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Offline Acl mum

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Acl and the older lady!
« on: September 03, 2013, 10:19:55 AM »
I hope my posts will encourage the less sporty ,over fourty  year olds fight for surgery.
About fifteen years ago, on a skiing holiday my family urged me, a natural snowplougher, to go in the next class to do parallel turns. I thought the Swiss instructor said 'follow me' , but sadly I was wrong and wrecked my knee. With three teenagers  and a workaholic OH I didn't bother getting any treatment and was just careful with it. After a few years I started noticing increasing instability. A couple of pivoting slips in the kitchen caused slight problems. The final crunch ( literally) happened two years ago,  slipping on wet tiles in a mountain cafe while the rest of the family skied. Everything was torn. I bought a hinged knee brace from physioroom, which was great.
 At the GP I was told that they didnt do surgery on the over-fourties! By now I was 61, and a very active outdoorsy type. I was sent to Physio, which was excellent, and he too said it was unheard of to refer people like me for surgery. However if I wasn't happy, after doing everything he threw at me, to go back to the GP.  After an icy winter when I had to crawl across some black ice to the back door, and yet more falls I went back fighting to the GP.  My other arguments included  knowing another acl-er who broke her hip aged 70 because of it causing a fall, and someone else who developed balance problems with Parkinsons and the Un- operated acl  is now a disaster.
The GP agreed to refer me, and the next hurdle was approached. I wanted a specific local surgeon with  an excellent reputation. 'Oh the computer (choose and book system) can't do that.' I then suggested she wrote a letter to him instead. She looked gobsmacked,  being unaware that they could still refer to specific people , and agreed.
One month on, I met the surgeon. His first words were 'I'm not ageist'.  His closing words were that I was suitable for the operation, and two months later, here I am, on Day 15 post -op!!
 
So anyone who wants treatment, don't be fobbed off, do the physio and keep fighting!
More post- news later.
 

Offline IHMK

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Re: Acl and the older lady!
« Reply #1 on: September 03, 2013, 12:26:47 PM »
Hooray!  Welcome to the realm of post-op diaries!  I am so glad to hear you finally got your way, but outraged that you had to fight so hard for it.  That's just nuts.

How are you doing, 2 weeks in?  How did it go?  Details, numbers, tell all!
My knee story: http://www.ihurtmyknee.org

28 March 2013: tore right ACL (also meniscus tear, MCL tear ["Unhappy Triad"!!], tibial plateau fracture & condylar bruise)
28 June 2013: surgery to reconstruct ACL (allograft)

Offline virtual_me

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Re: Acl and the older lady!
« Reply #2 on: September 03, 2013, 12:59:39 PM »
That's terrible that you had such a fight for it.  What was their reason for saying you shouldn't have surgery?!

Anyway, I'm glad you've finally had it done and are on the road to recovery and doing so well already from the sounds of your walk!

Offline Kaputt_Knee

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Re: Acl and the older lady!
« Reply #3 on: September 03, 2013, 01:38:48 PM »
Ageism and shortage of funds - two of the active older person's greatest enemies in terms of getting treatment in some parts of the world!

I was told categorically by my UK orthopaedic surgeon that he never operated on anyone over 35!  :o Which was interesting as he had operated on me twice already and I was 38 when he carried out the first one!  ;D As I pointed out this discrepency, he conceded defeat and operated, carrying out his first patella tendon reconstruction (although mine was technically a revision).

Fast forward to me making mincemeat of my other knee in 2006 and the attitude here in Germany was totally different - what are your goals, and an expected return to sport! When that reconstruction was eventually revised, same question and same answer from me - to get back on my skis by the end of the coming season. Oh no he said ...... (I filled with horror dreading the next part) .... it is only August now. If you work hard at the rehab you should be able to ski by the beginning of the season! Cue great signs of relief and big cheesy grin! Due to the damage he found when he went in, he apologised and said it might take a ittle longer - it did, about 6 weeks longer!!!!!!  ;)

Fight for what you know is right for you! Far more young people suffer reconstruction failures due to a combination of going back to sport too hard too soon and not rehabbing properly and continually. With age comes the realisation that perhaps you are not indestructible after all and the hard work in PT is perhaps boring but necessary!  ::)


[edited to correct spelling mistake  :-[ ]
« Last Edit: September 03, 2013, 04:38:05 PM by Kaputt_Knee »
1989 big trauma R. knee - sorted
1990-2004 3ACL recons and 20+ arthroscopies -RK
3/06 LK ACL torn!
4/06 ACL recon, kneecap broken
09 &10/06- 2x meniscus trims
3/07 - Notch Plastic & Lateral Release
14/8/08 complete revision ACL plus LCL/PLC recon
6/2/09 returned to skiing! Whoopee

