Free At Last!!!

SIX WEEKS!  Today marks six weeks of recovery.  Even better...today they picked up the CPM machine and took it far from my house.  Melissa helped me get it ready by placing it right by the door this morning.  I would hate to slow the guy down as he leaves our house.

Nevertheless, I still have to work on range of motion; and because we no longer have the assistance of a machine, Melissa has to help me out.  The routine is that I lay on the bed, belly down, and she slowly pushes on my shin causing the knee to bend.  Very quickly she realized a little of what I have been going through...the knee was so stiff that it took her entire body weight to get me to 90 degrees.  After a few attempts of working the knee back and forth the knee warmed up...and with lots of help and lots of pain we got close to 120 degrees.  I honestly think she secretly enjoys the power of bringing the pain. : )

Not having to lay on the bed for 6-8 hours a day has been a delight.  I have had so much more time to work, to read, and to play with the kids.  In some ways, I feel like a new man.  I even enjoyed a concert today from the best musician I know.

Thursday is the next big day.  I get to go see Dr. Tarlow for an update and hopefully permission to go to the next level in the rehab process.  That would mean getting a bend in the hinge on my brace and starting official physical therapy.  The bend will allow me to sit in a normal chair and to drive once again.  Watch out everyone...I think I remember what it means to drive.

More to come this Thursday following the doctor visit.

Progress update:
ROM at 120 degrees
No pain meds
Still icing regularly
80 straight leg lifts/day

I feel like I am going nuts

Am I stir crazy???  YES, yes I am!  After spending 5+ weeks sitting in a recliner or laying in the bed...I am officially stir crazy.  Several things have been recent contributors to my current condition:

• I am really tired of using the CPM machine.  I wish there was someway I could use the machine at night but the machine is too uncomfortable now that I am bending the knee to extreme measures.
• The weather has been so nice outside and it is a bummer that I can't take full use of the time outside.  I miss evening walks and playing with the kids in the yard.  However, I know that soon this will change.
• My foot really hurts.  One thing I didn't expect was for my foot to hurt after all the time not using it.  I guess that is one thing I overlooked.  Even though I have been allowed to put a few pounds on that leg...my foot hurts so bad that it is fairly uncomfortable to use.  But like most things...this too shall pass.  So I am still using it.
• Pain meds in some ways helped the days go by faster.  Now that I am no longer on heavy pain meds it has become increasingly difficult to sleep...both during the day and night. (Currently I wake up around 8-12 times a night)
• My scar is healing and not looking so grotesque.  However, today the actual scar has become very painful.  Anytime something brushes my scar (including my brace) I want to scream.  Hopefully, this gets better soon.
• Lastly, you know you are stir crazy when you have played 55 games of risk in the past 4 weeks.  

Now that I have come to grips with my issues of cabin fever...I am really looking forward to going to the doctor next week.  I am praying that he will finally allow me to bend the leg by opening the locks on my brace.  This will at least allow me to sit in a normal chair and drive.  I think I might even have to take drivers ed again.  I don't think I have ever take 6.5 weeks off of driving.

More to come...today I am at 117 degrees ROM.

5 weeks down

Today marks five weeks post-surgery.  In many ways it is really hard to believe that it was five weeks ago that I under went this surgery.  Here is what is new and some of the highlights of hitting the 5 week mark:

• Today I am done using the walker.  That is right...I am now 100% on crutches.  The change comes because I am allowed to put 25lbs on my leg when getting around.  The balance that this gives me allows me to use the crutches without any fear of falling.  (I actually had to stand with my left leg over the scale and slowly put weight down until I figured out what 25lbs feels like)
• This morning is also my first day off of pain meds.  I have slowly weened myself over the past 10 days off of Percocet and then Vicodin.
• I have one more week of using the CPM machine.  After that I really want to take the machine out to the desert and blow it up.  Anyone want to join me?
• My leg still turns deep red anytime that I stand up.  I look forward to the day that my color tones are the same.  
• I still have to spend several hours a day icing.  Though the scar is looking good the knee joint itself is still pretty swollen and icing helps.
• The goal right now is to be able to do a full leg lift before I go back to the doctor on March 1.  Practice and pain is the name of the game.
• Overall, recovery has really slowed down from the first three weeks.  Now its more about following the routine and making sure I hit all the marks...Today I am at 114 degrees on the CPM, I have 7 more weeks of using crutches, and hopefully PT starts soon.

