returned to competitive stop & go sports like basketball & softball/baseball & volleyball.  I know one of Dr. Cole's past guys climbed Mt. everest this summer.  And I saw another who successfully got onto the ski slopes black diamond run also but that's still not the stop & go sport.


Courtney - I haven't had any pain in the back of my knee.  I did have some iflammation there early on, but my whole knee was still pretty swollen then.  Also, my screws aren't too close to my scar.  I am pretty sure they're a couple inches off to the medial side of my shin.  Sorry I am no help there.  I do still have to work on my scar.  I think the tissue can keep coming at you for a while.

Take care,
Room 101

Title: Re: Room 101's December 2, 2008 ACI (May 29, 2009 update)
Post by: slyguy1 on June 24, 2009, 11:35:37 PM
That's great that you did your research and homework regardless of being in the best of hands. Dr. Cole from what i hear is the best and patients travel distances to see him from what i've heard. I totally agree that the patient has to be optimistic and follow protocol as much as possible. I also think that success is also dependent on the degree of damage and location. The triathalon guy David was back running after his microfraction....people reading his success automatically think they can achieve the same . His lesion was smaller and on the non-weight bearing area where there is better blood supply thus better healing. It also helps to be as fit as him....not everyone competes on a competitive level as him. I assume Dr. Cole saw your MRI and pictures from your last surgery? As more info comes out about the complications i think that overgrowth and more surgery later is the biggest issue. Would getting some PT to strengthen the quads help in post recovery any? I am thinking the muscle just shuts down with surgery and it doesn't matter how strong it was prior. My biggest concern now is the AMZ and having screws for the rest of my life. It's like a bridge dental procedure done as an alternative to a dental implant where they have to knock out 2 healthy teeth to do the bridge. Someone new wrote in to say that she had an ACI 10 years ago and she is doing great....just replied to her on the general info post section. She is upset that the os just did microfraction on other knee without notifying her....which is similar to mine where i was not told in advanced that it would be done....i am still griping about it 4 years later.

Coutney, it sounds like a question for your PT. I don't know if you get massages on the knee but i am told they are great to help the healing process and maybe reduce some pain...and have you ever heard of Reiki? I just heard from a friend ....i am going to google it for some info. Hope it was a better day today for both of you:) Take care

Sly
Title: Re: Room 101's December 2, 2008 ACI (May 29, 2009 update)
Post by: Room 101 on June 25, 2009, 04:55:46 PM
Hi, sly.   

I did my homework, but I was also desperate and ready for something better  :P - I know Dr. Cole is one of the top in the country, but I venture to think there are many good choices.  I thought I'd have a long wait with him, but I really didn't.  I did take all my MRI, X-Ray & bone scan results to my first appt.  I completely agree that the damage has to do with success also.  No doubt.  I know my lesion was pretty big, almost my entire patella, so i am truly careful.  PT is definitely there to strengthen quads.  When I left PT I still had a 3 cm discrepancy, but the gap was closing consistently.  I thought I'd never be able to do a SLR again after 5 weeks.  I still couldn't lift my leg well.  That's how crazy the quad shutdown was for me.  I could do them standing and lying on m,y side, but  not the standard ones from lying on your back.  I kept working the other ranges and when I could do one on my back I could do 50.  Wacky.  I wouldn't worry too much about the screws.  Bottom line is if they end up causing a problem, they can come out.  I just don't tend to notice it much.  I notice the tenderness of the spot on my lateral tibia where they took the bone more than anything.

10 years and doing well.  That has a very nice ring to it.

On the workout front, yesterday was a very good day.  I was able to do resisted one leg romanian deadlifts with no pain and no "help".  It was awesome  :D

Take care,
Room 101


Title: Re: Room 101's December 2, 2008 ACI (May 29, 2009 update)
Post by: slyguy1 on June 29, 2009, 01:57:08 AM
Hi Room 101,

                   I am assuming your other knee is good and strong which i also think makes a difference in supporting overall success. That is great that you are still improving and you are on your way to more success. A concern i always had was doing leg extensions....correct me if i'm wrong that almost all protocol is against doing them. For me i always felt better doing them even in the past but now i am doing them at high reps but at low resistance. Just the other day at the gym i did as much as i could one leg at a time. I don't extend the leg all the way just about 3/4 and try to control form....i get a better pump than i do with any other exercise...i really feel the burn. I've been consistant with my workouts last week and i had less pain this weekend. Maybe my new MBT shoes are also helping as i do feel better with them on. I sometimes forget to take my supplements of fish oil and that glucosamine stuff...have to improve on that. How does Dr. Cole feel about supplements? I hope you had a good weekend...here in the east it was more summerlike with a bit of mugginess but it was ok after all that rain...take care:)

Sly
Title: Re: Room 101's December 2, 2008 ACI (May 29, 2009 update)
Post by: Room 101 on June 29, 2009, 10:59:15 PM
Hi, Sly!

Honestly, my other knee has the same issue.  ::)  I have had multiple scopes on it.  It does not dislocate as often as my other knee, but it hurts and grinds just the same.  I am getting to the point where I am having problems pushing a hard workout due to the "good" knee hurting... but I just ice it and go on.  We'll just take that a day at a time.  I'm not thinking about it at this point.  I'm great at ignoring things.

Leg extension... I have not done one since about 1999, and I don't have any plans to ever do another workout which includes them.  It puts so much pressure on the knee joint, and there are many other ways to accomplish the same result.  It hurts me thinking about extensions.  ;)

As for supplements, I do take them, but I actually go to a family doctor who has a more holistic approach. He's an MD, but has a bit of an alternative flair, so I was taking those supplements already. I didn't discuss with Dr. Cole beyond how some would affect medication, etc. To be honest, I am also friends with a chef, and she helped me with a post surgery nutrition plan as well. So, i went through every angle, hahahaha. I am a dork.

To be completely off topic... I had the best weekend. Since I was laid up over my birthday, my hubby gave me the best possible gift. I got all my best friends together, 6 of us total out of 8 were able to make it. We have been friends since first grade or younger. They came to stay for the weekend, and my hubby did the cooking so I could do the talking, hahaha. It was absolutely fantastic. I am in a stupor today from no sleep and too much laughing.

Take care, and have a great week!

Room 101


PS - I still gotta look up those MBT shoes.  I don't know what those are.  I wear the Under Armour shoes, and they have been great for me.
Title: Re: Room 101's December 2, 2008 ACI (May 29, 2009 update)
Post by: courtem10 on July 01, 2009, 07:31:48 PM
So I had an interesting conversation with my physical therapist on monday that basically threw me into a nervous tailspin. We were just chit chatting about my recovery and progress. I was telling him how it's easy for me to get frustrated, and he reminded me that I have to be patient and that I'm right on track. So then I started asking him about my specific time frames for runnnig and sport, etc...bc he was saying that I may be able to start the eliptical next week. Well anyways, he then tells me that I am right on track to be running now if my knee were feeling back to full strength and that sports were to follow. My mouth dropped and I shockingly asked him how that was possible that my cartilage was already developed, and that if I began doing those exercises too soon the cartilage development would be compromised. He told me that according to the rehab protocol it said I was fine, but his rehab is only based on the AMZ not the ACI. Not to mention, through my own extensive research I know that patellar ACIs require more rehab generally as they are a harder area than the typical femoral condyle. Anyways, he told me that was something I needed to ask my doctor because he wasn't aware of this. So I immediately put a call into my doctor the following day- he was in surgery, so I am still waiting for him to get back to me. But now I am so leary of physical therapy bc I know none of you people out there started running anywhere near this point, and some of you still aren't doing it after almost a year's time. We will see what doc says when he calls, but I'm certain he is going to affirm my opinions. Luckily he is in the same building as physical therapy so they can discuss and work together on things like this. I just want everyone to get on the same page. God forbid I go out and start doing this running or whatever and I destroy my developing cartilage. I'd be completely screwing up my knee, and I don't ever want to have to go through this again on the same knee. Speaking of repeat torture- similar to room101- I am already starting to feel the same symptoms in my good knee. :( I know it's only a matter of time before I go down this same road with that knee. Why aren't our bodies more durable to be as active as we like?? :(  And to make matters worse- we are experiencing yet another violent storm here. I'm beginning to think summer is being completely bypassed this year.

Courtney
Title: Re: Room 101's December 2, 2008 ACI (May 29, 2009 update)
Post by: slyguy1 on July 01, 2009, 09:47:01 PM
Hi Courtney.......as soon as i read your post it got really overcast as if it's gonna pour down any second....i have a feeling we will make up for this with extreme heat later on this summer. Just like finding a good OS finding a good PT is also a challenge. That's incredible how he would be saying that it was ok even with a femoral defect i would wait at least a year before attempting anything like running. It's a bummer that those of us are genetically inclined to go thru what we are going thru. Are you still getting that pain you had mentioned before? I am curious if your OS has scheduled a follow-up MRI to get an idea of how your healing is going. I would repeat the famous mantra "patience is a virtue" and wait it out...curious as to what response your OS is going to give you...one good thing about summer and heat is that it is better for the knee than the bone-chilling cold....take care
Title: Re: Room 101's December 2, 2008 ACI (May 29, 2009 update)
Post by: Room 101 on July 02, 2009, 10:07:47 PM
A knowledgeable PT is important for sure.  My PT had worked with ACI/AMZ patients before.  I was very comfortable.  It's hard to be patient.  I feel like my body wants to go go go, but my leg strength is still not there, and I can tell when i do certain exercises.  We keep making steady progress, so that's all I can ask for.  It's been 7 months for me, and I can't imagine running, although it's been so long since I could... it's great if you feel like you could run at this early stage... I am no where near ready!!  Hopefully the protocol is straight forward enough to let you know what should & shouldn't be attempted.  I do know that it does no harm to try things, and if my leg isn't ready it tells me... and I know I won't hurt it long term, unless of course some crazy accident happens like falling down stairs or twisting it crazily for some reason...

It's an ugly thought to go down the path again, and I try not to think of it... but can hardly help it when it hurts me or gives out on after working out... we are all sooooooooo lucky  ::)

Take care Courtney & Sly and let's all keep our eyes on the big prize!!!