Offline Acl mum

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Re: Acl and the older lady!
« Reply #4 on: September 03, 2013, 02:03:09 PM »
The GP was evasive at the first refusal. I didn't push her for a reason,hoping that the first physio old enlighten me. He thought it was either funding or ageist attitudes to fitness levels  of older people.
Anyway, the day surgery unit was brilliant, and surgery with nerve block absolutely fine. The anaesthetist was chatting to me and said 'by the way, do you know they are holding your leg up in the air'. Luckily I was sedated enough to think that that was hilarious.
The first few days were uncomfortable but much better than I expected. Thanks to you folks I was fairly organised for life with crutches. I was surprised to be able to weight ear.  Day  5 was PT and gentle exercises and homework book. No numbers yet. The plan is  6 sessions with him,then to join Acl Class in the gym. I enquired whether  that would be all sweaty footballers. He looked sheepish and said that we would all have tailored plans. He asked me what targets I had, so I said to walk downhill on the moors in a straight line, not sidestepping, to go to a posh dance and not have to hang onto my partner for grim death,  to jog gently, and to be able to step off a moving canal boat safely. I have dogs, and would love to pick up the agility class I had started , which I gave up because there was too much turning.
Different bits of the knee take turns making themselves known . Today it's a bit creaky. Last week I had the yellow staining down the shin from synovial fluid, but that has gone. The two tiny cuts are healed and the inch long one on the graft site is healed but a bit sore,and the hard lump is going .i think the inner stitches are dissolving. There's a band of swelling just above . I have a cryocuff, which is great.
I don't like standing much, walking is good and I have gained the confidence to use stairs without the crutch,but still like it for reassurance.
I'm not in a great hurry to get super fit, I just want to get the graft and the lateral ligaments and tendons normal. I assured the surgeon that I had no intention of playing football or rugby and spoiling his handiwork.

Offline PhillyCanuck

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Re: Acl and the older lady!
« Reply #5 on: September 03, 2013, 02:32:27 PM »
Great story!  Congratulations on seeing it through, and good luck with the rehab.   Hope you are able to avoid   'sweaty footballers'.  I'm still laughing.

Offline virtual_me

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Re: Acl and the older lady!
« Reply #6 on: September 04, 2013, 09:57:48 AM »
It sounds like you're doing fantastically!

My NHS physio has an ACL class also, but only for those of us who I think are over about 9 or 10 weeks post surgery.  The others are probably 20-something year old footballers.  At least I tore mine doing something more original (falling off Ben Nevis!)!  This injury has shown clearly to me that I'm not indestructible after all (somehow, amazingly, (I'm very clumsy) I had never had a major injury before).

My aunt and uncle had massive trouble finding a new GP when their one retired (they're in their early/mid-'70s).  Definitely awful ageism in the NHS due to the way the it is run.

The GP was evasive at the first refusal. I didn't push her for a reason,hoping that the first physio old enlighten me. He thought it was either funding or ageist attitudes to fitness levels  of older people.
Anyway, the day surgery unit was brilliant, and surgery with nerve block absolutely fine. The anaesthetist was chatting to me and said 'by the way, do you know they are holding your leg up in the air'. Luckily I was sedated enough to think that that was hilarious.
The first few days were uncomfortable but much better than I expected. Thanks to you folks I was fairly organised for life with crutches. I was surprised to be able to weight ear.  Day  5 was PT and gentle exercises and homework book. No numbers yet. The plan is  6 sessions with him,then to join Acl Class in the gym. I enquired whether  that would be all sweaty footballers. He looked sheepish and said that we would all have tailored plans. He asked me what targets I had, so I said to walk downhill on the moors in a straight line, not sidestepping, to go to a posh dance and not have to hang onto my partner for grim death,  to jog gently, and to be able to step off a moving canal boat safely. I have dogs, and would love to pick up the agility class I had started , which I gave up because there was too much turning.
Different bits of the knee take turns making themselves known . Today it's a bit creaky. Last week I had the yellow staining down the shin from synovial fluid, but that has gone. The two tiny cuts are healed and the inch long one on the graft site is healed but a bit sore,and the hard lump is going .i think the inner stitches are dissolving. There's a band of swelling just above . I have a cryocuff, which is great.
I don't like standing much, walking is good and I have gained the confidence to use stairs without the crutch,but still like it for reassurance.
I'm not in a great hurry to get super fit, I just want to get the graft and the lateral ligaments and tendons normal. I assured the surgeon that I had no intention of playing football or rugby and spoiling his handiwork.

Offline Hobblescotch

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Re: Acl and the older lady!
« Reply #7 on: September 04, 2013, 09:43:03 PM »
I love your list of knee goals! One of the things on my list is to take a dance class and wear heels. It's quite a diverse list you have, but all of which require excellent knee stability; I'm appalled that the GP refused at first! I thought it was pretty standard practice for the GP to refer you to a specialist to have the discussion about whether it would be appropriate for you - most orthopedic surgeons will know enough about what's going on in the field of ACLr to know that the level of function and desired activity are more important than age. Good for you for insisting on talking to the right person!

You said that you'll start the ACL class after 6 physio sessions - any idea when that will be? I'm at 11 weeks and I've still only had 4 :) Also, it sounds like you're doing quite well and could show those sweaty footballers a thing or two!

Offline Acl mum

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Re: Acl and the older lady!
« Reply #8 on: September 05, 2013, 09:57:56 AM »
DAY 17
Oh yes, I'd forgotten about shoes with heels more than an inch high!  None left in my wardrobe.
The last couple of days have been pretty idle. The band of swelling above the knee has  gone down almost completely. I'm sure that swelling hampers the exercises a lot.  I can see my kneecap to give it  it's wobbling treatment., and all incisions healed. The one at the top of the shin where the graft is fixed seems to be very firmly held together under the surface, hard all around, but not pulling.
Extra physio in the house is dragging laundry baskets with a dog lead on, gentle squats in front of washing machine,  ditto for feeding dogs, picking up dog poo,  gardening for a while, and trying to put nail polish on toes that seem far away!
Yesterday my son took me to a small supermarket, and I took a crutch for self defence against small children running about, without whacking them.  I'm certainly slower at getting round, and the brain is stagnating too, but that's Kneeworld.  A friend of mine ,who is 66 , broke her foot at the weekend falling off a stepladder whilst redecorating, but she and her crutches have still gone  500 miles in a car and  on a ferry  to Orkney. There's no holding these modern older ladies back!
Tomorrow is my second PT visit,which I am dreading, but I hope I will get some proper feedback. I think Acl classes are a couple of months away ( well into the football season).
Phillycanuck: I'm sure Canadian ice hockey players are fragrant and charming in comparison!

