Painkiller on the loose

What to do when the über strong painkillers don't help anymore?

Been munching on Panocod all day (5 so far) but the pain persists. The solution is probably not to take another one, but I did (don't worry, maximum per day is 8, I'm well under).

It didn't exactly help that my dad accidentally pushed one of the crutches so it fell on the knee, right on a stitched part. And I've been such a good girl both today and yesterday and stayed as much as possible in bed, knee elevated and flexing the ankle to avoid swelling.

What to do, what to do?

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Sunshine in mind

Took my immobile self out into the 26 degree heatwave today. Neighbours looked weirdly at me as I hobbled out with greasy hair, squinting like a cave man in the sun, and in wrinkled clothes - but they politely said the obliged hello.

At least I think they were neighbours. I haven't been home for a while so I don't recognise anyone these days. Strange faces in familiar houses They may just as well have been burglars breaking into my true neighbours' homes. But how can I know? It's hard to tell the difference.


I managed 40 minutes before it got too warm. I'm not used to these tropical Scandinavian environments. Also not sure how successful it is with the knee, stitched up and all, to be in bright sunshine (apparently the ozone layer is extra thin as well).

Inside, attempted some exercise but after severe pain, decided to take a magic pain pill. That was at 2. I just woke up. Knocked me out for two hours on the sofa.

So now back to the rest of training!




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JoJo Bureaucracy 1 - 0

I've noticed that if you just ask nicely for things, you tend to get them. The clinic where my physio works was very much fully booked until end of June, very much so indeed. Could they please ask him if he possibly maybe had an appointment this or next week (insert silky voice and imagined puppy eyes, slanted head with blonde pigtails)? Naturally so. And the result? Appointment booked with the lovely clear blue-eyed C.J Wednesday at 11.30. Bam!

He's rather married, but beggars can't be choosers.

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Grr...

Physio mission attempt #1 - Fail.

People @ Medicinskt Centrum Norrköping - just tell me if it's not possible to get an appointment this/next week! If I know, I can arrange otherwise. If I don't know, I'm stuck here waiting for you to get your hindsides in gear. It's not difficult. A simple 'Hello Mr Physio, you know the note we left for you on FRIDAY? Yes, is it possible? No, ok, done.' A quick phone call later to Miss JoJo, and problem solved.

I'll wait until 3pm today. Time is ticking...

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Bruised

A bruise is spreading on my calf. Good? Bad? Normal?

Day 6

More pain! My intake of painkillers increase day by day, which is probably not a good thing. At the same time I don't want to be in agony if I don't have to. I think it's partly because the numbness has started to wear off now and on one side I've regained all sensation. And the swelling is reduced a bit as well.

Today is physiotherapist mission. Last chance for my old lovely one to sort himself out, or I'll turn elsewhere. Have one or two other viable options, and have contacted them to see if there is any possibility at all to get an appointment this week or next. I need this one to be a man. If I'm going to see him 2-3 times a week, it can't bloody well be a woman. I'd die from boredom!

Let me explain. I've seen 7 physios to date in my life. 5 of them have been men. 4 of them I've fallen in love with. There is something about physios - they're intelligent, comforting, fit, caring - that just makes me fall. Women ones are not bad, that's not what I'm saying at all. The two women I saw at Capio Artro Clinic last week were terrific! But they're not men. They're not handsome, smiling, caring, lovely men. So this time, I better get a good one; married or not is less important. It's about looking, not searching for a prospect. But I probably should have ditched English lit and university and gone for physiotherapy. Maybe one day...

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Boredom

Today is very much characterised by boredom. I have plenty to do - novel planning/writing, Japanese learning, exercising, TV watching - but the painkillers make me sleepy and I have no energy for anything. And if I sleep I feel like I'm wasting time. It's a hard life.

Got directions from physio today - work-out is indeed 4+ 2 times a day as I thought. Keep on moving pretty much. Day 5 and I'm fed up - great. Welcome to 12 months of HELL! Obviously won't be in bed for 12 months but it will be 12 months of hard work. Eyes on the prize...

