Saturday 6th October 2012

Home - Saturday 6th October 2012.

Still not feeling too good seem to be having a bad reaction to the Anaesthetic. Everytime I move I just want to be sick.
Well for 3 days in not much has been happenening other than me consentrating on getting my leg as straight as possible by pushing it into the bed and trying to get the pit (back) of my knee to touch the bed by supporting my foot with a rolled up blanket. Also trying to do heel slides but I am in too much pain and feel far too nauseous to do anything. :(

Its later in the afternoon now and I am on my way to my local A&E Department as I have just had my first carrier bag shower and I feel so ill, dizzy and like I want to faint. I also keep vomitting everytime I try to eat or drink. Best to get checked out.

Returned from A&E Department

So glad I went along there, it appears that I was suffering from something known as Ileus (Bowel Paralysis) basically that my Digestive System is still not woke up from Anaesthetic. I was placed on a drip to rehydrate me and given some antisickness medicine via IV and had an X-Ray taken of my stomach.
I have been discharged with some Lactulose Liquid to take over night and was told to drink plenty of fluids that I could also some anti sickness medication.

Just want to curl up and die right now guys......

A cocktail of Morphine, Codiene and Paracetamol and plenty of rest.

Thursday 4th October 2012 - Day Of Surgery

Well here we go!!!! It's the morning of surgery and I am just about to leave the house for the hospital. It is about 35 minutes drive from my home town of Liverpool.....

Was due to be at the hospital at 7:30am but I didn't arrive until 8:40am. There was a really bad traffic jam on the motorway which isn't the usual route I would have taken.. I rang ahead an let the ward know and they were very understanding.

Upon my arrival I was shown to a side ward which was opposite the Nurse Station which was reassuring, I then sat with a Nurse and went through some admission paperwork, I was then visited by the Anaesthetist who went through some further questions on my lifestyle, eg Do I smoke? and how many? How much Alcohol do I drink? If I take Amphetamines or Ectacsy tablets? Or when was the last time..... I told him I do not use these sorts of drugs but that I smoked 10-15 cigarette's a day.

He then told me what he would do in regards to helping me with the pain and also administer General Anaesthetic. He also advised that he would give me an injection in my groin in my Femoral Artery for a nerve block whilst I was under. I was told this will help with the pain above my knee but as I was having a bone plug extracted and a piece of my Patella Tendon this may not help for the pain below my knee. He also advised he may pump my knee with a Local Anaesthetic to help with the pain when I wake up.

One of the Surgeon's also came to visit me shortly after to explain the procedure, he drew a arrow in black marker pen and started to describe the usual procedure for an Arthroscopy he then went on to say how my Surgeon would extract fibres of my hamstring and use them, I stopped him in his tracks and advised that I was told I was getting the Patella Tendon graft. H e quickly referred to a letter mounted on orange paper which explained the full procedure and type of graft to be used. He apologised for the mix up and went onto explain how my Patella tendon would be extracted with a bone plug on each end and used then to be held in place by some Calcified Pin's which would eventually morph into bone after some time.

Nervously waiting for Surgery.... Eeek!
 

I was then told I would be called for around 10:30am as I was late to arrive they had arranged for another patient to go before me. (funny thing is for some reason I wanted to be 2nd in and by default I was)

Below is a video of the procedure I went through. I also had a horn tear to my Meniscus.

 

I went down for Surgery at 11:00am and the procedure was finished around 3:30pm. I was placed in Recovery and was transfered back to my side room shortly after. I had an Adverse Reaction to the Anaesthetic which let to further complications later on, which I will explain later.

 

It took me some time to wake up and come out of the Anaesthetic I was in a bit of a bad way as the below picture shows.

 

After the Anaesthetic it took me a long time to come around, I was attached to IV Morphine and an Antibiotic drip, an Oxygen mask and a blood pressure monitor.

Once I managed to come to my senses I could not stop vomiting, this lasted for 4 days, I was distracted mostly by the nausea and vomiting to even think about my leg. For some reason the IV Morphine was removed early hours that evening and replaced with Paracetamol IV, I just couldn't stop vomiting for the life of me. I spent Thursday and Friday night in hospital and was discharged 1pm Saturday 6th October 2012 (almost exactly to the hour 6 months since injury)

 

 



When I woke I had these straps on my legs which were attached to an air compressor at the end of my bed to prevent DVT

The next morning I was visited by 2 Physiotherapists as I was not up to it after Surgery on the Thursday, I was shown a technique to get in and out of bed by using my left leg (good leg) as an anchor underneath to help take the weight and to prevent the graft from being under strain.

