Recovery - Day 1

Day 1 for me started when I came round from the anaesthetic. This was officially on Wednesday night. The surgey kicked off about 3pm and apparently I was on the table for about 2 hours. I can't remember coming round from it quite as clearly as I can remember waking up from the hernia operation I had last year (is my body falling apart or what!), but I do remember having a nurse explaining what all the tubes going into my arm were there for.

The one on my left was for any drips they wanted to put in, and I think had probably been used during the surgery for fluids. There was also a green plaster on the back of my left hand which I think was where they put the aneasthetic in.

On my right arm was a tube leading to what was effectively an oversized syringe hanging around my neck. This was the good one. It contained morphine which I could administer whenever the knee was painful. Great stuff, it made my shoulders feel really heavy and then you could just drift off to sleep. It's set so that you can't overdose and apparently I used less of it then most patients - get in. Maybe a higher pain threshold, probably too lazy to press the button.

My right leg was also immobilised by a pressure bandage which was huge, and the knee had a drain coming out of it to drain off any excess fluid. Here are some photos off the leg with the bandage on - the one where I look in pain was just playacting - thanks to my sister Helen for these :-)












Anyway, my mum and big sister liz came to see me on the Wednesday night. I don't remember much about it as they were they at about 7:30pm and I was still well out of it. Apparently apart from introducing the nurse to my sister (who is also a nurse and they knew each other from another hospital) all I managed was some sarcastic grunts!

GRIZZLY BIT =>

Part of the aneasthetic was an epidural in my lower spine which took away all feeling to my legs. However, this also cause you to lose feeling in your bladder and makes your sphincter seize up (so I'm told). There is a danger that your bladder can fill up and you are unable to relieve yourself (or even know that you need to). They try and avoid this by not giving you too many fluids, but it still happens. I can remember a nurse asking me if i needed to urinate and saying I wasn't sure. There was a test by which they put pressure on the bladder, and then I could tell I did need to. So they gave me a bottle designed for the purpose. However, what with the morphine and other aneasthetics I was drifting in and out of conciousness (and I'm sure it was about 4am at the time - although I could be wrong). So like when you are standing next to someone at the urinals, I couldn't do it. They then had to catherterise me. This basically means putting a drain into your bladder through your uretha. Well, as a bloke this had never happened before and its not comfortable. I don't remember much about it happening as I was well out of it. And it does have some advantages as you don't need to get up and go to the loo ever again! But it's still very weird. The worst feeling is that if you move the pipe you can feel it all the way to your bladder and it means you stay very very still. It made sleeping at the end of day 1 a bit uncomfortable, but at the time you just don't care.

GRIZZLY BIT OVER

So the start of Thursday morning I was woken up with breakfast at about 7:45ish. This was a full on fryup. I wasn't sure if I was going to manage it as I hadn't eaten anything for about 36 hours. However, once it had gone done I felt fine. Although I was more restrained in the rest of my meal choices for the rest of the day (its always hard to pick from a menu when you are not really hungry).

After breakfast I was given a bed bath. Another interesting experience, but again, although it sounds embarassing at the time you don't care. What with tubes coming out of all sorts of places, I didn't feel I had much dignaty left, so youre just grateful that someone is looking after you. The nurse also managed to change the bedclothes with me still on the bed. A delicate process when moving the knee as it hurt and I didn't want to put any strain on it at all. But I was well impressed with this. The bed has these cleanable mattresses. So they have some plastic coating over which sheets are put. The matresses are well comfy though. Soft and firm at the same time. So, that was breakkie and getting washed.

The physio also visited during day 1, and gave me some exercise that involved moving my ankles to get the calf moving and one involving tensing the thigh muscle to stop atrophy. This one hurt a bit as it pulls at the wound site. But that just means that the exercise is affecting the correct place.

The knee hurt on day 1, as the aneathetist said it would when he stopped by. (He also apologised for the catheter as he'd been hoping to avoid it - I had been warned before going down that it was a possibility). This meant the morphine was used, so I was dozing a lot.

Lunch was a sandwich I think. They also gave me a lot of tea.

I whiled away the start of the afternoon by watching School of Rock with Jack Black. I wasn't up to reading or playing computer games as these required far too much concentration. By some impeccable timing at the end of the movie my Mum and Helen came in to see me for about an hour which was ace.

In the evening my friends Luke and Ralph both popped in to say hi and they were joined by my Dad who had swung by after work.

Oh yeah - I also got a call from Sara who rang about 9 in the morning. I was a little dopey during this comversation, but it was appreciated. I'd got text from loads of people as well, wishing me well, thanks to you all. It really helps to know people are thinking of you.

So all in all, not a bad day given I was totally immobile for the whole time.

Oh yeah - as for the other bodily function. Well the morphine slows down the peristalsis in your gut. So it wasn't a problem on day 1!

What did they do?

Well, I'm not the best person to explain this.
However, the following website gives a brilliant breakdown of what happened.
Some of the detail about the operation may be wrong, but the general information as to where the graft was taken from and where it was attached is all correct I think.

