some show-and-tell

Today’s rehab report along with some photos of my knee in progress.

Day 58 (7/18)

After being gung-ho about going back to work, I realized that I wasn’t ready, yet. The first night without pain medicine was less than stellar. I had the CPM machine going at 80 degrees till about 2 AM and then felt some stiffness/bruising so I took my knee out of it and applied the pressure bandage and went to sleep without a cold pack system since I couldn’t feasibly hook it up and apply it myself. I awoke at around 4 AM with the knee feeling pretty stiff and, more worryingly, with a need to go the bathroom.

The horizontal to vertical pain now firmly entrenched in my head, I cautiously swung my legs down over the bed. Immediately, I felt the blood rush down my knee and the extreme pain had to be endured again. The pain is almost down in the calf area, not the knee, slightly to the sides where all the bruising is (I have pictures later for the curious few). It lasts for about 3-4 minutes–lesser if I decide to brave it and get on my crutches and try to put weight on the leg. I’m not sure what it is, but it is not comfortable. I used the restroom and collapsed back in bed. The gratification to going back to a horizontal position is instantaneous as well, so at least I have that respite.

Unfortunately, the lack of pain medicine (or perhaps the mental lack of pain medicine) kept me awake for most of the next few hours. Thankfully, at some point, my parents woke up and were able to apply the cold therapy machine on my knee. However, they’re going to be gone in a couple of days so I need this pain to go away soon or figure out how to get that machine going myself, in a comfortable manner. The ice was nice but it again leads to stiffness and discomfort and I had to shift my weight around to feel comfortable for periods of about 8-10 minutes.

Since I couldn’t sleep, I decided to research my pain on that veritable resource of information–the Internet–and found several accounts of people claiming that they had lots of pain when standing up during the 5th-6th day after surgery that eventually just went away. I’m hoping my pain will follow a similar course. I also made the decision to take off work/work from home the rest of the week since it seems that going to work for those 2-3 hours (as well as the extra time spent throughout the day in a non-horizontal position) may have intensified the pain.

I did have to drive my dad to the airport but after I got back I had the cold therapy machine to look forward to. Most of the rest of the day was spent with the cold therapy machine and short naps as it allowed. I was able to get a little bit of work done remotely, as well. I gave the doc’s office a call in the afternoon and he said he would put me on weaker pain meds and that I could rely on Ibuprofen and Advil to manage any pain as necessary, as well. I was also able to crank my CPM machine up to 85 degrees and finally spent some time doing my exercises (conveniently before the PT appointment). Doing the physiotherapy exercises actually feels good, possibly because I have something to distract my mind from the pain or possibly because I’m causing my blood to go to a different place. Although it’s all probably because I’m back to being somewhat horizontal.

The visit to the PT office today continued to establish the positivity as I was able to chat with another ACL surgery patient who was about a week ahead of me. He told me he had many of the same pain symptoms in the first week that have all but gone away now. My physiotherapist also reassured me that the pain when standing up from a laying down position should be on its way out fairly soon and is primarily because the various systems in the body are trying to reestablish the routes for the blood (or at least, that’s how I envision it). Anyhow, she said a lot of patients complain about those symptoms and that I should bring it up with my follow-up meeting with the doc on Monday if it is persisting.

As for the activities during the rehab session, I once again started by stretching (bending and straightening) the knee joint with a band and then did the little session with the electro-stimulating thing. My unknown units number this time was 72–just a 5-unit increase from last time. I blame it on the fact that I had gone into the session having done about 40 minutes of my own electro-therapy about an hour prior. After that I did straight leg raises and then a knee-bending exercise with a foam roller below my knee. The PT was pleased with the straightening on both these exercises.

I then got off the bench and did a set of calf raises. These were pretty painful since they basically hit the bruises down the side of my leg. Apparently this exercise will get rid of the “standing up pain” if I do it regularly so I’ve put it on the docket. Next, it was over to the leg-press machine where I did a couple of sets of leg presses (both legs and single leg) and a set of calf raises. After that was done, I did a knee extension exercise with an elastic band where I basically bent the knee, straightened the knee and then lifted my ankle. After a set of about 30 of those, it was time to walk.

The PT said I was ready to walk with one crutch just on my right-hand. After fumbling around with the balance aspect of it, I was able to do 4 sets of cone walks (walking over 5 6″ cones back and forth equaling one set) with one crutch (no brace)! This was exciting because it now gives me a free hand to hold stuff. I can’t express how awesome it is to finally be able to hold something other than crutches. She recommended me wearing a brace if I was out in public but that I could do it without a brace at home.

Finally, there were a few more exercises with the elastic bands (quad extensions–I’ll touch on them in a later entry) and an exercise where I lay on my expanding belly and tried to bend my leg up backwards. It was hard. I had to use my right leg to do the bend for my left leg. After it was all said and done, I was at the PT for over an hour but I felt refreshed and not pained!

My mom and I went to H-E-B to pick up groceries after that, where all the standing took a toll and hence we cancelled a following stop at Target. I came back home and iced my knee for about an hour before taking a shower. It’s probably psychological, but the pain is slowly decreasing when I’m standing up. Or, rather, I’ve found that if I just go straight into walking instead of standing and waiting for the pain to engulf me, it only takes 2-3 steps for the pain to dissipate. I’m hoping for a good night’s sleep tonight and if I have pain, I filled a prescription for hydrocodone to help me through. I’m hoping I don’t need it, though, especially after talking with the PT about the “standing up pain” being expected.

I’m probably going to work from home again tomorrow just to be safe and so that I can spend my mom’s last day here with me. If the standing up pain decreases, I’ll consider going into work on Friday for a half-day or so.

Now, for the photos (not for the faint of heart)!!

If you felt like this entry was two-toned, you’re not hallucinating–it was. The first half was written before physical therapy and the second half after it. Before PT, I was very negative and kind of tired of the pain. After physical therapy, I felt refreshed and reenergized. I’m glad my recovery is unlike other accounts I’ve read where the physical therapy causes all sorts of pain. I, for one, am glad for the concretely measurable improvements I’m making and, of course, for the only exercise I’m getting.

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