ACL Surgery Week 12: Quick update

Week 12 update: 
Went to see the doc today and everything looks good. I've been okay'ed to start running. Needless to say, run/walk routines to start, then spiral exercises, sprints and finally some zigzag cutting exercises. My PT estimates that I should be able to run at more full speed in about 2-3 weeks!

ACL Surgery Week 8: Continuing PT and Starting food plan

My physical therapy sessions have been going well.  Nothing much to report other than here are a few highlights:

• Been going to the gym for a month now and have become quite a gym mouse.  Bike, elliptical, swimming, pilate class, yoga class, and now this body pump weight class (been twice).  Keeping classes to low impact ones and things seem to be going well for my leg.
• Bike workouts up to 45 minutes in length
• Elliptical workouts up to 25 minutes in length
• Continuing to increase weights on my leg press, leg extension, inner and outer thigh workouts.  Added glute extensions in the past 2 weeks.
• 10/13 - Biked outdoors on my road bike.  Even though it was only for 6.5 miles as part of leading the Biggest Loser 5k run.
• On the downside, I pulled my hamstring again.  It just seems really fragile.  

I'm now ONLY 4 weeks away from officially being able to start running again so that gets me quite excited :)

I've been moderating what I eat so that I don't gain a crazy amount of weight during these past 8 weeks where I haven't been able to work out as much as usual.  This past Monday, October 16th, Ben and I decided to start on a prepped food plan called Personal Trainer food.  The thought was to see what types of food and portion control this plan offered versus what we were already doing on our own.  Right off the bat, the portions are very small :)

Here's a look at the past 3 days which were all entirely randomly selected off of the bags in the freezer.

Oct 14 lunch		Italian Style Meatballs and Green Beans
Oct 14 dinner		Garlic Herb Chicken Breast and Cauliflower
Oct 15 lunch		Smoked Brisket and Broccoli florets
Oct 15 dinner		Mozzarella Roasted Garlic Chicken Sausage and Scandinavian Blend Veggies
Oct 16 lunch		Grilled Tender Chicken Breast and Green Zucchinis
Oct 16 dinner		Meatballs and Brussels Sprouts.  My "everything is round" meal.

The first day was rough since we weren't totally prepared.  We didn't have enough snacks handy to fill in the gaps.  On the second day, I had a headache and felt tired and weak all day.  Part of that was probably due to the sugar crash/leveling and we had come off of a weekend away and eating (aka gorging) out.  We also picked up some cheeses, deli meats and got a better idea on how many nuts we were able to eat to complement our 2 meals a day of prepped food.  Now on day 4, things are going better and I don't feel like I'm hungry all the time.

In terms of the food, some of them are not bad.  Some, I've definitely made them better.  The meats have all been pretty good.  The vegetables are all very fresh and taste very yummy on their own.  I haven't had to put much of their garlic sauce on them.  My least favorite so far are the brussels sprouts which I normally love.  I think they're just a bit too soggy for my taste.

Overall, trying to keep active and eat relatively healthy so I don't go soft during this recovery period :)

ACL Surgery: 6 Week Mark!

I had my 6-week check up with Dr. Peterson yesterday, 10/2.  The visit was rather short but filled with good news!

The assistant escorted me to the room and saw that my leg extension and flexion were pretty good.  Then Dr. Peterson showed up, checked up on my knee and checked how loose/tight the new ACL is.  He said it all felt pretty solid and that I'm good to start using the elliptical, bike outside, swim, and any activity that was in a straight line motion [YEAH!!!], except for running [BOO...].  He said it was best to wait till week 12 to start running since some people have experienced knee irritation from starting to run too soon.  Also, the next 6 weeks are really when the graft is the weakest so best not to add any unduly stress on it.  He frowned a little when I told him that I had already been swimming all good.  Upon a little more prying, he said I could start running in 4.5 weeks if things were going well instead of waiting the full 6.  We'll see...  But overall, all great news.

Right after my doctor's appointment, I had my PT appointment so I got to share the good news with Doug who started me on the elliptical the same day!  It felt great to get on there.  I've been given a plan to start with some biking and a little of elliptical (10 min), and slowly work my way to more elliptical and less biking if I want.  I'll switch it up depending on the day :).

ACL Surgery: One month mark!!!

It's been 2.5 weeks since my last update. Things have been improving slowly.  Wound is healing and getting better.  You can barely see the top 2 holes and the other 3 will probably leave a mark forever.

