Currently Reading: TF&S; Mindfulness in Plain English
Going to do a little something different for this Wednesday post: ACL Chronicles will be updated as the days go by, keeping track of the details of my rehab journey. In classic "Flowers for Algernon" style.
[12.17.2014]
First, the surgery day!
 |
| Before my knee becomes a cantaloupe :[ |
7:30AM Pre-op: I talk to the nurse, who gets a urine sample from me, and asks me to wear a standard hospital robe with just my underwear on. The nurses all say I look like a young little thing... (but I'm 24!) I put my belongings in a bag and keep my phone on me until the last possible minute. She asks me my name, DOB, and the operation I'm going to have: "left knee arthroscopy with possible (read: probable) ACL reconstruction and meniscal repair". I talk to the anesthesiologist who recommends a "femoral block" which will be a local anesthesia injected into my femoral nerve. It is strong and lasts for up to 24 hours after the surgery. It will help manage pain. I don't remember having that before but he recommends it. And since insurance no longer covers "cold therapy systems" (see Donjoy IceMan Cold Therapy System) for knee surgery patients (I have one from my last surgery but we've lost the AC adapter), I decide to accept his recommendation. I am wary of anesthetics but I don't think there are any other options to help me avoid excruciating pain. He gives me a dose of valium to relax me and tells me it'll feel like two shots of tequila. Eh. Didn't really feel like that as far as I remember. But perhaps I was more friendly? The doctor meets with me to mark me knee. The PA meets with me to tell me what kind of graft I am going to get, the bone screw, and the company that distributes these materials:
Arthrex BioComposite Interference Screw (10 x 28 mm) made of 30% biphasic calcium phosphate and 70% PLDLA, intended to be bioabsorbed into the bone.
Arthrex ACL Tightrope (Tibialis Tendon Posterior Frozen from the Achilles of a donor)
Later, I ask for my medical records and a copy of the serial numbers of these implants.
I'm slightly amused by the fact that I have part of someone's Achilles heel in my knee.
8:30AM OR: I am wheeled to the OR, half an hour later than scheduled. They sprawl out my arms to make me more comfortable and the anesthesiologist (Dr. Ho) talks me through what he is doing: 'I'm going to inject you with the anesthesia now. It's going to be really strong. Strong enough to put you out in about 5 seconds.' He distracts me with various questions as I tell him that the injection kind of hurts. 'Are your parents from the Philippines? Think about going there.' is the last thing I remember. I remember seeing the time before then: 8:42AM.
10:15AM Post-Op:At around 10:15, I awaken to my dad beside me and the nurse unstrapping me from something. She says 'Welcome to the land of the living. Your surgery went really well.' I ask the nurse a few questions as the brief me on the discharge instructions. She asks if I want something for pain and I say I don't need it because it's a narcotic. They say the center will call me to check up the next day. My dad and I spend about half an hour making small talk until I decide it's time to go. Sandra and a nice nurse named Sonny helps me onto a wheelchair while my dad gets the car. We leave by 11 something AM. I am recommended to not bear any weight on my knee because of the meniscectomy and the biocomposite bone screw. Too much too fast can cause failure of the bone screw to reabsorb, I'm told. The meniscal damage was worse on the medial side (a buckethandle tear) with some damage laterally.
Homeward Bound:
My mom finds our old Donjoy Iceman but we are missing the AC adapter and I contemplate ordering a replacement so I can have it around when I go back up north.
Thursday will be the moment of truth...
[12.18.2014]
I wake up and take care of some work-related business - since there seems to be a crisis happening at the Ocular Oncology Clinic.
During the day, ice is kept on the knee on and off and, keeping it elevated. But I still can't feel very much cold in the morning. I decide to take ibuprofen over acetaminophen for the anti-inflammatory effects. 1x200mg in the morning, 2x200mg twice during the day.
Over the course of the day, the pain increases. It is tolerable but I can feel the warmth from the swelling. (4-5 out of 10 right now?) It's definitely uncomfortable... when I touch the femoral region, I still feel numb, though. Maybe I haven't metabolized all of the local anesthesia yet.. My sister helps me make mint verbena tea. Yum. I need someone to refill the hot water during the day because crutches make it hard to walk hot water around.