I haven't had a go on those continuous motion machines either.

http://www.arthroscopy.com/sp05018.htm
http://www.arthroscopy.com/sp05025.htm

It's all very cool. I know that the screws I had inserted are made out of stainless steel rather than being biodegradable (I had to ask at the following appointment a week after the op). I was also given the product stickers of the screws in case there is a product recall. I've been told that they shouldn't set off any airport alarms as they are quite deep.

So, that was the op. Obviously I didn't remember much about it!

Why did I need an operation?

Some would say the answer to the question above is simply 'football'.
Ok, I tore the ACL in my right knee whilst I was playing football but it wasn't the game itself that caused the injury.

It happened because I was in a crouched position (as you are supposed to do when defending) and slightly side on to the play. I then pushed off with my right leg whilst turning to my left and having my knees bent. The pitch was sticky and my studs didn't move through the mud.
My lower leg therefore was pretty much stationary whilst the upper leg was turning, causing me to over extend the ligament in my right knee.

I heard a very loud click/popping noise (which was audible on the sidelines apparently) and there was a lot of pain. The comedy moment of falling to the floor and yelling in agony will live long in my teammates minds (so they tell me), especially the banging of the ground with my fist - i swear it helped. It was more of frustration that I knew I was going to be out of action for a while rather than the pain.

I managed to get up, walk off the pitch and even do some light running. I even tried to carry on playing, but after kicking the ball once I knew I wasn't going to be able to continue.

Interestingly there wasn't much pain. Certainly in the weeks that followed, although I couldn't straighten my leg, or fully flex it, I could do pretty much everything else.

To cut a long story short, I saw various healthcare professionals but the knee specialist told me that I had torn my ACL and got an MRI scan which confirmed it. The options were to not have an operation, but not to play football again and be very careful playing sports involving planting the feet and twisting, or have an operation, risk it failing and not being able to play football for 9-12 months.

To be honest, I wanted my body back in working order and didn't want to be restricted now or in later life, so I plumped for the op. Deciding that some pain and a slow recovery were preferable to not playing football ever again!

Here's some interesting websites that explain how the knee works and some common injurieis

http://www.arthroscopy.com/sp05000.htm
http://www.ski-injury.com/

So, my firms private healthcare kicked in and I got a date for the op of 15th Feb.

I'd already booked a ski holiday for the end of Jan, and foolishy had not gotten travel insurance. So without a willing buyer I decided to go. I got travel insurance (and will now be purchasing it annually to avoid this problem again) and also a hardcore knee brace, which I was told I had to wear to avoid causing more injury.

Here's a link to the website of the firm where I bought it from.
http://www.technologyinmotion.co.uk/flash/knee-bracing/index.htm
I bought the flex sport one (the white one) as it was slightly slighter than the Edge brace, and not as rigid. This might have given me more confidence that I should have to go down black runs, so I plunged for the other brace.
This firm were really helpful, and because they are based in Wimbledon I could go and try it on before buying.
It was expensive though, and for a weeks sport seemed like a lot of money.

So with most of my work finished or handed over to colleagues and my flat as organised as I could get it I set up camp at my parents house, where my initial recovery would begin. the hospital I was in was private so I could take my PS2 in, which staved off boredom.

Unanswerered questions

Pre-op is a funny time. I wasn't sure exactly where they were taking the graft from, or how I was going to wash and perform other bodily functions if I couldn't move.

Fortunately the nurses and consultants answered all the questions and the aneasthetist was also very helpful.

At about 2pm on 15th, I took a premed (basically sleeping pills of some description) and some painkillers. This was after the nurses had shaved my knee - using a really funky razor that could be used dry (why aren't these available in the shops?), given me a natty anti-embelism pair of tights, the delightful paper pants and the open at the back dressing gown. So feeling slightly like an experimental animal and very drowsy I was wheeled off to theatre.

At this point, there was much to worry about; I'd set myself on the path of the op and the unknowns such as the level of pain were experiences waiting to happen. I'd done as much as I could to make sure I wasn't going to be bored not working, or being able to move and although there are always risks with surgery I knew that God was with me throughout the whole thing.

My main prayer was that they wouldn't operate on the wrong leg!

Steves Knee Recovery Blog

I've said I'd do it, and finally I've got onto Blogger and set up an account.

I've wanted to have a general Blog for a while as I think it's a good way of letting many people know what's going on with me. Especially for those peeps I don't see very often.

However, the impetus for the Blog has been the Anterior Cruciate Reconstruction surgery that I had on my right knee on 15th Feb 2006.

Due to not being able to travel to work for a few weeks I've got the time to write to this Blog and let everyone know all the grizzly details of the op and the recovery process.

Hopefully I'll add some photos of the knee in various stages and then stuff about other things that are going on in my life. It might be interesting to some!
Although as a point of principle, I've decided not to write about work, in order to keep my professional life seperate from my personal life. Of course there are a lot of things at work that affect what I do, and changes there can cause big upheavels elsewhere, but the details will only ever be general.

I'm still mulling over talking about specific people. But I think for now it is probably best if I keep it about me.

Enjoy!