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Author Topic: Deepak's ACL reconstruction 24-6-10  (Read 85515 times)

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Offline Snowy

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Re: Deepak's ACL reconstruction 24-6-10
« Reply #15 on: July 02, 2010, 02:11:08 AM »
Sorry it's taken me so long to check in - have been mostly offline as my parents have flown in for a visit this past week. Glad to hear all is going so well, and that you're listening to your body and responding accordingly. I think that's probably the best thing you can do at this point. :)

Really interested to hear that they did a quad graft. When you have more info, I'd love to hear why your surgeon opted for that route - and how you find the healing of the donor site. I think it's a relatively rare option compared to hamstring or patellar tendon; I know only one other person here who's had a quad graft.

Keep up the good work! :)
Mar 11: R Biceps femoris tear (skiing)
Jul 10: ACLr (hamstring autograft)
Mar 10: L ACL rupture (skiing)
Feb 06: L partial ACL tear (kickboxing)
Dec 03: R bone edema (motorbike)
Jan 01: R patellar chip (motorbike)
May 93: R ACL sprain (hockey)
Ongoing: bilateral PFS and OA

Offline ouch09

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Re: Deepak's ACL reconstruction 24-6-10
« Reply #16 on: July 02, 2010, 11:47:37 PM »
Snowy, thanks for dropping in. Yes, I saw from Cosmic's thread that your parents were over and they & you seemed to be having a great time !  :)

I'm going to have my stitches removed on Monday, so I'll ask the surgeon about the quad graft - if that's what it is. It has subsequently occurred to me that the surgeon may have been able to take a graft from the hamstring arthroscopically and the quad surgical wound may be where the drill popped out from the femur.
ACL rupture playing football May 2009
ACL hamstring autograft reconstruction 24-6-10

Offline ouch09

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Re: Deepak's ACL reconstruction 24-6-10
« Reply #17 on: July 03, 2010, 12:11:20 AM »
Day 7

Had my first shower post-op, having covered my wounds with cling film (as advised by one of the orthopaedic dept nurses) to keep them dry. It feels great to be clean again. I understand now what people meant when they described "straw" hair in their post-op diaries.

My bowels were still not right, so resorted to taking a laxative "lactulose", which finally did the trick. I can't believe that my bowels have been screwed up for so long even though I stopped taking the codeine on day 2.

The internet food shopping arrived - Yeah ! I was pleasantly surprised that I no problem lifting a box of 12 bottles of beer - nothing weight-wise compared to what I was lifting in the gym, but now this is a major milestone. Just got to make sure I don't develop a beer-belly ... :)

Did loads of ankle pumps, heel slides, quad sets, single leg raises.

Iced my calf since it was swollen. The calf has now turned a shade of yellow-green, which is apparently standard when the blood pools in the calf. I also have a black bruise on the back of my knee where the brace has been digging into my leg when I have been putting on & taking off my socks & trainers, and have been trying to bend the knee beyond 90 deg. In addition, I have another black bruise on the inside of my foot - my feet pronate so this may be the reason, although I do wear orthotics to control this. Perhaps my bad gait has caused me to pronate more & the orthotic fought back ... :)

« Last Edit: July 03, 2010, 12:40:12 AM by ouch09 »
ACL rupture playing football May 2009
ACL hamstring autograft reconstruction 24-6-10

Offline ouch09

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Re: Deepak's ACL reconstruction 24-6-10
« Reply #18 on: July 03, 2010, 12:36:06 AM »
Day 8

My calf and achilles tendon are really tense and killing me today. Perhaps I overdid it with the knee exercises or perhaps icing the calf wasn't a good idea. On the positive side, the swelling has gone down on the calf.

I remembered I had this problem last year and a physio I saw recommended that I apply a hot water bottle to the calf to reduce the muscle spasm. I try this and it eases the tension and pain, although not eliminating it completely.

It seems mad to apply heat to a muscle in 30 deg C, but it works !

I remember now that vickyny has posted a question in the cruciate ligaments forum about stiffness in the calf - I wonder if this had been her problem and whether she ever got it resolved ...

I notice there is a small yellow patch on one of my dressings. I am concerned it may be pus, which indicates the presence of an infection. One of the info sheets I was given by the orthopaedic dept said you should contact your GP if there is any pus.