The surgical center or doctor was supposed to call me today but they didn't! Now I need to call tomorrow and ask about:
- how I should ice my knee
- scheduling physical therapy
- post-op exercises
- weight-bearing risks
The pain becomes more bothersome as the night progresses. I have started to feel the cold from the cold packs and ice. I am starting to become irritated at how long it takes me to accomplish small tasks, like using the bathroom, sitting on the couch, and getting food. Irritated at my helplessness, I guess. A common reaction for someone who revels in her own independence. But as the pain becomes more commonplace, my mood improves. Even typing this out helps.
My youngest sister played at a varsity basketball game and didn't invite me--she said she played well, started, and made a reverse layup! Also, my favorite Celtic signed for the Mavs. I'm missing basketball already... I played with Spicy Cilantro just 3 days ago. :'(
Update: Mood significantly lifted when Marvs calls me. lol :)
[12.19.2014]
Last night was the worst pain I'd been in--preventing me from falling asleep. 7-8/10 probably. I was tempted to call people to help keep my mind off of the pain.... I can feel most of the pain around the knee (I can draw an oval around the kneecap where I feel the pain is localized). The pain is more profound right above the tibia, I'm guessing where the tibial tunnel was created. I'm growing more accustomed to the pain so that's good I guess.
The post-op support hasn't been that great from my care providers. I want to partially attribute it to the holidays but it's really no excuse. I think a patient that didn't have previous experience would not find it strange at all but since I have an experience of care that I can compare with (Kaiser), I am a bit more critical. I called and left a message with the receptionist for someone to call me back and give clarification on post-op instructions. In the interim, I found a pretty good link explaining what I should do post-surgery from Broward Health Sports Med. And this link from BWH explains why allografts will take a "longer" full recovery process: revascularization is slower than for autografts.
Takeaways:
1. Wear the immobilizer during sleep for 3-4 weeks post-surgery to prevent a "flexion contracture" (stiff, bent knee).
2. Usually the dressing is changed within a week post-surgery. The dressing for me will not be removed or changed until my Tuesday follow-up appointment.
3. Patients need to be disciplined in their recovery from allograft implantation. This makes sense to me because the biocomposite interference screw is designed to reintegrate with the bone and that takes about 2-3 months for complete integration. The allograft usually takes a 1-2 months to vascularize and connect.
4. Home exercises until I can start PT:
There are also some exercises that you are expected to begin later in the day of surgery. Continue to perform your exercises after discharge for 10 minutes every hour while awake. These important exercises for the first several weeks include, straight leg raises, calf pumps, and heel props. After surgery, your knee would tend to get stiff in the bent position if no exercises were done. Heel props are extension exercises (ones that help the straightening of the knee to match the other side). The flexion (bending) exercises will begin in therapy and continue while at home.
In the meantime, my two non-fiction reading materials (Thinking, Fast and Slow and Mindfulness in Plain English) are pretty interesting juxtaposed against each other. TF&S has a very journalistic writing style, with concrete examples and psychosocial studies cited. The zenbook is very theory driven anda practical instruction handbook on meditation and mindfulness. TF&S explains that we have two different mental systems (System 1: responsible for fast, intuitive response and reading, drawing connections, etc. and System 2: responsible for logical thought and effortful thinking). By reading the two together, it's pretty cool seeing how meditation helps one get in tune with their theorized System 1 and have more control over it... and why that would be from a psychological perspective. Finished reading the zenbook.I've been trying to practice mindfulness. Often, I need to be diligent in my body's reaction to the pain/healing process after surgery. My muscles tense and I need to relax them. I need to recruit muscles that seem painful to recruit. I need to be psychologically calm to avoid stress hormones.
[12.21.2014]
Yesterday was an uneventful day, full of routine. I've begun to take off the immobilizer when I'm relaxed and icing my knee because it is so damn uncomfortable.
