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

Monday, April 11, 2011

Another Journey From Reader Susan

the first day post op after, with the cadaver tendon before picture of my knee, those strandy things at the upper left hand corner is all that was left of my PCL, or at least that's what my doc told me.


Hi skinnygurl!


I'm sharing my PCL story in case you want to share it on your blog and maybe allow your readers to hear about another experience. I first tore my PCL in May 2005 when I fell ice skating, I caught a rut and landed square on my tibia, pushing it back. I heard a sort of pop, but didn't think too much of it at the time. I got up and finished my skating session, figuring it hurt just because I fell. Afterwards, when I got off the ice, I couldn't bend my knee enough to sit onto the bench, the manager had to get my skates off for me. Getting into my car, I had to move the seat all the way back just so I could get in. I kind of just ignored it all though, as I was leaving for a trip to Israel a couple weeks after that. I bought a knee brace and kept it wrapped up. When I came back from Israel, and it was still bugging me, I went to a doctor who took a couple x-rays, and said I just had a little chondromalacia and sent me for PT. Obviously, it didn't help much, and eventually, I just got used to the looseness of my knee.


A couple years later, I started medical school, and during our first year, we had a musculoskeletal physical diagnosis lab, which included the diagnostic tests of the knee. We practiced these exams on each other, and when my partner did the posterior drawer, and it was unexpectadedly positive, she jumped, gave a little yelp. Our group preceptor came over, looked at my knee, did a couple other tests, and told me these tests have virtually no such thing as a false positive, he was 99.9% sure that I had a torn PCL. So there was my diagnosis, given in a rather unconventional manner. He told me if I tore the PCL, I likely also had other damage, since a PCL tear rarely happens in isolation. I had to see an orthopedist for my insurance company to approve an MRI, so I went, told him my history, and he sent me for the MRI. MRI report comes back as normal. The ortho looked at it himself, and said he disagrees with the radiologist, the PCL looks torn to him, and it didn't matter what the MRI report said about the PCL, it was most definitely torn just from the exam alone. And wouldn't you know it, I'm one of those rare beasts who managed to tear only the PCL. At that time, he told me surgery is not recommended because I was functioning at a high level already, I was skating, running, basically doing everything. Surgery is also more difficult and complicated than an ACL repair, so he basically just told me not to do anything at that time, and I was happy with that answer.


Flash forward to about 2 years after that, and I started getting more and more instability and pain in my knee. It was constantly giving out on me, just collapsing for no reason. I eventually had to stop skating and running because of the instability. And then it started giving out just walking up the block. That was kind of the turning point for me. I went back to the surgeon to ask about reconstruction. He told me that he agreed I needed surgery, but he wasn't comfortable doing it, since it's such a rare surgery. He sent me to Hospital for Special Surgery, and in July 2010, I met with a surgeon there. Surgery was scheduled for the beginning of my one month vacation, which happened to be just before Thanksgiving. November 23, 2010 I went into the hospital and had the distinct honor of being the only PCL reconstruction that day. I walked into the OR, and there had to be about 17 medical students and residents waiting for my surgery, guess they all wanted to see the PCL repair since it's not a very common surgery. I don't remember too much after the surgery, except that I had to meet with a PT before I could be discharged to learn to use crutches, and he was incredibly good looking and very strong. I wish I had worn nicer sweatpants because he really was very handsome.


The next couple weeks were pretty much all the same, laying on the couch, playing video games, needlepointing, going stir crazy. I started PT at day 13 post op, which was exciting at first. But then I could only do exercises on the table since I was non weight bearing for 6 weeks. The interesting part is that I had to go on residency interviews during the time I was on crutches. It makes for a very interesting time, wearing a suit, bulky brace, and being non weight bearing and spending a whole day on your feet. Definitely was not easy, and not something I would want to do again. But my arms got really toned. At 6 weeks, I was cleared to lose the crutches, and I was able to start doing more intense PT using the treadmill, the weight machines, etc. After that, it seems like the rehab just started going a lot faster. 8 weeks post op, and I was able to lose the big bulky brace. My surgeon said he doesn't recommend any sort of functional brace because there isn't anything that would really support the PCL anyway. Still not allowed to run though. At 12 weeks, I started using my hamstrings again.


14 weeks post op, I went back to see my surgeon, and he signed off on my case. He said the PCL was stable. There is still some laxity, but I went from a grade 3+ to a borderline 1/2. He told me before the surgery that if I get back a degree of laxity, it's considered a success with the PCL. He explained it will never be perfect, but it should be stable enough that it won't collapse on me and I can do everything I want to do. If I was a professional, it would be unlikely I could go back to playing at a professional level, but to kick around a soccer ball with my friends, or go ice skating at a semi-serious level, or run 5K or 10K shouldn't be an issue. He told me I could start running again at around 20 weeks post op, and I wouldn't need to see him again unless there was a problem, and I can stop PT since I could do all the exercises on my own anyway.


