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November 12, 1997
Lots of pain and lots of discomfort, almost, but not quite,
unbearable. I'm taking Percocet at the maximum dose, two every four
hours, and it does absolutely nothing for the pain. I watch a movie, send
e-mail to friends and co-workers letting them know how I'm doing and
that's about it. Once again I try to sleep without much success.
November 13, 1997
Today is my first post-op visit with Dr. Mott to get my dressing
changed. It goes well, he says everyhing is looking great and checks my
flexibilty and strength, both are good for two days out from surgery.
Once again, sleep is tough to come by.
November 14 - 16, 1997
I spend the weekend laying around the apartment, watching TV and
trying to do a little reading, but my concentration is pretty much shot
right now. By Saturday, the pain isn't so bad, and I stop taking the
painkillers. All they seemed to accomplish was make me lightheaded and
sick to my stomach. The pain is starting to become bearable without the
medication. On Saturday afternoon I watched the Badger game on TV, they
played respectably against Michigan, the number one team in the country,
and have nothing to be ashamed of, even though they lose. Sunday's not as
uplifting, though. The Packers play the worst team in the NFL, the Colts,
score 38 points, and still manage to lose the game. It's as if the
defense decided to take the day off, and only play at half-strength.
Sunday evening, a couple friends stop by, we order Chinese and watch "The
Simpsons" and "King of the Hill." They're grateful for the study break
and I'm just grateful for the company.
November 17, 1997
I go to class for the first time, today. One of my roommates is
presenting his research proposal in our departmental graduate colloquium.
He's asked me to introduce him, which I'm glad to do, since he did the
same for me last month, when I presented my research proposal. I have to
say that it feels great to get out after having been cooped up for the
last six days. Sleeping still isn't going very well. The brace is
irritating the bruising on my shin, and the resulting pain makes it tough
to sleep.
November 18, 1997
Today is one week out from surgery . I have my first physical therapy
visit, and Jenny, the therapist, gives me the first of what will certainly
come to be a long list of exercises. She also measures my strength and
flexibility and says I'm right on track for my rehab, and maybe a little
ahead in some areas. The best part is that I can now take the brace off
when I'm walking in safe environments.
This afternoon, I spend a couple hours at a public informational
session for the Madison Student Radio broadcast tower. We seem to be
stuck between a rock and a hard place on this one. The FCC has limited
our construction area to a small sliver of land, and some of the people in
that township are vehemently opposed to the tower being built in their
backyard. We'll just take it one step at a time and see what happens.
Tonight I figure out how to deal with the irritation from the
bruising. I wrap a small towel around my shin before putting on the brace
to act as a buffer and take a couple of Percocet to dull the pain. It
seems to work.
November 19, 1997
My second doctor's visit today. He says everything is coming along
great and also told me it was alright to get the incisions wet. This
means that I can go home and take my first shower in eight days. While
the combination of sponge bathes and talcum powder have overcome the BO, I
don't really feel very clean anymore. The removable showerhead, in
concert with a kitchen chair, seem to do the trick since I can't stand on
my own in a slippery shower. After twenty careful minutes, that includes
several joyful choruses of "Singing in the Rain," I feel human again.
November 20, 1997
I had my second therapy visit today. They added a whole bunch of new
exercises. The therapy is not fun by any means, the bending exercises are
especially painful. But I do them religiously, since I know they are only
for my benefit in the long run.
November 21 - 23, 1997
Friday is a pretty quiet day, I just stay around the apartment,
watching a little TV, reading the newspaper, and getting caught up on
various odds and ends.
Saturday is about the same, although I venture out with one of my
roommates to get some lunch at a fast food joint about a half block away.
Today, my knee hurts so bad along the front that the only way I can raise
it ot or lower it from the footstool is with the aid of my right leg,
otherwise the pain in the patellar region is excruciating; although
standing and walking on it doesn't feel too bad. I'm not sure what it is,
but if it doesn't get better by tomorrow, I'm going to call the doctor.
