Approaching the 2-week benchmark

Tomorrow will be my two weekiversary with my reconstructed ACL. I haven't posted in a few days because there hasn't been much to report. I'm frustrated with my progress--or I guess that's lack of progress. I'm STILL completely on crutches. At PT today though, my PT showed me how to walk with just one crutch. I can't do it on stairs so it's really just for around the house, but I guess at least that's a baby step? I was hopeful I'd be walking semi-normally before my flight home, but as Saturday looms closer and closer, thats seeming less and less likely.

My goal was to be walking without crutches after two weeks, and that's just not going to happen. It's making me nervous about where I'm going to be when the kids come back to school. That's only two more weeks away... There's no point in stressing myself out about it though--all I can do is what I'm doing now, which is to stick to my PT routine, ice a lot, and walk on it a little bit every day.

10 days out

10 days out of surgery and I'm still very much on crutches! I am getting soooooo sick of these guys. I'm putting more weight on my toe every day though, so I need to remember that and stay positive.

I got this cool toy at physical therapy last week: they're electrodes, and they send a current into my quad muscle to remind it how to fire. It reminds me of those As-Seen-On-TV commercials for the "Belly Burner" (featuring the guy eating chips and watching t.v. saying, "I can't believe I'm working out!") It's cool, it makes my quad muscle tense up, which they can't quite do on their own yet. I also use it on a lower setting for pain relief, which feels amaaaaaaazing. Is it possible to become addicted to a low electrical impulse? I'm scared I'm going to resort to sticking my finger in a light socket to get my fix after I have to return this guy.

Of course I've been getting excellent care from my "nurses" :) They are sooooooo helpful! They very kindly create moving obstacle courses so I can test my reflexes and practice sharp turns on my crutches, and they also provide a customized "bath" service, featuring personalized licking and stinky breath. I don't know what I'd do without them!

And just for your viewing pleasure, here are a couple more pics of my sexy knees:

This one is of the teeny wound left behind after the first of the steri-strips came off. It's pretty small, hopefully it won't leave much of a scar!

|

|

|

|

|

|

|

|

|

|

|

|

\/

And this one is a comparison of my swollen left and normal right knees. There's not much of a knee to be seen in the left one. Ice, ice ice.

One week musings

This is my leg one week out of surgery. It's doing ok! No bruising, and the swelling isn't bad. In this pic you can see steri-strips covering all the smaller incisions and band-aids over the biggest one (I think that's where the arthroscope went in?) They're healing well. My range of motion is good too--I'm at 125 degrees now, and 140 is considered "normal". I hate to brag (ok, no I don't) but my PT said this is one of the best looking knees she's seen a week out of surgery :-)

It's still really weak though--I guess it just takes time for the soft tissue to heal, and there's nothing you can do to rush that. I wish there was. I'm sick of crutches. I'm trying to use them the right way (all the weight on your palms, with no pressure on your armpits) but my underarms are still bruised.

I completely stopped taking Oxycodone yesterday, and I've since realized how much I hate that stuff. I didn't realize until it was out of my system how foggy it makes me feel. I've felt so much more lucid and more motivated the last two days! It was hard for me to force myself to do even my simple PT routine two days ago, whereas today I feel so much more energetic and engaged. I guess I shouldn't attribute all that to the Oxycodone--I'm only a week out of surgery, so obviously every day is going to make a big difference at this point.

Good news: I made my first social outing last night! I went out with a couple of friends to go watch bluegrass music at a bar I like. It was fun, but also hard. I take up so much space--I have to keep my leg propped up and fully extended, and even though I was constantly adjusting my padding and brace and it was still very uncomfortable. Plus crutches are the clumsiest things ever. I'm already a very clumsy person by nature, so put me on crutches and I really don't stand a chance. I feel like I make a huge scene everywhere I go, like an elephant walking into a room. Of course within ten minutes of arriving at the bar I'd knocked over a drink :-( Oy. At least everyone's extremely nice to a person on crutches!

Whenever I get sick, I do this weird thing where I try to imagine what would've happened to me if I'd been afflicted with the same malady as a serf in the middle ages.

I think I would've survived this! At least as long as I could've taken a couple of weeks off to heal after the initial tear. Obviously I wouldn't have had any kind of reconstructive surgery, but I think based on where I was at before surgery, I would've made do and continued working the land, or whatever it was serfs did...

