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Author Topic: Meniscus repair (19th April) followed by ACL reconstruction (17th June)...  (Read 41946 times)

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Offline virtual_me

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Just found this site!

I had surgery to repair my meniscus on 19th April.  I was making really quick progress after that surgery, and was soon going regularly to the gym (cycling, x-trainer, rowing and weights).  I'd also gone back to climbing, and was cycling a fair amount.  I wasn't allowed to run though.

Then on the 17th June (10 days ago) I had ACLR surgery, in which they did a hamstring graft.  I don't know if the meniscus surgery will slow my recovery from the ACLR at all.  I do think the easy recovery from the meniscus lulled me into a false sense of naivety regarding the ACL.  I knew it would be tougher, but I think I just assumed I would make really quick progress since I did on the last round.  And I also didn't quite realise how painful it would be.  I've been brought back to reality now though.

I had the surgery around 9am and felt pretty bad when I came round.  They gave me morphine and finally said there was only one more thing they could give me but it would make me nauseous and I'd probably have to stay the night.  So I declined.  Felt really woozy throughout the day.  I was finally released about 5pm.  I felt ok pain-wise and even managed some wine (against nurse's orders!) that night!

The pain for the next couple of days wasn't too bad.  My mum came up to look after me for a week, and we went out for dinner a couple of times.  The pain started around 4 days post-op and became quite excruciating, particularly when I had had my leg in a position for a while and then moved it.  It was particularly bad with a burning type ache around my shin, which I now think might be from the very impressive bruising that I finally noticed on Monday (one week post-op).  I'd been thinking my leg still had some iodine staining on it, and then finally clicked that it was bruising when I noticed the most disgusting black bruise over the back of my leg from just above the knee to just below it (I guess related to the hamstring?).  This also explains why it was so painful when I was sitting on hard chairs at restaurants!

The pain probably wasn't helped by going for a mile walk on Sat (5 days post op) and again on Mon (7 days post op).  I've since been chastised by the physio.

The pain finally started to be less bad yesterday (9 days post op), and I even slept reasonably well last night (before then, whenever I moved I would wake up in excruciating pain which would take a while to subside) and have only taken one dicolofenac so far today (none of the co-codomol).  I'm still getting these blood rushes, but not as bad.  I'd rather get off the pills if possible as they have made me super constipated!  I was put on diclofenac and co-codomol.  I guess I'll stick with the diclofenac to try and bring the swelling down.

Physio-wise, they've given me 4 sessions in a hydrotherapy pool.  I had the first session 3 days post-surgery and the 2nd  yesterday, 9 days post surgery.  The 3rd is tomorrow (11 days post).  Then I'll progress to dry land.  At the physio they have me doing exercises to bend and straighten my leg in the water with weights, walking around without crutches, and a couple of exercises to work on balance.  At home I'm doing the usual heel slide, trying to straighten my knee, hanging my leg off the bed, leg raises... They also said to try and move the knee cap around a bit but I keep forgetting to do that.  When they checked yesterday I think they said it was +1 extension-wise (my other leg apparently hyperextends so I need to get to minus something), and the bend is 106 degrees.  I wasn't very swollen when I first went, but it hadn't gone down much yesterday, which they said is probably because I've walked too much on it :(

As such, I've started icing (they initially said I didn't need to as I had so little swelling but I've ruined that!).  They also advised applying heat to the bruising to soothe it.

Yesterday she said I could use one crutch indoors but need to carry on with both outside for now.  But I often can't be bothered to use it indoors.  I appreciate this is probably bad, but it's a bit of a faff and tricky when you're trying to do washing etc.

I've managed to get out a bit - when my mum was here we went out for dinner a few times; I went to the cinema on Tuesday with a friend (Cineworld kindly provided me with a chair to put my leg on), and last night out for dinner with my partner.  So I'm luckily not going too too stir crazy.

I haven't got a brace or anything either - I don't think they go in for them in the UK.

And I have delightful looking staples in my wounds.  I'm getting those out on Tues - I'll be glad to get them out but not looking forward to the process (I'm a wimp). 

Hopefully I will also get a chance to speak to the surgeon then to find out exactly what he did, as I didn't really see him after the surgery.

