the commencement of rehabilitation

This post examines my experience of ACL surgery through the rehab process, which is currently ongoing.

Day 53 (7/13): Rehab starts

At some point during the night, my nerve block wore off and instead of being greeted by unparalleled pain, which I had expected, I was greeted by the warming ability of being able to wiggle my toes again. Of course, the oxycodone probable played a part in deflecting the pain, but let’s just pretend that I’m some sort of Herculean man unaware of little things such as nerves complaining.

I had my first rehab/physical therapy appointment at NASM at 10 AM, which was somewhat problematic because I was in no condition to drive. My friends were also at work and I didn’t want to bother them more than I already had so I convinced my father that he would be okay to drive the approximately 3 miles that the therapy location was. In retrospect, I’m glad that the surgeon’s office/physical therapy center is so close to where I live.

We headed over to the physical therapist who undressed my wound and commented that it looked pretty great for the day after surgery. Swelling was minimal and she was surprised that my only pain, thus far, had been soreness from the hamstring graft. She did caution me that sometimes the pain got a lot worse before it got better and that I could expect a considerable amount in the coming days.

She had me do some quadriceps flexing sets and some leg raises, both of which looked good. She also put some electrodes on me and got a baseline measure for how strong my quads were. They were 35 of some unknown unit. Apparently my right leg, if I had measured it, would have been about 350 of the same unknown unit. Long way to go. She also had me walk around with my brace and crutches, but bearing weight on the operated leg. Satisfied with the results, she re-dressed my operated leg and said I was doing very well and was ahead of schedule in terms of recovery. But she still cautioned me about the oncoming pain. I’m glad she did, because boy did the pain come.

My rehab/pain relieving habits at home basically comprised of the following:

  • 1-2 tabs of oxycodone every 4-6 hours
  • 1 capsule of cephalexin every 8 hours to prevent infection
  • 1-2 hour sessions of this neat cryo-cuff cold therapy system
  • 1 hour sessions of a continuous passive motion machine to regain range of motion
  • 40-minute sessions of an electric muscle stimulator
  • Lots of laying around in bed with my knee elevated above my heart to prevent swelling
  • Lots of delicious comfort food

In preparation for the oncoming pain, I decided to switch from single tablets of oxycodone to two at a time. I guess it may have helped. But the pain finally came. The last of the nerve block finally wore off and the pain around my knee came. It wasn’t really debilitating pain but it was constant and annoying. The ice pack made it worse because I had to put it on to keep swelling down, but it just contribute to the pain because it felt like my foot was going to fall off. In honesty, the worst of the pain happened when going from horizontal to vertical as the blood rushed down the knee.

Going to bed on Friday night was particularly difficult and I actually made the decision to switch from the ice pack system to the CPM machine a little past midnight. Luckily my Dad was awake and he was able to assist in the changeover. In contrast to the ice machine, the CPM machine was nicely padded (with what I am envisioning is llama fur) and had a comfortable hum and repetitive motion that made for easy sleep. It did bruise the back of my thighs, though, although I’m told this is expected.

Day 54 (7/14)

I managed to get a good 5-6 hours of sleep on the CPM machine until it was time to chomp some pain meds at around 7 AM in the morning. My hunt for a snack was cured by a cereal bar which I essentially inhaled and popped a couple of pain meds and tried to go back to sleep. I went back to the ice machine in the morning and it was a lot more comfortable, although I still had to tune it down to an almost minimal setting.

Oh, by the way, something no one talks about when it comes to repairing torn ACLs is… constipation. Yeah, it’s kind of nasty. The laxatives don’t really help. But prepare yourself for that if you have to go through it.

Anyways, what made Saturday doubly special was the fact that I was going to have grihapravesh done on my house, or the Hindu “house-warming puja”. Of course, I was in no position to sit on the ground for 2 hours so thankfully my father substituted in on my behalf. After dozing for most of the morning on pain meds and machines, I finally got out of bed at around 10 AM and brushed my teeth. I took a short shower, which basically comprised of me painfully applying a garbage bag around my knee to prevent water from getting in and infecting my wound, gingerly stepping into the shower and kind of trying to get my body wet without getting the garbage bag soaked. The acquisition of a loofah helped greatly in the area of hygiene.

Once I got out of bed, I hobbled around a little bit and managed to catch the end of the puja. After that, it was time for another dose of pain meds and more time on the CPM machine. I think I was up to around 65 degrees on the machine by then (I’ll try to get more accurate numbers of this in future posts).

In the afternoon/evening I decided to venture out and drive and was able to do a short drive to H-E-B and Target. I walked around H-E-B and that quickly caught up with me as the blood rushed to my knee. It was quite painful and I had to sit down at Target while my parents shopped. When I got back, the ice therapy was a welcome change. The rest of the day was not really exciting and basically involved eating, watching movies and doing more rehab.

Day 55 (7/15)

This was more of the same as the previous day, except that my dose of antibiotics was finally done. I did venture out to a furniture shop with the parental unit and purchased a dining table but that was about as much as I could handle before I had to rush back to my ice packs. I also decided to take another day off work to make sure I was back to a decent amount of strength, and also so that I could get another PT session in.

Day 56 (7/16)

This is today. I’ve got about a day’s worth of pain meds left and the knee pain is still there but it is subsiding considerably. The swelling is still there. One of the wounds from the incision is still bleeding a little bit, but there’s nothing bad, according to the physiotherapist. The measure for my quad-thing, which was 35 unknown units last time, has nearly doubled to 69 unknown units. The physiotherapist was excited to see that.

At the PT session, my maximum flex was measured at 95 degrees, which was awesome because the target for 2 weeks is 90 degrees. I’m not sure how straight I could get the knee. I also walked without the brace, but with the crutches today and it went swimmingly. I’ll be doing this at home and walking in public with the brace.

There’s still pain going from a horizontal to vertical but a lot of it is counteracted by the psychological reassurance from the physiotherapist. I’m hoping for more of the same! The plan is to go back to work tomorrow for at least half a day and come back early and work from home if I see too much swelling. I’m planning to set up the CPM machine at 75 degrees tonight while sleeping, to keep working on that range of motion!



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