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'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...!

My Comeback Continues... [5 Months Post-Op]

Towards the end of last week, my BOSU ball arrived!! I didn't get a chance to check it out until yesterday, and even then I chose to do what looked like the easiest of the included DVD workouts because I wanted to start out simple. So I promptly popped in the 'Long and Lean' DVD, and it was a lot of yoga-type poses (but, incorporating the BOSU, of course) and I was delighted to see that once I got past the awkwardness of doing the DVD for the first time, none of the poses created additional pain or strain through my knee! This included lunging poses where the BOSU was bubble-side-up and the forward (bent) leg was on the bubble. And now, a day later, I feel it more in my back and abs than my knee, which must mean in a left-to-right comparison, my legs are getting back to even!

The BOSU wasn't enough for the day though, as I have gotten pick-up ultimate frisbee back on the radar and we had a group planning to meet at 4pm. Eric and I have gone and thrown around a little, but that never prepares you for the stop-and-go running of a true pick-up game. So prior to getting started I strapped on my cleats and did some jogging on the field to remind my body of the ground conditions and being in cleats instead of runners. I also spent extra time stretching my legs out and doing some side-to-side jumping to imitate a quick change in direction. Besides the butterflies in my belly, I felt prepared to give it a try.

Originally I thought I'd have everyone huddled up and be making a blanket statement of 'take it easy on me!' but since we're not that hardcore (and, maybe the opportunity didn't really present itself) we just kind of got the game going and slowly but surely I reacclimated to the game and the feeling of being out on the field and active again. As soon as I started to feel comfy, the enjoyment really came for me... As out of shape as I might be for the sprinting aspect of the game, the knee held up amazingly and there hasn't even been any soreness since! There were a few plays where I became a little timid and avoided jumping up against other people for a free frisbee, but I will probably avoid major contact like that until I feel closer to 100%.

And my latest accomplishment on my 5 month anniversary from surgery, is that I've started a yoga class with my friend Jen! We chose a beginner level class we've taken before to try to get back into practice, and I am looking forward to the first session tonight where I can continue to monitor the progress in my knee and work on balance, strength, flexibility and relaxation! I am bringing along a foam pad to provide extra padding to my patellar tendon area during various kneeling poses, but aside from that I feel I have my entire range of motion (ROM) back, and hope there won't be many poses where I even feel a difference from side to side!

Namaste!

I Bit the (BOSU) Bullet... [20.5 Weeks Post-Op]

Time to step it up a notch.

The money I would have been spending on PT should be going towards a gym membership or equipment or something along those lines, but I just hadn't pulled the trigger... until now! I decided a BOSU ball would be a good purchase since I'd used it before in PT, and my therapist, Drew, also confirmed it's a good tool for rehab. Not to mention, it helped to get rave reviews from fellow blogger, Andrew, and also my friend Chris who has done some of his pre-med work with ACL rehabers. And BOSU isn't just good for balance and PT, but there are tons of exercises to be done on it which help all kinds of muscle groups. My arms and abs should be very, very afraid...

My dilemma was to decide if I should buy the consumer model or the commercial model. For about the same price I could get consumer +4 DVDs, or commercial +1 DVD. (See the difference HERE). In the end, I went with the consumer one, because while I'm all about getting a more 'durable' product, I will never put it through the use that a gym would if it was used for daily classes, etc. I hope I don't regret this decision!

How I Broke Up With PT [4 Months Post-Op]

Tomorrow I will be 4 months post-op. If you're an avid reader (or, recap HERE) you'll know my Doctor gave me the impression I only had a 4 month recovery (or, perhaps he meant 4 months of PT?…). I was skeptical then, and now that I'm here, I still know I'm not at 100%, but I'm doing what I can to get there.

Over the weekend I got yet another medical bill, and while I am blessed to be insured, I'm also blessed with a mathematical mind. Is what I'm paying for in PT really worth it anymore? Before I used to tell myself that having someone guide me, albeit 1x per week, was worth any cost to know I'm on track. However, the last month or so was very hands-off for Drew, and even regarding equipment use- aside from the 1-leg press and a BOSU ball here and there, most everything I can do at home. So, I approached Drew yesterday as I came into PT, asking "Is it OK if this is my last visit?" Drew gave me a long look and asked, "Are you breaking up with me?!"

