The Mental Side of ACL Recovery

The Mental Side of ACL Recovery

Whilst at hospital after surgery, doctors, surgeons, and nurses will continually tell you that recovering from ACL surgery is a long road because the healing process is so complex. They tell you about how “rest is key, and to not push yourself”. They tell you “it will get better, you just need to be patient”. And then you leave the hospital.

What isn’t mentioned is the mental health side of surgical recovery.

 

ACL surgery is a bitch, and will most probably affect you mentally in one way or another.

You probably will get ‘cabin fever’. Theres no doubt about it, this surgery will keep you house-bound for weeks. Please don’t expect to be up and about going out everyday, doing your normal tasks. Not only will the pain and immobility physically stop you from doing this, but you will be exhausted. Your body is putting in so much energy to healing your knee, that you won’t have any left to do anything else. To put it into perspective, the hospital gave me a sick note for a whole four weeks! They expect you to be out of action for at least a month. And this can get too much, very quickly. Trying to find stationary things to do for weeks on end is difficult. You will get bored. Theres only so much TV you can watch and books to read until you genuinely feel like you are completely wasting your day. You feel like you’re just waiting until the day when things will be better. And everyday you spend waiting, the further away it seems to get.

You will cry. A lot. And for no reason. The pain will be too much sometimes- this is the time to inhale all the painkillers. Also, there will be times where you will be at the bottom of the pit. You will have periods of acute depression. Don’t be alarmed, it won’t last forever. But i’ll be surprised if you still have you happy-go-lucky attitude after sinking into your sofa whilst watching hours of monotonous day time TV. This surgery will take it out of you. And its hard because you can’t just get up do what you like. You constantly have to be weary of your knee- you have to think about every single step you take, all whilst using energy draining crutches. The concentration as well as the physical side of it will wear you out. And when you’re tired, you get frustrated. And when you get frustrated, you will pity yourself. And when you do that, you will cry. This is a vicious cycle.But not everyday will be like this. Some days will be good, and some days will not be so good.

My advice for anyone waiting for this surgery, is to prepare yourself. Make sure you know everything you can possibly know- there is no harm in being ready. I think that was my mistake, I thought that this would be okay. I knew it was going to hurt and the pain was going to be intense, but I didn’t know what it would do to me mentally. One, because I was never told, and two, I’m stubborn and impatient. And its hard being told “it will get better” because you KNOW it will. It has to. But it just doesn’t feel like it.

I am just under 3 weeks post op, and I am still experiencing all of the above. My bad days are definitely out weighing my good days at the moment. I guess one thing that all of us that have knee issues have in common, is that we will never take a functional knee for granted ever again- we know how it affects us, physically and mentally.

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2 Weeks Post-op

2 Weeks Post-op

Sidenote: Potential gross pictures in this post of dressings and external incisions – please do not view if you are known to be a little queasy 

I am now 2 weeks post ACL surgery!!

Finally, I have reached one of the milestones they tell you about after having this surgery. Not entirely sure why, because nothing has really changed. Maybe, its a ‘well done you’ve reached two weeks of being able to sit and not have a complete mental breakdown woooo!’

My first statement is not completely true, things have changed. I got my gross dressings removed on day 10 which revealed my pretty neat incisions, and a load of bobbly internal stitches that are actually a bit freaky. They tell me they are meant to dissolve in time- I am not so sure.img_0599

(10 days post op-Operated knee, before dressings were to be taken off)

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(10 days post op- immediately after dressings were removed. Look at all that swelling!)

I am continuing with my exercises that they have given me, although I still cannot reach full extension. This is bothering me slightly because I know I won’t be able to attempt to walk until I get that full extension. I am trying my best, but the swelling is too much and my muscle loss and control in my quads is pretty dire. Another thing they won’t tell you is how much muscle you lose. I estimate to have lost at least half of my quads, and hamstring, and maybe about a quarter of my calf. One thing I am proud of is how toned my legs usually are. That will be the first thing I work on once I can get rid of those crutches.

I am still bed bound, 14 days later, having to use my splint and my crutches to get up and about. Today was the first day I spent all on my own as my parents went back to work after the Christmas break. Another thing they won’t tell you is that not only will you lose the use of your leg, you will also lose the use of your hands. Whilst I can now stand and walk using my crutches, I can do nothing else. I can’t hold onto anything, not my phone or a glass of water. Making myself lunch for the first time today on my own proved difficult to say the least. Balancing all my weight on one leg and leaning against the counter soon does wear you out, and you just wish it could be easier.

My operated leg is fairly bruised along the shin bone and I have a distinct patch of numbness running down the lateral side of my leg. I have read that the feeling may come back, or it may not. It doesn’t particularly bother me at the moment- its just freaky to not be able to feel part of your leg. The incisions seem to be okay though, no change there. I expect severe scarring where they took the graft. I am also experiencing anterior knee pain when I isolate my quads for exercise- not really sure whats going on there, maybe that will sort itself out.

