Progressing

Not a whole lot to really update you all on at this moment, at this juncture, in this space of time. Things are progressing. Did have a doctor follow up last Thursday 11/12. He thought it all looked good and I was progressing nicely. I was aware beforehand and he reiterated that the graft itself is at it's weakest 2-3 months post surgery. I don't really know all the medical science behind it but as part of the healing process with the graft, it's strong at first, becomes weak, and then begins to strengthen again.  So for now I am in a bit of a holding pattern with what I can and can not do with the knee/leg.  As it is, I still have a few more months to go before I can start to jog again because of the meniscus repair. But I have been using the cycle at the gym at work and will continue to do that. I am progressing to new exercises at physical therapy as I really try to focus on balancing on the leg without having to shift all of my weight over to counter balance. I do a lot of squats, a lot of steps. It's still difficult for me to control my leg going down and I am pushing to get better at that. But otherwise, I am completely crutch free at this point and able to get around to where I need to go. It still has feels, not painful, sometimes sore, but where the left leg just feels like a leg with the absense of feeling, the right leg still feels like, well for lack of a better description, that it got cut open and operated on 2 months ago.

Long story short, I'm progressing. Trying to get my range of motion further along so I can use both legs to go down stairs. Working on leg strength so I can balance better. And feeling a little less worried about the soon to be winter, ice, and snow season. Winter is coming. Oh and I almost don't have to think about what it takes to get out of my car yet, almost.

Doctor Follow Up

Had my four week post-op follow up yesterday.  The one I had been waiting for.  Doctor opened with "Are you ready to ditch the crutches?" -- UHH YEAH that's what I've been waiting for!  Got the green light to ditch them.  It should take about a week to transition off of them.  I began walking on my leg as soon as I left that room.  I'm still putting a good amount of the weight on the crutches, but it's so nice to be able to start the transition. I don't remember exactly how long it took for me to go from 2 crutches to 1 pre-surgery but that's what I'll be working on the next few weeks.

The only other take away other than everything looking good and him saying to not overdo the flexion quite yet (I'm at 82 degrees ROM as of the last PT appt Weds) was that it will take a while to get back to jogging.  With a normal ACL repair it's about 10 weeks. With an ACL repair with Meniscus it's closer to 4-6 months. (That's me)  Which I expected to hear.  Good news is that 1 of those months is already over. So projecting out 3-5 months from now puts me into the January-March range before I can get back into running.  That's fine.  I'm content to just be able to get back to walking at this point, and that should be soon.   I'm not expecting to be ready for kickball by Spring season, but possibly, hopefully Summer. And at the end of the day, if it takes me longer to return to be able to play longer into the future, I'm fine with that. IIWII right.

First Week Of Recovery

Been a minute since I've posted so let me see if I can bring us up to speed.  In my last post I talked about the surgery and how weird that experience was. Now let me see if I can appropriately recap the past ten days...

The first couple days after surgery were definitely the worst.  I didn't put many steps on the fitbit meter the day after surgery!  I spent most of the day on the couch. Oh, but I did go in for a followup with the doctor. We got our first look at it under the bandages. And it didn't look all that bad all things considered.  The doctor did confirm that I had some meniscus repair and that I wouldn't be able to put weight on my leg for four weeks. We asked about driving and he said that I could when I was feeling able to. He also drained some blood out of the knee cause it was pretty swollen and felt super tight. Flexion was a bit difficult and I had quite a ways to go with that, but I was able to straighten it and that was a great place to already be at.  If you can't straighten your leg after this surgery they basically have to do the surgery again.  That'd be awful! After the appointment we were on our merry way back home to rest, feeling a little bit better.

First look day after!

So pretty!

