December 28, 2007

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.