 

They had me walking up and down on crutches and showed me a technique of how to go up and down a staircase correctly. I went up and down a flight of stairs with the support of the rail and a single elbow crutch. I managed this quite well and with only some pain. My biggest fear was of losing my balance or fainting as I still wasn't feeling my usual self.



 

 On the day of discharge Saturday 6th October 2012 my bandage was removed and I had my wound site  assessed and re-dressed whilst still in hospital, the Staff Nurse told me that I had metal staples in my knee and that I had a 2 inch incision down the front of my knee also a single staple and 2 other small incisions before she revealed the below

 



With bandage removed



Once the protective dressings were removed this revealed the full extent of the size of the stapled incision down the front of my knee where the Patella Tendon Graft was taken from

 



This is with the protective dressing removed 06/10/12



I was discharged with the following medications and directed to take them as follows 2x 500g Paracetamol, 2x 30mg Codeine Phosphate and 15ml Liquid Morphine to take together every 4 hrs.

 

One serious cocktail of drugs :S





 

 

 

 

 

 

 

ACL Injury & Lateral Meniscus Tear to Right Knee

ACL Rupture & Meniscus Tear to Right Knee

29 Year Old Female

Combination League Football player

Hi everyone and welcome to my 1st ever blog of my ACL Injury Diary. I am due to get my operation in less than a week now and have decided to create this information blog for anyone else who is awaiting their surgery date. I am so nervous going into this not only the procedure and the rehab but the fact I have never been under Anaesthetic for anything in my life. I have managed to channel my anxiety into going for it now and getting it done.

I have given a brief outline below of the story so far and my injury leading up to surgery, as I will have more time on my hands post op I will be able to give a day by day information guide on my thoughts, symptoms and more importantly how I manage to cope with the pain of it all.

Everyone is different but from a women's point of view there are fewer information blogs about a women's experience of this and a tendency for more men to post about their experiences. (Which is surprising as a study has proven that more women than men sustain this type of injury)

I hope you enjoy reading my blog and can relate to it, I am not a trained doctor but if I can help with any questions in anyway I can, I am more than happy to help, and share my experiences with you.



Why I'm doing this?

The idea of this Blog is to give you an idea of what the surgery is like from a women's perspective as in dong some research online there doesn't appear to be much in the lines of real life experiences from a woman's side of things.

Whilst doing research it has only been brought to my attention now after playing for 20 years that women/girls are more prone to this sort of injury due to the structure of out anatomy.

 

 

Why women more than men?

Women have a wider pelvis which leads to a greater Q angle of the femur. This means the femur angles inward from hip to knee, which leads to greater internal rotation forces of the knee joint and an internally facing patella (knee-cap). Women have less muscular development, especially in the vastus medialis oblique, which plays a crucial role in patella alignment. Women have greater knee flexibility, which may decrease joint stability. They also have a smaller intercondylar notch which impinges the ACL, thus placing it under greater tensile stress. Finally, women have increased foot pronation, which also places internal rotation forces on the knee.

 

 In summary

Women suffer more non-contact ACL tears than men. This is because of anatomical and physiological differences that predispose women to having internal rotation forces at the knee which makes them more vulnerable to ACL tears during landing and cutting movements. In addition, women are not as strong as men, which potentially leads to less control of the knee and more internal rotation.

Sunday 6th May 2012 - Charnock Richard FC, Charter Lane, Chorley

Another normal bright, Sunny Sunday Morning, woke up early in my friend Ruth's house, jumped in my car and went the farm shop to buy a dozen eggs thinking to myself ' this will be the last time I do this in a while' but didn't think it would be this long....

Yes this was the last game of the 2011/2012 season and we had the North West Women's Regional Football League Division 1 title at our feet. This was my 1st year at Chorley Ladies FC out of 20 years of playing football.

I have been playing football (soccer) since I was 8 years old I'm now 29. Aswell as football I have always been a all round athlete competing in many different sports other than football from a young age including Ju-Jitsu, Kickboxing, Athletics,(Long Jump, High Jump, 100 meter sprint) Rounders, Hockey, Tennis, just a general all rounder.

There was a day when something had to give, and after avoiding surgery on my MCL with a grade 3 tear whilst playing for Everton St Domingo's LFC in 2007 my luck was about to run out.

It was a double header match against Burnley Ladies which consisted of 2 60 minutes games one after the other ( cut short from our usual 90 minute matches) we only needed to win 1 game to clench the title and did do easily with a 6-0 win. It was about 10 minutes left of the first game when my injury struck.

