Post-op/PT

First post-op visit this morning. Dr. X said everything looked great. He bent her leg until she said it was uncomfortable, about 30 degrees. This was normal he said. Cleared her to shower, but she chose not to navigate the 16 stairs to the bathroom upstairs when we got home. Tomorrow.


Started PT this afternoon. The physical therapist had her try some leg lifts while she was lying down. She couldn't raise her leg at all. He said this is normal and there is sometimes a disconnect between the brain and the muscles after surgery. They can usually correct it, but sometimes have to do something called e-stim.Once he helped her get her leg up, she could keep it up for a bit and then he had her do some leg raises. Once she got it up and going, she could  lower it all the way back down and immediately back up, unassisted. It's the getting going she needed help with. As long as she kept it going, she was good. Not that it didn't hurt, she was fighting tears. These will usually be with her leg locked and straight, but there is a lot of swelling and her leg won't really go completely straight. This is the main thing she will work on for the next few weeks. The PT said the swelling should go down in about a week. He is a really nice guy. Gave her a couple minutes to gather herself and brought another patient over to meet her. It was a really old guy, at least 45...haha. He had ACL surgery two months ago. He told Caroline he came into PT in a wheelchair and that she would get through, he knew it didn't seem like it, but she would. 
The PT then showed her how he wanted her to walk with the crutches. She came in using them like her leg was broken, swinging the leg as if it couldn't touch the ground. She now has to walk, very lightly putting her right toes down, supporting herself with the crutches, and then walking on the left. It is much slower and she is convinced she will look "like an idiot at school like this", but its how she will straighten her knee, getting more extension. They absolutely do not want her knee to get used to not being all the way extended. 
She also sat on the edge of the table and let her knee just bend naturally, not forcing it. She has to work on this 3x-6x times per day, working up to 10 minutes. This was the only thing he did with bending her knee. 
We also were given instructions to have her  lie on the couch or bed several times per day with her ankle on about 4-6 pillows, getting a super high leg raise and then she can do her ankle pumps while in that position. 


When she was walking out, the new way, the "old guy" told her how great she was doing and that he didn't walk out like that for three sessions. We know, she's a beast.


Needless to say, she was exhausted when we got home. In addition, we are almost out of the Percocet and are weaning her off and onto Tylenol and Alleve. She was a little panicked wanted to know how she was going to sleep. Really?? She's hardly slept in four days. I'm happy to report she went 7 1/2 hours between pills, went down to one, and still took a three hour nap. Then woke up and did her first PT at home. 

I read over the surgery report that Dr. X gave us a copy of. 
1. Grade two Lachman
2. Grade two pivot shift.
"The patient had a fully torn proximal anterior cruciate ligament that was scarred to the PCL and was retained.."
"We did not put in an interference screw because we could still see some tibial physes."

In plain language, he said her ACL had reattached itself to the PCL and bone and so it was better to leave it in. The tissue would bond to the new ACL creating a larger, stronger structure. The screw part was because he couldn't go through her growth plates in her knee because she is still growing.