Tuesday, March 28, 2017

Week Two

When people ask 'how's the knee doing?', I find myself answering something like "Oh doing great. Could always be better, but it all depends on how you look at it." In some ways I'm where I expected to be two weeks post op, and others not so much. But I'm ok with that, as every knee is different and there's no one recovery timeline that will be 100% customized to you.

Week two observations:

- I'd say after day 6 was when I really noticed that not just my knee, but my whole body was tired and sore. It's quite the core workout getting in and out of bed (it's like doing V sits multiple times a day!), and my upper body got its fair share of work as well given the crutches, getting in and out of the car, using the handrails going up and down stairs, etc. Who needs P90x? 😆

-I realized that rest days are necessary for your muscles during recovery (well that seems like a no brainer now that I type it out and read it like that... 😋  ). This is quite the oxymoron as you might be thinking hey but you are already resting all the time... when really it is just like any other training regime. Your weak quad/leg can only do so much so fast, and building back quad strength takes time, even though you want to get it back as soon as possible and work on it hard every day. Working on ROM is another story however, but when it comes to the quads, the same basics to gaining muscle apply. Stretching, foam rolling, etc. all still comes into play no matter how much or little quad muscle you have at a given time.


My circle of PT exercises I do multiple times a day- Side leg raises, hamstring leg raises, straight leg raises and inner leg raises.

-As I mentioned above, ROM (range of motion, aka flexion of the knee) is a new concept to me, and I'm finding out you can't treat it like a muscle. I've never in my life had to work on getting back a basic physical movement before, so I was not sure exactly how much to actually push it/work on it. Thankfully, between a friend on her third ACL recovery (who had 90% ROM in her week two!) and my PT, I was able to clarify just how much is ok to do... which btw was alot more than I was doing. With the stitches out, I feel so much more confident with flexing my knee. I went from 90 degrees flexion to 110 degrees (see this pic for ROM knee measurement). But working on my flexion brought back a little swelling, which in turn decreased my stability in my knee. A brace here helped me alot. Wearing a brace post op is all personal opinion, as it can have hindering effects (e.g. mentally thinking that knee is weaker because it's in a big brace, so you end up using that knee/quad less). I really didn't want to pull a crutch back out, so I decided to use my brace in this situation... and it's definitely doing a good job. Felt it catch my knee a few steps so glad to be wearing it now. And it honestly reminds and helps me from being too ambitious (instead of not using it enough)! Once the swelling goes down though and stabalizer muscles are able to wake up, I probably won't wear it then.

These pictures are 10 minutes apart- the picture on the bottom is before and top is after. This is from spending just a few minutes bending past and enduring a few moments in the "uncomfortable but not painful" zone, then releasing. Quite the difference, and it certainly is almost all mental. And yes, I changed pants and rooms between the two pictures as well :P 

Post working on ROM and icing... not a very happy knee!

Towel bends
Looking forward to what week 3 holds :)

Thursday, March 23, 2017

Post Op Appointment, Day 9


Had my post-op appointment today and all went really well! Took x-rays, went over my images from the surgery, and also got the stitches out. I asked about how much I can do and about pushing it too much, because knowing me I am more likely to do too much too fast, than not enough. “It’ll tell you. Just listen to your knee.” She said. Which makes sense- it’s also pretty much how I base my training: If it feels good, push it a little. If it’s feeling sore/tired/swollen, slow it down and rest. I was given a compression sock to wear in place of the wrap followed by the statement “If it can’t swell, it won’t swell” and I was on my way. Didn’t have anything out of the normal to talk about and I’m well aware of my ‘homework’ between now and my follow up appointment with my surgeon Dr. Vidal in 4 weeks.

I also left my crutches at home this morning, as I felt confident in my quad control and the crutches were proving to be more of a hassle than help. So 8 days was the magic number 😊

I feel so ‘free’ so to say now with no crutches or stitches… nothing ‘holding me together’! Well.. except for the big screw in my tibia! 😳

Today was also the first time I really felt a sense of joy/happiness since the surgery. Yes I was in a good mood with positive thoughts and such, but that alone doesn’t mean that you are truly happy inside. It was a small sensation of the feeling you get after working hard and achieving something- much like reaching a summit or crossing a finish line or... successfully getting through the first few hurdles of post ACL surgery 😛


The screw is for double fixation, I believe is what she called it. Basically it is to pull the graft/new ACL tighter.






