Yesterday marked my 4-week anniversary of ACL surgery.

Recovery continues to go well. The improvements are less significant from day to day, and more noticeable from week to week. My PT consists of a lot of the same things I was doing before, but usually just a step higher. There’s a lot of core exercises mixed in there too- calf raises, leg press, squats, lunges, leg raises, pilates exercises, bridges, balancing on one leg and throwing a ball against the wall and catching it. I no longer have to go quad sets and straight leg raises. I ride my bike 5-6 days a week for over 30 minutes a day. I would ride longer except I get really bored. I think I’ll try to ride more like 45 minutes most days this week and try to dodge boredom by watching my Buffy the Vampire slayer DVD’s. I am still massaging scar tissue. My knee doesn’t get sore so much any more from being on my feet for long periods of time. Walking is becoming more and more natural and faster, although the ice still scares the crap out of me. My knee aches a bit, but sometimes it feels so good I forget that it’s hurt. The stiffness in it continues to get better and better.

My PT says I can maybe begin to ride outside in mid-May, 3 months after surgery. He says riding single track on a mtn bike may be possible at 5 months. But, he keeps following everything he says with, “if it’s okay with Dr. Beim”. I know when I spoke with her before surgery she was really adamant about not riding single track until 6 months. Now that surgery is over and recovery is going well, I’ll talk to her again. I have another follow up appointment with her on Tuesday.

My ROM is -2 (w/in 1 degree of my other leg) and 133. I’m getting better at walking down the stairs but it’s still tricky. Going up stairs is no problem. My PT still consists of most of the things mentioned a couple of posts ago, with some additions. I am now also doing some leg raises lying on my side and rotating the leg in circles in that position too. I’m also doing another pilates exercise, lying down, band around legs just above knees, feet together, raising my knee up. I did it all the time in ski conditioning so I’m familiar with it. It really strengthens the hips. Other than that I’m riding my bike more and more with more and more resistance. I’m working up to 30 minute sessions now. My PT guy basically said I can ride as much as I want (on my trainer) with as much resistance as I want as long as it doesn’t hurt or irritate my knee, or cause swelling. My swelling is going down more and more. Now, it’s more noticeable which areas are larger due to scar tissue, not just swelling.

The ibuprofen is causing my stomach to go haywire after taking it for awhile. So, I’ve decided I’m going off of it. I read on the Internet that something like 30% of long term NSAID users end up with stomach ulcers. I really don’t want that. It would really really suck if I had to give up chocolate during a time like this So, I’ve looked into it and I’m going to try some herbal anti-inflammatories. My chiropractor gave me something called EnFlux which has a concoction of Boswellia and turmeric among other things, known to be natural anti-inflammatories. I’ll try that. And of course, still icing regularly.

It’s over two weeks post-op now. The first week I had amazing progress. That progress has slowed, but that’s to be expected. My knee still keeps getting better and better. I’m largely off the crutches. I really only need them when it’s snowing outside. The swelling continues to go down and nearly all of the bruising has gone away. On Monday the doctor removed the surgical tape covering the incision points. There were some of the dissolvable stitches poking through, but they said they should go away or they will cut them out in a few weeks. My ROM is over 125 now. I’m doing lots of physical therapy both with my PT guy and at home. I’m able to ride my bike on a trainer now with a higher resistance now so I can actually get a good workout. My PT consists of some stretching, massaging my scar tissue at the incision points, moving my knee cap around, straight leg raises, quad sets (tightening my inner quad muscle), step-ups, balancing on one leg on a pillow, leg presses, squats, calf raises, some exercises with a pilates band, and core strength exercises. I spend at least a couple of hours a day working on my PT exercises.

Other than that, I’ve been very busy working. My work load has increased since being injured in February. I suppose that’s good. I would have had to turn some of these jobs down if I was still skiing. Might as well work a ton if I can’t ski!

The hardest part has been not being able to ski. April is my favorite month, when ski mountaineering usually peaks. Knowing that it’s right around the corner is hard for me to cope with. I will be going out of town for a week in April to visit my family in Ohio- trying to escape the April mountaineering scene. But, I can’t take more time than that off as I just have too much work to do. Hopefully the work will keep my mind off of these things!

I am doing great! Five days after surgery, I’m back doing my tutoring for the local HS kids here. My PT guy is weaning me off my crutches (started at my PT session this morning). My knee feels stable- quad firing just fine. And I haven’t been using a brace at all. My knee is still quite a bit swollen, but I have ice on it a lot- every hour or two. It helps that I have about 7 ice packs- some borrowed, some old, some purchased a couple of weeks ago. I’m also taking ibuprofen, but no other pain killers. My ROM is at 0 and 110. The pain is minimal and has been the whole time. In a couple of days I should be on the bike.