I also want to know whether he got a review of the MRI sca,n because it is strange the ACL rupture didn't show up in that when he was so certain it was torn (and scans are supposedly 94% accurate according to him), resulting in me having to have two separate surgeries (bad for me, a waste of resources for the NHS).
« Last Edit: June 27, 2013, 03:52:21 PM by virtual_me »

Offline Hobblescotch

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Wow, I'm so impressed by how much you've been able to do immediately post-op - walking, dinner, cinema, and even crutchless laundry, how fabulous! It sounds like your PTs are really on the ball too; I've read a few articles on restoring extension, and while it used to be common to aim for just 0 degrees, there's been some more recent research that suggests that knee symmetry is more functional (which seems logical to me). I had the same problem with the cocodamol clogging me up, and I was super glad to be done with that medication!

Hope that some ice gets that swelling down, and that your recovery continues to go so well  8)

Offline virtual_me

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Hehe, well I just bore easily (I'm a terrible patient) and I think I would have got really depressed if I hadn't got out at all.  It's been lifts or taxis.  I'm not sure it's the most sensible stuff to be doing (the walks definitely weren't).  I have had one crutch with me when doing laundry :)  I have hydrotherapy tomorrow morning, so perhaps they'll tell me off some more.

I've just been noting some questions down for if and when I get to see the consultant (did you see yours after surgery, or do you have a meeting booked?  I'm hoping I can catch him when I go to get the staples out).  I've read that if you have meniscus repair at the same time as ACL reconstruction it can slow your recovery, so I'm curious as to whether having had mine repaired 2 months prior will have had affected this surgery.  While I'm happy with the job he's done on my knee, I have found the NHS overall to be dreadful at communication.

I'll be interested to follow your progress too, since we had the same surgery and close together.

Offline virtual_me

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After feeling really positive about the pain easing yesterday (I only took 2 diclofenacs yesterday), I didn't have the best night's sleep last night and took a couple of co-codomol during it.  However, feeling fine today (it's almost 4pm and I've taken 2 diclofenacs and 2 co-codomols during it).

I had my 3rd hydrotherapy appointment today.  Firstly, they seemed shocked that I'm not getting my staples out till Tues (15 days after surgery).  Apparently you shouldn't have them in more than 10 days, and it will probably get quite itchy.  Another item to add to my list of complaints!  They tried to get someone at the hospital to do it today but couldn't get through to anyone.  They'll try again on Monday, but if not I'll have to stick with the original plan :(

Good news though is that they managed to get me my first dry land physio appointment for Tues.  So I have my last hydrotherapy on Monday and then begin the regular physio the following day.  That's good!

Hydrotherapy was surprisingly fun today (perhaps evidence of how bored and lacking in exercise I've been!).  I particularly enjoyed it when I had to stand on one leg and catch a ball he threw at me!  And he then had me running round part of the pool.  It's great as you can do exercises you wouldn't be able to do for ages on land.

Other positives: My bend is 115 degrees (and that's with the staples still in, which apparently limit you), and my extension is +1 (I need to get to +4).  And the swelling's gone down a bit.  So all a big improvement from just 2 days ago.  He also said I can officially stop using crutches indoors and just one outdoors.  But I just went out for lunch and felt a little unsteady with just the one.

All in all, other than the staples, things are progressing well. :)

Offline Hobblescotch

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Ugh, those staples sound incredibly uncomfortable. I have steri-strips covered with weird bandages that look vacuum-sucked to my leg, and even those pull when I stretch so I can only imagine how uncomfortable staples must be! I hope you get them out asap. I know I've said it before, but that hydrotherapy sounds awesome! How do you manage to keep your dressings dry? You are just making out like a bandit with the physio :)

Hope you have a fun weekend with your friend!

Offline virtual_me

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Wow, just realised, it was exactly a year ago today I fell off Ben Nevis and (as it turned out) ripped my ACL!  At least I've finally been fixed and am on the road to recovery. 

(Mind you, the physio today did say that people who've had their ACL rebuilt are more likely to need knee replacements in the future, so, going forward, it's important to always work on having strong quads.)

Had my final hydrotherapy appointment today :(  .  I'll miss those as they were fun!  Along with my other exercises, he also had me hopping on my ACL foot and stepping downwards.  I had sharp pain in the front of my knee cap when I was stepping up (facing forward), when I'd got to about 10 steps, but it subsided and was then fine.  The physio said this is normal, because my quads aren't doing much.

My bend is 123 degrees (with the staples still in) and my extension is +3 so only one more thing to go!  The swelling continues to slowly go down.  He says I can go out for 20-30 mins, without sitting down, with one crutch (which I've naughtily been doing already).  I'm comfortable walking around indoors without any crutches.