On Sunday I stayed in to watch the Packer/Cowboy game, the first time
Dallas has played in Green Bay in nearly a decade. The Packers played
like the Packers of last season and did an amazing job, dominating the
Cowboys, especially in the 4th quarter. During the game, though, Dallas'
Nate Newton went down late with a knee injury, and I instinctively felt a
twinge in my knee. I don't think I'll ever see another knee injury in any
form and ever feel the same again. I'll always have great empathy for
anyone else who goes through what I'm experiencing right now.
On the knee front, the pain is still there and I called the doctor's
office. The doctor on call says the pain I'm feeling in the patellar
region is pretty typical when the graft is taken from the patellar tendon.
He told me to ice it down and call my surgeon on Monday if it still hurts
then.
November 24, 1997
Overall, my knee feels pretty good, although the pain in the patellar
region is still there. I put in a call to my surgeon, Dr. Mott, and am
waiting on his response. I no longer have to bandage the incisions, as
there was no blood on the last bandages. I'll take that as a good sign
that things are healing up. Tomorrow is a big day for me, at midnight
I'll go back to work for the first time in two weeks.
November 25, 1997
Two weeks out from surgery today. Today's therapy session was still
more ambitious. I've had several more exercises added on, including one
to work on balance, but no new exercises added to my home routine. The
therapist has me down to one crutch and no brace when I'm around the
apartment, or any other safe environment. I'm still waiting on the day I
can sleep without the brace, that call is up to the doctor. I see him
next week, and I'm going to lobby hard to have something done to make
sleeping more comfortable, either no brace, or a different kind of brace.
My current brace just seems to aggravate the bruising and swelling to the
point where my leg hurts like hell when I wake up in the morning. The
other milestone of the day was that I took my first shower standing up
this afternoon, and all went quite well.
November 26, 1997
My first day back to work, and everything went good. My knee got a
bit sore and tight from sitting so much, but that was alleviated by simply
getting up and walking around. I got home a little after 8:00 in the
morning, packed up my stuff to head home for the holiday, took a quick
nap, and then hit the road in the late morning. It should be good to get
home for a few days and see my family and be cared for beyond all belief
by two wonderful parents and a couple of overprotective sisters. All in
all, the trip home went well, three hours in a car and my leg felt pretty
good, and only one stop to stretch out.
I'm continuing to do my exercise routine religiously, even going a
little further (i.e. doing more reps) than what is required by my
therapist. The knee feels OK after the exercises, not as sore as it has
only a few days ago. But I do have to admit that the 15 minutes of icing
and elevation afterward certainly do feel good, and is a welcome relief.
November 30, 1997
The trip back to Madison today makes me realize one important thing:
My knee is not yet ready for three hours in a car. By the time I get
back, my entire left leg is sore. Of course, I don't think it helps that
the muscles in the leg have lost their tone and turned to flab due to the
inactivity.
December 2, 1997
My therapy is now kicking into high gear. Today I spent time on the
treadmill walking backwards, did leg presses, and rode the stationery
bike. I'm also beginning to be weaned off the crutches and the leg brace
which really feels great. I can now walk unassisted in "safe"
environments. I'm at 95 degrees of flexibilty at three weeks out, which
is five degrees ahead of the game. Things are looking good at the moment,
but I expect a drop off fairly soon, since there's supposed to be a brief
period of decline before the slow, steady climb back to full strength.
December 3, 1997
Work this morning (midnight to 8am) went pretty well. The knee and leg
felt pretty good. Especially walking around without crutches or a brace.
However, went outside this morning in the snow and on the wet, slippery
sidewalk, and felt pretty unsure and unsafe with crutches and no brace,
but felt even less so with it on. Now I'm beginning to dread the onset of
winter.
