Getting Moving

Post op day 6 - first day of physiotherapy

With a 10:00am appointment, I set my alarm for 8:00, planning to be out the door by 9:30 and leaving plenty of extra time for unforeseen obstacles.

I woke up at 6:00 and couldn't sleep so puttered around online until 7:00 before falling asleep and resetting my cell phone alarm in a sleepy haze, finally waking up at 9:10, only twenty minutes before I was set to leave. Also, my pain meds had warn off and I was tired, cranky, sweating, and in pain. Crap.

I popped some Tylenol and got up, heading to the bathroom to attempt a quick standing sponge bath to freshen up for the physiotherapist. I then collapsed for a moment or two back in bed in exhaustion before forcing myself up and into shorts and a t-shirt. Choosing which t-shirt to wear proved rather difficult. I was going to go with the one I got in Thailand after bungee jumping but thought the image of my hobbling down Dundas St. in brace and crutches with that t-shirt would be too ironic. The same went for my "Ambassador of Nova Scotia good times" Alexander Keith's t-shirt. I went with a simple "Canada" t-shirt instead.

Time was ticking and I went into the kitchen to prepare something to eat. I was feeling anything but hungry but knew I needed to eat something before heading out so I spooned some yogurt and Harvest Crunch into a bowl, got a glass of orange juice, and hobbled over to the table. My leg was throbbing so I also hauled my plastic bags of peas to the couch. I stretched out on the couch, icing my leg while trying to eat my granola and check the weather and the address of the clinic in only a few minutes. At one point I was trying to put the bowl on the coffee table and I kind of knocked or tipped it, sending granola all over the floor. It's still there. I have to work up the energy to sweep it up. :(

Anyway, I finished eating, found the information I needed, and by that point it was already 9:35. I sadly had to forego brushing my teeth so that I could have enough time to put on my socks and shoes. I hadn't worn socks since the surgery. They were very difficult to put on, as were my sneakers, and I finally left the house at 9:40 feeling anxious and unhappy. I almost considered taking a taxi but decided to buck up and walk the three blocks to the clinic.

It was fine. The cool morning relaxed me and I was careful not to rush for fear of falling. I wonder if I look like a spectacle walking down the street in such a condition.

I arrived at the clinic with five minutes to spare, my leg throbbing mildly, and was asked to fill out some paperwork before taking a seat in the waiting area for a few moments. Man, sitting in a regular chair is the pits. It is exceedingly uncomfortable - even painful - to sit with my brace-straightened leg hanging down to the ground. A footstool would be better, but even that is painful without any support in the middle of the leg. I need full leg support to feel at ease.

A few minutes later my physiotherapist Michael came and introduced himself. He shook my hand and led me into his little office. It's TINY! This clinic is not one of those larger sports medicine clinics with many people getting treatment at the same time. It's a small, multi-purpose place that has homeopathic treatments, massage, and all kinds of other things. There is only one physiotherapist on site. I hope he has the expertise and equipment necessary for this treatment.

Anyway, he asked me a few questions about the history of my injury and what has happened so far. He then asked me to walk for him with crutches and gave me some constructive criticism on my technique. I need to step with my back leg and the crutches as the same time to distribute weight properly. He took some measurments of the circumference of my thigh and knee, had me do a few very small exercises involved flexing and pushing my foot and my knee, and he did some weird massaging that almost felt more like he was just holding my leg in different places, only moving his hands very very slightly. It actually felt very nice and soothing, but I wonder what the effects are. He did the same kind of gentle massaging/holding of my head. It was quiet and lovely. I don't really know...

Oh, another thing he did was pull out a big coloured book of anatomy and actually took the time to show and explain what exactly my injury was and how exactly my doctor repaired me. The surgeon never took the time to really give me a good explanation of these things. It really amazes me.

Apparently, the surgeon cut out a small central stip of my patellar tendon along with a small piece of bone from the kneecap and from the bone in my shin. This piece of tendon with bone attached on either side was drilled into place where my Anterior Cruciate Ligament was, though the bones of the femur and Tibia (I think). The ACL is typically a ligament with very little blood flow which is why it doesn't heal and when torn it just sort of shrivels up and dies. By drilling and attaching the tendon graft though the bones, which have a healthy blood supply, a new ligament grows along the graft within however many months, leaving me with a brand new ligament. So the patellar tendon is not acting as a new ACL like I thought, but is instead the scaffolding for a new ligament to grow. Fascinating!!!

All in all I really appreciated the soft, calming nature of this physio and the fact that he really took time with me.

I told him about my lack of health insurance, though told him that I don't wish to compromise the quality of the therapy because of it. He suggested meeting once a week (I've heard people go for physio three times a week...). This week I am to focus on icing and elevating to get rid of the "gunk" and working on regaining my range of motion. I've got a 0 degree straight leg, which is perfect, and I think he measured me at 60 degree bend on the operative leg and 140 on the good leg. There's a goal if I've ever seen one...

This initial visit cost me $90.00 and every subsequent visit will be $50. Great... It sucks to have no health insurance. But I guess it's good we're only meeting three times a week.

Oh, one last thing. He showed me how to properly elevate and ice, and apparently I've been doing it wrong all week.

To elevate, you can use a regular chair flipped over with pillows resting on the bottom of the seat. Lying flat back, put your leg up against this structure so that the knee is a good many inches above the heart. This allows the swelling and fluids and "gunk" collected during the day to get outta there.

For icing, do ten minutes on, ten off, then ten on again instead of 20 minutes all together. The first ten prep the leg for the second ten. I'm not sure how. Instead of using a towel (or tea towel as I had done) wrap the leg in saran wrap to keep germs away from the incision but to allow as much coldness to come in contact with the leg. Then put the ice (or frozen peas as I've been doing) directly onto the saran wrap.

An hour later I paid my $90.00 bill, made another appointment for next Monday, and was out the door, hobbling back home where I arrived and began elevating and icing as directed.

Let's see how the rest of the day goes. Mom is on her way over with lunch!!