Today I had my final pre-op meeting at the hospital, two weeks exactly before the big day. So, back to Sunnybrook I trekked, this time looking for C wing ground level. I arrived at the receptionist's window with five minutes to spare and she asked me to take a seat in the waiting room. Nobody else was there. This looked to be an out-patient physiotherapy clinic and maybe a fracture clinic too.
I was called in and greeted by a friendly physiotherapist whose name I can't recall. She had me take a seat and then went to get a pair of crutches from across the room, returning and adjusting them for me. She instructed me on how to walk (crutch, bad leg, good leg, repeat) and how to take stairs (good leg first on the way up, bad leg first on the way down.) People say they HATE crutches and though they seemed fine and almost fun on the first trial, I'm sure the novelty will quickly wear off.
Next she gave me a few different handouts of information. One interesting thing I learned is that I'm having the bone-tendon-bone graft type which takes a piece of my patellar tendon instead of my hamstring. For some reason I had been assuming the opposite all this time and I'd been working to strengthen the hammy. No harm there, I'm sure, but now I must do some research on the patellar tendon graft.
I also got a list of frequently asked questions for this surgery, prepared by my surgeon, Dr. Paul Marks. Here it is for your reading pleasure:
Q: How long will I be in hospital?
A: Typically, you will stay in the hospital overnight and go home the morning after your surgery.
Q: When can I start walking?
A: You will be walking with crutches and a splint/brace on your leg by the time you leave the hospital. You may put as much weight on your leg as is comfortable and slowly increase the weight over the first few days until you are fully weight bearing.
Q: How long do I have to be on crutches?
A: Until you get permission to walk without them from Dr. Marks or when the therapist tells you there is good quadriceps control.
Q: How long will I have to wear a brace/splint?
A: Dr. Marks will tell you when you can start walking without the brace. This is usually within six weeks of your surgery and is largely dependent upon muscle control and comfort. You do not need to sleep with the brace.
Q: When should I see my physiotherapist?
A: As soon as you know the date of your surgery, you should book an appointment with the physiotherapist of your choice within the first week after your surgery. Please provide the physiotherapist with the exercise guide given to you at your physiotherapy pre-admission appointment at the hospital. In the meantime, focus on the home exercises given to you in the hospital.
Q: Should I use ice?
A: Yes. You can apply ice for twenty minutes and then take it off for one hour while awake. Keep the knee elevated above your heart.
Q: When can I drive?
A: You can drive as soon as you feel safe and comfortable. You should practice driving in the parking lot first. If you have a right knee surgery then driving will be delayed approximately six weeks.
Q: When can I return to work/school?
A: You may return to a sedentary job or school as soon as you are comfortable. If your job is more physically demanding, you should discuss your return to work date with Dr. Marks.
Q: When can I return to sports?
A: Once again, this should be discussed with Dr. Marks. Typically, you are looking at a timeline of approximately six months before returning to vigorous sports or sports that require a lot of direction change i.e. soccer or basketball (or ultimate!) There are many sports that you can begin prior to this i.e. jogging, cycling, ice skating, etc. Dr. Marks and your physiotherapist will guide you on the specifics. A brace may be recommended for certain activities.
Q: How big is the incision?
A: The incision varies depending on the procedure that you have. If your repair is one using your patellar tendon, the incision is approximately 5 centimeters (2 inches) long and slightly off centre of your knee below your knee cap. If the repair is done using your hamstring tendons, you will have 1 small incision 2 - 4 centimeters long on the inside of your leg below your knee. You will also have 2 small marks on either side of your knee just below the knee cap for the instruments involved in this repair.
Q: will I have a lot of pain?
A: Some discomfort after a surgical procedure is to be expected. The amount of discomfort varies widely from person to person. All attempts will be made to minimize discomfort both immdiately after the procedure and for the first few days at home. While in the hospital it is important that you inform the staff if you are in pain. When you are discharged home, you will be given a prescription for pain medication that can be filled at any community pharmacy. While at home, please follow the pharmacist's instructions for use of the medication.
Q: How long is the operation?
