PCL recovery

Hopefully when this shapes up into something, it will help other people going through a similar surgery... not much out there on PCL's, and I think there should be.

Sunday, January 30, 2011

Back from vacation

So I came back from my cruise vacation yesterday, and it was brilliant. First, the knee stuff. Overall, it was pretty good. I wore the brace on the flight down to Orlando, and I had quite a bit of pain and swelling on the plane, I guess from the pressure changes. But I was able to sit in the bulkhead, which was nice cause it meant I had extra leg room. Once we got to the airport in Orlando, I had a wheelchair take me to baggage claim because it was a long walk over there. Got our bags, and found our shuttle to take us to our 7 days of rest and relaxation. The people at Carnival told me that I could get a wheelchair at embarkation, but being a platinum cruiser, I had VIP boarding anyway, and got to skip all the lines. Which was nice, because the lines were long by the time we got there. I did have to get a pat down at the cruise terminal, but they were much nicer about it at the cruise terminal than they were at the airport.

We got on board, and went straight to lunch. I kept the brace on mainly because I had nowhere to put it, since our rooms weren't ready until 1:30. During sailaway, I skipped out on the traditional dancing, I didn't think it would be smart for my already swollen knee. I bought a spa pass, which was great for me knee. $150 for a week pass, and it was the best $150 I ever spent. Our dinner table was in a great spot. Our ship has 2 dining rooms, one in the middle of the ship, and one in the back of the ship. Since I knew I would have to minimize my walking, I had requested a table for 2 in the middle dining room, since it was closest to my room, nad we got what I had requested, and also very close to the door, and no steps to walk up. I definitely appreciated that.

So like I said, overall, the knee was OK. When we got to the ports of call, we went to the beach, and walking over the sand was difficult, as was climbing into and out of the water with all that sand. I think I underestimated just how difficult it was going to be. On one of our stops, I was having a lot of pain, and it felt like my knee was almost subluxing, so I ended up wearing the brace as it was a long walk down the pier, but the beach was right off the pier. I think it did help somewhat, although trying to keep it free from sand was annoying. I did wear the brace around the ship every now and then when it started swelling a lot and making these cracking noises.

Whenever someone saw me with this big ole leg brace, people asked me of course what had happened. I think most of them thought it had happened on the ship. So after I told them I had surgery, they of course all had to show me their knee scars too. It's like it was some secret club. Everyone felt the need to show me their scars, and tell me their stories. Although going along with the slightly older clientele on this cruise, I think everyone I met had knee replacements. I also kept up with my rehab as much as I could. I went to the gym almost every day. I learned in the afternoon, it's much quieter, the only people at that time are the dancers and entertainment staff, and the older people. I didn't feel quite as bad riding the bike with a resistance of 3 when an 80 year old was next to me, as if some incredibly fit 20 something sat next to me thinking he was the next Lance Armstrong. And the dancers, well, they're so focused on themselves they don't care what anyone else is doing.

It was fun when I saw the staff in their though. There is this one guy that runs the comedy club on board, and he sat on the bike next to me, and had his script that he was reviewing for his warm up before the comedians come out. He was fun to talk to, and let me hear some jokes from his warm up that night. I also saw the cruise director there once. These people are like mini celebs on a cruise, so I got a kick out of seeing them there, almost like I was seeing someone famous. Usually, after the gym, I would hit the spa. They had this mineral pool, it was nice hot water, with jet streams and what not. In there, I would usually do some leg extensions, knee extensions, lifting my leg, and walking up and down the length of the pool. Stuff like that, that my PT told me to do. And then of course, I would just melt into the relaxation after that was done. From there, you hit the steam rooms and saunas. I can't tell you how incredibely relaxed I would feel after that. I made sure to make an ice pack after the spa though, because the first time I didn't, my leg got very puffy. But it was brilliant, that spa is the best invention ever. Besides the mineral pool, there are 2 different steam rooms, and 2 saunas with heated tile lounges. I could have spent the entire week there. And the showers in the spa were amazing. They had shower heads that came out from the sides, and misted, and all these other settings. Loved it.

