Post Op – Days 59–67 (Sept 18 – Sept26)

I hit the two month post-op mark on Sept 22!  As the days go by, the progress is becoming less and less apparent while the issues that didn’t exist before are becoming more and more obvious.  In addition, I am not able to devote my time to therapy like I did before, be it due to work load or due to other factors.

The issues that are cropping up are scar tissue and numbness around the incision area; pain in the foot (became prominent after calf raises) and pain in the heel of the other foot (non-surgical leg – became prominent with performing hamstring curls on the surgical leg).

I am working on the scar tissue and trying to massage away the numbness – but, it is not a good feeling right now.  I just hope the numbness goes away – it is a weird pain.  The pain in my feet has limited the walking even though I am trying to walk every other day as much as I can. 

The physical therapy sessions are continuing at twice a week schedule.  Adding an exercise here and an exercise there.  The best part of the routine is the massage – I am only doing this therapy for that one reason – even though the exercises do help.  The walking is becoming normal, although I am very conscious of my gait.  Stiffness still persists when I get up in the morning and after long periods of work (sitting).  I am able to do a lot more things than before – many times not thinking too much about the knee. 

My next goal is to get some jogging/running into my schedule but that has to wait till November first week when I see my doctor.  Will post again in the next couple of weeks with pictures.

Post Op – Days 47–58 (Sept 6 – Sept 17)

Another two weeks go by as I hit my 8 weeks mark post surgery.  The routine continues – work and more work.  Two of the most hectic weeks I have had work-wise in the last few months.  On the rehab front, things have been progressing well.  The physical therapist added some hamstring and calf exercises.  Just can’t believe what a couple of weeks of inactivity can do to your leg.  The quads and the calf have really gone down and the strength one loses is incredible.  In any case, the calf became extremely sore for a few days.  However, in a couple of days after I started these hamstring and calf exercises, my gait dramatically improved. 

Just after the six week mark, the scar tissue was becoming more prominent.  The PT mentioned that the body starts to ‘lay’ the scar tissue around this time.  This was interesting to know.  He ‘dug’ into the scar tissue and massaged the heck out of it.  It was incredible to see that the scar tissue – more a ‘blob’ – just disappeared after that visit.  I started to massage the tissue perpendicular to the cut every day now.  The scar tissue related pain comes and goes. 

I also learned that the time between the six and nine week marks is critical.  I forget how I got this information, but I learned that the allograft basically loses all its strength (about 50% that is) around this period as the body begins to grow its own tissue/cells in the graft.  It will be another month or so before the graft starts to come back to life.  That I thought was quite interesting.  The swelling has subsided tremendously –though there are good days and bad days – and I can almost walk normally now. 

In the mean time, my physical therapy at home has gone down to once a day now.  Just not enough time to do it twice anymore.  I have been biking about 20mins followed by walking about 1.5miles a day – four to five times a week.  Schedule permitting, I would like to walk every day, but has not happened yet.  My typical physical therapy includes 20 mins biking (stationary); 30 mins walking (around the neighborhood); heel slides for 20 mins; work on hamstring for 10 mins; quad tightening - 30 of them - about 5 mins; 30 straight leg lifts with 5lb cuffs - about 10 mins; squats (no weight) 2-3 sets of 10 each for about 10 mins; hamstring raises (standing straight and flexing the knee as much as possible with 5 lb cuffs) for about 5 mins; steps for about 5 mins; calf raises for about 5 mins; for a total of about 2hrs.

The surgery is a dream now!  I can’t even start to imagine how smooth the whole process has been.  If this is normal, then, people should just do it and not look at other non-surgical options.  I may be over-simplifying this, but, I can unequivocally say that the two months prior to surgery were more painful and more discomforting than the two months post-op (except that time when I had to wear the brace at all times).