Here's a summary of where I'm at:

• Extension:  Full extension comes pretty easily now.  
• Flexion (how close your heel can come to your butt): This one has its moments.  I went from 140° to 147° to being able to touch my butt after 1-2 of these and my knee has warmed up.  It is still hard, sore and slightly painful to hold for 20 seconds. 
• Pain: There pretty much hasn't been much pain except during full flexion exercises.  I did also manage to overdo it on my hamstring exercise and had to rest it.
• Weight bearing:  All good here. I'm even doing heel touches which are exercises where my right leg is on a 4" step and full weight is on my right leg while trying to lower and touch my left heel to the floor.
• Ability to walk without crutches: I've been crutch- and brace-free for the entire 2.5 weeks now.   Leg still gets tired more easily after workouts and long walks.  I try not to walk too lop-sided when that happens.
• Ability to drive (right leg surgery):  Been driving! All good here!
• Strength: My strength workouts have been on a plateau for the past 2 weeks.  
• Balance: Solid.  
• Ability to walk without a limp up and down stairs: This has been getting easier.  I still feel pulls on my hamstring when I go down the stairs but it's slowly getting smoother.
• Jogging and Biking: Got confirmation that the doctor doesn't prescribe running till the 12 week mark.  I have been walking on the treadmill and working my way to 18mph over 20 minutes right now.  When it comes to biking I'm at 40 min of biking at 80+ RPM with relatively low resistance but varying it.
• Jumping: Too far away to think about right now.
• Cutting:  Too far away to think about right now.
• Unrestricted return to sports: Probably 6-9 months away.

For those interested, here is the list of exercises that I've been doing for the past month.  These have been focused on getting me back to full extension and flexion and building up my quads, calf muscles and slowly my hamstrings.  I was told many times that the hamstring recovery was going to be the longest and only living through it now is it sinking in.  My left hamstrings are a LOT weaker now and I pulled it at week 3 so I have pulled back on weight exercises on it for now.  Hopefully, I'll be able to slowly build them up once they are fully healed.

Week 1 Workouts

1. Heel slides - using bands to get as much extension.
2. Quad Sets - Rolled towel under the knee and lift and hold for 10 secs
3. Quad Sets Plus Pillow Squeeze - Lift both heels and then Squeeze and hold for 10 secs
4. Quad Sets Plus Straight Leg Raise - "Lock, Lift, Lower, Release".  Slowly start adding rep and weight
5. "Outside" Leg Raise
6. "Inside" Leg Raise
7. Repeat Heal Slide
8. ICE

Week 2 Workouts (added)

1. Move Knee Cap
2. Heel Raises - started at 50/50 weight 
3. Standing mini squats with not resistance
4. Stationary Bike for "Range of Motion" 6-8 min

Week 3-5 Workouts (added)

1. Heel Raises - adjusted to 100% weight on my right leg
2. Prone Leg curl to 90 degrees
3. Standing mini squats with Blue Band
4. Steps - Front steps.  Started at 4" steps then moved to 6" steps.
5. Steps - Side way steps.  Started at 4" steps then moved to 6" steps.
6. Prone Heel to Butt stretch w/ strap to get more flexion.
7. Biking or Swimming - for cardio with increased length.  Biking still at low resistance

ACL Surgery: Checking in end of Week 2

I got great news from Doug, my physical therapist, today.  I'm doing great!  My quad and other muscle strength are at where most people are at the 1-month mark.  I've been okayed to walk around without the brace, my flexibility continues to improve and I had a lot more workouts added to my daily routine.

So here is my summary of where I'm at:

• Extension:  Got full extension!  Knee still gets stiff way too easily when it's in the same position for too long.
• Flexion (how close your heel can come to your butt): I've gotten up to 140° today when I'm sited.   I'm now working on my flexion when I'm lying on my stomach.  Best today was at 124° and this is the one I really need to work on this week.  
• Pain: This hasn't changed too much.  I'm down to taking a Tylenol in the morning and Ibuprofen in the afternoon.
• Weight bearing:  Full weight on it and started trying to walk on my right with equal weight so I'm no lop-sided.
• Ability to walk without crutches: I started week 2 being told to only walk when the braces were locked.  I actually wasn't very good about keeping to this.  I started walking with the brace in full range and then the last 2 days I've been walking around the house without it.  Good thing that Doug has officially okay'ed me walking around without the brace anywhere I go now.  With the exception of when I'm in very crowded places like going to a football game.
• Ability to drive (right leg surgery):  I'm okay to start driving.  I haven't tried it yet but will need some practice first with the pedals while the car is off.
• Strength: My right thigh definitely shrunk in the 1-week my leg has been in the brace.  Luckily, my PT workouts are paying off and it's getting its strength back every day.
• Balance: Solid.  Can stand on my right leg.  Can quite squat or bend with weight on it yet.
• Ability to walk without a limp up and down stairs: From what I've read, this will be 3-4 weeks out but I'm working on it this week.  Walking down the stairs is incredibly hard!  I'm starting with 4" steps.
• Jogging: I wish.  From what I've read, I might be able to start running in 2-3 months.
• Jumping: Too far away to think about right now.
• Cutting:  Too far away to think about right now.
• Unrestricted return to sports: Probably 6-9 months away.