This afternoon, I told the doctor that I feel safer and more
comfortable walking outside without the brace than with it, and he said I
could go without the brace outside, as long as I understood the risks
involved if I should fall. They're pretty high, too, if I should slip and
fall I run a very good risk of doing some serious damage to the knee. As
long as it's not slippery or icy, I'll go out without it, but will wear it
when things are more treacherous.
December 4, 1997
Therapy today was hell. I'm on the stationery bike, the treadmill and
doing leg presses in addition to all the other stretching and
strengthening exercises. It leaves my leg pretty sore most of the time,
but I know that it will eventually improve and that it's all for my own
good, so I stick with the program and just bear the pain as best I can.
If I'm sitting for a long time, straightening my leg is pretty
painful. When I walk, it sometimes feels like the knee is going to give
out on me, but as yet it never actually does, which is probably a good
sign.
This afternoon, I walked about ten blocks to run an errand, using the
crutches but no brace. My leg and espeially the knee felt OK afterward.
Generally, things feel better if I'm up and walking, rather than just
sitting or lying down.
December 9, 1997
I hit 120 degrees of flexibility in therapy today, that's one heck of
a milestone at four weeks out from surgery. Actually it's two weeks ahead
of the rehab protocol. I shouldn't be at this point until six weeks out.
The next stop is full flexibility at eight weeks out. The quad muscles
are pretty soft now, but there's a little bit of tone starting to come
back. It's a long way from what it should be, though.
The rehab program got even more ambitious today. In addition to all
the other stuff, now I'm also on the stairstepper, plus even more
exercises to do at home. Thre's still a lot of soreness in the knee, but
the therapist assures me that it should clear up very soon. In the mean
time, I'll stick with the ice when things get too bad.
December 11, 1997
My therapy regime is slowly starting to add in exercises to work on
pivoting motion, as well as more and tougher exercises to work on my
balance. I'm about to be weaned off the treadmill and have more time
added to my work on the stationary bike and stairstepper. My range of
motion (i.e. flexibility) is holding at 120 degrees, and that's probably
OK. Since I'm two weeks ahead on that score, I don't want to chance
pushing my knee too far beyond where it should be at this time. I'm also
starting to get back some of the hyperextension in my knee, it measured at
-1 degree today. By comparison, it was at -5 degrees before my surgery.
After therapy today I watched a surgical training video showing some
of the techniques that were used in my ACL reconstruction. The only one
that made me cringe was the removal of the patellar tendon graft. Now I
understand why the patellar region of my knee hurts so much, because they
take a pretty good sized chunk of the patella (knee cap) along with the
tendon.
December 13, 1997
The pain in the knee is killer. Whenever I stand up, it feels like
the knee is going to buckle (not from weakness, though, but from the
pain). It mostly goes away, however, after a few minutes of walking
around. On the up side, I can do a pretty good job of going both up and
down stairs. Also, I walked the two blocks to the convenience store and
back this afternoon without crutches, being careful to avoid any ice or
slippery spots. I think I'm starting to get my "sea" legs back.
December 14, 1997
Once again, I put in a few blocks of outside walking without the
crutches. This trip was two blocks to the laundromat and then back an
hour later. I even towed a luggage caddy loaded down with laundry both
ways and lugged it down the steps of my second story apartment and then
back up them once I got back home.
December 15, 1997
The pain isn't that bad today, just the usual series of aches and
pains. Like I told a friend last night, if it didn't hurt, then I'd be
worried. It seems to feel better when I'm up and walking around, as long
as I don't over do it. The therapist has told me to expect the knee to
hurt when I changes positions, such as from bent and sitting to straight
and standing.
December 16, 1997
My therapist has eliminated a bunch of the exercises I have been
doing. I've been upping the reps on most of them, so she feels I'm
probably not gaining too much from them anymore. She has added exercises,
though, that are designed to work on side-to-side range of motion and
pivoting. These are actually challenging and even kind of fun.
