Reconstruction Completed

My left ACL has been reconstructed. The hospital was fantastic, really great. Well, one day the nurses forgot about my pain meds all day, but other than that, I was impressed. My room was set up for four people, but they used tall built in bookshelves and curtains to keep privacy. Typical stuff like TV's and cabinets- but also great grassy/nature views and carpets (yes, carpeting in the room). The meals they served were waaay more fancy than I've ever enountered in my multiple hospital stays, and they brought you coffee/tea every morning/evening (ceramic teapot, with the fixin's).

Having many surgeries, I feel I'm in a position to compare experiences a bit. Here, you check in briefly, and are taken (walking, not wheeled) to your room rather than to the pre-op area, close to the OR. A nurse comes in and asks lots of questions, and you gown-up. I'm (I'm switching from the "you" to "I" format now) put into the bed, and she brings in a cart with bentadine (sterile packs) and washes my legs, hip to toe (both) and wraps them in plastic and tapes them closed. She explains that they do this here, as well as a 2nd time in the operating room. I'm wheeled from there to the theater (see, you HAVE a surgery IN the theater) area where the anesthesiologist evaluates me (30 seconds for R500). Turns out he was a one-time Judoka, and was fond of leg sweeps. Hopefully for his Uke, he was also fond of off-balancing and keeping track of which way joints bend. People who pass are in the typical scrubs, and they're all quick to smile and say hello. I'm wheeled into theater where I scootch over to the operating table and the anesthesiologist sets up my IV and gives me something to "relax" me, then something to knock me out. This is the first time I've not been asked to count back from 100.

I wake up with the typical shivers, but the morphine kept me out for many hours. When I woke up, I was pleasaently surprised to find the dosage of the morphine (which I controled with a pump, as usual) is good, so I'm not fucked up or scared of my feet. A friend, who has been so helpful I can't even begin to thank her visited (Grethe) and I'm sure I made no sense whatever.

The next day I'm better, put onto regular pain meds (IV) and see the physiotherapist. Do this

everyday, that everyday, some of this, that and never that. Go up some stairs and I'll see you tomorrow. Same deal the next day along with a test on how well I navigate stairs (I passed). Much to the nurses agitation, I take a shower, repeatedly telling them this ain't my first rodeo, and that I'll call if I get light headed in the slightest (I was fine).

OomJan, my Judo sensei visited, and it was a needed emotional crutch (I didn't realize I needed it until I saw the concern on his face). It wasn't visiting hours, but he's such a charmer, he wormed his way past the fierce nursing staff. Later, Maret (another life-saving friend, from Judo, who brought me to/from the hospital) and Faf came to visit (the offending Judoka on which I will comment no further). Grethe also came again, wielding licorice (amen).

Got home Friday afternoon, to a new flat in the same building (G110). I'm officially handicapped, so I've been put into the "Paraplegic" room, which is a horrible name for a sweet flat. I have a full bed rather than that piddly twin, and it's higher off the ground, to boot. I have windows everywhere, and a shower in the corner of the bathroom as well as the regular tub! There are handrails all over the place, and there's even a second bedroom for my "caretaker" (who, incidentally, insists on cooking my vegetables in red meat fat whenever I am not vigilant).

While my caretaker is very nurturing, I find her protectiveness a little hard to take. She chimes in when I see the Dr., undermining my carefully worded questions about my proposed activity levels and leaves bits of broken glass on the floor for me to find with bare feet. She hordes the garlic as if it's coming out of her salary and I think she stole my credit cards. But, she is quite good at foot rubs, and she did give birth to me, so maybe I should keep her for a little while.

Today is day 10 from my surgery, and I am running ahead of schedule (I can bear full weight [briefly] and can bend the knee 90+ degrees). I'm not going to push things though, as there's still lots of swelling and soreness (with the tissues they mangled around the knee, not the knee itself). My calf is like an overstuffed sausage at this point. This is a standardized timeline for ACL recovery.

0 - 2 weeks

Partial weight bearing - Full Weight and Knee Flexion to 45 degrees.

2 - 6 weeks

If wound healed, swimming (no kicking), Gentle Stationary Cycling and knee flexion to 90 degrees.

6 Weeks

Graft at weakest so be cautious. Full Weight bering. Full active range of motion and most PT exercises.

3 Months

Muscle Conditioning, Cardio Fitness and

Propriception exercises (not to be confused with the entomology term 'proprioreception')

6 Months

Sport specific training

I see my new physiotherapist on Monday and will get some sort of routine/instructions. Hmm,

if she's an expert, maybe she can help me with other medical bodily issues, like my loose skin. Perhaps there's some use it has that I'm just not aware of. I could retrain my brain to use the flesh like a flying squirrel or something. Fold back when not in use, and when leaping from a rock to the ground 4 meters up, fan out to allow me to glide down with ease! Then again, why think so small? There's lots of people around with loose skin. Cirque Du Soleil could form a troupe of just people who've lost lots of weight and have a spectacular flying show unlike any other. I'll have to explore that idea some more. I'll keep you all posted.

Here are some cool pictures of a praying mantis that chose the wrong flat to come into the day before my surgery. I played with him for a while, and as I'm now an entomology student, I didn't hold him hostage, I put him in a killing jar and then pinned him systematically to a board, using no less 19 pins. I'm a terrible person.