The actual Injury

It wasnt really a high impact challenge I have been in worse and come out better the other side but this time I just didn't get back up. I blocked a player from crossing the ball side on with my right foot planted into the ground wearing moulded studs as I turned outwards to run with the ball I felt the other players knee strike the inside of mine then a loud 'pop'. That was it game over :(

I was struck down with pain immediately, when I tried to get up I just couldn't no matter how hard I tried my knee almost went into lock mode and the pain was excruciating. I had no swelling to begin with just a large blue bruise on the bottom part of my fibula bone, a severe shooting pain from the back of my knee right up my hamstring to my lower back and a pain to the outer (lateral) side of my knee.

I put ice on my knee straight away and elevated it aswell as applying as much pressure I could to my knee front and back. After 45 minutes or so we were League Champions and the pain appeared to have somewhat subsided at this point.

 This is where I made a big mistake....

As mentioned the pain had started to subside and with the use of a crutch I was able to join in with the League celebrations and Presentation of  the cup. (It was finally ours) As the evening went on it progressed into an evening of celebration. I'm thinking the amount of alcohol I consumed that evening acted as a painkiller only to be woken around 4:15am by an extremely horrific pain in my leg I had fallen asleep on Nat Parry's couch. :(

I managed to clamber off the sofa and make my way across the living room floor to the house telephone and call a cab, ambulance anything all I knew was that I had to get to a Hospital. I managed to somehow make my way to the taxi cab (the pain was at its peak at this point) I explained to the driver and he took me to my destination which was my car parked up at the clubhouse, I made my own way back to Horwich, fighting through the pain.

Upon my arrival my friend Ruth was stood waiting to drive my car after calling ahead and waking her, she didn't believe how much pain I was in until she saw the extensive swelling and the shorts I had on cutting into my leg.

We then made our way to Royal Bolton Hospital A&E Department where I was seen promptly and escorted to the X-Ray room, I was given painkillers at this point which didn't relieve anything.

X-Ray which told us nothing due to the swelling in my knee which didn't go down for 6-8 weeks even when following the R.I.C.E Procedure (Rest Ice Compression Elevation)

 

 

Approx 5:45am Monday 7th May 2012 (In agony feeling sick)

 

 

 

Initial Treatment

 

I was given a follow up appointment to go back in a couple of days to see the A&E Consultant on Thursday 10th May, a pair of crutches and some 8/30mg Co-Codamol tablets. With only a crape bandage for support and advised to not remove the dressing and not to soak it in the bath.

 

 

As you can see I am not very happy and believe me the pain was not something I would wish on anybody. I then returned back home to take some painkillers I was given and get some sleep. Upon Taking x2 8/30 Co-Codomol I had an adverse reaction and felt a vertigo type symptom and nausea accompanied by physical sweating and shaking to the point where I had to get under a cool shower to cool down. This was proven to be the start of a difficult time starting with trying to get up the stairs.

 

 

I didn't manage to sleep one bit all that day or night it was just constant pain and then dizziness and nausea when I took the painkillers, I just felt in a no win situation.

 

Thursday 10th May 2012 - Outpatients A&E Appointment (1st visit)

 

The image below shows the extent of the swelling in my knee no matter how much ice I applied it wouldn't go down, was thinking to myself I shouldn't have spent that night celebrating after all.

 

Upon visiting the Hospital I was told that it would be difficult to assess as I was still experiencing pain and lack of movement in my joint at this point. A minor assessment was carried out to test the resistance, and to ensure there was nothing more serious suck as a fracture, but again I was told my knee was still too swollen to examine. I was given another Outpatients appointment for the following week Thursday 17th May 2012.

Thursday 17th May 2012 - Outpatients A&E Appointment (2nd visit)

I attended my Hospital A&E Outpatients appointment hoping to get some sort of diagnosis this time the swelling at this point was starting to go down and bruising was becoming more visible now. I was able to bare weight on it with more of a ache rather than a pain but it was at this time I was starting to notice the crunching sensation in the outer (lateral) side of my knee. I explained this and this time it was becoming more apparent as to what I had done.  The Consultant carried out the Lachman Test, Posterior Stress Test, Varus & Valgous Stress Test and also the McMurray Test to assess my Meniscus.

As you can see the swelling is starting to reduce but still having a negative impact on my ROM (Range of Movement)

The A&E Consultant suspected that I had torn my Lateral Meniscus and because I couldnt fully extend my leg it was said that there was some bits of cartilage or Meniscus debris within my knee joint which was preventing me from straightening my leg along with the crunching sensation.

