Been There, Done That, Got The T-Shirt.

Hello, dear reader. It's been a while.

As I mentioned briefly on New Year's Eve, I re-tore the ACL in my right knee December 28th during sparring class. This is the knee that started all this business almost exactly 2 years ago.

I ducked under an opponents punch way too deep, with my right leg forward, and tried to explode upwards with a back fist while most of my body mass was still moving from right-to-left. I made it about 3/4ths of the way up, then my right knee bent sideways and I went down.

Last Monday, January 11th, I had an ACL revision done on the knee. The procedure is much the same as ACL reconstruction, except with a lot more prep work and bigger hardware. The prior ACL is removed and loose tissue cleaned up, and the old fixative screws are taken out. (I have my old screws as a token now.)

As with the prior 2 reconstructions, I opted for a femoral nerve block with a spinal block so I could observe the procedure. Good news is that the meniscus continues to be well anchored, with no signs of damage save for a tiny floater they caught doing laps in the saline on camera.

Again, like in December 2008, the spinal wore off a bit prematurely and I had major cramps in my lower back due to the position I was in on the table. Also, I began to feel the pins and needles in my right leg as the spinal wore off, and the tourniquet was removed. Yes, I could have opted for some sedation or pain killer, but I weighed the cost of $100 a pop against my short term discomfort--we have new insurance that would have me paying more out-of-pocket now--and I decided to save a buck or two.

Because the bone tunnel necessarily has to be enlarged, the replacement tendon and hardware are also larger. The original upper fixative screw was installed into the end of the femur 'from below,' essentially within the knee joint. This time, the screw was installed into the end of the femur from above, which meant my quads took a beating from being retracted while this somewhat gruesome business was conducted. I saw that bit from the arthroscope and realized that it's gonna sting like the dickens when the blocks wear off...

On a funny side note, Dr. K had some difficulty tightening this upper screw, losing his grip at one point and nearly knocking over some monitors and IV poles in the operating room! I suggested perhaps an impact wrench might not be a bad idea, but he replied that using motorized assistance tightening screws could result in over-torquing.

Once Dr. K was done and the other surgeons could take over closing things up, I reminded him of my request for a t-shirt from the clinic; I figure a guy is due something for his trouble after 3 operations! He not only made good on the promise, netting me a nice long sleeved Under Armor shirt with embroidered logo, he even put it in a gift bag with a birthday card and delivered it personally while I was in stage 1 recovery.

The card reads "Each year the wishes just get bigger and better!" with a note: That's 3 years in a row! Enough already! (Just kidding.)

So the first 36 hours post-op sucked as usual, peaking on Tuesday night when I had a major charlie horse in my thigh that felt like a dagger was stuck there! Fortunately a bit of Tylenol with Codeine took care of that and I could sleep peacefully. Since Wednesday I've taken nothing but Ibuprofen, a good thing and par for the course.

First PT session was Thursday. My prior PT clinic has closed its doors due to the recession, so I opted to do PT at the clinic where the surgery took place. There I met Ben, who will be my main PT this time around. I was encouraged by being able to toddle around the house with just a cane already, a very positive early milestone that the knee can bear weight well already.

Surprisingly my quads were firing quite well, and I could do straight leg lifts without too much difficulty. I even have a bit of hyper extension, already nearly equal to my good knee. Flexion is only at about 60 degrees while on my back, maybe 70-75 hanging over the edge with assistance from the good leg. The biggest stopper right now is the local knot of swelling to the outside of the quad, the result of insult to the tissue from installing the fixative screw.

Last night I was wide awake at 3am with a mild fever coming on. So on top of the typical post-operative pain, I had body aches as well, and lay awake for probably a good 2 hours trying to find a comfortable position. I should also mention, it's the first night back in my regular bed upstairs, and not on the totally comfy couch downstairs, so re-adjusting to sleeping on the mattress probably contributed to lower back cramps. Meh.

Well, tonight I'll be hanging out with Mrs. Shaft while G-Shaft goes to a schoolmate's birthday party for a few hours. We plan on tossing back a few Amaretto-Sour's while watching a movie and enjoying a new recipe for cold Thai peanut noodles.