Surgery in South Africa

Ok all, it's on. Insurance came through, and my $13,000US surgery has been approved. I even have some leftover coverage for physical therapy! No worries, MediClinic is a large hospital system here, sort of like Fairview is, in Minnesota. They're the upscale private hospital and are the ones with the great reputation around Stellenbosch. I go in tomorrow at noon, and they say I'll be there for two nights. Naturally, I'll take pictures and post them of my new wounds. Ah, finally, surgical scars that might pass for a shark attack!

I'm going to the Theater, and there's going to be blood.

April 20th, a very large, very strong and very new white belt tried to sweep my leg during Randori. For those non-Judokas, that means just "free-practice." This fellow is very nice, and until this night had refused to throw me at all, for fear of hurting me. Being that I've been slammed into the mat more times than I can recall, I told him over and over again to just be normal with me, and that he'd not hurt me. Ha. I should have added that this was only if he integrated tsukuri (off balancing me). He put his foot down against mine, so my left leg was blocked, then tried to shove me over his leg (to my left) with brute force. Problem is, my knee doesn't bend that way, and without the tsukuri, all that happened was my body above the knee went one way and the parts below the knee stayed stationary. I heard- as did he, I think, I loud POP-POP and we both froze. I knew something bad had happened, but thought since it only mildly hurt that it wasn't serious. This was something that could have happened easily to anyone- just to be clear. This guy is not un-skilled, and he was going for a gentle throw, and it was just one of those flukey things that could happen to anyone.

Later that night the mild pain and wobbly feeling turned into rockets of pain if the knee bent. In the morning I got a ride to the ER and was told it was likely a meniscus or other ligament tear, but that there was no bone in it so not to worry too much. I was to stay off it for a few days and go follow up with a Sports Dr. 8 days later when I could get a ride to said Sports Dr. (it's holidays left and right here, and I couldn't get a ride to go earlier as I was supposed to), she tortured me for a bit, then said she thought it was a more serious tear, with cartilage flipped under bone that would need theater (surgery) to repair. She sent me back to the hospital to meet with an orthopedic surgeon right then and there

Sigh. NOW, this Dr. did a very light exam and said immediately that his gut feeling was that it was an ACL (anterior cruciate ligament- one of the main ligaments on the knee) tear. I already knew that this was the worst-case scenario, as the other Dr's had casually and briefly mentioned this tendon.

A very expensive and immediate MRI (it's a "real" hospital, they have an MRI there) confirmed his gut feeling and I'm scheduled for a full ACL reconstructive surgery Wednesday (May 4th) at the Stellenbosch MediClinic. This is the private hospital network in South Africa, and the one everyone, and I mean everyone says is the place to go. So far I'm impressed with the care as my surgeon has emailed me personally, and in the ER, the Dr. himself came to get me after my series of X-rays. They've all been very kind, informative and attentive.

The kicker is this: there's something about the body's reaction to this injury that makes it a surgery they won't do after 14 days from the injury date. This all happened so fast, that I can't really remember the details right now, but if I don't have the surgery Wednesday, I can't have it for 6 weeks. AND cause it's "holiday season" in South Africa now, and my diagnosis was made late Friday, not one lick of information has been sent to my International Insurance company and the hospital will cancel the surgery if they don't get a letter of guarantee by the surgery. Today (Monday) is flippin' Banana day or something, so literally, the insurance company will have one day to make the approval. I'll be sweating bullets tomorrow (and being an utter pest to the surgeons office until I get confirmation that they've sent it), that's for sure.

The surgery itself seems to be pretty standardized. They don't have the same cadaver supply here that they do in the U.S., so I'll have hamstring grafts taken from my right leg. They drill through the femur to get to the tendon to make the repair, and though there's some open incisions, it's kept pretty minimal. From reading other people's ACL repair blogs, I expect to be on my feet with crutches within a few days, and to put full weight on the knee within 2 weeks, for sure. After that, the physical therapy is to begin (again, insurance allowing) and in 6 weeks I'll be able to ride a stationary bike (the "stationary" part was highly emphasized) and in 6 months (MONTHS) I'll be able to get back to Judo.

To say the least, this shredded ligament has derailed my "training" and I'm trying to see the positives. If anyone has any- besides "it could be worse," I'm all ears. I'm not sure yet how this will impact my studies, but I've been a good student so far, and I should be able to take exams, so I think it will all work out.

On a side note, the night of my diagnosis, a homeless cat that I've blogged about got herself knocked up (I guess she didn't take advantage of all the free condoms) and was crying outside in the cold. I found her and took her into my room (which is very much not allowed, but she's been living in people's flats the whole semester, anyway). I realized what was going on, and made a little bed for her and watched her abdomen cramps. During the night she painfully (she's very young herself) gave birth to 3 live (one dead) kittens. I'm sharing my bed now with this family until they're old enough to be sent out into the world (homes or a shelter). Elizabeth did find a home for the mama though, on a vineyard, so she's all set. I'm going to see how much it will be to fix her and see if the other people who have taken her in will go in with me to take care of her. Her personality is much improved since giving birth- she's very affectionate (though a rough mother, to say the least).