I'm almost back to my full range of motion. My hyperextension
measures at -5 degrees which is normal for me, and my flexibilty is at 125
degrees, which is only 10 degrees short of normal. Additionally, my stair
climbing is pretty much back to normal, also. The knee gets a little
sore, but the gait itself is OK.
Well, last night I witnessed the height of stupidity in ACL rehab.
Jerry Rice, of the San Francisco 49'ers, was back on the football field
only three and one-half months after having ACL reconstruction. It takes
a minimum of two months just for the graft to fully heal! And he's
already out there playing. It looks like he found out how misguided that
was, though. He injured the knee during the game. The "party" line from
the team is that it's unrelated to his previous injury, but there's no way
you can convince me of that. Even if it's not the ACL, the fact that his
ACL reconstruction can't yet be at 100%, has to have something to do with
it, because it surely has to put additional stresses on the other
structures of his knee. I feel sorry for Jerry, because he's undoubtedly
under a lot of pressure from the team to play, especially in the playoffs,
and even more so because they want the return on the money they're paying
him. But now the 49'ers may not have him for the playoffs, or even
possibly at any time in the future. For any pressure they put on Rice,
and I wouldn't doubt they put quite a bit on him, they should be ashamed
of themselves.
December 18, 1997
I'm starting to feel a good deal of pain in the back of my knee the
last couple of days that was severely aggravated by the stair stepper this
morning. By taking my time with my exercises and with some extra calf
stretching betwwen exercises, it feels OK, and the pain cleared up pretty
well afterward. I also ventured out and walked a good deal without
crutches this afternoon.
Well, the diagnosis is in on Jerry Rice, he broke his kneecap Monday
night. And here's the big thing: Recent medical research shows that in
more aggressive ACL rehabs there is a higher risk of patellar fractures.
And no one has ever had a more aggressive rehab than Rice, back on the NFL
gridiron after only three and one-half months. So, there's nothing the
49'ers can say anymore that would convince me Rice's latest injury isn't
related to to his ACL reconstruction.
December 19, 1997
I hit the first major milestone of my rehab: Full range of motion.
When I saw the doctor this morning, he measured my bending range of motion
and it matched my pre-op range, 135 degrees. And since my extension was
already at -5 degrees last Tuesday, that puts me at FROM five weeks and
three days out from surgery, which is 2 weeks and 4 days ahead of the
target date for FROM.
In two-and-a-half weeks I'll be taking my first Cybex test to compare
the realtive strength of the two legs, and if the left is at 70% of the
right leg, I can begin a light running program.
December 23, 1997
My rehab regime is beginning to take a new direction. I'm being moved
from regaining my range of motion (which is pretty much back to normal)
and preventing loss of strength and conditioning, to building strength and
mobility, with the end goal of getting me back on the volleyball court,
and (my own personal goal here) on a ski slope for the first time in my
life next winter. One of the toughest exercises so far are the squats,
where I have to squat down in a position similar to what skiers call the
"egg," it's also the same as the service receive stance for volleyball. It
doesn't seem like it would be that bad, until you try it on a weak leg and
hold it for a total of several minutes (over five to ten reps).
Another tough exercise, but for a completely different reason, is
balancing on my bad leg with my eyes closed. Again, it doesn't seem too
hard, but once I start losing my balance, I start laughing at myself and
can't stop, making it pretty much impossible to continue. This is one of
several exercises I'm doing now to regain my sense of balance on my left
leg as well as rebuild my own confidence in the leg. Something very
important if I want to get back into active sports.
Also, no more lethargy. My therapist is pushing me into rebuilding my
conditioning and endurance. Forget the five minutes on the bike and five
minutes on the stairstepper. Now I'm up to a total of thirty minutes a
day on my choice of bike, rowing machine, treadmill or stairstepper. This
actually makes me feel good, because I'm starting to notice a very real
difference in how I feel, that is I really feel like I'm the worst shape I
have been in a long time. If I pass my first Cybex test in two weeks (and
my therapist thinks I'll do well), then I can begin a running program.