More tomorrow, possibly pictures, and what the future holds for Paul "Hack Shaft" Pederson.

3rd time: NOT a charm...

I'll be brief since we're heading out the door to a New Year's party (Happy New Year, by the way).

Monday at sparring I tried ducking under my partner's kick and coming up with a back fist from underneath.

At a guess, I was moving sideways too much, and tried coming up while the mass of my body was still shifting sideways.

The result: That too-familiar shifting sensation of a joint dislocating.

Tuesday was the MRI.

This morning's visit with Dr. K confirms that I re-tore the ACL in my right knee - the first knee that started this blog in 2007.

Surgery in 2 weeks. Sorry, everyone.

Seeing Red

Whew, what a busy month July turned out to be!

I tested for my half-belt (or "stripe") at the end of May, the day after officially having all restrictions removed by my surgeon. It felt like the toughest test I'd done, but I was very proud of my performance and felt stronger than ever.

Throughout June and into July I suffered a string of weird minor injuries, all outside of Karate class.

I strained both quads sprinting way too hard during a routine Saturday morning run, was knocked out of commission for a week with a nasty virus, and two weeks ago I twisted my left ankle something fierce stepping into a pothole on a local walking path that was overgrown with grass.

Waking up with stiff joints and pain has become de rigeur in my morning routine until I've loosened up with a hot shower. I'm OK with it, though, since it's a predictable thing.

What I didn't predict was testing for Red belt just shy of 2 months after my last belt exam!


It went well, but with all my down time I was less conditioned than I cared to be. This was most noticeable when doing slow-count kicks. Remember those??? Well, for Red belt and above, you no longer do them holding a barre or against a wall to steady yourself.


You're in the middle of the room.


And you darn well feel it when the test is done!


I talked to my instructor about having such a short interval between belts after the test. The curriculum requires a progressively higher number of classes between belts as you move up through the ranks, but he feels I'm ready for advanced belt classes based on my progress since returning from injury. Wow, how cool is that?!?

Tomorrow night's class is canceled. My school's head examiner for black belts is personally conducting a special class for advanced belts, which is predicted to be well over an hour long--possibly closer to two hours. It's intended as a preview of black belt screenings, and I'm both nervous and excited to take part in it.

When I went to watch the Family That Fights Together during their final screening back in November, the Examiner spotted me coming into the lobby and took time out--right in the middle of the screening--to offer his condolences, emphasizing that "there is life after this."

You see, he's a 5th Degree black belt with reconstructed ACL's in both knees.

We're an immense distance apart in rank, but wear the same scars marking our initiation into a regrettably elite club.

I look forward to working out with him if for no other reason than to thank him for his encouragement and his faith in me.

Freedom

I'm free...I'm free!
And freedom tastes of reality.

"I'm Free" from The Who's rock opera "Tommy"

1. Saw Dr. K this morning, restrictions are removed.
2. "Have a good life," he said.
3. Made a pact with him that we shall never meet again under these circumstances.
4. Got the above song stuck in my head.
5. Testing for my next belt tomorrow morning.
6. Sparring Monday night...

Old doc, new tricks

Thursday's visit with Dr. K went as expected. No surprises, and I'm cleared to begin running. Granted, in the chilly state I live in it's not been above freezing the entire month of January, and mornings are still dipping into the negative numbers even today. Combine that with a nasty cold I've been dealing with over a week, and I'm just not ready to head out for an early morning jog! I do promise to post some pictures when I do, however, since the mornings are so beautiful this time of year.

Having been through all this before, I had some fun with Dr. K and the medical student working with him. As I sat on the table with my legs dangling down, he asked "OK, which knee are we looking at today?" I told him to guess. "Well, they both look the same," he quipped.

I replied, "If you can't tell, then you must have done a pretty good job!" as I pointed to the left knee. Truth be told, they did look very similar in terms of minimized scarring. The only real give-away would be the slightly shorter patch of hair around the left knee and shin, still growing back from being shaved.

