On Writing, Tech, and Other Loquacities

The collected works of Lana Brindley: writer, speaker, blogger

OMG my ACL! Two weeks post-op update

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Well, here we are, two weeks out from surgery! There’s a lot to go through here, so I’ve broken it up a bit.

Day of surgery

The day went pretty smoothly, I had a quick coffee before 7am, and was fasting from then on. I headed over to the hospital at 10 and checked myself in. First thing was to change into a gorgeous hospital gown, with a compression stocking on my good leg, and delightful paper knickers and booties. You’ll forgive me for failing to instagram this, I hope!

From there, I had a consultation with a nurse to do my paperwork to check me in, the anaesthetist came to run me through what was going to happen, and the drugs I would have to take home with me, and I also had a quick chat to the pharmacist to go through the medication I was on already and whether or not I needed to change anything (I didn’t, so that was easy).

After all that, they laid me down in pre-op, the anaesthetist gave me the first injection, which made my head swim but I was still with it (although feeling pretty happy), they wheeled me into the operating theatre, and that was about the last thing I remember.

In recovery, there was a nurse waiting for me as I came around. I recall trying to work out if my leg hurt but couldn’t actually figure it out (drugs are great, aren’t they?). I was shivering uncontrollably, despite warm blankets, and very thirsty, though. The nurse gave me some water, and at some point I got moved to my room, where I fell back to sleep. It was about 7pm when I came around properly and could have something like a conversation (well, it seemed like a conversation from my perspective. Could have been meaningless gibberish and the nurses were too polite to mention it, though). At that point, I was conscious of my leg feeling uncomfortable, but it wasn’t really painful. I was given dinner which I didn’t really eat, and taught how to use the pain button.

I basically just dozed in short periods from there right through until morning, with interruptions due to nurses checking my blood pressure or giving me tablets, trying to find a more comfortable position, and one terribly exciting trip to the toilet which involved far too many people and an awful lot of equipment. My knee had a huge bandage around it, and my leg was encased in a splint. They did put an ice machine on my knee at one point but I couldn’t feel any cold through the bandages so they took it away. The most comfortable position was on my back with the head of the bed raised (really, it was the only position, I wasn’t very mobile at all).

Day after surgery

In the morning, rattling from all the pills I’d taken, I lolled in bed and read a book while a parade of people came past to see me. The physio gave me stretches to do in bed (quad activation, and ankle pumps for the calf muscle), then came back with crutches and we had a little lesson on partial weight bearing crutching, including stairs. The surgeon came to see me and told me he’d done not one but two meniscus repairs (lucky me!) and that everything went well and I was to come see him in two weeks to get the bandages off, the pharmacist came to talk me through my drugs, and then the nurses took my IV out (goodbye pain button!), bustled me off for a shower and to get dressed, and not long after lunch discharged me into the care of my Mum. I was going home!

Mum brought my car around to the front entrance, while an orderly took me out in a wheelchair (via the chemist to pick up my showbag). We put the front seat of my car all the way back, and I was able to sit down on the seat, swing my good leg in first, then use my hands to swing my injured leg in. At this point, I had zero ability to carry the weight of my lower leg in my knee, so using my hands to move my leg was essential.

Now, I know you all want to know what was in my showbag!

  • Palexia (Tapentadol): This one knocked me out something fierce. As soon as it was in my bloodstream, I was completely unable to stay awake. I took this one at night for a couple of days, which helped me to get some sleep in the first few days home.
  • Endone (Oxycodin): This one was actually a little scary for me. I took it once without the Palexia and found that I was lying in bed completely unable to move, but not asleep, and not without pain. I didn’t take it again after that.
  • Clexane: An anti-coagulant. This was an injection I had to take once a day for ten days to prevent blood clots. I got special instruction from the nurse on how to do it, and it wasn’t too difficult, except for the fact that after you’ve removed the needle it was sore for a couple of minutes and it was really hard not to rub the site. It also left pretty horrific bruises, but on the upside: no clot!
  • Paracetamol Osteo: My new favourite drug. It’s just like regular Panadol, but has a higher level of paracetamol (so no more than two every six hours!). The benefit of this over ordinary Panadol, aside from having more paracetamol, is that it has the regular stuff on the inside, with a coating of rapid acting, so it works fast, and keeps working. It helps to smooth out the up-and-down effect of regular paracematol. The extra added bonus is you can buy it over the counter at the chemist, and it’s super cheap.
  • Anti-nausea drugs, which I didn’t take because I didn’t have any nausea
  • Anti-constipation drugs: I took a Macrogol powder once a day, along with some Benefiber once a day (I had been taking Benefiber for the couple of days prior to the surgery as well, just to try and keep everything in good working order), but didn’t take the tablets in the end.

