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Author Topic: ACLr Musketeer - Snowy's reconstruction, 9.7.10  (Read 148623 times)

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Offline Snowy

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ACLr Musketeer - Snowy's reconstruction, 9.7.10
« on: July 10, 2010, 12:40:41 AM »
I have my new ACL. :)

After a largely sleepless night last night, we left for Delta Hospital at about 5.30 this morning.  Our good friend Renee stayed over so that she could chauffeur us, and we were at the hospital for checkin at about 6am. By this point I was feeling really nervous, and Jen was doing a lot of soothing and hugging. It helped a bit that the nurse assigned to me was on her very first day on the unit, and was almost as nervous as I was. She gave me a very tasteful surgery outfit to wear (open-backed gown, housecoat, thigh-high green socks fresh from the warmer and puffy blue paper slippers) and then took my blood pressure, temperature etc before taking me through to set up my IV.

The IV caused us a bit of amusement as my antibiotics were being delivered via lactated ringer's solution, which is the same stuff we give our cats for their renal insufficiency. Because I was tensed up (the nerves) the nurses both had trouble setting the IV line; they were very apologetic but I told them it was a valuable lesson for me on how the kitties feel when we get a bad needle stick! Once the IV was in Dr. L arrived, initialed my left knee and chatted with us; I introduced him to Jen and he ran us both through what to expect for the day and over the next two weeks. He has a really nice presence: calm, confident, and patient while also being very direct and to the point.

One of the OR nurses then came and explained what would happen in the operating room. Once she was done I said goodbye to Jen (my eyes welled up a little at that point) and was wheeled away to theatre. I'd explained to the nurse that I was nervous about the anesthetic, and she and the second nurse worked really hard to reassure me and put me at my ease. (All the staff at Delta were absolutely fabulous; I can't say enough good things about them.) The OR itself looked fairly intimidating, with arrays of monitors and some scary-looking surgical instruments laid out on the table. I'd hoped for a choice of anaesthetic, but it turned out that the general wasn't optional. They gave me a drug to relax me, and the last thing I remember is the anaesthetist saying "You're just going to go to sleep for a little bit."

I woke up about an hour and a half later, at 9.30am, in recovery (I'd been told by the nurses that Dr. L is one of the fastest surgeons they work with.) I felt really groggy for about 15 minutes or so, then my head started to clear. I was also desperately thirsty and my throat was feeling rough from the breathing tube, but I hadn't been awake long enough to have water. As the grogginess wore off I became more and more aware of the pain in my knee (no femoral nerve block); a really deep interior pain that I assume was from the bone drilling. They gave me a dose of fentanyl, which took care of it briefly.

By 10am I was feeling much more clear-headed, and they wheeled me back in to the day surgery recovery area. The nurse also went and got Jen, who'd spent my surgery time in the very lovely hospital garden. I was very, very happy to see her. The nurses brought me some ice chips and Dr. L came by to see how I was doing. He said the surgery had gone very well indeed, and he was really impressed by the size of my hamstring tendons given that I'm not a very big person - he said they should make a really strong graft. He also gave us all the immediate post-op instructions in writing, and a prescription for painkillers.

By this time the fentanyl had worn off and the pain was escalating again, so the nurses put me on a morphine drip briefly. I have to admit that I totally underestimated the initial pain, I think because so many of the accounts I've read were from people who had nerve blocks and thus found the immediate recovery quite manageable. The morphine didn't really kill the pain, but it made me care less about it.

We hung out in the day surgery recovery area for about an hour and a half while the nurses monitored me; I dozed a little, and of course updated the Cosmic's Cafe thread to let everyone know that I was in one piece.   ;D They cleared me to leave just after noon, so Jen called Renee and after a very challenging wrestle with my clothes I was ready to try and move. My leg hurt so much that I really couldn't imagine standing on it, but in the end moving wasn't significantly more painful than lying still. They brought me a wheelchair, but the thought of sitting on my freshly cut hamstring was entirely too horrible and so I got onto my crutches and slowly made my way to the exit.

I'm now at home, learning to use my Cryocuff (worth its weight in gold), eating ice-cream and waiting in some discomfort for the first dose of the new pain meds. The leg is incredibly sore - the deep bone pain, some sharp surface pain which I think is the incisions, and a lot of stinging pain from the hamstring graft site - but I'm fully weight-bearing with the aid of crutches. It doesn't really hurt more to walk with the crutches than to stay still; the challenge is getting from prone to upright and back again!

