Thursday, April 14, 2011

Evan needs our opinion

Hi there, My name is Evan, and I'm currently a senior at Cornell University. I took a nasty fall one night this past December, and I apparently tore my PCL and have been just dealing with it until I have my scheduled surgery this coming June 10th. I came across your blog about your experiences with this debilitating surgery, and I was hoping you could give me a few more details as I try to make plans for the summer. More specifically, after your surgery, exactly how limited were you? For example, I know that I'm going to be locked in a brace and have crutches, but do you think I will be able to maneuver the leg at least? Or does it hurt even to move it (even when it's not bending)? I ask because I'm trying to figure out where I should live during the summer -- in my apartment at college or at home. I'd much prefer to be at my apartment, but I don't know if I'd be able to subsist on my own. Also, it seems like you're into fitness and exercise as I am, and although this might sound irrational, one of the things I'm most worried about after this surgery is staying in shape! Do you have any tips on what you did post-op so you didn't lose muscle and/or gain weight? Any other tips or advice you have would be great, too. Thank you so much in advance for your help! Regards, Evan Thanks for any comments. Skinnygurl

10 comments:

jomo said...

Evan

-I am currently at day 65 post-surgery for a completely ruptured PCL.

You will be able to maneuver after 2 weeks...but when I say maneuver I mean with crutches and not well at all. You will have a severely diminished quad muscle in that leg, and not be allowed to use the hamstring for a long time. Doing exercises other than leglifts will be difficult to manage on your own for around a month and a half.

My girlfriend is an RN, and was able to help me for the 3 weeks after surgery and intermittently after that. It helps dramatically to have someone that you can rely on for assistance. Getting places, grocery shopping, and bathing at all extremely difficult on your own and essential actions.

As far as exercise...I wasn't able to do any "real" exercises until 6-8 weeks in where I could start plank-like exercises. You are very limited in those first few months, so I would suggest getting a set of hand weights, such as adjustable dumbells. There's not much you can do, since I wouldn't suggest altering your eating habits post-surgery. I would almost suggest getting more protein in your diet and overeating slightly after surgery just to ensure your body is being provided with. You will lose weight in the affected leg...but gain slightly elswhere. I don't think my weight has changed much but you can tell if you are active that you've gained some body fat in certain locations. Once you get into week 8/10 you can start doing more and more exercises so I wouldn't worry about staying active immediately after surgery because there won't be much you can do.

Hope this helps. I have my 3rd followup appointment today, have just started walking sans crutches in the last 2 weeks :)

susanv85 said...

Hi Evan,

I'm not sure what you mean by "maneuver" the leg. I was able to lift it up and down, but I couldn't bend it on my own, and I wasn't allowed to since that activates the hamstrings. I had very little pain after the surgery, the worst pain was in the recovery room, but after that, it wasn't bad at all, I think I only took 2 or 3 Percocet's total post op.

Personally, I wouldn't want to have been on my own after the surgery, I don't think I would have survived if I was living on my own. Besides that fact that simple things become much harder with crutches, things like getting into and out of the shower would have been impossible on my own. I also had a strange reaction from the anesthesia a couple days post op, and if I was home alone, it could have been a bad situation. But I don't know how I would have managed cooking meals, doing laundry, etc if I was living alone. Not to mention, someone needed to drive me to all my post op appointments, and my physical therapy sessions. Surgery was on my right knee, so I couldn't drive for a while. I also live on the second floor of a 2 family house, and I didn't trust myself to go up and dwon stairs on my own for some time, not to mention you're gonna have to bring food into your house somehow, if both your hands are occupied with crutches, how will you carry anything? Basically, my opinion is, if you can, live with your parents until you can walk again. It will make you life so much easier.

As for exercise, there really isn't much you can do. I spent the first 6 weeks of therapy on the table, except for when I got to ride the bike for 10 minutes. But even riding the bike, it's not going to give you a good workout, because at first, it's going to be really hard just to even go around, and you'll be focusing more on regaining the flexion than getting a workout. Once I was cleared to weight bear, I started walking a bit more, and riding the bike harder. But you will lose some muscle tone, and you'll probably become a bit flabbier. You're going to have a lot of atrophy in your operated leg, and its' going to get jiggly.

Right now, I'm about 20-21 weeks post op (surgery right before Thanksgiving, 2010) and am back in activity. I'm running lightly again, taking zumba classes, and I plan to go ice skating tomorrow. I still have a noticeable difference between the legs, my right is still smaller and somewhat jigglier, even though I do as much muscle training as I can. The muscles go away quick, but take a while to come back. But, I didn't gain a lot of weight post op, and I'm getting more in shape again now that I'm cleared for activity. I haven't run for more than 8 minutes without a break to walk yet, some of that is because of deconditioning, some of it is because of the muscles being weaker and my gait becomes noticeably off after about 8 minutes which starts stressing my good leg too much, but it's improving every day. When I first went back to running, which was only about a week and a half ago, I could only do about a minute without stopping to walk.

Best of luck to you.
-Sue

Evan Carr said...
This comment has been removed by the author.
Evan said...

Thanks so much for your comments and advice! With the post-op recovery, I guess I was trying to get a sense of not only the immobility (which seems to be the main hassle) but also the pain, length of time before you can bear weight, etc., which was touched on. When I injured the leg, I was laid up for almost a solid month on crutches mostly because of the swelling, so I was mainly just trying to do strength training for my upper body (the thought of keeping any lower body activities seems like a pipe dream at this point).