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Mobility training

The programme I do for mobility is quite easy and short, but is to be done 4 times a day.

1. Lean on your elbows with the healthy knee bent, the operated leg straight in front of you. Slide the operated knee, resting on the heel, towards you, bending as far as you can. Hold for 5 seconds, then slide slowly back. Repeat 3*5 times.

2. Rest the heel on a towel/pillow with stretched leg, lying down on your back. Stretch back of thigh for 5-10 minutes.

3. Sit on the side of the bed, or on the edge of a chair. Use a ball or a dumbbell for this one. Put the foot of the operated knee on the ball and roll the ball in and out, from full stretch to as far bent as you can. Repeat 15 times. Healthy knee stays still on the side.

That's it.

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Day 5

Ice, ice, ice! Still pain, and still on the side of the knee. Will call the hospital today and ask if it's normal. Also looked at my papers and on one, it says work out 4 times a day, while on the other it says work out 2-3 times a week! Bit of a difference. Might have to ask about that too.

Painkillers making me sleepy as always, but have to try and do some more novel planning today. I'm eager to start writing!

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Day 4

Wow. Pain. And thanks to the painkillers I take to quench the pain, I feel nauseaus and tired. Not a brilliant combination.

It also hurts on the side! What I've been told is that it's supposed to hurt in the front of the knee because we used the patella (and trust me it does!) but what worries me is that the sides, both inside and outside, are not very painful. Even after 2 happy lull pills. And the calf is so swollen. Meh. Might call/e-mail and ask if it's normal, just to make sure. Mobility is improving though, so that's good. However, I'm over this lying in bed. My abs are disappearing and my arms are cushion-like rather than the guns they were a week ago.

Entertainment ahead - Japanese weekdays + more novel planning!

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Surgery

In my first ACL reconstruction, we used piece of the hamstring, the muscle on the back of the thigh for the new ligament. As this muscle cannot be used again, I chose to take a third of the patellar ligament on the front of the knee this time (see pic). What happens is that part of the patellar ligament is taken, together with small part of the bone as well, and put in as new ACL. Because bone grows into bone, as opposed to tendon to bone as is the case with hamstring, the recovery with the patellar ligament supposedly is quicker.

Of course this means that pain after the surgery is located in the front rather than at the back (I can confirm this fact) and that any sitting on knee can prove difficult in the future. The procedure is simple. The surgeon drills two holes in the femoral and tibia and attaches the new ligament with screws. Because my tibial tunnel from the first ACL was so misplaced, there was no problem in drilling a new one. The femoral tunnel was alright placed, but my surgeon could still make use of it for the new reconstruction.

According to the doctors, it takes 6-8 weeks before the new ligament has healed completely and the patellar bone has grown fully into the femoral/tibial bones. Better start munching that calcium!

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Spoke too soon

...way too soon. Pain has now grappled the knee! I've taken 2 more painkillers but the pain persists. Maybe I was a bit too eager on the work-out? But then again I don't know how much is allowed/intended and how little is too little. I try to push as much as possible, but it is only second day after all...

Ice + pills + rest...only recipe right now. Please let it feel better tomorrow.

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Day 2

Wow, boredom is not to be underestimated. I have plenty to do, or that I could do, but just so tired.
Anyways, got started with rehab exercises today.Painful, I tell you. But I can also say that after having done 70% of today's work-out, it feels better, if ever so slightly.

The initial exercises are basically just to get movement and flexibility back: so bending, stretching and bending some more in various forms and shapes. There are also some strength exercises: for example lying on the side, lifting the leg up and down slowly, placing weights on one leg, then shifting to the other, and lying flat on stomach, lifting the injured knee then slowly lowering it again. As I've taken the patella for my ACL, the exercises that require hamstring action are fine, but the quads, my oh my, it's difficult. Hopefully with perseverance it'll get easier though. I can already tell an improvement in movement, so fingers crossed!

