Everything You Never Wanted to Know about Having ACL Reconstruction Surgery
When I found out I had to have ACL reconstruction surgery, of course I googled it, looking for people who had the same surgery. I found a few blogs about it, but I quickly found that reading them raised my anxiety level. Still, it was good to have a little information in advance from people who had been where I was going, so I'm going to pay it forward by writing about what happened to me. This promises to be a long, boring post, but hopefully it will help someone like me who wants to know exactly what happens when you have ACL surgery.
The surgical center I went to was Kerlan-Jobe in Los Angeles and my doctor is Dr. Daniel Kharrazi. So far, I've been really pleased with the treatment I've received from Kerlan-Jobe, Dr. Kharrazi, and especially the staff at Kerlan-Jobe.
Here's a run-down of what happened in the days preceding my surgery:
1) Pre-op Appointment
There was no examination given during this appointment. Instead, Kerlan-Jobe staff and Dr. Kharrazi's assistant asked questions about my medical history and gave me the information I needed to prepare for surgery. It also gave me the opportunity to ask questions, such as:
Q- How will I get up to my apartment after surgery
A- Crutches (It turned out I was a little too off balance to use the crutches and nearly feel over a couple of times on my way up in the elevator and the pathway into the condo. I ended up using one crutch and Mick to slowly hop from the elevator to our unit.)
Q- How soon can I shower?
A- Second day, but must keep brace and dressings dry. Best option is to put leg into a garbage bag and cinch it at the top.
Q- How soon will I be back in the gym?
A- Ten days to two weeks, after my first post-op appointment.
Q- How long will it take to reach my current level of function?
A- About six weeks
I recommend you write down your questions so you don't forget anything.
2) The paper work they gave me at the pre-op appointment indicated I would receive phone calls from the insurance department of Kerlan-Jobe and the anesthesiologist. The insurance call happened a few days before the surgery and verified that my insurance was covering the procedure after my $3500 deductible was paid. The anesthesiologist called the night before. It was a helpful call--he explained what anesthesia they'd use and how it worked.
Day Before Surgery
1) I prepared everything I could think of for when I returned home from the surgery. I set up a bed on the couch and replaced our big coffee table with a small end table so it could be easily moved. I set out the clothes I'd be wearing while I was "laid up," including socks and underwear, so my husband or myself could easily get it. I put items like rubber bands, glasses, and lip balm in a small bowl so I'd have them when I needed/wanted them. I set up an easily accessible power strip where I could plug in all my stuff--computer, iPad, iPhone.
Making the couch-bed up in advance was the best thing I did though. Try to anticipate your needs as much as you can and prepare in advance. It was great to be able to just go straight to the couch with everything within easy reach.
Day of surgery
1) We were told to arrive at 8am for a 9:30 procedure. When I got there, I had to sign a lot of forms. It was also the beginning of the question: "Which leg is it?" (the left one). I was asked that again and again, confirming and reconfirming it was my left leg being operated on.
2) A nurse called for me and took me to the pre-op room. There were about five beds there, each with a person waiting for surgery. One of them was an Olympic volleyball player, but for privacy's sake I won't reveal which one.
3) I was given a hospital gown and a warmed blanket and told to take everything off, put the gown on, and leave it untied in the back.
5) The nurse gave me a purple permanent marker and asked me to write "YES" with an arrow on the ankle of my left leg.
6) The nurse put cotton around my arm, then a blood pressure cuff which remained on throughout the procedure. She explained the cotton prevented irritation from the cuff since it had to be on so long. She also put a finger monitor on me and attached some electrodes (not sure if this is the right word, but you know, the sticky things they put on you so they can attach monitor wires.
7) She inserted the IV needle. I must say she wasn't the gentlest of nurses and this fell under the category of "no fun." After the IV was in she drew blood and then it pumped fluids into me, which caused my right arm to feel cold, but not uncomfortably so. They'll give you more heated blankets if you want them.
8) Next came the worst part: Waiting. And waiting and waiting. Not sure how long, but it felt like forever because at this point, the anticipation of what was to come was causing me a lot of anxiety.
9) Finally, one of the nurses who would assist during the procedure came in and introduced herself. She asked me again which legs was being operated on and I passed the test by saying "the left one."
10) The anesthesiologist came in and administered a sedative to keep me calmed while he injected the nerve block in my femoral nerve.