New hourly exercise routine, usually after icing:
1. Calf pumps: Spell out alphabet twice. + 25 5'' holds (without brace)
2. Heel props (without brace)
3. Straight-leg raises: 25 from full resting position, 10 x 5'' holds (with brace)
The strength of my knee seemed to be quickly disappearing due to the lack of muscle engagement. I really can't wait for my first PT session...
Today is the first day I did without the Advil/ibuprofen.
Also, finished reading Cat's Cradle.
[12.22.2014]
Finally, the last day before my follow-up appointment. And the day I will attempt to properly shower. I know it sounds gross, but they recommend you sponge bath until the dressing is changed and the wounds are completely closed to prevent infection. Ugh, I've felt gross and antisocial for too long already. It feels so goooood to feel so clean!
Today, I decided to take ibuprofen, mostly because it was uncomfortable every time I sat down to try and do work. The exercises are getting easier. The problem is my opposite knee and other parts of my body are starting to feel tons of pain from overcompensation. :(
I had this horrible nightmare last night where I had to go to the ER because I coughed up the biocomposite screw that was supposed to keep my graft in. It made no medical sense and I knew it in my dream yet I was so scared that I was going to mess up my surgery/recovery that I went through the motions of going to the hospital.
Psychological resilience is something I'd forgotten about until now. Simple tasks are so difficult now. It is hard to clean the house. It's hard not to feel a little depressed. Perhaps from the lack of monoamines (neurotransmitters) that I get from physical exertion. Perhaps because I'm frustrated at the slowness of life right now. Perhaps because it is so difficult to peacefully get something done because of my physical discomfort. Legs are really taken for granted...
[12.23.2014]
First follow-up appointment. I had three stitches removed but the big one (where the tibial tunnel was drilled) cannot be removed until next week. It was, as I suspected, the greatest source of physical pain for me. Since the wound was so large, it stuck to the gauze. Gruesome sight :(Since I'll be up north, I will need to see my PCP there, have the stitches removed and get an auth for physical therapy at that time. The important thing right now is getting my range of motion back.
I guess I have to take PT into my own hands from now on.
Couple things accomplished during this appointment (make sure you keep a list so you make sure you cover all your bases in your limited time with the specialist! relying on the staff to guide you through everything is probably the worst thing you can do. you must be pro-active):
- Requested a disabled placard (this will be signed by the physician and I will need to bring the signed records to the DMV; $6 for a temporary parking placard for 6 months); processing time: 48 business hours
- Requested medical records/chart for future doctor; processing time: 2-3 business days
- Obtained a disabled letter for work (stated how long I would have the disability and that I cannot take public transit)
- Received authorization printout for PT
- Received printout of arthroscopic images from surgery :)
- Told to change gauze dressing for stitches once a day and received greenlight to shower normally albeit carefully
- Scheduled first PT appointment/eval next Monday Dec 29th
- Greenlighted to start ROM exercises
- Told I was not allowed to weight bear for 6 weeks post-op (to allow for graft healing) - that puts greenlit walking without crutches at January 28th...
I feel a lot better now that a lot of the protective padding for the knee has been removed.
The next few weeks are going to be tough.
I got to 70 degrees flexion though! (in brace) :)
I got to 70 degrees flexion though! (in brace) :)
.JPG) |
| ... what am I looking at??? |
Also went out today for the first time to socialize. Hasn't even been a week yet but I got out of the house. Woot.
[12.25.2014]
I've successfully hit 80 degrees ROM. Tomorrow I'll try to go 90. Strengthening exercises are helping and I can do a few SLRs without the assistance of the brace. But I don't want to move too fast -- don't want to strain the new. I will need to sign up for some sort of gym membership so I can continue self-rehab and make use of a good stationary bike.
See my rehab worksheet on Google docs here.
Pain management: I usually take 200-400 mg of ibuprofen in the morning (blood rush to knee causes a lot of discomfort) and 400 mg at night (so I can sleep). I've succumbed to the OTC pain pills because I've realized that it's psychologically distressing to feel too much pain/discomfort and that could hinder the recovery.