Thursday 7th June 2012 - A&E Outpatients Appointment (3rd visit)

As I was yet to be diagnosed a further follow up appointment was arranged with the A&E Consultant in order for a full assessment to be carried out on my knee. After this assessment I was referred for a MRI Scan to be done to determine the extent of my injury and also what was going on inside my knee as things didn't appear to be settling down.  I was told that I would receive an appointment through the post.

 

 

The above photo was taken on 7th June 2012 as you can see the swelling/effusion has started to reduce now and the pain was still severe to bare weight without the aid of a crutch but was starting to push myself through the pain barrier in order to get the ROM back into my joint.

The bruising was where I was experiencing most of the pain it was on the outer side and inside/under my kneecap that was causing me more of a problem but only when trying to straighten my leg

 

 



12th June 2012 - Holiday to Tenerife

I asked if it was ok to fly and was given the all clear to do so. I spent a week in the sun, swimming as much as I could everyday in the hotel pool and in the ocean. I also walked unaided and at some distance. Anyone who has been to this country will know it can be hilly in parts. But after a few days in the sun and a bit of R&R I was able to participate in a Water Polo activity aswell as a game of 5 a side. This holiday is what I needed as not only was I feeling down from my injury I feel as though it was a good source of rehab and enhanced my well being as not only does this injury effect you physically it also has a detrimental effect on your mental well being. Try and take yourself away or stay occupied with some good friends or family members around you as a comfort.

 

 

19th June 2012 - Return from Holiday

 

Received my letter with my MRI Appointment for 9th July 2012.

 

9th July 2012 - MRI Scan

 

Attended Royal Bolton Hospital Radiology Department and had an assessment which involved some questions to ensure I was eligible for the MRI Scan to take place. They were straight forward questions such as did I have any metal in my body or a pacemaker fitted etc or had I been exposed to any metal fragments.

 

In the meantime I was trying to keep using my knee as normally as possible and went back to pre season training on Sunday 27th June 2012 to try and maintain the strength in my quads and also maintain my fitness levels as I was already starting to feel unfit after no vigorous training or activity for 2 months since the injury occurred.

 

 

 2nd or 9th August 2012 - MRI Scan Results - Meet Consultant Dr Gordon Shepherd

 

Dr Gordon Shepherd is a Consultant Orthopaedic and Trauma Surgeon specialising in surgery of the lower limb. His particular fields of interest are sports injuries and knee surgery. He regularly performs arthroscopic (keyhole) surgery of the knee, knee ligament reconstruction, meniscal and articular cartilage regeneration procedures and joint replacement surgery, both total and partial.

 

During his training Mr Shepard undertook several travelling fellowships to Boston, Denver and Adelaide to work with acknowledged world experts in aspects of knee surgery.

Mr Shepard was appointed as one of the sports orthopaedics consultants to the Commonwealth Games in Manchester in 2002. He provides orthopaedic surgical services to professional football clubs in the northwest of England.

 

After meeting Mr Shepherd in person and reading up on his experience and qualifications I feel as though I am in safe hands. The latter line which features above "He provides orthopaedic surgical services to professional football clubs in the northwest of England" is reassuring given the status of the standards of football in the Northwest of the UK such as Liverpool FC, Manchester United, Manchester City, Everton, Bolton Wanderers to name the most successful.

 

The key question Mr Shepherd asked me out of the whole process was "Do you want to play football again Kerry?" I replied "Yes" he said "Lets get it done then". And that was pretty much that the decision was made.

 

He discussed the 2 options to me  (a) A graft from my hamstring (b) A Patellar Tendon graft. He explained that due to me playing football at a high level (Women's Northern Combination League - tier 3 of the www.thepyramid.info/women/structure.htm) the best graft for me would be the Patella Tendon graft as there would be further complications if my hamstrings were to be used and that I would suffer with shortening of the hamstring and be longer in recovery.

 

I have also been advised that I may have a slight Meniscus tear which he can sort out whilst carrying out the Arthroscope Procedure.

 

I have done some research myself and weighed up the pros and cons of both options and I am no Surgeon so I have decided to trust Mr Shepherd and go with his recommendations.

 

After a short chat I was given a date there and then Thursday 4th October 2012. Mr Shepherd briefly explained what the procedure would be and what he had to do, it sounded far too graphic for me and the thought of having a hole drilled through my Femur and Shin bone made me wince.