We did some L-to-R comparison of lunging, jumping, balancing on each leg individually, as well as measured circumference at my knee, lower and mid thigh. Here's how I see my progress as of today:
Strength ~ 90%: For instance, I can 1-leg press pre-surgical weight, but it's still a little shaky. Which brings us to...
Control ~55%: It is still difficult to absorb the impact when jumping and landing on my surgical leg. Controlling the motion of something like a 1-leg squat is very difficult and borderline painful to do as I work into deeper bending. I think toning the muscle around my knee as I get it back will help improve this.
Mass ~85%: I still have mass to regain in my L quad, but even the mass I do have is not as solid as my R leg. I know this will come in time, but as trainers have told me along the way, I have further to go than most people based on the large size of my non-surgical quad!
Endurance ~95%: I might be guessing high, but if my knee were miraculously healed tomorrow, I think my endurance would be pretty good. Although I might take that down to 90% or so when I think of playing the full duration of a soccer game with minimal subs, or the continuous sprints of ultimate frisbee.

Now that I'm PT-free I can consider my options (what unattached girl wouldn't?!). Buy some equipment for home exercise, like a BOSU ball? Or spring for a gym membership to have equipment at my disposal? Or go to some open swims at a local pool for some 'low impact' jumping to work on control? I know I can always call Drew for questions, pointers, or help… plus he provided me with a few pages of exercises to keep working on. Any way I work it, I'm pretty confident I can do this on my own now.

Sorry, PT… It's not you, it's me. ;)

Fine Tuning My Knee [3 Month 1 Week Post-Op]

"How's your knee?" ... It's a loaded question that I get all the time. I think most people are just being nice, but if you care to read, here are some extra specifics.

Being over 3 months out, I figure I'm more than halfway to recovery. At my last follow-up appointment with the surgeon, he said we're looking at a 4 month recovery, which normally I'd be super excited about. However, seeing as how I'm not a professional athlete (surprise!) I believe I'll be taking the full 6 months before I decide to commit to a sports team, perhaps subbing once in a while before that. We'll see-- I want to be steady and confident before I go out on a field and act timid and end up doing something dumb because of my fear.

Current Abilities:

• Walking without a limp (including speed-walking)
• Running (slight limp when I'm slower, but the faster I go, the less I limp). I have not tried a dead sprint yet, but really, what's the rush?
• Going up stairs- Very even and seems controlled. Even taking stairs 2 at a time doesn't seem to show much weakness.
• Going down stairs- I can still feel the unsteadiness in my surgical leg as I move my non-surgical leg to the next step down. While some days it seems easier than others, there isn't a time I've gone down stairs and 'forgot' about my knee.
• Jumping- When jumping on both legs (think: jumping rope) I can feel my right leg doing more work the longer I jump. When jumping on just my surgical leg, it's still not developed enough to accept the impact of the jump like my other leg does.
• Bending/Straightening- I can bend my knee so my heel touches my butt, though I'm still not confident when squatting all the way down and using my body weight to bend it. For straightening, there is some uncomfortable feeling when it gets close to hyperextending, but I think I need to keep working to make sure I don't lose range of motion there. My kneecap also seems to 'catch' or 'pop' every so often when I go from straight to bent, but it's not painful.

Current Focus/Exercises:

• Doing PT at home: I've been a lot better with this since my birthday, keeping a promise to myself to do my part in my recovery. I take 1-2 days off per week, but otherwise try to run every other day, and on the in-between days I'm doing more pointed exercises like lunges, step jumping, shuffling... etc.
• Physical Therapy with Drew: I am happy to announce I'm back up to my pre-surgical 1-leg press weight, as of a week ago! It feels good to be 'back to normal' in that sense, even though it doesn't translate to a 'back to normal' leg as a whole. PT will continue 1/week at least through the end of this month.
• Quad Strengthening: Lunge, lunge, lunge!!
• Calf/Knee/Jumping: Lots of jumping and quick shuffling to build up not just my muscle, but also the motor skills to be using the muscles AND moving at the same time. One exercise I do- Stand on L leg at a step with R leg resting up on step; In one jump, land with R leg beneath you, and at the same time lift L leg to touch up on step; Alternate which leg you land on (and which touches the step) after each jump, and do this as fast as you can for 30 seconds. I find this is a great gauge of how 'steady' my surgical knee is underneath me, as well as controlling that leg as I quickly touch the step through the repetitive motion.
• Jumping on one leg: Being able to balance just isn't enough. Trying to jump and accept the impact (as I mentioned before) is a whole new game. In PT on my own I try to jump forward in a straight line on just my surgical leg, and land softly. I still have a ways to go here.

Drew told me that the exercises I still feel 'unsteady' doing are the ones that are the last to come back, so I'm well on my way to recovery. Also, I have another follow-up appointment with Dr. Jeff Shapiro next Monday afternoon, and I expect more good news there!