Today was also an emotionally difficult day.  I sold both of my single speed bikes and shipped them off.  Cycling has been a sport that I have enjoyed over the years and has really provided me a lot fun, friendships, stories, and even exciting adventures.  I don't know what level of cycling I will be able to do in the future but the freedom to Single Speed is now in the past.

Scar Update

The body really is an amazing thing.  After just four weeks my scar is looking pretty good.  Here is a quick look...no worries, this isn't nearly as bad as it was that first week.

4 Week Update

February 14...that means today is Valentine's Day!  So before I forget, Happy V-DAY everyone.

Yesterday was also an important milestone in our house.  Yesterday marked four weeks post-surgery.  In many ways this week is a good time to commemorate the passing of time.  There has been a lot of change over the past few weeks but I still face a long road ahead.

Looking back over the first couple of weeks, I am glad those days are behind me.  On a scale of 1 to 10 being 1 as "no worries" and 10 being "life sucks," the first week after surgery was undoubtedly an 8.  Today I would say I linger around a 3 or a 4.  After spending the first 10 days exclusively in bed, living in the CPM machine, and not showering...life is now pretty good!  I am still living in my locked Bledsoe brace, but getting around the house is getting much easier and less painful.  I have even ventured out of the house to get to church and to get some ice cream.  I no longer have to beg Melissa to do everything and that is a nice place to be.  I now shower every other day, but I am still 100% dependent on Melissa to help me get clean.

My knee is still swollen, but most of the bruising has gone away.  My scar is healing very nicely too.  Last night I made some more progress in that I am now allowed to take off the brace when sleeping.  It felt a little weird but it was very nice to let the leg air out for a lengthy period of time.  I also have begun doing patellar manipulation.  Basically, what that means is that I relax the leg and have to manually move my knee cap around, mainly side to side right now.  This is to help eliminate scar tissue damage and to keep ROM at a comfortable and stable level.  I must say that it isn't the most fun thing I do in my day.  It is also hard to find the knee cap because the knee is still swollen and the knee cap is not noticeable without feeling around for it.

Furthermore, my hair is back after shaving it before surgery and the beard is also coming in very nicely.  I have also lost a total of 20 lbs...much of that being muscle.  I really look different then pre-surgery Lee having lost weight and muscle definition, using a walker, and growing a beard.

Four weeks are now done and hopefully the hardest part is now behind me.

ACL tears create big problems...at least in my case!

Things continue to move forward.  This week marked the first major change in my routine.  No longer do I need to spend 8-12 hours attached to the CPM machine.  I have now graduated.  At least that is how it feels...I now only need to spend 6-8 hours on the CPM machine.  The two extra hours in my day has been a great blessing and allows me to spend a little more time resting, playing with the kids, and time to get out of the house.

Over the last couple of weeks I have answered a lot of questions as to the reason my knee is in the shape that it is...being that I am so young to have a knee in such bad shape.  Here is an article that I think explains some of the why's behind my knee problems.  Really, it all comes back to my ACL tear 6.5 years ago.  Once I tore my ACL and my meniscus...nothing has ever been the same.  As you will see...that happens more often than we may know.

Article written by my Knee Surgeon, Dr. Stefan Tarlow and posted on his blog at http://blog.tarlowknee.com/

This studies examines patient behavior patterns and patient physical ability to resume their "normal life" after surgery for complete ACL (anterior cruciate knee ligament) tear.  

This is information that orthopedic surgeons are aware of but is not common knowledge in the general population.  The point here is that an ACL tear of the knee is a severe and life changing injury, and despite sophisticated treatments based on years of research we as surgeons are not able to return all our patients "back to normal".  

Most people have not returned to their preinjury level of sports participation at 12 months after anterior cruciate ligament (ACL) reconstruction surgery. Twelve months’ follow-up is too early to assess return-to-sport outcomes accurately.

This study was undertaken to evaluate how many people have full return-to-sport outcomes after ACL reconstruction surgery.

Data was collected at 2 to 7 years after ACL reconstruction surgery regarding preinjury sports participation, postoperative sports participation, and subjective knee function. 