Post Op - Days 42-46 (Sept 1- Sept 5)

The big day – my second post-op doctor’s appointment – came and went on Thursday.  There was much anticipation which kinda fizzled out very quickly.  First, my wife takes me to the doctor’s office just in time and while in the waiting room, this woman walks in with the brace that I detest the most.  I make a small conversation and she indicated that this was her six week appointment as well.  I wondered aloud how she was able to wear it for that long.  She showed me some pads that she used to keep it comfortable.  I could see that I was doing much better than her in terms of walking – may be not using the brace helped my thigh muscles to become stronger!  So, I think if one can walk without the brace, one should try (of course, without rushing it) – just my opinion!

Then, I go inside and was itching to see the surgeon and when he did come in, checked the leg by moving it more gently than his usual baseball practice.  Said everything looks great and asked me how my ROM is.  I went all the way – very very close to normal (like the other leg) and he was a little taken aback.  He said it puts stress on the ACL and I should not push it – which was a bummer!  Then, he said I could drive which I knew already– just that my wife wanted that reassurance.  He said I could walk a mile on flat surfaces, do stationary biking about 10mins or so – I was already at 25mins and his comment was to be smart about this.  He also mentioned that the swelling comes and goes.  Here was a pep talk – in my words: 

When a professional athlete tears ACL, he/she is done for the season/year – it takes that long for the ACL surgery and rehab.  The surgery creates major trauma in the knee area and it takes a long time to heal.  One has to be smart and not push it.  The body takes a long time to accept the ligament and starts growing its own cells and tissue in this ligament.  In about a year, the ligament is as good as its own and histology shows that the ACL is no different from other ligaments –meaning the tissue is histologically similar to other tissues in the body, even though the ACL in my case came from an Allograft.

So, I am told that I have to take it easy and let the body heal itself.  I was asked to come back after two months and I need to continue my physical therapy twice a week and see how it goes.  All in all it was fine but knowing that “it’s like wet cement in there”, I still wasn’t too excited following this visit.  Now, I just need to take things slow and focus on other aspects of life – like work and kids schools which starts tomorrow!

Yesterday (Sunday), I went for a walk around the neighborhood (1.5miles) and it felt really good.  In fact, when I woke up this morning, the knee felt much better than other days – not as stiff.  However, I did notice that the swelling was a little more than usual.  I think I am feeling better by the day and I have to be extremely careful not to hurt myself as I am not conscious of my knee as much anymore.  Add to that, I am extremely busy with work and other matters.  Will keep my fingers crossed and hope the next few months go by fast.

Post Op - Days 34-41 (Wednesday - Wednesday)

Ok – I am getting behind on my blog updates which means I am getting busier elsewhere – where else but work.  Too much going on and it has put a lot of pressure on my schedule – very little time to think about my knee.  Add to this, the earthquake followed by hurricane Irene (which wasn’t too bad where we live); the construction work going on in the house; kids' school starting in a week; and there you have it - seems to be enough going around.

I try to exercise twice a day now – once, if I go to physical therapy.  Once a day, I have started to bike about 25mins (started at around 15mins and now I am at 25 mins) along with a bunch of exercises totaling almost 1.5hrs and the other time, I don’t bike but go for about an hour.  So, spending 2.5hrs/day has made it difficult to catch up with many things.  Add to that, I had to go to client site several times during this period which basically meant I am out the whole day.

You get the idea – I am slowly transitioning into my regular schedule!  The knee becomes sore when I bike and when I spend the whole day on my legs and away from home.  The interesting thing though is that I almost feel normal – the wounds have healed quite well except that the scars still remain – see below (taken yesterday):

I would say I am at 70%-80% in terms of walking and remind myself to be careful as my therapist made a comment that I look ‘way ahead of schedule’, however, it is like ‘wet cement in there’ and I should be careful.  Also, the swelling and the soreness constantly remind me that I am not there yet.  But, I am getting there slowly but surely.  The best thing is that my six weeks doctor appointment is scheduled for tomorrow.  So, I will try to update my blog after the appointment.  Few more weeks and I should be up and running (hopefully)!