Speaking of the mini celebs I saw in the gym, there were some real celebs on board. They were shooting "Alvin and the Chipmunks 3: Chipwrecked" on my cruise. Jason Lee was on board, as was the guy who plays Ian Hawke, and of course the Chipmunks and Chipettes. We were asked to sign up as extras if we wanted, and on the last day, my boyfriend and I got called to be extras. It was fun, but I'm not sure if I would do it again. It was a very long day, it was cold, and we had to be in shorts and tee shirts. "My" scene is at a Chipettes concert, make sure you look for me :) I can't say the filming bothered me at all, they were really nice about answering questions for anybody even if you were just watching the filming, explaining what was going on, how things work, how they later do the animation, stuff like that. And they in no way took over the ship, they would close off only a small part at a time. Besides, with all them filming, there was less people competing for deck chairs. The only problem was that in the scene, we were supposed to be dancing. I kind of bounced around as my dancing, but after a while, my knee started getting really sore and swollen. After about 7 hours, I asked the background director if I could leave. We already did the parts where I was near the principals and he was moving us around to fill in the stage so they could shoot the concert from another angle. He was really great about it and said "You can leave anytime you want. This is your vacation and we're not paying you. We're thankful for whatever you give us". So for all that, all I got was a drink card, which was valued at $6. Still it was an experience, and maybe I'll see myself when the movie comes out.
I met the biggest celebrity on the ship: ALVIN!!!

Friday, January 21, 2011

Leaving on a cruise ship

Tomorrow, I leave for a wonderful week long cruise. My bags are mostly packed, boarding passes printed out, passports found. But of course, before I go, I had a PT session today. I think I had a break through today. I somehow reached full flexion. I'm not quite sure how that happened. It wasn't comfortable, and I couldn't hold it there, my foot would slide out, but he sat on my foot and kept it at full flexion. The thing is, I don't think I was all that excited about it, I was much more excited when I got around on the bike or when I took the brace off. Now, it was just like, oh, cool, I got full flexion.

My therapist had his student with him again today, and I was telling her how I know that I must have made some progress, because when I first went on the bike, I could hardly make it around, and I was going very slowly. I had to rock back and forth before I could get my knee around, and my therapist had to help me push it around. Now, I can just hop on the bike like it's nothing. I don't know why, but every time I go on the bike, it amazes me how just a few short weeks ago, it seemed impossible, and it seemed like this whole rehab business would never end. It seemed like I would be stuck doing the same exercises, staying at the same place for months and months. Instead, 2 months on, I can fully bend my knee after being warmed up, I can hop on the bike like it's no big deal, I can walk on the treadmill at a brisk pace, I can use the quad machines, started doing wall squats.

My plan for the cruise is to do as many of the exercises that I can do as possible. I'm going to aim for every day, but I can't guarantee that will happen. He did tell me to try to swim because that will be a great exercise for my knee, and I can do a lot of my exercises under water which will help build up the strength, but not put as much pressure on the knee. Lucky for me, the ship I'm on has some special pool in the spa that is supposed to promote healing, it's got minerals and jets in it or something. So I plan to do what I can in there. Hopefully I won't fall too far behind on my rehab.
My home for the next week!

Tuesday, January 18, 2011

Not quite....

Yesterday, I posted that I thought my knee was going to be stiff and barely able to bend because I was in bed for the past few days being sick. Well, my therapist must have magic hands because he got my knee to almost full flexion, I missed full flex by about 3 degrees, which is nothing!! But, it's not quite full flexion. No clue how that happened, but I'll take it. It's not comfortable getting to that point, but it doesn't hurt quite as much as it used to. I guess that means I'm healing? I'm starting to become a normal person again.