Take care,
Room 101     
Title: Re: Room 101's December 2, 2008 ACI (May 29, 2009 update)
Post by: courtem10 on July 06, 2009, 03:24:19 PM
Well after my previous conversation with my therapist and the call I placed to my doctor, my doctor called me back over the weekend to speak to me personally about my rehab. He told me that on Friday he had met with my 2 physical therapists to discuss my protocal and gave them specific things they needed to research regarding my case. He also said they were going to have a follow up discussion on Monday (today) to make sure everyone was on the same page and that nothing was being done incorrectly in therapy as to jeapordize my recovery. This conversation really reassured me, and now I am confident that my knee will be taken care of. I have therapy again tomorrow, so I should get more clarification as to the specifics of the conversation between my therapists and my doctor. Aside from that, I am still having the pain behind my knee, but it seems like it's another by product of all the swelling. My doctor typically doesn't do any additonal MRIs to measure the progress of the developing cartilage, but I am sure if I was in excessive pain he would want to investigate further. For now it is tolerable and seems typical of this stage. Obviously I will monitor it and if things worsen- bring it up. The warm weather is deffinitely better on my AMZ site- the cold and rain really increase my pain :(  I agree on not trying to think about repairing my other knee, but like you said, Room101- it's hard to do when you're suffering through workouts and things. Not to mention, it seems to be getting worse now since that knee has had to bear the burden while my other knee recovers. Do you guys think ACI is something you would consider in the near future on your other side?? Or would you rather live with the pain after going through it once??

Take care,
Courtney
Title: Re: Room 101's December 2, 2008 ACI (May 29, 2009 update)
Post by: Room 101 on July 06, 2009, 10:58:49 PM
hi, Courtney.  I am glad you got things square between your OS & PT.  That is important.  Hopefully the coming weeks will bring less swelling and the behind the knee pain will go away.  I briefly had some swelling back there.  it didn't hurt me much, but I did ice the front and back side of my knee for a week or so.  It is crazy how the weather makes the AMZ site achy.  I don't miss that  :P

You have asked a really interesting question about getting it done on the other knee.  To be honest, I go back & forth.  Some days my other knee hurts a lot, and now that I've been through this once and I know what to expect and I feel comfortable with my OS and PT... some days it seems like a good idea to pursue more details... and then there is my alter ego that realizes how fortunate I am to have had a fairly smooth ride so far and who also understands the risks and questions on whether it might fail, and that this has been a very long and expensive trip... for one knee.  So, my answer is a solid, absolute "I don't know".  that also tells me my other knee is not bad enough  ;D  -- I was begging for mercy before the last surgery.  I think it was driving me insane to be so useless.  Also, I am only 7 months post, so I don't have a good indication of success, even though today it feels like a grand success.  I am not counting my chickens yet.  I know i have a lot of work ahead of me still.

This weekend rained out Saturday, which was ok.  We had family over starting around lunch, so i didn't do too much activity.  Sunday was absolutely beautiful.  We walked the dogs on a 4 mile walk, and then we took a 5 mile bike ride.  I felt absolutely great afterwards.  I had no swelling, the mildest of soreness, and today I woke up with my knee feeling fabulous.  That is a great sign.  I am really noticing an increase in strength, and I am looking forward to my workout tomorrow.

have a great week, and hope you all had a nice weekend.

Room 101
Title: Re: Room 101's December 2, 2008 ACI (May 29, 2009 update)
Post by: Hathor on July 08, 2009, 07:03:58 AM
Hey 101, sounds like you are going great. I have also been pleased with my progress and am now at 7m 1week (not that I'm counting or anything). The last couple of weeks have been really good. Having said that, I went go karting a few weeks back with some friends and was reeeaally sore for a few days after 15minutes of racing. Karting should be added to the list of things not to do until 12months !! >:( I didn't feel any pain while driving but felt it afterwards. I think it was from hitting the brakes hard going into the corners. Suggest anyone else with patella defects steers away from this activity until 12m.

Since then though, I have been progressing well. I can now do back to back days of bike/rowing cardio and not feel sore (muscle or defect). I am still going easy on the amount of resistance but building up a notch at a time over the weeks. I was over the moon last week end when I passed an old couple on their mountain bikes ;D.

Other than the cardio, my routine still consists of the same SLRs, swiss ball wall squats, leg press and one leg bridging and cycling with one leg. All very tedious and boring but mandatory for at least another 5 months. I'm hoping that when I can get back to pre-op cycling levels I should be able to cut all this back as the riding in the hills and in big gears works all the quads and hamstrings. I was watching the riders & their quads in the Tour de France with envy yesterday.

How have your ITB's been. Have you tried that stretch I suggested. Also, be careful that the saddle height on your bike is set right as, if it's too high and your hips are rocking even slightly, this will really tighten the bands up.

H
Title: Re: Room 101's December 2, 2008 ACI (May 29, 2009 update)
Post by: Room 101 on July 08, 2009, 07:52:03 PM
Hi, Hathor.  Good to hear from you.  It's been a while.  It sounds as if things are going well for you.  Interesting read about the karting.  My hubby and friends have been trying to get me to go to this cool place by us.  Now I know I shouldn't for a while.  It did seem pretty intense, and I am a very careful person with this rehab... I was being careful  and then i saw the bills and I became even more careful, hahaha.  All I can say is WOW!  :o

I was super excited when I awoke Monday after doing the 8 1/2 miles walking/biking and I was not sore in the least bit.  It feels really good, and it's hard to hold back at times.  I am still doing my same routine pretty much.  On days I lift I only walk a mile or so at night, and on the off days of lifting I bike and walk.  I'm not doing the one legged things you talk about, although I did attempt your ITB stretch... not sure I did it right though  :P  -- I haven't needed the Graston torture from my PT in a few weeks now.  I have stayed loose, which is also positive. 

Yesterday at my workout I was able to do an exercise I hadn't been able to do before without assistance.  If only I could explain it... It was exciting and I hurt a little afterwards.  Today I am a bit sore in the knee, but it's dull so it's nothing.  I just got tired because I felt nothing until I was nearing the end of my second set.  I cut the reps from 8 to 5 on that set.  I just need t gain endurance.     It's so tedious, haha.

So, Hathor... since I am not anything more than a casual biker, is there a system for setting up the seat height?  I'm pretty sure we measured seat height.  A friend of ours made us bikes a few years back, and I know he did a couple things to help the torque on my knees, but it would be ideal to know if my seat height is good.  I feel good, but that doesn't really mean much  :P

Thanks, and good to hear from you!

Room 101
Title: Re: Room 101's December 2, 2008 ACI (May 29, 2009 update)
Post by: Hathor on July 10, 2009, 04:55:26 AM
101

Setting the saddle height can get quite complicated and depends on the individual and the type of bike but the basic rule of thumb (and easiest) is when sitting on the bike and with your foot on the pedal and pedal at it's lowest point you should have a slight bend in the knee. A low saddle will work the really quads hard and will aggrevate the front of the knee, a saddle too high normally rocks the hips, pulls on the ITBs and causes pain at the back of the knee.

If you like maths, the saddle height should be a function of the length of the inseam of your leg and should sit between 105% and 109% of your inseam length (ie crutch to bottom of your foot with shoes on).

Note this is not an exact science but if you change your saddle height, do so in small increments as the body takes time to adjust. (change in saddle height changes reach to the handle bars so it has bigger impact on the body than you might think).

Good luck.

H. ;)

Title: Re: Room 101's December 2, 2008 ACI (May 29, 2009 update)
Post by: Room 101 on July 11, 2009, 12:16:31 AM
Thanks, Hathor :) -- I will check that out over the weekend.  I recall doing something like that when the bikes were made.  Like I said, our friend makes custom bikes, and he did ask for all kinds of measurements.  It has been a few years though I don't think I am old enough to shrink quite yet  ;D

I asked my trainer what the crazy exercise was that i don't need assistance on any longer.  He calls it a suitcase deadlift.  I alternate picking up and setting down a kettle bell.  When I work the surgery leg, I set the bell on a 4" step, and on my other (I hesitate to call it good) leg, I set it down on the floor.  You drag your foot backwards and extend that leg fully behind you, lifting so the heel is about as high as the other leg's knee.  the kettle bell sits right next to the planted foot.  It's pretty crazy, but I already felt stronger doing that move today then Tuesday.  It's pretty sweet.  the best part was how sore I got in the glutes, hahaha.  I love being sore after a workout!!!!  good sore, obviously... not knee sore.  No one likes that  ::)

have a great weekend all,
Room 101
Title: Re: Room 101's December 2, 2008 ACI (May 29, 2009 update)
Post by: momhanaway on July 15, 2009, 04:12:46 AM
Glad to hear that you are doing well!  I haven't been on here in a while, so I have a lot of catching up to do reading the posts.

Momhanaway :)
Title: Re: Room 101's December 2, 2008 ACI (May 29, 2009 update)
Post by: Room 101 on August 04, 2009, 07:38:04 PM
So, I figured it has been quite a while and I'd give an update.  8 months for me was August 2nd.  Hard to believe, to be honest.  Things are still progressing well, although I am doing the same cardio I was before.  Long walks, 6-8 mile bike rides and the stationary bike on days it's raining.  Overall, I feel really good.  Most days, I don't think about stairs or walking or anything of the sort.  I had a rough week back in July... I don't know why it hurt or why i struggled, but going down stairs started bugging me... it went away when I babied my knee a bit.  I don't notice any swelling anymore, and in fact I hardly think about icing it.  My right knee is starting to officially be more of a burden.  I'm looking forward to being able to ramp up the workouts.  I keep making improvements, but I don't see the OS until end of October.  I assume I'll be more free to increase intensity at that point.  I have a lot of work to do in my mind to get there.

As for my workouts, I have progressed to being able to do weighted dead lifts and weighted Romanian dead lifts.  I have managed to do a slight pistol sit downs at a very slight angle.  I usually try them once per week.  I wasn't able to do them 2 weeks ago, and last week my good leg was better than my other leg.  I took that as a real positive.  Friday is my day for that exercise.  I don't seem to tweak my knee while working out any more either.  That just kind of went away at some point.  It's weakness that stops me now and not pain.

I lift 3 days per week, and do longer cardio 3 days per week.  I always take one full day off at some point... Usually I need it after one of my training sessions. 

Hope you all are doing well.  I don't really have much news, and I am thankful for that...