I still get woken up a few times at night when I've laid on the leg, or moved it or something, and it hurts.  Other than that, there's not really any pain at all.  In fact, writing this is what made me think of it - I hadn't even thought about pain today before now (other than when I was doing that exercise in the pool, but I mean the achey pain), or taken any pain killers (other than the 2 aspirin I'm supposedly meant to take to stop my blood clotting, though not really sure I actually need to take those - will check with my GP friend, but she told me not to bother after the meniscus surgery).

And I can sit at my desk for much longer. without getting so horribly stiff

I have my first dry land physio appointment tomorrow.  And I will be so glad to get those staples out and be able to wear my jeans again!! :D

Offline Hobblescotch

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Ouch, fell off Ben Nevis? Back to full extension is an excellent anniversary present! It's so inspiring to see your progress, since you're just a few days ahead of me and doing so well. Considering the nature of the surgery, with all of the drilling and chopping, I was expecting more aches and pains. Like you, I've found that it's settled quickly into stiffness, rather than full-on pain. Hopefully it'll be even more comfortable for you tomorrow, once you finally get those staples out! Good luck with your busy knee day :)

Offline virtual_me

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Hobblescotch - yes, but only technically! I was roped up so didn't drop very far! ;)

DAY 15

So today I had my first regular physio appointment.  She gave me some new exercises to do.  Said I should still use one crutch for longer distances.  I'm back to full extension, yay; my bend was down to 115 degrees - apparently it would bend more in the water, hence the 123 degrees yesterday (and I think she said the average bend is around 135 so I'm not far off). 

She put me on the bike which I was really excited about.  Unfortunately, when I pedalled I felt a weird sensation in my kneecap.  A bit like when you need to click your knee, but somewhat more uncomfortable.  So she took me off it.  I almost felt like crying with irritation as I'd been so excited at the prospect of getting on it!  But I guess even if it looks and feels like it's doing well, I have to remember I've had quite major surgery and I don't know what's going on inside.  I had no real reason to think I might have torn the graft, but she tested it to be certain and it's fine.  Next session is in a week.

Anyway, I was feeling pretty disappointed and grumpy when I left.  But then I went to see the consultant.  He was amazed by my progress!  Said I had barely any swelling, full extension and a good bend (despite the clips).  I don't think he could quite believe it! :D  So that was really encouraging.  I told him about the pain when I tried to cycle and he said he wouldn't normally tell people to go on a bike for 4 - 6 weeks and since I'm only just into week 3, this isn't anything to worry about.  As it is he seems to think I'm well ahead of the game.  (I saw the 16 year old boy in the waiting room, who had his op the same day as me, and he still had bandages on his knee and was walking on two crutches.  Who says the youth are fitter?!)  I think I'm generally very robust and heal well, and the fact that I really worked on strengthening myself in the few weeks preceding the op (as soon as I could after the meniscus surgery) really helped.

I have an appointment to see a nurse in 7 weeks (should be 6 but I'm away for a wedding then).

Then I went to have the staples out.  It wasn't quite as horrific as I'd been anticipating.  The first ones she took out were the top ones which did have a sharp unpleasant sensation, but surprisingly the ones out of the big cut came out much less painfully.  I guess the ones around the knee cap have probably been stretched and become more embedded when I've been doing my knee bends.  Anyway, it feels amazing to finally have them out and the skin feels less tight! :D  I have a couple of plasters on them now, but as soon as they feel good I can get back into my normal jeans.  Hoorah!!

I was even up for walking home (1.4 miles).  We walked about a 3rd of that (up and down a small hill) and I could have gone on but it was pouring with rain so we jumped in a cab.  No pain though, and I haven't taken any pills today.

So all in all looks like things are progressing nicely!  :D
« Last Edit: July 03, 2013, 09:32:31 AM by virtual_me »

Offline virtual_me

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Day 16

I think perhaps I'm about to embark on a boring and frustrating part of the recovery.  The pain has gone and I feel fine, and therefore feel like I'm capable of doing much more.  But I'm not.  I want to go for a proper walk, go to the gym, go for a run, go for a cycle, damn it!  Basically just to be normal!  Grr.

I'm also getting an occasional sharp stinging sensation on the outer side of my shin - where it lost sensation after the surgery.  Could this be the nerves mending themselves?

In positive news though, I'm wearing jeans again! :D
« Last Edit: July 03, 2013, 05:15:44 PM by virtual_me »

Offline Hobblescotch

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Those are some cool looking puncture marks. Your incisions look so much cleaner than mine, since you had the staples around the small incisions! Is all of your bruising gone?

What a boost from your OS! My NHS PT said the same thing about waiting longer for the bike, and it only makes sense that some exercises are still going to be uncomfortable just 2 weeks post op.