On Sunday I was able to keep my podcast on schedule, publishing episode 19. I used a bunch of songs that referenced doctors and knees, haha. I had planned to return back to work on Monday but by Sunday night I didn't feel quite ready to return. I emailed my boss and asked for a couple more days to recover. I did work from home on Monday and was able to get caught up on some of my work. I took Tuesday off.  On Tuesday I remember thinking that the previous 5 days or so just slipped by, even though I had spent 98% of that time on the couch. It was time to get out of the house! By this point I had weened off the painkillers. I believe I had 1 at night Monday and Tuesday but other than it not feeling super awesome, it felt alright. Still pretty tight. Earlier in the day on Tuesday I went out to see how it would feel driving. The leg was a bit ginger but I drove around the neighborhood a bit. Driving wasn't all that bad so I planned on driving to work the next day. Wednesday morning I woke up and drove into work. No problems. 

The first day back at work was a bit rough. Playing catch up never is fun. We have a lot going on. I felt super tired about half way through the day but was able to, somehow, power thru the day. My oldest started Kindergarten the day before surgery and since she's right next to where I work, I get to pick her up. I managed to crutch into the school to pick her up that day and every day since.

On Thursday I had another post-op followup with the doctor to remove the staples. The doctor again reiterated that I needed to keep using the sticks for another three weeks and that he would see me again on October 8th. (basically the day I am counting down to now). The knee was still swollen but he said that it was looking good and that I was doing great so far. It felt great to get the staples out. I had been looking forward to it for a few days at this point!

No more staples!

I had Friday off as part of my 9 day schedule. I had my first post-op PT session in the morning and because I can't start putting weight on the leg we started pretty simple. A lot of leg lifts and working on the flexion. The leg lifts were really hard the first couple days and have been hard. I wasn't able to lift it at all the first couple days in recovery. He gave me some pointers on how to work on a few of the exercises and everything went well. Starting over is a bit tricky considering how far I had progressed before surgery. Every day gets better. I go again today after this post gets finished.  After PT, I returned home and took it easy for the day.  At night I met up with some kickball friends and went to the WAKA end of season party.  I got voted the Prince of kickball lol. I was so confused when they said my name. All like, what's this for?? haha..

Let's Party!

Hanging with The Box!

With some of my favorite people from other teams! -- Terri is hilarious!

I always hate the last day of kickball cause I don't get to see everyone over the winter. With our team not playing Fall ball the off-season has come (and in my case especially) even quicker than I would like. But them the breaks. It is what it is to borrow an oldie but goodie.  At the end of the night I was super tired and headed home! We hung with the neighbors, the Cocoa bunch, on Saturday and on Sunday I enjoyed one of the best days of football I've had in a while.  Both of my teams (Falcons and Patriots) beat local teams and their obnoxious fans had to stick forks in their mouths by 5 o'clock.  It was glorious.

This week so far has been pretty manageable. I'm super busy at work so that has made the time go by pretty quick.  We have some fun weekend plans for Saturday so that will be nice.  And as I mentioned before, I am basically counting down the days until October 8th when he'll say that I can start putting weight on this leg.  It was tricky the first time starting to relearn how to walk after two plus weeks, I imagine it will be as tricky after four weeks. I need to keep working on flexion and getting the swelling to go down more and more. In time these things will come. Everything has gone as expected. Every day is slightly better than the previous. People at work that I see in the halls wondered why I was using two crutches after they had seen me get down to one. I had the surgery yo! No, it didn't get worse. It got fixed!  Now it just needs to heal up a bit more so I can progress towards the end goal.  It's definitely uplifting to know that there is a light at the end of this tunnel and that I'm not where I was a month ago, in a holding pattern waiting to get the surgery.  I'm staying as positive as I can. Like I said, every day is better, and new days come all the time!  I'll write again soon. I definitely missed being able to do a 5k at lunch time today with the weather cooling down.  Some day again. Some day.  I'll get there.  It may take a bit, but I'll get there.  Love you all.  Thanks for reading!

The Surgery

Meant to write this earlier. Of course. But as I sit here watching the first weekend of NFL football I know I've already gone way way late on my deadline. I've been too lazy to do it but I've been thinking about it so hopefully this turns out ok.

