The snowHeads ACL rehab club !

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Scarpa, A good plan for sure !

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AndAnotherThing.., as SS says these next few days are the worse - you might be asking yourself was it really worth it - going to the loo etc was the hardest thing!

I found using some really baggy cargo style shorts to be really useful as I could then put all I needed into the pockets when I was hobbling round the house, and take them off easily.

I think the worst part for me was a week or so post op when I had some really intense pain around the bottom of my shin, so bad I nearly took myself to the Doctor, but after some Googling found out that it was fluids and blood from the swelling that had run down (via gravity) into the bottom of my leg, damn painful when standing up, getting out of bed.

The other Godsend was using the Cyro Cuff three times a day to reduce the swelling, very effective piece of kit and worth the money (see ebay).

Two or three weeks post op my hamstring, or area where a piece was taken from starting cramping / twinging so bad once or twice that I thought something had come undone - I found I became a wee bit paranoid about screws coming undone and bit's pulling out of place as it were Puzzled

Bear up and try and keep motivated - and the plus point above all else is that you've not got a good stretch of time in front of you to get strong again!

Well, the person's real but it's just a made up name, see?

Weathercam, Cheers. I guess the problem is I don't know what's 'normal' and to be honest it's a 'tad' worse than I expected ! I'm sure this is due to the swelling. I'm using ice through the day and have staggered my ibuprofen / paracetamol allocation and that seems to be keeping the pain a bit more manageable.

Roll on the first physio appointment next Friday.

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Is that the only pain killers you have? I was prescribed morphine as well saying that I had to stop taking it as it made me feel very sick

Anyway, snowHeads is much more fun if you do.

I was given some prescription pills for the pain (or swelling or both) on discharge from hospital, though can't remember what they were exactly.....

Just re read my blog and this is what I said.........

That first night's sleep was good and I was not in too much discomfort. The next day I was surprised at how mobile I was and I even made it to the pub in the evening. The weekend also saw me out and about as well!

In terms of pain I was only taking two coadamol twice a day and the anti inflammatories, after four days I'm weaning myself of them, though will carry on with the anti inflammatories as the swelling is still quite severe.

Pretty well from as soon as being on crutches I've been able to put all my weight through the bad leg, and have managed to hobble around ok. I am surprised how mobile I am, maybe over doing it at the weekend as the swelling is still quite intense - so need to work at that to get it down.

It was probably being on my feet a lot initially and maybe not elevating that resulted in my server swelling problems a week on, or that was just going to happen anyway, who knows, think there are no hard fast rules for everyone and each individual will have different experiences etc

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I've wondered if the lack of 'hard' pain killers is deliberate to stop me moving around so much. Actually not to bad when upright and can weight bear reasonably ok, only using 1 crutch, and can move slowly without it. My main concern is the swelling is restricting the amount of flex I have, but I'm doing my best to keep it moving, but it bloody hurts!

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AndAnotherThing.., really feel for you - I too didn't think the pain would be as bad as it was / is - and the worst of the bruising / swelling is still a week away - sorry - but like I said earlier maybe that was just me - anyway nothing a few extra paracetamol and ibuprofen can't sort out.

Do not put too much hope in your first physio session, don't expect any "Lazarus" type recovery - especially as, which is likely as it is only a week after your op, you'll still have a lot of swelling.

I should be out cycling rather than on the laptop but the weather is so dire out there - think might have to go on the turbo for a spin.

After all it is free

AndAnotherThing.., I'm back home now so Skype me when you want to! The pain is so intense due to the bone drilling more than anything but it tones down fast. Beware of the blood rush pain when you get up from the bed/sofa. It is perfectly normal but it was the one thing that had me crying more than anything else. Going to the loo was agony and I actively avoided drinking anything to make sure I did not have to get up too often. That was a bad move because I became dehydrated. In the end I accepted that it would hurt, cried when I could not take it then focused on getting back to my bed/sofa.
Remember that the nights will always seem to be worse, but it really is only because there is nothing else going on to distract you.