Side View




No stitches finally!

video


Wednesday, March 22, 2017

Day 7 & 8

One week and a day post op and in some ways I'm where I expected and others not so much.

The throbbing is still there each time I stand up, but swelling has gone down alot. I had a bit of a setback. Well no, not setback, plateau is a better word. Monday (day 6) I was able to bend my knee to 90 degrees, and Tuesday morning (day 7) I continued to work on bending it. However that tuesday afternoon, the throbbing became particularly painful and it felt harder/painful to bend it, which made walking and getting around much harder than anticipated. I ended up leaving work early and headed home to elevate, ice, and rest. I questioned if I had overdone it- I've chosen to take the stairs instead of elevator everywhere, I walk around the house without crutches, and have been out and about instead of at home resting... so the possibility is there, however I honestly don't feel as if I've pushed past any limits though.

Molly makes a great recovery buddy :) 

Today (day 8), my knee felt a little better and after seeing how it felt that morning, I decided two crutches were unnecessary and 'graduated' to leaving one crutch at home and only using one. Life is so much easier with one :)

Did a little less than normal today at PT- I had lost some confidence in it given the tantrum it gave me yesterday afternoon/evening. Warmed up with some previous exercises and then worked on bending it. I was only able to reach 88 degrees flexion today. Did a short 10 minute session on the EMS, it didn't particularly feel good but it didn't hurt at all. So not sure what to think of it. He asked if it felt any better/different afterwards and it really didn't at all, at least not immediately afterwards. I was able to use it alot more than normal once I got home after PT, so whether it was because of this EMS or not, I'm not sure. I'll certainly try it again though!

First time to use the electronic muscle stimulation- I get a little iffy around anything electrical anyways so I didn't particularly care for it, but it wasn't just absolutely terrible..! 

video
Of course, it always feels like you are bending it more than the video shows you actually are. Don't mind Willie, wondering just exactly what I was doing... Day 8 post op walking without crutches 


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Going up stairs- today was the first day I've been able to lead with my left leg going up- still working on using my quad muscles instead of relying on my glutes and hip. 


video
I was also able to do a few straight leg raises for the first time since surgery. Regaining control/use of your leg is quite the experience..! 



Tuesday, March 21, 2017

Day 6

I had no clue I would have my 'normal Monday' only 6 days after surgery. Well, semi normal. Minus the crutches and PT. But hey either way, PT will be apart of the new normal for me on Mondays!

I woke up semi early to get ready to go into work today. However the minute I placed my left leg on the ground, it swelled up and throbbed with pain pretty hard. My heart also raced for a little and I felt light headed. "Of course, the day I intend to go back to work is the one morning I just want to go back to bed" I thought as I was sitting on the edge of my bed, waiting for the throbbing to subside. It did get better though, and I'll find out that this would be the theme of the day.

My mind thanked me as I returned to my work, which in this case, I'm thankful is at a desk. "Guys I love being at work. I love work." I mentioned to my co workers as they just laughed and understood it must be nice to be out of my house. I had PT at noon today, but ended up coming back to work afterwards instead of going back home. 

Comfy at my desk :)
I as able to bend my knee to 90 degrees flexion at physical therapy, which is a great week one milestone. I've been able to extended it all the way since day one, so the focus is on flexion. It doesn't hurt to bend it, and I would love to try bending it more, but I really am just not sure about the pulling sensation on the stitches/tape on the top of my knee. It certainly gets to me, and honestly kind of freaks me out because I'm half way expecting it to just burst open at any moment, much like opening a bag of chips at altitude. 😝  

We also did a few exercises that pinpointed where some weakness had set in my adductors and inner quad. He watched me walk and although my gait was not close to perfect at all, I was still able to walk without crutches with confidence. Not quite done with them yet as he said to keep using them 'just in case'. Which makes sense and I don't mind- would rather spend a few extra days on crutches than try and rely without them too early. 