Here are some pictures of my leg and where it's been the last week :)  There aren't too many pictures between day 2 and today.  Even though things continued to improve, I certainly had my down days.  Saturday and Sunday were rough and my leg were bruised and in pain and my ankle were the most swollen I had seen them.  But things got better.

8/29 Day7 - Getting on my own bike.
I've now worked my way to 10 minutes

8/29 Day7 - back of leg bruising

8/29 Day7 - font view

8/30 Day 8 - Back of leg... looked worse

8/30 Day 8 - Front of leg... standing. 
My leg and ankle swelled up more this day.

8/30 Day 8 - at the theatre

9/4 Day 13 -Swelling on the knee looks mostly subsided.
But I can't see my knee bone yet.  

9/4 Day 13 - Standing front leg view

9/4 Day 13 - Back of leg - Bruising looks to be 
much improved! 

9/4 Day 13 - Bruising has unfortunately also 
moved down to my feet. 

ACL surgery: Checking in Day 7

A lot of firsts today!  I went to my first post-op doctor's appointment, went to my first post-op Physical Therapy (PT) appointment, took my first post-op shower, and managed to get a full pedal on the static bike.  Today turned out to be as fulfilling as I thought it would be.

I woke up feeling a little worried since my ankles swelled up more and I wasn't sure if it was because I might have compressed my leg a little too tight last night when I went to bed.  Doctor said everything was looking good and my swelling was less than this other patient who had surgery the same day I did. I got my X-ray taken and the screws are in there and everything looks good.  I won't need to go see the doctor for another 5 weeks.

Me at the doctor's office

My PT appointment was a bit more fun and uplifting.  I always enjoy seeing my physical therapist, Doug from MarRan Physical Therapy in Redmond.  He's just awesome!  He had lots of compliments and pats in the back for me :).  He said I was able to do a lot of the exercises that his patients normally do in week 1-2, and he'd never seen a patient be able to do a full pedal on the static bike so early.  I walked in with a flex bend measurement of 90° and after the exercises, I was able to get to 113° !  I walked away with more exercises and more information on how to better take care of my knee.  One downer is that I still need to keep my brace locked at full extension for now when I walk.  He said I should be able to walk next week with the brace set in full range of motion.  Yeah!

This is the adjustment dials for my brace.  There is one of these on each side.   To change the setting, you simply lift and move the pegs to another spot.  This is set at 0 flexion and I've been going back and forth between 0 (when I'm walking) and full motion (when I'm at my desk)

All I'm left to do is to keep up with the exercises every day and continue to RICE.

ACL surgery: Checking in Day 5

Things are progressing well from what I can tell.  My post-op check up is on Wednesday so I'll find out more then.  The biggest step over the weekend was the fact that I got to take off my compression wrap and be able to see exactly how my knee looks.  I've started on some of my PT recommended exercises as well.

Picture from Sunday (Day 4 - right after removing the compression wrap)

Picture from Monday (Day 5 - after icing it for a period of time)

I read a site that says to keep track of progress on the following fronts.  So here is my summary:

• Extension:  Got full extension!  It still feels stiff every time I have my leg bent for a while and try to extend again but at least I got full extension.
• Flexion (how close your heel can come to your butt): Not great...  I think I've got up to 90 degrees angle.  It hurts to flex...  and that's what I've been working on.
• Pain: Doesn't hurt until I move my knee.  The first movements always hurt the most, then it tends to settle in and hurts less.
• Weight bearing:  Been able to put weight on it.
• Ability to walk without crutches: I've been able to do this with brace on.  Without the brace, I still use the crutch to make sure nothing goes wrong.
• Ability to drive (right leg surgery):  Not there yet...  maybe in a week.
• Strength: It's only be 5 days since my last workout so I hope I haven't lost too much strength.  My left leg is getting hella strong through :).
• Balance: Definitely not at a point to try to balance on my right leg yet.
• Ability to walk without a limp up and down stairs: From what I've read, this will be 3-4 weeks out.
• Jogging: I wish.  From what I've read, I might be able to start running in 2-3 months.
• Jumping: Too far away to think about right now.
• Cutting:  Too far away to think about right now.
• Unrestricted return to sports: Probably 6-9 months away.

