One Week After Surgery

Mobility:
I have probably been pushing myself to be on my feet more than I really should be, so I'm making an effort to stay off them for the most part now. However, I've found that I can be on my feet for an hour or so at a time and it is bearable. Any longer than that and I really need some pain relief to keep going. Bending is going fairly well through my exercises, although it's a bit more difficult now than it was a couple of days ago as the swelling has really kicked up a notch. My leg extension is as it was prior to the operation.

Swelling:
As you will see in the following photo, by day 5 (left) the swelling had started to make its presence felt, and by day 7 (right) it has given me a serious case of cankles. Yeuuuck :/

With the swelling has come the inevitable bruising. About a week after your operation, a lot of the escaped blood from the surgery will have migrated down your leg. The following are some photos of my first operation, which show what the bruising looked like when I had the donor ligament taken from the knee being reconstructed:

This will eventually all pool in your foot, as you can see here:

As you can probably guess, this makes the leg/foot quite tender - unfortunately all you can do is wait for it to go away. Elevating, icing, and taking pain relief where appropriate is the best advice I can give you for most things concerning post-op knee pain!

If you have any questions or anything, feel free to contact me. Best of luck!

The Day After Surgery - Leaving Hospital

Depending on your reaction to the anaesthetic, you might wake up in the morning after a long sleep, but equally, you may have been dozing on and off all night. In either case, you will likely feel a bit comforted when you notice day breaking. Congratulations - you've gotten through the first night! :)

Hopefully you won't be in too much pain, but you will certainly feel a little sore. Don't be afraid to contact a nurse for more pain medication if you need it.

Try to eat breakfast when they bring it out. You may not feel too hungry, but once you start eating you may find that your appetite returns, and it is important to start putting some fuel back into your body. You will have lost a bit of blood, and your body has just gone through a bit of a traumatic experience. You need to recover! Food will help you do that :)

You will have a number of visits over the course of the morning to prepare you to leave hospital. One thing you may want to prepare yourself for a little is when they remove the drain tube from your knee. In the picture below, you can see the drain going into my left knee, and you can see where the drain on my right knee leaked overnight and got a bit of blood on me. Yucky! The nurses will clean this off for you though.

If you are having your first knee operation, you will almost certainly have had the donor ligament taken from the same leg as the reconstructed knee, so you will only have one drain, which will be attached to that leg. The reason I have two is that this is my second reconstruction. Hopefully you will only need one operation!

Removing the drains is a peculiar and nauseating feeling, and the site will sting and bleed after it happens. This is another of my least favourite parts of the process, but it will be over quickly! You're probably best off not watching it happening, and distracting yourself in some way. I, for example, played Pokemon on my gameboy while it was being removed. You may shake a bit afterwards - this is a perfectly normal reaction, and one which happens due to the shock of the drain tube removal.

After this, you will have tubigrip placed over the knee (or knees in my case). This will compress the knee and help with swelling. As you can see in the picture below, my drain sites leaked a bit of blood onto the tubigrip. Don't worry if this happens! It doesn't look great, but it's perfectly common and didn't even hurt especially. Also, feel free to appreciate that in the below photo, I have just been raising and icing my knees on a huge toy panda. Heck yesss :)

So, now to the stuff which will constitute the majority of the rest of my posts; swelling and mobility.

Swelling:

You would think that the swelling the day after the operation would be awful, and perhaps it was for me last time, although I can't remember. But as you can see in the below comparison between my legs before and after this operation, the swelling actually isn't particularly bad! It remains to be seen if it blows up a bit more over the next few days, but for now, not too shabby. The after photo was taken late at night after returning home, so this was quite some time after the operation. Sorry for all the blood in the photo, by the way, haha.

Make sure you spend plenty of time over the first day, and the days to come, putting your knee on ice and elevating it. This will help the swelling go down. Follow your surgeon's advice about this, but if you've forgotten, try doing it for 10-15 minutes every couple of hours. Another way to minimise swelling is to stay off your feet wherever possible, and your surgeon may recommend some other measures too.

Mobility:

Okay, so this is a bit of an odd one. This time round, my mobility is actually pretty darned good. Before being discharged you should be talked through a series of little exercises you will need to do over the next few weeks to regain mobility in your knee. I sort of flew through these and the doctor was quite impressed. I also managed to walk out of the hospital without crutches or a wheelchair. Please understand that this will not always be the case! I prepared very well for my surgery by strengthening my knees, and I am also quite young. I think that for these reasons, my pain levels and mobility are fairly exceptional. You may be quite a lot sorer and may require crutches or a wheelchair. This is not a sign that something has gone wrong with your surgery or that you are weak. Every knee recovers differently, and it is vital that you do not push yourself to do things that hurt very badly, because you risk re-injuring the knee.