                          (14 days post op)

I next see my consultant in just over a week now, when I will be 23 days post op. I am hoping I will see a significant improvement by then, but I am not counting on it. I should be going back to University this weekend for the second semester of my final year- but i’m not, and I’m gutted. I’ll be missing at least a week of uni, maybe more. We shall see.

My main goal for now is just to get the swelling down as much as possible and try to get full leg extension.

The Surgery

I was admitted for my ACL surgery on the 19th December 2016 at 7:30 am. At my pre op two weeks earlier, the nurse had said that I would need a ‘good book’ because they still operate at 4pm. One thing I didn’t want was to get there for 7:30 to then not go down until 4pm! That was just too long for me to be waiting, getting anxious. Thankfully, I was the first patient down. I was gowned, asked what knee was to be operated on (not great at decreasing that anxiety), asked a load of questions about my health and then wheeled down on a trolley to get dosed up on the good stuff.

I was wheeled into a room where two canulas were so thoughtfully shoved into my arm (they had to do two, cos my veins are teeny tiny and the first one didn’t find the vein). The anaesthetists pumped the general anaesthetic into my arm at 8:45 am. That was the last thing I remember.

I woke up at 12:10 pm in another room with a nurse in a chair beside me, feeling groggy and dehydrated. Thankfully I couldn’t feel my knee at all, I was still so numb. Once awake, feeling awful they wheeled me down to the main ward where I crept in and out of sleep all afternoon. My parents came to visit at around 3pm, and was I was starting to feel a little better. I felt amazing when the consultant said I could go home that day if I was able to get up and about. Unfortunately, my body didn’t agree with the anaesthetic, and after an evening spent throwing up and with super low blood pressure, they kept m in for one night.

Day 1

I work up on the ward in the worst pain I’ve ever felt. One thing they won’t tell you is that the pain after the surgery is much much worse than the injury itself. I was on all the codeine I was allowed. The physio came around about midday and got me up on my feet with my splint and crutches of course. I went for a VERY short walk and that was it he said I was ready to go home. Mum came to pick me up and after a very uncomfortable drive home I was place on the sofa and left with the painkillers. I couldn’t face the stars in my house that day, so I slept on the sofa. All in all, a very uncomfortable day.

Where it all started.

Where it all started.

I am writing this first blog post 11 days post op for my ACL reconstruction and lateral meniscectomy. I have only started to document this now as I have realised there were many things I didn’t know before surgery about my recovery that I wish I did know and i’m sure others would like to know also (plus, recovery is mind-numbingly boring).

If you are currently being lined up for the big op or are considering it, please for the sake of yourself do not take the decision lightly. Whilst this is a very common procedure and success rates are high, about 95%, this surgery will most definitely take it out of you. Well, it did for me anyway.

I more or less had to have this surgery done. I originally injured my ACL in September 2014 at the age of 19, a week before starting University (typical). There was no real concern over my knee stability at the time and the pain wore off after a few weeks. I went back to normal activity pretty easily. Looking back, we reckon I had partially tore my ACL at that time, but this was not conclusive.

In November 2015, 11 moths later, whilst playing football for my University team, I completely ruptured my ACL. A bad tackle came in from the left and everything moved except for my right knee which wasn’t going anywhere- that was was tore my ACL. After a trip to AnE, they confirmed that I had dislocated my right knee, and the impact had fractured my fibula.  I recovered pretty well from that injury, and was up and about after a few weeks. 11222180_10208279223281935_7430466873747888695_n

My housemate and I outside AnE, with a relocated knee, fractured fibula, ruptured ACL and torn meniscus (you’d never have guessed).

However, in late December 2015 I quickly, and painfully learnt about my meniscus tear. After sitting for a while with my knees bent, I tried to get up. A ridiculous, shooting pain ran straight up my shin and to the anterior part of my right knee. To my horror, I was completely unable to bend my knee or put any weight on it- it had locked shut at a right angle. To AnE it was.

Starting 2016 on crutches, I kept recovering well from my multiple injuries, but spent the whole year in fear of my knee locking and being bed bound for another few weeks. And that did happen. Multiple times- around 4 I think. My knee was locking at the most stupidest of things, one time I crossed my legs to sit in front of a mirror to put my make up on, and then, just like that, I couldn’t uncross them. It was beginning to become a joke.

I went through the normal NHS progression of appointments, MRIs, consultant appointments until I finally got a date for my surgery. 19th December 2016- 13 months after referral. Honestly, I wasn’t given that much information about what was going to happen or how long I would be in recovery for. I just know they were going to take a hamstring tendon, drill some holes through my bones and use the graft as a makeshift ACL, and then take my damaged meniscus out.

Thats where I am now, 11 days post op, 21 years old, with a tendon substituting my ACL, 2 screws holding it in place, and another pair of crutches to add to my growing collection.