I just got home from my second post-op appointment with my surgeon and my second session of physical therapy. (Ok, that’s not actually the truth. I got home more than three hours ago, but I had to seriously take a long nap. I was exhausted.) But today was mostly all about good news!
This time, I had an x-ray taken to make sure that the chunk of bone that was cut and moved slightly had not shifted. It hasn’t. Thank goodness. I don’t have a great shot because it’s a picture of a picture on a computer screen, but you can see the 2 screws that are now holding my knee together. The side shot is much more impressive because you can see that the screws actually go all the way through and stick out just a bit on the back side of my tibia. I just got sidetracked talking to the doctor instead of thinking about taking pictures, so I can’t show you that one. Maybe next time. He also said he has pictures of the actual surgery, but they’re on a random dude’s camera, so he’ll have to get those to me later. The random dude had a name; I just don’t remember it.
Ok, so on to the good news! My OS said that my knee looks “as good as any I’ve seen at this point.” He was very pleased with my flexion (more on that later) and the amount of swelling (it might seem like a lot to me, but it’s actually quite good for the trauma my knee has been through). The incision looks pretty good, too. I say pretty good because it’s a giant line down my leg that’s currently scabbed over. But everyone else keeps telling me that it looks great. He told me that he could tell I’ve been working hard. (Then I mentally patted myself on the back because I really have been working my butt off!) He asked if I wanted to get rid of the compression stocking, but I’m a little hesitant to do that. I’m worried that the stocking is really helping to control the swelling. They gave me a compression sleeve that I can switch to when I’m ready. I feel like swelling is my enemy right now, so I’m going to keep the stocking on for a while and maybe gradually wean off of it.
Next stop was physical therapy. I was really looking forward to it because I really felt that I’d rocked the exercises from last week. Last Friday, I wasn’t able to do even one unassisted straight leg raise (SLR), but I’d been able to do all of the sets unassisted since Saturday and have been getting progressively better. Pretty awesome, right? Yeah, well. Apparently, it’s too awesome for some people because I think my therapist is now worried that I’ll push it too far too fast. I won’t! I promise! I want this surgery to work more than anyone. It simply has to because there are no other options. So, it’s a bit of a letdown to have to report that I’m not really doing anything different now than I was last week. The only change is that my heel slides are now on the floor instead of in a chair.
Good news is that my kneecap appears to be mobile. My lower leg bones are also appropriately mobile. That means I shouldn’t have to worry about scarring at this point. I was glad to hear that because I’ve been worried about the possible scarring inside the knee that could hamper my recovery. We worked a little bit on my extension and flexion, and I’ll need to work more on my extension at home so that I can continue to improve the SLRs. I can get to about zero degrees extension, but there is still some tightness behind my knee that I need to work through. My good knee goes to about -5 degrees extension, so that’s what we’re using as a comparison.
My flexion is surprisingly good at this point. I have about 115 degrees active flexion and 122 degrees of passive flexion (sitting on a table and pulling my ankle toward my rear end). I only have 150 degrees in my good leg, so it’s really pretty good. Especially when you consider that I haven’t bent my knee more than 90 degrees in 2.5 weeks.
Both my surgeon and my therapist said that my VMO (vastus medialis oblique) is still shut down. Last week, my PT explained that, because of the trauma of surgery and the fact that I wasn’t initially allowed to engage my quads, the connection from my brain to the muscles has been severed. I spent a lot of time thinking about making my muscles work this week, but it apparently wasn’t enough. To help reeducate the VMO, he hooked me up to the e-stim today. It’s essentially electro-shock therapy for muscles. They put two pads on your leg (one on the muscle that needs to fire and one to complete the circuit) and hook you up to the machine. The first feeling you get is a “pins and needles” kind of feeling. This gets more and more intense until, all of a sudden, your muscle contracts. I was hooked up to the machine for 12 minutes. It fired for 10 seconds every minute, and each time it fired, I had to use my muscles to push down on a towel placed behind my knee to help retrain the muscles. It was an odd feeling. Not painful at all; just odd. I should have taken a video, but I was too engrossed in watching my muscles twitch. If he does it again, I’ll make sure to get video.
I’m still locked in my brace at full extension any time that I’m not laying down. This is going to be a drag for the next 4 weeks, but we have to protect the cartilage growing behind my kneecap. There’s very little stress on the patella when the leg is in extension, so I can walk on it now, as long as it’s locked in the brace. I can’t yet drive. Even if I had permission from the doctor (and I definitely don’t), there’s no way that I can physically drive because it’s my right leg that we’re talking about. I told my friend who went with me that I just need to practice doing the splits so that I can hang my right leg over the center console in my car while I drive with my left. I told my PT he didn’t hear that, but he was all “I don’t care what you do, as long as you’re in the brace.” I feel like that was permission.
I did ask my PT about biking today. He said we’re not even going to try for another 6 weeks, so about 8 weeks post-op. That was mildly disappointing, but we do have to protect the graft. I still have my bike sitting out in my dining room for motivation though. I’ll get there soon enough.