Weight bearing: I've been advised to not go without crutches until 6 weeks post-op. But I can try to weight bear for balance/standing, etc. It's been difficult but I want to be able to say that I can walk by the 3 week mark. I would still use the crutches though to allow graft healing.
[12.27.2014]
Day 10 Post-Op: Today I made my first ventures through single-crutch walking. It was energy draining and slow. But to know it was possible was glorious. I will slowly practice single-crutch walking as pain permits. I need to remember not to push myself too hard though. It will be a slow-burn process getting back to sports. I also fell unexpectedly today on my way back from the bathroom while I wasn't wearing my brace. Rahhh stupid slippery floors.
Rehab: Sticking to my rehab worksheet but I don't need the brace to do SLRs anymore (yay?).
Bruising/Swelling: Bruises still appear purple with some red. Still tender where bruised. I have two main bruised regions: (1) at my hammy (around biceps femoris) and (2) wrapping around the medial side of knee (probably because of the menisesctomy). Swelling is still significant. Looks the size of a small cantaloupe.
Flexion/Extension: Keeping my flexion at 90 and it is still pretty uncomfortable getting there due to the knee swelling. If I focus too much on flexion in exercises, extension seems to get more difficult. Prone hangs are pretty uncomfortable...
Pain management: I really only need ibuprofen at night to ensure that I can sleep. Sleep quality has improved. During the first few nights after surgery, I used to wake up from leg discomfort every few hours or so.
Medical records: Picked up my medical records and DMV paperwork for my handicapped placard.
Extra: Rondo got moved from the Celtics to the Mavericks. But since I am a "player fan" and not a "team fan," I guess I'm pretty happy for him. The Mavs look really good now and I'm actually excited to watch the NBA these days. (Plus it's the only way for me to get a basketball fix now that I've forbidden myself from the courts.)
[12.28.2014]
Hobbling pretty well with one crutch for half the day. ROM to 90 degrees getting easier. Tomorrow is my first PT appointment!
Can't sit in one bent position too long, though, or the knee gets sore and extending to zero is annoying.
I usually start breathing exercises before dozing off to sleep nowadays. However, last night, I was awakened full force by what felt like a spastic muscle contraction of my medial hammy. Owwwwwch that was super weird.
[12.29.2014]
Day 12 Post-Op, First PT Appointment:
For such a steep co-pay, the first PT appointment was a bit of a let down. I suppose I should have expected a less aggressive regimen when the name of the PT place is "Nifty after 50." I mean, different PTs have different philosophies but I distinctly remember my Kaiser doctor being very helpful since he had been an athlete in his past as well. PT says I looked like a basketball girl and she complemented me on my muscles. lol...
Because my surgeon recommended no weight bearing, I wasn't allowed to use the stationary bike (!!). And she didn't give me time to ice my knee. But oh well. I learned a few new exercises to add to my worksheet and refined some of my techniques.
UCSF Fitness and Rec is free from Jan 1-10 with a $0 enrollment fee if I join in January. Paying $49 for a monthly membership would be far more worth it than PT.... so I might just do that.
[12.31.2014]
2 Weeks Post-Op: Taking it Day by Day
- Hobbling comfortably with single-crutch for most of the day.
Rehab/Flexion/Extension
- Noticeable muscle atrophy of calf muscle (then again, I have abnormally large, athletic calves) and quads. Can't work on hamstrings too much yet since it puts a lot of strain on the knee.
- Comfortably reach 90 degrees flexion. (Very) slowly working my way towards 120. It's very difficult....
- Will start stationary bike next week. Making up for it by lying on my back and mimicking the bicycle motion -- also a good ab workout.
- Working out abs once a day. And got to 2 pull-ups on the doorway pull-up bar :D
- Removed brace for sleep last night. No noticeable consequence.
Bruising/Swelling
- Swelling tends to worsen during the day and is very slowly going down. Managed with 200mg ibuprofen (Advil) during late afternoon
- Bruising slowly going away; still a fading purple-ish in color
Pain Management
- Not too much pain. Ibuprofen taken as needed.