Offline nshah

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Re: Acl and the older lady!
« Reply #9 on: September 05, 2013, 12:21:26 PM »
At least I tore mine doing something more original (falling off Ben Nevis!)!
I had a car crash whilst on my bike so quite an unconventional injury too. Everyone seems to think I got off lightly but it certainly doesn't feel like that.

@aclmum I'd probably be classed as a sweaty footballer if you saw me at your acl class but we're all nice people :)

Offline Acl mum

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Re: Acl and the older lady!
« Reply #10 on: September 05, 2013, 01:23:54 PM »
I 'll never hear the end of the footballer comment!  :)
 DAY 17 confession...... I gave into temptation and got the car keys out.  After seeing how the knee felt pressing on the clutch pedal (manual gear change  4x4) , I started it up and went up and down the drive a couple of times.  Ok I know that's against the rules, but it makes you feel good! Nothing felt twangy in the leg either.
When did anyone else start driving?

Offline IHMK

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Re: Acl and the older lady!
« Reply #11 on: September 05, 2013, 03:15:22 PM »
I started out in an immobiliser brace, so driving simply would not have worked for me until the brace was unlocked, which happened about 3 weeks post-op so that's when I started driving.  It was a bit painful but I did it anyway - freedom!!!

I always say, it's better to ask forgiveness than permission ;)
My knee story: http://www.ihurtmyknee.org

28 March 2013: tore right ACL (also meniscus tear, MCL tear ["Unhappy Triad"!!], tibial plateau fracture & condylar bruise)
28 June 2013: surgery to reconstruct ACL (allograft)

Offline PhillyCanuck

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Re: Acl and the older lady!
« Reply #12 on: September 05, 2013, 08:42:32 PM »

Phillycanuck: I'm sure Canadian ice hockey players are fragrant and charming in comparison!

Charming, of course!  Many of us are.   Unfortunately, fragrant as well, just not at all in the positive sense of the term.  Wife used to make me leave my equipment in the garage, and then complained it caused the cars to stink.   

Glad to hear you are doing so well!  And congrats on the short drive.    I can't wait to drive again.
 

Offline Acl mum

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Re: Acl and the older lady!
« Reply #13 on: September 06, 2013, 04:14:25 PM »
Oops, I've just remembered that most of the local Sheffield Steelers ice hockey team are Canadian.  This may get interesting!
The hospital rang at 8am to postpone my second physio appointment til next week, after I have seen the surgeon.  I will just carry on with the first stage exercises. It's raining so I have stayed in being lazy whilst I have the opportunity. My OH is off work for the next fortnight so it won't be peaceful, and he likes eating three times a day which will wreck my weight loss. On the plus side , I will get out more.

Offline Hobblescotch

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Re: Acl and the older lady!
« Reply #14 on: September 08, 2013, 12:15:23 AM »

Phillycanuck: I'm sure Canadian ice hockey players are fragrant and charming in comparison!

Charming, of course!  Many of us are.   Unfortunately, fragrant as well, just not at all in the positive sense of the term.  Wife used to make me leave my equipment in the garage, and then complained it caused the cars to stink.   

I will second the fragrant comment of hockey players - I think the full-body coverage just increases the volume of stinky. On the other hand, they do have quite charming gap-toothed smiles...  ;D

Which leg did you injure? My apologies if you said it and I missed it. I think that and your transmission (standard/automatic) have the biggest impact on when you're supposed to drive. Having recently moved to London (when I am much too terrified to drive), I think location matters too - you need the reflexes of a cat to drive here!

I'm sure you don't need this warning, but make sure you're getting enough protein if you're trying to lose weight while recovering from surgery. Especially in the first few weeks, your body needs more than usual to repair all that tissue - hamstring muscle to build back, immune/swelling response, wounds to heal. Most people losing weight eat lots of protein anyway because it's filling, but I just thought I'd mention it in case :)

It sounds like you have some excellent dog rehab going on too - I know mine likes to be involved in my rehab. Picking-up-dog-poo squats are not my favourite, but on the other hand it's a good mandatory strengthening and balancing exercise!

Offline ozzie

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Re: Acl and the older lady!
« Reply #15 on: September 08, 2013, 04:31:33 AM »
Hi-I'm from the states-Atlanta, GA -and appalled to hear that knee surgery in the NH is limited for people by age. I don't want to say old folks, because 61 is not even close to being old.  . I would think knee surgery would be considered preventive medicine.  If  a knee problem like injured ACL goes untreated, it makes a healthy lifestyle less possible and more chance for falling, so inevitably more health problems in the long run? I'm certain that there must be less assertive 60 year olds who just gave up!  Good for you for successfully getting what you needed.
« Last Edit: September 08, 2013, 04:35:06 AM by ozzie »
ACI patella and trochlea & Fulkerson on Dec. 26, 2013-Dr. Scott Gillogly
ACI patella surgery and Fulkerson with Dr. Gillogly June 25, 2013
Extensive cartilage damage in both knees due to misalignment of patellas

Offline Acl mum

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Re: Acl and the older lady!
« Reply #16 on: September 08, 2013, 10:27:39 PM »
DAY 20
Ozzie, I agree with you wholeheartedly. If the NHS seems u available, people with private health insurance can get work done privately. Without insurance I believe an ACL costs about £4000.  The hospital saw me very quickly, so I have no complaints with them. Yes I am assertive in a nice way!

