Day 72

I do realize that much of the content of this blog is rather self-absorbed in nature. It is after all my blog about my knee so it seems there is little sense in writing everything in terms of random third person fictional references. Still, I find there is a somewhat uncomfortable level of implied self-importance involved with being the topic of most of these posts. A few people have said that rather than reading a blog when they want to know how I'm doing, they would rather just talk to me directly. This is certainly more personal, maybe even more meaningful. But somehow, verbally recounting status details even for just those blog-opposed few is strangely draining for me. I don't really mind discussions about the mechanics of it all (the surgery itself is rather fascinating if you can stomach the details) and I do appreciate the fact that anyone even cares enough to want to know how I'm doing. But honestly I'd rather write about my physical and emotional status once every few days than talk about it at all ever. I guess I just don't want to make this whole situation any more a part of my daily existence than it already is. Writing also forces me to provide a more thoughtfully considered evaluation of my condition and, perhaps just as important, how well I am (or am not) dealing with it.

The other main reason for these posts is that I hope to provide someone else who has an ACL injury (and what would necessarily be a lot of reading time on their hands) with key information and an insider perspective on the experience. The doctors will tell you what will happen after surgery. And they might even tell you that it’s going to hurt (“This will likely be the single most painful event of your life”, I was told by one surgeon). But what they won’t discuss with you is how all of this might make you feel at any given point during the journey. If you do happen to have an ACL injury, or know someone who does, one of the most important things to keep in mind is that every injury is distinct. Every recovery is unique.

Your mileage may vary.

The day before surgery, Doctor Stone pointed to a woman hopping on a small trampoline as we walked through his PT facility. “Three weeks”, he said with a hint of pride in his voice. She did appear to be a little hesitant about the safety of the trampoline therapy, but still, there she was, three weeks post-op with the same surgery I was going to have and she was hopping around like part of a circus act. Sure, I could get on the trampoline now, in the middle of week 10, but at week 3 I was still rocking back and forth in a corner, sucking my thumb and incoherently muttering something about my “boo boo”. It has since occurred to me that the term “ACL reconstruction” is not nearly definitive enough to make accurate predictions about recovery. There are two other significant factors to consider:

1.) How much collateral damage was done in the process of tearing the ACL?
2.) How does your body respond to injury, and especially that of surgery?

With respect to damage, if you are somehow able to tear the ACL with minimal additional strain on the knee (and it is possible if you hit it just right) then you will probably fair much better in recovery. I regularly hear or read about people who have torn their ACL and then finished the karate class, or played the rest of the game, or walked around for weeks before finally going to see a doctor. The moment I was injured I was instantly and dramatically debilitated. It felt like a bomb had gone off inside my knee. There was no opportunity to "play through the pain". In the midst of my pre-op investigation phase I talked to a local guy who tore his ACL playing indoor soccer, but then put off the surgery so he could hike part of the John Muir trail first. “Well, I wore a brace”, he noted as if that explanation was going to be nearly enough to get my head to stop spinning at the thought of it. I was three weeks into pre-op PT at that point and brace or no brace I was still barely able to walk through the neighborhood grocery store. Over the mountains and through the woods was definitely out of the question for me. Clearly, although the general diagnosis was the same, we did not have the same injury.

The other element of recovery has to do with the body’s unique response to the trauma - of the initial injury and then later of the surgery itself. I had the same surgeon, and exactly the same surgical method and materials as trampoline woman, so it was as close to a controlled study as I was likely to get without some research funding. But somehow the function of my knee did not recover at all the way hers did. Ten weeks, dozens of fully committed PT sessions, and countless compression wraps and ice packs since surgery and although the entry wounds are now well healed scars, my knee still retains hints of a freshly insulted joint - still somewhat awkwardly swollen and distorted. When I broke my collar bone at twelve years old (sliding off the top bunk in my sleep if you must know) it began healing itself within days, surrounding the break with an aggressive accumulation of bone tissue the size of a golf ball. I realize now that while this may be a preferable bodily response to a broken bone, it’s probably not ideal for joint injury.

With all of this in mind, I’ve found it helpful – to some extent even necessary – to consider the published rehab schedules and other people’s stories of recovery for what they are – single data points (just like this one) that make up a small part of the bigger picture. I’m beginning to accept that my recovery is uniquely and entirely my own. The successes, failures, and schedules of others, while interesting, are not mine in any real sense. As I wrap my head around this concept, the stress of comparison is removed from the equation. And only then am I able to successfully focus on what really matters.