Physical therapy progress

So just a quick update on how PT is going. I had a session yesterday, and when I got there, my knee was all sorts of swollen from the beginning. I think it's because I had 2 interview days in a row and was on my feet all day for those 2 days. Normally, he starts me off with heat just to loosen the muscles, but this time, he did some high frequency stim and ice for about 20 minutes first. After that, I did quad sets with 2 different angles, one set over a folded towel, and one over a ball. I do leg raises with I think a 1 pound weight, and of course, my favorite, the Jane Fonda.

Oh yea, that's the look I go for in PT

After all that table work, I usually get ultrasound to break up some scar tissue. The ultrasound is interesting. I don't doubt that it works, but you don't feel anything, so it's hard to believe that it helps. All the other exercises, they hurt, but it's almost reassuring because it feels like something is going on. With the ultrasound, you don't feel anything. Still, I like it, and since I'm a social person, I use that time to blab with the therapists and try to provide some relief from the rather geriatric population at the center.

And then I get to do my favorite exercise... the bike! He straps me in, and then I first warm up with just going back and first, and then start going all the way around. The therapist waits until I am able to go all the way around before leaving me on my own, making sure I don't fire the hamstrings when trying to make my leg go around. It hurts in the beginning, but once I get over the hump, then it feels much easier. I do that for a short time, he sets the timer for 3 minutes, but I always try to go for longer. After that, it's time for stretching and more knee bends, then more ice and stim and I'm good to go.

I do feel like I'm making progress, I do feel like I'm able to get my knee to bend more and more each time, and the point where it starts hurting gets higher each time. The first session, it would start to hurt at around 60 degrees, and it became unbearable at around 90. Now, it starts getting uncomfortable at around 80 or 90, and unbearable at about 110 or 120. My PT doesn't use the ruler thing each time, only at certain intervals, so I don't have the exact numbers, but I can feel it. The first time I got on the bike, it took me quite a while before I broke through to the point where I could get all the way around. Last time, I only had to pedal back and forth about 3 times before I was able to go all the way around. 

The most frustrating thing is that I'm still not able to walk or drive. I physically feel great. Sure I have quad atrophy, but my knee doesn't hurt too bad, only when I'm pushing the flexion. So I feel really good, but logically, I know the graft still isn't healed. My PT is supposed to call my doctor this week to find out if I can start weaning off the crutches. Hopefully I will have something interesting to post soon.

Day 13-first day of PT

I just came back from my first PT session today, and so far so good. Although I think I'm the youngest person there by far, everyone else seems to be of the geriatric age group. The therapist told me that it's better to schedule my appointments in the later afternoon because most of the patients prefer to go in the morning since they have nothing else to do.

Anyway, he explained to me that the beginning will be quite dull and there isn't much that I will be able to do. He looked at my knee flexion, bending it passively only, and I already got about 85 degrees, and a little bit further and better extension after he put some heat on my knee. The 85 degrees hurt a lot though, but he said that for being not even 2 weeks out, it's actually really good. I also did some leg raises, and I felt like such a wimp doing them, I could barely manage it, but I got it. I'm not yet allowed to do them at home though, unless I want to try it with the extra weight the brace adds. I am also apparently very flexible, or he just got used to working with older people. He lifted my leg to stretch the hamstrings, and as he was stretching it, I was getting uncomfortable because of pain in the knee, but not in the hamstrings.He kept going and said none of his patients can get that muhc stretch, and I still didn't even feel it in the hamstrings. Of course, he didn't know that I used to be able to lie on my back and bring my legs into an almost full split, and I used to stretch every night, but haven't since the surgery.

After that, he did some stimulation and I was done. Not really a whole heck of a lot that I can do for a couple weeks, and then things should start to get more interesting. But I'm encouraged, looking forward to going back. I'll be going twice a week for now, and so I'm going on Wed because that's when he has his evening hours.

Day 9... stitches are gone!

I got my stitches removed today, and I got to see the pictures from my surgery. I was so glad to get the stitches out, but the larger incision over the tibia, the nurse was peeling off the steri strips, and I apparently had a lot of steri strips, and the thread got stuck on the steri strips, which led to many ouchies taking it off. But at least I don't have regular sutures there, they closed it with a running stitch, so they pulled out one long piece of suture, and there were none externally to remove, so the scar should look prettier. Call me vain, but I'm a girl. It's at least 2-3 inches long, and I like to wear skirts, so I want the prettiest scar possible. Anyway, those are out, steris are put back on over all the stitches.