I slept really well last night,  comfy on my side with a pillow tucked between my legs.  Sleeping on my back isn't natural. My knee felt good too, feeling part of my whole leg at last.  I didn't have to concentrate so hard when walking (bend it, swing full extension, heel down first).  We had a lovely sunny dog walk beside a lake, but I was aware that my foot was not necessarily where I thought it was . PRioperception is the name. So  I had tone careful of tree roots  etc. The cocker spaniel  rolled in something disgusting so I had to hose him down and let him rub himself dry. Life seemed back to normal!
Tomorrow is the follow up  with the surgeon,  so I hope things are ok.
Hobblescotch, thanks for the protein reminder. I am eating fairly low- carb, and filling up with extra meat and eggs and cheese .  Lets hope one day we have thighs like Jessica Ennis!

Offline Acl mum

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Re: Acl and the older lady!
« Reply #17 on: September 09, 2013, 08:49:42 AM »
I just want to add that for people not familiar with the UK health system,  you always have to be referred to a consultant by the GP . This is a requirement for both Private and NHS referrals. GPs  the gatekeepers, and  can be such a pain.  Obviously they won't refuse a private referral unless someone is a complete time waster,  as they have professional standards of their own. You may well see the same surgeon in either scenario.  I asked to see a specific, expert, knee surgeon in the NHS system, which caused a flurry. The system normally just encourages you to choose a Centre. I had no desire to go to  the luxury place that was staffed by here today, gone tomorrow,  obscurely trained surgeons. I saw the chap I asked for and  have no complaints so far!

Offline Acl mum

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Re: Acl and the older lady!
« Reply #18 on: September 09, 2013, 05:10:28 PM »
DAY 21
 3 week check up with Surgeon : everything doing well, apart from wasted left thigh, which is beginning to strengthen. Full extension regained and a respectable ROM. Surgeon didnt do numbers. I can start very gentle  5 minute sessions on the exercise bike  twice a day. The PT will give me more work later this week.  Walking on smooth surfaces encouraged, just don't trip up! I was warned that I may feel twangs in the hamstrings, and to be careful of the delicate 4-6 week period.
See them again in six weeks, and periodically throughout the next  11 months. Otherwise just physio.
Very relieved I haven't overdone it!

Offline PhillyCanuck

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Re: Acl and the older lady!
« Reply #19 on: September 10, 2013, 02:11:02 PM »
This sounds great!  Be careful, and enjoy your new Acl! 

Offline Hobblescotch

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Re: Acl and the older lady!
« Reply #20 on: September 11, 2013, 09:34:22 PM »
Excellent news on the ROM and exercise progression! The muscle wasting is just how it goes, although I didn't realize how bad it would be until a few days postop - I told my PT how dismayed I was that the beautiful muscles I'd worked so hard on at prehab had vanished, and he just said, "Yup. They do." Cheers to thighs like Jessica Ennis'!

Also great advice on the 4-6 period for the hamstrings. Both virtual_me and I had problems during that timeframe, and I wish I'd had that warning.

Nothing says 'back to normal' like hosing off a dog that's rolled in something! ;D Getting out for doggie walks is a great part of rehab, and I'm glad that your knee is starting to feel like yours again!

Offline Acl mum

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Re: Acl and the older lady!
« Reply #21 on: September 11, 2013, 10:17:01 PM »
DAY 23
Visit to the hospital PT at last.  The patella is nice and wobbly and tracking properly, though I need to get a tiny bit more extension to get everything sliding smoothly all the time. He pressed on my raised leg to help it. Flexion is  great, and no more pushing limits on it for now. I forgot to ask for the measurement ,but it looks like 135.
I am walking properly, so we then marched to the gym for  5 minutes of cycling at whatever resistance I can do comfortably. Then it was the leg press for my pathetic quads. They must be improving because I can lift it better.
At home I can use my own static bike and add on getting up from a chair with no hands. It's breaking a long habit of bad leg being lazy. Then I went up and down his little staircase with alternating legs. I can't do this at home because our wooden stairs are to slippery, and we have three large tiled steps down to the bathroom with no handrail. I have positioned chairs for grab rails, and still use a crutch for the "good to go up, bad to go down" leg order .
 I am glad I tried  proper stairs because we will be staying at the in-laws next week,with long stairs. I shall hide away doing my exercises.
Driving is officially not approved till after six weeks .  It is my left knee,so thats the clutch pedal, easier than throttle/brake leg. My daughter who lives in Greece is coming over soon and is delighted to be put on the insurance, provided she chauffeurs me.
Well I don't feel like I am  being pushed too hard yet. PT told me the holes drilled in my bones were 7mm diameter. I'm so glad I was too floaty during the operation to know!
Jessica E is our local heroine, so maybe I should poach her PT!

Offline IHMK

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Re: Acl and the older lady!
« Reply #22 on: September 12, 2013, 10:57:37 PM »
I'm in awe.  135 degrees?  SWOON!!

You are doing fabulously well.  The differences in protocols continue to amaze me though - I would have thought you would be fine to drive, with all that ROM, but I guess it is the strength that they want you to get back before you go tearing up the countryside?

Still, if your daughter is keen to be chauffeur that's a good thing.  Being helpful is as much a blessing as being helped, if not more. 

