If your want the quick links, here’s the full series:
I recently had ACL surgery. Like most people about to go under the knife, I did a bit of research before my operation and I found all the usual stuff – anatomical diagrams of the inside of a knee, a description of what the actual surgery involves (lights, camera, scalpel).
It was a bit of a learning curve since I hadn’t even heard of an anterior cruciate ligament until mine went pop. And I found lots of medical stuff. Great.
What I didn’t find was a description of what it’s really like to have ACL repair surgery – and it turns out there were more than a few things that I didn’t know about the operation. So, in this article I’m going to share with you what the surgery was like for me together with how I’ve been recovering in the days, weeks and month post-op.
A couple of notes:
- I had my surgery in the UK on the (public, not private) National Health System. I can’t imagine that the experience would differ that widely around the world but who knows…
- As well as rupturing my ACL, I had a grade II tear to my MCL (not repaired) and a tear in my meniscus (repaired at the same time as my ACL).
- Advance apologies if you’re squeamish – I’ve included a couple of pictures of my incision so you can see what it looks like. I’ll give you another warning just before you reach them!
- When I say I recently had ACL surgery, I had it in 2016. What started out as once blog post about my experience has grown into a series of blog posts (see above for links).
ACL Surgery – 15 Things They Don’t Tell You
1. They shove a tube down your throat while you’re unconscious
I’m a grown up. I understand that there are things that need to happen while you’re being operated on. I just wish I’d been told in person (rather than finding out from Google) that they shoved a tube down my throat while I was out for the count. That way, I wouldn’t have been worried about why my throat was so damn dry and sore when I woke up. I also could have pre-planned and got some honey and lemon and throat sweets in for my post-op recovery.
2. They also insert a catheter and suppository
In fairness, they asked me if I wanted a suppository and my initial reaction was ‘urggghhhh. NO!’ until they told me it delivered 16 hours of pain relief. The idea of them inserting it while I was unconscious made me feel a little bit violated but I opted for that over having it inserted while I was awake, which would make me feel violated but with the added ‘bonus’ of a visceral memory of the event.
What they didn’t tell me (and I once again learned from Google) was that they also catheterised me. How did I surmise this? Well, I felt somewhat irritated in that area – something that lasted for around a week and made me wonder what they hell they’d done to me. Seriously, if you’re going to mess around in my ‘downstairs closet’ while I’m asleep, i) tell me about it; and ii) be gentle!
3. You’ll be weak…from hunger
I’m that person who needs to eat 10 small meals a day. Ok, that’s an exaggeration, but being nil by mouth from 8pm the night before until 3pm the following day can make you weak. Sure, I was fed tea and toast (which was a struggle to get down because of my dry mouth and throat), it’s simply not enough to sustain me.
The result – I felt very weak and sick when I tried to move from horizontal to upright on my crutches. The nurses were convinced I was having a reaction to the surgery. I was convinced it was something more simple – I was weak from hunger. A sandwich later and I was up no problem.
4. The end to end admission may take longer than you think
I was first to surgery (around 10 a.m.) and with an op time of about 1.5 to 2 hours, I had ideas that I’d be home by mid-day. As it turns out, I got home around 8pm. That was partly because I had to sit with my leg in a knee bending machine for a few hours post-op but also because I was too weak to walk (see above).
5. The pain medication will probably make you feel sick
I was given co-codamol (codeine and paracetemol) as my main pain relief medication and boy did it make me feel sick. Ever drank too much coffee and felt jittery/like you want to vomit? That’s what the codeine did to me. It also made me want to nap within 15 minutes of taking it. As a consequence, by day two, I was already phasing it out and replacing it with just paracetemol and ibuprofen instead. The downside – I was in more pain that I probably needed to be in those first few days but at least I was alert and not feeling sick.
6. It hurts (more than you think)
Of course I knew the operation wasn’t going to be a walk in the park (nor afterwards!) but the intensity of the pain in those first 3-4 days surprised me. Not feeling able to take the co-codamol didn’t help. The good news is that although the pain is bad those first few days, it does ease and I was on off-the shelf painkillers within a few days.
7. The pain medication will probably give you constipation
Another TMI warning
We all know what constipation is. Fortunately, my physio had pre-warned me and I just chilled out about it, waiting for my body to right itself. Which it did and within the week things were back to normal.
8. The surgical dressings will hurt as much as the incision
It didn’t occur to me that this would happen. I possibly didn’t help myself – I’m the kind of person who needs some sort of shower every day to feel like I’m not a slob. This meant I was changing my dressing daily – I had staples rather than stitches and was told not to get them wet (nurse: ‘you don’t want sticky staples’). I also kept my dressing on as long as the staples were in because my body magically started to push the staples out around week one and I didn’t want to snag anything.