I've taken 4 painkillers so far today (the strong ones) and I'm allowed another 4 in the recommended maxiumum daily dose, so I'm doing well! Keep having the ice pack on too, as it just feels better that way. I forgot how tedious this part is. So I'm starting to write a novel. And learning Japanese. Hopefully tomorrow I can be more structured and get some actual writing done.

Feel free to drop questions about ACL or surgery or anything! I'm quite experienced in these areas by now.

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Day 1

The day after surgery. Everything went fine - so much easier than I expected! Came to Sophiahemmet in Stockholm, to Capio Artro Clinic, a FIFA Medical Center, to see the physio early Tuesday morning. After that, had some waiting time before surgery prep began at 10.30.

The nurse, a trainee, tried no less than 6 (!) times to place the IV in my hand before giving up and calling her supervisor. I felt like I was in an episode of ER, but of course, being me, I didn't complain or ask her to get someone more experienced. Did I mention I have a slight phobia for needles?

 

Ready for surgery. As awesome an outfit as ever, open in the back, granny underwear, knee high socks. Rwoar! I got a bed in a room with 3 other people, my own TV and remote and headphones. Nothing to complain about! Very comfy bed too which was adjustable. After ages and ages of waiting, I was brought down at around 1pm for the operation, got into the room at 1.30pm and off we went. The anaesthesiologist lived on a street called the same as mine, except in another city. Random or what?

Woke up from surgery. The wounds had bled ridiculously much so they were changed and here's the result! Doesn't look too bad, does it? Bit bloody, bit swollen but overall just fine. I stayed the night, watching 2 ½ Men, Criminal Minds and some crappy shows (Tuesday eve TV just isn't good!) and got to go home around 11am the next day.

It's fantastic, I can put weight on the leg! I'm on crutches, but last time I couldn't walk or even stand up at all for 2 weeks. Now I've been given a programme to do every day to get movement back etc. Physio gave me 2 weeks before I can do plank or push-ups (yes, I asked) so it's not looking too bad. The easy part is over, now begins the hardest bit. But I'm confident. I'm happy and confident and proud and satisfied to be where I am. I've had the best people around me (Sweden's Official Football National Team surgeon who only yesterday operated on Josefine Öqvist, one of Sweden's best football players) and the loveliest nurses ever.

Thank you, Sophiahemmet & Capio Artro Clinic!

Next - details on surgery + initial training programme!

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Day 0 - @ FIFA Medical Center

Right the time has come. I've just seen the physio (who was a woman - disappointing!) and am now waiting to go into surgery prep. Getting nervous in a way because I know the hard work that awaits. However, this is the last day with this crappy knee, and the rehabilitation sounds a lot better than it was last time so I'm staying positive.

I had to fill out a form to describe what troubles I have with the knee right now, and realised then that I have loads. Yesterday I sort of started feeling that maybe I don't have THAT much problems..? But after doing the test, I'm convinced. Plus they say that at that moment where you feel you may not need the op - that's when you're ready for it.

So, in an hour or so I'll be lying on the table. Wish me luck. From here onwards!

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Day -1

After 2 ½ hours sleep, I left my flat, my flatmate, my village and flew back to Sweden. Thank god for waterproof mascara is all I will say!

So ventured to Sophiahemmet and Capio Artro Clinic in Stockholm to see Magnus Forssblad. I was so surprised! In his e-mails he's always been very short, very direct - but in person, he was the loveliest person! Not at all like previous surgeons I've had (not mentioning names) who seemed to treat patients as though we were massproduced t-shirts who just needs a generic print on before being chucked out. Oh, no, not this one. Asked me terrible, terrible question: "Are you sure you want to do this?" No, I'm bloody well not sure, but I think I have to.

So the surgery is scheduled for tomorrow. 10.30am. Seeing the physio at 8am (please, please let him be hot - I have a thing for physios) and then a little wait before the big thing. Decision made to go for patella, as it is the second one. Other option would have been hamstring from healthy leg, but considering it's one of the few limbs on my body actually undamaged (knock knock), I think I'd rather keep it that way.

