Week 2.5

So the doctor’s appointment went really well. They were surprised at her minimal bruising and lack of swelling. Three people told us it was really good sign that she was already at full extension. They took a couple of x-rays, which looked great. And they removed her dressing. The incision sites looked fabulous. They took out the stitches and the rest will dissolve.



He told her that she could start weight bearing and could come off the crutches when she was ready. Evidently, she was ready as we were walking out of the doctors office… But her leg was not. She wobbled a little and almost fell down. (Really Liz??) I cursed and she giggled and said, “Oops, that didn’t happen.”

We went straight to therapy. It’s sort of mixed bag of tricks for her injury. The protocols for ACL are not at all the same as the protocols for the meniscus tear.

She could do most everything the therapist asked, the one thing she couldn’t do was a straight leg raises in supine position. The therapist had to help her. On Saturday, so did I. But by Sunday morning, she could do it 30 times by herself.

On Saturday she went to her soccer game and Coach #4 gave her a clipboard and asked her to keep stats. The girls won! Some of us went to lunch afterwards and there were a lot of laughs. But when we got home the swelling was the worst I had seen it. She admitted to being in pain, so we elevated and iced for the rest of the night and Sunday morning, it was looking good again.

After Sunday’s game, (another win! Cha-Ching), she said that her knee really hurt and again the swelling was bad. We didn’t time the pain medicine well. (Rookie mistake.) And she was so tired. Four weeks ago, she could play a 70-minute soccer game and now, she gets tired after watching one.

I was afraid to send her to school the next day – but I did. She went to therapy that Monday too. She could bend her knee to 60 degrees and her balancing wasn’t great. Her therapist said, "If you don't get that knee to 90 soon, I'M going to have to get it there." EEK.

By Tuesday, she was off crutches! (As long as she wears her brace.)



At Wednesday's therapy session, she was at 78. Much improved!

This past weekend, the team had two state league games. One tie and one loss.
On Saturday, the girls owned that team. They just couldn't get it in the net. The Sunday game was brutal.

Yesterday at therapy, her PT added several new exercises. Liz said it was painful. BUT, she made it to 100 degrees and full extension! So the home exercises are working.


Physically, she's doing great. Mentally, the last couple days have been challenging. She wants to play soccer.

We found another blogger (www.runharperrun.com) that had ACL surgery two days before Liz. I was messaging him today and he said he was "trying to stay focused and positive, this injury is more mental than physical I believe."

Believe that.

And one last update... Calf comparison photo. (Taken today) You don't have to be crazy to see a difference this time.

One Week Down - Many to Go!

Wow!

It’s been a busy few days.

The first night was painful. Painful for her and painful for me to watch.

Saturday
When she woke up on Saturday, the only thing she wanted was that wrap off of her leg. Her foot was swollen and her thigh was swollen. It hurt if anyone touched her leg or her foot.

My sister is an Occupational Therapist, so I called her to come over to help change the dressing. While we were waiting, MyGirl just couldn’t stand it, so I slowly started taking the ACE Bandage off - only to find that there were three bandages wrapped tightly around her leg. We would take one off, wait a minute and then take the other one off.



It was a relief and a nightmare because after we got them all off, we had to put on a compression sleeve. (NIGHT. MARE.)

That whole day she winced before we even touched her. But, when her friends came to visit, she would be able to forget about her knee for a few minutes and enjoy the company.

Sunday
On day 2, my sister came over again to help with the shower. I do not know what people do if they don’t have an Occupational Therapist for a sister. We weren’t allowed to get her leg wet; she couldn’t take off her brace and she couldn’t put any pressure on her foot. My sister brought two things with her that I never realized I needed - a shower chair and a hand-held shower.

Liz stood up and my sister “bagged” her leg in one minute flat – trash bag and papertape. Liz hobbled into the bathroom and sat down on the shower chair and my sister slowly lifted her leg over the tub. Liz couldn’t put her foot directly on the tub floor because the angle was painfully awkward. Right before my eyes, my sister pulled two tupperware containers of different heights out of nowhere and MyGirl had a shower foot rest too!

The shower lasted all of 10 minutes. Liz crutched back to her room, my sis pulled that bag off and helped her get dressed. Not a single drop of water on that brace. AMAZING – especially considering when Liz has two good knees there are no 10-minute showers happening at our house.

She was EXHAUSTED by the time she got back in the bed. We tried to do therapy that day too. It was hard and she just couldn’t do it – and I just couldn’t make her.

Monday
The next day was better and we tried the therapy again. We were able to get through it. I had to help her lift her legs and keep my hand under her knee. If she had said, “Mom, I just can’t do it.” I would have said that she didn’t have to do it - ever again. But she battled through and by the time we did it the second time that day, she did much better.