 

I was advised I would be sent a letter to confirm this and also a letter with a Pre-Operation Appointment in which I am to attend to ensure I am physically fit enough to endure the Operation.

 

I'm not denying I have mixed emotions right now and all I can do is wait and concentrate on physically and mentally preparing for the operation date and receiving my letter to attend the Pre-Operation Appointment.

 

 

20th August 2012 - Received my confirmation letter and Pre-Op Appointment

 

Pre-Operation Assessment confirmed for 19th September 2012

 

 

 

12th September 2012 - Physiotherapy

 

Attended Physio today went over the Rehabilitation Programme and was given some handouts as to what is expected week by week and also what I can do in the meantime to help strengthen and maintain the quality of my quadriceps. It is very very important that you do your exercises given to you by the Physiotherapist and its also important that you do not push yourself too much.

 

I was advised by the Physiotherapist that at 6 weeks the graft becomes weak again and it is important not to strain it or damage the graft at this time. This is an added complication that I was not aware of until this time.



 

 

 

19th September 2012 - Pre-Op Assessment

 

Attended my Pre-Op Appointment at BoltonOne Health Centre I was asked a series of questions around my medical history and also immediate family history in regards to being under Anaesthetic or sedation. I advised the Nurse at this point I have never been under any form of Anaesthetic and I have never had a surgical procedure until now and that was something that is worrying me.

 

I had the procedure leading up to surgery explained to me and given some information on preparation the night before and what I will need to bring and what to expect. I was told that I must not eat solid food or drink anything that contains milk after 1am the night before and not to drink any fluids after 2am. I have to attend the Hospital at 9am on 4th October 2012 and will be in for 1 or 2 days.

 

 

25th September 2012 - Last Training Session with the team

 

Had my last training session before surgery tonight. Strangely enough my knee felt really good tonight and I participated in full training which included various tactical drills, shuttle sprints and a competitive match with various conditions included.

 

I will really miss the girls and having a laugh, I am also so happy to see them doing well sitting 2nd in the league right now http://full-time.thefa.com/Index.do?league=6883466 

 

 

KEEP THE FAITH

YELLOW & BLACK ARMY

 

 

 

27th September 2012 -  1 Week before ACL Reconstruction

 

Sorting out my handover for work now and its starting to sink in that I will be under the knife so to speak this time next week. I am anxious but just want to get in there and get it done now, I have a new job to start also at the end of November so I have that in my mind as an incentive to work hard at my rehab and get back to fighting fit

 

Sunday 30th September 2012 - Watched my last game for a while

Went to watch my team play for the last time until I'm back on my feet, away against Stockport County Ladies FC. It was a brilliant game to watch despite the rain pouring down. A brilliant all round team performance and well fought back to the end coming from 2-1 down with only 10 players to finish 4-2 match winners. Not only winning 7 in 7 games we are now top of the league!!!

 

This has hightened my spirits and given me a positive boost going into my surgery as I am only 4 sleeps away now. It has spurred me on and gave me inspiration to get back fighting fit and be fitter

and stronger for the summer tournaments. CLFC <3

 

 

 

 

 



Monday 1st October 2012 - 3 days Pre-Operation

Its monday night and I'm feeling anxious now as it's getting closer. For some reason tonight my leg has been aching all evening, not sure why, but I havent done any training or swimming like I have been as I thought it's best I rest it in prep. Going to try and get some sleep.

Tuesday 2nd October - 2 days before Surgery

I went to watch my team train for the last time tonight and also seeking some last minute reassurance from my team-mates and friends. I felt quite emotional this evening but watching the team train from the sidelines just made me more determined to get back fitter and stronger than ever and get involved in the near future.

Wednesday 3rd October - Night before surgery

Finished work this evening.... I'm finding it hard to relax now, just off out for a meal with my mum and dad feeling a bit anxious and feel like I can't eat anything.

21:00
Back, managed to eat a bit and I have now had a bath to help me relax I have taken some last minute photo's as a before surgery memory before my leg gets messed up I suppose



You can see the definition of my Patella Tendon in which they are going to use for the graft in this pic

Night before pre suregery, nice and clean

Nice shape and full range of movement 6 months after injury, day before surgery


Its now 1am and I can't sleep. I have to be at the hospital at 7:30am on Ward G5 in Royal Bolton General Hospital in prep for my surgery to start approx 9am Thursday 4th October 2012.

All kinds of thoughts are racing through my head, but I have weighed up there is more advantages of getting this done and if I want to return back to a high level of competitive football, which I do, it's for the best, best get some sleep I'm up at 6:00am.

WISH ME LUCK!!