He demonstrated good surgical results to the student with a cursory Lachmann test and a pivot-shift test that months ago would have insulted the MCL sprain accompanying my torn ACL. We also chatted about the mechanics and root cause of injury to each knee, making for really rich conversation between surgeon, patient, and student.

At my 6-week appointment last year, I was asked if I had any more questions. "Sure," I said, "Am I going to be able to play drums??"
A puzzled Dr. K: "Well, I certainly don't see any reason you couldn't."
Me: "Great! 'Cause I can't play them at all!"
(insert rim shot: ba-dum bum)

This year: "Am I going to be able to pilot a plane?"
A year wiser Dr. K: "Could you do it before?"


See, you can teach an old Doc new tricks!

One down, four to go

Monday was my 6 week mark. This represents being 1/4 done with the 24 week protocol!


I celebrated today by forgetting my appointment to check in with Dr. K, and re-scheduled it for Thursday morning after my PT session.


Today's report: 30 reps @ 4 pounds, 32 sit-ups and push-ups. Numbers keep going up as the days go down!!!

Love

My wife loves my knee.

She said as much this week.

Well, she loves the rest of me, too, but my operative knee in particular comes in handy for Christmas shopping since it nets me a handicapped parking pass.

Notable milestones:

- 110° of flexion, -3° extension, and straight leg lifts with no noticeable lag.
- Beyond weight-bearing and walking without a limp, I was actually able to balance on the operative leg on a mini trampoline at PT!
- Stitches are out.
- Immobilizer brace and cane are gone. Amen.

Only noticeable ongoing issues are my leg coloring up (normal, but rather gruesome looking) and mild cramping in my quads. I'm strictly on Ibuprofen, and should be weaning off that soon.

This year we added a Wii to the household. With the addition of the Wii Fit, I hope to work a lot on balance as I work on strength and flexibility throughout my rehab.

As I reflect on the events of my 39th year, I realize that I am approaching 40 with 3 people and 4 screws inside me.

My resolution this year is simple; Start daily push-ups and sit-ups January 1st, adding more each week. Starting at 10 of each daily, in addition to my PT regimen, and add 1 each day. By my anticipated return date in 20 weeks, I should be at around 150 daily. Wish me luck!

What's your fitness resolution this year?

Hack Shaft II: The Clone (Pictures!)

Welcome to the sequel.

Unlike many movie series, my second ACL reconstruction experience so far has exceeded expectations. Here's a few comparisons:

- Initial injury. No swelling vs. puffing up like a balloon. My ACL had somehow managed to fold over itself immediately after rupture, effectively choking off any hemorrhagic blood flow and preventing swelling. What a miracle and a blessing, it saved me from Pre-Op PT to restore Range Of Motion.
- Locating the femoral nerve. Got it the right away vs. needing a few minutes (and hitting some raw nerves in the knee joint.)
- Lower sedation levels. The spinal block injection didn't bother me any more than the prick from insertion of the I.V. catheter; last time they knocked me out for about 15 minutes. Since I was far less sedated, I was able to experience the whole surgical procedure without memory holes. Yes, I'm one of those sadists who watched his own surgery...Again!
- No nausea from pain meds. Since Vicodin made me constantly nauseous, I raised the issue this time. We ended up with good ol' Tylenol 3 (Tylenol + Codeine) and it worked like a charm. Vicodin and its analogs are powerful Codeine synthetics, and my pain threshold just didn't justify the side effects. I remembered tolerating Tylenol 3 in the past, so we combined that product with 800 mg doses of Ibuprofen and I was much more satisfied with the results. As of this morning I'm strictly on Ibuprofen since I had no significant pain when I woke up.

Some things weren't as positive. The spinal block began wearing off as they were closing up; last time it didn't begin wearing off until I was in Stage II recovery hanging out with Mrs. Shaft.

It didn't cause problems with any surgery-related pain since the femoral block was still active, but my posture on the table made things uncomfortable at that point.