BTW for my last revision surgery, I was on a morphine pump with the feed directly into my femoral nerve - I still had the blood rush pain and the bone pain broke through the drugs frequently in the first 3 days. I resorted to the extra push button most often when I was in the bathroom I think. high as a kite on the "porcelain throne"!!!!

Keep monitoring using the pain scale of 0 (I have no pain) to 10 (WTF, amputate please!!). I think I averaged around 7/8 the first couple of days apart from when I went to the loo when it was off the scale. Then it scaled back to about a 4/5, again except for the blood rush pain. By about the 6th day I was OK and getting more and more mobile and was discharged from hospital to rehab at home. That put the pain levels back up again because I was non-weight bearing due to the LCL repair. As I live on my own in a first-floor flat, it was too much looking after myself, so I got my sister to come out here to look after me for the 6 weeks I was not allowed to put any weight through the repaired knee.

Let things settle down a bit and expect to have a wee bit more pain before it starts to reduce. I really do know what you are going through, so you have my sympathy. Take care

Crikey, someone PM Miranda and RachelQ and tell them not to open this thread for a bit. Sounds exruciating!!!!!!!!!!!!!!!!!!!! Skullie

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Pedantica, Much better this afternoon wink

Trying to be good !

snowHeads are a friendly bunch.

AndAnotherThing.., good. Have a nice glass of something...

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Pedantica, I'll ask my Nurse wink

I'm sort of doubting it will be allowed unless it's water ! Still, as I'm not on proper narcotics it's hard to say no.

To proper narcotics.... Just Say No!!!

http://youtube.com/v/jCLs0jv_Efk

You need to be on gear to sit through this Laughing

You know it makes sense.

Scarpa,

Otherwise you'll just go on seeing the one name:

A snowHead

miranda, Many said that about the EOSB thread too Laughing

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Time I joined the thread! I posted in January which is when I injured my ACL and have been playing the NHS game ever since. I injured mine the day before I came home (last ski down, thankfully!). Well, I didn't ski down! I had the fun of being brought on a blood wagon. My bill, which included xrays and a support, was 550Euros, but my insurance paid within 2 weeks of me claiming.

When I got home I went to my local GP surgery, just asking where I could get crutches, and they sent me to get them from a physio in the next town. He suggested I went to A&E and get into the system which I did. I got referred to orthopaedics and on my second appointment there the consultant referred me for an MRI. I decided to speed this up by getting it privately, £350 at a clinic in Milton Keynes which is purely an imaging centre, no treatment done there.

I then brought forward my next consultant appointment but only saw his registrar and he didn't have the scan and radiographers report on my file (which I later found out was because it was sat on consultant's secretary's desk in the unopened post whilst she was on holiday). I had been given a copy of the scan at the imaging centre but hadn't yet got the report, so I had a copy of the scan with me. The registrar happily sat and looked at the scan and told me my ligaments were intact and looked strong, but that I may have small tear in some cartilage. The next day I received the radiographers report which said the exact opposite, report a complete rupture of my ACL, and all cartilage good.

I sent a faxed complaint to the complaints dept. at the hospital who said they couldn't comment until my consultant came back off holiday, and after a few shirty faxes back and forwards they eventually said I should just go to my next appointment with my consultant and take my issues up with him.

In the meantime I got myself an appointment with a consultant at a private hospital, and I was completely up front telling him of the NHS issue and that I just wanted a second opinion and not to have private treatment. He had nothing to gain or lose when telling me that he agreed with the report, based on physical examination (you can still see my knee moves about massively when manipulated compared to my other knee) and he also explained the scan to us in detail, which was really interesting.

I then had my next appointment with the NHS consultant who, not knowing I had seen someone privately, said I should continue with physio and he hoped I would make a good recovery without surgery. When I showed him the report from the private consultant, he said they different opinions and it was up to me to choose who I went with. He also defended his registrar for giving a completely bullsh*t opinion saying that 'he did the best he could under the circumstances, I wouldn't have been happy if he hadn't been able to give me any opinion would I' Er yes, the truth would have been preferable to utter boll*cks! He also revealed at this appointment that he doesn't do knee surgery and would refer me to someone else at some point anyway if he felt surgery was necessary.