So, let me give a quick synopsis of the happenings over the last few days.

Wednesday- Day before surgery.
I tried to call the docs office like 5 times to pay over the phone with the credit card the amount I’m supposed to pay before surgery. I had been fighting this whole thing with the people at the doc’s office and they agreed to allow me to pay the day before surgery to see if more claims had been met against my deductible. I couldn’t reach the person I needed over and over. Finally, at like 4:30 I pretty much freaked out- because I was told I needed to pay the amount before the surgery, or I won’t be having the surgery. So, a nurse calls me back, finally. She says that they’ve had an emergency there- a pipe burst in the surgery room. So, they were relocating my surgery from the surgery center to the hospital- same time, same doc, different nurses and anesthesiologist. When I asked about payments, she says not to worry about it . I didn’t actually need to pay it. I was now told that since I will have a different anesthesiologist I could no longer drink water or eat past midnight, whereas the anesthesiologist I’d spoken to said I could eat before 6:30 am.

Thursday- Day of surgery.
I woke up, cleaned the house, and get things ready to be in a gimp state for a while. My surgery wasn’t scheduled until 2:30 and they told me to arrive at the hospital in Gunnison at 1 pm. Frank and I were going to do some grocery shopping in Gunnison before my surgery so we headed down early. On the way, the hospital called and asked if I could come in right away. So, I got there at 11:30 am instead of 1 pm. The nurse sucked at putting the IV in and my veins apparently suck for IV’s, not making a good combo. That was the most painful part of the whole experience- more painful than anything post surgery. I kept wondering when I was going to see the anesthesiologist so I could make sure that the plan I made with my other anesthesiologist was still on track- a spinal with a femoral block. He came in thinking I was going to do general anesthesia with a femoral block. I said, “No, I want a spinal.” But, apparently he didn’t do spinals with femoral blocks. So, spinal it was, only- well, on top of the sedative which made me really goofy. They wheeled me into the surgery room and Dr. Griggs (Beim’s assistant) showed my the allograft that was going into my knee. It was stringy and kind of looked like a really long piece of string cheese. I remember talking to the doctor and nurses off and on throughout the course of the surgery. I distinctly remember Dr Beim saying, “She has a bit of cartilage damage here.” And I freaked out and said, “Cartilage damage??” She had warned me prior to surgery that some cartilage damage could require microfracture treatment which meant 6 weeks non-weight-bearing post-op and I wasn’t really up for that. She replied back to me, “Oh, it’s nothing really. We’ll just scrape it out. It might be old. I’m not even sure you damaged it when you did your ACL. ” Next thing I know, I’m sitting in recovery, hair-net off, glasses on, talking to a nurse that’s friends with GB. I don’t really remember a whole lot in between, but I do know I was awake. I just don’t remember it! Dr. Griggs comes by and gives me these pictures from the scope.

Dr. Beim has a habit of bragging about how little time surgeries take her. I’m not sure if this is a good thing or a bad thing. But, she boasted a surgery time of 35 minutes. Recovery took much longer than anybody expected. The spinal didn’t want to wear off. So, I waited for about 3 hours. Finally, I was able to stand and crutch around enough to go sit in a car for 45 minutes and then make my way up 2 big flights of stairs to my apartment on the third floor. Never in my life have I have wished that there was an elevator more than right then.

I was hungry. I ate. I took some percoset. I felt fine. Then around 10 pm things went downhill. I started getting nauseous. I took and anti-nausea pill and that helped some, but not completely. On top of that I was having the worst muscle spasms I’d ever had in my life- in the calf and hamstring of my newly-built knee. The pain of the surgery wasn’t bothering me, but the muscles hurt like hell. So we called the doc. Dr. Griggs was on-call and said to take more percoset. So, I did. Which ended up in a major vomiting session around midnight. Two hours later I got up to go to the bathroom and nearly passed out because I was so dizzy from dehydration and lack of food. That night sucked. But, by morning I was feeling better.

Friday- Day after surgery.
I stopped taking pain killers, including ibuprofen. Decided I’d rather be in pain than puking, but the pain wasn’t terrible anyway. Went to my first PT in the early afternoon. He had me stretching my calf and hamstring, which ended my spasming muscles. He had me working on firing my inner quad muscle, which fired right away with no problems. After that, I pretty much slept most of the rest of the day, and night. I didn’t wake up until 10 am on Saturday.

