12 days post surgery

It's 12 days since surgery. The knee is working pretty well and although I continue to walk with a limp, I'm have not use the brace in 4 or 5 days now. The leg in general is strong and I've had no problems other than the ability to flex completely.  I can get my heel past the top of theknee of the other leg without any discomfort. It seems to be working very well, but this is only my estimation. Tomorrow I have an appointment with the surgeon to review progress. I am curious if what I'm experiencing is normal now or not. 

Muscle definition has returned except for the area around the knee.  There is a sensation that accompanies any knee injury that I have experienced which is the fullness in the knee joint due to the liquid buildup there. If feels as if, if the liquid was gone I would be ready to play, but knowing better, I'll take it at the pace that I should even though I would like to obviously go faster.

Upon complete extension of the leg, I still do feel a little tug in the knee. I suppose this is due to the ligament needing to stretch to its proper length yet, and/or the internal fluid preventing this from happening comfortably. At any rate, other than that, the limp and inability for full contraction, the knee feels normal with no pain. I'll find out tomorrow what the doc says.

Getting better fast.

I could be that the techniques have evolved. I could be that my memories of the last ACL reconstruction as worse than they should have been, but the recuperation seems like a walk in the park. Not a big deal, I think, so far. Over the last couple of days, I've regained a  good amount of flexibility in the joint, and feel comfortable walking, with a limp, anywhere. On the stationary bike today to test where the knee is vs. two days ago, and the leg can go around the loop with little problem or discomfort.  The swelling has reduced further and today I can see muscle definition in the thigh area as I flex the quadricep. The knee itself is still swollen, and the fluid is still build up over the sides of the knee, but it's coming down rapidly. Taking Motrin twice a day, 3 tabs helps this plus the refrigeration by cold pack, I'm positive helps. 

When the knee is flexed over the last day or so, if feels as if the ligament is stretching out little by little. I can feel this doing the exercises prescribed. When the knee is double, I can reach just above the other knee when the other  leg is laying flat. As I extend I can feel the ligament wanting to resist, but after a number of stretches, this ceases and becomes comfortable. This is now getting easier and less stressful on the ligament apparently and it does seem like the motion is becoming more normal. A very good sign, I think for this point in time. 

Have returned to the weight regimen for the upper body. In terms of psychological state, that helps a lot. I do few exercises with the legs, as I think it's proper to remains cautious about this for the time being. Mostly arms, and core at this time.  The cardio vascular end is suffering, but with good luck I'll resolve this with the stationary bike when allowed to do so.  The next appt is on Wednesday next.  Between now and then, the prescribed exercises, proper diet so as not to put on unnecessary weight and continue with upper body work.

As far as getting around, inside the house, I'm not using the brace for the most part. I'm reserving the brace for outside the house as nothing is predictable there.  

Tuesday, 23 Sept. Swelling is down significantly. 

I think that the post I put up yesterday did not make it somehow. Oh well. 

The knee itself is still swollen but compared to Sunday and even yesterday, I can

sense more flexibility and less fluid inside the knee. The exercises prescribed are being done at a higher rate that those suggested and for the moment am getting around  rather well and developing more confidence.  It recalls the numerous knee injuries that I have had in the past, as far as the swelling and the time taken for the swelling to come down. In this respect, it feels like any other knee injury, however, I do know that this is different.

This is a picture of the knee as it is yesterday. Four holes. The promised three, so I'll have to ask what the fourth one is. 

As far as mobility, the two end points of extension and contraction are the areas where there is the most sensitivity. I'm able to double the leg to about 85% now and I suppose, due the swelling, it will not let me go further. On the other end, total extension is less problematic. However, at the full extension, I can feel the stretch quite noticeably. Going up stairs is not a problem, going down, I do have to steady myself and the leg will not quite give the security of movement that I need. Walking around the house, about 85% right now. 

Drove to get supplies yesterday. No problem driving. Getting out of the car, just a little as the brace was on. 

In general, not too bad in my opinion for the progress so far. The problem as noted before will be recovering cardio-vascular conditioning and muscle mass.

Sunday 9/21/08 4days post surgery

It's been 4 days since the surgery. 

No to bad to say the truth. Not nearly as much pain as I expected and in fact have not even 

needed the percoset that was prescribed. The 1st day after surgery I even went back to work although my movements were severely limited. Made a couple of calls, answered email and did some other administrative tasks. The femoral block was well worth it. I also think that because of the alograph, an their not taking the hamstring from the thigh, made the whole thing less painful. 

The surgery was about 1 hour and apparently went well. I'll know more details in 2 weeks when I go back for a check. The knee is obviously very swollen at this point and has little mobility. Nonetheless, I have been doing the prescribed exercises with little difficulty. Even tried to get on the stationary bicycle, but there was no way that my knee would permit a full circle.  maybe next week. 

Started back lifting weights yesterday for the upper body. Noticed quickly that the stamina has already fallen off. That's expected. Also expected is the loss of mass in the operated leg. I'll take measurements this week to see how much so far.

Compared to the last time I had this done, the pain is far less, I'm in bed far less and feel as if the recovery should take less time. I don't know if it will or not, but as of right now, I feel hopeful that the return to the pitch will be short. 

The real problems at this point are boredom. I can only read so much and watch a limited amount of TV before my brain starts to short out.  Back to the weights.

OK. Today is the day.

I'm ready. A little anxious. I know there will be pain. I know that I'll be uncomfortable. 