My operative leg was strapped to an immobilizer board, and the end of it was digging into my left butt cheek. My right leg was dangling unsupported over the edge of the table at perhaps mid-thigh position.

The resulting dead (rapidly becoming live) weight pulled my lower back into an increasingly uncomfortable arch and began tweaking my lower back something fierce! I tolerated it to a point, and when it seemed like closure was still gonna take a bit I brought it to the attention of my nurse anesthetist. Since lumbar support wasn't available, and raising my torso to a higher angle just exaggerated the discomfort, I ended up with a shot of some narcotic (under protest.)

I felt it was overkill, and when the first dose didn't settle my lower back I got another. That settled things down, but made me a bit more woozy in recovery than I cared for. Leave it to an anesthetist to conclude the solution to any pain is more drugs.

My advice for anyone reading this and preparing for surgery: If you're awake, get lumbar support in place if possible!! My conclusion is they probably couldn't place anything there since it was the injection site for my spinal block, and perhaps they needed to watch it or something.

Once closing up was done, my cryo-cuff was installed as well as the immobilizer brace I'd brought in for re-use. This time, however, they installed a compression wrap along the length of my leg, rather than just gauze to hold dressings in place. Unfortunately this resulted in a lot of insulation between cryo-cuff and my knee, so it was pretty much ineffective until dressings were changed the following day and a few layers removed.

This morning was the 48-hour mark and so I removed the dressings to shower up. Things look pretty much as expected, but my leg as a whole seemed much more swollen than last time. I assume removing the compression wrap probably induced that, as well as a lack of proper cooling for the knee the day before.

The only thing out of the ordinary was a nickel-sized blister at the end of some of the steri-strips on my shin. I contacted a nurse at the clinic, and the conclusion is it was most likely the result of unusual rubbing at that spot. I trimmed back the steri-strips to better expose the blister, then padded the site with some larger gauze to protect it until it either drains or the fluid is re-absorbed. Fluid in it was clear, so I'm not too concerned unless it bursts and creates an opening for infection. Just something to watch over the next few days.

As for getting around, I'm on a cane at home already and crutches in public (for speed), so am able to bear weight well. Couldn't do a straight leg raise at PT yesterday, so I'm working on quad sets and assisted raises using my non-operative leg along with passive extension while icing and such. My numbers are +10° extension (should ultimately be around -10°) to about +75° flexion.

I got a looong way to go, baby!

For the gruesome of yousome, here's before and after pics of the ACL:

The tip of the probe is in front of the Posterior Cruciate Ligament, the ACL's partner. "Cruciate" refers to the crossing of the two ligaments working in concert to hold the shin in proper position relative to the thigh. The lower end of the ACL took some bone with it when it ruptured, and somehow folded over itself choking off blood flow that would have otherwise caused massive post-injury swelling.


Welcome the PCL (top-left to bottom-right) and it's new ACL partner (bottom-left to top-right.) May they perform their duet perfectly in concert until the day I die.

In closing this post, I want to take a moment to thank two anonymous people for their decision to be organ donors. Since my replacement ACL's are both allografts, (harvested from cadavers) I give my most heartfelt thanks to them both for checking that box on their state ID or driver's license forms. I hope you both enjoy the ride as I cruise into my 40's next month and continue my journey to black belt and beyond.

Time, and time again.

The date and time are set, the countdown reset.

December 15th, 8:30 am.

Saw Dr. K on Friday, he confirmed it is a complete ACL tear, and is just as baffled as I am as to the lack of swelling. He mentioned that sometimes it's the result of chronic ACL wear, but he saw no indication of that. Guess I'll just count my blessings I didn't have to go through the whole swelling-reduction program prior to surgery!

No indication of Meniscus damage, and signs of an MCL sprain which will resolve itself without surgical intervention.

As I head for my repeat, it's a reminder of all the things I had to do last time. Pre-op physical. PT appointments. Follow-up appointments. Work scheduling. Short-term disability. Allograft decision.

On.

And On.

And yes, I will be watching surgery again. That was cool the first time, gotta catch the sequel!

