A Difficult Resolution to Make
It is easy to forget why I put myself through ACL reconstruction surgery when I’m not in the dojo and around the people I train with on a regular basis. Although I miss karate greatly, after enduring these past two weeks, it would be easy to convince myself that going back is a bad idea. It’s a very scary prospect, the thought of reinjuring my knee or hurting the other one.
Yesterday, a karate friend came for a visit and it was just the mental boost I needed. Seeing him and discussing karate and training brought it all back to me, the reason I put myself through this. He brought me a book on training for speed, and the visit lit a fire under me. My fear of going back was trumped by a new determination to get back in there. I need to get back in there. Just being there makes me feel better, and that is what I’ve been missing these past couple weeks. My goal is to get back into the dojo within the next two weeks.
This may seem like a minor thing to someone who doesn’t know my dojo. However, my dojo is not exactly easy to get into. There is a big step to get up into the dojo with double doors, which is challenging enough on its own for someone who has to walk with a completely straight leg. The big step is followed by a full staircase of very narrow steps. The railings do not extend to the very top of the stairs. Since injuring my knee in October, I’ve been sitting and scooting up and down those stairs Lil C style. Just being able to get in there would feel like such a huge accomplishment right now; and I know it would feel good to see everyone and watch them train. This will be a big step back to independence, and one that I need to do soon. It has nothing to do with my knee, but everything to do with my mental well-being.
I worked a bit on that independence this morning. I showered, got dressed (minus putting my shoe and sock on my left foot because I just can’t do that yet), and drove myself to physical therapy. Everything took twice as long to do as it usually does. It felt good to be in the car by myself, but I need to remind Mr. BBM to not use the emergency brake. I had to contort myself into a pretzel to apply enough pressure with my right foot to release it, since my left foot is just not ready for the job yet.
The drive was going fine until my new navigation system started talking to me from its concealed location on the floor. I about jumped out of my skin, thinking someone was in the back seat. Flustered from that little scare, getting out of the car almost induced a panic attack. I’m semi-claustrophobic. I don’t like being stuck. I can barely stand being in my knee brace sometimes because of feeling confined. In order to get into the car, I had to slide the seat all the way back so as to pull my bent and sore leg into the car without twisting it. Once in the car, I moved the seat back up a bit to be able to drive comfortably. Forgetting I had done this, I tried to get out of the car without first moving the seat back and started having an internal freak out session when I couldn’t get my leg out of the car.
I tried to quiet the anxiety by telling myself that if I was able to get in the car just five minutes ago, then there’s no reason I shouldn’t be able to get back out. It was then that I remembered to move the seat back and life got a little easier.
We started my PT session with ice and stims as usual. I was able to complete my quad sets with only a small rolled up towel under my knee for the first 15 and then nothing under my knee for the last 15. My knee cap feels a little funny when I do them that way, but I need to make sure I can keep full extension. My PT gave me a 2.5 lb. weight for my leg lifts today and that went fine. I’ve been doing leg lifts like crazy at home so I think I’m getting a little stronger.
Then it was time for the bending. The first few bends are always so difficult. My knee feels so stiff and uncomfortable, but after five or six, I can move a lot better. My PT helped by gently bending my knee for me after I had done a bunch on my own. It felt so much better when he was doing it for me. I don’t know what it is about him, but he’s very soothing and he helps me relax. He brought out the measuring device and I dreaded hearing the number since I wasn’t feeling like I was bending that much.
109 degrees.
That’s a six degree improvement from just three days ago. Today is the two week mark post surgery and my PT said that at this point he likes people to be at 90 degrees. He said I’ve "shattered" that. Despite his encouragement and a number that can’t be denied, I have to say that I don’t feel like I’m shattering anything these days.
The progress may seem rapid to my PT and to others, but to me it seems to be at the pace of a snail. I want to feel normal in the worst way. I want to be rid of the crutches. My PT asked me why I feel I still have to use them. I showed him how I walk without them. It’s not pretty. It’s a stutter step on that left leg to quickly get me back on my right. Putting full weight on my left leg feels like teetering on the edge of a cliff. My quad is still rebelling.
He said we’re going to try to get me off the crutches within the next week or two. He told me to try to use just one at home, and keep putting more and more weight on that leg, since it will also help my quad muscle come back to life. Once home again, I was able to get around with one crutch in my kitchen. My goal for the next few days is to put more and more weight on that leg for longer periods of time.
