Fifteen Years Ago Today...

...I helped blast a $4,000 remote controlled helicopter drone out of the sky over Todendorf, Germany, using a $38,000 missile.

Four years ago today, I had my right ankle surgically repaired. It started making popping noises going up stairs this year. Happens pretty much all the time now.

Knee Update: Into The 9th Week

Had a visit with the Orthopedic Surgeon today, another follow-up for the knee. He's pleased with my progress, which is really no surprise given how PT has been going. He did a couple laxity tests and some other mild poking and prodding, and said it felt great. We talked some about what's next, and what I can and can't do at this point.

Golf is something I can do as tolerated, just swing easy. No running just yet, but the elliptical should be fine as long as I'm careful. Should be able to start straight-line jogging in about another month.

In October or so, I'll have to visit with him again about getting a brace for skiing this season.

Now, for the stuff everyone's been either waiting for or dreading: the 'scope pics. Apologies for the poor quality, I had to take pictures of the pictures, and they were poor quality printouts anyway. I'm going to see about getting digital copies.

Clockwise, from upper left: ACL, ruptured; Hole for pin; New ACL; Pin

Knocking Some Dust Off The Blog With Another Knee Update

Gosh, ever since I got into Twitter and Facebook (curse you, parents, brother, classmates, and friends! :) ), this old blog just isn't what it once was. Massive catching up needs to happen, but I'll get to what I can get to. Might have to do some beer blogging again, especially if the Highland Pub here in Gresham keeps coming out with kickass stuff on nitro, like the Oatmeal Stout and Vanilla Gorilla Porter a few weeks back. Damn good stuff. Then there's the goodies you can get on tap at 4th Street Brewing (used to be Main Street Ale House). Yum.

Anyway, I got to looking through the comments from previous posts and noticed this:

Dyanne said...

Hi--I am having ACL reconstruction in June, and I have been scouring the Internet looking for information. I found your blog and wondered if you would mind sharing more information about your surgical decisions and your recovery process. Did you go with the patellar tendon, the hamstring tendon, or the cadaver tissue? How much range of motion do you have now? What is your predicted comeback percentage? (80 percent? 100 percent?) I am a very active high school English teacher and professional dancer/co-director for an NBA team. I am worried about being able to dance 100% after this surgery. Not that I have a choice--I certainly can't dance now. I have a sprained MCL, sprained LCL, torn ACL, torn meniscus and a bone bruise. I am not a happy camper...

Hopefully, my responses will be helpful, so here goes:

Regarding surgical decisions - I went with the hamstring harvest/graft. I spoke at some length with my brother, who had an ACL repair done about 3 weeks before I even injured mine, and he recommended the cadaver tissue, given his discussion with his orthopod. I wanted to get my own recommendation from my orthopod, since he'd done the 'scope job on my shoulder in 2008 and I felt I could trust his judgment. He recommended the hamstring graft, citing success rates and the issues surrounding rejection/infection and other risks with cadaverous tissue versus my own tissue. In talking with several other ski patrollers who have had ACL repairs, the recommendations seem split right down the middle as to one over the other, and everyone I've talked to so far has been pleased with their repair. So it's probably a toss-up, but my recommendation is to find an orthopedic surgeon who you trust and go with whatever procedure he/she has most experience doing.

Regarding range-of-motion - I can reach 135 degrees of flexion on my own as of the last measurement in my 7th week post-op (last week). As for comeback percentage, all I know is the doc says I will be able to resume skiing when the season starts, but he wants me in a brace for the first season back. I figure if I can ski, I'll be able to resume pretty much all activities unrestricted.

Regarding recovery - I was given some PT exercises to do starting just a few days post-op, nothing more than setting the quad muscles and bending the knee. I started full-on PT about 2 weeks post-op, and that consisted in the beginning of ROM exercises and stretching, and have since moved more towards strengthening. I was on crutches until a month post-op, and my doc said I could ditch the brace at week 6. His recommendation was to wear it whenever I felt I needed to protect the knee, but generally I didn't need it anymore at that point. I've been going to PT sessions twice a week, and doing take-home exercises daily, most of which are focused on strengthening and proprioception at this point.

Regarding the rest of the comment - Sounds like your injury was quite a bit more severe than mine - I tore the ACL, damaged my lateral meniscus, had a noticeable bone bruise, but the damage to the MCL and LCL wasn't significant. The latter bit was somewhat of a surprise to me, given how it happened, but I'm thankful I didn't have what my PT referred to as "the sad trifecta" of ACL, MCL, and meniscus/menisci.

I hope your surgery goes well and best wishes for a speedy and complete recovery.

In other news, the Ski Patrol awards banquet was last night. We went, and had a decent time. Both of us weren't feeling particularly well, and the price of drinks didn't go a long way towards improving that. The prime rib was excellent, though. I got to see a lot of people and give them the knee update face-to-face, catch up with a couple of the guys who helped me that fateful 12th day (one of whom was coming off a knee repair this past season), and talk to an old sled coach who is now the Patrol president about his shoulder surgery. The best part was seeing some of the newbies I'd coached get their crosses. I think that's what will keep me coming back to the banquet. It certainly won't be the price of the drinks.

I was given a certificate of appreciation for sled-coaching, even though my season was cut short by the knee injury. I was absolutely shocked to get another Honorable Mention for the Barney McNab Hill Patroller of the Year award. I'm flattered and honored, of course, but very surprised. Unfortunately, we both were feeling kinda crappy, so we bounced early.

Knee Update: 1 Month Post-Op

Well, technically tomorrow marks the full month, but today was important enough not to wait. Besides, it's my blog and I get to choose which hairs I want to split.