In many ways, I'm glad for you that the recovery is boring. The eventful ones are rarely eventful in a good way! Obviously, there's a lot of excitement and progress in the first little while, and sadly it's a long haul. I guess that's the price you pay for reaching so many of those milestones early - you have to wait longer to get to the next step. I'm starting to feel impatient to get back to normal too, even just to get back to everyday activities like walking longer distances, going down stairs normally, sitting up for several hours... but really, out of all of the problems to have at this point, what a great one to have!

It definitely sounds like nerves mending, since it's in the area that was numb before. How big was/is the numb area?

Hang in there, you're doing great  8)

Offline virtual_me

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DAY 17

Well so far has been an 'exciting' day (hey, it's all relative!).

Yesterday I went for 2 walks - there's a park may be a normal 8 min walk up the road with a nice pond and ducklings in it.  So that's where I've been going, and then walking round the pond and feeding the ducks.  The first walk yesterday was ever so slightly longer as I paid a visit to a bottle bank first.  Anyway, all in all by far the most exercise I'd done to date in a day since the op.  I also did all my new exercises a couple of times yesterday.  I felt fine from it, though my knee was a little stiff when I woke up this morning.

I did wake up in the night from a weird pulsing ache in my ankle.  Luckily got back to sleep again fairly quickly.  Haven't had that before and it's not returned yet.  I haven't had an undisturbed night's sleep yet, but I'm not awake too much.

Anyway, I thought I'd take it easy today.  Did my exercises.  Did some work (I should add that I've been able to sit at my desk pretty comfortably for long periods of time for quite a few days now).

But then my rubber ring arrived (the float came the other day)!!  So I decided to take myself off to the public swimming pool.  I took a cab there.  Once there, I decided to take a look round the gym they have as I'm considering swapping when I'm well enough.  That was probably somewhat self-torturous, but in a way it felt good being in an area of exercise again!  Then I went to the pool.  Somewhat grim, and a little scary as the floor was wet so I was worried my crutch would slip.  Still managed to lower myself gently in and do most of my exercises, despite the children screaming and splashing around me, and trying to steal my float (damn you, school holidays!).

Then, feeling exhilarated (!?!), I naughtily decided to give swimming a go.  The hydrotherapy man had said I should wait 6 weeks, but he went on to say that this is based on no evidence, so pfft!  I went into the slow lane and very gently kicked my legs.  Obviously I mostly used my arms.  I felt a tiny twinge in my left knee early on, so kicked even more feebly.  Let me tell you, lengths mostly completed using your upper body, are pretty hard work!  But I managed 6 (3 breaststroke with my arms and 3 front crawl).  I even worked up a bit of a pant and heartbeat!  Amazing!  And it's funny how just a little bit of exercise makes you feel so much better!

I then went into the jacuzzi and attempted to do my step ups in there (as there was no step in the pool), but that was quite hard as the water wasn't really deep enough.  Then a hilarious man said 'Bit soon to be at the gym isn't it?'.  I should have retorted that that was why I wasn't in the gym, but by the time I understood what he said (he had a thick Glaswegian accent so I kept saying 'pardon'), the moment had passed.

Then I left and decided to walk to the bus stop (what would normally be a 5 min walk), and my leg felt fine doing it, so don't think I overdid the pool.  Never have I enjoyed waiting for a bus so much!  Just being outside, in a normal place (rather than a hospital), being able to take public transport (other than the annoying, unreliable Glaswegian taxis) - bliss!

My other exciting and naughty news is that last night I ordered an exercise bike.  I was looking at getting an attachment for my road bike so that I could use it indoors, but this almost worked out as expensive as getting a proper exercise bike, and at least this way I can watch TV or something while using it, rather than having to sit in the garage.  Hopefully it will arrive tomorrow!  And even post rehab, it will be useful for a bit of additional exercise, especially on those dark wet Glaswegian winter nights when a run doesn't seem that appealing...

The only discouraging thing so far today was that when I got home I attempted to walk up the stairs without my crutch.  That wasn't such a good idea.  Nothing bad happened, but it hurt and I couldn't really do it.

I'm sitting icing my leg now, after all this exercise.
« Last Edit: July 04, 2013, 05:23:02 PM by virtual_me »

Offline virtual_me

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Those are some cool looking puncture marks. Your incisions look so much cleaner than mine, since you had the staples around the small incisions! Is all of your bruising gone?

What a boost from your OS! My NHS PT said the same thing about waiting longer for the bike, and it only makes sense that some exercises are still going to be uncomfortable just 2 weeks post op.