When I first injured my knee, one of my instructors told me that "injuries teach us patience." I’m not a very patient person, but I think that my resolution for 2008 will have to be becoming more patient. Otherwise, this rehabilitation is going to be too frustrating and annoying. Becoming more patient is the only way my mind and body are going to be able to get along.
What’s your resolution for 2008?
ACL Surgery: Survival Essentials for the First Week
Hack Shaft is having ACL reconstruction surgery this week. In the interest of helping him and anyone else who might be about to go through this all around lovely experience, I thought I’d share with you the first week survival essentials.
- Giant bags of frozen peas:
My surgeon didn’t recommend using the cryo-cuff (which I hear is fabulous) because he said that ice works just as well. I’ll do you one better. Giant bags of peas in plastic grocery bags are key (and having someone who can break them out of huge chunks is also key). Mr. BBM spent much time slamming my frozen peas into the sidewalk, kitchen counter, etc. I wasn’t willing to go all Bruce Lee on them so that was his job. I’ve found in recent days that icing the underside of the knee along with the top feels awesome. Ice as often as you can, because it really feels good and helps the swelling disappear faster. I iced my knee at least six times a day the first week. - Elevation:
Pillow Set-up for first weekSmall pillows did not do the job for me. That could be because I have insanely long legs. However, king sized pillows and extra soft body pillows are essential. A body pillow folded in half at your foot with a king sized pillow or two on top, slanted down towards your butt is the best position I found to provide some relief. Top that with a bag of peas and that’s the closest you can get to heaven in the first few days after surgery.
Pillow Set-up for after the first week (The Sleeping Beauty pillow, propped on the inside of your foot, helps to keep your leg straight through the night so your ankle doesn’t droop over and get sore.
- Anti-inflammatories: I can not even BEGIN to tell you how much better I started feeling when I was told to add ibuprofen to my pain meds regime.
- Chair for the Shower with Arms:
My first shower was without a chair and it was agony. You have to be able to sit down. If you can also prop your leg up on the outside of the shower to put your leg on, you’ll be even happier. You must also have good help, because getting in and out of the shower is tricky. Here’s the process that I found works best: 1. Turn the water on and get it to the right temp BEFORE getting in the shower. 2. Slide your bottoms down and sit on the lawn chair (I should warn you that it’s going to suck even if you warm it up first), making sure to use the arm rests to evenly lower your weight down. 3. Prop your leg up on the outside the shower chair, and take your brace off. 4. Turn the water on. Prepare for the shock of your life even if it is the right temperature. 5. Shower as usual but for the first few times have someone stay nearby to make sure you feel o.k. and to direct the stream to the right spot so you don’t feel like you’re being water-boarded. 6. Have three towels handy: one for your hair (ladies), one for the body, and one for the leg and then floor. 7. Dry off the floor outside the shower thoroughly. Make sure your crutches are dry too. 8. Have someone help you stand up as you get out of the shower. I know that was hella boring, but you will SO thank me for it later. It took several days to streamline this process properly. - Remote Controls, Book, and Tissues: There is nothing more annoying and/or tear-producing than when something is just out of reach when you need it and you’re in pain. Make sure the things you need are always within reach. It will spare you much annoyance. Although I fully intended on reading through those early days, the pain is such that you can’t concentrate on what you’re reading. So, Tivo some good distracting programs in advance of your surgery or stock up on magazines that don’t require you to think too much. People Magazine anyone?
- Prune Juice, Colace, Senokot:
Meet your new best friend.Yep, you need them all. Since I only drank one glass of prune juice and I plan to never do so again, if you need some, I will totally mail it to you. Take that Colace and Senokot daily. Trust me on this one.
- Good Help: You will need someone to cook for you, bring you food, bring you drinks, bring you your bags of frozen peas, and even help you get dressed the first couple days unless you feel like playing horseshoes, with your underwear as the horseshoe and your foot as the stake. You will get really good at this eventually (I have anyway). If you can find someone who’s not going to get all annoyed at your demands and someone who will wake you in the early days every two-four hours to take pain meds/anti-inflammatories, you will be a much happier person. Thank you Mom, Mr. BBM, Big I and even Lil C (who was awesome at bringing me my crutches when someone had left them propped against the wall too far to reach when I really had to go to the bathroom). I also felt a lot more comfortable during those early days when someone stood in front of me and helped stabilize my crutches when I went up the stairs backwards.