The best thing I did was see the private consultant because he is at a hospital which I know takes referrals under the NHS 'choose and book' scheme, and at the end of my appointment with him he said he would be happy to see me under referral from my GP. Clearly I couldn't put much trust in the original NHS consultant so I went back to my GP and got referred to the other one at the private hospital under NHS.

I saw him last week and he confirmed what he first said which is that, maybe i'd be ok skiing with a brace, maybe i'd be able to get back to running but not guaranteed, and he definitely thought I wouldn't ice dance without the op. So i've got a date in 5 weeks time!

All through this procedure its been clear that before surgery I need to get as big a range of movement as possible, and build my muscles in my injured leg, and i've been working on this. Another point to note is that very soon after my injury I started to see a personal trainer (who had helped me in the past with my lower back disc injuries) and she, as usual, has been great in pushing me. I also saw a private physio to start with, and then eventually got a referral on the NHS to a physio. The NHS physio, bless her, was about 19 and clearly straight out of college. She printed out some standard exercises, way below the level I was doing at home and with my PT even though I had told her what I was already doing. I went twice, but the second time she just didn't up the game to the level I was already at, so I haven't been back.

That's the story so far.

Any tips on getting my leg to bend further are welcome. Its still painful when I try to bend it too far. At the moment I'm laying on my front on the floor and pulling the leg towards my butt with a resistance tube, on a daily basis. I can just about get it bent enough to reach my toes with my hand, but the other leg bends enough to touch my butt (no I don't have a big butt!).

I'd also be interested to know what people think about how soon I'll be able to drive after the op? I only work 1 mile from home and want to be able to drive myself there asap, and also drive myself to my PT about 20 mins away.

And the obvious question, skiing?! Our group booked for January 2013 and I put my deposit in just a couple of weeks ago, but the consultant says 9 months til I can ski. Any advances on this anyone?

Any tips on strengthening my leg. I'm doing step ups (whilst cleaning my teeth!), one leg wall squats, one leg squats. Also weekly I'm doing one full body workout with PT, one fully body workout at home, three cardio workouts (crosstrainer and uphill walking on the treadmill with handweights), and one pilates/yoga class. Anything else specific to the injured leg, as its not as strong as my other one?

Thanks guys,

Deb

Well, the person's real but it's just a made up name, see?

debbiem, Glad you got the appointment in the end.

It sounds like you are already well on the way with 'pre-hab' - I did maybe 6 weeks worth from injury to op. My physio (Sports Injury specialist) was very keen on gaining full leg extension and that's a recurring theme for the immediate post op. The test is to sit on the floor, legs straight, and see if you can press the back of your knee into the floor. Tightening your quads may see your heel lift off the ground too. I also worked on getting at much flex back as possible but didn't quite manage to be able to sit on my heels as I could before.

Other than that, lots of proprioception stuff, 1 legged stuff, eyes closed, balance boards etc. After that it's building quads and hamstrings.

Driving wise, they say 2 weeks in my documents, less if it's your left leg and have an auto.

Assuming I can get in my car (I'll need a lot of flex) I'd have thought I'll be OK to drive in 2 weeks for sure. (This is day 3 post op.)

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I was signed off work for 6 weeks and was given the all clear to drive after about 4 if my memory serves. It was my left leg and it was my other leg I think It would have been longer. I was back to hockey training 6monthd after the op I could run but my leg still felt flat ie no bounce while running compared to the other, I must admit I wouldn't have been comfortable skiing that soon I was targettinh 9 months but then shortly after returning to hockey I found out I was pregnant and got told by my gp that I shouldn't ski or play hockey while pregnant so it was a long while after I actualy skiied again.

