Day 14 Post PCL Reconstruction - Patience is NOT Working for Me

Two week out and I am feeling pretty good. My only complaint is that I developed a slight allergic reaction to the beta-dine used during surgery. From my knee down I have a rash and my leg feels like its on fire.

A Lot has happened in the past 10 days, so I thought I would breakdown the major milestones.

Day 5 PPR (Post PCL Reconstruction): Took my first post op shower. This was the first day I started feeling human again.

Day 6 PPR: Returned to work. While I held up pretty well, I learned that one should not communicate via e-mail while under the influence of pain killers.

Day 8 PPR: Drove for the first (I stopped taking my narco pain meds 24 hours prior). Stitches were removed and replace by Steri-strips. Made it home safely from the OS office and promptly returned to taking pain meds.

Day 9 PPR: Went to Jiu Jitsu promotions and to my surprised was promoted.

Day 10 PPR: 100% off all pain meds.

Day 11 PPR: Was able to help the woman take our son to and from school. Driving is no longer painful.

This past Monday I started to push my workout routine and have started making significant progress with regards to rehab. Today I walked, using my crutches, for half a mile. I am performing the following workout 4 days per week (M, T, T, F):

ISO Knee Extension - 2 sets of 10 reps/Body Weight
ISO Hip Adduction - 2 sets of 10 reps/Body Weight
Resist Hip flx Supine - 2 sets of 10 reps/Body Weight
Gravity Hip abd - 2 sets of 10 reps/Body Weight
Assisted ROM (Range of Motion) - 2 sets of 10 reps/Body Weight
Single Legged Squat (Good Leg) - 2 sets of 10 reps/Body Weight
Toe Touch Walk

I will be headed back to Jiu Jitsu tomorrow to try some drilling...Hopefully this is not going to be a bad decision.

“Today I will do what others won't, so tomorrow I can accomplish what others can't”
― Jerry Rice

Day 4 Post PCL Reconstruction

Today was my first follow up appointment post operation. I got to see my knee for the first time since the morning of my surgery. I still have a pretty good amount of swelling, seven puncture wounds, and a moderate amount of bruising. Overall the knee looks better than expected. I am also ahead of schedule from a recovery perspective. I have been able to reduce my pain med intake to one percocet every six hours and I am able to perform some basic exercises from my original physical therapy plan. I am hoping that this is a sign that all the pre-surgery PT and knee prep is going to pay off.

It turns out that I had a new PCL reconstruction technique performed on me. In fact I am the first person my doctor used this technique on. Here are some links about the procedure used on me, hopefully somebody will find the information useful:

Surgical Technique Brochure

Surgical Animation

So far I am happy with my current progress. I go back on Friday to get my stitches removed.

Third Times a Charm

I was scheduled to have my PCL reconstruction done on February 4th and as some of you may have noticed, nothing was ever posted. Well, I had my surgery cancelled because I had a real bad flu and they don’t like sick people at the hospital. After I got better my surgery was rescheduled for Feb 28th, I didn’t post anything because I didn’t want to jinx the new surgery date and have to do another reschedule. The good news is that yesterday the reconstruction was performed and I am now resting at home. I am still recovering from anesthesia, so while what I type makes sense to me...it may not make sense to you.

Yesterday, my day started at 0400(4:00AM). Actually the previous day never really ended because I got almost no sleep due to nerves. I would suggest to anybody having any surgery to ask for valium to take the night before so you can sleep. My surgery was schedule to start at 0715(7:15AM) so I had to be at the hospital at 0600 to get going on all the pre-op stuff. Everything went very smooth, with the exception of my blood pressure(nerves), and everybody was ready for a two and a half hour long surgery. I walked into the operating room, the anesthesiologist starts doing his thing, and the last thing I remember is the gas mask.

So I start waking up and as my mind is getting recombobulated I asked, “What time is it?” and my wife who just sat down next to me says its 1315(1:15PM). Even with a major amount of anesthesia fog I realized surgery went a tad long…like double. At this point I am having an internal panic attack wondering WTF happened. I asked the nurse what happened during surgery and my wife was able to tell me that my surgeon was performing a new allograph technique and did not take that into account from a timing perspective. I spoke to my OS later in the day and found out his assistant didn’t know this new allograph technique which essentially made the entire surgery single threaded. Outside from that minor timing hiccup, my surgery went very smooth. I got home by 1445(2:45PM) and have been resting as much as I can.

Pain hasn’t been a major issue so far. When I was in recovery I was pretty sore, but now I would say I am at 4 on a scale of 1-10. I do know pain is on the way, the local anesthetic is starting to wear off and I am hoping I can manage with the meds I was given. Currently my pain management routine is as follows:

• 2 Percocet every 4 hours
• 800mg of Advil staggered 2 hours after the Percocet.

I am icing A LOT. I was given a cryo cuff and I am basically icing 30 minutes on/30 minutes off.

 

Here are the final surgery stats:

•  5.5 Hours.
•  Complete PCL replacement using a donor Achilles tendon.

Lessons learned:

1.  Ask for valium so you can sleep the night before.
2.  Surgery time estimates are just that, an estimate.
3.  Stay on top of icing and pain management
4.  If using a Cryo Cuff, get a couple of ice bags from the local stop and rob to augment your ice maker.

T Minus Two Weeks

Surprise!!! I was originally supposed to have surgery in two days (January 23, 2013) however my insurance will not cover the allograft if I have my PCL reconstructed at the surgery center I was originally scheduled to use. In order to keep my out of pocket expenses to a minimum I reschedule the surgery to February 4th and will have it done across the street at the hospital proper.