At home

Once I got home, my Mum put me to bed, brought me food occasionally, and otherwise left me alone to nap in front of the telly for about 48 hours. I watched the clock pretty carefully to make sure I was taking all my drugs at the right time, I got up to go the toilet (very gingerly) when I needed to, and otherwise tried not to worry about things. I kept my legs out in front of me in bed, propped my back and shoulders up on all the pillows to keep as comfy as possible, and tried not to move around too much. I found that I needed to keep the bottom corner of the doona flipped back off my foot, as it put pressure on my knee, and I didn’t really bother elevating it as it was mostly just uncomfortable to do so. I didn’t feel like eating much of anything at all, and I really didn’t want anything with a lot of carbs or spice (which is completely unlike me). I ate mostly salad, with a little grilled chicken, and drank lots and lots of water for those first few days.

The first week

Overall, the first few days were pretty miserable, but once the pain dropped and I could get rid of the heavier duty painkillers and move around a little more, things became much easier. I was down to Panadol only by Day 3 (although I was always very ready for my next dose as soon as six hours was up). Mum went home on Day 5, and by then I could get up out of bed and sit on the couch or a chair with my lower leg propped up on a beanbag and some pillows for at least short periods of time.

The second week

It was around the beginning of the second week that I started getting excruciating pain in my calf muscle. I spent most of the day (and night!) just pumping my foot up and down trying to relieve the cramping. Around Day 8 I made it a mission to make sure I was getting out of bed and moving around at least a little bit every hour, which helped during the day, but at night the cramps were keeping me awake. Pacing up and down your bedroom floor on crutches at 2am is not fun. On the upside, I wasn’t noticing any pain in my knee any more. I briefly wondered if it was a blood clot, but when I opened up my splint to massage the knots out of my calf, I noticed a small grey bruise (unlike the yellow bruises which had coloured my shin since the operation) right above the most painful part of my calf muscle, it was also not swollen or hot. I started to suspect the splint was to blame, and not a clot.

I drove for the first time on Day 9 (yay for hurting my left leg, living in Australia, and driving an auto!). I can go very short distances (less than 10-15 minutes before my knee starts getting sore) and I need to make sure I can open my door all the way so that I can get in and out (so no close parking!), but it’s enough to be able to drive down to the shops and get milk, or drop my daughter off, or go to doctor/physio appointments.

I saw my surgeon on Day 10 (and not a day too soon!), who agreed that the splint was probably causing the calf pain, but sent me for an ultrasound anyway just to be sure. He also removed my dressing to expose my gruesome wounds (which I have also failed to photograph. You’re welcome), put me into a compression stocking for swelling, and sent me off to get a new ROM brace.

The ultrasound confirmed no clot (yay!) and the new brace immediately helped relieve the pain. The splint had a foam strip that runs down the back of the leg, and the calf pain was occurring at the precise end of that strip. I gave it to the physio who fitted my new brace for me and asked her to please burn it. I suspect she thought I was joking. I wasn’t.

What next?

At the moment, I’m not taking any pain relief during the day at all, except for icing it twice a day for at least half an hour. I take paracetamol before bed (and usually wake up almost exactly six hours later for a second dose). I’m wearing the ROM brace during the day (set at 0-90°, which will remain for six weeks, this is a condition of the meniscus repair. I’m really only able to move about 0-40° right now, but physio will help with that), and a splint from my original injury that doesn’t have that nasty foam strip in it overnight for comfort, with a compression stocking for swelling. I can sleep on my left side, with the injured leg straight out, and my other leg in front of it, but can’t sleep on my right side in the same position (with a pillow under my injured knee) for very long before it hurts, although this is improving. Dr Davies tells me this is because he moved around a lot of stuff on the right side of my knee, so it’s more tender there. My appetite is not quite back to normal, but it’s definitely improving. I start physio tomorrow and will keep going once or twice a week until I’m off crutches at least. I’m moving around well now, and even managed to cook a meal for dinner last night, so everything is starting to go back to normal, except I still make a cup of tea in a thermos so I can carry it to wherever I want to sit! Only four weeks on crutches to go …

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