Day 6

PT Today. Heel slides and Quad Sets. Trying to get full extension back and flexion (sp?) that is getting your leg straight and bending it back. Also I am letting my leg hang off the bed, so gravity can do its work, that is thigh on bed, sitting position, but instead of getting out of bed, let the leg hang there. The outside of my quad, what they tell me is the IT Band or somesuch is on fire and cramps up so when trying to bend or flex my leg it feels like that's whats stopping me not the knee. Been rubbing it frequently to loosen it up.

Getting very sick of sitting around in the same spots, have been stopping the pain killers, taking them only at night as while they help get you through the day, and allow you to be happy staring at a door knob for hours they keep you rather spaced out, and block you up like...like man I got nothing I was thinking beavers in a stream, dutch boys, dikes none of which sounded good or appropriate, but the pain killers, constipating worse than the government cheese, you are going to need some help so when you fill your prescription stop by another aisle.

day 3

so had PT yesterday, besides taking a look at it, nothing much happened, while I was zonked out and in some pain, still disappointed nothing really happened. at home I'm having better success managing the pain, plus I took the immobilizer off when I am just hanging out, that and I took a shower sitting in the tub with the water coming over me, that was sweet. I know not to rush it so trying not to be stupid when having the brace off but man I needed a shower, so moved very slowly. also icing it pretty often and doing ankle pumps and quad sets, i find if I have the right amount of vicodin in my system I can do the quad sets with minimum discomfort, other times if I am trying to do a set or a leg lift it feels like my staples are going to pop out.

i waited until everything dried nicely before putting new sterile gauze over the staples and wrapping with an ace bandage. Huge storm coming up the east coast +10" due around boston, so am glad that i got the shovels out, got the blower working and salt buckets set, however, need more gas and it's a 2 cycle so have to work out the ratio and explain it to my wife so she can square it away.

I having the brace off feels great and I am handing my leg off the end of the chair and letting gravity give it its flex back, can get to about 90 degree okay. My first ACL recon, left knee about 14 years ago, the rehab sucked, mostly because there was no follow through from my then orthopedist, so i got started late, and getting my range of movement back was painful and it took everyone in the office sitting on me and a towel in my mouth to bend my leg back, so wrong, so without actively bending anything letting it flex. feel much better today, more mobile on the crutches and my head is back in the game a bit.

day 2

Last night the pain started coming. I remember last time someone telling me that after 24 hours all the medication that they used during surgery etc. may start to wear off, and my incision sites started to throb. I think the pain pump has dubious value because I turned it off this morning before seeing my doctor, took 2 vicodin, and felt better than I had with the pain pump, also feel like I have more control of my leg.

Was at the doctor's to have my dressing changed, and the pain pump 'catheter' removed, man they need to shave everywhere they put tape, because the catheter was inserted close to the tenders, having it ripped off super sucked. you would think shaving would be standard procedure, maybe would think about shaving myself, upper thigh over to the 'balzac' region on the leg getting operated on just so that would not be an issue.

Try and do leg lifts, keep a pillow if you can underneath your heel trying to keep the leg straight and stretched out. PT in a couple of hours.

Day 1

I used my own patella tendon this time. Since I had this same operation on my left knee 15 years ago I expected it to be more painful but so far so good. They use a femoral catheter for pain block plus Vicodin so all good. The femoral artery block with attached pain pump is something I did not like last time since it made my leg feel like dead wood and was very weird. However, I think it depends on how well they place, and maybe who places it. They use ultrasound to get it in place, and you can feel you leg jump a bit as they send a small current through it to make sure they get the right nerves. This one feels great.

Leg is completely immobilized for now. Ice on it over all bandages. Getting around okay and touch my toe on the floor without pain. Most likely all the Pain meds. 1st PT (physical therapy) appointment set for tomorrow. Experience at the hospital was probably a B- down from A last time. Last time they were always putting warm blankets on me, and probably upped the dosage of Valprin(?) which makes you feel like you had a six pack on an empty stomach as I was much more aware of what was going on, not necessarily a good thing, and had to ask for the blankets, which makes a huge difference in making you feel comfortable.

The general anesthesia smells like paint thinner when it first hits you but you are awake for only about 5 seconds, next thing you know you are in recovery. Which depending on how busy it is can kind of suck as more people are wheeled in and you hear them waking up, and some people are loud making all sorts of strange noises. When you get move to post op much mellower.

