Surgery&Recovery

 My Surgery & Recovery: 

• My surgery time was 2:30PM but they asked me to come at 1:30PM. I was there at 1:25PM.
• When I reached the Surgery center, front desk lady asked me to fill the form about my details (my details, surgery part, person picking-up after the surgery etc)
• At 1:30PM nurse called me (they asked my wife to stay out) and took my weight, BP, about my surgery details (which part, why it is required etc). They want to make sure doctor didn't mis-guide about the surgery.
• They took me to a separate room
• They asked me to remove my clothes and asked me to wear the Gown
• Then one more nurse came and re-checked my Surgery details
• They asked me to sign some forms about the Surgery (risks, Allergies etc)
• They gave me Iv
• One more nurse came and trimmed the hair on the knee
  

  

  Knee after trimming hair and doctor marked my knee

  
  
• Then my Orthopedic Surgeon came and marked my knee with Sketch
• He explained the Surgery details one more time
• Anesthesiologist came and explained about the anesthesia and Allergies
• They called my wife and gave us some time to chat
• At 2:30PM they took me to the Surgery Room and my wife got couple of pictures of mine
• They asked me to shift from my current bed to Surgery Bed
• That is it. I am not aware of any thing else after that.
• Around 4PM doctor showed the pictures of my surgery to my wife and gave her details.
• Around 5:30PM they called my wife. One my of my friends (Sudha Pamuru) was there at that time
• They were cracking some jokes but I am laughing but kind of drowsy some times
• Around 6PM they asked me to go home. My Friend (Vidya Sagar Mula) drive me back home

After Surgery in the Hospital

My Recovery :

Contact your physician if you experience any of the following:

• Temperature above 101F, Chills
• Uncontrolled nausea/vomiting
• Soaked dressing
• Calf pains or numbness in your leg
   

Day 1:

• Still you will have little bit Anesthesia effect. So you will not be having any pain
• They will ask you to do Straight Leg Rise exercises. But you can't lift your leg. So some one needs to do this for you.
• Ice the Knee for 20-30 min every one hour while awake. You will have a wrap on your knee so you don't feel much cold but still you need to ice the knee
• You need to elevate your leg when you are on the bed. This is to increase the blood circulation. You can use pillows for this. It is very difficult to elevate the knee only keeping the pillows below your ankle. So it is better keep some thing from your thigh to elevate the knee. I used pillows and one comforter for this. Increase the thickness of the comforter from the thigh and keep the pillow at the end.
• You can't bend your knee. So you need some help to go to rest room
• Constipation is the biggest problem. You can find more information about this in "Personal Life" Tab
• Before taking pain killers, you need to eat something
• Based on your pain you can increase the pain killers. Doctors will give you the information about this
• Nurse told me there will be itching when I take pain killers (side effect). I didn't think about that. But in the mid night I felt that. I didn't sleep well. But I didn't see the itching from day 2
• You may need to go restroom very often because of the Iv
• Some cases you may see bleeding out side of the knee wrap. You may need to contact your doctor for this. I didn't see this in my case
  
  
  

  

  
  
  

  At home - keep leg elevated 

Day 2 :

• Same as day 1
• Started using CPM Machine with 20 degree. Don't use CPM Machine more than 8 hours a day
• In my second surgery my doctor didn't suggest CPM 
• Then increased to 25 degree
• You will have wrap around the knee. When you the CPM Machine your skin may stretch more when you bend and get bit irritation
• 
  
  

Leg on CPM Machine

Day 3 :

• Same as Day 1
• Increased my CPM Machine to 40 degree
• Doctor asked me to change the bandage. It will be difficult to change it by yourself. You need some help from others because you can't bend your knee.
• My friend (Vidya Sagar Mula) came to change the dressing.
• At the time of surgery they fill your knee with arthoscopic fluid. So the dressing may be wet and have the appearance of diluted blood from the surgery. So don't think it is all blood.
• Before changing the dressing, you need to keep gauze dressing ready
• Remove the dressing and throw all gauze dressing.
• Once the dressing is removed, there should not be a great deal of drainage from any incision
• If there is, call your doctor
• Don't remove the sutures or steri strips
• Re-wrap your knee by keeping gauze dressing

Day 4 :

• I increased my CPM Machine to 85 degree angle after reading lots of information in the Internet. That is biggest mistake I did. When I went to post-opt I realized the reality.
• Because of the 85 degree, there was big stretch on my knee and one of the sutures opened. So don't try to increase the CPM Machine angle too much. Just increase small amount. You will reach 90 degree automatically in 10 days.
• My doctor suggested not to exceed 90 degree in 3 weeks. He warned the newly added ligament may become loose

Day 5:

• Nothing special. Normal as it is

  Day 6:

• Had post-opt
• Doctor opened the bandage and removed the Steri Strips
• One sutures opened because of my too much angle using CPM Machine.
• Removed all the sutures. My wife was bit scared and didn't see what doctor is doing
• Closed all the wounds with Steri Strips again
• No need to keep the bandage any more
• There was too much fluid in the knee
• Doctor asked me to apply the ice for 4 times a day for 20 minutes each time. Don't ice your knee more than that because if you ice your knee more time there is  change some cells will die inside the knee because of too much icing
• They asked me to walk using crutches and changing the knee brace angle to 30 degree (it was 0). I tried but it was bit hard. I got bit nausea after walking 10 foot steps. I drank some water and I was fine.