A total of 314 participants (age 22-42) were studied at 2-7 years after ACL reconstruction surgery. At follow-up, 45% were playing sport at their preinjury level and 29% were playing competitive sport. Ninety-three percent of the study sample had attempted sport at some time after their ACL reconstruction surgery, and many of these could not participate due to the effects of their knee injury.  Some took as long as 3 years after surgery  to return to full activities, but still not to the exact same activities compared to before the knee injury. 

Here is the point.  Less than 50% of the study sample had returned to playing sport at their preinjury level or returned to participating in any competitive sport when surveyed at 2 to 7 years after ACL reconstruction surgery. People who return to sport within 12 months may not be able maintain their sports participation farther into the future.

Super Bowl Weekend

What a great weekend!  This weekend I enjoyed the freedom of getting out of the house for some fun in the sun.  Saturday night we ventured over to my in-laws for burgers and for a final wheelchair fitting.  The wheelchair has been nice...it allowed me to go outside and to watch my kids play around on the swingset.

We also had a good laugh attack.  I look like such an invalid sitting in my wheelchair with a blanket wrapped around me.  Nevertheless, it was awesome getting a little time outside and time with the kids.

Yesterday, was my biggest outing.  We got up extra early so that I could get time on the CPM machine before heading out to church.  It was great getting to see my church family and to reconnect with friends.  However, when it came to the Super Bowl and party's...it just wasn't going to happen.  The day was tiring and left me with a lot of time to make up on the CPM.  On the side...I did enjoy watching the game and it was nice seeing the Giants pull out another win.

This is going to be my first week that I try to get back to work.  However, any work that is getting done will be from the home and most likely when I have the energy to tackle something.  By no means will it be a full work week...but it is nice to change up the routine a little and to put the movies down.  What a trip!

A few tips for ACI patients

ACI surgery hasn't been like any other surgery I have had before.  Because it is so different and new, I wanted to pass along a few observations and tips for others that might be thinking of or are planning to have ACI surgery.  Here are a few things noticed in my initial weeks of recovery.

1. Stock pile lots of movies...you can just plan that the first few weeks you will spend sitting in a recliner or in bed.  To help pass the time I have watched way too many movies and TV shows.  Netflix instant stream has been a huge blessing.

2. Get married...I cannot imagine going through this on my own.  Seriously!!!  You will need someone to help you with your brace, CPM machine, fix you meals, to get random things for you, help you get to the bathroom, and lastly...bathe you.  I am pretty close with my parents but would much rather help from my wife than my mom when it comes to certain things on the list.  Be ready to lose some dignity as you walk through the recovery...don't fight it.

3. Have WIFI and a computer or ipad...my ipad hasn't left my side for the last two weeks.  I use it for everything from checking the web, watching Netflix, to updating the blog.  It has really kept me from going crazy.

4. Develop a routine...without having a specific routine it would have been very difficult to get all the hours on the CPM machine.  Needing to put in 8-12 hours/day on the CPM machine forces you think about how you are going to spend every minute you are free, as in finding time to ice, to spending time with the kids, to getting a shower.  The time you have gets eaten up very quickly.

5. Buy a toilet seat riser...get one with handles.  The handles really help you push off back to your feet.  Also, I look forward to placing the "cadillac crapper" on the toilet when guests come over for visits.  It will be a great conversation starter!

6. Know your insurance...I am already getting surprised by what the insurance company covers and what they don't.  Make sure you have a good understanding of what your benefits include, keep track of all your paperwork, and be prepared to appeal anything that comes back not covered.  For instance...we just found out our insurance wants to cover the CPM machine for 21 days and not the entire 6 weeks.  You never know how and where this blessing/curse will show up.

7. Lean on loved ones...you are going to need help and lots of it...even more if you have kids.  For the first little while you will need someone with you 24/7.  If your spouse needs to run an errand you will need to find a friend or family member to come and babysit you.  Furthermore, your spouse will need a break and it is ok to ask a friend to come and sit with you as they get a little rest.  We have been extremely blessed to have people bring us meals, take the kids to the park, help around the house, etc.  We couldn't have done it without having some outside help!

The knee continues to heal.  Here is a quick pic of the scar as it stands now:

Also, we picked up something to help me get out of the house this weekend.  I am looking forward to going to church this Sunday for the first time in a few weeks.  This wheelchair we found on Amazon has the leg extensions to support my leg in the immobilizer. (which was harder to find than you could imagine)