*Can you tell I'm going out of my mind with boredom?*

Things you should have before undergoing ACL surgery (in no particular order):

1) A mantra. Can't stress the importance of this enough, at least for me. It's been massively helpful for me to have something simple to repeat over and over in my head at tough moments (like when I was fighting off tears as they wheeled me into surgery; when I woke up nauseous and feeling like hell; during the pain of the rehab exercises; and whenever I'm generally frustrated). This is corny and a bit embarrassing (and I am completely bastardizing the Ayurvedic concept), but mine is "Ride to Montauk". One of my rehab goals is to save up for a road bike. Next summer I want to do a "century" (a 100-mile bike ride) from Babylon to Montauk. This is motivating and it generates a relaxing mental picture for me. It keeps me looking forward and reminds me that no, this won't be forever. Feel free to borrow it :) Another possibility: "Clear eyes, full hearts, can't lose."

2) A flexible shower head. It makes bathing a whole lot easier after surgery.

3) Flexibility and ab strength. I promise, this is a very worthwhile pre-surgery goal! Being able to touch your toes without bending your knee will make your life a lot easier post-surgery. And just try standing up while keeping one leg straight and non-weight-bearing: you'll see what I mean about the ab strength. My abs are really sore at the end of the day, every day, even though I'm basically just hanging out in bed. Tearing my ACL was, like, the best core workout EVER.

4) Supportive friends and family. I'm so grateful for everyone who has helped me to stave off insanity throughout this process. Especially my mom, who has been a real champ. I don't know what I would've done without her.

5) A yoga mat. Very helpful for doing rehab exercises!

6) Tote and messenger bags: a crutch-user's best friend.

7) A comfortable "command center", complete with chargers and a power source, water bottle, reading material, a melange of pillows, and your personal pharmacy. You will want everything within arm's reach. Set this up before you go in for surgery!

8) A notepad and pen on hand, for keeping track of your meds. This was massively complicated (at least IMHO, but I'm horrible with this sort of thing). I'm lucky my mom quickly set up a simple system for me. Add a little Oxycodone to my already-poor working memory and I definitely would've OD'd without this. Mine is simple: the name of the drug, the hours apart I'm supposed to take it, and if I need to eat with it. Then I write down the time every time I take it. Example:

Oxycodone (6 hrs, EAT) 9pm, 12am, 6:30am

Tylenol (6 hrs) 10am, 4pm, 10pm

You get the idea... Maybe this occurs to everyone else on earth, but it didn't occur to me!

9) A knog! (That's a knee-blog.) This is soooooooo self-indulgent, and I'm sure it would be massively boring to anyone other than me, but it's nice to have an outlet. And I think in a year I'll be glad to have this to look back on to see that yes, I have made some progress. (Or maybe I'll think the same thing I think now: that it's massively self-indulgent and boring.)

The Art of the Sponge Bath

My daily cleaning ritual, oddly enough, is my favorite part of the day. There is something about being clean that I find fundamentally necessary to my sanity. After I initially tore my ACL, being able to take a shower was crucial to feeling human again. It's the same thing post-surgery, but I've had to change my approach because I have to keep the incision sites dry.

After the initial tear, I hopped/flung myself into the shower and showered standing on one leg. It was incredibly precarious, and I'm lucky: a) the shower rod didn't collapse when I used it for leverage; and b) I didn't slip. It could have been disastrous. This time, there's no question of actually getting into the shower since I can't get my left leg wet at all. So I do a modified sponge bath, which is surprisingly effective!

It requires more equipment than a normal shower: I use two big towels, one small one, and a wash cloth. It's also extremely helpful to have a removable flexible shower head. It makes it soooooo much easier to wash your hair! [Stupidly, this didn't even occur to me until my mom asked if I'd been using theirs. The first time I washed my hair after surgery, I did it very awkwardly in the sink.] The whole thing is done sitting down next to the bathtub. It works surprising well! It's also interesting to see how little water you actually need to get clean.

It's a weirdly relaxing process--I recommend sponge baths for everyone!

Back in the (Legasus) saddle

I'm now two days out of surgery. To fill you in:

I've been cutting down on my pain meds pretty quickly. I started out with an arsenal of Oxycodone, Toradol, Tylenol, and an anti-nausea pill to take with the Oxycodone and Toradol. I'm also supposed to take Aspirin every day. I don't like taking the Oxycodone because it makes me sleepy, and I'm almost out of Toradol because the doc didn't want to prescribe too much (I guess anti-inflammatories counter-intuitively actually slow down healing) so now I'm pretty much down to the Tylenol. The pain has been surprisingly mild, actually. I guess I missed out on the worst pain by spending the first night and day in the hospital--they kept me really doped up there. I'm obviously staying off my knee and being really gentle with it, but as long as I ice and elevate, I haven't felt much need for extensive pharmaceuticals.