Full extension is the most important to regain my then bend I regained wasn't as good as my other leg but was deemed acceptable.

Don't be surprised if even with all your weights work and training if you still see visible muscle loss that I was told by my consultant is a classic symptom of the injury

Anyway, snowHeads is much more fun if you do.

debbiem, good that you have it sorted............

I too had a similar problem with physio on the NHS (post op) and kicked that into touch pretty quickly, really was a case of dotting the i's and crossing the t's with inane printouts of exercises and the like.

I had a long wait before my Op (NHS) as it was put back a few times which resulted in nearly three months delay - in that time I was cycling a lot, 100ml plus on some rides with a lot of vertical.

Re driving post op - I drove just over a week after the Op - automatic, though think I drove the manual pretty soon as well.

I had the op beginning of Sept and was skiing in March, prior to going out did a half marathon cross country over the Downs in really foul conditions. I skied in a brace and was fine in pretty well all conditions apart from off piste heavy snow (similar to what did my ACL) and soon as I encountered that confidence went and I went straight into the back seat, that I think is going to be my nemesis Sad

And post Op with all the exercise and strengthening I've been doing (did 110km on the bike today & nigh on 900ms vertical) as NickyJ, mentioned I reckon I'm still seeing visible muscle loss which is something I just can't work out why.

debbiem, so it does sound like you're working hard, and hopefully putting the effort in now will help in the long run.

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miranda, Hope you op goes OK today (??)

My 1 Week Update:

In the end I had a straight ACL reconstruction, and the surgeon reported no damage to the meniscus etc. The first day was pretty uncomfortable, mostly due to the amount of swelling. It's hard to move your leg with what must have been a 1/2 litre of fluid transforming it into a football !

However, a week in the swelling is much reduced and muscle tone is visible when I tense my quads. I'm happily walking up stairs on the 'bad' leg and have ditched crutches except for first thing in the morning. I'm able to walk 50m or so to garden pond and back again, but I'm not sure of I would like to do much more than that for now. According to the physio's protractor I've 95^ of flex. She also 'suggested' not to be using the bad leg on the stairs - at least if we are going to follow the surgeons rehab protocol. Embarassed

My approach in the 1st week has been -
Ice (Frozen Pea's, asda 2kg packs seem best) 20 mins per hour.
Leg elevated on the sofa & on pillows at night.
Minimal walking
Using my trips up the stairs as an opportunity to try and lift\flex the bad leg (after day 3 or 4).

I've kept off my feet as much as possible, and focused on trying to keep the blood moving (Ankle flexing\pumping) and getting\keeping full extension, so Quad tensing while trying to flatten leg. In terms of regaining flex, I've tended to build it into everyday activities, using gravity to help it flex getting out of bed in the early days, and thinking about how my feet are positioned when sitting down so that I can gently increase the flex.

I've just cased the follow up appointment with the surgeon as it hadn't come through and that's scheduled for Wednesday afternoon.

Other than that the next objective is to get to the shops to stock on on Ibuprofen and Paracetamol as my prescription is about to run out. The buying restrictions are going to be a pain !!

Overall so far so good and each day has seen improvement.

Then you can post your own questions or snow reports...

Me and hubby went in to tescos and both bought max on pain killers them hubby went back in Again got some more and bought those from a different till. It is such a faff isn't it.

Edit to say this is in response to an earlier post about overnight or not I got a bit confused by how the iPod touch displayed the thread: My consultant always did them with an overnight and the reason was due to his experience of having had An ACL reconstruction himself. For me that was a really good thing as at the time I had private health care that only kicked in if what I needed involved and overnight stay so it meant I had it done privately and a lot quicker as a result.

After all it is free

That's all sounding good, I'm really appreciating the info as I only have 4.5 weeks to go, and I'm getting an idea of what I'm in for!

AndAnotherThing.., all sounds good - but please, and also to others going under the knife, it's your knee, and you want the best for it, so don't scrimp on the Rehab.

I've used ice packs / peas etc over many years and this thing is sooooooooooooooo much better!