My sister has Monday's off so soon after I left my work that afternoon we went downtown to our go-to place, Euclid. We chatted for a few hours then I continued on to a coffee shop close by to meet one of my ski buddies who also went through ACL reconstruction a few years ago. All this up and down felt just fine- I just had to endure the 2-3 minutes of throbbing as I first stood up, but then was able to continue on...! It was late as I got back home, and I thought 'hmm not too bad for only 6 days post op!'. I listened to my knee all day and was ready to call it and head home if it insisted, but I never felt any pain or signs to slow down, so I just kept going :) 

Sunday, March 19, 2017

Day 5

I read a few blogs that had their pain scale logged each day, much like I was doing, which helped me expect how much pain I might be feeling on what days post op, etc. However I've had 0 pain, which seems to be the case most days so I'll hold off on that. You can just expect a 0 each day! If I do, I'll mention it below.

But man what a difference a day can make. Today was much better, both mentally and physically. Writing gives me a chance to put my thoughts into words, and it helps me to write about both the ups and downs.

Woke up feeling great, swelling was down so staying in yesterday was a good idea. I was able to get out and about in the morning. Being around people, seeing my sister at the coffee shop she works at, going out for lunch... this was what my mind needed after being cooped up all day yesterday!

I had felt this a little before, but today it was especially noticeable. Each time I would stand up (either from sitting or laying) and stand upright, for the first few minutes, I could really feel the blood and such rush down my leg and to my knee. It wasn't panful, it just felt like alot of pressure.. like a water balloon so the say! I'm assuming this is because the swelling was down, so the blood was able to make it's way into new places.

Yesterday I'd say I really couldn't get around without my crutches, had some slight pain in the morning, it was still swollen so didn't do many exercises, and basically felt a little helpless. But today, the opposite of everything listed is true, hence why I mentioned how crazy a single day can make. I relied on my crutches, oh, just 50% of the time, and occasionally walked a few short distances without them. Swelling is down, and was able to do my exercises working on ROM (range of motion). So super excited to see progress..!

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Passive towel bends, ROM 5 days post op


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Active (no towel) bends, ROM 5 days post op



Saturday, March 18, 2017

Day 4

**Fair warning, I'm half an optimist and half realist in my thinking. It's just how I've learned to deal with things. I don't let negative thoughts get to me, but I do let reality thoughts in. And I see nothing wrong with that. So no need to think I am 'losing motivation' or 'giving up' when in fact it's quite the opposite, for me, personally, in my own life. It is different for everybody.**

Pain in the morning: 1
Pain in the evening: 0

I woke up this morning hoping to be able to get out and about for a short bit... but I soon found out that was not going to be the case. I hadn't iced all night (granted it was elevated all night) but PT combined with no ice led to a swollen, and mildly aching knee this morning. Whether it was actually from no icing or just moving it at PT, I'm not sure. Went downstairs to grab breakfast and coffee and prepped for a full day in my room with my laptop and ice therapy machine (which btw- is a lifesaver. I could not imagine icing without it, given my room is upstairs and kitchen downstairs).

Today was mentally hard (and I'm certain of many more to come), particularly due to a few combining factors:

-When I woke up and saw/felt my knee really not any better than yesterday, it was a reality hit as to just how slow and long this recovery is going to take. This injury will be with me and on my mind every single day, for a good year atleast.

-It was a gorgeous 80 degree Saturday, and I couldn't even simply stand out in the sun due to the throbbing when I stood up. The few times I did walk around my house, I wanted so badly to be able to just take a few steps on my own and not rely on something else (afterall I did have more confidence in my knee today as opposed to yesterday, so thats a plus!). I love the crutches as they allow me to get around, but I also really dislike relying on something other than my own physical strength to get around. Out of all the athletes who go through an ACL tear, I'm certain I am not the only one to feel this way. But I know looking back here, the time on crutches will seem so very, very minimal.

-My dad, mom and sister all left early in the morning with things to do, and how I wanted to hop in my Xterra go about my own way as well. I wanted to move, do my physical therapy exercises, go up and down stairs, progress in some way... but my swollen and tender knee was telling me otherwise, and I had no other choice than to just lay in bed and ice. I elevated and iced for hours, 20 minutes on, 20 minutes off. I used the timer on my phone and it reached the point where my internal timer would go off within 1-2 minutes of the timer on my phone.