Take care,
Room 101
Title: Re: Room 101's December 2, 2008 ACI (May 29, 2009 update)
Post by: slyguy1 on August 05, 2009, 04:01:48 AM
Hey 101......thanks for the update....sounds like you are improving still with time....really happy that you are a success. As you are probably aware....there are a lot of runners out there hoping to be able to do it again someday...myself included. Did your doctor doing the surgery ever mention the ability to ever return to running? I am just curious cause i've been told by an expert that the ACI alone is one thing but with an osteotomy....running is totally out of the question. I've already accepted the fact that i will never run again but for those hoping with ACI or MACI which includes osteotomy....may have to rethink their goals. Has anyone ever come across any info on that piece of info? I've also been informed that the stem cell procedure is a waste of time and a whole lots of money.....which is why it is still not FDA approved. Thanks for any comments....keep up the good work out there:)
Title: Re: Room 101's December 2, 2008 ACI (May 29, 2009 update)
Post by: courtem10 on August 05, 2009, 04:42:04 PM
Hey Slyguy,

I am about 4 months out from my ACI & osteotomy and my doctor has total confidence that I will be able to return to running after this procedure. Based on our discussions, it shouldn't happen for quite a while- maybe 1-1.5 years after the surgery. However, I really trust his oppinion and so far things are moving well. Plus I am young (26) and was a college athlete and continue to be very active. So with all that working in my favor I have no reason to doubt my return to athletics and running. I am curious what doctor gave you this info about not running ever again?? What area was your ACI done on??

On another note- I have reached yet another roadblock with my stupid insurance company and this surgery. I have gone to 17 physical therapy appointments in the last 4 months. My insurance company specifically says they will cover a maximum of 60 visits per calendar year. However, they have now denied coverage for any futher visits for my rehab- claiming that I am back to my pre surgery condition. I am outraged as I still have frequent pain, and obviously am not back to normal as the only activity I can do is ride a stationary  bike for 10 minutes w/o resistance. Not to mention the strength on my surgery knee is only about 25% of my good knee. So hear we go again with appeals I am assuming. It's so bogus. Everybody who has gone through this knows what a lengthy rehab this surgery entails. I'm just so fed up at this point. :((((

Courtney
Title: Re: Room 101's December 2, 2008 ACI (May 29, 2009 update)
Post by: slyguy1 on August 06, 2009, 05:49:50 PM
Hey Courtney,

                  I'm sorry you are having insurance issues....i think most people with this procedure have similar issues. I went in with meniscus tears on both knees and opted to do one knee....even though they wanted to do both. I am so glad i chose one and that being my stronger right knee. I came out of surgery and woke up in a wheelchair....the nurse told me i had microfraction done....i had no idea that they were going to do that. Anyway, you know most are not successful....it's been over 3 years and i am currently waiting to get another MRI done in Sept. I used to be an athlete in school and later a rec. runner. I recently spoke to a runner....female....32 years old...running since she was 7 years old...a competitor. I did not get the specific details but after 4 surgeries she is at a dead end....i asked her about ACI and osteotomy. She was told by her OS that ACI is ok and may be successful but the osteotomy part makes the ability to run impossible b/c the bone is compromised. That's only one doctors opinion and may not be true.....have you heard of anyone having the same procedure done and get back to running? I am thinking the ones that did run again only had ACI only....without any other procedure done previously.

Prior to my surgery....which was on the arterial femoral condylte about the size of a nickel according to my OS....i wish i had waited just a little longer and had straight ACI.....i would've been better off right now even if i did not run again....at least it would last longer. I went to a cartlige expert OS a while ago and he just looked at me and said i know i have to break your leg to correct the allignment and would not answer a few questions i had going in for my appointment....15 minutes....150 dollars....i never went back to him. I did not get the bill yet but i probably will in due time since i have a deductable with the insurance. Anyway, hang in there....all this will pass and you will be doing a lot better...
Title: Re: Room 101's December 2, 2008 ACI (May 29, 2009 update)
Post by: Room 101 on August 06, 2009, 05:56:47 PM
Hi, Sly! Running... I haven't been able to run a mile for a good number of years. I don't miss that too much :P - but I digress

I believe running is actually part of my OS's rehab. I was under the impression anything was possible if the ACI/osteotomy were successful. I couldn't walk 1/2 mile before my surgeries, so everything from here on out for me is a bonus. Having said that, I fully intend to get back to sports. Like Courtney, I was a college athlete and mentally I haven't been right since my knee became so wrong.

I will be absolutely thrilled if I can play competitive softball and golf again. Throw in volleyball & basketball for a total bonus. This whole knee thing has really given me a lot of perspective on where I want to go athletically. I guess I have come to terms with potentially a less than ideal activity level for me... but if I have a good, solid moderate activity level I think I will be happy. I can do 10 miles worth of activity in one day now where I couldn't do 1/2 mile before. That's awesome. I would love to throw in mountain hiking and perhaps a mini triathlon or something, but I am still taking it one day at a time.

I have read too many instances on this board where failures occur very late in the game, and I am not counting any chickens. I will continue to work hard and do more as my knee allows. We'll see where the threshold is when it happens.

One day at a time is my thing. I am merely happy at this juncture to be seeing improvements. I need to still get strength back in that quad. It's amazing how hard I work and how little it seems to come back. I had read that on here quite a lot, but it still surprises me.

This is all still new to me, and the ending is a mystery.




Courtney, sorry to hear of your insurance woes. Hope it all gets worked out. You're 4 months out. Wow! I know I still had some pain at 4 months. I think that was a bit of a frustrating time if I remember. Feeling I should be able to do things, but it hurt. Sounds as if you're doing quite well in spite of bogus insurance probems... keep doing what you're doing, and it's great to hear from everyone!



Take care,
Room 101
Title: Re: Room 101's December 2, 2008 ACI (May 29, 2009 update)
Post by: runnerbeth on August 10, 2009, 06:26:40 PM
Slyguy,

I had both ACI and an osteotomy and have been able to return to limited running.  My ACI was on a patella defect (result of a soccer injury) and the osteotomy was used to take pressure off the area and correct some minor preexisting alignment issues.  I was previously a fairly serious runner - multiple marathons and frequent 5k/10k races.  My doctor basically said he wouldn't run again if it was him (risk vs. reward) but agreed that limited miles would be ok.  He never mentioned the osteotomy specifically causing problems for running.  He was more concerned about the patella defect.  (FYI, I also had a failed microfracture prior to the ACI/osteotomy.)

I haven't returned to the level of running that I hope to eventually, but that has been primarily due to other (non-knee) reasons.  (I have an 18 month old who keeps me very busy and I'm currently pregnant with my 2nd child and do not do any running while pregnant due to the extra weight.)  Next year I hope to get back to a level where I can run a few times a week and race a 5k once or twice a month.

Feel free to send me a message if you have any questions.

Good luck!
Beth
Title: Re: Room 101's December 2, 2008 ACI (May 29, 2009 update)
Post by: Peg Leg on August 11, 2009, 01:13:04 AM
Slyguy,

I had an Osteotomy 10 months after my ACI to my MFC, due to a worsening problem with a patella defect.  It was an attempt to buy me some time and pain free walking.  My Dr. told me if the surgery was successful, I could be jogging ( I am NOT a runner!) in 6 months.  He said once the bone healed that jogging would be fine along with my other interests.  Unfortunately, I never got to the point that I could test that theory; now that I've had a replacement, I suppose my running days are behind me.

Courtney, my Ins. is a b***h to work with, too.  My PT says it's the worst company he's had to deal with ever!  You would think that if they agreed to pay for the surgery, they would want to fully rehab you, but no!  I've had 6 surgeries in 2 1/2 years, the last being a replacement 6 weeks ago, and they still approve visits in lots of 3 and 4!!  It gets to be so frustrating!!  Hang in there and make sure your PT documents everything; don't give up!!!

Room 101, keep up the good work!  I'm really glad things are going so well for you. Keep working on the quad; I think they must be very shy and really need to be coaxed to come out of their shell!!  I think mine has a phobia of some sort and is totally freaked out by being seen in public!!

peg
Title: Re: Room 101's December 2, 2008 ACI (May 29, 2009 update)
Post by: Hathor on August 30, 2009, 11:24:09 AM
Hi all

It's been a while since I've been on this board, mainly as I haven't had too much to report. I saw my surgeon last week for my 9 month check up who was v happy with the progress in my quads and general movement in the knee. I get a bit of catching/crepitation  (pain free) which he said will need scoping in a couple of months and perfectly normal with patella overgrowth.

The knee has been really good. I am doing most ADL's without even noticing the knee and even when I push hard on the exercise (bike/rowing) it is pain free ;D. Without getting too carried away, I actually believe it feels way better than the ACI first time round (3-4yrs ago) at this point so am feeling pretty optimistic.

Hope you are all doing well.

Hathor
Title: Re: Room 101's December 2, 2008 ACI (May 29, 2009 update)
Post by: jonhark on August 31, 2009, 04:29:35 AM
No news is great new Hathor!!

I'm on a similar path as you it seems. I have some popping and crepitus over the defect. I had an MRI which revealed a band of scar tissue and overgrowth. I'm going to hold off on the scope for now as I'd like to wait until 12-18 months before they go back in.

I have no swelling, warmth or major pains these days. I will get occasionally sore if I do too many stairs throughout the day---especially down stairs.

I've recently started doing the rowing machine, elliptical and some more resisted biking. My knee has responded really well!!

My thoughts are the ACI process is a little longer than MACI as the cells are less mature than the MACI process. My other ACI has really taken the full 2 years to get to a pain-free level. In the end the results should really be about the same as they are the same chondryctes that are harvested from your articular cartilage. The really interesting stuff is the work Zimmer is doing on neo-cartilage. Apparently it has an advantage over more mature (more-worn) adult cartilage.

J

Title: Re: Room 101's December 2, 2008 ACI (May 29, 2009 update)
Post by: Hathor on August 31, 2009, 11:32:33 AM
Hey Jonhark

Good to hear you are also going well. I have been doing some rowing but no more than 10mins at a time and I'm trying to not bend more than 90-100d on each stroke. How much rowing are you doing and are you going easy or hard? Have you had any specific instructions on what you can/should do as I can't find any literature on rehab protocols re rowing, seems to be plenty on cycling.

I used to row 30-45mins on the ergo and long to get back to it as an alternative to cycling on my days off.

H
Title: Re: Room 101's December 2, 2008 ACI (May 29, 2009 update)
Post by: Redleg on September 06, 2009, 11:32:09 AM
Rm 101 and others, really great to read all your comments and your progress. Well done on being so positive.

I've been reading them for weeks amongst others in my buildup for the op which happened on Friday (today is Sunday). Right at the beginning (what an awful thought). Just got home and somewhat overwhelmed by the lack of mobility and how on earth Im going to stay calm and non weight bearing for weeks and weeks etc. Its clear from reading that everyone is different, surgeons etc all have different regimes and not to rush it. My op was an extensive one, large defects in two locations care of dislocated knee via a sport injury in 2000 and a extensive ligament reconstruction in that same year. Im 43 and still pretty active. The ligaments were well strung and these have allowed full range of skiing and other sports, but Ive concentrated on swimming and cycling to avoid the impact effects.

