Every Surgery is Different [2+ wks post-op]

I kept such close tabs on my recovery from the last surgery that it's hard not to go back to the blog and see if I'm "keeping up" with myself from last time.  When I'm "ahead" it's a good thing to have that comparison, but when I have unfamiliar feelings, pain or am not "on track", it can be very frustrating.

In the first week I felt a lot of improvement over the last surgery, but during the 2nd week it tapered off a little and I started to focus on my pain level and how much bend I was getting. There was a lot of aching when at rest and it constantly feels like the kneecap would catch, which kept me from improving my gait and working on things like going down stairs. More than either of those is the pain I'm feeling on the outside of my thigh, even just to the touch. Drew tried to explain that it might be coming from the bruising I have irritating some nerve endings and causing the sensitivity... I am not sure that's what he meant, but whatever is causing it, I think it's something that needs to run it's course.

There has been improvement now as I'm closer to 2.5 weeks. The general aching pain has subsided, but the thigh sensitivity is still present. I can stand/walk for longer periods of time and we've added some strengthening items to the PT exercises. Those exercises include angled squats (knee bending from 90 degree bend to straight), mini-squats on the Bosu and balancing on my surgical leg while throwing and catching a weighted ball. I feel strong in these exercises and have been doing them at home to stay on track.  Only once has Drew had to do a little "forced bending" at PT to work on my range of motion (ROM), but it was not nearly as bad as last time, and hopefully we can avoid it going forward!

One thing I have to remember is that I can't compare myself to myself... When I mention feeling "behind" to my physical therapist he stopped and (quite seriously) claimed that it doesn't matter that I've had the same surgeon, same procedure and same physical therapist... Every recovery is different and I just have to listen to my body and work on the rehab!

Photos from 7/30, 13 days post-op:



Yes, I'm trying to flex my right quad!

Working the bend, bruising starting to fade

Crazy bruising; waaaay more than last time

Bruising, Home PT, Getting Out and 2nd PT [4-6 days Post-Op]

I must be doing something right! When I tried Friday (3 days post-op) to bend my knee, after a little "warming up" I was able to go beyond 90 degrees. This had me pretty excited considering last time around that was my goal at 6 days post-op.

07.22.2012 5 Days post-op and bending well beyond 90 degrees!

Also, I feel I am able to stand for longer periods of time, take less pain medication and just feel more mobile in general.  I can even go up and down stairs (veeeery carefully) by taking one step per stair, instead of the prior oh-so-cautious 2 feet on each stair as I make my way. (Of course, when carrying my daughter I revert to the most careful stepping!)  Perhaps part of my successful recovery is having the cutest little buddy to distract me...

07.20.2012 - Playing in mama's full-leg length ace bandage..!

Ironically the bruising this time around is much worse, but at least it doesn't feel as bad as it looks!

07.22.2012 - 5 Days Post-Op

07.22.2012 - 5 Days Post-Op

07.22.2012 - 5 Days Post-Op

Yesterday (5 days Post-Op) we got out to watch my hubby and friends play softball and get some fresh air. It went well, many asked how the rehab was going and it was another nice reminder that I can't wait to get back to my normal mobility so even things like spectating are enjoyable again!

Tommorrow will be 1 week post-op. Crazy to think, but grateful this time around seems to be going smoothly. The only hiccup I feel so far is today at PT I was asked to scoot forward in a rolling stool by using both feet to "pull" myself along, and at times my kneecap would catch and pop a little. Drew had me change the exercise so I was "pushing" (going backwards) and perhaps we'll try again on Wednesday when (hopefully) swelling reduces even more.

First PT, Walking W/O Crutches, Firing the Quad [2-3 Days Post-Op]

I spent the first day after surgery at home resting, icing/compressing using the thermocomp machine while trying to keep my leg elevated. I was mostly on the couch and attempted to fire my quad muscles a handful of times, or when sitting on the floor I would try to lift my heel off the ground.  The good thing about this being the second time around is I knew what I could expect going into physical therapy, and I wanted to be capable of doing the first "easy" things without much pain.