Bone holes description

Day 7 and Day 8:

• Nothing special. Normal as it is

Day 9 :

• My wife saw 2 blood clot spots back of my knee part. I called my doctor and explained about those. He asked me to come to hospital
• But he said at the time of surgery some blood may leak to the back. It will go away after some time. It disappeared after 4 days

Blood Clots 

• Still I had the fluid in my knee and I was unable to lift my knee to do straight leg rise exercises.
• Doctor decided to remove the fluid from the knee by injecting
• Doctor removed all the fluid and I was able to lift my leg.
• I started walking using crutches

Day 10, 11, 12, 13, 14, 15:

• Continued straight leg rise exercises atleast 150 per day. I can see bit improvement

Week 3:

• Started my Physical Therapy. Normally some doctors will suggest for the Physical Therapy from Week 2. But my doctor said take rest and do Physical Therapy from Week 3

Week 4:

Week 5:

• Started stationary biking for 5 minutes (twice a day)

Week 6:

• Started stationary biking increased to 10 minutes (twice a day)
• Staircase UP and DOWN exercise. I had too much pain when I tried to do that. So my Physical Therapist postponed this to next week

Week 7:

• Unable to do more exercises because of heavy office work load
• Tried Staircase UP and DOWN exercise. Still had the pain but continued

Week 8:

• Able to walk properly on the flat surface without limping
• Stationary biking increased to 15 minutes without stopping (twice a day)
• Cross walking

Week 9:

Week 10:

Month 5:

• Staircase UP and DOWN is easy now.
• Stationary biking increased to 20 minutes without stopping

Month 9:

• Played VolleyBall for 3 hours in a Sand Court and was fine. Movement is not that good but ok. 
• Still I feel the fear to jump

Normal Process after the Surgery:

• When you leave the hospital to continue recovering from ACL surgery, you will be given specific discharge instructions with regard to driving, activity level, medication, and any further restrictions necessary.
• Your healthcare providers will also advise you of any symptoms that require immediate medical attention. Because knee pain is normal, you will also be given medication.
• You should expect to have your knee wrapped and possibly be in a brace that helps keep your leg straight. This brace is only used during walking.
• Your thigh muscles will be weak after the surgery, and the brace will protect your knee from suddenly bending. This is usually worn for two to three weeks after ACL surgery.
• You may use crutches to help with walking, and these may be put aside as soon as you are comfortable bearing weight on your leg without them. The Ace wrap can be removed in two to three days, but most doctors prefer to remove it themselves on your first post-op visit.
• You should expect to see your doctor for your first follow-up visit 7 to 10 days after the ACL surgery. Stitches are removed at that time, and an exercise program will be established. Your doctor may have you begin range-of-motion exercises prior to your first visit.
• Your doctor will send you to see a physical therapist to work on range-of-motion and strengthening exercises after your ACL reconstruction. Physical therapy can last from three to six months, and you can expect at least six months to possibly up to a year to regain the full function of your knee.
• Your doctor and therapist will determine the specific exercises and schedule. Usually, the first six weeks are focused on regaining the range of motion. This is followed by a strict exercise program to regain your strength.
• The graft must both heal into place and become part of the knee. Therefore, you will need to be careful not to do too much activity too early, as this may cause the knee to get inflamed, reinjured, or may increase the risk of a graft failure.

General ACL surgery recovery time:

ACL injuries regardless of whether they require surgery necessitate “time off” so the ACL and other affected portions of the knee can heal.   If surgery is necessary, patients are usually directed to wear a knee brace and/or use crutches.  In rare situations where other injuries exist, an above the knee case (AKC) may be needed.  The brace and crutches are generally utilized for the first six weeks after surgery.  During this time, rehabilitation through physical therapy will occur.  A typical timeline (after surgery) for patients to do the following activities is:

• rest, ice, elevation, compression—2-4 weeks (occurs during the 2 weeks after surgery)
• walking and biking—12 weeks
• running—6 months
• competitive sports—no earlier than 8 months (9-12 months typical)

If you have had multiple or a serious ACL injury, your recovery time may be prolonged.  Remember, if a patient attempts to resume “normal” activities too quickly, the ACL may not fully heal and additional surgery may be necessary.  Athletes should be careful to follow their doctor and surgeon’s advice.  Returning to a competitive sport too early may cause permanent damage to your ACL, causing your mobility to be irreparably harmed.

Your medical professional usually will clear athletes to return to their respective sports when the patient has:

• full range of motion
• no pain in the affected knee
• the ability to walk and run without pain or limping
• the ability to move laterally and diagonally without pain
• the ability to jump, crouch, and kneel.