Here are what my legs looked like once I came home, with the steri strips on them. I have 2 more incisions on the side of my knee that you can't see. And of course, my surgeon's signature basically tattooed with permanent marker until such time that I can scrub my leg. Swelling looks really good, and there is a small yellow bruise over my shin, but it's not horrible. My calves shriveled down to nothingness though. It's kind of upsetting actually, because I used to like my legs, and now one of them is turning into a matchstick.

When I mentioned how little pain I was having, he said that usually, the PCL is not a painful surgery, it's just a long and annoying process. When I asked about walking, I was of course told not yet. He said if this was ACL, I could essentially be walking around as soon as I felt ready, with the PCL, it's a totally different beast, and even though you feel fine, you need to give that graft time to heal. I have a cruise coming up in about 7 weeks, and when I asked about the possibility of that, he said there is no reason not to go, I'll still be in the brace, but I should be full weight bearing by then. I don't mind going in the brace, I just want to go! 

The office gave me a list of PT offices near to where I live, since the hospital is too far and inconvenient to go to twice a week, and the first place I called said they're on the second floor and there is no elevator. Definitely not going there, it's hard enough managing the stairs to my apartment, definitely do not want to do it for PT. I just don't understand how a PT office cannot be equipped to deal with people with crutches, in wheelchairs, etc. But I'm going to another location of the same chain of offices which is close to where my boyfriend lives, so it should be fine. I start on Monday. I am so excited, I can hardly wait. 

After my visit, my dad took me to my favorite restaurant. The food isn't exceptionally good, but I basically grew up there. My dad used to work across the street from that restaurant for 20 years, and we used to go there at least once a week, so it's like seeing family when we go there. And they make the best chicken souvlaki I ever had. We always get treated like royalty when we go there, which isn't too often anymore because the restaurant is in a part of Manhattan that we usually don't go to. But, the hospital is in the same neighborhood, so it works. 

I scanned in the pictures the surgeon gave me cause I'm a nerd and I think it's pretty cool, so without further ado.... the BEFORE

Those strandy things are the torn PCL I think

And now the AFTER

Thanks to the donor for giving me a new PCL.

Yay me!

One of my favorite things to do in the mornings when I have nowhere else to be is lie in bed, watch TV and drink tea or coffee in bed. But, being that I'm now non weight bearing, my hands are occupied by crutches and I couldn't think of how to carry my tea in the mornings. If my parents or boyfriend were here, they would bring it for me, but right now, I'm home alone until my best friend comes over later. So I thought about it, and then I figured it out. I have a small cross body bag, went into the kitchen, made the tea in my spill proof travel mug, put it in the bag, and crutched back to the bedroom. I am proud to say I made it without spilling a drop. The bag is also handy for carrying my nook, my phone, pain pills, and all other doodads around the house. And this took me all of one week to figure out! I'll feel silly if other people figured that out sooner, but oh well. At least now I feel like I have some more independence.

My wonderful sister went to a specialty shop yesterday and bought me needlepoint and a huge hunk of yarn. I used to knit scarves, and that was the only thing I knew how to knit. I never needlepointed before, but hopefully it would keep me occupied. I started it last night and it's coming along. It's actually very easy, I don't think I'm doing it completely right, but it looks nice on the "good" side.

I'm now going to take the time to complain about this parasite attached to my leg, aka the knee brace. Since I had the PCL repaired, they don't want my tibia to sag after the surgery since this could stretch the graft, so they put a bunch of those OR towels behind my tibia to keep it forward. Those towels are starting to annoy me so much. They itch, they rub against my leg, I'm ready to go crazy. I put some soft padding at the edge where it's the worst, but I can't really lift my leg very well. I've also got some burning at the incision under the steri strips. The other incisions are teeny tiny, I have just one or 2 stitches keeping those closed, but under the steri strips, it's a bigger incision. And it is burning like crazy, but the rest of the leg doesn't look inflamed, it doesn't feel hot, so I don't think there's an infection. I feel fine otherwise. I'll just mention it to my OS on Thursday's followup.

So what is this?

My name is Susan, I'm 25, in my final year of medical school, and 5 years ago, I should have listened to my mother when she told me not to go ice skating that faithful day in May. But I didn't, and I fell, and I tore my posterior cruciate ligament, or PCL.  Anyway, not to bore you with the details of the last 5 years, lets just say that as time wore on, my knee got more and more painful, more and more unstable, and I finally decided to do something about it. Finding a PCL surgeon is no easy task though, and so I ended up going to Hospital for Special Surgery in Manhattan. Lucky for me, I am only about 30 minutes from there. The doc I saw there told me that if I didn't do the surgery, I would be heading down a path towards arthritis by the time I'm 30. That just doesn't fly with me. So I made the decision to have surgery. And I made the decision to start this blog because I'm bored just laying around on the couch with nothing to do, and hopefully typing will keep me occupied.