Another question if you have the time: When was it that you finally got off crutches (sounds like around 6 weeks for you, jomo?), and when you did, were you walking normally, or was it really difficult/painful?

Thanks again!

jomo said...

i got off the crutches ~halway through week 7 i think. To walk correctly I had to slow my pace, it didn't really hurt much from walking. After a few weeks there wasn't really any pain related to the knee other than mid-workout.

btw I just got my brace removed yesterday at my followup. Feels amazing!

susanv85 said...

I was off crutches at around week 6, and got rid of the brace at week 8-9. When I lost the crutches, it was difficult at first, but because I was still using the brace, it was a different gait. I was able to start walking sans brace at PT at 6 weeks when I was cleared for weight bearing, and it wasn't easy at first, I was walking at a speed of 0.5 or something ridiculous at first, and I was getting a lot of discomfort in the back of my knee, I wouldn't call it actual pain. By the time the brace came off, I had gotten hang of the whole walking thing cause I had been walking on the treadmill, with more progressive speeds. But the first time I took the brace off to walk without it was in PT, when I went from the seat where I was getting ice to the equipment in the gym area, which is about 10 feet. I still remember that being very odd, almost like I had forgotten how to walk, my PT had to walk me because he was afraid I would fall since it was like my leg had forgotten what to do. But after that, it wasn't bad at all.

Maybe I'm abnormal, but I had very little pain post op, the most pain came from trying to regain flexion in PT. Otherwise, it really wasn't too bad pain wise. The first time you go back to do anything, it's awkward at first, but then each time gets easier.

Molly said...

Evan:

If you can go stay with someone who will care for you during the 6-8 week post-op period -- DO IT! My first two weeks were quite painful, but not so much after that. PT can be quite painful, so if you want to take a pain pill afterwards, you'll want someone to drive you. The 6-8 week post-op period goes by quickly. 'Enjoy' it.

lisa.case said...

Hey Evan I feel like I may be able to relate some to you since I'm also a college senior and know exactly what you mean with the living situation! I had my PCL reconstruction done in December and I was warned that I was pushing the envelope of only being home with 24/7 care for 4 weeks before moving 500 miles back to school. Luckily I had a very aggressive surgeon, I was only mildly using crutches by week 4, usually just one for balance until about week 5. Unfortunately to say I was completely useless to myself for the first almost 2 weeks. At least the first week I would say have someone there to help, I couldn't sit down very well without someone holding my leg up or shower very well. That's what Moms are for though right? For at least 2 solid weeks I needed help with a lot of things, dressing and just maneuvering around, but you will adapt if youre on your own. I learned to use my good leg to hold my bad leg up while getting in or out of the car and sitting. You get creative. It was miserable for the first week or so pain wise, just sleep with the meds to avoid some of that. I did not even have a brace, which was against my opinion, but I ended up being fine.

Whatever you decide to do just make sure you have someone that is available to help you if you need or are able to call, driving is out of the question for almost 6 weeks (if its your right). I ended up being on my own essentially from the end of week 4 til now and I did fine, but i will say I have a wonderful group of friends and boyfriend who put up with a lot of my crap helping me, mainly getting my butt up and down 3 flights of stairs daily. I found that age was most DEFINATELY on my side through this, you will heal faster just because of that factor. Im almost 4 months post-op and riding a bike daily for miles, and found a new love for weight lifting since i cannot run.

Good Luck!

Karree said...

I had a bad car accident in July and a torn PCL and meniscus along with an L-1 compression fracture, rt
ankle injury, and rt arm. Most things are healing but
my knee is still swollen, painful and I can't do my normal activities. Like kayaking, bicycling etc I would like to have surgery and was refered, but was told I was too old. I am 57 but am very active and most guess I'm in my late 30 's early 40's. Why can't I have a chance at full recovery? Karree

KJ said...

How many surgeons have you seen, Karree? I had 3 opinions on my knee before I decided to get the surgery so it doesn't hurt to shop around.

A friend that tore his PCL said his surgeon told him that he shouldn't get PCL surgery because "it never ends well." It's my opinion that some surgeons just don't perform the surgery period.

You need to see a surgeon that regularly performs PCL operations (it's not common at all so I have a feeling those surgeons are few and far in between). What part of the country are you in? Someone on this blog can probably refer you.

I will say that is a difficult surgery and not having age on your side will be a huge factor. I had no idea what I was getting into and I had the surgery at 30 years old. It pretty much took the better part of 2 years to recover from it.

Whether you have the surgery or not, that knee will likely not ever be the same. It's really important that you understand that and can level your expectations based on that.

Is your PCL fully ruptured or a partial? I played rugby for 6 years with a partial then fully torn PCL. It took at least 6 months after the initial injury for my knee to stop hurting though and I think it was a full year before I didn't get awful pain whenever I caught my toe on something.

Scar tissue can go a long way in healing and I've met a couple athletes with torn PCLs that skipped surgery and just let scar tissue build up. They are fine now.

Are you anywhere close to needing knee replacement? After my injury I developed arthritis on 3 surfaces in my knee so that's something to keep in mind too. You definitely don't want this operation and then have to turn around in a few years and get replacement.