Friday, February 23, 2018
I'm sorry I totally screwed up with keeping up with my knee surgery journal and blog. My knee healed up really well, and today years later it doesn't even feel like I've had surgery as a matter of fact my knee is better than a knee I had that I was born with I can do anything I want although I don't jump up and down a lot or do a lot of side-to-side movement because that's not good for a half knee replacement.
Thursday, December 5, 2013
How to Stay Fit Before Knee Surgery.. Prevent and Repair Muscle Atrophy
Hello! it's me, Lisa. I want to talk about what happened to my muscles before and after my knee surgeries, and what I did to stay fit through it all...
When I fell last March I was in pretty good shape as I was swimming twice a week, and hiking, but with my knee completely blown out I couldn't even walk! I had to use crutches and some of the time I was in a wheel chair. My muscles started to atrophy right away, and my left leg muscles got a lot smaller. I am just over two months post surgery number 2, and I can walk great! I only used crutches after last surgery (partial knee replacement) for about three weeks! Then a cane for a week or so.. You can avoid a lengthy time on crutches or wheel chair bound if you work hard before and after surgery. Many people just lay around waiting, but DONT DO THAT!!! Even though you are in pain, there is a lot you can do...
I just want you to know that you also MUST keep as active as possible before surgery! I lost a lot of muscle mass.. You will have muscle wasting just like me, even if you do stay active. You just cannot do enough with the injured leg to prevent it... and the muscles hat atrophy and decline will make your leg very weak, plus you lose muscle "memory". That is, after the injury, and after surgery too, you may not be ABLE to get your hamstring or thigh muscles to even move! You have to do special movements to bring them back. Like squeezing a small rubber ball between your legs... I also bought a reclining excersize bike which I used twice to four times a day prior to surgery and after surgery starting at about ten days (stitches need healing time). I like the bike because I put it in front of my tv..lol So I could veg out AND work out at the same time.... I thought they were really expensive, but I got one for under $150 and its really neat! Here is link if you wanna click and see what I got, click HERE. It's hard to do much with gravity on your leg, but this bike let me lean back and no weight on my bad knee..
I also got some hand weights that helped me keep my arms in shape... these sets are inexpensive and worked great for me! CLICK HERE TO SEE.
My Physical Therapist said that it can take up to a whole year to rebuild the muscle I lost!!!! But the good news is, that you can rebuild muscle at any age!
Like I said in my last post, I used the Arctic Ice electric pump with it's nifty wrap to ice my knee all day on one ice fill-up CLICK HERE to SEE What it is . I used it on and off all day. It was awesome because I couldn't walk, so my husband would fill it up before he took off for work in the morning. It stayed ice cold all day which was SOOOO much easier than trying to get back and forth from the freezer! I still use it after working out most every day!
Listen to your doctor! Mine wanted me to lose weight before surgery.. Seriously? How do you do that while mostly lying around with your knee packed in ice? Well, you got to eat LOTS of veggies! I ate baby carrots, celery, and cut up brocolli and cauliflower... I dipped the latter in a little fat free ranch dressing because I am not a big raw veggie eater. I ate a lot of veggie and other clear broth soups. I had fruit, like apples, bananas, and grapes. These were what I snacked on all day long. For meals I had lean meat and stayed away from white rice, pasta and pizza... (all my favorites). I just told everyone NOT to bring me junk! but i snuck in a candy bar every now and then, but i really enjoyed the healthy snacks I ate and lot's of protein for healing!. Sinc I don't drink alcohol so that was not giving me empty calories (plus its just a very bad idea if you are on pain meds).
e I was alone and couldn't cook most days, I liked all the healthy snacks that I had delivered right to my door..CLICK HERE to see lot's of great healthy snack choices! They are sent right to you! I LOVE Technology!
I d id stretches every day in bed, and sitting up... It took about ten minutes twice a day... I had to do them in bed until a few weeks ago when I could finally do them on the floor ..
Massage your scars a lot!! they need to be really broken up and it will feel like a tearing sensation, stings! but it's ok!!! Keep putting lotion on them too.. I used: BEST HEALING CREAM! Click HERE to see
Walk as soon as you can and keep on walking! Go to all your PT appointments and DO THE WORK AT HOME!!! It will take many months to recoup your strength so go easy!!! PLEASE don't overdo it and reinjure yourself..ACL takes about 6 months or more, and partial knee replacement takes around 5 months for everything to knit up nice and tight..
