July 27th - Recovery Day 10

I had my post operation appointment today. Dr Richmond told me that everything looked good! He showed me pictures of the inside of my knee which just looked like a 4 year olds finger painter to be honest - I didn't know what was going on. But he told me my range of motion was excellent and that I didn't need to use both crutches and the brace - he recommended the brace for everything except small distances

My range of motion is up to around 110 degrees today I think and pain isn't bad (6-7) so continuing to impress. I also went for a walk today - a little over a mile with just the brace and it felt great! 

July 26th - Recovery Day 8

Woke up in agony a few times during the night so had to stop the elevation and eventually take off the bandage - but it feels surprisingly good this morning - no problems getting up which is always good news! 

I've increased range of motion today too - just past about 90 degrees with a pain level of only about 6 so that's more good news! 

Really pleased with how things are going so far! 

July 25th - Recovery Day 7

One week since the operation and the recovery seems to be going to plan. I have about 90 degrees range of motion on my own and the full range of motion that the CPM offers (-10 to 120 degrees) when I'm using it. I had physio again this morning. I think I was a bit more prepared this time - I got the bus there and taxi back and I've been taking my Ibruprofen and Oxycodone every 4 hours (2 Oxy tablets) to try and stay ahead of the pain. 

The physio confirmed that the pain was just a reaction to the therapy and over-exertion and as she put it 'It's going to get worse before it gets better'. She said it looked like it was improving - the colour has faded a bit to be fair. It feels good today - I can bear nearly all my weight on it. She put me through the same routine today: Ultrasound, Laser and Stimulus. 

Around 4pm it started to get sore but now at 8pm the pain has eased off quite a bit. 

Rob Kramer showed me how I should bandage up my leg. He said the best way to do it was have it elevated and iced for a while and then bandage it - that way the blood is cooled and not flowing into the knee. Then starting down at my ankle wrap it around in crosses - essentially wrap up the leg, then in the same direction go back down, then go up further etc. The further you go up the looser the bandage should get. This also aids blood flow - he said you don't want it too tight around the knee, you don't want blood to get trapped there. So it should be tightest down near the ankle - but also not too tight that it restricts blood flow to the foot - swelling will occur if it's too tight. 

Here's an example of the bandaging:

You can see the crossing as the bandage goes up the leg. 

Today:

Range of motion in CPM: -10 - 120. Pain level: 3/10. 2 x 3 hour sessions

Range of motion on own: 5 - 90. Pain level 5/10. 4 x 45 min sessions

July 24th - Recovery Day 6

Most painful day yet!!! 

Was in agony today - couldn't even get up to go to the bathroom for most of the day. It wasn't too painful lying in bed - elevation was very aggravating and as soon as I stood up and the blood rushed down my leg the pain was unbearable. So I just pretty much stayed in bed all day and drank smoothies! I guess that's the importance of staying ahead of the pain with the painkillers. I'd really slacked off taking them. 

I'm presuming it's the physio work kicking in...along with the exercise I did on it yesterday - a lot of movement between going to the physio, cooking and hanging out playing poker with the lads. We'll take it easy for a few days and hope the pain subsides. 

Range of motion on CPM: 5 - 90 (in the am) -10 to 110 (in the pm). 2 x 3 hour sessions. Pain level: 6

Range of motion on own: 10 - 60, 5 - 75. 3 x 45 min sessions. Pain level: 8

July 23rd - Recovery Day 5

I went to the physio this morning. His name is Robert Kramer. He said I was doing very well in terms of ROM and swelling. I was able to walk without crutches this morning, although I try and use them as much as possible. He introduced me to one of the girls there - Lena, who worked on me. First she gave me laser treatment - this is primarily to remove bad blood cells and regenerate new ones as far as I understood. Next was ultrasound which heats the inside of my leg and promotes healing. Again trying to remove the bad stuff which slows down the healing process. Finally there was electronic muscle stimulus which gets the muscles working around the knee. 

I walked home from the physio - a little over half a mile. I used both crutches but still bore a lot of weight on my leg. It felt really good. I hit a wall around 4.30 in terms of energy so went to sleep for a few hours. I woke after a couple in pain - I took my leg down from being elevated and it's a little better. It's quite painful now though - going playing poker with the lads - I'll try and keep it as elevated as possible but it's quite painful! Some drugs should do the trick! 

July 22nd - Recovery Day 4

July 20th - Recovery Day 2

July 19th - Recovery Day 1

The incision was covered with steri-strips. A small plaster covered that and then there were 2 coverings of bandage underneath the outer ACE bandage. 