My leg is neon pink from the antiseptic from foot to thigh, has a big tensor bandage covering the knee itself, and a small incision that keeps bleeding at mid-thigh, above the bandage. The day's two big surprises have been how well I bounced back from the anaesthetic, and the extent of the initial pain.

I think that's probably more than enough tedious detail from me. :) Thank you all so much for your good thoughts, here and on FB - they made my day and definitely helped keep me going through those horrible nervous hours last night. Hard to believe I'm actually on the other side now!

Hope you're all doing well, and having very good knee days. xxx
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 clarky_vl

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Re: ACLr Musketeer - Snowy's reconstruction, 9.7.10
« Reply #1 on: July 10, 2010, 02:22:21 AM »
Hey Snowy!!

So glad the surgery is over for you now and you did great with the anaesthetic! Sorry you are in so much pain, I have found all of mine incredibly painful also, all the anaesthetists and pain specialists I have had for my surgeries have also always commented that it is well known for being a painful surgery! I guess all I can say is the same as everyone else will, take it easy and take your pain meds (and of course, keep eating the ice-cream  ;D )

I am glad surgery went smoothly and you now have a lovely new ACL! :)

Vicky
11/10/07 ACLr-hamstring, lat meniscectomy, microfracture
29/7/08 ACL revision-hamstring/LARS
7/7/09 ACL revision-quad/LARS
20/2/10 Screws out, bone grafts, arthroscopy.
6/7/10 ACL revision-BPTB allograft
14/3/11 Screws out, bone grafts, arthroscopy.
Then: ACL revision + extra-articular repair

Offline tez27

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Re: ACLr Musketeer - Snowy's reconstruction, 9.7.10
« Reply #2 on: July 10, 2010, 03:24:43 AM »
Snowy so glad to see your home in one piece and able to start the first of the musketeer diary's, it sounds like it all went incredably quickly and smoothly, its such a shame though that you didnt have some kind of nerve block to help with the initial pain, at least I should be ok with this knee catherter thingy my Doc told me about, it seems that they can keep injecting something to numb the knee while I am still in hospital, so not feeling quite as upset about having to be in for a couple of days at least I should be relativly pain free [i hope].
Thats good also that Jen was able to be with you in the recovery ward to keep you company and to satisfy herself that you were ok and had come through thing without any comlications.
I hope you manage to get the pain under control and you have a good nights sleep tonight I look forward to hearing how things are going for you.
Take care and a big post op ((((((hug))))))) from me....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 ouch09

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Re: ACLr Musketeer - Snowy's reconstruction, 9.7.10
« Reply #3 on: July 10, 2010, 08:18:22 AM »
Congratulations on aquiring your new ACL !  :)

Sorry to hear about the terrible pain you had post-op. I must have had a femoral nerve block, since I was pain-free, although the surgeon never mentioned this to me pre-op. But it does explain my subsequent difficulties with bladder control  ;) There's a consolation for you - you didn't have to go through the indignity of having a nurse monitor you while you empty your bladder !

You lucky thing - getting neon pink antiseptic ! Don't tell everyone, or they'll all be asking for it  ;)  I only got yellow antiseptic. Nowhere near as cool as neon pink.

On the subject of coolness, what type of theatre undies did you get ?

Glad to hear your stomach has been OK, unlike mine immediately post-op, and that you can enjoy ice-cream. What flavour did you go for ? My favourite is mint with pistachio.

Oh, and the super model says get well soon and sends hugs to you  ;D
« Last Edit: July 11, 2010, 12:32:12 AM by ouch09 »
ACL rupture playing football May 2009
ACL hamstring autograft reconstruction 24-6-10

Offline zaiemk

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Re: ACLr Musketeer - Snowy's reconstruction, 9.7.10
« Reply #4 on: July 10, 2010, 08:50:04 AM »
Congratulations Snowy - I was like you - less worried about the procedure more about the GA - I hate being knocked out, artificially.

Its a tough call whether the nerve block is better or not - whilst it does kill the pain post op, it also means you have no nerve feedback from your movements, which makes it hard to gauge how far to push your initial exercises.