Saturday and Sunday.
Began taking ibuprofen again. Things kept getting better and better. My knee was getting stronger, more stable, but still swollen. Took gauze off and took a bath. Baths are always so much appreciated after you can’t have one for a while! I still have sutures , covered with white tape. The white tape should fall off on it’s own, or they’ll take it off in a couple of weeks. I began tutoring students again and began getting around on my own. Driving was not a problem since I have an automatic and it is my left knee that is injured.

Monday
I had my second day of PT. He had me working on my normal strengthening of the quad, but he also began weaning me off of the crutches. I was balancing on one leg (injured leg) to get myself to trust it. Since I went so little time without putting much weight on that leg, I didn’t lose much muscle memory. Going off of the crutches will take me a little while though, especially on the stairs. My muscles in my knee really hurt when trying to pick up my leg more than a couple of inches.

All in all, I’m doing pretty well. I’m so happy the surgery is over. Now the real healing is beginning!

I am happy so far that I went with an allograft instead of a hamstring autograft. So far, this surgery is a lot easier and less painful than my patellar tendon graft ACL repair on my opposite knee done 12 years ago!

Well, today is my three week anniversary of tearing my ACL. I am scheduled to have surgery on Thursday March 12th.

My knee is feeling pretty good these days. I am walking without a brace or without crutches, even on ice and snow. I am still walking slowly, but more naturally than a week ago or so. I can ride my bike for up to an hour now with little to no pain. My range of motion is nearly 100%. I don’t feel the instability in my knee anymore, really. But, I do feel this kind of grinding or something catching on the left part of the inside of my knee. I only feel this when I lock my knee straight, and then release it. I don’t know if this is some meniscus damage or what. The doc said it might just be from the swelling. But, if this wasn’t here, my knee would be feeling pretty much normal, despite being without an ACL. I had my last pre-op PT appointment early this week on Tuesday. My PT guy was happy with my progress and says I’m ready for surgery.

And believe me, I am ready for surgery. I was ready like two weeks ago. It’s so mentally challenging to be on the mend and feeling pretty good about your progress only to have it taken away by surgery again. I’m healing now, but not for real…. because I don’t have any ACL yet. It’s kind of like a big tease.

I had my pre-op appointment with my doctor on Friday. Really, this appointment was completely unnecessary. I think it’s just one more way for the doc to make money. She just had me sign some forms about payment and risks and gave me some prescriptions to fill so I have them after the surgery. Basically, all of this could have been done the last time I met with her. We didn’t even talk about anesthesia options. She just said the anesthesiologist would call me before the surgery to discuss my options.

Something about surgery scares me. It always has. I don’t know why. But both times I have had surgery before (to repair my right knee ACL and my left thumb UCL) they had to give me something to calm me down because my blood pressure was so high because I was so nervous. I don’t know why I get so scared. I guess it’s because the surgery is completely out of my control and I’m basically throwing my life into the hands of these medical professionals. I know that the risks of surgery are relatively low compared to so many other things I do. But, it still just scares me.

The other thing I’m worried about is that the doctor will find more damage in my knee than we expected. I don’t know– maybe it’s because she spent so much time talking about it that it’s on my mind. She said that even with MRI’s and x-rays, we can’t see everything. So, my knee could still possibly have some meniscus or cartilage damage we are not aware of. The bad thing about this is that the recovery can be a lot more painful if she finds these. If she has to repair cartilage, I will have to be non-weight-bearing for about 6 weeks and then sleep every night with a machine that moves my leg back and forth. I am not really excited about that. There’s a good chance that she won’t find this extensive damage, but I won’t know until I wake up after surgery. The not knowing part also kind of drives me crazy.

I have been really busy these last couple of weeks. I have been tutoring more than ever, going to PT and doctors appointments, riding my bike (on a trainer), lifting weights (core and upper body), cooking, and trying to be as social as possible. I am so busy, I don’t know how I ever fit the skiing part in before!

At first I was really bummed about not being able to ski. I am still pretty bummed about it. But, the weather has been so warm these last few weeks that feet of snow have been melting. We haven’t had a lot of new snow. And a lot of ice has melted that was on our streets and sidewalks. Because the weather hasn’t been the best for skiing, it’s helping me miss it less.

At any rate, I’m coping pretty well. ACL injuries are so common in the skiing world, it’s just part of the sport really. And I just keep coming back to the realization that so many worse things could happen…. because it’s true. I should be back for skiing next season and by then, all of this will seem like a blur

Well, after a few threatening phone calls yesterday, the surgery scheduler from Dr. Beim’s office called me bright and early in the morning today. My surgery date is set for Thursday March 12.

It is a relief to have a surgery date. It’s such a mental game when you don’t know…. when it’s been over a week since I’ve seen the doc and still don’t have a surgery date. Setting the surgery date is another step in the healing process. Now I know when it is. I can schedule things around it. And now I know when the worst will be… the few days after the surgery. After that, the real healing can begin.