Between surgery and 2-day post-op PT, I kept a steady diet of pain pills, assuming if I didn't the pain would be close to unbearable. I popped one before PT and my brother drove me in.  I had the immobilizer on and utilized the crutches going in, but once we were in, Drew had me doing a handful of exercises I expected:  straight leg raises, heel slides (knee bends), balancing on my surgical leg, walking across the PT area and back, straightening my surgical leg while laying on my belly...  Luckily I was able to do all these things without too much pain or needing any outside assistance.

That being said, Drew told me I didn't need the crutches anymore, and would only need to wear the immobilizer when in public so people around me would be cautious of my leg! This was huge (and, perhaps a little over-confident) but it made me glad that I was already on the right track.  At home I keep the crutches nearby, but can tell I'm not leaning on them heavily anymore (literally!)!

We even cancelled the 3-day post-op PT, as Drew knew I would take the at-home PT seriously, and he handed me a sheet of suggested exercises.  Today I've been doing them (rather) religiously, and each set of reps builds my confidence a little more.  I even ventured across the street to do my exercises in the park while my bro and hubby played some tennis at the courts there. All in all this is not a bad way to start recovery!

On top of that, after a pep talk from Drew, I was encouraged to scale back the pain meds and only take them when I'm in need of them, instead of as a preventative measure. The 4-6 hour schedule turned to "as needed" and I was surprised to find myself successfully doing at-home exercises well after the meds were no longer in my system.  I still have one now and then, but am grateful that it's more for achey pain than for anything more serious.

I'll be back at PT bright and early Monday morning (day 6 post-op) and my only concern is getting my knee bending back. In the meantime I'll work on it at home and try to go beyond 90 degrees so that the forced bending doesn't reduce me to the puddle of moans and tears I was when it was done to my other knee!

ACL Surgery - Take 2! [Surgery Day Re-Cap]

It's been just over 6 weeks since my right knee ACL tear/MCL sprain playing outdoor soccer. In this time I was able to celebrate my 30th with some great friends and family, as well as attend a beautiful and super-fun wedding up north this past weekend (Congrats Schindlers!!).  Once the fun was over, it was time to get my game face on for surgery.

I tried to prep for surgery by doing the expected the day before- clean up, prepare the couch where I'll be sleeping the first few nights, do some grocery shopping to have snacks on hand... And luckily I also got to meet the brand-spankin'-new addition to the Schwartz family, Mr. Ashton Reid who was born on Friday the 13th! (I forget how small babies are in those first few days-- he is an absolute CUTIE!). It was a great distraction, and Congrats again to Jordan and Katy!

I had my reservations going into today's surgery.  This injury was a lot worse, with the sprain of the MCL and just general muscle tone already fading pre-op.  I also had pain when bending my right leg or putting weight on that leg while standing with it completely straight. I thought to myself that feeling "injured" pre-op (as opposed to feeling fabulous like I did prior to my other knee surgery) might mean that recovery would be more difficult. I can't say if this is true or not (seeing as how I'm not even a half day post-op as I type this) but Dr. Shapiro assured me that the two things were not necessarily linear, and that the pain I was feeling when standing was likely still from bone bruising.  This was good to learn, that apparently it can take 3-6 months for some bone bruising to completely heal, because I had started to convince myself that it was a mental thing. Going into post-op with a mental hurdle already in place would have made for a rough start, since learning to use your knee and surrounding muscles again is very much a mental challenge!

In the last few weeks I'd popped in to talk to Drew, the physical therapist I'll be seeing again. There were no Doctor's orders to do pre-op rehabilitation ("prehab" as I call it), so Drew gave me some at-home exercises with the goal being to fire my quad muscles. In the same visits he mentioned he's "got a plan" for me this time around, to hopefully avoid the oh-so-frustrating hiccup I had last time around 22 days post-op.