I get an appointment the same day with the GP practice nurse, who takes a look at the yellow stain and tells me that it is not pus. I am not convinced and insist that she takes a look under the dressing. She tells me that if she takes a look, she will have to change the dressing and the dressing she has is not as good as the specialist orthopaedic water-proof dressing I currently have. I agree to this, since I'm paranoid about getting an infection.

She turns out to be right - there is no pus, and all the wounds are clean. The yellow stuff turns out to be blood plasma http://en.wikipedia.org/wiki/Blood_plasma.

No more showers for me now until I get my stitches out, since the new dressing is not water-proof and the wounds should not get wet.

Another storm in a tea-cup ...  ::)

« Last Edit: July 03, 2010, 12:43:36 AM by ouch09 »
ACL rupture playing football May 2009
ACL hamstring autograft reconstruction 24-6-10

Offline ouch09

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Re: Deepak's ACL reconstruction 24-6-10
« Reply #19 on: July 03, 2010, 12:57:09 AM »
Day 9

My calf and achilles tendon are still painful, so I'm not doing any knee exercises and not elevating the leg while sitting on the sofa, since even that is painful - it pulls the achilles tendon.

I'm not walking (outdoors) either, so basically reduced to staying in bed for the majority of the day.

I apply the hot water bottle to the calf and achilles tendon twice during the day, and as a result it feels better than yesterday.

I don't use any ice on the knee today, since the swelling seems to be manageable.

Even though I hate codeine for its constipating effect, I'm considering taking it again to kill the pain. The other problem with codeine is that it can make you completely unaware of any problems that may be occurring - nerves exist for a reason.
ACL rupture playing football May 2009
ACL hamstring autograft reconstruction 24-6-10

Offline tez27

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Re: Deepak's ACL reconstruction 24-6-10
« Reply #20 on: July 03, 2010, 03:56:27 AM »
Deepak sorry about the pain but from what I have read its important to keep on top of the pain meds so maybe you stoped taking the codine too soon, saying that if you find the codine has a detremental effect on the old bowel ask your gp for tramadol I find I have the same problem with codine but I am fine with tramadol and to be honest I think it works better.
When I had my scope the hospital nurse gave me these post op waterproof dressings so that I could change them whenever I felt I needed to, did you not get anything like that cos they were very good and they came in different sizes to cover different size wounds.
I hope you start to feel some improvement in the pain soon
Take care Tez
L K injured 25th June 2008
scope Jan 5th 10
diagnosis ACL rupture
fiberous band excised from acl
ACLr July 19th 2010  scope on 24th Sept 2011
ACL has failed incorrect tunnel placement
23rd July 2012 1st stage of a 2 stage ACL revision
10th May 2013 2nd stage ACL revision

Offline kcknee

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Re: Deepak's ACL reconstruction 24-6-10
« Reply #21 on: July 03, 2010, 04:46:05 AM »
Deepak-

Are the codeine pills  in tablets that you can cut in half? I know I could cut the percocet pills in half so the pain was less, but I wouldn't fall asleep. Anytime I get near the narcotics, I have to take the over the counter stool softeners, not a laxative, or there's trouble. Have you tried having someone get those for you to take with the codeine? It will help you to move around more if the pain isn't as bad.

I was in an immobilizer for the first 10 days, so never flexed my leg at all. The pain was worst going to sit down and rising again - when the blood rush went into my calf. Try to keep your leg elevated and do the ankle/ toe pointing flexes to try to get the blood not to pool. My OS told me on the 10th day when I was allowed to start bending my leg and told to stop using crutches, that the muscle contractions in the normal heel to toe walking would help pump some of the fluid out of my leg and reduce the swelling. 

Good luck. I hope the pain starts to ease up.

Kristin
12/31/08 - Skiing injury L knee
6/1/09 - ACL stump removed from joint
8/31/09 - ACLr - Hamstring Graft
12/21/09 - Ant Fasciotomy 
8/26/10 - Anterior Interval Release
12/6/10, 5/5/11, 12/22/11 - Fasciotomy
12/7/12 - Nerve Decompression
6/3/13(m), 7/29/13(l), 12/13/13(m & foot) 2/3/14(l) Fasciotomy

Offline Snowy

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Re: Deepak's ACL reconstruction 24-6-10
« Reply #22 on: July 03, 2010, 07:33:04 AM »
That's too bad about the pain levels. :( I'd try scaling the meds up a little at a time until you reach a level that gives you relief without sending you into a codeine stupor or making you feel like the pain is so numbed that you might do something you shouldn't. I'm not a big fan of codeine either, so I understand why you'd want to try and cut it out.