Some types of pain you push through, and other types you don't. Today's progress was going to be made off of my feet, and its hard when you are so used to progress being on your feet.

About 75% of my weight on my left leg, still a little wobbly for 100%. I know I know- patience. It's only 4 days post op. 

video

Working on some muscle flexion, atleast I don't have to be on my feet for this one!


Friday, March 17, 2017

Day 3, 3/17

Pain in the morning: 0
Pain in the evening: 0

Took the ace bandage off first thing this morning to take another look at it. It was very swollen with fluid and such, which explains the unstable/loose feeling I get while walking on it (thank goodness for crutches). I've heard once the swelling goes down though it starts to feel more stable, so I am not too worried about it.
Without the bandage

Side view of swelling- not painful though
Had my first physical therapy session today, 3 days post op. I'll be going twice a week for a few months, and then possibly decrease to once a week. The first 'exercise' we did was simple, he just moved my knee cap around. I was so very cautious and nervous of him touching it, he even laughed a little and said 'protective much?' 😛

We then worked on moving the vastus medialis, or the inside quad muscle. I could move it a little it felt like, but I couldn't really tell (although he could!). After a few other exercises, we ended with towel ROM bends. This was the first time bending my knee post op and I was so cautious, I asked him "are you sure?" atleast three times before. I obviously have never done physical therapy before... here I am asking the therapist if he knows what he is doing. Ha 😅  I know I just need to build some trust! I was able to bend it passively (with help from the towel) to 45 degrees. I could feel it pulling the skin on the top of my knee, but he assured it was ok to feel that. 

Towel bends!
Overall, I'm so very excited to start working on getting my strength back and walking normal again. I'm going to be cautious on just how much I do, but you can bet I'm not just going to lay here and do nothing!



More elevate and ice. I also put my right compression sock back on for a bit


Day 2- 3/16

Pain in the morning: 0
Pain in the evening: 0

Again, another painless day! 😃

Took off the ace bandage wraps today to take a peak for the first time at my knee. It looked better than I had expected- for some reason I thought there would be bruising, but there was none. It was odd not being able to feel, let alone see my kneecap because of the swelling. Keep icing and keep elevating!

Day 2 Post Op


Puppies wanting to come say hi.. and jump up on my knee :P 

Added an extra pillow afterwards to elevate it over my heart

Going up and down stairs is getting easier each time. I even tried a few step ups with my left leg first, then followed by the right. Although one movement I cannot do yet is a single leg raise. I try, and mentally I am telling my leg to raise, but it's as if the message is not reaching my leg. Sometimes it feels like it does though, and I feel my quad twitch a little as if to say "I'm trying, I'm trying!". I tried a few calf raises on the stairs, as well as 'pulling' with my toes on the carpet, if that makes any sense 😋 

Currently just taking Naproxen every 5-6 hours, and a few of those times I even wondered if I needed to. But I remembered reading about how you need to stay ahead of the pain, instead of waiting till after you feel the pain to take it.

I'm very very happy with my mindset now as well. I don't really think about skiing, hiking, or mountains in general. 100% focus on rehabbing my knee and also a lot more focus on my classes. It is unfortunate I won't be able ski any of that amazing spring corn this season. I definitely was down and devastated for a few days when I initially found out about my ACL, but over just a few short weeks, my mindset took a complete 180. It was hard at first, as change always is. But once I shifted my mindset and perspective of this experience, it isn't too bad afterall. 

Thursday, March 16, 2017

Day 1, 3/15

Pain in the morning: 0
Pain in the evening: 2

-First day post op went alot better than I had thought it to be... again. I guess I really made it out to be alot worse in my head..! Still, maybe the worst is coming, and I shouldn't alter my expectations just quite yet.. But I'll take this for now. 😃

-Up and down stairs was not a problem- going down I was even able to put a little weight on it and act like it was a 'normal' step down. Can't step up going back up though, so my right leg just leads and then is followed with by my left.