I will pack and gift wrap my uniforms and equipment this weekend. It was a ritual I used before, and one worth repeating. It symbolizes the pain of putting away my Karate for a while, with the promise of rebirth, restoration, and renewal in 27 weeks.

Happy Thanksgiving, all!

Really Weird.

I want to thank everyone who commented for your support. It may be a few words on a blog, but I'm glad to know I'm not taking the trip (again) alone!

Friday night's screening was really cool. I'm sure the 5 people from my school will fly on to the final exam with no problems! Lots of people were asking about me, whether what they'd heard was true.

I hadn't the assistant instructor from that night since the injury, and he took time to step off the mat and check in with me. Mr. Fab was, ironically, the only one present for both ACL ruptures.

Most impressive, however, was our 5th degree in charge of Black Belt screenings. Mr. War took a moment--right in the middle of screening--to give me his personal condolences. He himself has had both ACL's re-constructed, and stated "There is more after all this..."

So on to the "Really Weird" bit.

This time, my ACL tear emitted a 'pop' as one would expect. However, there was no swelling whatsoever! Now, I've no idea how that's even possible, unless some unusual situation--perhaps a bit of bone on the end--managed to immediately close off the blood vessels that typically run through the ACL. Normally these suckers swell like a balloon almost immediately from the hemmorhage, but not this time.

Weird, huh?

While Dr. W stated the MRI did confirm a torn ACL, I forgot to ask if it was partial or complete tear in his opinion. Hopefully Friday's visit with Dr. K will shed light on that particular mystery.

So tell me: Anyone reading this experience a partial tear only, or some level of injury where no swelling occured???

Reset.

Folks, I am sorry to report that I'll be re-setting the clock at the top of my blog shortly.

Saturday I got the call from my doc, the MRI confirms I've torn the ACL in my left knee now as the result of a bad landing from a tornado kick on Election night.



At this point, looking at the second week of January for surgery for a variety of reasons, some financial, some just plain timing.

I mentioned to the staff at the clinic that I really didn't intend to make this an annual visit, and I'm not looking forward to the look on Dr. K's face next week.

On the plus side, it's almost time to plan for flexible spending accounts again, so I can set aside pre-tax money again for the next round. I also have all the specialty stuff, like an exercise bike and the all-important cryo-cuff.

And so another round begins.




Plbbbbbbtttttttt!!!!

Surgeon's Report: 3 Lovely Words

I had my final visit with Dr. K this morning.

His exact words:

WELCOME TO GRADUATION!

No more restrictions--even if I played football, he'd have OK'ed me for full contact.

The sky doesn't get any bluer, nor the light any greener than that. AMEN.

If I could save time in a bottle...

Hey, everyone. Send a special welcome to Chad.

While I'd never wish the pain and suffering of ACL injury, reconstruction, and recovery on anyone, I do sincerely welcome him to this growing circle of Martial Artists blogging about their experiences. While Chad found my blog first, I still have to tip my hat to BobSpar for being the blogger I first found!

My usual posting time at work has been consumed with, well, lots of actual work lately! I never did post the milestone at PT back on April 9th: I am cleared for exercise with no restrictions.

Does this mean I'm back at Karate? Not at all. But it does mean I can go beyond linear motion and really dig in to my final phase of rehab.

Ladies and Gentlemen, I am now slow-count kicking on both legs, and it feels great! It's amazing how what once was a dreaded class drill in strength, balance, and muscle memory is now something I embrace with gusto. I feel a lot of pride in being able to stick a leg out there and hold it rock steady again.

I've pushed my running to a strong 2 miles, typically 7-10 minute bursts with a minute or two of walking to give the knee a break. I mix up the walking segment with backwards walking, and do some drills running in all sorts of ways.

Working myself around in a circle:
- Running forward for a 10-count (1-2-3-4, 2-2-3-4, etc.)
- Grapevine sideways, left (good) leg leading for a 10-count
- Running backwards for a 10-count
- Grapevine sideways, right (operative) knee leading for a 10-count
- Back to regular running

If you're a regular runner, give this sequence a shot to break up your routine. Just one of these gave me the muscle burn of an extra 1/4 mile sprint!