In the mean time, I was looking at some photos from the weekend that I got hurt, and I found this one. This photo was taken moments before my ACL decided to go kaput on me!

Today I had a meeting with Dr. Beim that really led to just more frustration. I had to wait over an hour just to see her- but she did make a special appointment for me in between surgeries, so I guess I have to expect that things will happen. Anyway, she took a look at my MRI, confirmed my ACL was gone and that I likely don’t have meniscus damage. She started going through the surgery options and techniques with me in huge detail. And I actually really liked that. I like knowing what’s going to happen and why. She went over the options (and downfalls) of what to do should she get in there and see a torn meniscus or cartilage…. explaining recovery with cartilage especially can be a real pain in the butt. She doesn’t think I’ll have these issues, but she wanted to warn me.

So, what’s the frustrating part? Well, she sat down and started asking me if the surgery scheduler had called me yet. I said, “No, and that’s been kind of frustrating.” I explained to her that I called on Thursday (which I was told to do after our appointment last Tuesday- to call if I hadn’t heard anything in a couple of days). That the people hadn’t even started the paperwork on getting surgery started for me yet. The receptionist told me Thursday that someone should call me Monday. Well, by 3:15 on Monday I hadn’t heard anything, so I called. “Oh, the scheduler is busy right now, but she’ll call you back later today.” Well, no call happened. I figured, “Well, that’s okay because I have an appointment with Dr. Beim Tuesday (today) so everything should be all set after that.” Anyway, Dr. Beim went to go check on things and came back with, “Well, they were waiting for approval from your insurance company (to have the surgery) and so that’s what was taking awhile. The scheduler is busy today, but she should call you tomorrow.”

I was so surprised… so caught off-guard… and so pissed I didn’t say anything. I was getting the run around AGAIN. I had called my insurance company. NO AUTHORIZATION WAS REQUIRED. I was told that multiple times by my insurance company. What have these people at this clinic been doing? What does it take to get a freaking surgery date? I saw her first LAST TUESDAY…. 8 days ago. And I still don’t have a surgery date. C’mon people!

When I got home and GB and friends saw me bawling my eyes out in frustration, calls were made. These people know that if they don’t call me back tomorrow, they’ve lost my business. I’ve already begun calling doctors on the Front Range.

Right now, I’m not really impressed with Dr. Beim’s staff. I probably won’t even bother recommending her to any one else. This has got me thinking that maybe I should just take my business elsewhere. Maybe I should go back to Dr. Sterrett at Steadman/Hawkins– he did the surgery on my right knee 12 years ago and it’s holding up great.

Anyone else have issues like this before? Ugh. So frustrating!!!!!

So, I’m officially geeking it out during my gimp phase. Yesterday I had an MRI. the doc wanted to just double check and make sure the injuries were as she suspected (torn ACL, but all the other ligaments okay) and see if she could check for meniscus damage. I’m feeling a lot of grinding in my knee, although it’s never painful. So, I’m suspecting I have at least a little meniscus damage. Anyway, I took a moment to pop in the CD from my MRI yesterday to check out the images. They’re pretty cool. I don’t really know how to read and MRI image (although in some cases, you can definitely pick out what’s what), but I thought I’d post some of them up here. This is a sampling of 6 images from over 500 to choose from!

Physically, I’m doing pretty well. Physical therapy is helping improve my strength and flexibility. I can almost get my knee completely straight, and I can bend it nearly as much as my other knee. I have been having trouble getting the inside quad muscle (VMO) to “fire”. When I had major patellar tendonitis in this knee several years back, this was also a problem, so it doesn’t surprise me. I am able to ride the bike (I have a trainer I set my road bike on), and I’m slowly increasing the resistance and time. I am basically off crutches, except for going down the stairs of my apartment building. Two big flights of stairs is a bit much for me to handle without crutches yet. I’m walking around inside without my brace- as my PT encouraged. I’m afraid to walk outside without a brace with all the ice and snow– but I was able to do so in Gunnison yesterday because they have cleared the sidewalks free of ice and snow.

Mentally, I’m hanging in there. I’m trying to keep busy and keep positive. It’s a constant mental battle. Sometimes I just want to cry because there were so many things I wanted to do this spring… and I’ll be missing them all. But, then I remember, that what I’m going through is not a big deal comparatively. So much worse things could happen. The hardest part for me is the social aspect. Skiing was my social life. Now I don’t have it and I feel so out of the loop.

At any rate, I’m hanging in there, and my knee is getting stronger and stronger and more and more ready for surgery. I have no surgery date set yet, but I should know more next week after I visit Dr. Beim on Tuesday.