Upshot: this constant pulling off and putting on of adhesive dressing took its toll. In fact, I’ve had the dressing off for nearly a week and the skin where the dressing stuck is still tender. I have been using Elizabeth Arden’s 8-hour cream. It’s not your average moisturiser – it has a bit of a medical scent to it and it has amazing repairing properties which have really soothed my skin.
9. The small incision – not as small as they say
Just a couple of camera holes and a small incision. Yeah right. My incision is a couple of inches long – which looks a lot on a 5ft tall person. Pre-surgery, I’d just seen the scars from other people, which were a lot smaller because, well, healing and all that. I know my incision scar will shrink too but that first time I saw the cut, I was a bit shocked. Photos of the incision further below.
10. Bathing is an epic challenge
At the time when you need stability in the shower the most, ACL repair surgery takes one leg out of action. Had it been decent, I’d have videoed the various poses I found myself in while I simultaneously tried to wash my body and hair while keeping my dressing dry. I have to say, my yoga came in very helpful.
By about day 10 I simply gave up and just showered faster.
After three and a bit weeks, I’ve finally had a soak in a bubble bath – I was advised to wait a little in case the fragranced products irritated my skin after having the staples out. To be on the safe side, I went with a baby bath foam which I knew was going to be gentle on my incision.
The rest of the time, I’ve just been using my L’Occitaine Lemon Verbena shower gel as usual and this week I’m going to buy some Bio-Oil to help reduce scarring. Some articles say don’t bother but I say nothing ventured, nothing gained.
11. Having your staples out is brutal
I’ve had stitches removed before and apart from feeling a bit queasy (I was 10 years old – I was allowed to feel queasy), it didn’t hurt. For some reason, I thought having my staples removed would be the same. Not so.
It hurt like hell!
First of all, they use a sharp, metal staple extractor – in fact, I was supplied this in the hospital and for a good few seconds I thought I was looking at a DIY jobbie until the nurse read the horror on my face and reassured me it was just to take to the clinic; I didn’t have to pull them out myself at home.
The problem with this tool is that to get the staples out, it needs to fit under the staples – which is right where your skin is most tender at the point of incision. Some of my staples had lifted themselves up a good few millimetres by the time of removal which I was so grateful for. I can’t imagine the pain if they were still flush with my incision. Take pain pills before you go and take comfort in the fact that there are people who have more staples inserted that you would after ACL repair surgery. Plus, the relief of having them out is worth the pain.
12. Initial progress will be quicker than you think
I couldn’t believe the hospital had my leg bending back to 45 degrees within just a few hours of surgery. Sure, the contraption was fresh out of a horror movie, but it did an excellent job. I was also given stair and crutch training, which gave me the confidence to go home that day. I was told I could weight bear and within a few days I was taking steps without crutches – I’d expected a much slower start to my recovery and I was frankly delighted with myself.
And here’s the contraption in action just a few hours post-surgery…
13. ‘Back to normal’ progress will be slower
(On the plus side, all this feet-up, stay indoors business means I’m finally catching up on some of the books on my reading list).
I should say that I also had a medial meniscus repair at the same time as my ACL surgery. However, as I had a horizontal tear in the cartilage in the ‘red’ blood vessel zone, it just required a stitch, so I’m not sure it’s added that much more to my recovery time (that’s based on zero expert opinions, btw).
14. The physio protocol is impressive
I knew that ACL repair was common but it hadn’t occurred to me how well-established the ACL recovery protocol would be. With goals and exercises for each phase, if you’re a person who likes to have something to aim for and a bit of a tick-list to get through, you’ll like the structured approach to the physio.
15. Having ACL repair surgery is totally worth it
I was told that I could live without having surgery and many people function happily without having their ACL in place. However, as my physio said, that’s fine for people with a desk job who maybe go to the gym a couple of times a week. That’s certainly not me.
At only 40 years old, and with one eye always on the next adventure, I wasn’t prepared to live a life limited by forward-facing, even-surface activities. I want to climb more volcanoes. I want to swim with whale sharks again. And if I ever find myself having to outrun an ostritch in the dessert (look, strange experiences tend to find me), I’d like to know my knee has my back.
Mentally, I already feel better knowing that my knee bone’s connected to my thigh bone (ok, not necessarily anatomically correct, but there’s a song in there). Knowing that in time I’ll be able to get back to all the adventures I’m used to, I’m 200% happy I went ahead with the surgery.
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