When this morning rolled around, the nerves really started to hit me. Which, in my defense, I think my way of being anxious or nervous is relatively laid-back... But still I felt my heart rate rise at times, or had a mental flicker reminding me that I'd soon have drilling done to my bones! :/  Luckily I was sent a ridiculous amount of texts and facebook messages of support from friends and family who knew I was going under the knife today, wishing me luck and a speedy recovery. Have I mentioned how absolutely lucky I am to be surrounded by such great people?! My nervousness must not have showed much, since the nurse anesthetist asked if my husband and I "were in the medical field" since we seemed so calm about the whole thing just minutes before surgery!

The schedule was very much like last time, just 2 hours earlier.  Today we had a 10:30a arrival, 12:30p scheduled surgery (which started closer to 1pm, I think), 3p-ish awakening from anesthesia, and by about 5p we'd already gotten home, got our daughter from a friend and were chillin' on the couch with the thermocompression unit (similar to THIS, but with a sleeve for the leg) wrapped around my knee!

Post-op at the hospital, Dr. Shapiro informed my hubby that they had to remove about 5% of my meniscus. This isn't much to speak of, but according to MRI they were not expecting meniscus damage.  Otherwise it sounds like surgery went as planned.

At home I focused on getting some water in my system, a little food, and using the thermocompression unit to keep me comfortable. For fun I decided to try to flex my quad of my surgical leg, expecting it wouldn't be possible since it normally "shuts off" due to the trauma of knee surgery. To my delight, it DID flex without having to focus too strongly on it, and it doesn't cause any additional pain to do so.  Granted I am not flexing with all my might, but firing at all is the goal, and I was excited to see I could do this (and, continue to do it) as a nice prep for upcoming physical therapy!

I also remember last time I had this surgery that standing up and taking my leg out of an elevated position was very VERY painful as the blood rushed to the knee. Today I've been up and around just a few times since I've been home from surgery, and either the pain meds are better this time around or I'm just having a more positive experience! I am hoping for the latter, and this is giving me a glimmer of hope that post-op will indeed be easier the second time around.

This does not mean that I expect to "get away" with taking it easier in physical therapy (PT). I still fully expect to have to feel the burn as I get back range of motion (ROM) and fire the muscles. I am grateful that I know what I'm in for (even if I'm not looking forward to it) and am ready to commit to the physical therapy to ensure a full recovery!

Let's just hope this positive attitude and committed demeanor don't get too shaken as the reality of it all comes upon me! Meanwhile I'm looking forward to my visitors/helpers and spending a little extra time with my 11-month old daughter, Ellie... Even if it does mean we'll be learning to walk at the same time!!

I Know Some Pretty Amazing People....

I've never felt so down on my luck and yet absolutely lucky at the same time!

Once I learned about the ACL/MCL tear, my hubby alerted our closest pals and I must say, I was flattered by the outpouring of support. So many people said what a bummer it was, but if there was anything they could do to help, to let them know. Thank you ALL for your love and support -- I continue to be floored by how lucky I am to have such great people in my life. Oh, and careful what you offer -- we might just take you up on it!

And without further adieu -- some of my favorite reactions:

"It's like your knee said "Happy 30th Summer, I'm going to remind you how OLD you are getting" ;)" - Erin (HS girlfriend)  Note: I'm not 30... until July!! :)

"The only other people I hear of this happening to are NFL running backs! Good thing you are just as tough." -Jordan (brother)

"To my dearest Summer ...I just heard and send my deepest apologies as it’s a total bummer... (followed by a kick-ass poem complete with all the personalities from the soccer team we were playing with when I got injured...)" -Erin

[Insert picture of Ashley's cats here with a dry erase board which reads "We're sorry, feel better"] ""They don't understand the concept of a knee, but they still feel for you" -Ashley

"Let me know if there is anything you need...motrin, ice, Jack Daniels." -Kristina

"(Trying to come up with the bright side...) Attention! You'll get lots of attention. People will ask to help you. People will cook you food and maybe even clean your house. Attention can be fun!" -Molly

Thanks again for all the love (and the laughs!). I'll keep you posted!

I'm Baaaaaaaaaaaaack! And Not in a Good Way... [36 days pre-op]

When I went down with this injury, I knew it was bad. I expected the worst, hoped for the best and... Well... Ended up somewhere in between.