It get's behind the knee, below the knee and generally all around whilst also adding a degree of compression.

http://www.physioroom.com/product/Aircast_Knee_Cryo_Cuff_with_Cooler/2272/35982.html

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Weathercam, Nice, trouble is I spent the money on ski's !

A little cheaper than I thought it would be though.

snowHeads are a friendly bunch.

AndAnotherThing.., glad to hear that things are coming along. Hope you continue to make progress. I would say that if you have no problems with ibuprofen then other anti-inflammatories may be more effective.

I saw the surgeon on Tuesday and my knee is still quite swollen. I have to continue with physio and go back in August. He is quite prepared to operate if I want/need and so I have a lot to think about. Keep us up to date with your progress.

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ianmacd, Cheers. Hope you get the swelling sorted soon so you can move forward Happy

Hello, not long since I had the op so thought I'd post whilst the going was good and could do a positive one! I have to say I think AndAnotherThing.. has been quietly very brave about his experience as I could not imagine being packed off home after the op with just some paracetamol! I have had so many drugs of so many different sorts over the last 24 hours. I don't know if this is private care of if it's just French care but I have decided to forgo any ideas of having a British stiff upper lip and just go with it!

I was given a pill to "relax" 2 hours before the op, then something in my leg from the anesthetist (but things were very hazy by this point so I can't remember what he was saying), then I have a flashback memory of the the anesthetist asking me if I was ready to have "des reves merveilleux" and then putting a mask over my face, a vague memory of coming round in the 'salle de reveil' and saying my leg hurt a bit and asking if that was normal and them saying yes and giving me some morphine, then coming round again a bit later and getting some more morphine, then getting moved back to my room a few hours later and getting more morphine and then hourly visits throughout the night for bp checks, temperature checks, to get the ice on my knee changed and... yes, more morphine. Am now at home with some codeine.

To be honest, I think I would have felt extremely nervous going home on my own and not really knowing what was going on and how much I should let it hurt particularly as I find it really difficult to sleep on my back and so was waking up a lot during the night quite apart from the regular check ups. The French are no doubt a bit OTT with the drugs but I'm also getting a nurse coming to my home every day for the next two weeks to give anti clot injections, the physio coming here on Friday and meeting the surgeon on Monday, so they are keeping a good eye on me. Currently, I do recommend getting treated in a country of hypochondriacs.

Weathercam, I did get one of those cuffs on your advice in the end as they do look really good, although as it happens the hospital have sent me home with an Ice Band brace which is made of fabric which two latticed ice packs slide into to cover the whole area back and front of the knee. We decided to get the cuff because we have so many sports people staying in the chalet and have a training escapes running camp here this summer as well as all the skiers, cyclists, mountain bikers and hikers etc. so thought it was a worthwhile investment for us and our guests as you can get various attachments for ankles, elbows and so on. However, if anyone is looking for a cheaper option for personal use then this Ice Band brace is very effective and convenient, covering all the affected area and lasting a decent length of time.

You know it makes sense.

miranda, Glad to hear you are home safe and sound Happy

Hope the physio goes OK.

I feel cheated that I didn't get morphine & codine wink

Otherwise you'll just go on seeing the one name:

With the price you paid, AndAnotherThing.. I'm sure you're very happy really! With all the meds and the crutches etc, this is going to end up costing about 3000 euros. Our doctor seems to think we will be able to claim some of this back from the Caisse but it's a private hospital so certainly things like having your own room and the surgeon's personal fees of € 400 won't be coming back. We are counting on not getting anything back and so it's a bonus if we do. I have a lot of faith in the NHS and wouldn't normally go private, but we had some money put aside for a holiday which we wouldn't have been able to take because of my knee anyway, so we paid to have the opportunity to time the operation when it suited us and to have it France so I didn't have to travel afterwards to come back for the summer season. Still, it was quite nice coming round in the early hours of the morning to this view (though mobile phone shot doesn't really do it justice) and I do recommend the Clinique Generale in Annecy.