Psychological
- Feel pretty good now that I've returned to work. It's tough getting places but at least it's something to keep my mind occupied.
- Less active about my social life at the moment.
[01.03.2015]
Stitches Removed
Doc said that the stitches can be removed two weeks post-op but since I couldn't follow up with him in SoCal, I could go to a PCP appointment or visit Urgent Care to have them easily removed.
I thought I could ask a nurse friend to do it but UCSF (my work) was pretty much a ghost town and I couldn't find anyone. In my frustration and with the weekend upcoming, I decided to remove the stitches myself. In the end, I successfully removed three!
I certainly don't recommend ever doing this yourself. It's not in a controlled, sterile environment and you may not have the right tools. I used tweezers and a pair of eyebrow scissors and sterilized them using hydrogen peroxide and alcohol.
While I am still able to hobble on one crutch, I've decided to take "break days" (yesterday and today), using one crutch, to allow for tissue healing. I don't want to mess anything up!
[01.07.2015]
3 Weeks Post-Op
I am capable of hobbling without the brace now. I still use single or double crutch as needed though! Taking care of my knee feels like a job I have on the side--very tiring.
Rehab/Flexion
- Still in charge of my own rehab
- Purchased an exercise peddler for use at home. As the need arises in the future, I also plan on getting free weights for the legs, medicine/kettle balls, and a balance trainer. (However, I'm still thinking about whether or not it's more worth it to purchase a gym membership of some sort.)
- Haven't measured flexion but it is well past 100 and comfortable at 90.
Muscle Atrophy/Scar Tissue
- Every time I look down at my legs, I am sad because there is such a noticeable size difference. I also realize... if I wasn't athletic, I would look a LOT slimmer (skinny fat).
- I noticed that there is some buildup of scar tissue where the surgical incisions are made. I've begun massaging every morning (~15 minutes) and evening (30 minutes).
Bruising/Swelling
- Bruises on the medial side of my knee are still there but the hammy one has fade considerably.
- Swelling seems pretty stagnant. However, I have not been very zealous about icing it or doing cold therapy. I have a cold therapy machine but I haven't been able to go out and buy ice for it (since our fridge doesn't have an ice machine). I've begun wearing a knee sleeve over the knee to help with compression.
- I'm starting to notice a bit of bruising on my shin. It's very tender there. Ugh, where is it coming from...
Pain Management
- I haven't taken ibuprofen for 3 days now. Perhaps I should to manage the swelling, though.
Psychological
Some days I feel great, others I feel apprehensive about the recovery progress of my knee. A coworker told me that he started walking at 2 weeks (non-compliant with what his doctor told him). I was told to be non-weight bearing but I feel like it's better to maintain muscle strength around the knee. I will just do one notch of intensity lower than what feels right to account for the fact that allografts heal slower than autografts.
[01.08.2015]
I want to focus this entry on nutrition and diet: Since my surgery and returning to norcal one week ago, I've been somewhat careful about what I eat and how much money I spend on eating. This is a grand opportunity for me to improve my diet habits. More specifically, I'm focused on reducing sugar and refined carbohydrates intake, and increasing vegetables/fruits and lean meats intake. It's very important to take nutrition and diet seriously post-op. You want to promote your body's natural healing abilities, keep mentally sharp, and be at an optimal weight.
So far, I've tried to incorporate more power foods like pineapples, spinach, eggs, and aloe vera juice. I haven't done much else in a concrete way. However, I do find myself craving leafy greens and salads more often (it just feels so much cleaner). I weighed myself and found that I definitely dropped the holiday weight and now I'm wittling down extra pudge. Dropping a few pounds will help a lot with recovery as well. End of month weight goal: 123.
I've successfully hit 80 degrees ROM. Tomorrow I'll try to go 90. Strengthening exercises are helping and I can do a few SLRs without the assistance of the brace. But I don't want to move too fast -- don't want to strain the new. I will need to sign up for some sort of gym membership so I can continue self-rehab and make use of a good stationary bike.