In my much-anticipated reunion with Dr. Shapiro I told him I was afraid for the "jiggle test" he'd do on my newly injured knee... I remember from last time that it was none-to-pleasant and the Doc promised he'd "be gentle" this time, though I assumed you can't exactly be gentle when you have to check for torn ligaments inside the knee.

To my surprise, he was more gentle. But unfortunately, this gentleness was a result of my knee being so loose that it didn't require much effort for him to know that both my ACL and MCL were torn. In hindsight, I wish the jiggle would have hurt just to prove the tendons were intact!!

The expected occurred... The tears came and I stammered about how I had a 9.5 mo old baby girl at home that I need to chase around and there wasn't a good time to be laid up due to surgery. Dr. Shapiro kindly handed me the generic box of tissues as I collected myself and tried to reassure me that I've been through this before and did very well -- so I can do it again. He encouraged me to schedule the surgery sooner-than-later because there was nothing to gain in putting it off.

Due to the MCL injury, surgery could not be scheduled for at least 4 weeks to give it time to heal (because apparently it's not a completely torn MCL, but a stretched or partially torn tendon that will, over the next 4 weeks, regain it's tightness/elasticity). We put July 17 on the books and in the meantime, scheduled my MRI for the next day to determine if there was additional damage.

Still, I was outfitted with a fancy leg brace that goes mid-shin to mid-thigh that will support my leg (keep it from the lateral slip that caused this in the first place) so that the MCL heals correctly and I don't do any further damage between now and surgery. I've never been one for accessories but am getting used to the brace now, after only 4 days of wearing it.

This morning I went over the MRI results with Dr. Shapiro and luckily we learned that there is no damage to the meniscus (which, actually is rare to not have damage, so this is good news) and aside from some bone bruising, the injury is exactly what Dr. Shapiro had expected.

Between now and surgery I will do some exercises at home to strengthen the muscles around the knee and maintain maximum range of motion (ROM) as the swelling subsides from the initial injury. I spoke with my good man, Drew (who was my best friend/worst enemy as my physical therapist last time) and told him to expect me back in mid-July.  After the initial, "What did you DO?!"  and exchange of pleasantries, I realized I'm still uneasy with my leg in his hands and that's going to be one disadvantage to the therapy after surgery this time -- I know what to expect, and I know at times it's going to hurt like hell.  Luckily I documented my previous recovery with this blog so I can follow along and try to keep pace with myself!

I also know in the end it will be worth it, because I have a baby girl I plan on chasing around for many years to come, and hopefully I won't have to hang up my own cleats / turf shoes / tennies just yet...!

ACL Tear... Take 2? [Say It Ain't So!] .. 3+ years post-LH-op

On Sunday I was playing outdoor co-ed soccer. We won our first game, which led to a second game since it's playoff time. Weather was windy, but beautiful, and we had a nice full team (which meant plenty of subs). My hubby and daughter were even there to spectate.

Around the middle of the second half we were down 2-0. Maybe more. We were probably not going to win this game, but we were having a good time anyway. The other team had 2 or 3 guys that consistently came up the middle of the field, had crisp passing and dribbling between them, and it often resulted in a shot on our goal, or a mad scramble by our defense.

I subbed in on defense (outside of my normal comfort zone of midfield) and was marking one of the guys with fancy footwork. He'd made his way by me a time or two, but I kept pressure on him when I could, to give our goalie a break if nothing else! My eyes were on the ball, I'm planting and cutting to keep up with him dribbling the ball this-way-and-that when....

CRUNCH. *I collapse*

I saw it happen. To be honest, I'm not sure where the ball started or ended up. Or if the other player and I even made contact or if it was just my planting and pushing that made this happen. But the upper and lower half of my right (non-reconstructed) leg seemed to move independently of each other, in a side-to-side direction.  No bones were sticking out, so that was good. No blood... also good. Kneecap looks to be in place, and I could move my toes, my ankle.. even bend and straighten my knee-- a little. But no one should have to watch their own leg appear to become dislocated momentarily. It's just scary, especially given my experience with the other knee!