So lets start with what I remember from surgery day, shall we?
Day 0: surgery I showed up at HSS bright and early in the morning, got registered, sat around and waited until they called me in. Since they never believe you when you say that you're not pregnant, they made me take a pregnancy test. After that, I was led to my pre-surgical waiting room. It was very nice, very swank. I had my own private glass enclosed cubicle, whereas every other hospital i have been to, patients are just seperated by curtains when waiting to go in to surgery. I had my own flat screen TV to pass the time.  Changed into the gown, and had a physical done by the PA. Met with the anesthesiologist, who told me that they don't hear about ice skating injuries too often, guess I'm a rarity with what my actual injury was, as well as how it happened. He told me I would get something to make me nice and drowsy (propofol, I think it was), and then they would place a spinal afterwards. Very glad I don't remember the spinal. The nurse came to take me back to the OR, and it seems like as soon as I layed down, I was out.

Apparently, 2 hours later, I was taken to recovery. Honestly, the rest of the day is a bit blurry. I do remember waking up in the OR at the end of the surgery, but I don't remember getting to recovery. Next thing I know, I'm in recovery and asking the nurse if I still have both my legs because I couldn't feel anything. The next thing I remember after that is sitting in bed eating a turkey sandwich. I'm sure at some point that I asked for food and to sit up, I just don't remember it. I got transferred to the second phase of recovery, where I was allowed to put on my clothes and I met with the physical therapist. Learning to walk on crutches when you're still drowsy from anesthesia is not a good thing. I almost fell quite a few times, especially on the stairs that I had to learn to take, but lucky for me, I had a very handsome PT who was very strong and caught me each time. My dad says I was flirting with him, I don't think that's true.

After PT, they gave me another Percocet, and told my dad he can leave to get the car, and they would wheel me down when security called them. Well, while he was gone, I started getting so nauseous. I apparently turned very green, very nearly threw up. Which of course meant I couldn't go home just yet. But eventually I did leave, and we stopped for lunch, and when I came home, I was faced with the prospect of getting up the 14 steps to our 2nd floor apartment. Going up the way the PT showed me was not going to happen. I ended up scooting up on my behind, much easier.

At home, this was my leg set up. I think I layed around for a couple days like that. That ice pack was great.

Day 1 post op My very sweet boyfriend came over and spent the entire day with me since both my parents were at work. He bought his wii with him, and is leaving it at my place for as long as I'm immobile. Pretty much, I just slept all day. In the evening though, I felt awful, I got up to use the bathroom, and once I got there, I got so dizzy, I actually fainted. I was very confused, I felt awful, I couldn't sit up at all, couldn't do anything. I had no clue what was going on. My dad managed to get me back to my bed, but then that same sensation happened 2 more times that night. Luckily, it hasn't happened since, but it was very scary. My thought is that it was just the last of anesthesia leaving my system. I was also able to take the pressure wrap that was under the brace as well as all the icky bloody gauze and cover up the stitches with bandaids. For those that care, this was my leg on the first day post op.

It looks swollen, but not terribly so, and there is virtually no bruising. That yellow is the iodine they use to clean the leg before surgery, and when I can finally get my leg wet, it should come off. I am also wearing shorts, you just can't see them, shorts were much easier to put on than trying to get pants over monster brace.

Day 2-now: Nothing special happening. Haven't had much pain, I was actually having more pain before the surgery than I am now. Of course, I'm totally non weight bearing and haven't started PT yet, so that might have something to do with it. I got up to the last boss in world 8 of Super Mario Bros, tried to knit a scarf and instead ended up with something resembling cookie monster, watched more movies than I thought possible. Started going rather stir crazy. Yesterday, which was day 5 I think, I finally went out of the house to my sister's new place. It felt so good to go outside, and I don't think I'll ever again take for granted how nice it is to go out. You don't realize how much you take for granted until it's taken away from you. Walking down the hallway seemed like a Herculean effort.

So that's pretty much my life right now. I go to see my OS on Thursday for my first post op and get the stitches out. That's what I'm most excited for, as they are itchy and driving me crazy. I have a suture removal kit at home, and I was ready to take them out myself, but I somehow don't think my doctor would approve. I also have residency interviews coming up in a couple weeks, which should be interesting, as I'll be hobbling around on crutches. I'll be sure to update how that works out.