 

 Luckily there was minimal bleeding so everything was quite clean when I took it off for the first time. I just put back on the plaster and ACE bandage after cleaning the wound. 

 

I didn't sleep well last night - it was more out of the uncomfort of having my leg raised up in the air than actual pain. In fact I've had very little pain except when doing my exercises. I was given the following exercises to perform 3-5 times daily: 

 

  

 

 

 

 

1. Ankle Pumps:  With your legs straight, bend your feet toward your face and then point your feet away from your face. Repeat 10 times.

 

This one was relatively straight forward and painless

 2. Quad Sets: Lie on your back with your legs straight. Tighten the top of your thighs by pressing the back of your knees into the bed. Hold the contraction for a count of 5. Relax and repeat 10 times

This was a little tougher. With the swelling and the fact that I can't get to 0 degrees of my own accord it seemed like my leg wasn't moving on this exercise. 

3. Straight Leg Raise: Lie flat on your back with your operated knee straight. Bend your opposite leg so that your foot is flat on the bed. Keep your leg straight while raising it 6 to 18 inches in the air. Lower gently and repeat 10 times.

This was the toughest exercise today. 

4. Tighten Glute muscles: Lie on your back with your legs straight.  Tighten your glute muscles and lift your hips off the floor slightly. Hold the contraction for a count of 5. Relax and repeat 10 times.

And this the easiest. 

Range of motion in CPM: 0 - 48. Pain level: 3/10

Range of motion on own: 10 - 40. Pain level 7/10

July 18th - The Big Day!

My appointment was changed from 12pm to 9am so I had to get up a few hours earlier this morning. After getting home at 3am after going to the midnight showing of Batman I wasn't in the liveliest of moods. But my spirits were good. I wasn't allowed eat for 18 hours before surgery either so I was starving all morning. I got in to the New England Baptist Hospital at about 7.45 and was immediately brought upstairs to me temporary room. Nurse after nurse came in along with Dr. Richmond and the head anesthesiologist. One of the nurses set up an intravenous on my right wrist and another shaved my knee to be operated on. Dr. Richmond came in and signed my knee for surgery.

I was informed by everyone of the procedure and I was brought to the OR around 9am. The (cute) anesthesiologist there gave me a shot to relax (although I didn't really need anything) and I when I got into the OR I was moved from my bed to a narrow operating table. I was quickly given a mask with pure oxygen and a shot to put me under. Next thing I knew I was waking up and moving back from the operating table to my bed with a bandage and brace on my leg - I felt relieved I had indicated the right leg to operate on ;-)

They took keep me up near the OR for a couple of hours where I was struggling to stay awake and around 1pm they brought me back to my room. I watched TV and rested for a while and all the nurses came in to care for me with some drinks and biscuits. I was allowed leave at 4pm. My mother and brother arrived later that night and I got a few hours in the CPM machine. I felt very little pain - I had been given a local anesthetic so I had been told that the pain wouldn't kick in until the middle of the night or the next day. They told me to stay on top of my meds to prevent pain as much as possible - shouldn't be too hard.

 

Range of motion in CPM: 0 - 40

Pain level: 3/10    

                      

Range of motion on own: N/A

Pain level: N/A

July 7th - Pre-Op Appointment

Photos taking after my pre-op appointment. Although not clearly noticeable my right knee is still quite swollen. Sexy legs eh!?

I went in for a pre-op appointment on Monday 7th July. I immediately knew I was in good hands when I saw the big poster above the main doors which read. 'Welcome to the New England Baptist Hospital. The Official Team hospital of the World Champion Boston Celtics'. I have a rigorous checkup during which the nurse asked me how I hurt my knee - she guessed soccer. I on When I confirmed that it was she asked me was I playing professionally.
Either she was just teasing or this was a very good hospital. I concluded the latter, possibly just to comfort myself that extra bit. She told me I was perfectly healthy and that I would have some blood taken and I'd be good to go home. I was shocked she thought I was perfectly healthy - especially after the spending July 4th weekend drunk in Long Beach with a bunch of Irish college students out for the summer! But...I wasn't complaining. I was actually now looking forward to the operation. I figured it was the real starting point for my recuperation.

July 7th - Physio Appointment

I set up an appointment with what seemed to be the closest Physio to my house, Kramer Physical Therapy Associates. After getting over the initial shock of all the staff speaking in Russian, Robert Kramer came and greeted me - he was not Russian, or at least he didn't seem Russian. It was a professional place and the equipment was to a very high standard. We talked over the injury and my pre-hab. He agreed that it was very good and very important and I strengthen my leg as much as possible before surgery without going overboard. Assisted one leg squats, cycling etc would all benefit me in the long run. And it will be a long run...