I tried skipping rope for about 2 minutes before I had to give up. The one I bought is plastic, which is rather stiff in the cold morning air. Not only does it tend to trip me up just as I'm getting into a rhythm, it also whistles really loud, and I don't wanna wake the neighbors!

I plan to buy a spool of cotton clothesline that's heavy enough to be effective. My hope is to work up to about 5 minute jumping sessions, mixing up alternating feet with one-foot hops. I really want to be light on my feet when I return to sparring, and this is the best exercise I can think up.

Coming soon: visits to the local park for some more interesting drills such as running figure-8's, walk/run uphill backwards (there's a variety of slopes available at the park), and the occasional break for forms / kata.

That old feeling...again!

It may seem a mundane thing, but a sweet little event happened this afternoon...my operative knee gave just a teensy "crack" as I got up from my office chair late this afternoon. Ahh, what a nice thing to hear again.

It echoes some progress I noted today, such as dimples in my knee when flexing the quads. Just a bit of persistent (but not painful) swelling remains below the knee cap.

At PT today, the big news is that I hit 126 degrees of flexion here on day number 22!

Next Friday when I go to see Miss Molly at PT, We'll begin "Closed-Chain" movements, if I recall the term correctly. That means one-legged knee bends, essentially, and taking stairs normally without guarding the operative knee. Later that same morning I have my 4-week follow-up with Dr. K.

In the meantime, I picked up an ankle weight, adjustable from 1/2 to 10 pounds in 1/2 pound increments. Was going with just 1 pound of weight for most leg lifts last week, and 3 pounds for prone and standing hamstring curls. This week I graduated to 2 and 4 pounds, respectively.

I'm gonna have to start exercising both legs at this point, or risk my operative knee and leg becoming stronger than the other!

Day 9: Antici..................................................

...pation!

I was just perusing the protocol for rehabilitation from knee surgery. Looking at weeks 13-24, about 4 to 6 months post-op, I'm shocked at the hopping exercises. I mean, my knee is giving me sympathy twinges thinking about square, diagonal, zig-zag, single-leg, and straight-line hopping! YIKES!

Still, I have to trust that my surgeon and PT know what they're doing. Based on costs, they'd darn well better!

For the martial artist reading this, think back to that very first class, when your uniform and white belt were both creased and stiff, still reeking of the plastic bag you just pulled them from.
Remember how far away your current belt seemed then!

The sick irony is that it will be longer for me to return than I've been taking classes. 7 months from injury until I expect to return, and I was just entering into month number 5 of classes. (I've studied the Arts previously, albeit quite some years ago!)

However, I realize that I can still fill time with Karate:
- Work on core.
- Do Form in a chair or in my head. Limp through it when I can, walking through the motions without actually kicking.
- Get familiar with that new Bo, so it becomes an extension of my arms when I return.
- Improve my upper body and core strength while getting the knee back in condition.
- Figure out exercises to use as a sub for some boring PT--like 4-count slow kicks vs. side leg raises to work abductors and hip flexors.
- Continue to record belt tests on DVD for the school--then review and learn from them, using the "best in class" as a visual aid for Bo and open hand Forms.

On a side note, I've taken notice of ACL injuries in the media all of a sudden. It's contagious, I swear! Previously I mentioned Jason Chambers' poorly executed tornado kick. Then comes the return of American Gladiators, where Jesse Foster tears her knee up during Power Ball. Looks like yet another one bites the dust!

Day 6: On the cusp

Things went tremendously well at PT this afternoon. I've a challenge to work on straight leg raises now--initially it was only 9 in sets of 3, 4 times a day. Today I found out the goal is 300 in a day, which I don't intend to do right away!!!

Flexion is improving, and the auto-chill accessory showed up today. That'll be fun to try out this evening.

Took my first full-fledged shower on the loaned shower bench, and it was mahvelous, dahlink! I've been keeping clean and all, but ya just can't beat a good shower--except with a nice long, hot bath. The Steri-strips fell off, so I put a large band-aid in place to hold two clear nylon sutures that were poking out, looking rather important.