Well, I started running slowly at 19 weeks post op, not much difference in a week, right? And when I say slowly, I mean really slow. I completely forgot how to run, it's almost the same sensation I was getting when I was relearning to walk, I had to think about where I was placing the foot for each step. I have been doing a walk/run every day so far this week, and so far, it's holding up really great. I'm really happy with how secure it feels. Once I get into the groove and find my stride, I don't worry about my knee collapsing. I also went to my first zumba class, which was a great test for my knee.I'm not able to do a lot of the jumping, but I kept up with the class and my knee didn't hurt at all. I also started a belly dance class at around 17 weeks post op, which started me getting confidence in my knee, even though it's not very stressful for the knee. I know it's still early, but so far, I'm really happy with my decision to do the surgery. Going through the rehab, I was wondering if all this was worth it, if I would go through all this rehab just to end up with a knee that wasn't any better. But now, I'm not thinking about my knee when I walk, I just walk. I can run, I can zumba. I haven't gone back on the ice yet, since that requires a lot of deep knee bend and I'm just not able to do that yet without a lot of pain, but being able to run and survive a zumba class gives me the confidence that I will be able to do anything I could want to do. I'm happy that my knee is no longer holding me back, and I'm sure the people around me are happy to because I don't complain about my knee as much either.


Anyway, there's my PCL success story. Hopefully it wasn't too long and boring, and maybe someone else can benefit from reading it.
-Sue

Thank you for sharing your journey Sue. Us PCL Survivors know the length and pain of recovery so please don't feel as though your story is too long or boring. I'm very happy to share and like you hope someone else can benefit from you!
Skinnygurl

Monday, February 21, 2011

Here Is A Thank You Note From Stanislav Of Russia

Hi, Skinnygurl!
My name is Stanislav, I am from Russia. A year ago I had a severe knee injury while skiing. PCL, MCL and miniscus were completely torn. So, as a result, I had a complex knee surgery in Germany and spent two months in a rehab center.
Naturally, during all this time I'd always tried to search the internet to check how I was doing and what were the prospects. And the best source of information I could find was your blog. Thank you very much for very important and incouraging information!!! Every time I wasn't happy with progress, I checked your situation for the same time ex surgery and usually I felt much better after that, as my recovery went even quicker than yours :)
Now, a year after surgery, my injured leg still looks smaller and I still have some feeling in the knee when walking, but I can easily run a mile or walk 10 miles. So, I believe it's ok.
This week, a year after surgery, I spent several days in mountains skiing again. As it turned out, it was easier for the knee to ski than to walk. I could ski the whole day with minimal sensations in the knee.
Thank you very much again for your blog. Great job.
Stanislav

How wonderful Stanislav, I thank you so very much and glad you found this blog to be helpful. Congratulations on your progress.
Skinnygurl

Tuesday, February 15, 2011

3 Years Ago Today



Hello and welcome to my blog. 3 years ago today I went to the gym, ran 4 1/2 miles, logged my progress and went to work like any other day. That night I took a fall which changed everything. I tore my PCL.
Prior to that I didn't know what a PCL was. If you're reading this you probably can relate.
I had surgery and after a long recovery, here I am!

I invite you to read my story along with the journey of other PCL survivors.

Stay tuned and feel free to leave comments. If you have a journey you would like to share feel free to email me at sprinter2fun@hotmail.com

Skinnygurl

Wednesday, November 17, 2010

KJ's PCL Story

Hello everyone and welcome to my blog.
Here is another pcl survivor story! Thanks for sharing KJ.
Skinnygurl

First, I love your blog! I just found it yesterday and I'm almost done reading the entire thing! Thank you for sharing your story and giving others a place to share theirs.

My story is a little long because it took me 6 years to get the surgery. A little history: Original tear occurred in April of ’03. I took an awkward tackle straight-on below my knee during our Midwest Rugby Championship match (we won at least).

The MRI showed a partial tear of my PCL so they advised PT only and no surgery. The next 5 years looked like this:

- Played at Nationals in June ’03 right after the injury (dumb & painful)
- Missed most of fall ’03 season due to pain but resumed regular playing in spring ‘04
- Played at the Midwest level in ’05-’06 (grueling training schedule) and attributed knee pain to over-training. I know now it was due to the original injury.