Onward!
My knee story: http://www.ihurtmyknee.org

28 March 2013: tore right ACL (also meniscus tear, MCL tear ["Unhappy Triad"!!], tibial plateau fracture & condylar bruise)
28 June 2013: surgery to reconstruct ACL (allograft)

Offline Pamela49

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Re: Acl and the older lady!
« Reply #23 on: September 18, 2013, 05:50:35 PM »
Acl Mum, thank you for the reply you left in another thread I started. Your story is very encouraging - to me and to many people.
« Last Edit: September 19, 2013, 07:30:29 AM by Pamela49 »
- Right knee ALC rupture 2/2013 (skiing)
- ALC reconstruction 7/2013

Offline Pamela49

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Re: Acl and the older lady!
« Reply #24 on: September 18, 2013, 05:55:19 PM »
I was 49 when I had the surgery. I am two months post surgery now with ROM fully restored since Week 7 and life mostly back to normal.  I have no doubt that I made a right decision for me and my age has never been an issue.
« Last Edit: September 19, 2013, 07:36:35 AM by Pamela49 »
- Right knee ALC rupture 2/2013 (skiing)
- ALC reconstruction 7/2013

Offline Acl mum

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Re: Acl and the older lady!
« Reply #25 on: September 24, 2013, 11:03:22 PM »
Today I am annoyed!
It's five weeks now,  and I should have been having PT  tomorrow. This would be my third visit. Phone call today told me he was ill and to rebook for seven days time. This is the second delayed appointment , so I asked if his patients were shared out to other staff, since it will be six weeks and only two visits by then.   I know I can just carry on with the boring baby exercises and increase my cycling and knee bends,but that's not the point.  I pointed out that a week of knee rehab was a long time, and the receptionist said no but she would tell the lead person.  I have decided for myself to drive, though my hamstrings ached a bit this morning. It's just for pressing the clutch occasionally in pretty empty roads.  I would rather have the check on my progress and a proper approval!
I have a read a link somewhere that compared outcomes of no PT versus lots of it, which showed very little ultimate difference, so I hope my lack of encouragement means I am less likely to overwork the graft, though meaning my muscles rebuild slower.
I was visiting family last week and did less exercising, but far more stair work.  Today I used a lightweight electric lawn mower for a while, a gentle walk with the dogs off- lead  and drove  4 miles to my first session of Greek language evening class.   My brain hurts. And it was up two flights of stairs.Grrr

Offline IHMK

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Re: Acl and the older lady!
« Reply #26 on: September 24, 2013, 11:17:10 PM »
Acl mum, how frustrating not to be able to get your PT coaching when you're raring to go!

On the reassuring side: your range of motion is already pretty spectacular, and that's the most critical bit in the early weeks.  You can always build up the muscles. If you're cycling on a stationary bike as well, that's fabulous for your muscles. My PT told me last week that he had one patient who rehabbed her ACLr almost entirely with cycling (she was a cycling fiend).

So grumble away - you're entirely justified, but I don't think you really need to worry.
My knee story: http://www.ihurtmyknee.org

28 March 2013: tore right ACL (also meniscus tear, MCL tear ["Unhappy Triad"!!], tibial plateau fracture & condylar bruise)
28 June 2013: surgery to reconstruct ACL (allograft)

Offline virtual_me

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Re: Acl and the older lady!
« Reply #27 on: October 02, 2013, 09:59:43 AM »
That is annoying about the PT.  Bloomin' NHS! :(  Did you manage to get another appointment?  How are you doing now?

Offline Hobblescotch

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Re: Acl and the older lady!
« Reply #28 on: October 02, 2013, 03:05:15 PM »
Two rescheduled PT sessions is irritating, so it'd better be an extra good one when it comes (came?). You've been making such great progress though - great ROM, back to driving, walks with dogs...! How were the stairs at the in-law's? Also, is the Greek class for a trip you have planned?

Hope things are going well!

Offline Acl mum

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Re: Acl and the older lady!
« Reply #29 on: October 03, 2013, 06:42:38 AM »
Hi all,
I saw the PT this week at 6 weeks.  My first one has rotated on training and I have new one who looks like he's just out of kindergarten and very scared. He knows the theory, but I am glad I have learnt so much on Kneeguru with you fellow sufferers to be sure of what I should be doing.
My leg straightens out fully, and it can bend it unassisted to 140 and I can tell it would go further if I helped it, but there is no need to stretch it whilst the graft is still delicate.  Graft paranoia is flavour of the month. He assured me that the reconstructed hamstring is the thickness of his little finger. However this reminds me that I have got this gap in the middle of my back leg where they were stolen from.  My remaining hamstrings are like spaghetti.  Although I can walk fine, my leg doesn't necessarily land precisely where intended. This is noticeable in leg lifting exercise when it waves about a bit.  The quads are showing signs of life again, proved by progressing from zero to three weights on the single leg press apparatus. Pathetic but, improving.

The stairs at the in-laws weren't great, because they have spiral turns and the tread is narrows to nothing. However if my blind father-in -law can do them, so must I.

 The Greek evening class is up two flights of stairs, though there is a lift but I won't go in one alone. I visit Greece every year because my daughter lives there permanently, in Zakynthos, with  a Greek firefighter. His English is good but I want to progress beyond sign language when visiting his mum. I'm not sure that knowing the Greek for hippopotamus will help. It's really interesting to learn, like unlocking a code and gives me something to think about on the exercise bike.
As I left the class, guess what, I spotted a girl on crutches with a telescoping knee brace on. I must have a quick word in tea break time soon!