The "happy" medicine really worked. As soon as it kicked in I became very charming and entertained everyone within earshot with my pithy comments and fantastic sense of humor.
The nerve block is injected into your femoral nerve and completely numbs the area. It's effects last from 10-16 hours and it helps with the intense pain immediately after the surgery.
When he injected it, the muscles in my thigh started twitching violently. Thanks to the "happy" drip I laughed through the whole thing.
9) They wheeled me into the operating room, where "Welcome to the Jungle" was playing which elicited comments from the nurse and anesthesiologist. I told everyone I wasn't familiar with the song because it was "before my time." (see reference to pithy/funny comments above).
10) They helped me get onto the surgical table, where I lay staring up at the ceiling. That's my last memory.
1) I woke up in the post-op room with a nurse standing beside me, helping me "come back." She offered me crackers and soda or water. My mouth was so dry I couldn't eat the crackers without taking sips of the soda in between.
2) They administered more pain medication through the IV and gave me a Darvocet and an anti-nausea pill since I told them I'd had bad experiences with Percocet and Percodan.
3) They brought Mick into the post-op room. Boy, was I happy to see him!
4) The surgeon's assistant, who is a very handsome man, came over and explained what I needed to do between now and my first post-op appointment.
-Keep leg straight at all times
-Keep brace on at most times (he said I could open it up and let it "breath" now and then, but I haven't done that yet).
-Increase food intake gradually
-Remove dressing in 2 days and apply new dressing
-Put no weight on leg until nerve block effects dissipate as the muscles are too weak to hold any weight
-After nerve block wears off, partial weight on leg, with crutches
I should point out here that different surgeons have different protocols. For example, your surgeon might have you start using the continuing motion machine (more on that in another post) as soon as you get home. Mine doesn't want me to start that until after my post-op appointment. Follow your surgeon's instructions!
5) The nurse helped me put my pants on, then removed my IV and electrodes and transferred me to a wheelchair. She let me put on my shirt by myself though. After that she wheeled me to the restroom.
6) An orderly wheeled me downstairs, where Mick was waiting with the car. Do yourself a favor and make sure your back seat is clear, because that's where you'll probably have to sit. Mick and I's back seat was covered with ski equipment and he had to scramble to remove it all so I could get in.
Home at last!
1) I spent the rest of the day entirely on the couch. There was a lot of drowsiness so I just turned on a DVD and let myself go in and out. I found I was pretty content to just lay there without any entertainment at all in fact. I guess the one good thing about surgery is that my normally active and neurotic mind has been shut off.
2) It took a few rounds on the crutches before I felt secure using them. I didn't try to get up unless Mick was there to supervise. But now, the next day, I'm much more confident and independent (though still won't use the crutches if Mick isn't in the house).
3) There is some pain, but it is manageable. Mostly it feels like I'm straining the muscle in the back of the knee. When I move there is additional pain on the top right of my knee and it feels like I shouldn't do it, but if I push past that initial moment of pain I find it's not unbearable and I can go about doing what I need to do.
4) I slept well last night. The only problem is staying one position all night--I woke up pretty sore.
5) The pain pill situation is interesting. Up until about an hour ago I hadn't experienced any nausea, but right now I'm feeling it. I'm also sweaty and a little clammy. I think I'll reduce my pain medication the next time I'm due to take it.
6) Today Kerlan-Jobe delivered the continuous motion machine and a Game Ready ice machine. Like I said, I won't be using the motion machine for awhile but I started with the ice today and kept it on (intermittently) for about 4 hours. It definitely reduces the pain, and consequently, I've been able to reduce my meds. Believe me, I'm not trying to be a hero, nor do I oppose being drugged at this time in my life, but the risk of nausea makes me reluctant to take them.
Okay, that pretty much does it for what happens during surgery. It is definitely not the most pleasant thing in the world but it's not as bad as I thought it would be. Actually, it's about as bad as I thought it would be, but I'm in a much better place than I expected, probably because I'm sleeping so much. I'm sure the time will come when I go stir crazy and get depressed but so far it hasn't happened. I'll post more about it if/when something that I think will be helpful to other people happens.
Before I go, quick shout out to my wonderful husband Mick who has been at my beck and call since yesterday (some would argue since he married me). Seriously, I could not get through this without him.
Finally, if you made it to the bottom of this post, here's a reward.