Injury and Diagnosis

I decided to start a blog on the advice of a soccer dad whose daughter has been through this twice in 12 months. It seems like a good way for family and good friends to keep up with Caroline's progress. (I am mother's daughter, I love details. I like to tell them, I like to hear them. So a lot of these are for me, and my mom. And Katy. And for Caroline when she's older.)


Timeline of events: 


March 8th-Caroline was at soccer practice. In her words, she was running, stopped, her leg straightened, she felt two pops, she took another step, lots of pain, and she went down. She told me later in the car that she thinks she cried out and cried, which she was embarrassed and a little shocked about. The asst. coach from her team saw it happen and called me later that evening to check on her and tell me what happened, I was across the street with Emily at practice. Coach Brett said it looked like she hyper-extended her knee. There was no other player involved, no contact. When we got home, she could bear some weight with pain, and we iced her knee until she went to sleep.


March 9th-When Caroline woke up, she had a lot more difficulty walking and a lot more pain. We were able to get her in to an Orthopedic in Newnan that we have been to several times, most recently in Feb. when Emily had a high ankle sprain. She didn't go to school (you know she hates that, NOT). The x-rays were normal and the Dr. said her symptoms were consistent with hyper-extension. He thought her ACL seemed stable and said she most likely had a deep bone bruise, which could take two weeks to four months to heal. He told us to get a knee brace, take Alleve, and use crutches for a few days. (We have had crutches in the closet for years, and the girls always used to love to play with them. It's not so fun when you have to use them, apparently.)
We made a follow-up appointment for the 19th. 


March 10-14 Caroline used crutches and iced her knee. Started to feel a lot better. Swelling went down somewhat, and she could bear more weight on it. Straightening all the way was the most pain. No crutches past the 12th. She missed the first regular season soccer game. First game she hasn't started since she was about, oh, EVER. It was a hard day.


March 15- Caroline told me she thought she was going to be fine and probably didn't even need to go to the Dr. on the 19th. (In case you are a non-club soccer reader, you go to practice and games, even if you are injured. You sit on the sidelines, observe, and cheer on your team..) So on this day, I took Caroline to practice with her begging to play a little. (Okay, hindsight, I should have said no way. But, it could have happened at school or home too) I called her coach and we agreed to let her move around a teeny, tiny bit at practice. Which she did. I saw her go down this time. She was literally walking, and her legs buckled underneath her. It was kind of slow motion. She said she felt a pop. Her coach helped her up and off the field. He later told me that's when he got worried it was ACL. 


March 16-18 Back to crutches and more frequent ice and Alleve.


March 19- Back to the Newnan Ortho- He did more stability tests and said her knee still felt pretty stable, but with her pain and knee giving out, ordered an MRI, which they did that afternoon.


March 20-22 NO crutches, feeling a little better. Still can't straighten.


March 22- Newnan Dr. said MRI results show partially torn ACL. He recommended four weeks of twice per week physical therapy, have a custom ACL brace made that she will wear from now on, forever at soccer, then another follow-up exam. He was hoping that if her ACL was partially torn, there would be enough fibers still receiving blood flow, that it would heal on its own. BUT, there was a 50% chance that it wouldn't be stable enough for soccer and she could go down again. He said she might be good to play in 1-4 months.  WHAT??!! He obviously doesn't know this kid, she plays soccer about 5-7 days per week. That is not going to work!! 


Timeout on the timeline. We know a lot of soccer kids that have torn their ACL. It is happening more and more. Emily has two girls on her club team that just came back in August from ACL tears the year before. One of those girls just tore the other one last week in a high school game. So when Caroline got hurt, we  said we know its not going to be ACL, but if it was, we would call Dr. X.


Back to March 22- Leave Newnan Dr's office with a prescription for  PT and a custom ACL brace, send about 100 texts, frantically find out Dr X's real name so I can get through before 5:00. It's 4:30. In the parking lot. Trying not to cry. Can't make an appt without a referral, our pediatrician is closed. CRAP!!! Caroline is pretty quiet. 


March 23- Because Caroline is 12, I get to talk to Dr. X's assistant. Apparently being 12 and tearing your ACL is special. She tells me fax to her MRI, he will look them over and decide if she needs to be seen. AKA, needs surgery. I know this because when I called Thursday to try to get an appt and couldn't without a referral, the front desk said he sees only surgical patients. I can't get it faxed from the Newnan office, so I go pick up a copy and I drive it up there so he will have it Monday morning. Pat, the assistant promises to call me before lunch on Monday. It's a long weekend for all of us.


Dr X's resume 
http://www.emoryhealthcare.org/sports-medicine/sports-medicine-physicians/john-xerogeanes.html


March 26-Pat calls me before 10:30, she is awesome. Dr. X thinks Caro's ACL is torn, he wants to see her Weds.  DOUBLE CRAP!!! I did a ton of research over the weekend and talked to four sets of parents of players from our team/club who tore their ACL and three had Dr. X do the surgery. I knew pretty much what the choices were and what the surgery and recovery were, from talking to these soccer friends. 


March 28- Met Dr. X. I feel really weird referring to him like this, but I really have no idea how to pronounce his last name. He is super nice, was great with Caroline, made us feel very comfortable. He did all kinds of stability tests that they didn't do in Newnan. (Let me clarify that I have nothing against the Dr. in Newnan. We just wanted a specialist. Someone that did ACLs all the time.) He showed us her MRI and said that while it was poor quality, it showed that her ACL was completely torn. He said it would not grow back. And that we could choose not to do surgery, but her knee would never be stable enough to play sports.Obviously, that's not gonna work! 


So here's where we stand today.


Caroline is having ACL reconstruction surgery to replace her torn ACL on Thursday, April 5th. We should receive a call Tuesday letting us know what time. It's outpatient, she will be home by late afternoon. Dr. X plans to get her new ACL from her quad, which he said are beautiful. There will be about a one inch incision on the bottom of her quad, right above her knee. Her surgery is a tiny bit more tricky because she is still growing, but he will not go through her growth plates, and she will be fine. The rest of the surgery will be through three small holes around her knee. I will copy some links for anyone that wants to know that details, but they essentially take out the torn ACL, drill holes in her femur and tibia, and thread the new ACL through like a needle and thread. I can't really think about all that without tearing up. The recovery period is long for contact sports that require a  lot of cutting and turning. It will be 8-10 months before she is able to play soccer again. 


Please keep Caroline in your thoughts and prayers. She has received tons of support from her family, her coaches, her friends, and her teammates. She will continue to need it. Tonight she is anxious and restless, wishing it was behind her. She went to PT on Friday, just to get established with her therapist. He gave her some pre-surgery exercises to do, which bothered her knee quite a bit. 


(While you're at it, please send some prayers and wishes to Sydney, Emily's friend and teammate who tore her second ACL two weeks ago at a game, surgery is the 17th. And to Kylie, another friend and former teammate who is having ACL surgery the same day as Caro, another Dr. X patient.)


A few interesting facts I have learned this week:


This is a really simple, yet complete explanation of the knee and ACL.
http://ehealthmd.com/content/what-anterior-cruciate-ligament


7 of the 21 players on the USWNT have torn their ACL. Rapinoe tore one ACL twice, Rampone has torn both. (Caroline's goal is to play center back for the USWNT.)


According to Dr. X,  if Caroline had a twin brother, she would be 4.5 times more likely to tear her ACL than her twin brother.