Like some of the others, I've heard that ankle pumps can be a great way of helping move excess fluid along. It might also be worth looking into lymphatic massage - this was a huge help for me in the aftermath of my original ACL tear (I had massive, very stubborn swelling) although I don't know how easy it would be to do it with the wounds still sore.

Take care, and I hope things feel better soon.
Mar 11: R Biceps femoris tear (skiing)
Jul 10: ACLr (hamstring autograft)
Mar 10: L ACL rupture (skiing)
Feb 06: L partial ACL tear (kickboxing)
Dec 03: R bone edema (motorbike)
Jan 01: R patellar chip (motorbike)
May 93: R ACL sprain (hockey)
Ongoing: bilateral PFS and OA

Offline ouch09

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Re: Deepak's ACL reconstruction 24-6-10
« Reply #23 on: July 03, 2010, 05:31:47 PM »
tez, I think you're right about me stopping the codeine too early. I tried taking 2 paracetomol last night, but they had no effect, so I'm going to take the codeine tonight.

Thanks for the suggestion about the tramadol - I'll discuss it with my GP next week.

No, my orthopaedic dept didn't give me any extra dressings - I think they don't expect you to need to change the dressings before you have the stitches out. You have a good orthopaedic dept where you are !  ;)

After a sleepless night, this morning it occurred to me that I should try elevating my leg in bed, with a pillow under the foot - something I should have done as soon as I got home ... Anyway, it did reduce my pain, so I managed to get a few hours sleep in the morning :)
ACL rupture playing football May 2009
ACL hamstring autograft reconstruction 24-6-10

Offline ouch09

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Re: Deepak's ACL reconstruction 24-6-10
« Reply #24 on: July 03, 2010, 05:55:56 PM »
Kristin, unfortunately my codeine comes in capsule form, so its all or nothing. What's the difference between a stool softener and a laxative ?

Wow, in an immoboliser for 10 days ! That must have been tougher than what I'm going through, at least I can flex my leg. I also find that when I get out of bed I get a pang as the blood rushes into the calf.

I know that the normal advice is to do the foot point & flex (ankle pumps), but that may actually have caused my achilles tendon pain, so I've had to stop doing them. I'm now reduced to merely wiggling my toes, which has a similar effect but doesn't hurt my achilles tendon.

Alternatively, you may have hit the nail on the head : I haven't been walking heel to toe, but rather walking flat footed & using my hip to lift the bad leg. A physio I saw last year spotted this & told me I should stop "hip hitching" and instead walk heel to toe, which probably helped resolve the problem.

I'm going to have to make a concious effort to walk heel to toe, since I know I will hip hitch by default, since its easier.  ;)
« Last Edit: July 04, 2010, 12:36:58 AM by ouch09 »
ACL rupture playing football May 2009
ACL hamstring autograft reconstruction 24-6-10

Offline ouch09

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Re: Deepak's ACL reconstruction 24-6-10
« Reply #25 on: July 03, 2010, 06:14:43 PM »
Snowy, yes lymphatic massage sounds like it might be very useful, although like you, I wonder how it would be done given that I still have wounds.

Last year, the "super physio" who advised me to use a hot water bottle on the calf, and corrected my "hip hitch" gait, also gave me a wonderful calf massage, but I was lying on my stomach at the time, which I'm not sure I could do yet. I would have kissed that physio if she hadn't been married !!  ;)
ACL rupture playing football May 2009
ACL hamstring autograft reconstruction 24-6-10

Offline ouch09

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Re: Deepak's ACL reconstruction 24-6-10
« Reply #26 on: July 04, 2010, 12:26:06 AM »
Day 10

Felt better today than yesterday. Calf wasn't killing me anymore.  :)

Managed to do my knee exercises once & iced the knee (not the calf !) once.