When I fell last March I was in pretty good shape as I was swimming twice a week, and hiking, but with my knee completely blown out I couldn't even walk! I had to use crutches and some of the time I was in a wheel chair. My muscles started to atrophy right away, and my left leg muscles got a lot smaller. I am just over two months post surgery number 2, and I can walk great! I only used crutches after last surgery (partial knee replacement) for about three weeks! Then a cane for a week or so.. You can avoid a lengthy time on crutches or wheel chair bound if you work hard before and after surgery. Many people just lay around waiting, but DONT DO THAT!!! Even though you are in pain, there is a lot you can do...
I just want you to know that you also MUST keep as active as possible before surgery! I lost a lot of muscle mass.. You will have muscle wasting just like me, even if you do stay active. You just cannot do enough with the injured leg to prevent it... and the muscles hat atrophy and decline will make your leg very weak, plus you lose muscle "memory". That is, after the injury, and after surgery too, you may not be ABLE to get your hamstring or thigh muscles to even move! You have to do special movements to bring them back. Like squeezing a small rubber ball between your legs... I also bought a reclining excersize bike which I used twice to four times a day prior to surgery and after surgery starting at about ten days (stitches need healing time). I like the bike because I put it in front of my tv..lol So I could veg out AND work out at the same time.... I thought they were really expensive, but I got one for under $150 and its really neat! Here is link if you wanna click and see what I got, click HERE. It's hard to do much with gravity on your leg, but this bike let me lean back and no weight on my bad knee..
I also got some hand weights that helped me keep my arms in shape... these sets are inexpensive and worked great for me! CLICK HERE TO SEE.
My Physical Therapist said that it can take up to a whole year to rebuild the muscle I lost!!!! But the good news is, that you can rebuild muscle at any age!
Like I said in my last post, I used the Arctic Ice electric pump with it's nifty wrap to ice my knee all day on one ice fill-up CLICK HERE to SEE What it is . I used it on and off all day. It was awesome because I couldn't walk, so my husband would fill it up before he took off for work in the morning. It stayed ice cold all day which was SOOOO much easier than trying to get back and forth from the freezer! I still use it after working out most every day!
Listen to your doctor! Mine wanted me to lose weight before surgery.. Seriously? How do you do that while mostly lying around with your knee packed in ice? Well, you got to eat LOTS of veggies! I ate baby carrots, celery, and cut up brocolli and cauliflower... I dipped the latter in a little fat free ranch dressing because I am not a big raw veggie eater. I ate a lot of veggie and other clear broth soups. I had fruit, like apples, bananas, and grapes. These were what I snacked on all day long. For meals I had lean meat and stayed away from white rice, pasta and pizza... (all my favorites). I just told everyone NOT to bring me junk! but i snuck in a candy bar every now and then, but i really enjoyed the healthy snacks I ate and lot's of protein for healing!. Sinc I don't drink alcohol so that was not giving me empty calories (plus its just a very bad idea if you are on pain meds).
I d id stretches every day in bed, and sitting up... It took about ten minutes twice a day... I had to do them in bed until a few weeks ago when I could finally do them on the floor ..
Massage your scars a lot!! they need to be really broken up and it will feel like a tearing sensation, stings! but it's ok!!! Keep putting lotion on them too.. I used: BEST HEALING CREAM! Click HERE to see
Walk as soon as you can and keep on walking! Go to all your PT appointments and DO THE WORK AT HOME!!! It will take many months to recoup your strength so go easy!!! PLEASE don't overdo it and reinjure yourself..ACL takes about 6 months or more, and partial knee replacement takes around 5 months for everything to knit up nice and tight..
Tuesday, December 3, 2013
I recovered fully! Blew out ACL, tore meniscus and broke femur!