- Pillows in the Car/Car Procedures: You have to sit in the back seat until you can bend your knee comfortably 90 degrees. Here’s how to do it without knocking yourself unconscious. 1. Use the crutches and back yourself up to the back seat. Have someone stand nearby to take your crutches and help you lower your head (police man style) so you don’t hit your head). 2. Sit down on the edge of the seat (using your hands to lower yourself down) and use your good leg to scoot yourself backwards until you are up against the opposite door. 3. IMPORTANT: Make sure your bad leg foot is clearly inside the vehicle and that it won’t get bumped by the closing door (Yes, I found out the hard way). 4. Have a pillow in the car and use it to prop up your leg. (This is key to your comfort the first week). 5. Getting out is done by sliding back across the seat. Use your good leg and arms to help scoot yourself along while using your muscles to hold your bad leg up in the air. Having someone to help stabilize your leg during those first few days is really helpful. Make sure they understand that they should support your leg at two spots. I found the lower back of the thigh and the lower calf to be the best support spots for a helper. Whatever you do, don’t let them grab your heel or ankle. Ouch.
- Sleeping: Unless you’re one of those strange people who enjoys sleeping on your back, sleeping after ACL surgery (especially once you’ve kicked the pain meds) is not at all fun. Having heavy covers over top of the knee was uncomfortable, so I found that leaving my injured leg on top of the usual covers with a lightweight fleece blanket on top of the injured leg helps a lot.
- Let it Out: This surgery is emotionally trying. It is a mental and physical test like no other I have ever experienced. There were days that I sobbed in the shower during that first week, and I needed to do that. I also wrote it all out because it felt better to get it out. It is OK to feel sorry for yourself. Just don’t spent too much time doing so, because it does get better (says the girl who showered by herself this weekend for the first time since before surgery and is currently bonding with her frozen peas once again).
Best of luck to you Hack Shaft, and to anyone else about to endure this challenge.
Why Parents Need to be Involved
I found this article today and it made me so angry. A 39 year old karate school owner took sexual advantage of a 15-year old female student at his karate school. If you read the article, you’ll see that the girl was made to sign an "oath of obedience" for her training. What I want to know is this? Where were the girls parents when she was being asked to sign such a document? No daughter of mine would ever be allowed to sign such a document; and I would NEVER allow my kids to train at a place where I wasn’t allowed to watch every second.
If there is one thing I can’t stand, it’s martial artists who proclaim to uphold the values of the martial arts when their intentions are completely classless. Any adult who takes advantage of a child should rot as far as I’m concerned. This is just one of many incidents like this, where young impressionable students are taken advantage of under the guise of martial arts training. It really is a shame that there is no governing board to take care of disgusting people like this, because this certainly isn’t the first time and it won’t be the last.
As a former teacher in a public school, I had to submit to background checks and finger-printing. I’m starting to think that any type of teacher, including karate teachers, should have to undergo these types of screenings. Anyone can start up a karate school, put up inflated claims about who they are and what they know, and use it as a base for seedy behavior.
How do people like that live with themselves? I hope they throw the book at this guy, teaching others like him a much needed lesson.
Not Just a Random Nick
I am 11 days post ACL reconstruction, and I am finally feeling better. Today, the stitches came out. It was painless minus one of the poke holes which killed because I think it had healed a bit too much, and the biggest bottom incision which was a single running loop stitch. It looked very strange once the steri-strips were taken off, and when the nurse pulled that one out I definitely felt it. "You’re going to feel pressure" is nurse-speak for "this is going to hurt." However, after enduring post ACL surgery pain, what’s a little discomfort when it comes to having stitches removed?
I was happy that the nurse took the steri-strips off and took the stitches out, because doctors are notorious for doing those kinds of things quickly. The nurse took her time and slowly pulled back on those steri-strips. I was expecting agony, but it was nothing. She told me that my doctor usually tries to make the incisions "prettier for girls." I hadn’t really thought about scarring before, but now that it’s over that is certainly nice to know.
The surgeon came into the room after the nurse had placed more little bandages over the incisions. They will stay on until they fall off. One of the incisions (top left) bled a tiny bit so that one looks sort of nasty. Besides that, my knee looks and feels a whole lot better now. I was kind of embarrassed when he first came in. The last time he saw me I was sitting on a bedpan, hardly capable of holding my own head up. We shared a little laugh about that. I’m ready to put that whole experience permanently behind me now.
After gently checking out my knee for a couple seconds, he sat beside me and told me he had pictures. He pulled out two pages full of pictures of the inside of my knee. He showed me where the ACL had completely ripped off the femur. He also showed me the shredded remains of it, which he had to clean out of the PCL. I got to see the drill holes that run entirely through my tibia and femur and I also found out what that random nick on my thigh was from.