Another Year Older- What a Year! [12 Wk 2 Day Post-Op]

My blogger name has been updated.. I'm officially "Summer, 27" ! I celebrated Thursday (and the celebration continued on into the weekend) but I must say, it's been nice to get "Happy Birthday" cards as opposed to the last cards I'd gotten which read, "Get Well Soon!" !!


I think age 26 will forever be marked in my mind as "the year I tore my ACL." It's wild to think that initial injury was over 4 months ago, and surgery over 12 weeks ago. Time sure flies!

I've been blessed with a great network of support, a fantastic doctor, a wonderful physical therapist and lots of resources, including my fellow fallen friends who are going through their own ACL journey! Thanks to everyone (again.. and again.. and again..) for your support!

My goal is to take 27 and make it a strong, healthy year. Obviously injuries like this can't necessarily be avoided (unless an active lifestyle is given up - which I'm not willing to do) but I will do what I can to control my rehabilitation and future athletic endeavors!

On that note, I will be making a much better effort at doing my at-home PT. I've gotten lazy in the last week or two, and it is showing when I now go to do simple exercises at home, including lunging and some jumping tasks. Since I'm down to 1 PT session per week with Drew, I need to make sure I'm doing my part so he can progress me to the next exercises and lift any limitations aong the way!

Round and Round We Go... [9 Weeks 4 days Post-Op]

Due to mixing it up in PT on Wednesday (and in the process, doing a handful of exercises until my muscles truly fatigued) I was awfully sore starting Friday morning. As a matter of fact, the limp returned [but before you are sad for me, read on], this time due to my muscles in my non-surgical (R) leg being so sore that I was then favoring THAT leg! Maybe it's nothing to be excited about, since the last thing I need right now is an ever-growing right quad. However, CHEERS to my left (surgical) leg for being strong enough to put up with the flip-flop of the limp! Luckily, the soreness has since faded substantially, and I'm back to a generally normal gait...

Instead of trying to bust out more PT exercises on Friday, I thought trying a yoga DVD would be better, to stretch and work on breathing. It was nice, including some lunging poses, however, about half way into it there were some poses I chose to skip. For example, one req'd kneeling and putting weight on the area where they took my graft, and by the time that one came about, I decided I had stretched enough for the time being!

To feel like I'm still doing what I can on my own, today I did some walking and a mile run on the track [where my new iTouch helped break the monotony of going round and round- Thx BB!]. That was followed by lots of stair work on the local HS bleachers. Since they're half-steps, I would go up taking 2 steps at a time, always leading with my surgical leg, forcing that quad to do most of the work. Going down I would step down with non-surgical leg, forcing the surgical quad to, again, bear the burden of controlling the balance and movement as I stepped down.

Stairs are one of the things I am using to track my progress. When I end up ahead of someone (going up or down) in the stairwell at work, I feel myself getting flustered as I hear them galloping closer, and I can't seem to go as fast. I am noticing some improvement, but for now they'll just have to deal with it - I refuse to take the elevator!

Now, back to enjoying the weekend! Happy (early) Father's Day to all the daddios out there, and especially the best one I know-- Papa John! ;)

"Rumping" [6 weeks, 4 days Post-Op]

When I left you, dear reader, I had told you of my first attempt at running. I have since undergone yet another PT session (which included about 10 minutes of 2-minute intervals of speed-walking and then 'running') ... but I wouldn't call it running. It's more of a cross between limping and running... which my good friend Jesse so cleverly coined "Rumping".

Today I gave the run/walk intervals another try. I was advised by Drew to go to a track (meaning level surfaces and a nice padded course) but since there was a soccer game going on in Berkley's track infield, I refused to run around the game and provide entertainment for the ~100 people there. So, I went outside of my trainer's wishes, and hit the streets (very carefully, might I add). First, it was taking my walk from a slow, to normal, to eventually quick pace. Then, once I felt comfy, I tried running again. It felt just as awkward as the first two times, but if nothing else, it felt good to be out, trying, and breaking a sweat!

I believe the reason I can't shake the limp while running is I am (1) still having a hard time mentally trusting my surgical leg, (2) my muscle mass in my surgical quad is substantially less than my non-surgical and (3) when I do run, I am not letting my surgical leg extend out all the way, therefore I'm running shorter strides on that leg versus my 'good' leg. This overcompensation caused a little pain in my 'good' leg's hip towards the end of the run, but nothing I feel when walking or going about my day-to-day.