Oh, and looks like some extra blood is pooling around various places in my leg now, most notably on the instep of my foot. Not painful, not swollen, just a pretty shade of purple down there.

Been walking real well today, even with the brace. Hoping I'll get permission to drive Friday from Dr. K, as I'm doing well bearing weight on the new knee.

Tomorrow I'm 39, so today is the cusp-of-the-cusp, if you will, of turning 40. Aw, it's just another plateau in life's uphill climb anyway, may as well pause to enjoy the view!

Surgery: Let me introduce you to my good friend, Annie...

Folks, let me tell you. When having ACL reconstruction, you've got to meet Annie.

Her full name is Anne S. Tease-Ya, and she loves playing mind games! (Annie is a man actually, but humor me for the sake of word-play.)

I met Annie the morning of surgery, and she wore many labels that day:
- Femoral Nerve block
- Spinal block
- Monitored sedation

I was firmly against meeting her military aspect, the General, having seen the aftereffects in my daughter G-Shaft many times over the years.

The fun began with the Femoral Nerve block. Annie gave me a shot of something to bend all the straight lines on the ceiling. While I admired the interesting patterns forming overhead, Annie got busy with a probe making my right thigh jump in various ways. One location made my patella jump quite uncomfortably, so I warned Annie not to go there again with the probe! After a short time, she was satisfied with the location and shot me up with a long-term agent to shut down feeling in my thigh and knee for the next 12 hours.

Next was the Spinal Block. This one I remember nothing about after sitting up and leaning forward on a pillow in the operating room, so Annie must've slipped me a Mickey to make me forget those 10 minutes.

From that point on I was nicely mellowed out as I watched the team set up for surgery.

I felt just fine, no anxiety or anything while watching video of the procedure on a nice flat screen monitor. Once the scope portion was done, the nurse asked me if I wanted to watch the rest. I agreed, and she angled the monitor like a mirror for me to watch in fascination as the crew closed things up.

Rolling into recovery I felt just great, and was SO glad not to have general anesthesia when they shortly offered me coffee and a granola bar to snack on while Mrs. Shaft and I discussed lunch.
Once the tingling in my legs went away and I could differentiate between a rub and a scratch from the nurse's fingernail, I checked out and we headed for home.

For cryotherapy options, I went with the gold standard of a Cryo/Cuff Cooler. However, the system offered by my orthopaedic clinic was a manually cycled system, as opposed to the AutoChill system that many other people mention in their blogs about ACL reconstruction. The manual cycle isn't bad, just far less convenient than the autochill system (and only 50% of the price.) For a manual cycle, you connect the cuff around the leg to the cooler with a hose, open the air valve, and let gravity drain the warm water out of the cuff. Then you close the valve, swish the water to mix it with ice water in the cooler, open the valve, and hold the cooler above the level of the cuff. Gravity pushes chilled water into the cuff.

As you might imagine, this is a PITA to keep doing, and the chilled water in the cuff only stays effectively cold for perhaps 5 minutes, requiring another manual drain/chill/fill cycle.

So Mrs. Shaft and I did some digging and found a local sales rep to order the AutoChill add-on. It's a simple air compressor that connects to the top of the cooler, creating alternating vacuum and pressure to force chilled water in and out of the cuff automatically. It should arrive Monday.

So if you're reading this for research, my advice is to plan for the extra cost and get a cryo cuff with the auto chiller system, or plan to do a lot of 10 pound arm raises to cycle your chilled water manually.

Back to our story...once arriving home, I was blissfully pain-free and enjoyed my lunch and a couple of Vicodin, relaxing with the Mrs. and generally enjoying the afternoon.

In the evening, young G-Shaft went to her first sparring class--reluctantly--and I was very proud to hear she survived intact, winning two of three rounds against her fellow students. I heard one other student really wanted to wail on her and was reprimanded several times for swinging wildly. G-Shaft scored all her points with punches, which is pretty cool considering her slender build doesn't look like it packs much of a punch. However, the night before surgery I had her put on her gear and throw a few punches at my palms with sparring gloves on--that kid has a lot more power than I thought!!!