Tuesday
Therapy was much easier. She could lift her bad leg by herself and no one had to put their hand under her knee. My sister came over to give her another shower. The prep time was shorter but the shower lasted a bit longer. She was able to get dressed by herself too – it took ten long minutes, but she did it.

Tuesday night, Hubs woke up to find that she decided to unplug herself from her polar pack, lift her bad leg out of bed with her good leg, somehow snag her crutches and go to the bathroom by herself. WTHeck??? (When I found out, I almost flipped but at the same time I was relieved because I knew she had to be feeling better!)

Now, she’s doing pretty well – considering she hasn’t left her bedroom for six days. Tomorrow, physician follow-up appointment, stitches out and maybe, no crutches. At this point she has not been able to bear any weight through her leg, but tomorrow, he supposed to take her off of her crutches. We will see!

Can you believe we are only one week from being able to ride a stationary bike and 9 weeks from running?

Meanwhile, the team came in second place in the Bash in the Boro and has two state league games this weekend. Liz should be able to be there to cheer them on!

Day of Surgery

Well, yesterday went pretty well. Of course, there were a few bumps in the road, but hey, what are you going to do?

The night before surgery, we were going through the list of everything the surgery center had told us. Baggy sweatpants/Shorts, no nail polish, no make up, no body spray, no perfume, no food after midnight.

Some of her teammates stopped over to see her and bring her some gifts, which was great. She wanted sushi for dinner, which was fine with me...hubs wasn't quite as excited.

When we got back I put clean sheets on her bed and she took a shower with disinfecting soap - required by me, not by the surgery center. (Maybe a little crazy, but we will use any advantage for a good recovery) I would have preferred the disinfecting shower to take place the morning of, but Liz wanted to have time to straighten her hair in the morning even if it meant getting up at 4 am to do it. And she did... without a single complaint.

On the way out of town, I stopped and picked up my sister and we were off to Baptist. When we arrived, we registered and within 15-20 minutes, Liz and I headed back to the pre-op area to get ready. The nurse asked us tons of questions and told us exactly what to expect. Liz was funny and made a couple of sarcastic jokes at my expense.


Please, notice the straight hair!

Then the nurse told me about the option for a femoral nerve block. I had read about it when doing my research, but they hadn't mentioned it to me, so I didn't think it was an option for us. I was glad it was an option because it meant for the first 12-18 hours she would have almost no knee pain.

Then the anesthesiologist comes in. He was a calm, mid-50's guy with an English accent. He's going through the drill of asking Liz all the normal questions and pulling needles and gauze pads together out of drawers and then asks how she injured her leg. She said, "Soccer." He stopped what he was doing, looked at her and says, "Socca is my LIFE!" He asked what position she played. They both played center midfield so that gave them even more to talk about. It was probably calming for Liz, but in my mind, I'm thinking, "Umm, about this surgery..." (He was actually very good and would request him again.)

I had to leave when they actually started the IV and femoral block, but then I got to go back to pre-op until they took her back for surgery. The medication made her a little emotional and little loopy. One nurse asked her if she felt drunk and she said, "Umm, I don't know, I've never had a drink before."

Her surgeon came in and talked to her. He marked the knee for surgery with his initials and wrote "NO" on the good knee. He told us the surgery would take about an hour and half, maybe two hours if he had to do some extra procedures.




They came and got her and I started the countdown.

So we went to the waiting room - to wait.

The doctor came out and gave us a rundown of how the surgery went. The ACL replacement went well. He started drawing pictures of her knee and explained that her meniscus was torn in several places. He thinks she had a couple of those tears before the ACL tear and the ACL injury basically shredded it. He had to choose whether to repair it or remover 80% of it. He said that since she is so young, he thought that most of it could be saved. So, he stitched it up, took some blood from her arm, extracted the platelets from the blood and packed the platelets around the meniscus to help it heal. Then he brought out the pictures he took during the surgery. He took a picture of meniscus opposite the injured side of her knee that is fine. And a picture of the stitched up meniscus. I thought it was amazing.


Torn Meniscus


Repaired Meniscus

He gave us some exercises for her to start the following day and said we could see her in recovery in 50 minutes. I started the clock. At 48 minutes, every time someone came out the door and they didn't call "Tank Family," I felt like I got punched. Then it was 60 minutes, then 70. Finally, at 78 minutes, they call, "Elizabeth Tank." As we are walking back, the nurse told us that she is having a lot of pain in the back of her knee. (The femoral block only covers the top and sides of the knee.) When we made it to her recovery bay, I felt my face make "that face" that I make when I see something I am not supposed to be seeing. She was visibly in pain - ALOT of pain. Our English anesthesiologist came over and explained we may have to give her a sciatic block, but they would try to push some IV pain meds first. Her pain level went from 10 out of 10 - to 8 out of 10. More IV meds - 5 out of 10. More IV meds - 2 out of 10. The nurse looked at me and says, "I'm going to step out to give you some privacy and let her get dressed."