Here I am Sunday, a full 4 days since having ACL reconstruction w\ hamstring graft surgery.  Right now I feel okay. I was finally able to lift my leg yesterday and it is not easy. Can't wait for another week to go by basically :)  Before that, here's a flashback to last Wednesday when I went in for the procedure.

Wednesday morning we dropped V off at school and I enjoyed a couple last chance steps before the upcoming inevitable. Into the school and out. I wish I had taken some video of how far along my progress was with walking. All I have are my memories. It'll do. I was due for arrival at the Bone & Joint Ambulatory Surgery Center at 8:30am for a 10:30am procedure.

Got there, signed papers, Sat in waiting room for about 4 minutes. Got called back. Changed into hospital gown. Got to put on a sock sleeve type thing on my non-operating leg. Just in case anyone forgets I suppose. Okay.  Confession: I wore bright red undies just in case, as well.

After getting my vitals all checked she said my blood pressure was a little high. Um, yah. I'm about to get all chopped up here! Ha. at one point the guy across from me was told that his blood pressure was abnormally low and that they may need to give him something to increase it a bit. He said that's what they had to do last time, somewhere else with something else.  Must take a lot to get that guy angry in his normal life. He probably just goes about his day not really giving a crap about much either way. Good for him.

I got the IV inserted into my left hand and of course still felt like I had to pee a million times even though the last thing I had was a big gulp of water at 10:30pm the previous night.  I think I had a brownie at about 9:00pm. That was my last food.  Sara came in and sat and waited with me shortly around 9:15am when I was already prepped and basically ready to go. I still had to pee a few times.

Nearly an hour later the anesthesiologist asked me if I could read magazines in the backseat of a moving car. Um, hm. It's been a while but I can. But it's not awesome. So no, not really.  I also confirmed that the epidural anesthesia would be fine. Typing this paragraph in is making me hazy. Just thinking these words again. Anyway, few more minutes went by and then I got the back/spine epidural put in and Sara had left before that and now I was on my back and about to go. They even asked me my name, date of birth, and procedure that I was having done.  One last time.

I got wheeled down into the operating room and wow this will sound cliche, okay maybe not. Back step - Right, by the way, before all this the anesthesiologist said that with the epidural I could watch the procedure on TV. Well, that wasn't possible either way cause I didn't have my glasses and I am so so very blind. I was blind for a couple hours during this part of the story so that doesn't make any of my abilities to take in and observe my surroundings any easier. So okay, the cliche part is... When they opened those doors and wheeled me into the actual operating room all I saw and remember was seeing like a dozen of those movable bright lights, like the ones you see at the dentist but obviously way bigger and brighter. The lights were moving all over the place. There was a whole team of people in the room too. They lifted me off the bed and into, ha, or rather, onto the operating bed or whatever. Who knows what they put me on. I sure don't. They could have tossed me down the river at that point and I probably wouldn't have cared much. I was along for whatever ride was about to happen.

I think I remember the surgeon saying hello early on but its very fuzzy. He did stop by the pre surgery staging area waiting room earlier in the day and told us he was doing three ACL surgeries that day. Jeeze. This guy. I asked which one I was and he said 2nd. I "guess" that's good. Who knows.

I don't remember much. Early on, if I had glasses, this would have been the spot where I could have watched the exploration part of the surgery on TV. I never even saw a TV. They could have had it pointed right at me and I wouldn't have known. Usually when I can't see, I just close my eyes and go to sleep. I like sleeping. So I took a little nap.

At one point, I woke up. We were most certainly not done. I couldn't feel anything. I imagine they noticed I woke up cause they gave me more of something that felt cool down my right side. That sensation started in what seemed like my right shoulder and just went down. Yeahh. Whatever. I didn't even care what was going on down there but I did think about it and knew that's why I was there. I was pretty comatose. I can't remember if my face was covered, or not covered, or how much I could actually see in the room. Maybe I tried to look at it at one point? I can't remember.  They even started banging on my leg a couple times with something. That was strange. I could definitely feel that it was a bang on my leg, but it didn't feel like anything. It was like a tap through my core with no effect. I cant even speculate as to what part of the process that may have been. It would be cool to get a copy of  the procedure on DVD if that's possible.