Monday, January 17, 2011

I think the word is freedom

Today was a huge day! I took my brace off!!!! The big ole clunky brace came off my leg, and I survived!! Technically, the brace should have come off tomorrow as that is when I am officially 8 weeks post op, but I had been walking without it at home, and I figured there isn't much difference in a day, so I went to the mall, and bravely left the brace at home. My knee feels so stable, that I'm not quite used to it. I'm used to my knee always giving way on me, every step being wobbly and shaky. Now, I still have a limp because I still haven't quite figured out this walking thing, but I feel so much more secure, my knee doesn't feel like it's sliding around. By the time I came back to my car, my knee was feeling quite a bit sore, and I did have more swelling than normal, which is to be expected. But the soreness is not in the same place where I was having pain before the surgery, most of the soreness now is around the quad tendon area, before a lot of the pain was on the medial side of the joint line, and I think the soreness is just from weak muscles. Tomorrow, I plan to walk into PT wearing my yoga pants which are a little bit more figure flattering than the baggy pants that I've had to wear because of the big brace.

On the bad side, I was sick all weekend, laid in bed for about 3 days straight. I didn't do any of my home exercises, so my knee feels very stiff now. I tried to work it as much as I could earlier before I went to the mall, but I'm afraid that when I go to PT tomorrow, it just won't bend as much as it did before. With this rehab, it seems like if you miss a few days, you fall behind pretty easily. My leg definitely feels weaker than it was on Wednesday, because I haven't done any leg lifts, no quad sets, no exercises with the theraband. I guess it's true if you're just lying in bed for 3 days normally, but I guess I noticed it more because of the atrophy in my leg. Hopefully it won't be too bad tomorrow.

Wednesday, January 12, 2011

All alone in therapy

We got hit with a little more snow last night into this morning. It really wasn't that bad, and the streets were cleaned much faster than it was after the blizzard. I went into the hospital this morning for my rotation, and then back home. I knew today I was going ot be in the hospital later, so I scheduled my PT for later in the day. I got out earlier than I expected, so I called and asked if I could come in a few hours earlier. I have never seen the therapist that excited.

I walked into the office, and it was filled with the staff, but absolutely no patients. One hand therapy patient I think, and that was it. Apparently, the average age of the clientele happens to be in their 80s, and most of them just go to PT cause they don't know what else to do. I work mainly with "Boss Man", but there is another therapist there as well that I have seen a couple times when he was unavailable. Lets call her "Nice Lady". "Boss Man" had a student with him, and "Nice Lady" was bored out of her mind, so she kept me company while I went around doing my exercises. I don't think I ever laughed so hard in my life. I have no idea how many sets of 10 I did because I just couldn't keep count. She kept going on and on about how she wants an invite to my wedding next year. Only thing is i'm not engaged yet. Hmm... maybe soon.

So today I worked with "Nice Lady", and while she was stretching me, she let me in on a little secret. Apparently, "Boss Man" loves it when I come in and he grabbed me as soon as I called to make my initial evaluation appointment because I'm young and have an orthopedic injury, and I'll actually get better, unlike a lot of the elderly patients that are really there because the docs don't know what else to do with them. She said that he "salivates" when I'm coming in because I have a real injury and I don't complain about the pain involved or having to do too much. I always knew I was their favorite patient :)

The other advantage of being the only patient and being stretched by "Nice Lady" instead of "Boss Man"? We were able to put what we wanted on TV. Which meant we could turn off ESPN and put on "Say Yes to the Dress". "Boss Man" was teaching his student something, and there was only 1 male PT aide there, so he was quickly outnumbered by the rest of us that wanted to watch "Say Yes to the Dress". Much easier to have my knee bent when I can watch people choosing pretty dresses, or laugh at the terrible dresses they chose.

Anyway, rehab is coming along pretty quickly now, which I'm really happy about. I had an interview on Tuesday, and I made it  the whole day walking without the crutches. And interviews are long days, so I was really glad that I was able to make it the whole day without any pain. And when I came home from the interview, I had some great news that made any pain go away. I just can't say what it is yet! But I am at 130 degrees of flexion actively, and 135ish passively. I'm using heavier weights on the leg raises, I worked up to 5 pounds at my last session. Today, I started doing step ups on taller stairs, and I started doing leg extensions on the machine set at 10 pounds, using both legs. The bike is no problem for me anymore. I started the treadmill as well, but only at 1 mile per hour. The sad thing is, the treadmill tells you how many calories you burn, and in the 7 minutes I went on the treadmill, I burned 9 calories. That's how slow I was going, but it was fun.  Or maybe because I was on the treadmill talking about chocolate melting cake....