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miranda, so glad to hear you're home. Love this bit -

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miranda, Wimp - couple of aspirin is all you really need. wink

Personal advice make sure you're moving as much as you can or get anti coagulants. Blood clots ain't fun.

Well, the person's real but it's just a made up name, see?

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Pedantica, fatbob, yes, I am home now, enjoying the pills and having just had my first home visit from the nurse for the anti coagulant injection - she'll be here every day for the next few weeks... plus I have those lovely anti-blood clot stockings. The pharmacist encouraged me to pick out the tan ones because they were "plus jolie" than the clear ones Laughing

I don't think "jolie" is any way an appropriate choice of words.

AndAnotherThing..,... the pub. It'll be a while for me yet, but that's something to look forward to!

Pedantica, will be thinking of you too. It's great to know you're in the hands of the best.

Anyway, snowHeads is much more fun if you do.

miranda, you sound bright and positive and I'm sure that's not just down to all that morphine Very Happy

Very impressed that you have a nurse coming for your daily anti-coag injections - our fit patients have a teaching session before discharge! We could have offered you teal coloured stockings though Toofy Grin

Good luck and take each day as it comes, no doubt there will be days when you are frustrated.

Lx

oh and re "des reves merveilleux"......did you?! wink

Pedantica, I seem to have missed that you are on the same path? Good luck for whenever...... Very Happy

AndAnotherThing.., all sounds good

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marmotte16, thanks!

Then you can post your own questions or snow reports...

marmotte16, thank you - very glad not to have to self administer injections! Claire gave me some good advice about eating and drinking before the cut off time as I wasn't that bothered about it - and then I ended up going 9 hours pre op without eating or drinking and was hungry afterwards whilst only being allowed a yoghurt and some pomme compote so I was glad to keep being knocked out to distract me from my hunger! So far, so really not too bad... and that's after another fairly sleepless night. The regular waking up is probably no bad thing - as long as it doesn't go on too long - as it means I am keeping the ice in my brace fresh and taking pills as and when I can throughout the night. I was expecting to feel a bit of a come down off the drugs as I remember feeling really bleak after a general anesthetic to have some wisdom teeth out when I was 17 - maybe that was just me being a moody teenager though! I have no doubt you're right, though, and there'll be some tears and frustration at some point along the line but after the talk of bone-drilling agony above, I'm mostly feeling relieved right now! I am staying on the prescription drugs for a while and will not be weaning myself off them and onto OTC strength at least until after seeing the surgeon on Monday and seeing what he says - I have no intention of being brave! But they're not as heavy duty as morphine and I'm really not in agonizing pain.

I probably did have some very weird and wonderful dreams in that operating room....

but thankfully I have very little memory of much about the whole hospital experience!

PS - to anyone thinking about the ice cuff/brace thing - this is what the hospital have given me http://www.vivomed.co.uk/CH1000_9245/Ice_Band_Knee_Brace.html

at this stage (whilst I still have a bandage and have to wear compression tights) it is more convenient and comfortable than the cyro cuff and obviously much cheaper. As I say, if I was just going to get something for my personal use then I would get this.

After all it is free

miranda, you are doing well Very Happy

Claire is back at work this week, so good to see her. (Not sure how long I should leave it before I mention the S word, probably autumn Toofy Grin

)

marmotte16, LOL... I remember as a teenager taking the syringe from the doctor and doing my own tetanus injection into my thigh muscle... that one hurt a bit but I didn't like other people doing injections for me.

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Scarpa, I think it's all to do with the suspense Toofy Grin

I have had horrendous migraines (thankfully few and far between now) when I have happily injected my own intramuscular anti-emetic which is a longish needle. However, I hate injecting my migraine drug which is pre-loaded in an automatic syringe - just have to press the button and hold but it really hurts so dilly dally a bit even though I feel extremely ill.
But, no one reading this should worry about anti-coag injections. Very straightforward and little needle Very Happy

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