a day in the life of acl surgery

This is continuing the ACL surgery post I made previously. The rehab posts will probably be more frequent since I’m spending a lot of time off my feet.

Day 52 (7/12): Surgery time!

I waited almost a full 2 months since my injury before I had surgery. The surgeon had recommended at least a 2-3 week resting period so that my knee would have had the swelling die down and not be inflamed (and also because he wasn’t available before then) but, as I mentioned previously, I went ahead and postponed it by a couple more weeks so I could enjoy a short vacation. The beach vacation I had with my friends was pretty stellar, by the way. A group of 10 of us drove down to South Padre and spent hours on the beach, in the ocean, in the pool and in a condo. We got to know each other very well–maybe better than we wanted to in some cases. Anyhow, back to my story.

The surgery was scheduled at the Cedar Park Surgery Center which is an ambulatory surgery center out in Cedar Park. What this basically means is that I get discharged the same day as surgery. I conveniently scheduled the surgery for a Thursday so that I could take one sick day (Friday) and still get about 3 days of rest before I had to entertain the thought of going back into work. As I mentioned previously, having my parents here was extremely awesome because I had someone to talk to, someone to take care of me 24×7 and also a delicious supply of home-cooked food (which I would have killed for without having to go through surgery, anyway).

I had to check in at 7:45 AM on Thursday, which meant a departure of time of about 7:15 AM since the surgery center was about 15 miles away. Because of general anesthesia, I was not permitted to consume anything past midnight (not even water). Surprisingly, I was able to get a good night’s sleep, which I had not expected because of nervousness and anxiety. I’m not complaining, though.

One of my friends had agreed to drive me to the surgery center and she arrived promptly at the scheduled time. The three of us piled into her car, crutches in tow, and we were on our way to the surgery center. The trip took less than the estimated 30 minutes, pushing me closer to being a part-time cripple quicker. Wee hoo.

The surgery center was small but swanky. I checked in with the nurse and signed a couple of things to the effect of “if you are dying, we have permission to save your life.” All pretty straightforward. There was a nice little TV screen there that had a spreadsheet broadcasting when each patient had checked in and when they had been admitted for pre-op. This gave me a somewhat concrete estimate of how long I had to wait. I ended up in the waiting room for about 20-25 minutes and was taken in for pre-op around 8:20 or so.

The pre-op nurse asked me to change out of my clothes into an exceedingly complicated hospital gown and then lie down on a bed with socks and a shower cap (or so it felt like). With socks. She then proceeded to shave my leg in a fashion that will embarrass me for weeks to come. Basically, the front of my left leg from my thighs down to about halfway through my shin. There is hair everywhere else. It looks spectacularly strange. She also gave me a tiny thimble of water with a couple of relaxants or pain killers or something. I didn’t complain or ask too many questions.

I was then interviewed by the anesthesiologist’s assistant who made sure I wasn’t carrying any infections in. Pre-op nurse tried to subtly put the IV drip into me but I was fairly distracted. At some point some more painkillers or relaxants were put into my IV and I began getting woozy. This is also when the anesthesiologist applied a nerve block on my quads to ease the pain I would feel post surgery.

I remember a few more things… me initialing my knee to make sure it was the correct one they were operating on, the rather large anesthesiologist talking to me, the surgeon coming in and writing “Yes!” on my knee to make sure he was going to operate on the right one, being wheeled into the OR, taking deep breaths of oxygen from a mask and then eventually being told that they were drugging me. And then I dreamed about a cricket match but was rudely interrupted. Post-surgery.

For those who are curious, my new ACL was constructed with a hamstring graft. When it comes to ACL surgeries, there are typically three choices: hamstring autograft, patella autograft and an allograft. The autograft implies that the tendon used to craft the new ligament is coming from the same source as the target ligament (i.e., me). Allograft is a tendon harvested from a cadaver. Before surgery, I did have to sign paperwork that said that an allograft would be used in the case that my hamstring tendon was deemed to be unusable. I would encourage talking with the surgeon about this because that was kind of a surprise.

The patella tendon has been the preferred source for ACL reconstructions for a while and that is only now changing with a bias towards the hamstring tendon. The hamstring autograft supposedly requires better expertise from the surgeon and also takes a little longer to heal, but the reconstructed ligament is supposed to be stronger and the long-term pain is supposed to be minimal. Apparently a patellar autograft leaves long-term pain in the patella that can prevent even kneeling on that knee again. It also comes down to the surgeon’s preference. My surgeon did all three procedures but the hamstring is apparently the one that he does the most often, so I figured I’d go with that option.

Back to my story… I woke up in a new room with the same people around me. My knee felt pretty numb. My parents were called in and I’m pretty sure I was not very fun to talk to. Several people came and went after that (people giving out the medical equipment I would need post-surgery, for example). I don’t think I saw the surgeon afterwards–I’m sure he had other procedures to do. I was offered some crackers and ginger ale, which I graciously accepted after much prodding. They were pretty good although I think the straw they gave me was defective because I kept spilling ginger ale on myself. I’m pretty sure it was the straw’s fault.

I called another friend to let him know I was ready to be discharged in about 30 minutes. We sat around and chatted till he arrived (with another friend) at which point I was allowed to put my clothes back on through that weird gown and was wheelchaired out to the car where I was remarkably able to get into the front-seat mostly unassisted. We dropped off a prescription on the way back home and then once I got home I pretty much passed out on my bed with the ice pack machine around my knee (more on the machines, later). I texted another friend and guilt-tripped her to pick up my meds for me from the pharmacy.

Since my leg was still pretty much numb, I didn’t feel much pain except for my hamstrings, which felt extremely sore. The staff at the surgery center had given me some leg exercises to do but they were basically exercises in futility since my quadriceps’ nerve block was still in action and I couldn’t even so much as wiggle my toes. That’s a weird feeling, by the way. Everyone should be able to wiggle their toes whenever they want to. It doesn’t seem like a difficult task.

I spent most of that day drifting in and out of sleep in my bed with my parents beside me. Once my meds arrived I had some oxycodone inside me, as well. Apparently the worst part was over.

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