Post-op Week 3: The Lowest Point (I Think)

I have been pretty down this past week. Unfortunately, there hasn't been a lot of good news about my progress. But it is what it is, and hopefully I have just reached a short plateau and will start seeing some real improvement soon.

At my Doctor's visit last week (Oct. 2) he thought that I was doing pretty well for only being two weeks out and gave the OK to start my clinicals the following Monday. So I did part-time (20hrs) and I love, love, love it. I am at the Ann Arbor Medsport complex. It is such a cool clinic. They have a huge gym, a room for post-surgical patients, a casting room, a pool, batting cage, basketball hoop. You need it, they have it for rehabbing sports injuries. The funny thing is that about half the people being seen at the clinic have had some sort of knee injury. My clinical instructor, Dale, has been in the profession for 18 years and has worked all over. I'm totally confident that I'll learn a lot from him.

One clue that I had that things were not going well for me was my clinical instructor. Dale is concerned about the state of my quads. Their shot. For example, I went to the pool on Wednesday and realized that I had forgotten my goggles. No sweat, I thought. I'll just kick back and forth for a while with a kickboard instead. Honestly, if I hadn't had that board, I would have sunk like a rock to the bottom of the pool. I haven't felt that uneasy in the water since the time I had to swim through a rapid on the Colorado river.

I'm lucky that I am in such a great place right now working with an instructor who has probably seen thousands of ACL injuries. So if he says something isn't right, then it isn't. Dale has been immensely helpful: giving my new stretches and exercises to try. I knew it was definitely serious though when yesterday he hooked me up to the Russian stim. Russian stim is a form of electric stimulation that is primarily used to get a strong contract out of a muscle that is too weak to do it on its own. In my case, my wasted quads. I had two large electrodes placed on my thigh, one over the VMO (medial thigh) and one across the top of the thigh. Then before he upped the power, he told me that I couldn't cry. All, I can say is that this hurt like hell. I have been hooked up to electric stim in one of our patient care classes (I've even been given a nice electrical burn because of it) but I have never had to endure it for 20 minutes. It would cause my muscle to contract for 10 seconds and then let off for 30 seconds. When the contraction is occurring, you also have to try to contract your quad on your own and try to push the back of the knee into the table. At first I thought, how am I going to make it through this? What I found though was that your body does adjust to the feeling and after a while, I was even able to turn up the amplitude a bit on my own. Apparently normal muscle should be able to handle a normal amplitude of around 80. I am around 55. Also, I noted, the harder you push down into the table and contract the muscle on your own, the less it hurts as well.

So how did I get in this position. I have been thinking about this today and I have 3 possible reasons.

1. It was a month between the injury and surgical dates so my quads were wasted before I got the reconstruction done. Add another insult such as surgery on top of that and my quads are really, really gone.

2. I got off my crutches too soon. I was feeling pretty good. No pain pills (not even Tylenol). But the added pounding from walking (in addition to weak muscles) means that the swelling isn't going down very fast leading to less mobility.

3. I am an abnormal case. My doctor doesn't normally send people to PT right after surgery. He says only a small number of patients that he has treated have had this problem. He says that he doesn't like to send people right away because of the issues of failure with too aggressive of PT at the beginning. Normally, he waits a few weeks and then sends them if he feels they need it.

So I am kind of in a tight spot right now. I have about 4 weeks from date of surgery to when scar tissues starts to form which is going to make moving my knee more difficult. I am starting to run out of time. I talked to my doctor yesterday and he is going to be having his office send a script for PT to a clinic here in Ann Arbor (Medsport it is!!!) I have also put myself back on crutches to try to get the swelling to go down faster. Also, I have Dale who told me yesterday that if my knee isn't bending well enough by Monday then he is sticking me in a room and bend it for me. One of the techs, Rachel, told me that they do that so you can scream and cry as loud as you want. I don't think that I can make it through something like that without crying.

So this weekend, instead of enjoying the homecoming festivities at CMU, I'll be spending it iceing and bending and exercising and re-icing my knee. In addition, I'll be listening to the Webcast of the Hawaiian Ironman because with all the cable channels that I have, there isn't one that carries the race live. Of course, there is about a dozen channels with football.