A: The operation itself takes 1 - 2 hours. Most patients will recover in the post anaesthetic care unit (PACU) for up to 2 hours before returning to the same day surgery unit where you began your day.
Q: How do I take care of the incision?
A: If you have steristrips on the incision, leave them in place until they fall off naturally or for a maximum of 10 days. You should make an appointment with your family doctor for 7-10 days after your surgery for removal of any stitches. The blue stitch needs to be pulled out from one end. Do not cut the ends off as the stitch below the skin is not absorbable.
Q: When can I take a bath or shower?
A: You should shower/wash with mild soap and avoid soaking in a tub until the incision is closed, clean, and dry. This is usually when the steristrips fall off and/or the stitches are out. Dry the incision carefully after exposure to water. If you take a shower, cover the incision with a plastic bag and tape. Be careful not to slip in the tub.
Q: When do I go to see Dr. Marks again?
A: You will be given a follow-up appointment with Dr. Marks when you are discharged from the hospital.
***
FAQs are useful! Maybe I knew almost all of this stuff already, but it feels good to have it in writing from my own doctor.
I also got a list of post-op exercises to start doing about a day or two after surgery, as well as some information for the physiotherapist I end up choosing.
The appointment was over in no time and I was back on the bus heading home, crutches in hand. I wonder if people thought I was walking very well for a girl holding crutches.
So, two more weeks left to go. My "strong-legs" exercise plan is kind of on hold to accomodate a very busy weekend and a subsequent head cold that's got me feeling pretty lousy. This weekend Steve and I are heading to Montreal for one last hurrah before Rick's wedding and then my planned immobility.
What fun!
More to come pre-op: "before" photos and leg measurements! Wow!
Tuesday, August 26, 2008
Tuesday, August 19, 2008
Pre-op
Three weeks to go!!!
I went for my pre-op surgery. Let me describe it a la fieldnotes styles:
Arriving more than half an hour early, I killed some time by perusing Sunnybrook's gift shop (hmm.. nothing struck me.. you'll have to plan ahead to please this patient) and ordering myself a medium cafe latte from the lobby Second Cup. I'm not a coffee drinker by training. I sat in the little seating area drinking my coffee and reading my book for about half an hour until I was only fifteen minutes early and I felt comfortable heading down to the room I was told to go to.
Once inside, the woman at the desk didn't even ask my name, directing me instead to head to the back two rows of quite a large waiting room bustling with people and activity. I think it was a waiting room for anyone having blood work done, but the last two rows were for we special pre-operative patients.
I waited for maybe thirty minutes more, reading my book and feeling my heart rate escalate as the minutes ticked by. Was it the realization that this surgery was really going to happen? The nurses were going back and forth calling out the names of people, doing unknown, likely terrible things to them behind closed curtains! Ahhh! Maybe it was just the foreign caffeine seeping into my veins and screwing with my equilibrium. Either way, I don't like hospital waiting rooms.
Finally a woman came and beckoned for me to follow her. We went down the hall just slightly where a scale was waiting. She weighed me in my shoes and jeans and breakfast weight! Ugh! How totally unfair. She also measured me and I'd like to report that I am indeed 183 centimeters tall. An online centimeters to feet converstion calculator has confirmed it: I am 6.04'! Holy toledo. Gone are the days that I think I am 5'11 and 3/4. I dig it.
The woman then asked me a bunch of insignificant questions about my address and emergency contact numbers.
She led me to a small examination room where I was soon met by a young thin girl calling herself an anethesiologist. She asked me about any allergies and medications I am on, asked me to bend my head back and forward, looked in my wide open mouth, and listened to my breathing. She asked about various health things like the state of my heart and the history of family issues regarding anethestics.
She also mentioned some kind of pain relieving injection that I will be offered the day of the surgery. Apparently they lead a camera into some area of my upper thigh so they can inject something into the nerve leading directly to the source of pain. Apparently I didn't really get good details, eh? She said this is a relatively new method of pain control and she made it seem like it would replace the need for narcotic pain relievers. This strikes me as odd since the few people I know who have gone through this surgery themselves all mentioned the drugs they were doped up on. I asked whether most people accept this new pain reliever (which apparently may cause nerve damage or bleeding...) and she said they do.