I can't believe this is the last day of my knee as we know it. I've had it ACL deficient for no less than seven years, and I don't even remember what it is like having a healthy one. What can you do? When I've been asked if I want to do sports, and what, I never know what to answer. My possibilities at the moment are very limited, and the scenario where I would actually be able to do stuff seems far, far away. Then again, I should not get ahead of myself. There is a 50/50 chance here, and it can go either way. But still...the thought it dazzling..

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Day -2

Had my last training session today before the surgery. Managed the following:

10 mins cycling (warm-up)
Leg press 10 reps, 60+70+70 kg
Leg curl 10 reps, 25+30+30 kg
Balance work
Stretch

Took it easy considering last week's dislocation, and it felt quite strong aftewards. Meniscus hurts like hell though, but think that's quite normal so I'm not too worried at this point. Tomorrow I'll see the surgeon. All fingers crossed for a successful visit!

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Day -4

4 days left until the surgery now. I managed to twist the knee, and consequently dislocate it a couple of days ago in the leg extension machine (don't even ask how -it happens all the time!). I've been through that before on a number of occasions but it usually goes back in place after a few bends/stretches, only taking ten seconds or so. This time was different. For what felt like an eternity, it stayed dislocated despite my extending and bending to try and replace it - for what I can only guess was about 2 minutes! If you've ever experienced this you know it's not really painful at all, just hugely uncomfortable and scary to be honest. Also knowing that it tears on your meniscus, which is already damaged. It feels as though the leg is going to snap off and bend in a completely wrong angle. Break almost.

It has been sore since, and I haven't been able to do more than light cycling. About to head to the gym now and see what I can do: either strength (staying away from leg extension!) or balance work. I'll put up some of my exercises tonight.

Any fellow ACLers out there?
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AC-what?

The ACL is one of two central ligaments in the core of the knee. There is the anterior, and the posterior cruciate ligament. The two ligament stabilise the knee in lateral movements and ensure that the knee cap stays in place, and does not put strain the cartilage called menisci.

An ACL can tear for many reasons, but sports such as basketball, football, hockey and handball are extra prone to ACL tears. It is also about 30% more common in girls than in boys. For a first time ACL tear, 90% of the patients can go back to their sport after reconstructive surgery, even if the knee never will be same again. For a second time tear, the percentage drops down to 50% in success rate.

In a first time surgery, the hamstring muscle is most likely used. The hamstring is part of your thigh muscle on the back of your leg, and provides an elastic replacement for the ligament. In a second operation, however, if the hamstring has already been used, the surgeon must look elsewhere for reconstructive tissue. There are three options: a. hamstring from the healthy leg; b. a donated hamstring, so called allograft; or c. patella. The patella is located in the front of the knee, and most commonly used for second time ACL surgeries.

Next: what is the operation?

Day -5

Finally blog up and running! Right, so, whomever has found their way to this little site, allow me to introduce myself. My name is Jo and I am 21 years old.

In 2004, then 14, I tore my anterior cruciate ligament (ACL) in my left knee during a basketball practice. This is the point where people usually go 'OWW!' and wrinkle and skrinkle their faces in imagined agony - but, surprisingly perhaps, it doesn't hurt. It is merely a very alien, very uncomfortable feeling, and you can hear the ligament snap (which, luckily for me, I didn't).

After keyhole surgery I was told I was 'so young' that I'd be fine without reconstructive surgery, and let loose with rehabilitation for 3 months. A year later, 2005, I was still not back in the game, and underwent surgery to repair the ACL using part of the hamstring muscle. I returned to basketball for a while but with continued problems, and in 2010 after a season filled with knee troubles, I tore the repaired ACL during a game. Another keyhole surgery confirmed torn ACL and medial meniscal damage, but, again, I was told I was young enough to cope without surgery. Again, it didn't work out.

So on May 25 I have my second reconstructive surgery booked. While I've been preparing for it, I have tried to find other people who have done the same thing, but without success. I know I would have appreciated to read about someone else's experience, so hopefully that's what I can give you through this blog.

Night x