I hope your meds help to cope with the pain, but it seems that you are doing very wel.

As you know everyone's recovery is different and depends on their physiology and mental strength. Go at the pace that feels best for you.  I took it very easy for my first few days and let some of the swelling subside, got used to the pain, and then started to move around a bit more every day.  Been hobbling around without crutches for short distances the last two days, obviously its no good for my posture/gait, but I feel a lot more stable putting weight through my knee at the moment - even with the brace off.

Take care and relax.
Zaiem

Offline lis1

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Re: ACLr Musketeer - Snowy's reconstruction, 9.7.10
« Reply #5 on: July 10, 2010, 02:01:35 PM »
Nice detail Snowy.

Glad to see you this side and the pain will wear off pretty quickly.  Glad to see that you are already FWB on your crutches that seems to be so important when you have a surgeon with that protocol.  Now i can say to you that my hamstring graft..........the one that unfortunately for me was done incorrectly and didnt work hurt more intially than the patella tendon one.  However it was easier to recover from.......am now 9 months out from the do- over and am finally beginning to feel normal........ish.  I still have days where things dont feel right and there may be a fresh issue going on which i will discuss with OS next month but on the whole i have to say that i believe this has worked.

Then of course i am counting till my next trip to Africa and some more work with the orphan kids, that sure keeps me going, esp as there is now a redundancy threat at work............anyone got a good job going???

Lisa

PS looking forward to the updates.
remidial meniscemtomy 1994
scope and tidy up july 2006
acl reconstruction and microfractures oct 2006 (failed on both counts)
oats june 2008 - very successful
acl revision patella tendon - oct 09

Offline crankerchick

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    • Derotation osteotomy & TTT Post-op diary
Re: ACLr Musketeer - Snowy's reconstruction, 9.7.10
« Reply #6 on: July 10, 2010, 03:16:34 PM »
Wow that was like reading a short story in a published magazine--very detailed, coherent, and full of style!  Pain sucks but like I tell everyone (and like my doc told me), surgery hurts, its supposed to LOL. It will get better with each day of course.

Hope your first night went well and you were able to have some rest. The cryocuff is indeed a blessing!

Now you are finally on the other side and can get to the good part--healing and rehab!
Mar '07 - plica excision
Oct '09 - femoral + tibial derotational osteotomy & TTT
Aug '10 - hardware removal
"You control your leg. Don't let it control you." -Smart trainer
"Get your a$$ in gear and go for it! Nothing will happen until you make it!" -Smart doctor

Offline Snowy

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Re: ACLr Musketeer - Snowy's reconstruction, 9.7.10
« Reply #7 on: July 10, 2010, 05:27:33 PM »
Succinct has never really been a strong point of mine.  ;D Thanks to all for your words of encouragement and support; they mean a lot, especially in this early post-op stage when everything is feeling incredibly challenging.

I'm afraid the remainder of the day yesterday was not a huge success; I let the pain get ahead of me and as a result was in a pretty excruciating state for the remainder of the night. I also ended up getting sick a couple of times, probably from the leftover morphine in my system. We watched one of our new seasons of DVDs and I drifted in and out of sleep after taking a whack of pain meds, but I didn't really get on top of it again before we went to bed.

J helped me get in a relatively comfortable position on my back with a pillow under my operated leg for support, and the good news is that I was able to get a pretty reasonable night's sleep - I think about 8 hours altogether. I woke up a few times when I moved the leg (even a fraction of an inch was enough to jolt me awake instantly) and to take my pain meds. Having had the miserable experience of feeling the full pain when I let it get ahead of me, I really wanted to try and get it back under control during the night.

The pain is definitely still present this morning, but feels a little more manageable and I was able to get around a little better when I got out of bed. Taking weight through that leg is okay (I feel it but it's not much worse than just keeping still) and I've got a bit of bend in spite of the hefty bandages. I'm managing a few ankle pumps (I've discovered the joys of the rush of blood through the calf when I stand up after having the leg elevated) but that's about it on the exercise front. Will see if I can coax my quad muscles into a few flexes later today.

