Monday, January 25, 2010

ACL Post-Surgery Rehabilitation

November 12, 2009

Being up and and awake off and on during the night takes a toll on us older people I tell you. But it's to be expected. DS15 seemed fully recovered from the anesthesia by morning and was feeling significant knee pain as well as his hamstring. I kept him at two Percocet every four hours plus a dose of Valium here and there to keep his muscle tremors down. His upper thigh would just quiver away, probably due to the work down on his hamstring. He at surprisingly little in the morning but did continue to suck down liquids. Still using the urinal, he hadn't attempted getting out of bed yet. Knowing that it had to be accomplished sooner than later, I started the process. Brace on and crutches ready, he swung around to get his leg off of the bed and stand. Not anticipating the blood rush to the leg, he just about passed out from the pain while getting to the bathroom. After speaking to the nurse later on, she said that the entire getting out of bed process should take a long time to keep from experiencing that painful blood rush. DS15 firmly stated that would be the last attempt out of bed for that day. The surgeon also called and acknowledged that as people experience different levels of post-op pain it was likely that he couldn't begin his post-op exercises that day. He did want him to be sure to run the Game Ready 30 minutes out of each hour during the day and do his ankle rolls and flexes every hour however. A lot of TV, listening to his English audio book assignment and visits from two friends were the highlight of the day. He continued to need the two Percocet every four hours which exceeds the recommended dose, but I'm figuring he should be able to drop down a little tomorrow...I hope.

November 13, 2009

Well so far the highlight of today's recovery would include staying within the maximum allowed pain killers, and at least so far, getting DS15 to stand with his crutches and not pass out. It would appear that the Percocet is making him terribly dizzy as his head spins whenever he stands. I've changed his dosage so that he's taking one every three hours instead of two lasting for six hours. Hopefully that will help with the brain fog and queasiness as well. He attempted to work on some school homework assignments, but just can't seem to pull lit off.

November 14, 2009

Last night we worked again on getting DS15 to get out of bed and use his crutches. No luck. The pain he is feeling once standing is just too much he says. Now I'm a little frustrated. His buddy who had his surgery the day before his has been up and about and even on the sidelines watching the team's playoff game last night. I'm not sure why such different outcomes other than DS15 also had meniscus repairs done as well. He's frustrated that the brace is pressing in all the wrong spots...that the knee feels like it's going to explode....that he's going to damage something. DH said he's going to just have to suck it up and work through the pain to get moving again. Quite unfortunate. Thought it would have gone much smoother than this.

I went back to some of the sites that used great demonstrations of how the ACL reconstruction with a hamstring autograph are performed and can see where the pain in originating from that DS15 is experiencing. The worst place is on the inside below his knee where the new ligament was attached to the bone. If you click on KNEE, then PROCEDURES, and then ACL RECONSTRUCTION WITH HAMSTRING you'll see what I mean. It's got to hurt.

November 15, 2009

More sleeping away the day by DS15. By mid morning though I roused him enough to get a start on his homework assignments from last week. It's hard to teach oneself precalculus when you miss your teacher's lecture, so we looked around on and found some college professors with whiteboard demonstrations that were quite helpful to him. He did get up and make it around on his crutches after that which was great to see. He had a friend stop by in the late afternoon which was motivation enough to try to get up the stairs to his gaming system. It just about wiped him out...which is so surprising since he's a top-notch, fit athlete...but he made it. I hauled up the icing machine and figured he was up there to stay for the night. Today was also the day to unwrap his knee which we did...carefully. He was a little apprehensive removing the layers of gauze for fear of catching his stitches. A photo of the knee would have been great right here, but he was not going to have it. No bruising but still swelling. There was a large angled stitched incision below the knee and two good sized ones on the knee as well as several smaller ones above. There hadn't been excessive drainage which I'm guessing was good. And now he was free to take a shower.