-Haven't taken any narcotics, although I do have them by my bed here just in case. Naproxen has been my friend though. I colored the Oxycodone red (as in, don't take!), and Naproxen green (as in take these!), as to not get them mixed up. I call my Naproxen tablets my 'green pills'. 😅

-Spent half of my day in my room and the other half down stairs on the couch. But either place, I had my leg elevated and ice near by.

The white compression sock on my right leg felt so good! 

-Later in the evening, my quad muscle would twitch, along with a few other muscles. My poor leg is trying to figure out what is wrong and how to re-wire everything! I also have found myself dozing off but then 'jump' back awake, which would make some muscles around my knee twitch/move without me even trying. Luckily these twitches were not painful at all.

-Pain crept in later today, I'd say around 9pm. Deep, aching pain it felt like, with an occasional sting here and there. Sometimes those stings were really intense and would stay for a good 10 seconds or so. Applying ice here helped tremendously for pain management.

Wednesday, March 15, 2017

Surgery Day 3/14

-Chose the quad tendon autograft as my new ACL choice.

-Surgery was at 10am so arrived around 8:30 to get prepped.

-The nerves and anxious feeling was exactly the feeling I usually get before an ultra race. Not sure how things will play out or what you will feel like afterwards. I also get very mean, I suppose you could say with this feeling, and it was definitely apparent this morning! Made fun of the anesnteiologist for him getting nervous just skiing down a blue run, laughed when I found out one of the nurses purposefully matched their shoes with their scrubs, and answered 'no' very sarcastically when asked if I considered myself an athlete. Ha yikes. 🙈

-They gave me something to calm my nerves before wheeling me into the surgery room. My blood pressure was really high apparently and they needed me relaxed. The last I remember was hopping from the bed to surgery table, and then I was out!

-Waking up after surgery was really fun :) I wanted to go back to sleep but also wanted to stay up and hear how it went. So I forced myself to keep my eyes open which helped me finally come out of it, kind of. "I'm like... 80% here" I said 😝

video

No Brace!

- I really, really thought that I would wake up with immediate pain, but none of that was apparent. It actually felt kind of good having my leg wrapped up like so (ha well probably owe it to pain meds). Dr. Vidal came by, smiling, and then said what we all want to hear, 'everything went great, and no meniscus damage"!!

-We were on our way out shortly afterwards. My style of getting into my car was very 'gymnast like' the nurse said! I really don't know why I just didn't slide in the the other side 😛

video

-Going up the stairs to my room once we got home was not hard at all, with actually using my leg (and handrails) to make it up with no problem. This is all going way better than I had made it out in my head to be I said to myself. 

-On a scale of 1-10 (10 is worst possible), my pain this evening was a 0. I could still move it and feel everything underneath the bandage, but it just didn't hurt. Again, I thought I was going to be so much pain. Maybe that's coming day 2 and 3, but right now it is kind of weird for me to not be feeling anything! I'll take it though!
Ice and Elevate!

Molly really, really wanting to help out

"Can I just... look at it?!"






Friday, March 10, 2017

One more

**I wrote this late one night when I was feeling down, so it's a little more detailed and thought out than I think my posts will normally be 😅 ** I debated on posting this, but here it is. (post is about my weekend out skiing post MRI results and but pre pre-surgery appointment with my doctor):

---------

Headed out for one last weekend skiing before calling it a season. Booked a few nights at the hostel there in Leadville, in order to stay up in the mountains for as long as I could before having to stay a few months in Denver. Went out for a short tour at Mayflower Gulch on our way out to Leadville on Friday. I remember thinking on the skin up ‘this feels fine, and doesn’t require any twisting motion. I wonder if post op I could somehow find a way to just skin up and then ride a chair lift down?!”. I was consciously aware of the way my quads felt as they worked with every step as I skinned up. I knew this would be their last uphill for quite some time. The snow conditions were not the best, so we only ended up doing one lap. We ripped skins and clicked in to ski back.

However, after I had transitioned, I was immediately aware that my confidence in my left leg had greatly decreased. It took some time to build up confidence for those first few turns since receiving the MRI results. To clarify, I had no pain in my knee.  I haven’t had any pain while skiing ever since the initial fall. You can ski on a torn ACL, the risk of injury is just higher. And I was willing to take that risk for a few more times on skis.