On March 13, 2013 I stepped backward on a stage riser and fell right off the side.. I fell about 3 feet and my entire body weight came down on my left leg.. The impact basically blew out my whole knee, destroyed ACL, shredded Meniscus, and broke the tip off my femur. Like taking a plastic drinking straw and hitting one end on the table..you know how it blows out the middle? Yes, like that!! except it didn't break the skin as it sort of "imploded"..Anyway, It was the WORST PAIN I HAVE EVER EXPERIENCED!!! Blinding White Light exploded in my Head, and it's a good thing nobody else was in the theater, because I know I probably screamed bloody murder! I writhed on the floor a while till I managed to get a grip, and breathe. Then I waited for someone to come in, about 5 minutes only, thank goodness, and when they did come in I called out.. rescued at last!
My xRays didn't show the bone break, because they took it from the outside angle, and the break was on the medial (in) side. That wasn't discovered until I had the ACL replacement surgery.
My MRI showed the ACL was completely gone! I had another injury the year before, but my ACL appeared normal at that time, so they could easily tell that my fall caused it to tear away completely.. (yes, it hurt like God Himself struck me with a sledge hammer)
ICE will become your BEST FRIEND! I am not a fan of strong pain meds, as they make it hard for me to concentrate, read, write, etc. So I used ice a lot! I have a Polar Care unit which is Awesome! You put ice and water in it, and plug it in. There is a pad that wraps around your knee and the ice water circulates through it for hours! You can leave it on for 30 minutes, take it off, then put it back on all day long on one fill of ice.. I HIGHLY recommend you get one. They have them on Amazon.com . Here is a link so you can check them out, Polar-Care-Therapy-Large-Combo at Amazon.com This unit will make it so much easier to keep your knee iced, and you won't have to keep getting more ice, which is hard on crutches! I LOVE mine, and still use it after exercise nearly every day!
I finally had ACL surgery on May 9th,
almost 2 months later. That is about how long they have to wait to let the knee calm down.
There are different options for ACL replacement. They can use Donor Tissue, or your own using either your Patellar Tendon, or part of your Hamstring Muscle. After considering all the options, I went for the Hamstring Muscle and I am very glad I did!
Here is a little info about each choice:
1) The patellar tendon bone-tendon-bone (BTB) graft has been the "gold standard" graft choice for ACL reconstructions since it was popularized in the mid-1980's. It has been used extensively by surgeons since that time and still remains the graft of choice for a high number of orthopaedists who perform this surgery regularly. The patellar tendon BTB graft has consistently demonstrated excellent surgical outcomes with a 90-95% success rate in terms of returning to pre-injury level of sports.
** The reason I didnt go with this option is because a lot of people cannot be on their knees after this surgery. It messes with your comfort in kneeling for a big percentage of people, and I didn't want to lose that ability. I like to kneel for many reasons, and just didn't want to take that risk..**
The "gold standard" graft isn't perfect, however. There may be more pain associated with this donor site than from any of the other graft choices, particularly compared to the hamstring tendons. As a result there is sometimes a greater initial atrophy or wasting response of the quadriceps muscle compared to say either a hamstring or cadaver allograft. This can require more prolonged physical therapy to recover from and could possibly delay the initial return to sports.
The incision (scar) is bigger, and almost all patients end up with a permanent loss of sensation 2-3" in size just lateral to the incision. There is a risk of patellar tendon ruptures, as well as fracturing the patella both intraoperatively as well as postoperatively, although bone grafting the defect in the patella at the time of surgery has reduced the incidence of the latter. Patients who kneel a lot for a living are often unhappy with the patellar tenderness and sensitivity that can occur at the incision site and should probably consider an alternative graft choice.
The incision (scar) is bigger, and almost all patients end up with a permanent loss of sensation 2-3" in size just lateral to the incision. There is a risk of patellar tendon ruptures, as well as fracturing the patella both intraoperatively as well as postoperatively, although bone grafting the defect in the patella at the time of surgery has reduced the incidence of the latter. Patients who kneel a lot for a living are often unhappy with the patellar tenderness and sensitivity that can occur at the incision site and should probably consider an alternative graft choice.
2) Allograft (donor Tissue):
Advantages: Performing ACL surgery using allograft allows for decreased operative time, no need to remove other tissue to use for the graft, smaller incisions, and less post-operative pain. Furthermore, if the graft were to fail, revision surgery could be performed using either the patellar tendon or hamstring grafts.