Today the knee is sore and somewhat swollen, but not infected, and my surgeon is pretty simple about it. No weight on the leg, and no knee bending, a range of simple isometric based exercises and come back on Wednesday. All sounds fine, but I do think he will be keeping me to this discipline for a long time given the particular position and severity of my defects (Ill write later when I have a more accurate description of them).

No real questions yet, I guess they will come over weeks ahead. I do get confused reading everyone's progress and live hour by hour at the moment with the terrible thought of slipping and putting weight on my leg. In the meantime just trying to work out how to do all the personal basics (and aren't they fun..!), avoid driving my wife nuts (failed already and Ive only been home 5 hours - we also have two young children..), and how to work from home for the next month..!

Look forward to chatting. Any suggestions on how to get through the first two weeks all welcome.

Chrs

Redleg
Title: Re: Room 101's December 2, 2008 ACI (May 29, 2009 update)
Post by: Rennschnecke on September 07, 2009, 12:05:36 PM
Welcome to the Club, Redleg!

For me the first 2 weeks went by in a blur of CPM plus a few other exercises from the PT.  As some others have suggested, I just made sure that I had a table nearby filled with goodies, e.g. drinks, a cup, books and tissues.  Also kept a box by the side filled with all sorts of snacks (I like to have a selection :)!).  One suggestion I didn't use was having a flask of hot drink nearby, but it would have been useful.

I didn't manage to do any work 'cos the table would bang into my knee if I had it at a useful height for the laptop.  But that's because I'm a shortie!  As a result, I spent lots of time watching TV.  Got to be an expert at Channel hopping.  I've never done that before, so I can now chalk that up as a new experience.  I heard that some people signed up to Internet film providers etc.  Because of the set-up for my CPM, I couldn't really do much other than read a bit and watch TV.  If you have kids, you could get them to play some board games with you to break things up a bit.

How to avoid driving each other nuts?  Not sure I can advise as I wasn't too good at that.  Maybe see if people can drop by for short periods.  I had people dropping in for a bit longer than I could manage and still do CPM etc., so got moody.

Oh, and keep icing.  I didn't do it so much as I felt quite good, but that may have promoted the formation of adhesions which I am now paying for.

Good luck with the rehab!

Title: Re: Room 101's December 2, 2008 ACI (May 29, 2009 update)
Post by: Hathor on September 07, 2009, 12:06:34 PM
Hey Redleg

Welcome to the world of dodgy knees in rehab !! My usual advice for the early stages is to take it real easy and as you will have read.....most of all, be patient. It's easy to say this now, but when you look back, boy does time fly !! Your first milestone is 6-8 weeks for weight-bearing so keep focussed on that.

Feel free to send questions through, there are plenty of seasoned patients on this board who will have answers to anything you want to throw out there.

Hathor ;)

 
Title: Re: Room 101's December 2, 2008 ACI (May 29, 2009 update)
Post by: Redleg on September 27, 2009, 03:40:03 PM
Hey, Hathor and Renn, thanks for the responses and words of encouragement. I've now finished week three. Sick of tv, sick of my laptop, sick of my emails, but the one good thing has been being in and amongst the kids every day (been working from home). "Daddy has a boo boo on his knee" is the explanation to visitors.. After week 1 have been constantly crutching about, however no weight bearing or knee bend at all so not very elegant. Key has been plenty of ice (Renn - got to agree here) and plenty of the allowed exercises although they drive you mad with the repetition. I also bought one of the electronic pulse muscle twitch machines so I could apply that to the inner quad muscle and keep that active, although even with tilted leg raises etc its in pretty dismal shape. i use it three times a day now.

I cant do any CPM as the lesion under my kneecap would be affected so its simply leg raises, quad tightening, toe twirls, leg swinging, rubber band on the toes, and recently squeezing the thighs together...! See the Doctor tomorrow and I guess Im hoping for some relaxation of the knee bend to 20 or 30 degrees, and potentially he go ahead to get into the pool soon just to start a bit of deep water walking and hopefully within a few weeks some freestyle without kicking. Maybe Im too optimistic, but over the next month anyway. We live in a condo block so have a pool in the grounds which makes it easy access.

Mental things gets to me. Just feel useless hanging around each day and missing all the usual things.

Tip of the day from me to anyone reading has to be using a bean bag (very well stuffed) next to the chair I sit on to rest the straight leg upon. Needs to be well stuffed to get the right height and keep support for the leg.

Exercise tip has to be getting into straight leg lifts as soon as you can without waiting more than a few days when the swelling loses its intensity so you dont lose that ability to keep leg lifts going and keeping them going, all day, every day, whatever you're doing... until it becomes second nature. Either lifting the leg or twirling the toes to keep the calf active and blood flowing almost continuously. Guess you have to check with your doctor on this as from reading some posts there are some different rules for diff cases.

Other thing was to have some stretch bands (pref the ones with handles on) for toe extensions to work calf muscle, but also for upper body exercises when you are just watching tv etc. Also found a couple of 1 - 3 kgs soft grip gym balls (trainers use them) with which I could invent arm and shoulder exercises with as I sit watching tv or talking to my wife. Just anything to keep a bit of activity.

Diet. Get the fish oils in, stay off the carbs, plenty of meats and protein, try a multi vitamin regime, vegetables, salads etc etc etc.. and off the fats (unfortunately). No alcohol if you can avoid it..!

Getting my hair cut with a No 2 razor the day before surgery also reduces the need to get to the hairdresser to early on in the recovery process..!

Finally, wound is healing, skin color is looking fine, swelling right down (not gone though), doc's happy and physio's happy, and wife almost round twist (like me) with the 'third' child around the house..!.

Hathor, no real questions at the moment but will keep you all posted.

Chrs,

Redleg
Title: Re: Room 101's December 2, 2008 ACI (May 29, 2009 update)
Post by: Rennschnecke on September 28, 2009, 12:45:58 AM
Hi Redleg

Glad to hear that you're surviving this rehab extravaganza! ;D

I agree with you (and many others on here) that the biggest challenge is the mind game.  I guess that's because we already know the pain game :(.  Now approaching Week 14 p/o and recalling that the greatest challenge when having a life change (and that's what ACI rehab feels like) is establishing a routine.  I don't know how you've been doing things, but my routine has been totally disrupted (not helped by Junior being at home sick this last week).

I know that the rehab protocols vary because of location of defects, size etc., but I had a CPM from Week 1 p/o with patella and trochlea 'kissing lesions' (2.8 x 2 cm2; 3.4x3 cm2).  Nevertheless, I appear to have developed adhesions so going in to sort this out on Tuesday.  I was just told that some people are loose and some stiffen (biology) so here's hoping that you're one of the 'loose' people.

BTW: you may want to keep a diary of all the positives you are experiencing so that you can look back at it when depressed to stem the negative spiral that can take place.
Title: Re: Room 101's December 2, 2008 ACI (May 29, 2009 update)
Post by: Redleg on October 01, 2009, 02:51:34 AM
Renn,

Thanks for your note.  Today (almost 4 weeks post) just had my first pool session with therapist, first weight on leg (under water), leg movements, small steps etc, slight bending to 30 deg, floatation aid between the legs and did a few laps of the pool in freestyle.  Wow.  Not exactly Baywatch, but what a great feeling to throw off brace and get in the water....!  Therapist thinks twice a day from now on okay pending any pain, swelling etc of course..   Amazing though how quickly you loose strength and fitness.  I could really notice my heart rate etc on small stroke activity.

Re the looseness..  its stiff at the moment that's for sure.  really tight at 30 degrees, but sure this normal and hope the bigger degrees similar.   

Cheers,

Nick

Title: Re: Room 101's December 2, 2008 ACI (May 29, 2009 update)
Post by: Rennschnecke on October 04, 2009, 01:02:29 AM
Great news about the water!  Your world has just expanded!  I think of ACI rehab as akin to a baby's development.  You have to learn to walk, then explore etc.  I also approach rehab as for conditioning training 6 week blocks increasing range etc. as appropriate.  I guess it creates the illusion that I'm still in training, but hey, whatever it takes to get through I suppose... ;)
Title: Re: Room 101's December 2, 2008 ACI (May 29, 2009 update)
Post by: Room 101 on October 06, 2009, 11:02:20 PM
Hey people!  Man, I haven't been out here for quite a long time.  Redleg & Renn, it's nice to "meet" you here, and I hope it all keeps going well for you.  The mindset with this surgery is a very tough obstacle.  I also struggled with being "useless" and watching everyone do everything for me.  It has been just over 10 months since my ACI.  I really felt like I had hit a wall, but I think it was the mental bug because the improvements are still slow and steady. 

I don't have any lasting pain or swelling, although I can certainly still overdo it easily.  The biggest encouragement for me was the last 2 weeks.  We were away on vacation.  We drove from Chicago to Boston, coastal Maine, new hampshire, vermont and Philly.  One of the highlights was seeing the Patriots play Atlanta.  I am a huge Pats fan, misplaced in Bears country.  Bleh.  It was outstanding.

As for the trip, we did so much walking.  We walked the Freedom trail round trip (twice).  the first days guess is walking 7 miles and basically being on my feet with no break for 7-8 hours.  Then, I climbed the 294 steps up the Bunker Hill memorial... which was done mostly as a knee test.  I felt great, and what I felt was tired quads, and I ended up coming down one leg at a time instead of normal stairs, at least half the time.  After the stairs, we walked back down through Boston again.  We also wandered around Harvard University on that day.  I was proud of the fact that we walked everywhere and never took a bus or cab or subway. 

When we got to New Hampshire we did a 3 mile hike up the Flume Gorge (plus a couple more hikes in not very hilly places).  Lots of up & down hill and some stairs.  My knee held up great.  I could have done more.  I think that is a huge sign of progress.  I had absolutely no stiffness in the car, either.  We did 12 & 13 hour rides to get across country.  I didn't really work out while on this trip because we walked so much. 

As for my workouts, we are still working tons of dead lifts and Romanian dead lifts and beginning to really push into the very beginning stages of lunging.  We always take it to the limit of pain, but keep the exercise pain free.  Even if I get sore, it is always gone the next morning.  I think that is the most encouraging sign actually.  My right knee now officially hurts way worse than my ACI knee.  yippee!!!