In many ways, I'm glad for you that the recovery is boring. The eventful ones are rarely eventful in a good way! Obviously, there's a lot of excitement and progress in the first little while, and sadly it's a long haul. I guess that's the price you pay for reaching so many of those milestones early - you have to wait longer to get to the next step. I'm starting to feel impatient to get back to normal too, even just to get back to everyday activities like walking longer distances, going down stairs normally, sitting up for several hours... but really, out of all of the problems to have at this point, what a great one to have!

It definitely sounds like nerves mending, since it's in the area that was numb before. How big was/is the numb area?

Hang in there, you're doing great  8)

Thanks for the encouragement! :)  You're doing great too!

I still have a slight yellow tint in my shin, and the black bruise on the back of my knee is still there, but it's no where near as horrible as it was.  The bruising around the incisions is all gone.  I was surprised he put staples in the small incisions, since he didn't for the meniscus surgery, and those were the ones that were more painful to get out.  Hopefully once the puncture marks have gone the whole thing will look reasonably neat.

Ha, yes, it was nice to hear the surgeon sound surprised.  Perhaps he was pleased with his handy work! :)

The numb area starts from just to the left and below the kneecap, may be 3 cm wide and 8 or 9 cm long... I think.  How big is yours?  It still is pretty numb and I haven't had any more of the stinging sensation today.  Who knows!?  The hydro physio chap said most of it should come back but some people are left with may be a penny sized area that is numb.  I guess that wouldn't be the end of the world!

You're right - definitely better to have a boring recovery than an eventful one and so far (touch wood) we both seem to be in that boat!
« Last Edit: July 04, 2013, 05:22:37 PM by virtual_me »

Offline Hobblescotch

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I am so awed by and jealous of your endurance! Swimming AND multiple walks?! I can't wait to get back to the gym, just for a place to go and spend some energy. First I have to be able to walk to the bus stop.

For some reason, I never got a numb patch. Actually, because of this and my immediate ROM, I doubted that my surgeon had actually performed the right surgery for the first few days post-op - then I got the hamstring bruise and relaxed :P I know from Snowy's diary that she had a small numb patch remain, and she said she only really noticed when she went swimming or wore tight pants.

Having an exercise bike at home is hugely helpful - it's so great at all stages of rehab. If it arrives tomorrow are you going to give it another go right away, or wait until PT next week? I'm guessing right away :D

Offline virtual_me

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I am so awed by and jealous of your endurance! Swimming AND multiple walks?! I can't wait to get back to the gym, just for a place to go and spend some energy. First I have to be able to walk to the bus stop.

For some reason, I never got a numb patch. Actually, because of this and my immediate ROM, I doubted that my surgeon had actually performed the right surgery for the first few days post-op - then I got the hamstring bruise and relaxed :P I know from Snowy's diary that she had a small numb patch remain, and she said she only really noticed when she went swimming or wore tight pants.

Having an exercise bike at home is hugely helpful - it's so great at all stages of rehab. If it arrives tomorrow are you going to give it another go right away, or wait until PT next week? I'm guessing right away :D

Ah from the sounds of your diary, it sounds like you're doing pretty well yourself, just at some different things from me.  Plus I'm a couple of days ahead of you... I do think I've been really really lucky though in terms of not having much swelling, and this probably makes an awful lot of difference.  May be the hydrotherapy helped too...

And you're braver than me in terms of ditching the crutches outside.  I think I could do it, and the area I'm in is pretty quiet too, but when the ground is unsteady, I like to have the support in case.

I absolutely cannot walk down stairs with my ACL leg first.  I can go upstairs with both legs, but I have to concentrate and go carefully.

My leg is a little achey now when I walk around the flat, after all the exercise, but I think (/hope!) it's just tired out.  If need be I'll just rest it tomorrow.

I think it is arriving tomorrow.  Haha, well I'll need to assemble it first!  Once that's done and if I feel up to it (my leg is tired now so it's hard to imagine!) I will give it a tentative go, but if I feel any pain I won't do it.  While I'm eager to progress and do things, I want to do it within sensible parameters and not hurt myself further!
« Last Edit: July 04, 2013, 11:53:00 PM by virtual_me »

Offline Hobblescotch

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I know, we're both doing fabulously  8) I think the minimal swelling makes a big difference - it really just allows you to do more in terms of ROM, quad firing, and other exercises right off the bat. I know you won't do anything painful and risky, but I also know you're raring to get cycling! Did the bike come today?
« Last Edit: July 05, 2013, 11:31:35 PM by Hobblescotch »















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