In terms of my past 3 days play by play.  Keep reading :)

Day 3 - Saturday

By Saturday, I was limping around in my brace and felt great.  So great that Ben and I decided to go to the Farmer's Market to pick up some more fresh vegetables for juicing and stop by Costco for some shopping and take advantage of the driving cart for disabled people.

I managed to not hit anyone except for Ben when I tried to back up too quickly to avoid someone else.  I'm a terrible driver, no doubt.

After that little excursion, I was quite pooped and spent the rest of the day RICE'ing (Resting, Icing, wrapped in my Compression and Elevating my leg).  I tried to do as many leg workout as I could several times a day.

Day 4 - Sunday

Doing my leg lift exercises at Seward Park.

I woke up early and decided to join the Seattle Green Lake Running group on their Easy Like Sunday Morning Run.  Ben was going to join in on the bike ride before hand and then join the run.  For me, it was an excuse to get out of the house and try a little more walking.  What a great day to be outside!  I got to walk around for about an hour or so.

Sunday is also the day that I got to unwrap my compression wrap and was able to take a good look at my knee.  As you could see in the pic, my knee is still quite swollen and it was certainly more purple/blue and swollen than what I was expecting/hoping for.

I also started doing the leg flex exercises.  These are quite painful.

Day 5 - Monday

I got back to work today and very quickly realized that sitting at the computer desk is the worse thing for my knee.  I've resolved to trying to elevate my leg at my desk or working on the couch.  Here's a picture of me working with my leg extended and elevated (and, yes, in my PJs).  My goals continue to be: rest the leg, ice it and try to exercise it every 2 hours or so.

And here are pics of my leg and the bruising situation.

I'll be going out for a walk again soon to get my walking in.

ACL surgery: Checking in Day 3

Surgery went great!  Dr. Peterson said everything went very well.

It's day 3 and I'm now off crutches and able to put weight on my right leg.  This has given me some freedom to walk around more which is great.  Below is a day by day recap:

Day 1 - Thursday

My surgical appointment was at 6:30am at the Seattle Orthopedic Center in Wallingford.  I had stopped eating since 10PM the night before and stopped drinking liquids since 3AM.  I was promptly checked in, put into a gown, had my heart rate, blood pressure and pulse measured, and greeted by Dr. Peterson who walked me through the next steps.  We both initialed my right knee so there would be no mistakes on operating on the wrong knee.  We both joked about it but I'm sure it's a concern that's frequently brought up.

Here's me (pre-op in the gown), my initials  me and Dr. Peterson with my signed knee:

Will, the anesthesiologist, and Kate, my nurse, both came to greet me as well.  I was luckily given an option to do general anesthesia OR opt for a spinal tap and be awake through the entire process.  It was a pretty easy choice for me.  With spinal anesthesia, I get to stay awake and watch the entire procedure, and I didn't have to be put under (and be afraid that I won't wake up).  Given the option, I took the spinal tap and staying awake option.  The only downside is that the spinal tap takes longer for the legs to come to their senses than waking up from a general.  Ben comforted me and let me know that it was no big deal to stay longer.  Choice made and in I went for the surgery.

The first thing they did was to take the graft by removing 2 strands of tendons from my hamstring.  The assistant showed me a strand of my tendon and then also showed me the graft after it was ready to go in to my knee.  Unfortunately, I couldn't really take pictures with my phone since both my arms were preoccupied (with AV and blood pressure monitors).

Here are the pics from the arthroscopic camera:

	Some pointers on what you're looking at: IMG_007-IMG_012: checking up on my meniscus  that cushions my tibia (below) and femur (above). IMG_014-IMG_016 is my busted ACL and how  it's not working.   Between IMG_016 and IMG_017 is a shaver that  goes around and pretty much shaves of my existing  ACL and it gets sucked out. IMG_017 is the drill about to drill a hole. IMG_021-IMG025: pulling my graft through.   IMG_026: new ACL graft in place!

I wasn't able to get a video but found a really good one on YouTube where you can pretty much get a really good picture of what my surgery was like if you're interested:

At 9:40AM: I was wheeled out into the recovery room where Ben was able to come see me.  At this point, they're just waiting for the spinal anesthesia to wear off so I'm able to support myself with my left leg and get into my car to go.  This is me after surgery under a nice warm blanket.