I've been doing some quad exercises since the day of surgery: leg lifts and quad tightening exercises every hour or two while I'm awake. The quad muscle atrophies amazingly quickly--not sure if that's because of the surgery or because of the tendons that were taken out of my hamstring. I've also been using a continuous passive motion machine, which I lobbied for. It's called "the Legasus"--isn't that glorious? It sounds so majestic! Apparently it's the same technology my uncle used when he tore his ACL 30 years ago. Anyway, I'm strapped into it for a couple of 2-hour shifts every day. I started with it set at about 35 degrees on Wednesday, and I already have it up to 75! It's kind of nice in the beginning when you see so much progress so quickly because there's nowhere to go but up... Oh, and as you can see, I still have to wear a ridiculous Dr. Seuss stocking. It's supposed to prevent blood clots. It's really not bad, I barely notice it, it just looks silly :)

So basically I've just been sleeping and watching lots of t.v. and movies. I discovered "Jersey Shore" is on my mom's On Demand--happy day!

Today, I had my first post-op doctor's appointment. It went well! He said my wounds look great--he even took the stitches out well ahead of schedule and replaced them with steri-strips so I wouldn't have to keep them in until my next appointment in two weeks. It was nice to get the gigantic gauze wrap off, so now I can see what my knee actually looks like. It's swollen, but a lot less scary than I imagined. [Side note: Can you see my doc's initials under my knee? They autograph you before surgery while you're still awake to make sure they don't accidentally replace the wrong ACL!]

The plan now is to stay the course: continue with the quad exercises and the Legasus; keep icing, elevating, and wearing the stocking; and take it easy.

I start PT on Monday (oddly enough, I'll be seeing a woman I went to high school with!) That will be nice--PT back in BK was incredibly helpful, and it gave me a lot of things to do on my own at home. I'm excited to get started.

Ughhhhhhh

If you are about to have ACL surgery, you probably should not read this... Consider yourself warned.

My surgery on Tues actually went well. It took the doctor longer than he expected ("It looked like raw hamburger in there," as the anesthesiologist put it), but everything came out ok. BUT, I had a horrible reaction to the general anesthetic. I spent the whole night puking/dry heaving and had to stay in the hospital overnight so they could keep me hydrated and give me pain meds through an IV. I don't think I'm exaggerating when I say it was the worst night of my life to date. Absolutely miserable. I got my own room, and the whole staff was amazingly nice so I really have no complaints on that front. It's just that when you're in the hospital, people come in to poke you and prod you every hour to make sure your blood pressure, pulse, etc. are all ok. So I got very little sleep, in spite of being heavily medicated.

This morning I felt much better. I was finally able to eat, for the first time in about 36 hours. Even the disgusting hospital food looked good! I kept that down and I was able to keep an oxycodone down, so they finally let me go home this afternoon.

The one good thing about the hospital was that they gave me pain meds intravenously, so I never had any pain. I'm holding off on oxycodone right now because a guy's coming over in a bit to fit me for a CPM machine and I'd like to be awake for that... So now I'm not nauseous, but I'm getting pretty sore. Fun stuff.

The pic above is my knee in my hardcore brace and an ever-flow ice thing. It keeps my knee continuously cool.

Ready or not...

Prepping for tomorrow... I'm about 15 hours away from surgery now. I spent the whole day running around town with my mom: pre-op appointments with the orthopedist and anesthesiologist, crutch and brace fittings, filling prescriptions, buying groceries, etc... At left, my supplies. Brace, crutches, yoga mat, body pillow, an array of meds, ice packs, antibacterial soap and sponges. Oy.

So here is the scoop, in case anyone ever reads this who is about to undergo something similar and wants to know what they're in for:

I got fitted for a hardcore brace today, which I will come to know intimately over the next six weeks. I also picked up some crutches. The other things are more for comfort: the body pillow is so I can elevate my legs evenly; the yoga mat is for doing my physical therapy stuff; and the ice packs are for obvious reasons. I'm not getting a continuous motion machine, which I'm a little disappointed about. I really don't get why my doctor is against them, but he is. No arguing with the "expert". I got four different kinds of pills: one is an antibiotic, which I'll only take for 24 hours; one is for nausea associated with pain meds; one is for swelling and pain; and the last one is Oxycodone, which is a hardcore pain pill. I always get nauseous with medication, so I'm going to try to get off the Oxycodone ASAP.