Finally, a nurse came along and checked my blood pressure and then gave me some information about my surgery. This is what I learned:
For two days before my surgery I am to bathe with a special anti-septic soap that I was given today (for free!) On Monday September 8th I will receive a call between 1pm and 3pm to let me know what time my surgery is the following day. This could be as early as 6am. I am to arrive on the 9th two hours before my surgery so that the nurses can properly "prep me", whatever that means, or so that I can suffer from a heart attack while I wait. I should remember to bring slippers and a toothbrush with me to the hospital. Only two people are allowed to accompany me to the hospital. I am not to eat any food past midnight the day before my surgery but clear liquids are permitted until some time before surgery which I forget. I am instructed to brush my teeth the day of surgery. I may or may not spend the night in the hospital depending on the time of the surgery and I guess how I do in the recovery room. I am not to wear any scented anything, any jewellery, or any make-up. That's all I know. I forgot to ask what to wear on my big day.
She gave me three mostly useless pamphlets; one about anethestics, one about pain management, and one about all the stuff I just wrote.
And that was it! No blood work, urine sample, or anything at all invasive. A walk in the park, really.
And - lucky me - I get to return next week for my physiotherapy appointment where I'll get to hear about all the fun post-surgery stuff. Can't wait for that part.
Gotta hit the gym!
I went for my pre-op surgery. Let me describe it a la fieldnotes styles:
Arriving more than half an hour early, I killed some time by perusing Sunnybrook's gift shop (hmm.. nothing struck me.. you'll have to plan ahead to please this patient) and ordering myself a medium cafe latte from the lobby Second Cup. I'm not a coffee drinker by training. I sat in the little seating area drinking my coffee and reading my book for about half an hour until I was only fifteen minutes early and I felt comfortable heading down to the room I was told to go to.
Once inside, the woman at the desk didn't even ask my name, directing me instead to head to the back two rows of quite a large waiting room bustling with people and activity. I think it was a waiting room for anyone having blood work done, but the last two rows were for we special pre-operative patients.
I waited for maybe thirty minutes more, reading my book and feeling my heart rate escalate as the minutes ticked by. Was it the realization that this surgery was really going to happen? The nurses were going back and forth calling out the names of people, doing unknown, likely terrible things to them behind closed curtains! Ahhh! Maybe it was just the foreign caffeine seeping into my veins and screwing with my equilibrium. Either way, I don't like hospital waiting rooms.
Finally a woman came and beckoned for me to follow her. We went down the hall just slightly where a scale was waiting. She weighed me in my shoes and jeans and breakfast weight! Ugh! How totally unfair. She also measured me and I'd like to report that I am indeed 183 centimeters tall. An online centimeters to feet converstion calculator has confirmed it: I am 6.04'! Holy toledo. Gone are the days that I think I am 5'11 and 3/4. I dig it.
The woman then asked me a bunch of insignificant questions about my address and emergency contact numbers.
She led me to a small examination room where I was soon met by a young thin girl calling herself an anethesiologist. She asked me about any allergies and medications I am on, asked me to bend my head back and forward, looked in my wide open mouth, and listened to my breathing. She asked about various health things like the state of my heart and the history of family issues regarding anethestics.
She also mentioned some kind of pain relieving injection that I will be offered the day of the surgery. Apparently they lead a camera into some area of my upper thigh so they can inject something into the nerve leading directly to the source of pain. Apparently I didn't really get good details, eh? She said this is a relatively new method of pain control and she made it seem like it would replace the need for narcotic pain relievers. This strikes me as odd since the few people I know who have gone through this surgery themselves all mentioned the drugs they were doped up on. I asked whether most people accept this new pain reliever (which apparently may cause nerve damage or bleeding...) and she said they do.