So, the summary is I have been hiking in the hills, walking for long distances, sitting in the car for long periods of time, climbing a ton of stairs, and I have had minimal swelling, no popping or cracking, little to no pain and recovery is always fast.  My hubby was more sore than I was after all the hiking & walking!

So, my next Dr. appointment is the end of this month.  I feel like it's going well, but I will continue to work in the pain free range and hopefully push to new workout limits.  My quad is still inferior, but I can see improvement so will keep working it out.

Take care all, and have a great week.  I hope to not be so vacant from this site.  I want to catch up on everyone's status!

Room 101
Title: Re: Room 101's December 2, 2008 ACI (October 6, 2009 update)
Post by: courtem10 on October 07, 2009, 03:39:13 PM
Wow, Room101!!! That's incredible to hear about all your adventures on your trip, and I'm so happy for you that the knee is really starting to come along. Keep it up. Go Pats!! I'm a die hard fan

Courtney
Title: Re: Room 101's December 2, 2008 ACI (October 6, 2009 update)
Post by: ajschnelk on October 07, 2009, 04:21:37 PM
Wow, that's amazing!  and to think you couldn't even walk pain free 11months ago and now you're hiking and doing stairs with no pain.  Glad to hear recovery is going well. 


BTW, Go Colts! ;)
Title: Re: Room 101's December 2, 2008 ACI (October 6, 2009 update)
Post by: Room 101 on October 07, 2009, 06:40:24 PM
Go Pats is right!  Last week's game sounded crazy!  I heard the last quarter on the radio driving back to Illinois!  Whew!!

asj - go Colts?  How did that happen  :D
Title: Re: Room 101's December 2, 2008 ACI (October 6, 2009 update)
Post by: Rennschnecke on October 10, 2009, 01:18:23 AM
Room 101 it's great to hear your story.  I find it quite inspirational and I keep returning to bits to remind myself of what it was like during the process.  At a little over 3 months po I've begun to wilt a little helped a bit by an LOA and MUA 10 days ago.  I'm going thro another hard bout of rehab to mobilise knee and reduce the risk of adhesions interfering again.  Not sure it's good yet.  Lots of pain plus inconsistencies with instructions.

For some reason physios seem to say you have to work hard on something multiple times to me.  When training to work hard means to push to the limit of what you can bear.  When I did this I ended up in pain for 2 to 21/2 h post exercise.  Now I'm told this is excessive.  Can't win.  Slowly working out that when physios say 'work hard' they mean just 'do it'.

Good news from the scope was that the graft is 'excellent' really smooth and well integrated.  It's so far so good and all the minor incidents I had previously can now be discounted.  Just got to care for it from now.  Just how do you manage paranoia as a result of ACI?  ::)

Hope everyone is well and enjoying the changing colours of the leaves ...

Title: Re: Room 101's December 2, 2008 ACI (October 6, 2009 update)
Post by: Room 101 on October 12, 2009, 05:29:18 PM
Hi, Renn.  sorry to hear of your troubles, and I hope it all goes right from here. 

I definitely had (and still have although it's less) paranoia... I tried not to, but I think it's normal to be careful and worry.  Most of my days/weeks are very good, but when I was absent from this site for 4-6 weeks it was because I wasn't changing in the way I felt... for good or bad.  I thought I'd hit a wall.  I will go through bouts of bad days where the knee just aches or hurts or stairs hurt... for no reason.  It's weird.  I think things just change & shift in there as the growth continues.  It seems to always go away.  I just try to be good to myself when it doesn't feel so good.  I go back to the basics of easy biking and gentle walks.  Just to get motion.  I did push it on our vacation, and it was great.  I was surprised how good I felt.

The hardest thing for me still to this day is to stand for a long time.  I get some swelling when I just stand.  We went to a couple concerts recently, and then we stood in line for a couple tours in Philadelphia.  Oddly, that bothers my knee the most  :P

have a great week everyone,
Room 101
Title: Re: Room 101's December 2, 2008 ACI (October 6, 2009 update)
Post by: hathor65 on October 13, 2009, 10:37:06 PM
101, good to see you are back on the board with some good positive updates.

I haven't been on for a while but thought I'd share some exciting news of my own. My OS did an arthroscope yesterday to check things out and to quote his post op notes "MACI is looking excellent". He took a load of photos and the graft looks pristine and white. He said that there was only a small amount of overgrowth to debride and some scar tissue to tidy up. He also debrided my fat pad as I've had some pain there on and off for the last few months. I'm at home for a few days icing and resting but can't wait to get going again with this good news. I am just over 10months post op.

I am heading to Vail at Xmas (snowboarding here I come  :-\) and on to Chicago to watch my Bears play the Vikings, can't wait. In terms of exercise these days, I'm cycling and rowing a lot and last week-end moved up to ride with some of the guys I race with and pushed the knee really hard for 30 minutes in a 1 1/2hr ride. No pain when riding and just a dull sensation the rest of the day. I went back out on Sunday for an easy ride and still felt good. I am also in the gym doing weights, mainly hammy curls, leg press, swiss-ball wall squats and limited leg extensions. I do 4 sets of 10 of each around 3 times a week.

I hope this gives fellow knee geeks some positive vibes and although it's a long slow process, it's moments like these that keep you going.

Hathor

 
Title: Re: Room 101's December 2, 2008 ACI (October 6, 2009 update)
Post by: Room 101 on October 14, 2009, 09:15:31 PM
Hi, Hathor!  Glad the scope went well and the graft is doing awesome  :D  -- We seem to be in the same spot rehab wise.  It's been that way from the start, haha.  I lift 3 days a week also and do biking/walking in between.  I hit a new milestone for me yesterday at my workout.  I was able to do 1 leg deadlifts w/ a 25  lb. ketle bell.  Before I was doing suitcase deadlifts, which is only about 1/2 the load since you set it down on one rep and pick it up on another.  My range with the ACI knee was short compared to my other knee, but it felt really good, and I had zero post workout pain.  I feel great today, so clearly it's ok to push that some.  My quads were sure feeling it, which was great.  I notice I have increased the size of my ACI quad quite a bit in the last month.  It isn't lagging nearly as bad.

Thanks for the update, and have fun snow boarding (be careful  ;) ) -- The Bears game should be nice and cold for you!

Room 101
Title: Re: Room 101's December 2, 2008 ACI (October 6, 2009 update)
Post by: Room 101 on October 29, 2009, 09:00:15 PM
Hey all... well, I had to cancel my Dr. appointment today   >:(  -- It has been rescheduled for December 10th.  I was so ticked.  I wanted to be cleared to do some more activity... nothing like running, but I guess I was looking forward to the doc's reassurance that all is well... I had a customer at work request a conference call for Wednesday or Thursday.  I emailed back and sad I was available except 12:30-14:30 Thursday.... so they made the call for 13:30 today  ::)  -- What are ya gonna do?

Oh, well.  I just get the same mundane routine for another 6 weeks, but that's ok.  I was hoping to swing a really light golf club when we go to Hawaii, but I'll live without it.  I don't want to do the twisting until I get released to do that, and I haven't been as of yet.

Things are still going well, although for the first time I got really sore after flying sardine coach Monday.  I had to stuff my bag inder the seat because everyone brings so much crap on board.  Then, I had a guy impeding on my part of the seat because he had a huge bag stuffed under his.  I ended up kicking him out of the way (he didn't speak English) because my knee was just throbbing, sitting in a weird position... so I made him move twice (4 times total) in and out of his seat with that big huge bag so I could go to the bathroom.  I am spiteful when i want to be... but hey, stay on your own side!!!   ;D

It was funny in hindsight... minus the stiff knees.  My good knee was way worse off than my repaired knee... so I guess that is positive...

have a great week!
Room 101
Title: Re: Room 101's December 2, 2008 ACI (October 6, 2009 update)
Post by: Hathor on November 05, 2009, 06:15:32 AM
Great story 101, I'd be doing the same thing !! It becomes a habit to scope a room out for the seat best suited to your 'bad' leg all the time. I always book aisle on planes and at the movies so I can stretch the left leg when I want.

I've been back to see my OS since my scope and now understand why it has been feeling so sore and recovery much slower than I expected (and sorer than all the other previous scopes I've had). Not only did he check the new cartilage, he cleaned out the fat pad and, unknown to me, also did a slight lateral release !! All in the best interest of "maximising an excellent overall outcome" according to him !! It's been 3 weeks since the op and he's restricting me to easy spin on the bike and squats in the pool for another 2 weeks or so....how frustrating, feel like I'm back in week 6 of the MACI !! I took the plunge and am on NSAIDs for the inflammation. He said it was safe....

He doesn't want to see me again and his parting words were that based on what he saw and felt with the probe on the new cartilage, that there is no reason why I shouldn't have an excellent long term outcome. He said it was firm and really well integrated so I guess it's down to me now and patience.

It's been weird hobbling up and down stairs after having made such good progress over the last 9-10 months.

101, your 12months are up pretty soon which is a major milestone to be celebrated. I'm a few weeks after you so will toast us both.

Hathor
Title: Re: Room 101's December 2, 2008 ACI (October 6, 2009 update)
Post by: courtem10 on November 05, 2009, 03:58:37 PM
Room 101- that's such a bummer about cancelling ur appointment :( But what can you do- life gets in the way of things. Anyways, have you tried a little running at all?? You're almost at a year! Wow, it's hard to be how fast time goes by.


General question to the group- has anyone out there run a marathon or longer distance race after having ACI done on there knees, and if so- how long after the procedure did you attempt the race?? I am looking into marathons for next winter (December 2010/Jan 2011) but not sure what I can be expecting to do at that point.

Courtney
Title: Re: Room 101's December 2, 2008 ACI (October 6, 2009 update)
Post by: Hathor on November 05, 2009, 07:07:31 PM
Hi Courtney

I did some training runs up to 20 miles from around 20 months and ran a marathon at roughly 26months when I had my first ACI.

I will not be doing that with my new MACI cartilage as something caused the last one to disintegrate after a couple of years and i can't rule out the running/skiing etc. that I was doing after 12 months.
I don't intend to start running until 24 months and will not be doing the distances i used to. I may stick to short triathlons where you are only running up to 3 miles.

Your case may be different but I am erring on the cautious side as i won't be going for a third ACI in the same spot !!