Offline Acl mum

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Re: Acl and the older lady!
« Reply #30 on: October 03, 2013, 07:05:18 AM »
I've just been reading posts on other knee problems from people in the US. I'm appalled! When the insurance runs out, or they dispute treatment, the consequences are terrible!  Here in the UK we take the NHS for granted,  I've had three babies and two problems with that, dislocated shoulder op, varicose vein op,  hysterectomy,  bladder sling, , previous knee physio, and now the acl. No health insurance needed.
Obama, I wish you well with your health reforms,  I'm sure the majority of the population need it. The insurance companies rule a greedy system, and the private hospitals charge people for blowing their noses.
Rant over!

Offline Hobblescotch

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Re: Acl and the older lady!
« Reply #31 on: October 12, 2013, 09:19:40 PM »
I giggled a bit about the hippopotamus. That could lead to some potentially awkward exchanges with his mother!

How's the knee?

Offline Acl mum

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Re: Acl and the older lady!
« Reply #32 on: October 16, 2013, 08:51:42 AM »
Eight weeks on, no problems to report
It's the little improvements that I enjoy,  I can change gear on the car without aching the next day,  walking further,  getting up from a chair without going 'ooff' every time, and at last can sit on the floor and then get up again!  It's makes you feel normal again.
Technically,  my ROM is fine,  swelling almost completely gone,  and the morning stiffness and clunking goes in five minutes.  My hamstrings  are still like spaghetti, and occasionally get a twinge in my calf  when doing exercises. The PT has upped the work  levels,  starting me on balancing  on a foam pad on one leg, then one legged squats, which were nasty.  Then step work, using bad leg going down first.  The leg press is a joke, I can only do three weight on it. Having nursed a dodgy knee for years,  I didn't have much strength in it to start with.  So I hope I come out of this experience in better shape than last year.
I also walked a couple of miles during the day, and now, next day don't feel any after effects,. So it must be time now to do it all again, and three times over.

Offline IHMK

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Re: Acl and the older lady!
« Reply #33 on: October 16, 2013, 03:00:26 PM »
I am so glad to hear things are going so well - and I hope you continue to have the most boring rehab story ever ;) Your comment about the ooff-less gettings-up made me laugh. 

Your weak muscles will beef up and then I bet you'll find the silver lining in all of this - new-found strength and vigor that you might never have had without having to face adversity first.
My knee story: http://www.ihurtmyknee.org

28 March 2013: tore right ACL (also meniscus tear, MCL tear ["Unhappy Triad"!!], tibial plateau fracture & condylar bruise)
28 June 2013: surgery to reconstruct ACL (allograft)

Offline Hobblescotch

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Re: Acl and the older lady!
« Reply #34 on: October 17, 2013, 01:19:16 PM »
Boring rehabs are such a blessing. Sounds like you are in an excellent place for 8 weeks postop!

Soon your spaghetti hamstrings will be penne... then cannelloni... and you'll have more strength than when you started :) Congrats on all of your recent milestones!

Offline Acl mum

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Re: Acl and the older lady!
« Reply #35 on: November 04, 2013, 09:09:09 PM »
10 WEEKS!
I had an outpatients appointment today, which is with the Senior Physio, not the surgeon. To my relief, the words perfect, excellent for 10 weeks, were used!  Considering I have a conservative approach to rehab, I was delighted. My quads need a lot of work , but she is confident that she will get me fit. I am starting Acl class in a couple of weeks! when we are given our own programme in the gym,sharing the equipment with a few other people. In my one to one sessions, I have been put on the cross trainer as well as increasing the load on the  leg press.  He arranged some little cones round me and I had to turn and step to the right colour cone on his call. This  replicates what I do at home in the kitchen in real life, and where my old dodgy knee would crash out.  When I have my programme, I will join the local gym.
I am trusting the graft more ,now I know it is fixing, and steadily trying enjoy the progress.  I find standing exercises are boring, and have remembered the more graceful ballet practice exercises I once learnt.   Pliés sounds better than squats, and go better with music!
I am turning up the level on the bike, and venturing on my longer dog walk routes. Hills are still out of the question. So life has resumed normality, and the bungee in my knee is letting me bend to clean the grime that has gathered in the corners of the kitchen floor.  The garden has missed me too, and is a mess, but I refuse to drag  a wheel barrow up steps.

Offline soccerblondie

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Re: Acl and the older lady!
« Reply #36 on: November 06, 2013, 05:00:12 AM »
Hey

Congrats on all your progress so far!  (I didn't realize we are at exactly the same point post op.  I am also at 10 weeks post ACL surgery)  I feel like I should be farther along then I am with my quad muscle...it's still tiny compared to my other leg!  :P

I also find the standing exercises boring haha.  I'm trying to be a diligent patient though

Offline Acl mum

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Re: Acl and the older lady!
« Reply #37 on: December 09, 2013, 08:44:08 AM »
16 weeks and doing fine. Physio appointments keep getting cancelled by the poor things being ill, but it has been noticed and I got a one to one session instead of acl class. So I am a bit behind on strength but the joint is fine.  I force myself to go to a private gym to do a bit more.
Yesterday the dog walk was a personal challenge, because I have avoided hills. I walked up  and down Stanage Edge,  a bleak Peak District escarpment, very rough and muddy , and steep. I had a stick for balance  but I managed so much better than a year ago, reminding my OH that I hadn't done anything like that without a hinged knee brace for two years.  He was less impressed when I realised I had dropped a dog lead near the top and he had to go back for it. But t at least he could do that at his own fast pace rather than my cautious speed.
My knee feels like it has a wide, strong stretchy belt inside it, that has some resistance  to it. I'm happy with that because it reminds me not to be an idiot.  The lateral ligaments and quads are still a work in progress. Stairs are noticeably awkward still, and crouching . I haven't started any jogging in the gym due to cancellations.
My weight annoys me, I lost 7lbs at the beginning, maybe muscle wasting, but I have put it all back on plus a bit more. I am pretending it is all muscle.
Well I hope this encourages people who are worried by reading the posts  by people with problems.  Remember that the the silent majority who are fine, don't need the forum support. I felt I had to write because I had never met any one over thirty who had had a cruciate repair, and neither have my physios!