Thanks to everyone for your reassurance about the pain. It makes sense that it hurts like hell when you think about what they actually do, but so many folk I know had the nerve block that I guess I just hadn't mentally prepared for how bad it would be. In retrospect, too, when I left hospital I'd just had a big dose of morphine and I didn't get on the new pain meds as quickly as I should have done when I got home. I'm not going to push things at all for the first few days, just give the knee a chance to settle down a bit. One thing I have plenty of is time. :)

My neon pink leg looks quite delightful; it's faded a little to a more mauvey shade and looks as though I have some awful necrotic disease in the calf and foot. I'm also sorry to report that I didn't get to join the team of fun surgical underwear; I got to keep my own (I wore a nice modest pair, just in case.)

I'm now back on my station on the couch, armed with iPad, book and cryocuff while J brings me cups of tea and makes breakfast. I have to say that I honestly have no idea how anyone would cope with the immediate aftermath of surgery on their own; particularly with the pain levels last night, I have been incredibly reliant on J since getting home.

Will be interesting to see how today progresses...
« Last Edit: July 10, 2010, 06:49:59 PM by Snowy »
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 Vickster

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Re: ACLr Musketeer - Snowy's reconstruction, 9.7.10
« Reply #8 on: July 10, 2010, 06:45:02 PM »
Snowy - excellent to hear it all went according to plan and that you are up and about and surfing!   ;D  Try to keep on top of the pain meds - take as prescribed even if you don't feel you need them at that point :) 

My leg was bright pink post scope too, with a lovely black arrow marking the spot - this can be rubbed off gently with a face cloth if you can face it ;)

Very disappointed that you had no paper pants - they were a highlight   ;D

Take care xx 
« Last Edit: July 10, 2010, 11:38:14 PM by Vickster »
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up

Offline roo222

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Re: ACLr Musketeer - Snowy's reconstruction, 9.7.10
« Reply #9 on: July 10, 2010, 08:31:31 PM »
Hey there Snowy, glad to hear your out of surgery with a new ACL!!

Just think, you are now a couple days closer to full recovery! ;D

Best of luck, keep the updates coming!
xx
March 2010: Torn ACL and meniscus damage to right knee (football)
April 2010: Arthroscopy to partially remove meniscus
October 14th: ACLr (hamstring graft) :)

Offline Cosmicsnuffle

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Re: ACLr Musketeer - Snowy's reconstruction, 9.7.10
« Reply #10 on: July 10, 2010, 08:37:14 PM »
Hey Snowy - hope you don't mind me popping across the road to partake in some jolly repartee over at Snowy's Place ...

How cool to have your own POST-OP thread  ;D.

Sorry to hear about the pain - I know you are very diligent and considered in your approach to things - and getting on top of the pain issue seems to be no exception. Great that you are doing OK with the FWB with crutches, and that you are letting Jen look after you.

Hopefully your experience of the general anaesthetic will be of reassurance to others who are equally tentative - do you get over hangovers as easily??

If it's 8pm here you must be in the heat of midday - hopefully you are able to rest overlooking some of those amazing views from your condo.

Keep up the good work and the smashing updates!

xx
Oct 04 - torn meniscus
Dec 05 meniscal trim and debridement
Sep 09 torn ACL, kissing contusions, knee locked 30-60o
Jan 10 ACL stump debrided, lateral parrot beak meniscal tear trimmed
May 10 ACLr (Hamstring)
Aug 11 mfx (focal lesion lateral femoral condyle)
Jun 14 100k walk London-Brighton 28hrs

Offline Lottiefox

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Re: ACLr Musketeer - Snowy's reconstruction, 9.7.10
« Reply #11 on: July 10, 2010, 10:59:04 PM »
Hey Snowy!

Great to see your POST OP diary - you're through and out and rebuilt! Woooooooooooohoooooooooooooooo!!!!!

Your diary makes excellent reading, and I'm really glad that things went smoothly and that the GA was pretty much a breeze. They do make you feel strange but you sound like you came out of it pretty quickly. I hope the pain comes under control shortly, is it dependant on the OS as to whether they use a nerve block or not? In some ways at least without one you can tell exactly where you're at in terms of pain and stuff, although I might not be saying that if it were my knee! (ask me about foot nerve blocks next week!!)

Great that J is being such a support, I am going to be glad to have Richard around next week to bring me tea and biscuits as well.  ;D  Good news on the 8 hours sleep too, your body was probably whacked out from all that swimming and cycling and reduced sleep pre operation. Sleep is good - allows healing.