So here I was, laying on the ground, gripping my right knee/leg. The tears didn't start to flow. Some primal groaning may have followed my collapse, but once that subsided, all I could think was... No, please no. Not again. Lord Almighty, we don't talk much, but please please please with a cherry on top, do NOT let this be a torn ACL. 

I can get over the fact that I would have surgery and rehab again. I know I'm capable and I bet my body is too. But now I have a 9.5 month old daughter who is just starting to get mobile and requires constant supervision. If I can't quickly react when she gets herself into a sticky situation, it puts her at risk, not just me. Putting her to bed or playing with her in our basement means carrying her up and down stairs and God forbid my knee were to buckle with her in my arms. These are the things I'm having a hard time accepting. Everyone knows it's not about me anymore!!

Whether it's a sprain, hyper extension or torn ligament, I've been vigilant about RICEing (Rest, Ice, Compress, Elevate) when I can. I'm walking at a snails pace to be sure I don't do any more damage, yet I'm still feeling the instability of my leg when I do certain movements. I do not recall such instability last time (when I was convinced it was NOT a torn ACL prior to having it checked out) so... as much as I try to keep my sunny disposition, I'm also sort of expecting the worst but hoping for the best.

So, tomorrow (6/6) I see my good man Dr. Jeff Shapiro bright and early and we'll see if he can put my mind at ease. If not, this poor blog may come right back to life.  I like blogging as much as the next girl, but I really was hoping I could stick to my yearly "everything is still fabulous" updates and leave the ACL surgery behind!!

Fingers crossed, y'all!

3 Years Post-Op

Again I find myself asking... where has the time gone?!

Over the weekend I celebrated my 3-year anniversary of ACL reconstruction surgery.  I am happy to report that the pregnancy I wrote about 1 year ago brought a happy, healthy baby girl into our lives in August, who today is 8 months old! Thankfully all the other changes that were going on in my body at the time did not result in any pain or discomfort in my reconstructed (L) knee.

After giving myself the standard 6-week recovery time from labor and delivery, I got the OK from my midwife to get back to sports. That night I was on the indoor soccer field! Since then my knee and post-pregnancy body have tackled more soccer, some frisbee, yoga (and recently hot yoga, or Bikram), volleyball... and this is just in the last few months. This summer is sure to bring on some softball, flag football, sand volleyball, running and maybe even some swimming if I can find the opportunity!  The only difference I can claim from a year ago is that I no longer use an egg-carton foam kneeling pad in yoga. It started because I forgot to bring it to class, and realized there is not so much kneeling, or perhaps it's just less of a pain, to have to use to the foam pad. So that is good news! I also don't feel the same tightness I wrote about previously, but the knees (and quads) do not feel symmetric still. It's been a long time since I've done any knee-specific exercises, but feel my legs are in decent enough shape for my weekend-warrior activity level!

The only challenge I can speak of today is related to my little one who is on the cusp of crawling! To encourage her I'll often end up on the floor with her, and on our main level that means either hard wood floors or a thin blanket to kneel on. We'll be spending a lot more time in the (carpeted) basement in the near future to keep both myself and baby girl with happy knees!

I expect in 1 year from now I'll have about the same report out, but only time will tell! In the meantime, I expect that day to be here before I know it...!

2 years Post Op

It's crazy to think it's only been 2 years since ACL surgery-- it seems like it was ages ago, and I credit that to getting back to 'normal life' and feeling good in respect to the knee and otherwise!

Any uncomfortable feelings that popped up around 1.5 years post-op have since subsided and I no longer have unexpected popping or discomfort.  The only times I can expect to be slightly annoyed are if I keep my leg in a bent position for an extended time (either sitting on my heel, or leg crossed underneath me - any time the knee is tightly bent) or sometimes with kneeling.  I have tried to get back into yoga and have wrapped up an egg-carton foam piece and brought it to my classes for kneeling poses.

Sports and activities up until the end of last year continued as I wanted ... I was playing year-round indoor soccer and outdoor in the summer, indoor volleyball (though I longed for sand in the summer but didn't have a team...), ultimate Frisbee pick-up games in the fall and the occasional yoga class.  The diversity of these activities didn't seem to matter as the knee held up fabulously!