Disadvantages: Historically, these grafts were of poor quality and carried a significant risk of disease transmission. More recently, techniques of allograft preparation have improved dramatically, and these concerns are less of an issue. However, the process of graft preparation (freeze-drying), kills the living cells, and decreases the strength of the tissue.
Young, athletic patients who have surgery to repair a torn ACL in their knee could eventually need another procedure if tissue from a cadaver is used during the reconstruction.Study results presented today at the 2008 American Orthopaedic Society for Sports Medicine's Annual Meeting in Orlando, Fla., have found that ACL reconstructions that use cadaver tissue fail in 23% of patients younger than 40.
** I'm over 50, but I am very active and these statistics were just too high for me! The strength of allograft tissue is less than the other grafts, but the strength of both the patellar tendon and hamstring tendon grafts exceed the strength of a normal ACL!!!! The bottom line is 85% to 95% of patients will have clinically stable knees following ACL reconstructive surgery.
3) Hamstring Tendon: The hamstring muscles are the group of muscles on the back of your thigh. When the hamstring tendons are used in ACL surgery, two of the tendons of these muscles are removed, and "bundled" together to create a new ACL. Over the years, methods of fixing these grafts into place have improved.
3) Hamstring Tendon: The hamstring muscles are the group of muscles on the back of your thigh. When the hamstring tendons are used in ACL surgery, two of the tendons of these muscles are removed, and "bundled" together to create a new ACL. Over the years, methods of fixing these grafts into place have improved.
Advantages: The most common problem following ACL surgery using the patellar tendon is pain over the front of the knee. Some of this pain is known to be due to the graft and bone that is removed. This is not a problem when using the hamstring tendon. The incision to obtain the graft is smaller, and the pain both in the immediate post-operative period, and down the road, is thought to be less.
So, after looking at the facts, and there is plenty of info on line, I decided that the longer healing time was worth the final outcome of a stronger ACL and more comfort too. I also read that the Hamstring will "naturalise" into an ACL that is basically the same as the tissue it replaced after about 8 months!
Disadvantages: The primary problem with these grafts is the fixation of the graft in the bone tunnels. When the patellar tendon is used, the bone ends heal to the bone tunnels ("bone to bone" healing). With the hamstring grafts, a longer period of time is necessary for the graft to become rigid. Therefore, people with hamstring grafts are often protected for a longer period of time while the graft heals into place.
So, after looking at the facts, and there is plenty of info on line, I decided that the longer healing time was worth the final outcome of a stronger ACL and more comfort too. I also read that the Hamstring will "naturalise" into an ACL that is basically the same as the tissue it replaced after about 8 months!
I am now six months out from my ACL surgery, and it feels great!
**However, I also had a partial knee replacement because of the broken femur 3 months after the ACL surgery, Setember 16, 2013, just 9 weeks ago! But I feel great and am walking normally! At six weeks after second surgery I was walking without cane, and even my surgeon said he couldn't tell which knee was hurt!
My new ACL is awesome! I used to feel my knee slip when hiking down hill.. I'm still taking it slow, of course, but it feels rock solid! I'm really pleased!
What is my secret to super fast healing? That polar pack device, lot's and lot's of stretching and exercise, including swimming 4 times a week, and getting off pain meds three days out of the hospital. I know that sounds difficult, but the pain was really ok, for BOTH surgeries with Ibuprofen and my Polar Care Pump: Click here to check it out! Polar-Care-Therapy-That Helped Me Heal FAST!
My Muscles still cramp a bit after a harder workout, but I just keep stretching well and using my Polar care afterward for about 20 minutes in the evening..
Good luck to you in this journey.. I actually got a new appreciation for my body and my whole life from the time I spent in a wheelchair, on cructhes, using a cane, and in Physical Therapy.
Ask a lot of questions! and don't let aomeone else make your choice for you. Just because he or she is a doctor, doesn't mean you do not have a choice in what type of ACL replacement you get. If your doctor isn't eager to talk about your options, then get a second opinion!
We have a "for profit" orthopedic surgery center here in Eugene, Oregon and I actually left when the first doctor wouldn't answer my questions! I got a GREAT surgeon who isn't associated with that clinic, and it made all the difference in the World!
All my best to you! Lisa M (lisanagain)
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