Finally, a nurse came along and checked my blood pressure and then gave me some information about my surgery. This is what I learned:
For two days before my surgery I am to bathe with a special anti-septic soap that I was given today (for free!) On Monday September 8th I will receive a call between 1pm and 3pm to let me know what time my surgery is the following day. This could be as early as 6am. I am to arrive on the 9th two hours before my surgery so that the nurses can properly "prep me", whatever that means, or so that I can suffer from a heart attack while I wait. I should remember to bring slippers and a toothbrush with me to the hospital. Only two people are allowed to accompany me to the hospital. I am not to eat any food past midnight the day before my surgery but clear liquids are permitted until some time before surgery which I forget. I am instructed to brush my teeth the day of surgery. I may or may not spend the night in the hospital depending on the time of the surgery and I guess how I do in the recovery room. I am not to wear any scented anything, any jewellery, or any make-up. That's all I know. I forgot to ask what to wear on my big day.
She gave me three mostly useless pamphlets; one about anethestics, one about pain management, and one about all the stuff I just wrote.
And that was it! No blood work, urine sample, or anything at all invasive. A walk in the park, really.
And - lucky me - I get to return next week for my physiotherapy appointment where I'll get to hear about all the fun post-surgery stuff. Can't wait for that part.
Gotta hit the gym!
Thursday, August 14, 2008
workin' it and appointments
So far so good with the "Serious Legs" plan. I've done Bodypump twice this week, walked my dog, biked up a big hill, and swam a bunch of laps.
Bodypump has two sections devoted to lots of squats and lunges, as well as dead lifts which are apparently good for the hamstrings. I did a quick search today and found a few more hamstring exercises that I'll incorporate into the mix. I also have to do some more balance work and stretching, I think. I wonder if I'll get fat after surgery when I can't do cardio.
I got a call from the surgeon's office today and now have a pre-op appointment booked for Tuesday at 10:30 so that's kind of exciting. Then the following Tuesday I have an appointment with the physiotherapist at Sunnybrook where they will set me up with crutches, a brace, and information about what to do immediately following surgery.
Everything's falling into place.
I don't feel nervous about it anymore. Not like I did when I got the first surgery date offer at least. I've come to grips with the reality of things and will certainly be a scared sissy when the time is right. :)
Bodypump has two sections devoted to lots of squats and lunges, as well as dead lifts which are apparently good for the hamstrings. I did a quick search today and found a few more hamstring exercises that I'll incorporate into the mix. I also have to do some more balance work and stretching, I think. I wonder if I'll get fat after surgery when I can't do cardio.
I got a call from the surgeon's office today and now have a pre-op appointment booked for Tuesday at 10:30 so that's kind of exciting. Then the following Tuesday I have an appointment with the physiotherapist at Sunnybrook where they will set me up with crutches, a brace, and information about what to do immediately following surgery.
Everything's falling into place.
I don't feel nervous about it anymore. Not like I did when I got the first surgery date offer at least. I've come to grips with the reality of things and will certainly be a scared sissy when the time is right. :)
Monday, August 11, 2008
Four weeks to go
With only four week to go until my surgery, I'm feeling the time crunch to get my muscles in as top shape as possible in order to ease recovery.
Before I go on about that, I just want to say that I have found this whole process to be very strange so far. Nobody has really given me much information and though the internet is of course a rich resource, I still have not received any details about any of this from my doctor or surgeon. When the surgeon told me the MRI confirmed my torn ACL he asked, "so what do you want to do?" Having done some independent research, I knew that I wanted to play sports in the future so I knew I wanted surgery. But I would have liked some advice and some pros and cons. The surgeon didn't even know whether or not OHIP covers physio for ACL injuries. It doesn't.
Last week a guy I know recommended a physiotherapist in my neighbourhod and, thinking I'd be proactive, I called the clinic to see about making an appointment. They said that I need a reference from my doctor but that making an appointment a few days before I want my first meeting would be fine. I called my surgeon and the receptionist told me that the doctor will give me a reference the day of the surgery. It all seems so laid back and casual to me. I would have thought the physio would want to meet me before the surgery and test my strength or take a look at the state of my knee before I arrive a few days after surgery. I guess this is the way it's done...