Offline gottarun13

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Re: Acl and the older lady!
« Reply #38 on: December 10, 2013, 11:37:25 PM »
I haven't been on for a while - trying get caught up with work etc.

ACL mum - GOOD for you!!!  I also was told, originally, that I wasn't a candidate for surgery due to age.  My OS, after hearing my activity schedule quickly changed his mind....it took more coercing of that for my insurance.  I actually had my procedure within about 3 1/2 weeks from injury.  I had some complications and had to go in for a 2nd surgery to deal with some marble scarring under my knee cap and in a couple of other spots (and a manipulation at the same time).  Since then, things have improved quite a bit.   I think I am now about 22 weeks post-op.  Upstairs isn't really bad at all, downstairs can sometimes be an issue.  I too have a little bit of weight to lose now :(

IHMK - Great to see you still on here and active :)
Virtual - same goes.   How is your ROM these days??  If I remember correctly you were having a couple of issues with it (I may be confusing you with someone else - if so - sorry)

On the downstairs note....anybody have recommendations for getting that quad strength even better than it is????  I do tend to get frustrated with that one bit but don't want to complain since it really is much better than before.

My LAST OS appointment is in March....but they want x-rays this month for a follow-up.   :)

Offline IHMK

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Re: Acl and the older lady!
« Reply #39 on: December 11, 2013, 08:49:02 PM »
gottarun13 - wow, it has been a while since I've seen you here! Yes, I am still here - for my sins :) By the way in recent housekeeping some of us voluble ACL folk got moved up to the >100 posts forum (thank you KneeGuru!), so that's where you'll find me and virtual_me and Hobblescotch.

It makes me very cross when medical personnel talk about the relationship between age and the decision to have ACL surgery. There is no support in the literature for a direct connection between age and success of ACLr. The best outcomes occur when the knee is in the best shape possible before the surgery, according to a recent paper in Am. J. Sports Med. that exhaustively reviews studies of ACL surgery patients between the ages of 40 and 70. There may be a relationship between condition of the knee and age, since the longer you've been around, the more likely you are to have done stuff to your knee especially if you're active and sporty, but it's not due to age per se. Sure, there is evidence for a slowing of healing time with age, but complete healing still takes place under normal circumstances. When people suggest that older people should not have this surgery, I would ask them for data, and if they haven't published their data, then their opinion is probably based on undocumented impressions and personal bias. In my view if it isn't published it didn't happen.

Yeah, I don't have strong opinions on this topic  :D

gottarun13, it amazes me how long the quads can take to come back. I've been doing all kinds of leg exercises at the gym, but I notice that if I sit in a chair and stick my leg out straight and then slowly lower my foot, my quads start shaking. So I've a ways to go myself. On the basis of that, I wondered if it would be beneficial to tie a stretchy band into a loop and put it under my good foot, put the foot of the operated leg through the loop and raise that foot.  I tried it and it is rather a good one for the quads. You could see if it does anything for you.
My knee story: http://www.ihurtmyknee.org

28 March 2013: tore right ACL (also meniscus tear, MCL tear ["Unhappy Triad"!!], tibial plateau fracture & condylar bruise)
28 June 2013: surgery to reconstruct ACL (allograft)

Offline gottarun13

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Re: Acl and the older lady!
« Reply #40 on: December 11, 2013, 09:11:28 PM »
IHMK - I share the same irritation with medical personnel.  In fact, not just with this surgery but with care in general.  I feel like you must either advocate for your self or have an advocate to get proper health care these days.  I have encouraged my dad to go to another doctor and push to get his knee handled.  He's not that guy and he wont' even let me help him.  Choices....

The band idea sounds likes a great idea!!  I have used bands but not in that manner.  I'm going to add that to the regimen.  I'm no longer going to PT and relying on myself...speaking of having to fight...the admin personnel at my PT place started calling me to deal with the couple of billing issues they were having for two of my visits.  I finally gave them a choice, I could do their job and get that settled and not come back OR they could do their own paperwork.  I haven't been back.

I will be back on regularly.  I feel like I'm at a bit of a stall on my progress and this seems to be the one place I can rely on for some great advice....and a swift kick :)



Offline IHMK

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Re: Acl and the older lady!
« Reply #41 on: December 12, 2013, 02:56:36 PM »
Be sure to do the band exercise such that you're going from a bent leg to a straight one. I did 3 sets of 10 on each leg, holding for a slow count of 10 last night before leaving work. I also looped the band around my ankles and tried to lift each leg straight out to the side, which kills the gluteus muscles (in a good way).  And I noticed that when I got home, walking up my very uneven driveway was TONS easier than usual! I was moving more easily and felt less unstable. When I told my PT about this, this morning, he gave the band exercise a huge stamp of approval and made me a new band, smaller than the one I have, and added another exercise: put the band around the ankles and take small steps to the side, making sure the toes are not turned out - the heel should actually be slightly out. So, a small step, then bring the opposite foot next to the other one. Say, 10 steps. Do it in each direction. It works the gluteus muscles also.