It's pretty crazy that when I first started PT, I thought I was going to be doing this boring stuff forever. The bike used to be torture for me, and I would have to rock back and forth before I could get my leg all the way around. Now, I can just hop on and go, and I can actually turn the bike on by pedaling, and keep it on, which is new for me too. I'm getting able to do more and more things, and it seems like the rehab is just going on at lightening speed now. Or maybe that's just because for so long, I couldn't do much off the table, and now I have much more freedom.

I leave for a cruise next week, and I promised I would do my best to go to the gym and do some exercises on the ship. I have to use the bike, walk at grandma speed on the treadmill, do leg extensions if the machine has a low enough weight (no more than 10 pounds of weight right now), as well as a lot of my floor exercises. This way, I can try to avoid losing any flexion. I might still lose a little bit because I'm not going to have someone pushing my leg to the absolute breaking point, but hopefully it will only be a couple degrees that I would be able to get back really fast.

Friday, January 7, 2011

6 weeks and change

I am just over 6 weeks post op. I already mentioned how I'm cleared to walk and weight bear, and the brace comes off in 2 weeks. The same day as my appointment, I went to physical therapy, which was great. I got to do a lot more stuff because i was finally cleared to weight bear. My knee is starting to look like a normal knee, the scars are starting to fade.

In PT, I started doing some exercises with those stretchy rubber band things, started doing step ups, and some other stuff that I can't remember. There was a PT student at the time as well, and my therapist was just running through some basics about the knee, using me as the example. He explained to her what the different scars are from, and was telling her why he likes his job so much, because you can really see people get better. Apparently, I was "really bad" when I came in fro the eval, I only had about 15-20 degrees of extension, and saying I had 60 degrees of flexion was being generous, and my knee looked like a balloon. Well, when I was there for my first eval, he told me that the swelling wasn't that bad, and I had "decent" range of motion. You know what his response was? "If I told you the truth, you would have just been disappointed, especially because you couldn't do anything at first". Gee thanks. But he probably was right, I was already not exactly depressed, but definitely blue after the surgery because I couldn't walk, couldn't go outside, it was really really tough at first, and if I had been told that I had more swelling than normal, it may have pushed me over the edge.

The best part? He measured my flexion again at the end of the session on Wed. On Monday, I got to 120, and that was the number that I went to the doctor with. On Wednesday, he remeasured me at 125 on my own, and 130 when he pushed it. I have no clue how I got that much improvement in 2 days, but I'll take it. On Monday, I get to go on the treadmill for gait training, because I really forgot how to walk. I walked a bit without the brace in therapy, but I think my muscles either shrank up so much, or they just forgot how to walk. I think the other issue is that I got so used to my knee being loose, that I had to compensate before the surgery, and that's how I'm used to walking, but I don't need to walk like that anymore. I don't know, it's complicated. But hopefully on Monday, I'll get to start relearning how to walk.

The other exciting thing was getting cleared to drive. I had an interview yesterday about an hour and a half from home. The program paid for a hotel room the night before, and so I drove out there after therapy on Wed. Wed was a busy day, right? Well, i got there fine, and crashed as soon as I got into the room. Thursday was a long day with a tour that involved lots of walking. I took the crutches for that, since I didn't want to walk that much right away. And then i had to drive back home, which took about 2 hours with traffic. By the time I got home, my knee was sore, swollen, puffy, and about 3 different colors. But, it's better today, so hopefully no long term damage.

Wednesday, January 5, 2011

Shout it from the rooftops!!!