Sleeping:

You will probably be prescribed some pain medication before being discharged. It's not a bad idea to get this prescription filled before the day is out, as you will likely find sleep difficult without some pain relief. Try icing and elevating your leg immediately before trying to go to sleep, and take your pain medication about half an hour before. You may be woken up due to pain over the course of the night - if it enough to prevent you getting back to sleep, try icing and elevating the knee again, and if it's still hurting too much after that, take the pain medication again as long as an appropriate amount of time has passed since your last dosage. Sleeping will be uncomfortable for some time after the operation, unfortunately, and you may find sleeping in your normal position too painful. Sadly, there's not much you can do about it other than ice, elevate and medicate, then wait for time to do its thing. If you're having really bad issues, contact your surgeon for more advice.

I hope you have a pleasant first day home! Best of luck, as always :)

Surgery Day

So the day of your surgery has arrived. Try not to be too anxious! The experience is obviously not pleasant, but it's also really not that awful.

Clearly not everyone's surgery will be the same, but I will give you a rough guide based on my operations (I'm currently recovering from my second ACL reconstruction on my right knee).

Before the day:

Prior to the day, you should receive information on how to prepare for the surgery. Read this attentatively, as it contains important information for your health and safety, particularly where the anaesthetic is concerned. Take note of any medications you shouldn't take in the leadup to the operation, and the time you need to start fasting. Failure to follow these instructions could jeapordise your safety in the operating room! Call your surgeon if you don't understand something or have any questions.

You may be sent two special sponges to clean your knee. In my case these were to be used in the shower the night before and morning of the operation. You might get them a couple of weeks before the surgery, so try to keep them in sight at home so you don't forget or lose them.

What to bring?

If you're only staying overnight, you won't need to pack too much stuff. Bring any x-rays you have of the knee, toiletries, something to keep you entertained (you may have to wait a while to be taken to your room after arriving, and you may wake up overnight and find yourself unable to get back to sleep), underwear, water (for the way home, you mustn't drink it while fasting), phone, wallet, etc.

What to wear?

Something loose, keeping in mind that your knee will not fit into something tight the next day! Track pants are a good bet, and slipon shoes are easier so you won't have to try leaning over the next day (nausea and/or pain will make tying shoelaces very unpleasant).

Ladies - I recommend not wearing an underwire bra, as this will have to be removed for surgery, and don'wear nail polish or make up. I forgot to do this this time, but try to get your legs waxed before surgery too, as shaving them will be a difficult task indeed afterwards.


After the operation:
You will probably wake up while still in the recovery room, however you will still be very drowsy. You may be able to look around a bit and talk, but it is equally possible that you will find it prettymuch impossible to open your eyes, let alone talk. Your mouth will be very dry, so if you can manage it, ask for a sip of water. If you are very nauseous at this stage, you may have had a bit of a reaction to the anaesthetic. Remember this, as you may need to let them know that this happened if you get another operation. They will then be able to make some changes which hopefully resolve this second time around. It may even be worth mentioning it to the doctors and asking them to note it down for future reference. I experienced terrible nausea when waking from my first knee reconstruction, but I let them know about it prior to the second one, and my recovery has been a thousand times more comfortable for it.

After a short period in the recovery room, you will be taken back to your room. Once there, perhaps after an hour and a half or so, your leg will probably be put in a movement machine which will bend it. This is a tad uncomfortable, but not awfully painful. You should now have the chance to eat, and depending on how awake and/or nauseous you feel, you'll either be very eager to eat (as I was this time) or you will be repulsed (as I was the first time). Apart from that, you'll probably just spend a lot of time sleeping and sipping water, as you will likely still be parched. This does put you in the unfortunate poition where you must inevitably use the bathroom, which you will either have to do in a bed pan, or the bathroom depending on how well you think you can bear standing. This is one of the most unpleasant parts of the whole ordeal if you ask me. 

This picture is a little unclear, but that's my leg in the movement machine. The little tub thing is a drain connected to my knee. During the night of both of my operations, this drain managed to detach a bit from my knee and bleed into the bed. If you notice this happening, alert a nurse. It's not a terribly big deal, but they will clean the blood off of you and realign the drain so that it stops leaking. This is more likely to happen when you get up to go to the bathroom, so just keep an eye out for it.