Thursday, October 18, 2012

Knee Rehab Update #1


Warning: There are post-op pictures at the bottom of this post!  They're not gaping wounds or anything, but if you don't want to look at bloody steri-strips, don't! :) 
As many of you may know, I tore my ACL on my fourth throw at this summer’s Olympic Trials.  I decided to compete at the London Olympics anyway, and am very happy that I made that decision; it was my favorite Olympic Games so far, despite being the scariest thing I have ever done!  After that, I moved all of my belongings to Colorado Springs, Colorado, where Russ’s family is and where we will both take up residence in December at the Olympic Training Center there.  We hiked and camped and just enjoyed the absolutely gorgeous fall (see pictures here) for about a month.  I wore my custom DonJoy brace on all outdoor excursions! When I had appreciated all I could having a normally-functioning left leg (and worked very, very hard to have it ready for surgery with pre-hab), I returned to San Diego to undergo surgery by the very talented Dr. David Chao.  He works with the San Diego Chargers, and has operated on numerous other Chula Vista Olympic Training Center athletes, including Mike!

I couldn’t have chosen a better surgeon, procedure (there are many options), or recovery plan for myself in this process.  Dr. Chao was the man who read my MRI on July 6th and encouraged me to go to London anyway.  Chris and Quincy haven’t stopped their flow of positive helpfulness, Chris kicked my butt to get me in shape for London and for surgery, and Wendy continues to say exactly the right things to make me smile gratefully and hope for the future.  I will be in Chula Vista with this awesome support group of therapists and friends until after Thanksgiving, when I will officially move to Colorado and begin forming new relationships, the closest probably with a new athletic trainer!  I’m nervous about the change, and worry a little that I’ll be leaving behind the best situation for my healing knee, but I trust that things will work out.  I’m awesome at rehab, and I know that patience and hard work will prevail!
Now for some recovery details so far! 
After a lot of thought and research, I chose to get a bone-patella tendon-bone autograft ACL reconstruction from the ipsilateral knee.  This means that Dr. Chao removed the middle third of my left patella tendon along with bone chunks from my tibia and kneecap, drilled through my tibia and femur at the precise angle of the anterior cruciate ligament, and inserted those bone plugs into the holes he drilled.  The fact that this method lets bone heal to bone makes it the strongest option in ACL reconstruction.  If I were to have used a hamstring tendon instead, the soft tissue of the tendon would have to heal to the bone inside my knee.  The recovery is easier with a hamstring tendon graft, but some patients that use hamstring grafts permanently lose strength in the last part of contraction.  I wanted to heal as closely to my normal self as possible!  Allografts (cadaver tissue) can also be used in ACL reconstruction surgery, but patients in my age group see the largest failure rates with someone else's tissue.  To get my knee fixed and then tear it again would be devastating, and I wanted to give myself the best chance in avoiding that!  The forces that are put on my leg throwing the javelin versus in an athlete doing something else (like skiing) helped me decide that my best option was to use my left patella tendon.  I feel really good about the decision!

Russ was here taking care of me for the first week after surgery.  The poor guy had so much work to do! I had a drain from the surgery site that had to be emptied and measured periodically (gross), and pills to take every four and six hours.  I needed help getting on and off the couch and feeding myself, and he treated me wonderfully! Much to everyone’s disappointment, the pain medication I was on had no side effects except that it made me sleepy.  Ridiculously sleepy!  All I did for four days or so was sleep and drink water.  I had visitors (thank you Britney, Maggie and Jamie!), and I managed to leave the house to go to dinner at Ian and Stacy’s on about day 3.

For the first two weeks post-surgery, I laid on the couch hooked up to my CPM and cold therapy machines, doing various exercises every hour.  Russ and I watched three seasons of White Collar while he was here, and I blazed through four Game of Thrones books after he left. I've also started re-watching Friends. :)

I got to start physical therapy at the training center about three days after surgery!  The most horrible thing about therapy so far has been regaining the flexion in my knee.  I had never felt any pain like it.  Imagine that you hit your knee with a giant hammer 5 minutes ago, so it’s still aching like crazy.  Then imagine that someone set the skin on the front of your knee on fire, and that you are supposed to lie quietly and pretend like nothing is wrong.  Maybe you should even have a pleasant conversation with the person who started the fire, because you think that will help ease the weird, awful pain, but instead it encourages that person to increase said pain.  This necessary evil was the bane of my existence for the first week and a half or so of therapy, but I think that the reason it was so unbearable was because it was so new!  Once I grew accustomed to the sensation, I could tolerate it much better, and I was well ahead of the doctor’s goals for me at my two –week post-op appointment.

Things have gotten exciting in this third week!  I get to walk without a brace or crutches in the training room, and without crutches, but with the brace on in the house.  Today is supposed to be my first full weight-bearing day, and I feel great. I started doing upper body workouts again on Monday, and I’m beginning fall upper body training this coming Monday!  I’m very excited about all of the (seated) medball throws in my future.  I walked for 20 minutes yesterday on the AlterG, and am getting better and better at stepping over little hurdles.  I have a little more swelling still than I would like, but I promised myself that I would see this as a restful time, and I need to be patient.  Plus, Chris says that I’m ahead on all counts of 95% of the patients in lots of ACL protocols he has looked up, so I’m okay with a few setbacks if they happen.  I’m ahead of the game so far, but I’m trying not to pressure myself to stay there if I need to rest in order to heal properly.  It’s really fun knowing that I will have a sound knee again as long as I do what I’m told!

My Mom is coming to visit this weekend!  I’m very excited to see her and maybe have her help me clean the house, haha. It's tough to wield a vacuum without two stable legs!


Pictures:


One week post-op:




Two weeks: 




Three weeks:



Like I said, I still have more swelling than I'd like, but I tried the NormaTec today and acupuncture yesterday, and it seemed to help a lot.  Hopefully we're on to something!  Please let me know if you have questions. :)