I have to scour myself with a special antibacterial soap before bed tonight, then I'll do it again tomorrow morning before I go in. This is to minimize the risk of infection. Also, of course there's the requisite no-eating/drinking-after-midnight. Luckily I have an early surgery! That rule must really suck if your appointment is later in the day.

So I'm supposed to show up two hours before the surgery, which means I'll be there at about 7:30. Then they'll prep me and put me under. I'm getting general anesthetic, which surprised me. Everything I've read said that doctors typically use local, but my doctor said that the epidural is so uncomfortable (it's hard to pee for a long time afterwards since you're completely numb) that he prefers general. I don't know how I feel about that... I guess I'm glad I'll be sleeping through the whole thing, but I know there are some big risks associated with general and I feel like it's not something that should be used gratuitously. But again, I'm doing whatever the doctor recommends.

The surgery itself should be around 2 hours. I'll probably be asleep in the recovery room for about an hour after, then they'll wake me up and take me to the short-stay area. I'll hang out there for another hour or so to make sure everything's kosher, then I'll be sent on my merry way!

Supposedly the pain won't be too bad tomorrow because the doctor will inject a long-lasting painkiller into my knee while he's in there. But once that wears off, it's probably going to hurt. A lot.

I got really faint while the doctor was going over all this in my pre-op appointment. So faint that I had to lie down. It was crazy, I can't remember the last time I felt that close to passing out. It was strange too because I already knew all of this--I've done a lot of reading about ACL surgery over the last month. Maybe it was the reality setting in?

I don't understand how people become surgeons. Even being in a hospital makes me nauseous. I know it's worse because I'm the one having surgery, but I definitely would not have the stomach for a career in medicine. Plus, what if you mess up? I make way too many mistakes in my daily life to possibly be able to perform in such a necessarily-mistake-free environment.

I'll try to post tomorrow after surgery, but I may be in too much of a drug-induced stupor to update right away.

Oregonia!

Touchdown in Oregon! And the surgery countdown has begun: T-minus 39 hours. The weather here was incredible today. It's almost enough to make me think about moving back--almost, but not quite.

I had a nice day with my mom in Portland after she picked me up from the airport. We went to the Japanese Gardens, then had lunch and did a little shopping. Portland is a great city; if it weren't for the weather I could totally

imagine living there.

Now I'm at my mom's place setting up my command center. We hauled a mattress and a box spring up from the guest bedroom in the basement and set up a makeshift bed for me in the office, since it's on the ground floor. I think it will be a very comfortable place to convalesce. Alas, I've been here for less than an hour and already all my possessions are covered with dog and cat hair :P

I have a few friends around town who I feel like I should reach out to, but frankly I'm feeling pretty reluctant right now. I probably should make the effort now since I'll be better able to socialize while I can still walk, but I'm really just obsessed with my knee these days. I've felt very introverted and goal-oriented since *the incident*: it's been hard for me to make time for people, and I don't feel like that's even remotely a priority for me. Apparently, side effects of an ACL tear may include: hermitage. That will probably change after a few days of being cooped up in my mom's house though... I'm sure I'll be begging people to come hang out with me soon!

Trying to find the positive

Most people who know me know that I don't handle stress well. I tend to get really negative and anxious, and I find myself feeling annoyed about anything and everything. I've been having a hard time lately not falling into that old pattern. I feel like I'm in such a negative headspace right now, and I don't know how to snap out of it. I'm probably more sensitive to it than anyone else.... At least I hope....

I know I have a ton of things to be grateful for. I'm so fortunate to have health insurance, and to have a job with a built-in three-week vacation so I can go home for surgery without taking any time off (hopefully). I'm also really lucky to have supportive, understanding people around me who have been incredibly helpful and encouraging throughout this process. I know all that. But the anxiety comes from uncertainty: I don't know what my rehab process will be like, and I don't know how long I'm going to struggle to perform at a basic level after surgery.