Here's to happily tired muscles!
My knee story: http://www.ihurtmyknee.org

28 March 2013: tore right ACL (also meniscus tear, MCL tear ["Unhappy Triad"!!], tibial plateau fracture & condylar bruise)
28 June 2013: surgery to reconstruct ACL (allograft)

Offline Acl mum

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Re: Acl and the older lady!
« Reply #42 on: December 13, 2013, 06:51:45 PM »
TODAY I RAN!

Okay, jogging up and down the gym three times there and back.  But no handles to hold, or Physio  next to me, and it felt absolutely stable.
It's 13 and a half weeks,  and I am ecstatic!

Offline gottarun13

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Re: Acl and the older lady!
« Reply #43 on: December 16, 2013, 03:54:49 PM »
ACL Mum - CONGRATULATIONS!!!!!!!!!!!!!!  What were you running on? Outside? Treadmill?  Either way, that has to be an absolutely fabulous feeling.  Great job on your progress!!

I'm just starting to run again (I'm at 6 months - took 2 surgeries to get this knee cooperating).  However, I can hardly wait until I can do it a bit easier and without feeling awkward.  I'm just having a battle of wills with my knee.  The knee is more than capable...just re-establishing trust and a normal gait.

I just started doing my home PT again like I'm supposed to.  I know, I know, I wasn't supposed to stop.  I did, that's that.  But I"m back :)

Alrighty, work is calling my name despite trying to ignore it.  Have a great week!!!

Offline Hobblescotch

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Re: Acl and the older lady!
« Reply #44 on: December 17, 2013, 04:09:29 AM »
CONGRATS!!! That's such a huge milestone, well done! Also, isn't it exciting to start doing things you haven't done since the injury? Challenging hikes without a brace - check! Keep it up, you're doing great :)

Good to see you back around, gottarun13!

Offline gottarun13

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Re: Acl and the older lady!
« Reply #45 on: December 19, 2013, 07:47:50 PM »
Baking, baking, baking and more baking.  I was really nervous to do my standard annual baking.  It takes me about 2 days (23+ hours to complete) and I make about 2,400 cookies.  I got it done.  My knee has been a little temperamental but way less than expected.  The toe, on the otherhand....gotta knife?!???

Here's a random question - if any of you have had ortho w/manipulation - 1. did they use the same holes as the original surgery?  Do you notice them being more prone to swelling than other spots??

I ask because I have one spot, OS has said its totally normal, but when I over do it, it will swell just in that spot.  It doesn't feel painful, just uncomfortable because its like I have a small water balloon in that spot.

Hobblescotch, Virtual Me, IHMK - Hi!!! Good to see you on here still :)  It almost feels like home lol.

ACL Mum - how are you???  You have had remarkable progress - so happy to hear all the things you are doing.  :)

Offline Acl mum

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Re: Acl and the older lady!
« Reply #46 on: January 28, 2014, 09:16:49 AM »
Five and a bit months update.
My six month hospital check up was brought forward, but not an issue. The surgeon  attacked my knee like an Olympic judo player . Relax, she said ,as she wrenched it in all directions.
I survived and she pronounced that the graft was secure, with a pronounced 'stop'.  The quads are still not fully redeveloped but it will be easier to concentrate on them with a good knee. A bit a massage with E45 cream on the leg scar too.
 Physio has become more arduous but I am capable of of doing so much more now. Two notches harder on the leg press, jogging in a figure of eight in the gym,  and much longer on the stepper,  and better at standing on bad leg on a trampette throwing and catching a ball at the wall. She devised some bench work for me to simulate stepping of a moving canal boat, and side stepping along the length of it. Then I can go back on holiday on them.
I have slipped on muddy slopes out with the dog three times, no problem apart from being licked to death by worried dog. What I still find tricky is getting up from the ground when there is nothing else to pull myself up on. Also my good side hip is complaining from overuse  sometimes. The physio has suggested exercises to improve the muscle use on that leg, doing one legged knee bend with it on the stairs.
So , I carry on with weekly physio for now, , and go back to the consultant in six months for a final check up.
Thank you NHS.
PS. There us someone else in my ACL class nearly as old as me, and he had coped for ten years as well before requesting surgery. He needs to be able to get on and off his horse safely.

Offline caraghk

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Re: Acl and the older lady!
« Reply #47 on: January 28, 2014, 05:01:53 PM »
Your rehab story is very inspiring. Congratulations its all gone so well!

I'm currently on week 6 postop of a tibial spine fracture (My ACL snapped off my tibia, so I had to have the bit of bone with my ACL on it reattached!)

Have had no weight bearing all that time and it's horrendous how much the quads atrophy. Good yours are coming back slowly but surely. :)

Offline Acl mum

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Re: Acl and the older lady!
« Reply #48 on: July 10, 2014, 02:36:58 PM »
 10 months  3 weeks.
  Today I was completely discharged from the Hospital!
To encourage the people who read this site and get scared by the posts from folks with complications, please remember that the vast majority of ACLs  are as straightforward as mine. Do as you're told by the physios,  and don't overdo the exercises. Once your graft is secure there is plenty of time to get the muscles back.
I won't be skiing or playing football, but cycling, hiking, mowing, boating and swimming are back on the agenda.
I now confess to being an active 64 yr old female, mum but not granny,  so I wave the flag for equality for oldies, after all, we all become one!
I've been more than grateful for the advice on this site, and encouragement from the others who went through the same op at the same time. I hope you are all fit and fine.
Thanks everyone !















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