Wednesday, October 28, 2009

Knee Surgery

Thursday, October 22nd: 
I had arthroscopic surgery today to repair a torn meniscus in my knee. The torn part had been flopping out of my knee joint, causing a lot of pain when it came out, and again when I shoved it back in. No other pain otherwise, though.  Here you can see the torn part of the medial meniscus:

(click the image to enlarge)

Anyway, during my original ACL surgery 3.5 years ago, both of my meniscuses were torn right in the middle of the C-shaped cartilage and were stitched back together. Unfortunately, there's very little blood flow in the knee, so it's often unlikely for cartilage to grow back. That's exactly what happened.  In the following picture, the pen scribble is circling the spot where you can see the original stiches:

(click the image to enlarge)

Luckily, the doctor said he only had to take about 25%, so that's a huge relief for me. Losing a large amount of your meniscus will hasten the on come of arthritis later.  Also, the meniscus is the cushioning between your leg bones, so losing it could cause pain while running.  Hopefully, that will not be the case.  Here is a picture with the torn piece removed.  Again, you can see where the original stitching was.

(click the image to enlarge)

The doctor said while they were in there, they checked out the other meniscus and my replaced ACL "because I couldn't complain."  Ha ha.  The good news there is that everything else looked good.  Here is a view of some dead guy's achillies tendon being used as my anterior cruciate ligament.  Looking good!  Thanks, Dead Guy!  I owe you one.

(click the image to enlarge)

After surgery, somehow I have no pain at all, except where they shoved the tube down my throat. I can walk on the leg (gently) and I can bend it 90 degrees, all without pain. The only weird thing is the knee is filled with fluid, so it gushes stuff around when I bend the knee, like when your stomach and intestines gurgle when you're hungry. It's very unsettling.

I'm not sure how much of the above is the drugs talking, but I'm really optimistic about the recovery now.

Saturday Update, Oct. 24: 
I got to pull all the bandages off my knee (except for the tape over the incisions).  It looks really great - only two small cuts, and a single tiny poke hole.  Unfortunately, the knee is starting to swell a lot, so it's getting very stiff and harder to bend.  At least the gushing is starting to go away.  And I can still walk on it without pain.

Monday Update, Oct. 26:
Went to the doctor this morning, who changed my bandages and cleared me to start doing exercises and bending the knee more than 90 degrees.  Nothing weight-bearing and no impact, but things like leg lifts, biking and the eliptical trainer are good.  I have a big packet of exercises to do.  Unfortunately, the muscles in my knee are not working so good now, and it's getting painful to walk.  Not painful in the area of the meniscus, but rather like something is out of place under the kneecap.  This scares me a lot.  On the good side, I was able to get on my bike today and gingerly ride to meet my kids walking home from school.  It was a little painful bending the knee, but not bad.

Wednesday Update, Oct. 28:
Walking is slightly easier today, or else I've gotten better not bending my knee.  I don't know.  I'm still not pleased, though.  I really hope this goes away soon.  I can bend the knee about 100 degrees.  I'm afraid to go much farther yet.  At least I was able to ride my bike better today.

Friday Update, Oct. 30:
So the trouble with bending my knee seems to be something under my kneecap that's out of place.  Hopefully this is just because of the swelling, and it will soon go away on its own.  Tonight, though, we went to the rock gym for Halloween Headlamp Climbing (all lights out in the gym, and you have to climb by headlamp).  I didn't climb, of course, but while the family was, I was stretching in the workout area.  As I was trying to bend my knee, it, as usual, got really painful and then SNAP!  Agony and then relief.  Something moved under my kneecap.  For a while after that, I could bend the leg easily.  I'm up to about 135 degrees.  Later, the pain in bending came back, but at least the breif relief gives some glimmer of hope.

Sunday Update, Nov. 1:
I was able to walk normally today, as long as I focused on the task.  I've been walking for a week with my muscles tense keeping my leg straight so it wouldn't bend and hurt, so now I have that muscle memory to overcome, along with the fear of pain.  I can will the leg to work properly, but as soon as I'm distracted, it goes back to stiff-legged limping.  Pretty weird.  I still can't go down steps at all.  Unweighted bending, though, is fine, up to the point where I feel it at the incision points.  Other than the scabs, there doesn't seem to be anything else preventing it from bending, which is great.  Biking also feels good, so I would like to start getting exercise that way.

Thursday Update, Nov. 5 (2 weeks post-surgery):
I seem to have regressed quite a lot.  I rode the stationary bike on Tuesday, and it felt ok on low resistance and slow speed.  At about 10 minutes, something really started objecting in my knee, and I quit at 15 minutes.  Wednesday and Thursday, I've been unable to walk normally at all, even with the mental concentration.  Today I biked for 20 minutes at slightly higher resistance, without pain.  So that's good.  But I still can't walk.  Going down stairs is out of the question.  Bending the knee feels fine, though, and I'm nearly back to my pre-surgery flexibility.  Took one of the bandages off today.. the cut looks fully healed.  The other was wide open when I went to the doctor that first Monday, so I'm keeping it covered.  It's being held on by some dried blood anyway, and I don't want to risk pulling the scab off.  Hoping to do some outside biking this weekend.. wish me luck.

Tuesday Update, Nov. 10:
Biking with the family and three friends went great.  I didn't push it too hard, but there was no pain at all, aside from the very first rotation of the pedals.  I'm planning to do it again today.  Also, Monday was the first time I was able to walk properly since right after my surgery.  Still walking good today.  So, other than not being able to going down steps, everything else seems to be progressing well, finally.  I hope as the swelling slowly goes down, the final piece will fall into place.

Friday Update, Nov. 13:
I walked down the steps for the first time in three weeks today!  Well, after my knee popped on the top step, the rest felt ok.  So, I guess I just need to get used to the initial agonizing pop, and all will be well.   Rich and I rode 15+ miles on our bikes yesterday, partly on gravel/dirt paths - great fun!

Thursday Update, Nov. 19 (4 weeks post-surgery):
Had a followup appointment with the doctor yesterday.  He cleared me to start impact exercises, like jogging.  He wants my leg muscles to get much stronger before I play soccer again, though.  I wasn't able to demonstrate the snapping sensation in my knee, unfortunately.  It's still doing it.  Doctor said it might be scar tissue, but I don't know.  I'm getting used to it now, at least, but I hope it doesn't last forever.  In celebration of being able to jog again, I bought some new turf soccer shoes.  Maybe it will be an incentive to work hard at exercising, which traditionally has not happened.  I did run about 2 miles today, which felt pretty good.

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