I want to be ready for the kids when school starts up again in the fall--that's four weeks after my surgery. It took me about four weeks to feel mostly normal after the initial tear, and I'd be very comfortable to be at this point four weeks after surgery. But I'm assuming that it will be a slower recovery process since there will be two sites that need to heal. I just don't know if it's realistic to think I'll be able to walk around much by mid-September. On the other hand, this time around I'll have nearly three weeks to devote entirely to rehab--not just one week like I had after the initial tear. So I really don't know what to expect, but I'm trying to be optimistic. Trying, but failing.

It doesn't help that I'm stressed about the surgery itself and the end of the school year right now as well. Everyone's always stressed all the time though, right? Clearly I need to develop some better coping mechanisms. What do other people do to handle stress?

Temptation...

Damn you, Shake Shack! They just opened their newest location on the Upper East Side--directly along my path from work to the subway--thereby making it impossible for me to stick to my resolution about eating better!

I love Shake Shack. Not just love, but looooooooooooooove. I have been known to go to Mets games with the sole mission of getting a burger. But the other locations are inconvenient enough, and the lines are long enough, that I rarely go. Unfortunately, that's not the case with this outpost.

After obsessing about its arrival all week, I finally went with some coworkers this afternoon. The line was less than 10 minutes! And this location has a really nice patio, perfect for spending a lazy summer afternoon nursing (ok, inhaling) a strawberry milkshake. *Sigh.*

I know one little burger and shake doesn't sound so bad. And it wouldn't be, if not for the fact that my class took a field trip to a bowling alley today (meaning I ate nachos and fries for lunch) and the school had its annual art show at a gallery in Chelsea last night (meaning I had a burger and fries for dinner with coworkers last night as well). It's hard to eat well in the face of reality! And bar food is my ultimate weakness--I would do just about anything for a mozzarella stick. My social life revolves so much around eating and drinking, and it makes it hard to reconcile what's best for my body with what's best for my mental health.

Side note: yesterday was my one-month knee-iversary. I bought my knee a bottle of Aleve to celebrate.

Late-breaking news

Just read a very interesting article in the NY Times about ACL surgery--and how fortuitous that it was published today! You can read the full text here, but the gist is that in several studies comparing people who underwent ACL reconstructive surgery and those who went with more conservative rehab (PT) the two groups had very similar outcomes in terms of knee stability and arthritis.

Anecdotally, the orthopedic surgeons they interviewed believed that patients who underwent surgery were much less likely to have knee problems (like a torn meniscus) down the road, but there isn't much (or any!) evidence to support that claim. Hmmmm!

*Note: I'm definitely still opting for surgery. I'm not ready to give up tennis and the option of other pivoting sports yet, and I absolutely don't want to risk further damage to my knee. Maybe down the road that will turn out not to be the best decision, but from what I know now it seems like it would require a serious lifelong commitment to maintaining strong legs to compensate for a missing ACL if I didn't have surgery.

Joy!

My PT told me today that my knee looked really good--"ready for surgery today", in fact! She said my range of motion is fully restored and my muscle tone looks great. Ahhhhh, it felt so good to hear that! I've been putting in a lot of work to get ready for surgery, and it was nice to have a vote of confidence that eventually, I'm going to more or less get back to where I started.

I realize I sound extremely dramatic saying this, but I feel like this experience has shifted my perspective significantly. I guess you could say I've always been on pretty good terms with my body, so it's been a real shock to suddenly feel like we have a semi-adversarial relationship. This is the first time I've ever experienced such absolute limitations, and it's been very humbling.

I guess ultimately it will probably turn out to be a good thing. Whatever doesn't kill us, or something like that... It's been frustrating trying to accept my limitations, but I think in the end it will make me more disciplined. Already, I feel like my priorities have shifted significantly. Example: I used to go to happy hour with my coworkers semi-religiously, but now I have zero interest in any kind of socializing after work that will keep me from the gym. All I want to do after work every day is spend time on the exercise bike. Above all, I want to take care of myself. I want to work out, eat well, and get enough sleep, because I know that's what my body needs. Of course there will always be exceptions, but I find it a lot easier to motivate myself to get to the gym and to cook healthy dinners these days.

Or maybe this will only last while I'm rehabbing. Maybe I'll go back to my lazy, drinking-too-much self as soon as I get the verdict that my knee is ready for full activity. And maybe that wouldn't be such a bad thing either... I guess it doesn't have to be a life-changing experience. It could just be a shitty thing that happened, and sucked for awhile.

Things I want

Someone sent me this video, and I just had to share. I wish this were real! It would be so useful on crutches. Muah!