Things have been going pretty well since the unwrapping and the follow-up a couple weeks back. PT is what it is, and happily that has been largely good. I'm working with Amanda again, so I have the level of comfort that goes along with knowing what to expect about my therapist's style/approach (she was my PT for the shoulder episode last summer/fall).

As with the shoulder, we're all about the stretching and range-of-motion work to start, and moving into proprioception and strengthening later. Today, I managed full revolutions on the bike, and actually got the thing up to 35+ RPM for a good bit. Did some walking around, some stretching, balance stuff, took some ROM measurements, all kinds of good stuff.

The funkiest thing was the "Purple Tool of Torture", which was esssentially this kind of scraper-looking thing. Amanda worked on the hamstrings with that and some nice warm gel, and it made a HUGE difference. Hopefully there'll be more of that, because it felt really good afterward.

Still have a lot of work to do, obviously, but Amanda is really pleased with my progress. Which means I am as well. ROM looks good (flex at 116 active, 118 passive; extension right at zero), motion looks good, strength is about where we expect it. The biggest thing about today was this: no more crutches.

I'll repeat.

No. More. Crutches.

I know, right? Awesome. I still have to be careful obviously, and I won't be doing any walkathons or anything for a good bit, but I'm very pleased. And I'm looking forward to the work I have ahead of me.

Knee Update: Unwrapped

Today was finally the day I got to take the wraps off my surgically repaired left knee. It felt good to air the poor thing out, as it was feeling very itchy and uncomfortable under the dressings. The bonus was that I got to take a proper shower as well, which felt fantastic. 

My first follow-up with Dr. M is on Friday, and hopefully that will mean I'll have some other things to share, like maybe pics from the scope and/or some MRI goodies. Here are today's pictures:

Full battle dress uniform - immobilizer, Cryo/Cuff port exposed.

Cryo/Cuff and pretty elastic wrapping...

Still looks like a nicely wrapped package...

There was a layer of cottony stuff, much of which is still stuck to the leg here, as I peel off the gauze pad. Sprung a little leak, it appears...

Still have some of the fuzz on, but here it is. I did finally get it all off of there before the shower.

You can follow my left knee's Twitter, if you're into that sort of thing: http://twitter.com/mikesleftknee

Now That's The Knee Surgery Over, How Did It Go?

Quite well, in fact. Check-in got bumped way up to 8am, so the likelihood that Imight have to spend the night diminshed significantly. PPMC's Short-stay area was just recently moved, and it looks really nice. The check-in area looks almost like a nice hotel lobby. 

I figured I'd have time to haul out the iPod and listen to some podcasts before my name got called, but I was wrong. They got me all checked in very quickly, and it wasn't long at all before I'm getting my IV and having my knee shaved. Nice nurses, very efficient. No missed pokes for the IV.

Doc M. dropped in to talk some about the procedure and what he wants me to do/not do after. Handshake, see you afterward. The anesthesiologist was excellent, making sure we did something similar to my shoulder procedure that helped with the recovery nausea. The anesthesia starts dripping via IV, numbing shots to the hip, and I don't even remember getting the shot that did the nerve block.

Next thing I know, I'm in the recovery ward, getting some ice chips and nurses dropping by to check on me. I kept dozing off and basically forgetting to breathe, as I kept hearing polite voices: "C'mon, don't forget to breathe now." I had to really focus on deep breaths, and my throat wasn't nearly as dry or sore as it was for the shoulder repair last year.

Got moved to recovery room, water and crackers now, still a little light-headed. Dr. M dropped by to tell me how things went, and all sounded like it was a walk in the park. ACL graft looks good, did some work on the menisci, looking good. Handshake, thanks, see you next Friday. 

B comes in, and we hang out watching TV and munching on the saltines and sucking down ice water. Took a good while for the light-headedness to get to the point where I felt I could get up on the crutches, but I had to - I needed to use the bathroom. The timing was good, though, since it was about the time I was getting antsy to 'go' that the nurses came in to help me give the crutches a shot.

After an Austin Powers-style urination, I got back into bed, we hung out some more until the PT gal dropped by to go over the exercises and see how I'm getting around on the crutches. Exercises for now are simply quad-sets and heel slides, nothing major for now. Can't really do them until the block wears off.

More hanging around in recovery followed, and we finally got let out since I felt good-to-go. No nausea, pain under control thanks to the drugs, okay on crutches = discharge. Had a fun little wheelchair ride, then into the back of the Sorento for the ride home. 

Just been watching TV so far, now doing computer stuff. Taking the next couple days away from work to chill and use the CryoCuff. No GameReady system for me this time, but the cuff is lighter, simpler, and I own it now. :)

Knee Update: MRI Review, Surgery Scheduled

I saw my Orthopedic Surgeon today. Went over the MRI and X-ray results, and I was actually a little surprised to see that it wasn't as bad as I had expected.

However, the ACL will need to be repaired. I had no doubt about that. What was surprising was there was less damage to the other structures of the knee than I figured, so in that respect there was some good news. The lateral meniscus was difficult to assess on the MRI, but we'll take care of all of that stuff when we get in there. 

I'd rather not have to be going through all of this, but at least I have people I trust working for me on this. The guy who did my shoulder last summer is going to do my knee, and he's done loads of repairs like the one I'm going in for. My PT will most likely be the same one who helped me rehab the shoulder, so I know what to expect from post-op PT. 

Surgery is next Wednesday afternoon (April 8th). Next post will probably be after that, pumped full of painkillers. :)

Knee Update: I-Day Plus 6

MRI finally scheduled for Monday morning, and a visit to the Orthopedist 2 weeks later. In a holding pattern until then. I decided to go back and see the guy who repaired my shoulder, since I trust him.

I'm trying to take it easy and be patient, but the lack of full mobility drives me a little nuts. Plus, there's still so much ski season left. Why couldn't I have done this in May or something? Frak.