Apparently, a long needle was inserted through my tibia, through my femur and out my thigh. It’s how they thread the new graft properly into place, with the right amount of tension. I was pleased to learn that it wasn’t a mistake cut, but the image of a needle going through my leg like that from the inside, sort of makes me wish I didn’t know that part.
The graft I got is an anterior tibialis tendon. It’s one of those super thick ones on the front of the ankle. In other words, I have a very serious graft in there. The surgeon said that my ACL tunnel was really small and tight, so they drilled a bigger hole there since he thought that perhaps my original injury was the result of a rope over a rock type scenario that wore away over time. That makes me a little nervous about my right knee now, but I’m not even going to go there for the time being.
I also found out that I won’t be upsetting any airport security with the screws in my knees. In a years time, they will have turned completely back to bone. That is pretty cool. I asked the surgeon if he had a disk he could give me with the pictures so I could share some nasty internal knee photos with you, but he didn’t. Consider yourselves lucky. It’s sort of weird seeing the internal workings of your body, knowing you were unconscious while some dude was in there with a camera. You’ll have to settle for this picture of the stitch-free knee. See that little reddish mark right below my pulled-up pant leg in the middle of my thigh? That’s where the needle came out. I added a before surgery picture for comparison’s sake. I think you should be able to tell the difference. Before leg: some muscle tone and pen marks; after leg: no muscle tone and dried blood.
I’ll be seeing my surgeon in another four weeks to check on my progress. Once I build my quads back up, I’ll be fitted for my functional brace which will be my best friend once I can go back to karate. He shook my hand, and told me he was going to have my PT "torture" me for a while now.
I know others have said PT is agony, but I enjoy it. Today, I was able to add 2 lb. weights above the knee for my leg lifts. I couldn’t believe how hard it was to do that. I’m going to try over the weekend to put more and more weight on my left leg to get that quad stronger so I can ditch the crutches. I can ditch them as soon as I feel ready. I’m just not there yet. My leg muscles are still rebelling a bit from all the trauma, making things a bit wobbly in the left leg. The last thing I want to do is blow my knee out again, so I’m going to be very patient when it comes to eliminating the crutches and brace.
At the end of my session, my PT measured my flexion and I broke into the triple digits at 103 degrees. That pretty much made my day. It doesn’t seem like it takes a whole lot to do that these days. A triple digit flexion combined with the absence of stitches, combined with less pain and swelling makes for a pretty fabulous day. I think I’ve rounded the corner and am finally beginning to imagine happier days ahead.
And just so we’re clear, I promise I will address some topics other than my all-consuming but fabulously interesting knee very soon. 😉
***The latest reviews are up at The BBM Review. If you’ve ever considered buying a sauna suit, you’ll want to check this one out. If you’re interested in a new educational video website, there’s another review you won’t want to miss.
The ACL Saga Continues
I had PT yesterday (nine days post-op) and unlike many who dread going, I look forward to it. I like making progress; and I like hearing that I’m doing a good job. It boosts me up and when you have this surgery, you need all the boosting you can get.
My PT was instantly shocked and pleased with the appearance of my knee. "I’m LOVING your knee," he said and went on to tell me that he doesn’t think he has ever seen a knee look this good at one week post op from ACL surgery. My knee cap is clearly visible. He said that the knee cap usually takes a couple weeks to make its debut post surgery. My swelling is only minimal now, and despite a pale yellow around the incisions, I never really got the big nasty bruises.
I was also able to support my entire leg without being braced for leg lifts. I’m now allowed to do them without the brace on. At the end of our session, he measured my flexion. I was nervous that it wouldn’t be good. My lowest incision is keeping me from being able to bend comfortably. It feels like it’s pulling. But despite the burning incision and the stretching steri-strips, I was able to hang out at 95 degrees flexion while he measured.
My PT told me he’s writing up a report saying that I’m doing fantastic for the appointment with my surgeon on Friday. Despite only taking some Tylenol before PT today, I’ve not had anything else. (The ibuprofen was starting to kill my stomach.) I’m feeling much more comfortable today and I think that this week will only continue to improve. I’m still taking it very easy, continuing to ice my knee and keep it elevated and stay off of it as much as possible. I’m obviously doing something right.
I needed a good day for a change. Stitches come out tomorrow.
Copyright
© Copyright 2006-2019 blackbeltmama dot com ALL RIGHTS RESERVED
Follow Me
Blog Designed By
My Creations
Things You Could Care Less About