Tough to concentrate when you come out of it, and it usually took me a bit to verbalize my answers, completely normal. I was at the hospital at 9:30 am got out at 6pm. I would suggest getting the first time slot if possible. In the hospital at 6:00am as its mellower and easy to get through traffic plus I had a much better experience at that time slot, not sure how much that depends on the time or who is on duty.

move slowly, keep your leg up, knock it out when you get to PT

Day of

grabbed my ipod, a book and my wallet. Put on loose pants (sweats) as they're easy to pull on over bandages and with a stiff knee. Had my kids put stickers on my crutches. Forgot to get plenty of reading material for my time on the couch. Hopefully my kids will take pity on me and get the paper. Didn't eat anything and don't expect to until tonight. Also forgot to get regular aspirin which minimizes the chance of clotting. Not worried about it, just a precaution. Going with my own patella tendon this time. First time I used this on my left knee, and 15 years later still holding up. Right knee was an allograph, borrowed parts, and only lasted 2 years. I don't expect this is typical but is the case with me. And as far as my doctor's is concerned is the gold standard. What sucks is that you are recovering from 2 surgeries, the removal and repair of a 1/3 of your own patella tendon and then the acl recon itself. Saw some xrays of my knee, the screws shows up very well and look a bit freaky. Probably will need a special card to go through the metal detector at the airport. Heading out the door...

The First, prep and pre-op.

I am in the unfortunate position of having my 3rd ACL Reconstruction tomorrow. With the last one I thought it would be helpful, if only for my own purposes, to have a playbook for this thing. A couple of things to square away are insurance, where you are going to Rehab and then what type of recon you are getting, whether you are using borrowed part, a'la an allograph (from a cadaver) or using your own parts, usually your own patella tendon. I know they use your hamstring, as well, but have not had and hope never to have the opportunity to have that one done. Only because I hope I never have to go in for another one of these things.

Find the best doctor you can find. My first experience was at New England Baptist back in the early 90's. I found the doctor by asking friends, and also calling the Boston Celtics and asking them who they used. I eventually went with a friend's recommendation which led me to New England Baptist, and after researching at the library (this was pre-internet), found the surgeon. I have found that hospitals are more like spas but back in the day you got thrown on a gurney, which was cold as hell, especially with a johnny made out of tissue paper and the open side where your ass hits the metal. I dealt with a surly guy who gave me a spinal, was pumped full of drugs and woke up in recovery pawing at the oxygen tube in my nose and my knee in a constant passive motion machine. I don't think they use much anymore.

My second was done 2 years ago at St. Elisabeth's in Brighton and I found my surgeon by asking my pediatrician because he is awesome and I trusted his opinion. This brought me to Dr. Diane English and I knew nothing about her except that my pediatrician recommended her. When I walked in to her office for the first time there were pictures of athletes covering the wall and found out later that she was the team doctor for BC football. So if you are looking for a doctor a highly recommend calling a local sports team and asking who they use, presumably they have done their homework.

Before I go further though I want to say one thing, which is REHAB. It's on you to get better and the way you get better is pushing yourself in rehab. Although I have met some fantastic PTs, its the work you do with them and on your own that will get you better. REHAB.

So pulling into my 3rd operation what am I doing. Got the insurance squared away, although I found out my usual PT is now not in my network so had to pick someone out of the insurance guide, but since it is not my first time at the rodeo I'm not so anxious. I set up the first rehab session weeks ago and booked the following three so I can get times that are more convenient to me. Booking ahead is essential so book as many and as far in advance as you can

Secondly, I am trying to take care of everything that I can think of that I need to do while still walking. These are chores around the house. Putting the ladder away. Filling salt buckets by the doors, as its winter time up here, doing some holiday shopping. I am never this organized but the surgery focuses you. I have set up my rides to and from the hospital. Most of them now have valet service if you are bringing a car, use it. Last time I drove myself to the hospital at 6am, my wife got a ride there and we brought drove my car home. ACL recon is usually day surgery, get there in the morning, out by 3 or 4pm that afternoon.

Third, get yourself squared away at work, set up auto responders on your e-mail and a message on your voicemail that you are going to be high on Vicodin for awhile so you won't be answering and if you do you won't be making any sense or that you will nodding off frequently.

Fourth, bring a book you wait around a lot and wear sweats or track pants for surgery you need something loose to fit over bandages etc. You don't really need to bring anything else unless you want something that makes you feel better, like a picture or something.

Lastly, while it sucks it is not a big deal. These surgeries are very common, it's going to go well but it sucks to go post-op and rehab.

I'll get into the particulars of which surgery I think is better, my experience, etc.