Otherwise I feel I am reaching a point where I actually sometimes FORGET about my 'bum' knee! It is a wonderful thing. The more I find myself putting it out-of-mind, the more I realize I am getting back to that 'normal' lifestyle I so desire. In the coming week I'll still be seeing my trainer 3x, but after that we've decided I'm ready to go to 2x / week. This can only mean one thing... PROGRESS!! :)

I'm Only Cheating Myself [9-10 Days Post-Op]

When I chose to have surgery, I knew my 'comeback' would be almost solely dependant on my efforts with physical therapy. I remember telling people that "all I can do once I have surgery is be a perfect little princess in rehab and do everything to a T so that I can return to sports nice and strong." This (along with walking down stairs, bending to 90 degrees and balancing on my surgical leg...) is easier said than done.

At PT today I worked with a different trainer, Michelle, who I had seen before but never met. Turns out I really liked her (mostly because she did the forced bend more slowly and evenly!). In addition to some 'usual' exercises there, I was asked to do handful of the exercises I'd been tasked to do at home. But in PT there was the fact that I was under the watchful eye of a trainer, and in that case I will always be more determined to really push myself.

What I noticed is that yes, I do exercises at home, but I don't do them religiously, and it was showing. One of the biggest comebacks in rehab is getting your quads (thigh muscles) to fire again, and basically return stabilization to the knee by using those muscles. One exercise to do this is to sit with your legs out in front of you and simply flex your quad muscle (which, in turn, forces your leg straight and knee towards the ground). Sounds easy, (and, IS easy in my non-surgical leg) but it's a real struggle on my surgical leg.

Another exercise is laying on your stomach, propping your surgical leg up on the toes (instead of keeping toes pointed) and again, flexing the quad so the leg straightens (instead of at rest, where the leg bends at the knee and rests on the floor). The pictures of the back of my legs, below, shows this.

These exercises are simple in concept, but when Michelle asked me if I was doing them at home, I knew the answer was, "Well, kind of" instead of the "Yes! 3 times a day!" and it reminded me that I really need to keep up my end of the bargain at home so PTherapy doesn't turn into PTorture every other day.

That said, it doesn't mean there hasn't been improvement. My rotations on the stationary bike were a *little* easier today, walking is becoming easier, I can stand longer without my knee feeling like it's going to explode... And exercises such as straight-leg raises while sitting or balancing on my surgical leg are showing definite improvement.

I work with Michelle again on Monday, and I am looking forward to it. Over the weekend I plan to make time for my exercises and push myself as if someone were standing over me, because I want to be able to answer her with a confident "Yes!" if I'm asked again if I'm doing my part at home.

More photos:

8 Days Post-Op

Featured as of my 1-week follow-up: New tape on the incision!

9 Days Post-Op

A Monumental Week [7 Days Post-Op]

Tomorrow is my 4th Physical Therapy and my first post-op appointment with Dr. Jeff Shapiro- I promise to get an entry up about that tomorrow... But, first things first: Here we are, 7 days post-op!!

If you would have told me this week would go by so quickly, I wouldn't have believed you. But trials and tribulations aside, there have been some definite improvements that have me keeping a positive mind in my eventual recovery!

• I can bend beyond 90 degrees and straighten to zero degrees
• I can bear all of my body weight on my surgical leg (veeery carefully)
• I can walk (albeit slowly and quite hobble-ish) without aid of crutches or a brace
• I can get up and down stairs without assistance
• I can drive
• I can bathe (woo hoo!)

Of course, there are many milestones including:

• Going up and down stairs w/o having to take them one at a time
• Walking w/o a limp
• Regain balance (on both and) in my surgical leg
• Regaining entire range of motion
• Running
• Returning to sports (this is KEY for my sanity!!)
• Getting back to 'normal' !

I understand this will take 6-12 months, and I'm not planning on being a hero and getting out there too early. However, I hope I can continue with physical torture... I mean therapy (!) with vigor until I'm where I am capable of being, both physically and mentally! Of course I wouldn't be able to do it without a strong network of support, so again, thank you to everyone for all your help and kindness.

And because everyone likes photos (or, is it starting to gross you out?!)... some Day 7 post-op pics, for reference:
Increased yellowing and bruising, primarily on the inside of the knee and a little down the shin.
Bruising has also come about on the back of the knee:

I don't seem to have any trouble straightening to Zero degrees, and there has been no change in the incision area, as I have not removed the tape nor gotten it wet. Bending the knee continues to be a challenge, and I can get it to about 100 degrees but not without pain.

Until tomorrow...