What amazes me is the seeming speed with which my rehab is
progressing. I'm only six weeks out from surgery and I'm starting to be
moved into a serious exercise program designed to improve my strength and
condtioning. As a point of reference, I was walking without crutches or a
brace within a couple of weeks. One of my roommates had the same surgery
several years back and said his rehab progressed much slower than what
mine is. It's not unlike the fact that twenty years ago this same surgery
would probably have kept a person in the hospital for close to a week, and
today we're being sent home the same day as the surgery. I don't mind this
at all. I'd rather be pushed along and rebuilding myself as quickly as
possible, instead of laying around getting more and more out of shape
everyday and then suddenly having to face the prospect of a long climb
back once everything is healed. The whole goal of this program is not
just rehabilitating the knee so that it's usable, but rehabilitating the
knee so that I can return to the same acivities and sports I was involved
in before as well as being able to take on new sports and activities.
Basically, to get me to a point where I don't even consider my my knee to
be reconstructed.
December 29, 1997
My knee has been feeling pretty weak the last few days. When I was
walking down the basement steps at my parents' house yesterday, it nearly
buckled. That left me a little shaken. What if it had given out? I
stopped and grabbed the handrail and had a vision flash through my head of
tumbling down the steps and tearing up my ACL graft. Not a pleasant
thought. So far, I've had quite a bit of confidence in myself and my
knee, but that incident changed things. I have another couple weeks
before my graft is considered healed enough that I don't have to worry
about tearing it up if I should take a fall. And throw that into the fact
that things are pretty icy and slippery outside this time of year, makes
me a bit nervous. I may just start wearing the brace when I go outside
for the next couple weeks. If I had this to do all over again, I'd wait
until spring to have the surgery done, so I wouldn't have to worry about
ice and snow on the ground.
December 30, 1997
The pain in the patellar region is back with a vengance these last
couple of days. It's not constant, but there are some very sharp pains
whenever I put any strain on the knee, such as during some of my exercises
or when I straighten it after having it bent for awhile. Both Dr. Mott
(my surgeon) and Jenny (my therapist) have told me that this is typical
for a patellar tendon graft and that it clears up with time. I just hope
it starts to clear up pretty soon.
January 1, 1998
Happy 1998, Everybody!
My knee has been feeling much better the last couple days. Today
there wasn't as much patellar pain while doing my rehab exercises. Plus,
I was downtown for awhile yesterday afternoon. While walking around my
knee felt pretty stable, not at all like it wanted to give out. And I
felt pretty confident walking around on the slippery sidewalks without
crutches or a brace, I just go slow and watch out for ice and snow.
January 5, 1997
I've been a naughty boy lately. I haven't been doing my exercises
the last couple days because my knee has been so sore and weak, so I laid
off over the weekend and now it feels pretty good. I'll get back into my
exercises again today, and hopefully my knee will be better now.
January 6, 1998
Well, my first Cybex test results
are in, and while encouraging, they certainly weren't where I hoped they'd
be. Tested at high torque, low speed my left leg is still pretty weak,
but at low torque, high speed it's pretty close to the same as the right
leg. My quads are still pretty weak on the left leg but the hams look
like they are right on track. That's not surprising, considering that I
did lose a good amount of muscle mass in the quads that's only starting to
come back now. The bottom line is that it looks like I won't be running
for a few weeks yet. I'll know better where I stand on Thursday, when I
meet with Jenny, my PT.
During the test I also learned another important thing: I am probably
a good candidate for screw removal some time in the future. The lower
inside end of the graft hurt a ton during the high torque part of the
test, which may very well be because of the screw there. This is
something I'll have to discuss with Dr. Mott, my OS when I meet with him
next week.
Rehab: Weeks 9 - 18
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