I know that I'll loose all the conditioning I've worked hard to do. I know that the road back

will be difficult and test my discipline as well as mental stamina. It has to be done.

From a mental point of view, I'm anxious, but my body doesn't know what is going to happen.

By not thinking about it, you pretend it's not going to happen. The body goes into shock anyway unless it knows that something is seriously wrong. This is probably good. One can separate the mind and the body for things like this.  I leave in about an hour.

Last night at the match, saw the PA who will be assisting. comforting that at least I know the people who will be working on my machinery. The world of hurt is about to begin.

Went to see the surgeon yesterday. 

BIG guy. Very nice and very knowledgeable. Was comforting to hear that he has great experience doing these: about 100 per year. Discussed a number of things including what type of ligament to use. Patellar tendon, Hamstring or allograph. Patellar tendon is the weakest, and the Hamstring and Allograph are about the same. Interesting to note that with the allograph, you don't have to recover from their taking that away from you leg. He said that in most cases they recommend this for people who need to ambulatory quicker. ( I like that) or older patients. Also the allograph, since it is a harvested  part, has no preference for blood type etc. so this is a good option, and most like the one I'll take.  Downside: cost, as always. 

Recuperation is still a bit of a mystery to me as yet. I still don't have a good idea as to what the first steps will be after surgery nor who I should schedule physical therapy with. I'll find this out in the next couple of days. 

Good thing. He said that the pain and recovery for someone who has had this a second time is quite a bit less. This at least with his patients. Perhaps it's his technique. 

Asked about information on the other knee, (left) as it is growing a little more unstable and I'm sensing pain in it. My suspicions are that the meniscus, which I have about 50% of and the knee cartilage are beginning to get thin. His response was that there are now remedies today and more on the horizon for this situation. (Great stuff)  Artificial replacements, donor parts and new techniques that should be able to let the knees go on for a long time.  One of the techniques that was interesting is that they can insert metal strips on the contacting surfaces to help the wear factor on the knee. This would seem a temporary situation as eventually because of the number of cycles the knee goes through, it would eventually wear out. The more appealing was the artificial meniscus and cartilage that is grown on scaffolding  that is placed in by surgery. If this remedy wear out, a new one can be placed in again, no problems with drilling and metal in the knee. Very interesting. 

Ok. the next step is the prepare for the surgery aftermath. 1st order of business is to find out what the first couple of days are like and what I should be doing. In the meantime, back to the exercise routine. 

9 more days

Keeping up with training is a bit difficult. Besides running my 

small company, I find that training in the evening is not an option mentally.

It feels as if I have to mentally prepare from the time I wake to go through

the rigors for the 1.5 hour training session. Although afterwards I do feel very well

and happy that I have accomplished this physical goal. Today for example, this is

the first day I feel well after a short cold and bronchial symptoms that had me out of 

commission for about 4 days. This along with the constant output of sputum remind

me that I'm not 100% yet.  Still after approximately 3 months of this regimen, the

results are undeniable. For a body of this age, it continues to respond well. The muscles

shape up, the weight comes off and the body wants more, mentally and physically.

Yes, evening workouts are not good for me. It has to be done during the day. It just works out better. The remainder of the day is gravy. This is like surfing at 5:00 am was when I was younger. First one out, get wet, get tubed, get tired.  There is nothing that could happen negatively  during the rest of day.

Little niggles from the weights yesterday. During the cleaning exercise I either pulled or put out of place a muscle in the lower hip area. If this doesn't resolve in the next day or so, it's back to Marvin the massager to correct this as well as the ligament in my bicep that is also out of its proper location. Yes. Apparently age has its problems, the little niggles.  However, better the niggles that come with this activity than those that turn up from non-activity.

10 days before reconstruction

There are no data on ACL reconstruction preparation procedures. There are however some recovery procedures. With this set of posting, my wish is to make light of what I have done to prepare myself for a quick recovery and track the recovery. It is hoped that this will also help others who are in the same position and give some type of guidelines to any one who faces this type of surgery.

The ACL has been torn since December of last year.  A series of things has prevented either the proper diagnosis or the ability to deal with a quick remedy due to experiments, health insurance and a myriad of other things. This is the second one for me. The left leg was first in about 1999.  A long time ago in terms of where the state of the art for these surgeries are now.

At any rate the date is set and I go in for Pre-op meeting with the surgeon on Wednesday. 

How did it tear? Footy.  A Liberian guy made a foolish tackle on a ball that was already in my possession. Knee on knee, but he had all the momentum. I was stopped on the left side of the pitch and drawing the ball back. Oh well. That's the nature of the game. He came out OK, I knew immediately that the knee was in trouble. More at some other time.

In preparation for the surgery, I've increased the level of weight lifting, and cardiovascular preparedness according to recommendations received from others. As a member of coreperformance.com, I asked for specific recommendations from them, but there are no articles available. In a kindly email the responded that the best recommendation they could give would be to "put as much in the bank as you can".  1 hour/day weights, 20 mins runs and numerous flexibility and plyometric exercises will, with any luck, let me get back to playing ball and surfing as soon as possible. 

Data for myself at this point, is 52 years, 5'10", 178lbs., Thigh circumference 58 cm, Bicep circumference 38cm. I will keep a log of how the circumference will drop over time and increase as I recover.  We'll see if I maintain the motivation and discipline to return in short order to my beloved Eurotrash F. C. and to footy in general.