See my rehab worksheet on Google docs here.
Pain management: I usually take 200-400 mg of ibuprofen in the morning (blood rush to knee causes a lot of discomfort) and 400 mg at night (so I can sleep). I've succumbed to the OTC pain pills because I've realized that it's psychologically distressing to feel too much pain/discomfort and that could hinder the recovery.
Weight bearing: I've been advised to not go without crutches until 6 weeks post-op. But I can try to weight bear for balance/standing, etc. It's been difficult but I want to be able to say that I can walk by the 3 week mark. I would still use the crutches though to allow graft healing.
[12.27.2014]
Day 10 Post-Op: Today I made my first ventures through single-crutch walking. It was energy draining and slow. But to know it was possible was glorious. I will slowly practice single-crutch walking as pain permits. I need to remember not to push myself too hard though. It will be a slow-burn process getting back to sports. I also fell unexpectedly today on my way back from the bathroom while I wasn't wearing my brace. Rahhh stupid slippery floors.
Rehab: Sticking to my rehab worksheet but I don't need the brace to do SLRs anymore (yay?).
Bruising/Swelling: Bruises still appear purple with some red. Still tender where bruised. I have two main bruised regions: (1) at my hammy (around biceps femoris) and (2) wrapping around the medial side of knee (probably because of the menisesctomy). Swelling is still significant. Looks the size of a small cantaloupe.
Flexion/Extension: Keeping my flexion at 90 and it is still pretty uncomfortable getting there due to the knee swelling. If I focus too much on flexion in exercises, extension seems to get more difficult. Prone hangs are pretty uncomfortable...
Pain management: I really only need ibuprofen at night to ensure that I can sleep. Sleep quality has improved. During the first few nights after surgery, I used to wake up from leg discomfort every few hours or so.
Medical records: Picked up my medical records and DMV paperwork for my handicapped placard.
Extra: Rondo got moved from the Celtics to the Mavericks. But since I am a "player fan" and not a "team fan," I guess I'm pretty happy for him. The Mavs look really good now and I'm actually excited to watch the NBA these days. (Plus it's the only way for me to get a basketball fix now that I've forbidden myself from the courts.)
[12.28.2014]
 |
| Don't look! |
Hobbling pretty well with one crutch for half the day. ROM to 90 degrees getting easier. Tomorrow is my first PT appointment!
Can't sit in one bent position too long, though, or the knee gets sore and extending to zero is annoying.
I usually start breathing exercises before dozing off to sleep nowadays. However, last night, I was awakened full force by what felt like a spastic muscle contraction of my medial hammy. Owwwwwch that was super weird.
[12.29.2014]
Day 12 Post-Op, First PT Appointment:
For such a steep co-pay, the first PT appointment was a bit of a let down. I suppose I should have expected a less aggressive regimen when the name of the PT place is "Nifty after 50." I mean, different PTs have different philosophies but I distinctly remember my Kaiser doctor being very helpful since he had been an athlete in his past as well. PT says I looked like a basketball girl and she complemented me on my muscles. lol...
Because my surgeon recommended no weight bearing, I wasn't allowed to use the stationary bike (!!). And she didn't give me time to ice my knee. But oh well. I learned a few new exercises to add to my worksheet and refined some of my techniques.
UCSF Fitness and Rec is free from Jan 1-10 with a $0 enrollment fee if I join in January. Paying $49 for a monthly membership would be far more worth it than PT.... so I might just do that.
[12.31.2014]
2 Weeks Post-Op: Taking it Day by Day
- Hobbling comfortably with single-crutch for most of the day.
Rehab/Flexion/Extension
- Noticeable muscle atrophy of calf muscle (then again, I have abnormally large, athletic calves) and quads. Can't work on hamstrings too much yet since it puts a lot of strain on the knee.
- Comfortably reach 90 degrees flexion. (Very) slowly working my way towards 120. It's very difficult....
- Will start stationary bike next week. Making up for it by lying on my back and mimicking the bicycle motion -- also a good ab workout.