- Tweaked my knee playing volleyball in spring ’07. It sent shooting pain through my knee that radiated out into my upper leg and I had to stay out of activity for 3 days. After that it didn’t hurt anymore. In hindsight I should have had it checked because that’s most likely when I completely tore my PCL.

- Kept playing rugby and played my final season in fall ’08. I barely made it through that season though because of knee pain

I went back to my original ortho who basically did nothing; saw a 2nd ortho who ordered another MRI. Follow-up:
- He saw the complete tear so I tried PT for 2 months at the end of ’08 and cortisone injections but nothing relieved the pain.
- Was referred to a 3rd ortho, Dr. Noyes at Cincinnati Sports Medicine, who happens to do an incredible amount of research on PCLs
- Stress test revealed a 11 mm drop of my tibia from my knee. I was questioned on how I kept playing; surgery is generally done once the tibia drops 6-8 mm. I told him it was easy since I didn’t know there was actually something wrong :)
- I was scheduled for surgery 2 months later (March 25, 2009)

I’m not gonna lie, I had no idea what I was getting into with this surgery because I’d never had so much as a stitch in my life; that’s probably a good thing.
- They used my quad tendon for the graph and surgery surprisingly took under 4 hours.

- The next 2 weeks were full of plenty of tears at rehab because of the pain. I had scar tissue issues and couldn’t hit 90 degrees flexion by the end of the 2nd week so back to the hospital I went for manipulation under anesthesia. That may have been worse than the actual surgery!
- I immediately jumped up to 106 degrees after that and made steady progress from there on out. I never had issues with range of motion after that and never had a problem with getting my leg completely straight. That was the only thing I could do from day 1!
-I spent 9 weeks total on crutches with my hip to ankle brace (I think I got a sleeve the last 2 weeks). The first month my brace was locked straight which is awesome when you’re trying to sleep. In all, the healing process went well though and my knee is solid and stable. My stress test at 1 year showed my tibia only dropped 2 mm which is normal so the graph has held. However, my strength test at 1 year was depressing and still showed a 33% deficit.

I should probably mention that 2 months after my surgery (while still on crutches) I got engaged! I was married 4 months after that so admittedly my rehab suffered a bit from months 3-7! Heck, is suffered the 2 months after we got married too :)
Current Status:
I coach high school girl’s & senior side rugby now and ran around all spring with a limp. It caused enough pain that I headed to a new rehab place in July to see if I could do anything about it. Manual therapy helped some but I think it’s as good as it’s going to get.

I think I'm glad that I didn’t have this surgery at 23 years old but the downside of having a janky PCL for so long: grade 3 chondromalacia of the patella with chondral fissuring and suchondral reactive osteoedema. Basically the same grinding & snap, crackle, pop others have mentioned plus I'm awfully close to being bone on bone (grade 4). I have arthritis in 2 of the surfaces along with effusion (water on the knee) & a baker’s cyst (in the back of the knee) that came back pretty much as soon as they drained it. I've also developed painful tendonitis in my good knee. They say this put off knee replacement an extra 10 years though so I have to look at the bright side.

By 18 months out I was done babying my knee even though I continue to have a lot of pain. I could do quick starts and sprint at rugby but always paid for it with LOTS of pain afterward. I am back to boxing & zumba which haven't bothered my knee too much. Running a 5K isn’t in the picture yet and may never be (I never really liked just plain running anyway - ha!) and I have no plans to return to competitive rugby, although I still feel my 12-year career was brutally cut short. Strength is still a nagging issue but it's better; pain is still my number 1 nemesis!
The Future:
I go back in March '11 for my 2-year and final check-up. I’ve skipped all the strength tests since my 1-year mark because they are expensive and I don't need them to tell me that I'm weak. I may get another one at 2 years just to see where I am. I still have 1 1/4" difference in my quad size and the catch 22 is I can't do extensions because of pain and I'm not supposed to do squats (I still do them with <20 lbs). Tough to get my full quad back with just straight leg lifts!

Unlike you, I'm not always sure if I'd do this again! :) It changed my life forever.




Saturday, August 28, 2010

Welcome To My Blog

Hello Everyone!
My journey is over but yours just might be beginning. Feel free to leave comments, questions or concerns in my comments sections. I have several people that have gone through this same surgery and are willing to help you as well as myself.

Wednesday, May 5, 2010

Andrew and his questions about PCL Surgery

Hello and welcome to my blog.

Andrew came to me for help.
Andrew, you'll find your questions and answers in the comment section of this post.

Thanks Everyone!!!!!!
Skinnygurl.