It seemed like from the point that I woke up until it was all over, not a lot of time went by. It could have been only 5 minutes. I'm guessing it was longer. That was so strange. When it seemed over, I thought, that's it? We're done? Ha. They rocked me off whatever it was they put me on and back onto a bed to wheel me out of there. I believe the nurse told me that I had been back there for an hour and forty minutes. Sure I was, sure I was.

My post op nurse was blonde. I'm sorry. I can't remember any of their names throughout the day. There were at least four or five of them. Five. Maybe more. Very strange post-op experience. My entire body was numb from my belly button down. I of course felt like I had to pee immediately. But I couldn't lift my legs. Either of them. I can't remember when I was given the immobilizer with ice for my right leg. It could have been immediately after, it could have been immediately before I left.  Either way, my only job at the moment was to wait until the feeling was restored in my legs. I was able to wiggle my toes. I had to pee. I was given a snack and drink. I got crackers with cheese and cranberry juice. The juice tasted great but I didn't drink all of it. My stomach felt fine as I ate the crackers. Slowly I became able to move my left leg. I was still without glasses and did my best to try to squint and see if I could see the nurse. I was directly across the nurses station and I could barely tell which one was mine. Haha. I had to pee.

They said I would start to feel the pain first in the bottom of my right leg. They were right. Ooh. Yow. Okay. This is the spot where they chopped a slab of meat off my hamstring to make a new ACL. Okay, so that's that.  A few more minutes went by and I could move my legs a little better but not good enough to get moved to the next outgoing station. I also had to pee before I could leave. Which I was totally on board with cause I really had to go!  Finally she took me to a rest room and I used a walker to get up and get to where I needed to be to do my business. I was ready! I was here... but nothing happened. haha. Maybe in a few more minutes I could go. It felt like she was waiting for me at the door, which I'm sure she was, but that doesn't make things easier for me in general. She knocked on the door and said that it was normal to be unable to at first . Half my body was just put to sleep after all. I got moved to that next phase room and just sat in a chair there. They brought Sara in and she gave me my glasses and I could see again!

They gave me some hot tea to help with the needing to go pee pee part. We waited a bit as the nurses continued to fill out more paper work in front of us. That folder was huge. At every station, the nurse had at least a half dozen to a dozen pages to fill out. Nope, they aren't paperless yet, Nope, you aren't. Who knows how much more time went by. It was around 2pm or shortly after 2pm. and it was time to try to go pee pee again. I got to the spot and was able to release. Sweet sweet glory release of pee. Wonderful.

A few more papers to sign. No more "Needs to Void" labeling for me and I was on my way. Another nurse wheel-chaired me to the car. Again she seemed to be going really fast, but for all I know it was a slow ride. I managed to get into the car and we went home. I got into the house and onto the couch. (Where yes, I've spent most of my time since, haha. jerk).

It all didn't exactly feel wonderful that first night home. Definitely worse than when I first got injured. It's been one of the stranger things, the feeling that it feels worse, but it's fixed, it just needs time to actually heal now.  I think I need to wrap this post up now though and talk about the first couple days after surgery in another post. I also had a followup with the doctor the day after surgery that also went well, but I've mostly been chilling since getting home. Each day is better than the previous. I'm able to straighten it good and flex my quads somewhat. I'm nervous about bending it. I can some. I was planning to try to go into the office tomorrow but I'm not sure. The doctor said I can drive when I feel comfortable doing so. Right now I can barely lift my leg and I'm still taking pain killers so I can't drive quite yet either way. Sara is willing to drop me off at work but we'll see. It's all a big hassle. I know. I'll just continue to wait and be patient until it all gets better. It will get better. It will.

Look at me, I'm ready for you to cut this knee.