Umm, Huh?? Really? 30 minutes ago, we were planning on another block, now we are pulling our car around? In about 15 minutes, we were headed back to Murfreesboro.

We got her home and set her up in the recliner and plug in her polar cooler. It's not working. Reconnect all the tubes and switches... still not working. FRICK!!! I got back in my car and drove back to Nashville to get another cooler. On the ride home from Nashville, I plugged in my iPod and listened to Aretha Franklin's version of "Bridge over Troubled Water" 11 times. That cooler worked - Thank God!

She had some more teammates come by. And her coach and her trainer. Her block was still working and so were her oral pain meds, so she was in a great mood. Before her coach came, she said,"Mom, take this sprite, I don't want coach to see me drinking this." I said, "You just had surgery, he won't mind." She said, "Mom! We are in season."

Her team played a game last night at 8 pm in club's tournament. We were getting updates and she was teary for the first half. They ended up tie-ing. Tonight will be better!

Her block wore off at about 10:30 pm. Needless to say she had a rough night - ROUGH. It's 9 am and she's sleeping now though.

Today - dressing change and home exercises begin. CROSS YOUR FINGERS FOR US!

Surgery Ready

The Monday I found out that Liz had an ACL tear, I sat down and started reading about surgeries, rehabs and recovery times. Good grief, there are a lot of opinions out there - a lot.

I read some personal stories that made me hopeful and some that made me sick to my stomach. But, I read enough to have an idea of what would be happening to MyGirl and the questions I needed to ask.

I waffled so much on whether we should use a Sports Medicine Orthopaedic or a Pediatric Orthopaedic that it made my eye twitch. As a matter of fact, I think my eye twitched so much I was winking at people for three days. Well, we decided on Sports Medicine and I was very lucky to be able to get into to see the surgeon in less than 48 hours. It helped that I already had the MRI.

After seeing the surgeon, I felt so much better. I can't decide if it's because of what he told me or because we now had a plan. I needed a plan. He was confident, but not arrogant. He was knowledgeable, but didn't talk over my head. He spoke directly to MyGirl and answered all my questions.

He examined her and was happy with her range of motion and lack of swelling.



He showed us her MRI and pointed out where the ACL is supposed to be. He used a model to show us how the twisting caused the ACL to snap and the bones to smash together which caused bone bruises. He showed us how the bones pushed out and caused the strain on the MCL and the meniscus to tear.

We talked about using a patellar tendon from a cadaver to replace the ACL. We talked about using her own patellar tendon. We talked about using part of her hamstring. We decided on using her own patellar tendon. It was all very--doomsday.

Then he told us about the recovery. I wrote:
Two weeks of range of motion/ strength training physical therapy before the surgery.
Have surgery
Crutches for one week
Begin Thereapy, walk for one week - no crutches
Add Stationary bike and elliptical
10-12 weeks - running
5-6 sprinting/soccer controlled movements Assess and prepare to play. (I don’t remember if that was 5-6 weeks later or 5-6 months after surgery but I will find out.)

Her spirits were better than they were when we heard the awful news and he had given her a new brace that made her a lot more mobile and that she didn't need crutches.



She went to watch practice that Wednesday night in the snow AMA (against mom's advice).

I texted: "It is snowing."
MyGirl: "I know, I love it."
Me: "Do you want to go, or stick it out?:
MyGirl: "STICK IT OUT"

I don't know why I didn't want her to go/stay except that there was a small part of me that wanted her to live inside of a snow globe that I carried in my pocket.

I sat in the parking lot and watched her kick a ball - it almost looked like a dribble. I almost had a come-apart in my car. (Thinking: Would it embarrass her if I drag her off the field by her ponytail?) Since then, I have calmed down. That massive brace stabilizes her knee and it's not like her ACL is going to tear any more...

She went to her first therapy session the next day. About 30 minutes in, I got a text from hubs that said: "Stretching hamstrings. First sign of tears."

That may have made my eyes water - you know, the pollen has been really bad - in my car - on I-24.

Now, it's been two weeks - four therapy sessions with the physical therapist, home therapy twice a day and pool therapy three times a week.





Check out these pictures. It's crazy how fast things happen. Her therapists told us that we wouldn't believe how much muscle loss she will have in such a short amount of time. The first photo is from Monday, March 25, her second therapy session. Just 10 days post injury, there is a noticeable difference in her calf muscles. The second picture is from today, April 2 - just eight days later - a huge difference. I see it at least... but then again, I'm borderline crazy some days.




As of yesterday, there was no noticeable swelling. She can bend her injured knee 130 degrees on her own (Good knee is 135 degrees) and she can fully extend her leg. Her hamstring stretches are no problem and she can pedal a stationary bike for 20 minutes non-stop (no pain, no tears).

She is ready for surgery. I just hope I will be by Friday. Fingers Crossed.