About 10pm, the femoral nerve block began wearing off, as evidenced by my leg broadcasting a moderate burning sensation to any nerves that were tuned in. Fortunately it was just in time for my next dose of Vicodin, so things settled down about an hour later.

That first night I tried just a half dose to keep my stomach settled, realizing that I'll need a full dose for a while longer and will just need to tolerate the slight nausea that accompanies it. Toughest challenge was finding a comfortable position that didn't push, pull, twist, or squeeze the leg in its immobilizer brace. I didn't really find a good position.


DAY TWO

The second day was filled with me tackling the near impossible task of finding a comfortable position to recline in, along with a post-up visit with the surgeon and a bit of running around at the local Target store for some odds-n-ends.

Dr. K was very happy with surgery results, and the good news is that I have no tears in the meniscus. Yay!!! I'd been using a walking stick regularly until surgery to avoid further injury to the soft tissues, looks like my vigilance paid off. I'll post a picture of the good and reconstructed knees once I download them from Mrs. Shaft's cell phone.

Target was fun as I toodled around in one of those electric shopping carts they make available to customers. That thing had the most obnoxious backup alarm, people must've thought I was a semi trailer backing up in the aisles!

A side note here to BobSpar--I bought a urinal at a local store, but haven't needed it yet since I'm currently recuperating on the couch within 20 feet of the bathroom. However, based on the sound of my voice this morning, I need to push fluids a bit more, so we'll see if anything "urgent" comes up! The urinal comes with a cap, and is probably a bit easier to use than a pickle jar. Also doesn't flavor the pickles...

DAY THREE

So we finally arrive to today, day number 3 post-op. The good sign I had this morning was that my leg had no pain in it while lying passively, so that's a major improvement. I go to my first PT session in about 2 hours, we'll see just what's what at that time and report back tomorrow.

(yawn)

I think I'll stop here, grab a quick bite to eat, and nap until PT.

Thanks to everyone for their advice, positive thoughts, and prayers. They're helping me tremendously!!!

Excellent videos about ACL injuries

This video has an excellent animation on the ACL's function, and how it tears:



This video of a wrestler tearing his ACL is just plain disgusting to hear. So why can't I stop watching it?

Another one bites the dust!

If you're a fan of Human Weapon on the History channel, they just aired an episode exploring the origins of Tae Kwon Do. At the end of the episode hosts Bill Duff and Jason Chambers are matched up with one of South Korea's best TKD instructors.

Bill gets knocked out during his second round, even being the large man he is with full protective gear on.

Jason tears his right knee's ACL with about 20 seconds left in his round. He attempts to execute a tornado kick with a poor landing, and the resulting torsion snaps his knee. He also lets loose an impressive stream of expletives that were beeped out.

He attempts to finish the round, but the pain and expletives just increase dramatically. I wanted to reach through the screen and smack him.



Macho...foolish...idiot.

I also had a conversation with a co-worker yesterday, and discovered she too is having reconstruction in about 3 weeks. She believes her "event" was likely about 10 years ago. Ten times she has endured episodes of excruciating pain as her knee joint locked up in flexion, apparently dislocating and requiring an ER visit to anesthetize the joint and pop it back into place. She's finally decided to get it diagnosed, and to have reconstruction.

I'm so glad this has been no more than a 4-week period from injury to surgery.

I can't imagine living longer than this with a sloppy, floppy knee joint, constantly concerned for whether my knee will pull a "flamingo" and bend backwards.

Dead man walking

I got confirmation from my health insurance company today that an allograft for my ACL reconstruction is an acceptable option, and they'll cover it.

For those not in the know, this option means using donor tissue sourced from a cadaver to build a new ACL in my knee during orthoscopic surgery in (gasp!) less than a week.

To the man or woman blessing my knee with their donation of a replacement body part: I give you my most heartfelt thanks. Hope you enjoy the ride.