Surgery Date Set

Had doctor followup this morning. He was happy with my straightening, bending, and walking progress. We set a next Wednesday date (9/9) for the surgery so that I could come back in for that followup and see him before his end of month vacation. Sounds good. Let's do it.

Once I have the surgery, I'll have a couple more weeks on crutches before I can start getting back to where I am now. Each step I take forward before then will help me after the surgery.

Let's chat more hat, let's do it.

MRI Results Followup

Meniscus is good. PCL is normal. ACL is completely torn. Lateral meniscus looks okay. Still a good amount of fluid in there which is creating the tightness disallowing me to bend it completely.  I need to work on getting the motion back.

Not everyone needs to have surgery. There are three groups of people. Some live their entire life not knowing the ACL was torn at one point. Another group of people can walk but can't trust it during sports. The third group of people have a knee that buckles when they walk and need to have surgery. I feel like I fall in this third group but I haven't really tested it out much since the injury.

It's to my favor that the meniscus is not damaged.

The biggest risk for the surgery is the stiffness.  Near normal range of motion is preferred prior to that.  The plan is now to start PT and work on the motion.

So that's where I am now. In need of finding a qualified physical therapist close to me. I need to start putting some weight on it.

Here's the actual analysis of the MRI:

EXAMINATION: Right knee MRI without contrast
CLINICAL INFORMATION: Jumped and landed awkwardly on 7/30/2015; felt pop and the knee buckled; persistant pain and swelling; difficulty with weightbearing; no improvement with conservative treatment; evaluate for anterior cruciate ligament tear.
TECHNIQUE: A routine right MRI exam was obtained.
COMPARISON: None.
FINDINGS: The body and posterior horn of the medial meniscus demonstrate a poorly defined globular region of mild/moderate increased internal proton density and T2 signal intensity. There is no associated disruption of the overlying meniscal articular surfaces. The anterior horn of the medial meniscus is unremarkable.
The lateral meniscus is normal in configuration and patterns of signal intensity.
The anterior cruciate ligament demonstrates moderately severe diffuse abnormal irregular oval thickening, diffuse moderately severe increased T2 signal intensity and a severe irregular wavy configuration.
The posterior cruciate ligament, the medial and lateral collateral ligaments, the iliotibial band, the biceps femoris tendon, the popliteus tendon, the infrapatellar ligament and the visualized region of the quadriceps tendon are intact.
There is a large right knee joint effusion. There is no definitely evidence of intracapsular loose bodies. There is a moderate medial synovial plica.
There is apartially fused secondary ossification center at the superior-lateral margin of the patella. The overlying articular cartliage is intact.
There is slight impaction of the central osteochondral surface of the lateral femoral condyle associated with moderately severe underlying subchondral intraosseous inflammation/edema.
There is mild/moderate poorly define increases subchondral intramedullary T2 signal intensity involving the posterior half the tibial plateau, lateral greater than medial. There is no assicated significant depression of the overly osteochondral surface.
All three compartments of the right knee joint are well-maintained. The visualized osseous structures are otherwise normal in configuration and patters of signal intensity for the patient's age.
There is mild to severe superficial and deep soft tissue inflammation/edema overlying all regions of the right knee. The visualized soft tissues are otherwise unremarkable.
IMPRESSION:
1. There is a large right knee joint effusion.
2. There is evidence of an acute, complete tear of the anterior cruciate ligament.
3. While the body and posterior horn of the medial meniscus demonstrate evidence of mild internal degeneration, there is no evidence of an associated linerar medial meniscal tear.
4. There is a slightly impacted osteochondral fracture involving the central region of the lateral femoral condyles associated with moderately severe underlying subchondral intraosseous inflammation/edema.
5. There is a mild/moderate diffuse osseous contusion involving the posterior half of the tibial plateau, lateral greater than medial. There is no associated significant depression of the overlying osteochondral surface.
6. There is a moderate medial synovial plica.
7. There is evidence of a developmental bipartite patella.
8. There is a mild to severe superficial and deep soft tissue inflammation/edema overlying all regions of the right knee.