So anyway, I believe I need to pay special attention to stengthening my hamstrings, quads, and calves. I plan to work out every single day for the next four weeks to accomplish this goal as well as to be in top form for my bridesmaid's dress.
Today I did a Bodypump class where we do LOTS of squats and lunges. I currently use 17 kilograms on the bar for squats and 7 kilograms on the bar for lunges. I hope to increase this weight over the next few weeks. Let's make my goal 20 kilograms and 1o kilograms for now and see if I can increase that even beyond my goal.
I also did 20 minutes on the elliptical.
I hope to atted 2 bodypump classes a week to work on muscle strength, 2 bodyflow classes a week to work on flexibility and balance, and to do cardio and any other leg strenthening I feel may be lacking, like some exercises I remember from a physio appointment I had months ago. I feel like I have good strength now but any improvement I can make now will be helpful.
Before I go on about that, I just want to say that I have found this whole process to be very strange so far. Nobody has really given me much information and though the internet is of course a rich resource, I still have not received any details about any of this from my doctor or surgeon. When the surgeon told me the MRI confirmed my torn ACL he asked, "so what do you want to do?" Having done some independent research, I knew that I wanted to play sports in the future so I knew I wanted surgery. But I would have liked some advice and some pros and cons. The surgeon didn't even know whether or not OHIP covers physio for ACL injuries. It doesn't.
Last week a guy I know recommended a physiotherapist in my neighbourhod and, thinking I'd be proactive, I called the clinic to see about making an appointment. They said that I need a reference from my doctor but that making an appointment a few days before I want my first meeting would be fine. I called my surgeon and the receptionist told me that the doctor will give me a reference the day of the surgery. It all seems so laid back and casual to me. I would have thought the physio would want to meet me before the surgery and test my strength or take a look at the state of my knee before I arrive a few days after surgery. I guess this is the way it's done...
So anyway, I believe I need to pay special attention to stengthening my hamstrings, quads, and calves. I plan to work out every single day for the next four weeks to accomplish this goal as well as to be in top form for my bridesmaid's dress.
Today I did a Bodypump class where we do LOTS of squats and lunges. I currently use 17 kilograms on the bar for squats and 7 kilograms on the bar for lunges. I hope to increase this weight over the next few weeks. Let's make my goal 20 kilograms and 1o kilograms for now and see if I can increase that even beyond my goal.
I also did 20 minutes on the elliptical.
I hope to atted 2 bodypump classes a week to work on muscle strength, 2 bodyflow classes a week to work on flexibility and balance, and to do cardio and any other leg strenthening I feel may be lacking, like some exercises I remember from a physio appointment I had months ago. I feel like I have good strength now but any improvement I can make now will be helpful.
Wednesday, August 6, 2008
Monday, August 4, 2008
I've got a date
I listened to my telephone messages on Friday afternoon just as I was leaving the city for the weekend. I hadn't realized that I'd missed a call from an unknown number.
It was the girl from Dr. Marks' office calling to offer me a surgery date: September 9th.
The weekend before will be quite something, for my brother is getting hitched. The rehearsal dinner is September 4th. The bachelorette party is September 5th. The pre-wedding party is September 6th. The big day is September 7th. The out of towner brunch in September 8th. And I'll go in for a reconstructed ACL on September 9th.
Nothing like something to look forward to during all the festivities.
I'll call and accept the date when the office is open on Monday.
Now, what to do in the five weeks and two days before? I hear I should strengthen them legs.
It was the girl from Dr. Marks' office calling to offer me a surgery date: September 9th.
The weekend before will be quite something, for my brother is getting hitched. The rehearsal dinner is September 4th. The bachelorette party is September 5th. The pre-wedding party is September 6th. The big day is September 7th. The out of towner brunch in September 8th. And I'll go in for a reconstructed ACL on September 9th.
Nothing like something to look forward to during all the festivities.
I'll call and accept the date when the office is open on Monday.
Now, what to do in the five weeks and two days before? I hear I should strengthen them legs.
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