So I had my pre op appointment today and all systems are go. The woman came to the appointment so she could get my post-operative care instructions (Translation, she came because the handouts given to me by the doctor would most likely never make it out of my truck). Here is my tip of the day.…You know PCL reconstruction surgery is the correct option when the assistant surgeon says “Oh Wow!” and the woman cringes just before hiding her eyes during the tibia push/pull test.

So how did I get to this point?

On September 14, 2012 I was training with my Brazilian Jiu Jitsu instructor, prepping for a competition that was being held in October 2012. This was the first roll (BJJ term for sparring match) of the evening. At the very beginning of the roll my instructor performed a sweep, which I have had performed against me hundreds of times, and when I landed on the mat after countering I felt a pretty good “sting” in my left knee. The sensation I felt was uncomfortable but it did not have me writhing in pain. I continued rolling, BUT I had limited use of my left leg. At the end of the roll my instructor and I both heard my knee “pop,” but again the sensation was more of discomfort and not debilitating pain. I took a break and then continued to roll the rest of the evening, working around my sore knee.

The next day at 3:00AM I woke up with severe pain in my left knee, I could not walk. At the suggestion of my wife I went over to urgent care where the doctor gave me a generic knee immobilizer, crutches, and sent me home with some pain meds. He told me to make an appointment with my sports medicine doctor for follow up. At this point I am thinking, ok this probably isn’t too bad and I should be back working out in a week or two.

A few days after my urgent care visit, I had my consultation with my normal doctor who specializes in sports medicine. My doc and I talked about how the injury occurred, he then had me lie on my back and bend my knee while he sat on my foot and push/pulled my shin. He then uttered the following words, “You tore your PCL.” My first question was, “what the hell is a PCL?” Now for
those of you reading this blog for educational purposes the following is a definition of a PCL:

http://www.webmd.com/fitness-exercise/posterior-cruciate-ligament-injury

My definition of a PCL is a lot more vulgar and since I want to keep this blog rated PG, I will not post my personal definition.

When my doctor told me I had torn my PCL I, my initial thought was that he hit the crack pipe pretty hard that morning. Seriously, I thought I should be in a lot more pain. When he ordered up an MRI, I figured I would play along and prove my doctor wrong.

On September 25, 2012 I went in for my MRI and later that day I received a phone call from my doctor’s office. At this point I am thinking to myself, quick turnaround equals negative on the MRI. Well it turns out my doctor was not smoking crack after all…I had a high-grade partial tear of the posterior cruciate ligament (Grade 3 tear). Next stop orthopedic surgeon where the news kept on getting better.

On October 26, 2012 I go to my orthopedic surgeon’s office and at this point I had done a ton of research and been a good little monkey by following doctor’s orders and staying off the knee. My OS had the chance to review my MRI and well it turns out I really messed things up. In addition to my PCL tear, I had separated my meniscus, sprained my ACL, tore a bit of my MCL, and ruptured a tendon. My OS’ biggest concern was the meniscus and MCL. He told me how NFL players would often tear their PCL and not require surgery, so he wanted to see if physical therapy would stabilize the knee. We decided to take a conservative approach and try to avoid surgery. I would stay on crutches for three more weeks and start light PT.

Three weeks passed and it seemed like the pain from the meniscus and MCL was getting better, but I still had greater than 10MM of movement between my femur and tibia. My OS and I decided to take physical therapy to the next level, but we realized this was going to be a last ditch effort. Up to this point I was doing my own PT three times a week. I was now scheduled for formal PT and in four weeks if I still had 10MM of play in my knee my OS and I would discuss surgery.

The following Monday I started with formal PT. It really sucks when the most basic of moves will bring a tear to your eye. Looking for reassurance I started to talk to my therapist about how NFL players will often tear their PCL and not require surgery. It was at this point I had my “Incurable Shitty Ankle” experience. My Therapist looks me dead in the eye and said, “NFL players have thighs the size of tree trunks, you don’t.” For reference please view the following video its 2:19 in.

http://www.youtube.com/watch?v=ey4WSb-BVDQ

About half way through my 5 weeks of physical therapy I took a small jaunt to Disneyland where my knee did not hold up at all. Upon my return home I was also attacked by my son’s potty stool (those things are lethal). It should be noted that “attacked by potty stool” is officially in my medical records now. Anyways after Disneyland and the potty stool incident, my therapist and I switched from rehabilitation mode to strengthening the knee for surgery. At the end of December my OS, PT, and I came to the conclusion that surgery would be needed.

Since finishing up formal physical therapy I have been working diligently on strengthening my knee in preparation for surgery. My therapist and I are hoping that going in strong will lessen my rehab time on the backend.

Introductions

I created this blog for a couple of reasons. The first reason was due to a lack of information on PCL injuries and the second really was to keep a journal of my recovery post PCL reconstruction. I was inspired to write this after reading information from two PCL blogs and all the comments associated with them. My hope is that this blog will also be able to help others get through their PCL injuries/recoveries. I would encourage you to read the following blogs:

http://skinnygurl-mypclsurgeryandrecovery.blogspot.com/

http://pclrupture.blogspot.com/

I guess introductions are in order…My name is Jon, I am 39 years old and I live a very active life. When I am not chasing around my four year old son I practice Brazilian Jiu Jitsu, run, lift weights, scuba dive, and play guitar. While playing guitar is not a strenuous activity, getting into and maintaining the appropriate rock guitarist stance requires healthy knees. All joking aside, the point I am trying to make is that my life has been disrupted because I tore my PCL. I am looking forward to the months ahead with both excitement and apprehension. My PCL reconstruction surgery is scheduled for January 23, 2013.