He also showed me the underwater treadmill that he had - can't wait to get into that! It assists you in that it puts very little pressure on your knee but helps to mobilize it quickly. I was happy leaving and would push my knee between now and the surgery.

June 26th - Appointment with Dr. Richmond

I was told to bring my MRI and Medical card to the appointment with my surgeon - what did I bring...only my medical card!! Not too bright this one! But he didn't mind - Dr. John Richmond came in and introduced himself - he searched for my MRI online but no luck and we discussed the operation to ensure I knew what I was in for. He told me much of what Dr. Ritter has mentioned about my future ability with and without surgery - the purpose of the ACL - and the 'cutting' sports possibilities.


Once he was sure I was opting for surgery we discussed methods. He mentioned the main three methods - the patella tendon for the top of my knee, the hamstring graft and donor tissue. He said he did all three quite regularly but in my case he would recommend the hamstring graft or the patella tendon. I told him I had issues with my hamstrings - my left more than my right but he was still wary since it was my right knee that it could weaken my hamstring more and he was happy to go with the patella tendon. I was too as I had read that although it would obviously weaken your patella tendon (they take the middle third of it which becomes your new ACL) it can actually be stronger than your natural ACL afterwards. For all methods success rates i.e. getting back to previous levels of performance, was between 90 and 95%.


He finally gave me a rehab sheet which outlined the progress I should be making on a daily basis for the first 28 days and thereafter on a weekly basis. It was quite detailed. It generally the norm for the knee to be inflamed, bruised and swollen after an ACL tear so the surgeons like 4-6 weeks between the injury happening and the operation. This is for a number of reasons but a main one is leaving the knee recover before 'ripping it apart'. I was in a good place considering I could play tennis (badly) without too much pain. Therefore he suggested I see a physio and get some exercises in before the operation - pre-hab as I called it!

June 3rd - MRI results

I went back into St. E's today for an appointment with Dr. Ritter. He sat me down and told me that I had a complete tear of my ACL, torn medial meniscus and two tears on my lateral meniscus - I thought he was joking at first...but no smile crossed his face so I quickly realised I was in trouble. I quickly decided to have surgery when he mentioned that I wouldn't be able to do any 'cutting' sports again if I didn't. I asked him what sports fell into the 'cutting' category. When he mentioned soccer, skiing, tennis and basketball my mind was immediately made up. He asked me where I'd like to have the operation - I said the best place there is so he signed me up for the NE Baptist Hospital in Boston to be operated on by Dr. John Richmond. I later found out that this was the official hospital of the Boston Celtics and according to one person I talked to - the best Orthopaedic hospital in THE WORLD!!

I wouldn't have needed surgery if I just tore the meniscus. But I would have them repaired if possible when I go in for surgery on the ACL.

May 28th - MRI

I went into St. E's in Brighton today for an MRI. Pretty straight forward - no metallic items of any sort and all possessions were removed from me beforehand. It took about 20 minutes - you know the big 'tunnel' machine you see in the movies that you get slid into - it's one of those. It's loud so they gave me earplugs and it felt pretty weird as I couldn't move at all for 20 minutes. But it was pretty painless in the end. My knee felt good today - a small bit of pain and a small limp but I felt I was on the road to recovery!

May 22nd - First Doctor's Appointment

I met with John Ritter today - 12 days since the injury and I was still on crutches and wearing the brace. He examined me and said it'd be best to go for an MRI as I had some bruising in the x-ray but no broken bones. He set one up for the 28th of May. He told me to only use the crutches and brace if I felt I needed to. I didn't. It was pretty much the last time I would wear the brace and use crutches until the operation. I even got in some basketball and tennis before the news that my ACL was torn. Not bad eh!

May 10th - Knee Injury

On May 10th while playing at centre back (out of position mind!) for Kendall Wanderers I went down after a challenge on another player with what Paul 'Your man for the wall' Garvey only could describe as Snap, Crackle and Pop sounds coming from my knee. After being lifted off the pitch my knee began to swell with what I thought was just a minor lateral ligament sprain - a ligament I had hurt a few months previous snowboarding. It was about 15 mins into the first half so I waited until the game was over to go to the ER - I had a rather important party to attend so the ER was just to pick up a pair of crutches to get the sympathy vote from some cute B.C. girls. About 3 hours later, after an x-ray, some painkillers and a crazy man in the next bed shouting abuse at the nurses for an hour I was released with a brace and crutches. A follow-up was set up with Dr. John Ritter for the 22nd. I never made it to the party!