- Working out abs once a day. And got to 2 pull-ups on the doorway pull-up bar :D
- Removed brace for sleep last night. No noticeable consequence.
Bruising/Swelling
- Swelling tends to worsen during the day and is very slowly going down. Managed with 200mg ibuprofen (Advil) during late afternoon
- Bruising slowly going away; still a fading purple-ish in color
Pain Management
- Not too much pain. Ibuprofen taken as needed.
Psychological
- Feel pretty good now that I've returned to work. It's tough getting places but at least it's something to keep my mind occupied.
- Less active about my social life at the moment.
[01.03.2015]
Stitches Removed
Doc said that the stitches can be removed two weeks post-op but since I couldn't follow up with him in SoCal, I could go to a PCP appointment or visit Urgent Care to have them easily removed.
I thought I could ask a nurse friend to do it but UCSF (my work) was pretty much a ghost town and I couldn't find anyone. In my frustration and with the weekend upcoming, I decided to remove the stitches myself. In the end, I successfully removed three!
I certainly don't recommend ever doing this yourself. It's not in a controlled, sterile environment and you may not have the right tools. I used tweezers and a pair of eyebrow scissors and sterilized them using hydrogen peroxide and alcohol.
While I am still able to hobble on one crutch, I've decided to take "break days" (yesterday and today), using one crutch, to allow for tissue healing. I don't want to mess anything up!
[01.07.2015]
3 Weeks Post-Op
I am capable of hobbling without the brace now. I still use single or double crutch as needed though! Taking care of my knee feels like a job I have on the side--very tiring.
Rehab/Flexion
- Still in charge of my own rehab
- Purchased an exercise peddler for use at home. As the need arises in the future, I also plan on getting free weights for the legs, medicine/kettle balls, and a balance trainer. (However, I'm still thinking about whether or not it's more worth it to purchase a gym membership of some sort.)
- Haven't measured flexion but it is well past 100 and comfortable at 90.
Muscle Atrophy/Scar Tissue
- Every time I look down at my legs, I am sad because there is such a noticeable size difference. I also realize... if I wasn't athletic, I would look a LOT slimmer (skinny fat).
- I noticed that there is some buildup of scar tissue where the surgical incisions are made. I've begun massaging every morning (~15 minutes) and evening (30 minutes).
Bruising/Swelling
- Bruises on the medial side of my knee are still there but the hammy one has fade considerably.
- Swelling seems pretty stagnant. However, I have not been very zealous about icing it or doing cold therapy. I have a cold therapy machine but I haven't been able to go out and buy ice for it (since our fridge doesn't have an ice machine). I've begun wearing a knee sleeve over the knee to help with compression.
- I'm starting to notice a bit of bruising on my shin. It's very tender there. Ugh, where is it coming from...
Pain Management
- I haven't taken ibuprofen for 3 days now. Perhaps I should to manage the swelling, though.
Psychological
Some days I feel great, others I feel apprehensive about the recovery progress of my knee. A coworker told me that he started walking at 2 weeks (non-compliant with what his doctor told him). I was told to be non-weight bearing but I feel like it's better to maintain muscle strength around the knee. I will just do one notch of intensity lower than what feels right to account for the fact that allografts heal slower than autografts.
[01.08.2015]
I want to focus this entry on nutrition and diet: Since my surgery and returning to norcal one week ago, I've been somewhat careful about what I eat and how much money I spend on eating. This is a grand opportunity for me to improve my diet habits. More specifically, I'm focused on reducing sugar and refined carbohydrates intake, and increasing vegetables/fruits and lean meats intake. It's very important to take nutrition and diet seriously post-op. You want to promote your body's natural healing abilities, keep mentally sharp, and be at an optimal weight.
So far, I've tried to incorporate more power foods like pineapples, spinach, eggs, and aloe vera juice. I haven't done much else in a concrete way. However, I do find myself craving leafy greens and salads more often (it just feels so much cleaner). I weighed myself and found that I definitely dropped the holiday weight and now I'm wittling down extra pudge. Dropping a few pounds will help a lot with recovery as well. End of month weight goal: 123.
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