Went for a 20 min walk (trying my best to walk heel to toe) to try to pump the blood out of the calf & foot. The bruising on the foot has increased on the medial & now lateral side. In addition, the bruising on the back of my knee has spread to the hamstring. This is why sleeping is so painful, lying on my back puts pressure on the bruised hamstring, and lying on either side puts pressure on the foot.

I'm giving in to the pain and taking a codeine capsule tonight. I have reached a state of inner calm and come to terms with my pain demons. We had a calm chat and agreed that in future we would discuss things rather than fighting  ;)

"It is a far, far better thing that I do, than I have ever done; it is a far, far better rest that I go to, than I have ever known." ... or so I hope  ;D 

[artistic license begins]

The super model called me again to ask if I wanted to join her in a new trendy bar, where only beautiful people are allowed. I expressed a concern that I would not be admitted since I wouldn't pass the beauty test but she said that wouldn't matter if I was with her. I said OK, sounds good, the only thing is I've got this knee injury and I can't sit with my knee bent for long so would have to keep getting up and walking around. She thinks about it for a second and then says maybe we should wait till your knee has healed. We agree to rearrange another time.

[artistic license ends]
« Last Edit: July 04, 2010, 12:32:19 AM by ouch09 »
ACL rupture playing football May 2009
ACL hamstring autograft reconstruction 24-6-10

Offline tez27

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Re: Deepak's ACL reconstruction 24-6-10
« Reply #27 on: July 04, 2010, 02:02:24 PM »
Deepak me thinks you have discovered that when people say its important to keep on top of the pain meds they aint kidding ;)
I hope you manage to find a comfy sleeping position, that's a bit of a worry for me cos I dont sleep very well just now so the chances of sleeping right after the op are prolly about nill :P
like the wee fantasy look forward to the next instalment!!
Take care Tez
L K injured 25th June 2008
scope Jan 5th 10
diagnosis ACL rupture
fiberous band excised from acl
ACLr July 19th 2010  scope on 24th Sept 2011
ACL has failed incorrect tunnel placement
23rd July 2012 1st stage of a 2 stage ACL revision
10th May 2013 2nd stage ACL revision

Offline Snowy

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Re: Deepak's ACL reconstruction 24-6-10
« Reply #28 on: July 04, 2010, 04:25:46 PM »
If you have artistic license, surely the knee should magically mend immediately after the op and leave you free to chase super-models? ;)

Glad to hear things are going better and the residual pain in other areas seems to be easing off. How are you finding the walking overall, apart from the gait issues? Does it hurt much?

Take care,

Kay
Mar 11: R Biceps femoris tear (skiing)
Jul 10: ACLr (hamstring autograft)
Mar 10: L ACL rupture (skiing)
Feb 06: L partial ACL tear (kickboxing)
Dec 03: R bone edema (motorbike)
Jan 01: R patellar chip (motorbike)
May 93: R ACL sprain (hockey)
Ongoing: bilateral PFS and OA

Offline ouch09

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Re: Deepak's ACL reconstruction 24-6-10
« Reply #29 on: July 04, 2010, 11:58:23 PM »
Day 11

Slept through the night for the first time in a week. The codeine really did work !  :)

Took some lactulose this morning to counteract the constipating effect of the codeine - that also worked :)

Did my knee exercises & iced the knee once today. Also used the hot water bottle on the the calf & achilles tendon, since the achilles tendon was still painful - as a result the achilles tendon is now only slightly painful to the touch.

I'm making an effort to walk heel to toe even within my flat. I've realised that I'm mentally trying to protect the knee when it actually is quite happy not being protected. Walking heel to toe engages the quads (and probably hamstrings) so hopefully will help to retain some quad, which is disappearing fast. Well, I was expecting the loss of quad muscle and if it didn't disappear it was going to be a bonus.

I went for another 10 minute walk in the evening (to try to pump the blood out of the calf - but you knew that already :)), however for the first time post-op, I didn't wear my brace and I was fine. To be honest, I think the brace is more of a hinderance than a help - I'll discuss this with the knee surgeon tomorrow when I have my stitches removed.

I forgot to say that my dad went home on Friday, since I told him I was able to cope on my own. I really needed him in the first few days when my leg was weak, but now its getting stronger everyday.
ACL rupture playing football May 2009
ACL hamstring autograft reconstruction 24-6-10