ACL replacement – 5 days in

I really didn’t know what to expect coming out of this surgery. Although I asked the doctor and met people who had it, the responses I got were totally across the board. I heard “You won’t be able to do major athletic activities for 6 months.” “You will be in physical therapy for a year or so.” “The main recovery period for meniscus tears is 3 – 4 weeks. For ACL replacement it is 4 – 6 weeks. You are having both, so plan for more than 4 weeks minimum.” From this, I figured I would be more or less useless for a month, and probably limpy and gimpy for a month or two after. Was that 4 weeks of crutches? 6? I wondered if I would be able to do Mocksgiving ok. I gave up apple picking for the year. I figured the birthdays were going to be a real challenge to me.

And the pain. I heard of people hooked up to automatic-knee-moving-machines. I heard people talk about excruciating burning pain as they went to move their knees – about how they could not even move them without help. I took the pain of my initial injury and multiplied it in my head. I heard about the goooood drugs I would be getting, and the nerve block, and what a bad moment it would be when the nerve block wore off. (For the record, I am unconvinced that the nerve block actually blocked anything.) I was prepared for blinding agony.

I’m five days in and on the couch. But here’s how I’m feeling.

I’m thinking that major surgery is fun enough I should do it annually. I have gotten to play 900% more video games, read more, relax, sleep in, write letters, keep up on teh intarwebs and play fun games with my kids.

The pain? I definitely think the surgery is less painful than the initial injury. This might be because I do have appropriate pain medication (and I am taking it – there is nothing to be gained by not taking my prescriptions). It is also likely less painful because I’m keeping off it and actually resting, which I did NOT do with my injury. But the excruciating burning pain? Nah. The worst is when I wake up in the morning and all my meds have worn off. I feel the incision points. I feel a throbbing ache through my knee. My calf is screaming in dismay at the inactivity, extremely heavy brace etc. But is it the fiery agony of hell? Nah.

The incapacity? I have decided that I was in a best possible scenario for this injury. Consider:
– Due to on and off reinjuries since May, my good knee has bulked up and is used to compensating/standing by itself/doing all the lifting
– Thanks to physical therapy and activity on my part, my “bad” knee is strong. My “baby’s first physical therapy” involves 10 straight leg lifts. I can currently do more than 30 before I get bored and quit. I was doing them before, and they’re not much harder after.
– My “bad knee” is used to not having an ACL. It has compensatory muscles. So the instability of my new ACL is much less of a factor than it would be if I had just busted a working ACL.
– I’ve been practicing a one-leg lifestyle. The crutches are a pain, but I’m really good at doing things with one good and one gimpy leg. See also: since May.

So far, I have excellent flexibility. I’m up to 90 degrees. I have to take off my braces, because they stop my knee from moving before any swelling or tightness stops my knee from moving. I’m almost at where I was before surgery (which is not the same as perfectly good, since I’d reaggravated my knee). I can place my weight on my bad leg (carefully, while holding on to the crutches). It doesn’t hurt the knee to be jarred or bumped in to. When I am up to date on my meds, sitting in my couch with my cold pad I am not experiencing any pain.

So I’m thinking that 4 – 6 weeks of completely wiped-out-ness is unlikely. I’m hoping to have maybe another week of crutches and then start returning to life as normal!

A few notes, in case you come here through googling acl replacement and meniscus tears and wonder what’s ahead:

I have a four-stage dressing system:
1) Bandaids. Three of ’em. Covering three incisions with a total of 6 stitches.
2) ACE bandage. Buy an extra one with velcro before surgery because it will be gross and you will want a new one. Keep this on to prevent chafing and provide compression.
3) My cold pack is fan-freaking-tastic. I would SO recommend this system to anyone who regularly needs to ice an appendage. Here’s their website: . It has a reservoir for ice water and a temperature sensor. It circulates cold water through a thin pad that I wear under my bionic-brace. It is immediate and effective pain relief, as well as reducing swelling.
4) Over all of this (and over my pants) I have a Rom Knee brace. It’s articulated, adjustable and lockable. I keep it unlocked during the day and am supposed to lock it while I sleep. I’m not sure why that is. It’s pretty heavy duty hardware, and I’m finding it a bit annoying. If it is tight enough to not slip while I’m walking, I’m afraid it’s cutting off circulation to my foot. If it’s loose enough to not create welts, then it slips down while I walk. I have to wear it 24/7 and it is the element I’m most looking forward to ditching.
5) Crutches – just normal aluminum affairs. I should have been doing arm strength training in prep. The first few days my arms were as sore as my knee!

Ibuprofen – I try to take 800 milligram doses, since I’ve heard that is the minimum dose to actually get an anti-inflammatory effect. This is probably the mainstay and most important pain medication I’m on. I reckon I’ll be on it for quite a while. A rule of thumb is an hour for every 100 mgs… so 800 mgs would be 8 hours, 400 mgs would be four, etc.

Percocet/Vicodin – I started on Percocet and could not tolerate the side effects of throwing up and falling asleep. We turned it in to the police when my husband picked up the Vicodin, which makes me a little light headed but otherwise seems to be having mild side effects.

Aspirin – for anticlotting/anticoagulation. It’s a very slight risk with this procedure, so it’s just sort of added in to the mix.

I took four days off work and will work from home (probably a touch part time) next week. I plan on going back into the office the following week – or about 12 days after the surgery was performed.

Questions, anyone?