I hit my 2 milestones:  I was able to regain sense in my left leg and I was able to go to the bathroom.  My right leg wouldn't regain all its senses till hours later since it needed to also wait for the femoral nerve block to wear off.

We finally left the Seattle Orthopedic Center at 11:40AM and headed home.


Here were all the pills I was prescribed:

On doctor's orders, I took all my pills after getting some food in my stomach.  The oxycodon made me feel a little drowsy and allowed me to get some more rest.

I spent the rest of the day with my leg elevated sitting on my couch with the Iceman ice machine on my knee, drinking lots of water and eating as healthy as possible to assist my body with healing.  Except for the trips to the bathroom on the crutches, it was pretty uneventful.

I took one more oxycodon before going to bed to help make sure I was able to sleep through the night and rest.

Day 2 - Friday

I was pleasantly surprised that my knee wasn't hurting as much as I thought it would since the oxy would definitely have worn off by now.  So I decided to stop taking oxy and just deal with a mix of Tylenol and Ibuprofen.  

Again, I spent most of the morning on the couch with my leg lifted and with the ice pack.  The doctor encouraged me to put weight on the right foot as soon as I could.  So I started putting some weight on it and was on one crutch for a little bit and, next thing you know, I wasn't using the crutches at all and was hobbling around the house.  Being more mobile was great!

In the afternoon, I walked around the house and the kitchen and decided to spend a couple of hours cooking.  I made carrot bread with my leftover juicing pulp, made turkey veggie casserole for dinner, and made some more veggie chips with the pulp.  Then I was pooped and got myself back on the couch for more rest and icing.

Rest of the evening was more rest, more icing and small attempts to bend my knee a little and try and get to full extension and some more bend.

This is a comparison of my legs.  Not sure yet how swollen everything is since I can't unwrap this until Sunday.  Can't wait to take a look to see how everything looks!

Starting my blog again

Quick Update 

It's been a long time since I've written on here.  I've failed at a couple of attempts of updating this blog in the past 3 years, leaving behind unpublished drafts with just a few sentences each.  I just deleted them all and have decided to start fresh.

Life has been a great adventure the last 3 years and I won't dwell on those for now.  I'm in Seattle, Washington, now and loving it.  This summer has been wonderful and Ben and I have had the chance to enjoy it to the fullest.

We've become quite the athletes in our own way and enjoying the outdoors.

An update on our races/events:

2010	Half	SF Half Marathon (1st half)
2010	Half	Long Beach Half Marathon
2011	Half	Rock n Roll Arizona Half
2011	Half	Surf City Half Marathon
2011	Full	Rock n Roll Seattle Full
2011	Full	SF Marathon Full
2011	Half	Rock n Roll San Jose Half
2011	Half	US Half
2011	Full	Rock n Roll Las Vegas Full
2012	Half	US Half "The Other Half"
2012	Full	Rock n Roll Seattle Full
2012	Full	Portland Marathon
2012	Full	Bellingham Trail Marathon
2012	Full	California International Marathon
2013	Half	Lake Sammamish Half Marathon
2013	Half	Rock n Roll Seattle Half
2013	100m Bike	Flying Wheel Century Ride
2013	Tri	Issaquah Triathlon (Sprint)
2013	205m Bike	Seattle to Portland Ride

Our wall of pride below:

What's Happening Now

I wanted to share our many accomplishments because I'm about to undergo ACL reconstruction surgery tomorrow morning.  I tore my right ACL back in January this year and have gone through physical therapy to the extent that I was able to get back to running, biking, kickboxing and hiking.  However, things still haven't been quite the same.  So I've decided to get the reconstruction surgery.

Not going to lie, I'm a little scared.  Putting your body under general anesthesia is scary to me.  Having parts of the hamstring tendons removed and drilling holes into your bones to rebuild a support to act as your ACL is scary.  Going through 6 months of physical therapy and recovery sounds excruciating.  I'm going to need to exert more patience than I've ever had before.  It'll be a challenge but I'll tackle it.

I'm looking forward to having a fully healed knee where I'll be able to play tennis, dancing, jumping, go rock climbing and get back into more running, biking and swimming.  Ben and I have plans to do a marathon every month for a year whenever I'm ready next year.  This list below is what inspires me to take good care of myself and recover well.

This is only the tentative list that we've started and we'll be adding more.

I'll be keeping a journal here of my surgery and its process so I can share my experiences and progress.

Here's to running, dancing, jumping, biking, hiking and much more with all of you later!