Hope this helps

H
Title: Re: Room 101's December 2, 2008 ACI (October 6, 2009 update)
Post by: courtem10 on November 06, 2009, 03:49:39 PM
Thanks for the info, Hathor. That really helps. I was shooting to run a marathon at a bout 16 months after ACI, but I guess that seems kind of ambitious at this point. Plus, I really don't want to risk my new cartilage. I'm sure you have already told the story on this board, but to avoid re-reading through all the old postings- how did you originally find out that your first ACI had failed? Also, when you say 'disintegrated' do you mean that the cartilage never properly attached to the defect? Take care everyone!

Courtney
Title: Re: Room 101's December 2, 2008 ACI (October 6, 2009 update)
Post by: Hathor on November 09, 2009, 10:04:35 AM
Courtney

At my 12 month scope it all looked good but at 2 years I had an MRI and it showed full chondral split and the new cartilage had broken up and was mixed with scar tissue. As it was so gradual I didn't really notice until I couldn't exercise without pains meds before and after. The graft itself took really well at the start on all accounts, but either I went too hard too soon or it never really formed into 'good' cartilage in the first place.

As I am at almost 12 months this time around again, I am going to go easy for another 12 months ie. NO RUNNING (or skiing) but will definitely be cycling, playing tennis, snowboarding very gradually over the next 12 months etc.

I may be a bit in the once bitten twice shy category but I am not going to lose another 18months in operations and rehab if I can avoid it with a bit of patience.

Hope this helps

H
Title: Re: Room 101's December 2, 2008 ACI (October 6, 2009 update)
Post by: Room 101 on November 09, 2009, 06:34:12 PM
Hang in there Hathor.. it sounds like the backwards step will be great in the end!!  I am so happy that it all looked good tot he doc!  Yes, my one year is December 2nd, and will toast to yours when I celebrate.  It's all going quite as it should I believe.  As I said, I had to cancel my follow-up and make it for mid December, but I am positive all the news will be good.  I just need to keep working it out and progress as I am able.

Courtney, it's so good to hear things are well for you also.  I have no plans to run for quite a while.  I guess I was so bad before the surgery that I am fat dumb & happy to be able to hike & bike & workout aggressively at the gym.  I just don't want to do anything to mess this up.  I had patella defect which has a much lower success rate anyway, and I don't see the need to run... I hope to play some softball in the summer and also some golf.  If that goes well then I would think about adding more sports back w/ possibly a mini triathlon.

Hope you all have a good week and best wishes to all those recovering!

Room 101

Title: Re: Room 101's December 2, 2008 ACI (December 2, 2009 update)
Post by: Room 101 on December 02, 2009, 11:10:19 PM
Hey fellow knee geeks!  I hope this day finds you all well and recovering nicely.  I have been away on vacation again... we kind of slammed it all into a couple of months for some reason.  We spent 10 days in Hawaii and had a blast.  My knee held up great, and I think I popped some scar tissue while swimming in the pool!  It hurt a lot at the time, but feels pretty good after the fact  ;D -- I worked out well while there.  I have started doing some crazy modified squats, one leg load w/ the other leg behind me on a 10" step.  It loads so cleanly, and is amazingly 100% pain free.  It should tremendously help my quad strength.  I got stiff on the super long flight but I walked it off quickly.  We hiked out at dusk onto the lava fields to see the current eruption site... I was a little nervous about this since you had to walk back in the pitch dark across uneven lava surfaces w/ big cracks and all that you could easily fall or lose your step... it actually went well.  I did trip once, but didn't hurt anything at all.  We did a couple more hikes to some waterfalls and I had absolutely no trouble.  It's so nice to not be in pain all the time and yet have some activity level... I never thought it would happen.  I know I am still really really careful, and I see Doc in 8 days.  I am excited to hear what he says.  I imagine my exercise repertoire will be opened up quite a bit w/ many less restrictions.  I still can't see running, but I need to work on quads still... work has been heck since I got back, and my workouts are suffering... which is not a good thing.  I am working longer than 12 hour days since I got back, and I am just exhausted... holiday time is supposed to slow down  ???

Ah well, it will all work out in the end I am sure.

Take care all, and I'll update again after my appointment.

Room 101
Title: Re: Room 101's December 2, 2008 ACI (December 10, 2009 update)
Post by: Room 101 on December 10, 2009, 11:36:17 PM
Hello, peeps!  Hope all of you are doing well.  I am writing again fairly soon as I had my one year follow-up w/ Dr. Cole today.  It was a great appointment, regarding the repaired knee.  He was extremely pleased with my progress at one year and said I should continue to see marked improvement for another year or more.   :)  I told him about the hiking in Hawaii to the lava flow, and he was seemingly a little surprised I had no issues... he said that where my defect was that I could have had some pain from doing that... I had no problems at all.  We discussed my workouts and what I was doing, and how I tweaked my knee doing apushup plank w/ my feet on the wall Tuesday.  I know I don't hurt the graft at all when that happens, but I get frustrated with the temperamental knee... but he said it might always be that way, where I do things and tick it off and it gets better.  I had very minor swelling in the joint today, so it's finally much better, just in time for my next hard workout  :D  I know for a fact that I am no where near running, and I didn't even ask.  I really don't care about that right now, and I want to continue to progress the difficulty of my workouts as my knee lets me.  Doc said I was doing the right thing by pushing and trying things, and if it gives me trouble wait a month and try again.  It has been working well so far.

So, the goal for my repaired knee is to continue pounding quad strength, hip strength and anything else that really takes the pressure off the knee.

The only news that made me cringe was the conversation about righty... the "good" knee.  Doc doesn't want to do anything while this one is still repairing, and I would prefer to not ever have to do anything with righty.... but reality has set in.  I've had two lockups this week, and one big sensation of righty giving out on me while walking... just like lefty used to.  So, the official watch righty is on, and I see Doc again in 4 months to keep tabs on it.  Worst case right now is a scope to clean it and see what is up.  I'll not think about it now and cross the bridge when it comes.  As I get more active, righty gets more angry.  I don't like the trend, but I also don't want to go through all of this to end up in the same sedentary place I was before  ::)

All in all, a great day.  I am absolutely on cloud 9 that things with lefty are going so well.  I look forward to pushing things and seeing how far I can go (within the scope of rehab, of course)

Room 101
Title: Re: Room 101's December 2, 2008 ACI (December 10, 2009 update)
Post by: ajschnelk on December 12, 2009, 02:46:05 AM
This is great news! Best of luck with your continued positive recovery. i am hoping everything goes well for me and I'm able to post similar results a year from now.  ;)
Title: Re: Room 101's December 2, 2008 ACI (December 10, 2009 update)
Post by: courtem10 on December 14, 2009, 02:48:21 PM
Hey Room 101,

So awesome to hear that your left leg has come along so well!! It's an inspiration for the rest of us still trudging through this journey. Hope your "good" knee holds up as long as possible. So daunting to face this surgery again, I try not to think about it


Courtney
Title: Re: Room 101's December 2, 2008 ACI (December 10, 2009 update)
Post by: Room 101 on December 14, 2009, 05:40:05 PM
Thanks, guys!  It's good to read up on your status and see all is progressing for you as well.  I failed to mention that I have on 2 occasions worn 2" heels with no issues.  Granted, it was dress boots and not spike heels, but it was a heel and not a completely flat shoe.  I felt great and had no trouble walking.

Take care, and everyone enjoy the week. 

Room 101
Title: Re: Room 101's December 2, 2008 ACI (December 10, 2009 update)
Post by: Hathor on December 31, 2009, 09:07:40 AM
Hi ACI'ers and MACI'ers out there and Happy New Year

Thought I'd update you with how things have been going with my left patella MACI at 13 months. I've just got back from a week of snowboarding in Vail and had a pretty good outcome overall. The affected leg was a little weak at times to start with (mainly quads and hammies) but I was able to get out every day for 6 days straight. Due to the intense cold, I spent a fair bit of time during the day in the various lodges having coffee and resting my leg. I experienced practically no pain in the knee in fact got more pain in my neck from a couple of bad stacks from whiplash!! I stretched religiously before going out each day and ended the day in the hot tub to relax the aches and pains.
I could probably have waited another 6 months to build more strength in the leg to have made the boarding more enjoyable but I will continue to work on that.

The trip finished on a high with watching my Bears beat the Vikings at Soldier Field...

I hope everyone else is doing ok out there.

Hathor

Title: Re: Room 101's December 2, 2008 ACI (December 10, 2009 update)
Post by: ajschnelk on December 31, 2009, 03:14:51 PM
wow, I can't believe you were able to board consecutive days without too much trouble.  If you can do this okay at 13months imagine what it will be like 2, 3, 4+ years post op.  Skiing is one thing I hope to get back to at after I recover from my throchlea groove aci (currently 4wks post)... I may even swith to a board to help out on the knees.  Grat to hear and thanks for sharing. 
Title: Re: Room 101's December 2, 2008 ACI (December 10, 2009 update)
Post by: Hathor on January 01, 2010, 07:14:36 AM
Absolutely, I'm very optimistic but I have to remind myself that the last ACI in the same spot failed for a reason.

I highly recommend the snowboarding though. I took it up after having skied all of my life because of my knee. It is nowhere near as intense on the knees as skiing and it was fun learning a new sport.

I hope to get back to skiing at some point in the next couple of years though.

Good luck

H
Title: Re: Room 101's December 2, 2008 ACI (December 10, 2009 update)
Post by: ajschnelk on January 02, 2010, 02:12:39 PM
did you ever find out anymore on why it possibily failed the first time?  I think I remember reading your posts and didn't you run long distance and snowboard very early with the last maci?  I am surprise you did what you did given your first one failed and the fact it's still early to be attempting high impact stuff. 
Title: Re: Room 101's December 2, 2008 ACI (December 10, 2009 update)
Post by: Room 101 on January 05, 2010, 12:33:02 AM
Hathor - Great to hear from you, and such wonderful news, too!  I am happy for you.  I don't ski or snowboard, so I am pretty lame in the winter  :P -- I did however go sledding a few weeks ago... up the hill climbing in a foot of snow.  I had no issues.  My knee got sore at the end, but simply because my legs were very tired.  I'm still doing the same 'ol same 'ol on most days, but I feel really good about the hiking and sledding, etc.  I have also been able to do 100% pain free front loaded squats and all kinds of different dead lifts.  I have noticed a huge improvement over the last 6 weeks in all honesty.  I was even wearing heels again over the holidays to different parties.  The one hard thing for me that causes swelling is to just stand in one place for a long period of time.  It sounds so simple, but as long as I'm moving it is all great.  Standing?  Wow.  We were at a neighbor's holiday party and I stood for 3-4 hours talking.  We moved around a little, but it was really crowded. I was so swollen by then end I could hardly bend my leg, but it went away as soon as I could get it up and ice once.  Wacky. 

hope you all have a great 2010!!