November 16, 2009

School was on the agenda for today, but when DS15 woke up, he realized that he hadn't taken any Percocet since noon the day before. By morning his knee was killing him. He also apparently didn't sleep well that night. So dosed him up and sent him back to bed for awhile to see if he could get past the pain. I woke him up a few hours later and suggested that he try to catch the last half of his third morning class and try out the rest of the school day which seemed like a good idea to him. On his way home from school he found out that a couple of friends were going to stop by. Good idea on the morale end of things, but bad idea considering how wiped out he was from just that much hauling himself and his 50 lb. backpack around school on crutches. After they left, he tried to work on more school work but said he felt absolutely awful...freezing cold...just yucky. I took his temperature since it sounded like he was having chills. But no, temperature was 98.6 orally. So off to bed he was sent. I made sure to wake up around 1 a.m. to give him another Percocet so that he could wake up and get moving in the morning.

November 17, 2009

Nothing ever goes as planned. About 6:00 a.m. DS15 called me in to say that he felt miserable. I took his temperature and this time it was 99.1. He was somewhat nauseated, didn't sleep well, and his knee ached. I can tell the difference in how his knee feels when he's not home all day to use the icing machine. He made it downstairs and plopped on the couch to promptly fall asleep. I put in a call to the doctor on call at the orthopedic office. When he called back he didn't think that the fever was associated with his knee surgery as the site looked clear when I had removed the wraps to look at it that morning. He didn't really have an answer for me. Maybe a flu bug. Fine thing to try to recover from surgery and get nailed by something on top, but it would make sense that your body has been stressed and your immune system is down. It was early enough that after falling asleep for awhile he actually got up and said he wanted to make it to school to catch his morning classes that he hadn't been to since last Tuesday. So feeling bad for him, I took him to school. By that time his temperature was normal, so I wasn't sure what to think. Could be that by his finally getting up and around and tackling quite a bit of activity yesterday that his system was flushing out all the accumulated toxins that had been lying around not going anywhere while he was fairly immobile. That will make you feel run down and feverish. As figured, I got a call after his third class with a call to pick him up. He came home and went to bed with the ice machine strapped to his leg so that I could run it every hour while he was asleep. He was out for the rest of the day until after dinner when he roused and again tried to tackle his school work. And then off to bed again.

November 18, 2009

Well today DS15 made it off to school on time and apparently felt okay. He had DH take him up there so I didn't check in with him to see how he was feeling.

November 19, 2009

Post-op appointment with Dr. Feinblatt today. Stitches were removed. Order for physical therapy given. More Percocet prescribed. Doctor seemed happy with what he saw other than he thought there could be a little more leg extension at this point. Physical therapy will take care of that. Once the leg gets straight enough that DS15 can put sufficient pressure on it and still be stable, the crutches can go away. The brace however will remain locked at 90 degrees and is to be worn at all times. Xrays of the knee were taken to confirm that bone growth was progressing as expected to anchor the hardware in the knee holding the new graft in place.

November 20, 2009

So thankful for physical therapists who know your situation on a level to be concerned. Even though we just dropped off the order for therapy, they did not want DS15 going the entire weekend without squeezing him in today to evaluate his knee and get him started on exercises to trigger those quads into responding and getting that knee straighter. With information and incentive, DS15 will hopefully be off the crutches this weekend.

November 21, 2009

Well DS15 decided that there will be no more crutches. He's walking with quite a limp, not so much from pain, as from not getting the extension he needs. But he's determined to work enough this weekend on extension that he will not need those crutches to attend school on Monday. The ache in the knee still drives him to take his Percocet though we're cutting it back to a half tablet as needed.

November 25, 2009

Hard to believe it's been two weeks since the surgery. No crutches. Pain meds down to bare minimum. Icing machine returned to supplier. Physical therapy underway. This day was hard to see even a week ago. Therapist feels DS15 is where he should be based on the surgery date even though he seemed to be a little behind initially. Due to the 90 degree lock on the knee brace, his progress will be a little slower than that of his buddy, but it's great to see the two of them being able to "do time" together. DS15 met an 8th grade football player he knew in at the physical therapist today who had just had his surgery last week...another ACL tear. He had the unfortunate situation of being too young to have a routine ACL reconstruction as his growth plates were still active. Apparently it was a bit of an experimental surgery, but according to DS15, he has stitches all over the knee and it looks miserable. With another varsity football player who had meniscus surgery today, that brings the known total knee surgeries from this year's football season from the Oregon City area to five. Five is a lot for a town our size.

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