Recovery Tips

Following are a few thoughts in case you or someone you know is about to have ACL surgery. I'm not a doctor and I don't play one on TV so clearly none of the following is intended to supersede any advice or direction provided by a medical professional. These are just a few things that I learned as I went through the initial post-op phase so I thought I'd include them here.

Get help
This is critical. Find someone who is willing to be at your beck and call 24/7 for at least the first few days. Talk to this person (or people) ahead of time and explain to them what will be required. Be explicit in your expectations so there are no misunderstandings. If you’re married, now would be a good time to tactfully remind your spouse of the “in sickness and in health” line that you both agreed to during the ceremony. Also, get creative and find a few tricks to help yourself. I wore a robe with big pockets so I could transport things while on crutches. I also hooked the foot of my good leg under the injured leg as necessary to help lift myself onto the couch or into bed.

Get comfortable
To suggest that the first week or so after surgery will be uncomfortable would be understating the situation by more than a little. Make an effort to help balance out the discomfort by increasing comfort in other areas. Get a stack of comfortable clothes. Get some nice socks or some fleece underwear. Whatever does it for you. I cut one leg off at the knee from a pair of sweats so I could stay warm while icing. Cook a meal or two ahead of time. Get some comfort foods at the ready. Keep them to a minimum, but an occasional fudge brownie or three might just be what you need to keep your heart in it.

Get situated
The first week is going to be a long one so get prepared. Create a space for your post-op experience well ahead of time. The space should have some method for leg elevation, and be somewhere that you can safely and easily sleep. Make sure all critical items are located within reach – food, water, crutches and meds in particular. I also had my laptop, tv remote, phone, magazines, ice pump, and a guitar all no more than 30 inches away once I got home.

Manage pain
This is the primary objective of the first few days. It seems like an obvious goal but for me, if the pain is severe enough for long enough I can actually begin to loose focus on trying to manage it. Certainly pain is subjective and post-op there is definitely going to be some of it but if things drift too far beyond your tolerance it will get miserable very quickly.

Transition slowly
The worst pain that I experienced came with the transition and aftermath of moving from a leg elevated position to standing up. The blood that rushed to my lower leg brought with it the most agonizing pain and teeth clenching pressure of the first week. I quickly learned that the key to limiting this pain was to transition in stages. Move the leg from elevated to flat, wait. Move the foot to the floor, wait some more. Slowly stand with crutches, then go on the move.

Do drugs
Understand how the different meds work, especially those that affect pain. I was given a narcotic (Percocet) and an NSAID (Toradol). The narcotics (at least for me) are primarily what I would consider “disassociative” drugs. They only reduce my association with the pain. It's still there but I don’t feel as connected to it. The NSAIDs are Non-Steroidal Anti-Inflammatory Drugs. These actually reduce pain by reducing the inflammation that is, in part, the cause of the pain. I was also taking an antacid and plenty of fiber to avoid any digestive issues caused by the surgery trauma and the various IV and post-op drugs. Last, if you end up on a course of anti-biotics like I did, consider following it with a probiotic of some sort to get your gut back in order.

Make a schedule
For your meds, make a written schedule of some sort that allows you to check off or otherwise record when you have taken something. You cannot afford to wonder if you just took a Percocet ten minutes ago. Missing a dose might make for an unnecessarily rough day and doubling up could be worse.

Feed the body
Eat eat eat. But try to eat as healthy as possible. Your body will be trying to recover from a major assault. This is not the time to fill it with pepsi and cheetos. Make sure you keep your digestive system as happy as possible by regularly tossing good food down the hatch. You can burn off the extra calories in a few months but if you go hungry and your stomach turns on you in the first few days, it will make things far more difficult and uncomfortable than they’re already going to be.

Be the potty
Females can skip this trick because honestly I don’t know how to help you here, but for guys, consider keeping a large empty plastic bottle handy. You really do need to stay well hydrated, but at least for me in the first two or three days, getting up just to get to the bathroom was by far the most painful part of the whole ordeal. Consider at least giving yourself the option of shortening those trips down to just a simple roll onto your side. Maybe getting up to go won’t be an issue for you, but a simple plastic bottle is cheap insurance in case it is.

Keep clean
As a guy I am genetically able to go for many days without bathing but doing so can eventually drive away anyone who had previously committed to provide post-op help. ACL surgery makes bathing difficult in part because of the pain and immobility and in part because the sutures cannot get wet for at least the first few days. Here are a couple of ideas –
1.) Face it. Skip the shower and just wash your face. Or even easier, go with a swipe of witch-hazel. You’ll feel cleaner even if the rest of you has begun to smell like the inside of a city dumpster.
2.) Sit down. Get a chair that can go in the shower. I used a milk crate but it was not very comfortable and eventually I got tired of the waffle marks on my butt.
3.) Hose off. Get a removable shower head with a hose. If you have to sit down to shower, this is a must have feature.
4.) Wrap up. I used saran wrap to keep my sutures dry. This method is not waterproof by any stretch but it's plenty splash proof enough. You can also get a shower bag from most medical supply stores.

Take off
Obviously you’ll be off work for some period of time but I’ve talked to some people who tried to go back to work the week after surgery. While this might be physically possible, depending on the severity of the procedure and the physical demands of your job, 2 weeks to a month may be more reasonable. For my surgery (ACL BPB allograft and meniscus repair) I had difficulty even working from home during the second week because I couldn’t sit in a chair for any length of time without my knee blowing up like a balloon.

Keep smiling
Even if you have to fake it, and you probably will, smile as much as possible. It's a simple and powerfully self-fulfilling gesture. Make a list of all the things you can do while you’re temporarily stuck with a bum leg. Find a project, learn a language, read a novel. Most importantly, be positive, be strong. And remember that the worst of the recovery is short and it will all soon enough be behind you.