Room 101
Title: Re: Room 101's December 2, 2008 ACI (December 10, 2009 update)
Post by: Hathor on January 05, 2010, 09:16:34 AM
Hey 101, good to hear you are doing great as well. Can't say I get any swelling even after standing but we are all recovering at different rates and in different ways. I haven't done any loaded squats so you are ahead of me on the front.

Despite having a great time in your winter, it was nice to get back to 100F here in Oz. Much like you, I'm back to same old but have increased the intensity. I am rowing (indoors) and cycling a lot and swimming/doing weights in between. I am increasing to 1-2 hard work-outs a week either on the rower or on the bike. The knee feels weird for the rest of the day after a max intensity workout but feels good to go the next. My plan is to use this approach until 18 months and if it's all still good will ramp up again.

I had a my first 'hit' of tennis on Sunday for the first time in 18 months. Fortunately it was just doubles so I didn't have to move too much. If any balls were out of reach I let them go as I am still not running. It felt strange pushing off with the 'bad' leg but no pain. Played for an hour and really enjoyed it.

Keep us posted on your progress.

H
Title: Re: Room 101's December 2, 2008 ACI (December 10, 2009 update)
Post by: Room 101 on January 05, 2010, 04:50:31 PM
haha, Hathor, I think our brains are on the same wavelength.  I have stayed away from impact and pivoting/twisting to this point, but I have done a lot of pushing off.  It's so strange to have zero pain... I don't recall the last time I pushed off with no pain.  We have an Australian Shepherd that loves to play frisbee, and I chase the frisbee like you chase the tennis ball, haha.  I also have gone to a couple of my niece's bball practices and done some passing and dribbling, etc.  It's getting harder to contain myself.

I basically do 3 hard lifts per week and throw cardio in on the off days.  I don't worry about days off unless my good (now bad) knee gives me fits, which happens more than I'd like.  I am getting tons stronger. I only swell when I stand for a long time, and I think it's due to putting all my weight on my repaired leg too stay off my other leg.  It's strange because I never swell after working out, even when I tweak it a little.

My big goal is to have a pain free knee by softball season... it will be 17 months post.  Since that involves twisting & impact, I'll get the OS's blessing hopefully in April to start testing it out.

Take care.  100F.  That sounds nice.  It was 10F here this morning.... which is a hot streak  :D
Title: Re: Room 101's December 2, 2008 ACI (December 10, 2009 update)
Post by: courtem10 on January 12, 2010, 04:07:19 PM
Hi Hathor & Room101,

So good to hear about all these triumphs between the snowboarding, hiking, and all your other activities. It deffinitely gives me something to look forward to!! Keep it up. Room 101- I know you are on the watch for your good knee. And like Ive mentioned before, I'm in the same boat. Anyways, I was wondering how soon your doc would consider operating on your good knee. I know you said you wanted to wait for a longer recovery......I'm contemplating going under the knife again soon, it would be right about a year after my other. Not sure if this is the best idea, but there's a lot of other contributing factors that would warrant this being done so quickly. So i'm not sure. I know Jon Hark had both his knees done, but I can't recall how close together he did them. Help.....

Courtney
Title: Re: Room 101's December 2, 2008 ACI (December 10, 2009 update)
Post by: Room 101 on January 12, 2010, 06:06:07 PM
Hi, Courtney.  I guess the glass half full of your post is that your repaired knee must be doing quite well to be considering doing the second one... but this boat we're in sure is craptastic.  I am having more & more problems with my "other" knee.  It locks often and gives out some, but we are really concentrating on strength training as I am again having trouble with pushing cardio & the resulting swelling & pain... even walking quickly.  I still do it, but not as long as I might want.  A lot of what I feel is the same as the other knee was, only not as severe.  My hope, honestly, is that perhaps it's just meniscus damage or something "simple".  It's so tender to touch it. and gawd, the grinding is brutal.

My repaired knee is awesome and has now taken over the role of the "good" knee.  I know when I saw the OS for my one year he wasn't even ready to talk about knee number two.  He checked it some, but he said he didn't want to go down that road so soon if it could be helped.  I know I still have a long way to go on the repaired knee.  I don't believe it could handle the burden yet of being the only working lower appendage. 

My plan is to continue to strength train and try to be patient.  I have an appointment in April to go back and let him check it out more thoroughly.  He made an appointment for 4 months instead of 6-12 months so we can keep an eye on righty.  I would venture that it will continue, and he did mention possibly a scope this year.  I am trying to get back to playing softball by summer, so if a scope were in the works, I would definitely wait until fall.  August/September.  I don't know if I can play or how it will work out, but that is my goal.

As for Jon Hark, I want to say it was like 18 months apart and he mentioned (I think) at some point that he maybe should have waited a little longer, but hopefully all is well with him and both knees are feeling well at this point.

Courtney, good luck with everything you have going on.  I feel your pain and wish the best for you.  Have you had any tests done on the second one?  Do you know the location/size of the problem (and all the other tidbits)?


Take care,
Room 101
Title: Re: Room 101's December 2, 2008 ACI (December 10, 2009 update)
Post by: Hathor on January 12, 2010, 07:36:00 PM
Hi gang

Sorry to hear the 'good' legs are causing you pain. If it's any consolation mid way through my rehab at 6months I started getting really sharp pain in my good leg too, right under the patella !! It seemed to flair up most when I did wall squats or exercises which put a lot of pressure on my good leg. I was really nervous that I'd screwed that one up as I have been favouring it for the last 3-4 years. Anyway, I had an MRI done via my local doctor so that I didn't worry my OS and it all came back with no findings. My PT told me to lay off the wall squats for a while and make sure I exercised both legs equally rather that 90% the bad one and 10% the good one. It took a few months but the pain has since gone away.

Sorry to hear of your troubles and 101 stay positive

H
Title: Re: Room 101's December 2, 2008 ACI (December 10, 2009 update)
Post by: courtem10 on January 13, 2010, 04:17:35 PM
I have an MRI scheduled for tomorrow night on my good knee. Then I go back to doctor next tuesday. We will see what the MRI shows for damage. Other than him moving my knee around and asking about the pain, I have no concrete evidence of specific damage. So now I wait for some hopefully good news. Although not that a clear MRI will stop the daily pain I have. No win situation :(


Courtney
Title: Re: Room 101's December 2, 2008 ACI (December 10, 2009 update)
Post by: Hathor on January 13, 2010, 07:16:49 PM
Fingers crossed for you Courtney. An MRI should provide most answers but as my OS once told me, "you can never really be sure until you get in there and take a look via arthroscope".

Hathor
Title: Re: Room 101's December 2, 2008 ACI (December 10, 2009 update)
Post by: Room 101 on January 13, 2010, 10:51:36 PM
Courtney, good luck tomorrow.  I wish you the best (which is an answer and a simple solution)  :)  -- I hope it all works out for you.

Hathor, Thanks for the encouragement... I do get seriously bummed when I have the right knee issues.  I try and focus on the repaired knee and how great it feels... yesterday working out, we were doing single leg bridges, and my left leg was so strong it blew my mind with how little fatigue I had.. and then righty crapped out mid set.  I applaud the success of the repair and lament the pain in my other knee.  I almost do feel as if it is something different though.  Whatever it is , well it's not as severe as lefty was prior to the AMZ/ACI, but it isn't good.  For me, it is too soon to pursue it.  I want to continue rehab on lefty and get back to as close to 100% as possible, which I know will only help righty to be as strong as possible.  April will be interesting  :P

Take care,
Room 101
Title: Re: Room 101's December 2, 2008 ACI (December 10, 2009 update)
Post by: courtem10 on January 19, 2010, 06:07:20 PM
MRI is done- now I go to doc tonight to read results. Saying my prayers!!  :-\


Courtney
Title: Re: Room 101's December 2, 2008 ACI (December 10, 2009 update)
Post by: lizonka on January 21, 2010, 12:56:49 PM
let us know what happens.
Title: Re: Room 101's December 2, 2008 ACI (**January 31, 2011 update**)
Post by: Room 101 on January 31, 2011, 07:14:23 PM
Wow, it has been so long since I have been out here, but I felt like I wanted to share an update.  I heard from a fellow knee-geek asking me how progress was at 2 years post op.  I didn't intentionally go away for so long on purpose.  Things with my knee have been really good.  I am 2 years and 2 months post op now.  In April 2010, I was pretty well released to do anything I could handle.  At that time, I knew I was still pretty weak.  I made a decision to play in a co-rec softball league.  From my competitive background this was far more social than strenuous and I figured it would be a great intro back into sport.  The first game or two were interesting.  I didn't have much trust in my knee as far as laterally pushing and running bases, etc.  But my hitting was top notch.  I haven't hit the ball that well in forever... I was finally pain free. 

Here is where it sucks (skip the paragraph if you don't want to read the story)... 2rd game back I was playing 1st and the guy who hit a grounder to 3rd decided to forego the safety base and try to knock the ball from my hand ... now this is as illegal as it gets, but like I said co-rec and the ump was like 100 years old and didn't care... so the guy did run full on into me, knock the ball out, knock the mitt off ... and he shattered the radius & ulna in my left wrist.  Thus the absence from this board, hahaha.  That was May, 2010 and I had surgery to install a plate and screws the next week.  It hasn't gone all that great and I just stopped therapy a month ago ... it was a very nasty break and the surgeon thinks it will take a year to get "back to normal" - I have lost a lot of RoM and enough function that it frustrates me.  I am told I should heal to the point of never knowing it happened... the other theory besides time is that the plate is irritating and will likely have to come out, which he won't do for at least a year post-op. So, I was away from here because I ultimately had to concentrate on my wrist and forget about my knee... for a while.

After neglecting my knee rehab during the summer due to my wrist rehab, we were really able to get back after it in the fall.  I made huge strides with strength.  We are always very careful regarding shin angle and lifting form, etc.  But I was able to really start doing full weight-bearing 1 leg exercises like 1 leg dead-lifts and we pushed some more difficult exercises like reverse lunging and even some moderate squatting and some serious combo moves.  I was on top of the world ... and then one day my "good" knee gave out during a dead-lift rep. ... and I threw out my back, which I have never done before.  That's the next saga, I guess.  We had to backtrack on the workouts to accommodate my "good" knee.  I had 2 months of fierce problems with my "good" knee and was ready to put my head thru a wall.  Now that I got the knee pain under control, my back seems to be a more chronic issue stemming from my hip which seems to be coming from my knee pain.   It's become clear that I am favoring something in a very odd way.  I go see Dr. Cole February 10th for an update on my ACI knee which he asked for yearly and I want him to look over my other knee and get his thoughts.  I was really hoping to wait on that until summer.