I am back from my follow up visit with the surgeon, I am now 6 weeks + 1 day post op. I think I must have been the happiest person in the office today. Why is that? Because he told me I can get rid of the crutches! And in 2 weeks, I can get rid of robobrace!!!! And after that, no more braces, no more crutches, I can walk like a normal person, wear normal pants again! I asked him if I would need a smaller brace, and he told me that since there is no good brace for the PCL, there is no point in wearing a brace that won't protect the graft. And I can drive again!!! I can't even tell you how excited I am. I made him repeat it 3 times just to be sure I got it. This was the conversation with my doctor:
Me: So I can get rid of the crutches?
Doc: Yep, use them only if you feel you need them.
Me: And I can drive again?
Doc: Yep, as soon as you're comfortable. And you can take the brace off if you need to.
Me: And in  2 weeks, I can get rid of the huge brace and just walk normally?
Doc: Yep, I usually get rid of the brace 8 weeks after PCL repair. If it was the ACL, you would already be out of the brace. And when you come back in 2 months, we'll see about getting you running and other fun stuff again.
Me: So you mean to tell me that after 6 weeks on crutches, 6 weeks of relying on other people to drive me, and 6 weeks of wearing baggy pants, I can lose the crutches today, take my car out of the driveway today, and in 2 weeks, look like a normal person again?
Doc: Yep, exactly right.
Me; And you're not playing some sick joke on me? You're not going to turn around and yell "Psych!" You have to be non weight bearing another 6 weeks and subject me to a lifetime of unfashionable pants?
Doc: Nope, you're doing good.

I really didn't believe him, but I was so happy, I could have kissed him. Especially because the brace will be off in time for my cruise. I leave on Jan 22, the brace can come off around Jan 18 or so. He did tell me though that if I will be doing a lot of walking, I might want to wear the brace and take the crutches just in case. He recommended that I wear the brace and take the crutches to get through the airport and onto the ship because it's a lot of walking, and he thinks it might be too much too soon after taking the brace off. But I'm ok with that, because while I'm on the cruise, I should be ok. Still can't wear heels on the cruise, so I'll be taking only flats, but I can wear shorts and skirts and not get crazy tan lines.

Something about a dancing dog and a smiling big faced kid sums up how happy I am right now.
Kinda funny though, he walked into the room and didn't realize I was post op PCL, he hadn't looked at the chart yet, but I had taken the brace off and put it in hte chair, with the crutches nearby, and he goes to me "Did we do a meniscus repair?" and I said "No, PCL". And then he goes "Oh that's right, we're making you go slow with that. If you were post op ACL, the crutches and big brace would be gone by now, but you're extra special."

I am still continuing with PT for now, and go back in 2 months for another follow up with the surgeon. And then after that, he said chances are I won't need to go back anymore. He said that I"m ahead of the curve when it comes to the rehab, he said most people are still pretty stiff and don't have as much flexion as I do, but I have good range of motion, and a smooth motion with the knee, which is apparently uncommon 6 weeks post op. I guess I got lucky with a good surgeon, and as much as I complain about him, I do have an amazing therapist.

Tuesday, January 4, 2011

Quote of the day....

"If you're not singing an opera, I'm not bending your knee enough"-courtesy of my therapist while I was begging him to stop. Apparently, if I was able to talk and curse at him (accidentally, I really didn't mean to call him those nasty names) then he really could bend further. It was only when I wasn't able to talk clearly that he took it far enough.

At least he's good natured enough to not take offense when I drop a few f-bombs on him, he knows I don't really mean it. They actually hung up an article that says that if you feel the need to curse, it's better to let it out because it apparently releases endorphins which makes you more able to deal with the pain. So I suppose you can say that it might even be encouraged. But it's only when the patient starts singing an opera that he decides that the knee has bent far enough.

Tomorrow, I go back to see my surgeon. Hopefully I will have some good news and be cleared to do more fun stuff at PT. I have a very nice progress note from the PT, my first day, I only had 60 of flexion, yesterday was 120. It's kind of nice to see that progress. I'm hoping I go see the surgeon tomorrow, and he lets me get rid of robobrace, get rid of the crutches, and start driving.

And as a thought of the day... why don't they make heated crutches? They could attach a solar power thing onto the crutches maybe so that when they're outside, the metal doesn't become freezing cold. I hate it when I'm walking outside in the freezing temperatures, and then go inside, take the gloves off, and I can barely hold onto the crutches because they're so cold. Guess that's the downside of aluminum crutches.