 I had never felt like that before… so unconfident in something so simple I had done so many times before. A simple, low angle slope now seemed super daunting. Just a few weeks ago, I was out skiing couloirs (which I was unaware of my ACL at the time!). It was very interesting to so easily see in myself the direct effect of how words can mess with you mentally. I also blame the terrible snow conditions at Mayflower :P

However, the next day at Vail was a whole different story, with amazing snow might I add! I met up with my group of ski partners- Lars, Ben, and Joel. Being with such great friends that day made me feel like everything was going to be just fine, nothing to worry about or even that I had all of these torn and partially torn ligaments floating about in my knee… ick. My knee felt great, and my confidence came back after a few runs in the backbowls. “Are you sure your knee is hurt?” Joel asked.
I kept to the easier routes down while the others went and found the hidden powder in the trees. That’s ok. I was on skis, and I was happy to see them come flying down with smiles on their faces. After all, I was smiling ear to ear with them as well.

I was conscious the whole day of how my knee and was ready to stop if it told me so. I did have a few ‘gives’ when I was turning right, (bent to the inside), which was a reminder for me that something is not right inside and to not push the limits (not that I was out to push them anyways!).

The weather got cloudy, windy, and much colder and I didn’t want to risk skiing in such low light and visibility, so we made our way back to the front side of Vail. We took a fun run back to the base, the one that we always take. I definitely took advantage and made way too many turns on such a simple blue groomer run… 😆

Back at the base, It took me a moment to click out of my skis since I couldn’t really see with the tears watering up in my eyes. But after a big hug from one of my closets of friends, I gathered myself, took a good look around, and thanked Vail for a short but wonderful ski season.

No Pain

How did it happened you ask- February 4th I was skiing at Arapahoe Basin, and had a full day exploring the east wall. It was later in the day as we traversed all the way across the east wall base and over to the tree chutes, only to find the hike up was closed. No problem, just ski over to Pallavicini lift for some runs over there. Sent it down a big wide, and relatively flat powder field to try and keep our speed. There was an area where the run dipped down and then straight up and over a small hill. Well little did I know this small hill was hiding a few exposed rocks at the crest. The others went a little more left and I for some reason was more right of the run, right in line with the rocks. I really wish Abasin had a pole or something up to warn skiers, but it was early season conditions, and rocks just come with that.

So I hit the rocks, my upper body kept going forward as my skis took a hard twist to the right. My left ski did come off... so ok... that is definitely enough force to pop your ACL! I remember the fall didn't hurt at all, although as I got up I wasn't sure what happened, as I was just skiing along and then now I had a face full of snow. As I put my skis back on, my left knee joint felt super loose. I thought perhaps I had just 'stretched out' the surrounding ligaments and such. Mainly because I had no pain. 0, zip, none. Nothing hurt. Craziness. I skied back down to the base, only able to turn left (since my left knee would 'dislocate' to the inside on my right turns). Some of the turns back down I just took with my right ski, ha!

Since there was no pain, I didn't go in and have it checked right away. I just slapped a small brace on it and kept skiing away. I actually went back to Abasin a few weeks laters and skied the east wall again with it torn (unknowingly). However, I did take a pretty hefty tumble down one of the couloirs there (due to a combination of factors, I think- my lack of confidence in not trusting my knee, soft deep snow, and my knee giving way on a turn). As I was falling I grabbed my left knee and held it close to my body, which I like to think helped save any further damage. Yikes 😳  That was the moment I realized ok. Something is up because I definitely was not skiing at my normal level. But did anything hurt the whole time? Nope! Odd. But makes sense knowing what I know about the ACL now.

Why?

No not why am I going through ACL reconstruction.. why I started this blog! Plain and simple, I want to share what I learn through my experience to help others with theirs. I swear, in the last few weeks, I have spent more time studying and research on the ACL than I have on my homework for all three of my classes combined. Alot of my reading was from personal blogs. I'm so thankful these people took the time to put what they learned online on a blog or similar, so that others like me can come along and have an idea of what to expect. I also like the idea of having details of my full road to recovery all in one place for later reference. I'll share the milestones in ACL recovery (Week 1,2, etc.) all the way back to the slopes! Ignore the title... it's the only thing I could think of 😋