In mid-December I learned of yet another change to my body that would impact my sports involvement... I got PREGNANT!  So, while I was bummed to have to bow out of my soccer teams and push aside the idea of getting another indoor volleyball team together - at least this time it was something that I wanted to happen! :) Luckily I still was able to sneak in 2 days of snowboarding in Boise over the Christmas holiday to get my taste of the snow for the winter since this meant missing an annual week-long trip out west.

Next week (April 14, 2011) marks my 2 year ACL surgery anniversary, and I'll be 21.5 weeks pregnant (more than halfway to the August due date!).  I've learned that in pregnancy I am becoming more susceptible to pulled / torn muscles and ligaments and over-stretching, etc as my body releases the Relaxin hormone to "loosen" my body for delivery. This, and the pregnancy in general, means my activity regimen has been reduced to running or walking on the treadmill as well as yoga classes that vary in difficulty.  By being aware of my limits and also knowing I want to avoid any other unnecessary medical procedures, I hope to keep myself healthy and uninjured!

Of course this means that this spring and summer I will be back on the sidelines but I plan to once again cheer on my hubby and friends who play on my adored sports teams so they'll have me back after the baby is born!!  Otherwise, all ACL-related feelings are very much 'back to normal' and I hope to keep it that way!

Unexpected Feelings (1.5 yrs Post-Op)

Generally I try to think positively about my knee. I've long since gotten back to most of my favorite activities (and most recently- indoor volleyball!) and being out and active gives me the impression that I'm 'all better' even if I openly admit that my surgical leg still has a smaller quad and some actions, such as jumping in place on one leg, feel decidedly different from one leg to the other.

In the last few weeks my surgical knee has been feeling... different. It seems to be a combination of feelings, not necessarily at once, that's had me mentioning to family and friends that it feels "funny". For example:

• In day-to-day motions my knee will suddenly feel tight like it's about to pop or crack to relieve the tight feeling. Sometimes it does pop or crack, other times I stop quickly enough where it feels like it got on the cusp of popping, but I change my motion to avoid it. The times that it does pop or crack is not painful, but slightly annoying.
• When sitting on a chair, with my legs straight out in front of me, I will apply a little pressure just below my patella (to the area where my graft was taken from). Keeping this pressure, I first flex my legs (straighten) and then start to bend them slightly (both legs at the same time). My surgical patella will sometimes feel like it's 'catching' or even 'grinding' as it slides up during the bend. I realize this is a very specific motion / feeling, but the engineer in me wants to put the knee in certain situations to see how it reacts compared to the non-surgical side!
• No matter how much I try to stretch, loosen, warm-up or manipulate my surgical knee, it seems to have a feeling like the pieces of the joint are not allowed to move as freely as the non-surgical knee. Imagine a non-surgical knee being surrounded by water whereas the surgical knee feels like it's moving through something thicker- like jello or pudding. Not painful, or even limiting, just... different.
• It's since gone away, but at one point when I would straighten and flex my surgical leg there seemed to be a popping noise at the BACK of my knee, towards the inside. I seem to recall this happening during rehab, and we attributed it to the swelling in the knee pushing parts of the joint out of place and hitting nearby veins/tendons/what-have-yous. So, either that was just a guess at the time, or perhaps there was some additional swelling in my knee recently to bring me back to that feeling. Either way, that particular popping/uncomfortable feeling has since passed.

I think with the change in weather and also sports seasons, now would be a good time for me to reconsider a continuous 'rehab' plan for my knee. I've got a BOSU ball that's gathering dust, and don't spend nearly enough time stretching before my various sports. I think it would be wise for me to get out for a run and some PT-like exercises more often before Michigan's winter weather sets in and I'm forced to strictly indoor activities.

On a lighter note, whenever I'm in the middle of an activity, the knee doesn't pop (that I notice!) or have any continuous feelings of pain or soreness that limit me. Perhaps it's that I'm distracted with the sports, or that in the faster movements the knee is performing like it's been (re-)designed to!