Keep us posted on how things progress, I've been thinking of you today. We went for a last pre onion blast to the seaside. I drove whilst i still can - 300 miles round trip but it was great to see some sea, paddle and chill out.  8)  Cloudy but 27 degrees, so not bad at all.

Hugs !!

Lottie xxxx
Bilateral patella OA since 2009, no surgeries.
Euflexxa working well x3 to current
Right forefoot CRPS post fusion surgery 2011
Refusing to let the ailing parts stop me....

Offline Snowy

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Re: ACLr Musketeer - Snowy's reconstruction, 9.7.10
« Reply #12 on: July 11, 2010, 02:04:51 AM »
Hey gang! Good to hear from everyone. It's so strange to be posting on my very own post-op diary after so much time on other people's. All the comments are wonderfully reassuring and supportive as I make my way through this rather weird post-surgery time.

Quiet day today, just letting things settle down and seeing where the knee is at. Still in quite a bit of pain, but now I've got the meds on a proper schedule it's much more manageable than the agony I was in last night. That was a really harsh lesson on the importance of staying ahead of the pain; I think I was experiencing the full repercussions of the bone drilling and it was easily the worst pain I've ever felt in my life.

Right now that deep interior pain has settled a bit, the hamstring graft site is okay at rest but feels twangy when I move around, and the incisions sort of ping at me every time I raise or lower the leg. I've also got some soreness in the calf now, and have been working diligently away at the ankle pumps to keep the blood circulating. I attempted a few quad flexes earlier; the response is more of a twitch than a flex, but at least it's moving. The little wound on my thigh (above the main bandage - I'm not totally sure what that one is from) bleeds whenever I move, which is annoying.

I have absolutely no interest in food at all; I'm not nauseated, just not hungry. I've managed a couple of bowls of ice cream and some bread and soup, but more because I know I should eat something than because I want them. I've been supplementing the food with Lucozade, specially delivered from the UK by my parents during their trip here - due to childhood indoctrination it's always one of the things I crave when I'm sick or injured.

Cosmic - it's been a long time since I had a proper hangover but when I did they were always rotten, so I'm pretty astonished about the rapid recovery from the anesthetic. My mum has always had awful reactions to them as well, but thankfully that's something I don't seem to have inherited.

Lottie - I don't know what the rationale for blocking or not blocking nerves is, but I think it depends on the anesthetist. I know the argument against doing it is because it can give you a false sense of how well the leg is doing and you don't get feedback on your actions, but if it would have saved me from that pain last night I think I could have lived with that!

Glad to hear about your seaside trip - that sounds wonderful. My most exciting excursion today was a brief crutch with J to the dumpster (I carried the keys for her while she took the garbage out) - all of about 5 minutes but it felt like a huge achievement!

Still smoking hot here - the thought of not being able to shower till Wednesday is not a happy one...
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 moz

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Re: ACLr Musketeer - Snowy's reconstruction, 9.7.10
« Reply #13 on: July 11, 2010, 04:51:23 AM »
Congrats Snowy, good to hear you are on the other side and on your way to recovery and  back to brand new albeit with a painful start. Hope the pain quickly subsides and all goes smoothly for you. Will keep a close eye on your progress.

Offline tez27

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Re: ACLr Musketeer - Snowy's reconstruction, 9.7.10
« Reply #14 on: July 11, 2010, 09:23:42 AM »
Snowy I was a.w.a.l yesterday, work then out with friends but was desperate to log on this morning to see how you were doing,
I hope your finding the pain a bit more managable and your keeping on top of the pain meds.
I got to bed this morning at 4.30 and didnt expect to be up quite as early as this but Misty's tummy has been makint the loudest gurgiling noises, I was woryed she was about to explode, just had a wee chat with Vicky on FB and she assured me that dogs rarely explode so that has put my mind at rest somewhat :D   
So glad your finding the cryo cuff a godsend and so glad mine is waiting for me I still havent tried it out so dont have a clue how it works, are you finding it pretty straight forward to use?
well I may go back to bed or I may have a shower, not too sure as am feeling a little fragile, last preop night out ::)   anyway I really hope you have a relativle pain free day just remember ice and meds and lots of rest and T.L.C from Jen ;D
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