That First Day

I slept on and off through the night even restarting one of my Netflix movies so that I could promptly fall back asleep. I woke up and it still didn't feel right. I felt the wobble when I gave my right leg a tiny bit of pressure. I knew it was pointless to try to hop into work. I logged in and canceled my meeting and gave a heads up to my coworkers.

I anxiously waited until Bone & Joint was open at 8am so I could call and try to schedule an appointment. Sara and the girls waited to leave in case I needed a ride. I didn't want to wait around to see the doctor. I confirmed my insurance was accepted there and was glad I didn't need a referral. The knee was never in much pain, but obviously there was discomfort. I've been happily accustom to using both of my legs with no limits for the past 36 years. This was new. Never before had I had a serious injury like this. It felt serious.

After being on hold for 10 minutes or so, cause apparently everyone needed to call at 8am, I got through to the scheduler and got setup for a 1:50pm appointment. Sara left for work and to drop the girls off. I took care of some work things and stared back at the dog who expected me to hop all over to let her out.

I'm super grateful that I had picked up running in the past year and a half to build up some leg muscles. My left leg right now is the early MVP through all of this. (After my wife and kids, teammates, friends, coworkers, etc). Gosh, sorry, sidenote: I've been so grateful to have an amazing family and friends. Really makes my eyes watery. My inner resolve is strong, but their support is what makes it spark.

I listened to Twiddle's live stream from Vibes and Sara came back for lunch.  We shuffled ourselves off to Bone & Joint. I hopped into the building, into the elevator, into the reception area (but 'nooo' not that line, lolz), into the waiting room, and then into the exam room.

I of course was hoping it wasn't anything serious, but it felt serious. On the way over, I said that I was just going to brace for the worst and hope for the best.

The nurse came in, asked a few questions. I'm sorry I don't know the technical term for these roles but the Crutches Delivery Lady came in with crutches, sized them up for me, and gave me a short demo. Never before. I hopped back up and waited for the doctor to come in.

Told him my story and he compared it to a bonehead move Mark Tiexiera made recently running through a stop signal at third base. Okay, so at least he understood my plight. He felt around on the knee and basically told me that it was likely an ACL tear. 70% sure he said. Something like that. I follow sports. I play fantasy football, baseball, etc. I knew what this meant. My season was over. My running season was over. And the recovery is long. I knew what it meant immediately.

I used my crutches to hobble to another waiting room to get an X-Ray on the knee. After the X-Ray I hobbled back towards the exam room and he showed me the images. He basically confirmed his suspicion that it was an ACL tear, likely a Segund Fracture. 100% likely he said. And that surgery would be in my future. I understood this. We still needed to have an MRI to confirm.

Back in the exam room, the Brace Delivery Guy came in with my new besty. He adjusted the straps or whatever and showed me how to take it on and off. We put it on and now I was all braced up. Half robot. Half man.

I scheduled my follow up appointment for the 17th. The MRI would be sometime before, since it had to be approved by insurance first.  I'm so thankful we have insurance. Don't not have it. You never know!

I made Sara take a picture of me with my new robot apparatus so I could show and tell. A lot of really nice people had a lot of really nice supportive things to say, and I'm super grateful again. Super grateful.

My attitude then (and 4 days later kickstarting this blogg recapping these thoughts) was one of positiveness. I should probably save some of my philosophies for another post since we're already getting wordy here but basically the basic premise is that this is just a set back, a knock down. We all know what happens to things that get knocked down. They get back up again. I'm not down. I'm not out. I'm not finished. I've barely just started. This is a setback but it's not the end.

Afterward, we picked up the girls, went home and took it easy the rest of the night!

Living that sweet robot life. Check me out now!

Twiddle Live at Seaside Park - Gathering of the Vibes on 2015-07-31
Intro, Beethoven And Green, White Light, The Catapillar, Amydst The Myst, Cabbage Face, Carter Candlestick