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!
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