My ACI knee is doing fantastic.  My hubby and I finally decided to try cross country skiing, and I felt like my knee was strong enough to give it a shot.  I never had done anything like it before.  No downhill.  No snowboarding.  At first I didn't trust my knees, but I got into it and the ACI knee responded very well.  We have since gone a few more times and totally love the workout and the challenge.  Each time we go, the ACI knee aches some but I wake up the next day feeling great.  The "good" knee is usually in a good amount of pain but the experience is worth it and it has been 2 decades since I could do that fierce a cardio workout.  I don't wanna stop now!!!

The bottom line is I still feel improvements in the ACI knee, and I am gaining confidence.  I know I will never be 18 again, and I know this might be as good as it gets, but really, it's pretty dang good.  I can walk and bike and cross country ski and lift and live my life walking up & down stairs with no problems whatsoever.  I might get stiff or swell up for a few hours, but I couldn't walk 1/2 mile before.  I couldn't have had a better result for the damage that was done, and I know I can get even stronger.  I had a long setback with my wrist and got behind on my knee rehab... oh, and I can actually kneel on my ACI knee now which I couldn't do before.  I don't want to do it for hours, but for short timeframes, it's fine.

So, that's it in a nutshell.  All is great with the repaired knee and the "good" knee is on the fritz...

Hope you all are doing well.  I need to catch up on my reading next!

Room 101
Title: Re: Room 101's December 2, 2008 ACI (**January 31, 2011 update**)
Post by: Melissa S on February 01, 2011, 04:17:34 PM
Room 101,
Thanks for the update.  It is always good to hear about patella ACI success stories.  I had mine done on Nov 8th, so I am 12 weeks out yesterday.  So far so good, but it is nerve wracking wondering if your graft will take and grow.  Good to hear that yours did and that your knee is feeling so good.
Sorry to hear about the wrist injury though, ouch!

Melissa
Title: Re: Room 101's December 2, 2008 ACI (**January 31, 2011 update**)
Post by: Room 101 on February 01, 2011, 05:07:48 PM
Hi, Melissa.  Glad all is well so far for you.  It's very nerve wracking.  I had so little function beforehand that I am extremely grateful for where I am now.  I had always wanted to get back to competitive sport, but you know ... I think after going thru all of this I am pretty dang happy and I can do so much... but honestly there isn't an activity I do that I don't think about what's been invested financially and time-wise, hahaha.  I pretty uch keep my activity pain free.  Sometimes after the fact I'll get sore, but as long as it sticks to a day I don't worry much.

Are you off crutches and all?  Who is your OS?  I'll look for a diary so you don't have to repeat it all.  Work is eerily quiet today with the coming storms :) 

Take care,
Kim

PS - The wrist injury does suck. It has honestly completely taken everything out of me.... more than the knee surgery ever did.  I would choose the knee surgeries again and again over this wrist injury.  And that is really really sick....
Title: Re: Room 101's December 2, 2008 ACI (**January 31, 2011 update**)
Post by: cdubb on February 01, 2011, 09:06:42 PM
Room 101, thanks for the PM earlier and you were spot on!  I sent you a reply back! Now reading this, I also see that we do have the same surgeon.  Work let us out early today and we're closed tomorrow due to snowmageddon, snowpocolypse or whatever your favorite term is!  Very glad to hear how well you're doing!  It's good to see the light at the end of the tunnel being only 3 months out myself (and doing well).  Just gotta figure out when to do that other knee of mine....maybe we can get our other knees done together and rehab together!!
Title: Re: Room 101's December 2, 2008 ACI (**January 31, 2011 update**)
Post by: Melissa S on February 01, 2011, 11:29:25 PM
That is great Room 101, I am 3 months out now and still feeling every step I take.  I am looking forward to the day that I don't think about my knee so much and just praying that that day will come.  I am off crutches officially as of this week.  I have been down to 1 for a while and been walking around the house without one for a couple of weeks.  My diary is in the <100 posts, and titled My patella ACI surgery on Nov. 8th or something like that, ha.
Glad to hear your knee sugery was positive and hoping your wrist heals too!
Title: Re: Room 101's December 2, 2008 ACI (**January 31, 2011 update**)
Post by: Room 101 on February 01, 2011, 11:36:15 PM
Hey cdubb!  It's great to talk to ya :)  I think rehabbing with a partner on the other knee is a good idea, haha.  It would certainly be much more entertaining!!  IO'm still in avoidance there :)  -- oh, and I am thrilled that we get to drive home in this weather disaster soon... our company is open for business tomorrow, so that should make for a fantastic drive to and from the office.  Perhaps all these weather folks are wrong!! 

Melissa, I have started reading your diary.  Customers started calling, so it was short lived... I'm glad things are progressing for you.  The day you quit thinking about your knee every minute comes and goes without realizing it, haha... I just suddenly found myself running up & down stairs like a kid again :)

All hail Huskies!!

Room 101
Title: Re: Room 101's December 2, 2008 ACI (**January 31, 2011 update**)
Post by: cdubb on February 01, 2011, 11:55:30 PM
I'm only 3 months out....and Dr. Cole said he wouldn't consider even doing the other one for 6 months post op.  Work wise and financially, I'd ideally like to wait a year...plus I then get a better read on the success of this left knee before I undertake the right.  Feeling quite positive so far though! Even did 4 inch box step ups at PT yesterday!  I took 4 weeks off of work for the left, but worked from home for a week and a half before physically returning to the office. I do not want to be that employee whose always off on a disability claim...especially since I work in insurance and workers' comp to be more precise and we joke about repeat offenders.  Granted, this is not WC and is disability, but still....

Sucks your office is open...maybe they'll reassess that plan??? I'm still expected to be available via e-mail and technically working, but with my husband and son home, not sure how much I'll actually get done.

Huck'em Fuskies was always my favorite!
Title: Re: Room 101's December 2, 2008 ACI (**January 31, 2011 update**)
Post by: Room 101 on February 02, 2011, 07:27:37 PM
So, the weather people weren't entirely wrong, haha.  Drifts as high as 5 feet and most of our drive was 3-3 1/2 foot drifts.  We are cleaned out and officially at work!! 

Cdubb, wow, I couldn't imagine doing another knee after 6 months... financially or just the process of going through all of it again so soon.  I am definitely enjoying my time being active again.  I was really lucky because my hubby works at the same company so I had a driver.  We brought a big comfy ottoman from home with pillows and I kept elevated and iced.  I couldn't have done it without him... but I was back at work very fast.

Huck'em Fuskies rules!!

Did you guys carry on the "inka dinka whole potato half past an alligator..." chant pre-game?  It got lost somewhere down the line I think, but we were hazed pretty good until we learned it, hahaha.
Title: Re: Room 101's December 2, 2008 ACI (**January 31, 2011 update**)
Post by: cdubb on February 02, 2011, 08:32:54 PM
Yes, we carried on with inka's all through my 4 years and the 2 years I coached the girls still did it.  I don't recall it all now, but I bet if I had enough drinks in me and enough prior Huskies with me, I think we could all remember and get a little rowdy! Maybe we'll need to work on that in April!   Too bad you can't make it!  And hazing....there was no hazing going on....  I believe with the new coach all prior traditions have been lost...I think she's too busy worrying if their toenails are painted.

Good for you for getting back to work quick.  I did not have a driver, so that alone was a challenge. I couldn't fit in my car until I was unlocked to 60 degrees.  I'm 5'11" with long legs, so until I got to 60, I had to just ride in the middle part of our van with legs extended on the seat. 

I will not be doing my knee 6 months after the other one. That would mean that insurance approvals would need to start getting in place now and Dr. Cole is always 6 weeks out scheduling, plus the process of growing the cells.  Although, I could ask for Denovo NT next time, so no cell growth needed then.  It's a tough call though. If  I wait a year, then I'd be getting it done right when my left would allow me more activity.  It would be 2-2 1/2 years total of limited activity with no break.  Getting it done at 6 months, at least they'd recover somewhat closer?  I can already tell my right is not happy with me.  I did the 4 inch box steps up easier witih my left op leg than my right leg.   The right bothers me more with the mini squats I am permitted also.  If time off work and $$ weren't an issue, ideally, I'd just get it done over the summer. 
Title: Re: Room 101's December 2, 2008 ACI (**January 31, 2011 update**)
Post by: Room 101 on February 02, 2011, 11:22:48 PM
I cannot remember it all either, ad when I say hazing, I mean that in the most loving way. All just a lot of fun that the coaches were part of most of the time... in fact we hosted a reunion in December and a few mates decided to rearrange the clothes closet and my workout room. The funny part was I didn't notice right away and it finally bugged me enough that I reorganized the closet just last weekend, haha.  Humor.  I miss those days!!!

I have absolutely no idea what is in store for my other knee.  I know after the first knee and the broken wrist that I need some time.  I hope that the other knee holds up enough to grant me that time.  It went out on me last night pretty badly just walking across the kitchen... oh, the joys of bogus joints, right?
Title: Re: Room 101's December 2, 2008 ACI (**January 31, 2011 update**)
Post by: cdubb on February 03, 2011, 01:45:54 AM
We did a swimming work out once at Anderson pool and while we were all in the pool, Donna and the other coaches switched up everyone's keys.  So, we're all heading to our cars in the field house parking lot and realizing our car keys aren't working.  Try figuring out who had the right car, apartment and door keys was a nightmare....the coaches thought it was hilarious!
Title: Re: Room 101's December 2, 2008 ACI (**January 31, 2011 update**)
Post by: Room 101 on February 03, 2011, 05:22:16 PM
Yep.  They did the exact same thing to us!!! 
Title: Re: Room 101's December 2, 2008 ACI (**January 31, 2011 update**)
Post by: cdubb on February 03, 2011, 11:51:04 PM
Some of us that had gotten together to watch the NIU bowl game this year said we should all get together and drive out and TP D&D's house on Halloween.  Did that tradition begin while you were there or was it newer?
Title: Re: Room 101's December 2, 2008 ACI (**January 31, 2011 update**)
Post by: Room 101 on February 04, 2011, 05:20:32 PM
Glad that tradition still exists!!  TP of D&D was a tradition before I got there.  We excelled at it!  Their current place is better ... more trees :)