Anterior Cruciate Ligament Surgery Day!

Here’s how my day went on May 2, 2011. I woke up at around 7:30, showered then got dressed. I chose this green dress that’s easy to slip on and off.  I  also put on my basic face, just so I’ll look more presentable. Concealer, foundation,powder, blush, eyeshadow, mascara and lip tint. No eyeliner because it will smudge. ACL tip #1- Wear a dress to surgery. The first time, I wore shorts and it was a hassle dressing up post op. ACL tip #2- Look pretty for surgery. It’ll make you feel a little bit better.

My mom and I pass by Asian Hospital to pick up my MRI scans, that Doc Canlas doesn’t really need.  He just told me to get the MRI so my parents could see I was really injured I guess. Then we get to St. Lukes at around 10:15.  Ate Donna is already there.

We were supposed to go straight to the OR but we  went to Dr. Canlas’ office by mistake.

Mom fills out forms, then the nurse tells me to leave all my valuables and jewelry. My camera can’t come with me so I don’t have pics of the operating room.   I get changed into a gown, booties then walk to the OR at around 11:30 Dr. Lim, the anesthesiologist is there. After  I lay down on the operating table, he hooks me up to an IV, then curl up into a fetal position so that they can inject my spine for the waist down anesthesia. They stick these dots on me for the ECG monitor. I get knocked out after that, I just remember waking up halfway, looking at the monitor showing the inside of my knee.  Dr. Canlas is there with Dr. Gandionco, who is from UP Diliman too. She graduated a year ahead. Nice and perky doctor.

I try to sneak a peek past the sheets they put in front of me, but the nurse makes sure I cant see. I can hear drilling, and feel the table move, but that’s about it.  Music plays in the background, I think I requested it, but I can’t remember what was playing. I can hear the doctors talking, giving directions. I think by 12:30 they’re finishing up. Catheter goes in -ick. Then I get wheeled into the recovery room.

I’m shivering all over despite being under a blanket, I think it’s the anesthesia.  Nurse Ruth gives me a heated air blanket. It was so cool warm, and that got me nice and comfy. Back to sleep. I have to be lying down flat and not lifting my head. Disobeying would mean headaches.  At 1:30 pm I still can’t feel my legs. I ask for nurse Ruth for my phone and snap some photos.

ACL tip #3- Don’t wear nail polish. I had a manicure and pedicure done on Saturday, to make me feel better but it turns out you shouldn’t have any nail polish on when you get surgery.  The nurses had to remove polish off my left thumb for the little monitoring thing. Nurse Ruth said I must have some special pull with the doctors that they didn’t remove all the polish off my toes too, since apparently if anything goes wrong during surgery like if your blood isn’t circulating properly, your toenails will show changes. Or maybe they just forgot.

At around 4:30 I was wheeled out to the waiting area where my mom and dad were hanging out so I could eat something.  My last meal was dinner the night before so I was so hungry.  I inhaled a Junior Whopper with cheese and onion rings from Burger King.  My knee is still not painful.

We wait a bit more, then the nurse administers antibiotics via the IV, then painkillers. She then wheels me back in the recovery room to remove the catheter then I’m done. They take me to the waiting area in a wheelchair, I get dressed out of my hospital gown then I’m off to the car!

FAQ:

1. What surgery did you get?

Arthroschopic ACL reconstruction (hamstring graft) with MCL trephination of the left knee.

Here’s the description on the record of operation. my notes in italics

• Patient placed in supine position under SAB  – I can still remember this
• Pneumatic tourniquet applied on left proximal thigh – I’m knocked out by now
• Asepsis and antisepsis done, sterile drapes placed
• exsanguination done, tourniquet inflated to 350mmHg –EXSANGUINATION??? sounds scary- google it.
• incision made over pes anserinus
• gracilis and semitendinosus identified, isolated and harvested –my hamstring parts?
• graft prepared, 4 strands measuring 7 x 110 mm
• anterolateral and anteromedial portals created – this must be when they were drilling
• arthroscopy done, findings (+) lax medial collateral ligament –
• ACL stump debrided – it means they cleaned out the remaining torn ACL out. 
• Tibial and femoral tunnels created- more drilling?
• graft inserted and secured at femoral end using RCI screw 7×25 mm and secured at tibial end using RCI screw 8x25mm –
• ROM done and noted no impingement- range of motion
• negative for Lachman test and anterior drawer. Tourniquet deflated
• Trephination of medial collateral ligament on the left knee done-
• Copious irrigation done- wow, they irrigated it copiously 
• Wound closed in layers: Vicryl 2-0 for fascia and subcutaneous tissue, Monosyn4-0 for skin -its absorbable!
• sterile dressing applied, knee immobiliser in place
• Patient tolerated the procedure well – yes, I did! 
• Tourniquet time:40 mins.

Phew. Thanks Google for providing clarifications on a lot of those terms.

2. Does it hurt?

During the surgery, no. The first thing that’s painful is the needle for the IV, then the feeling of the liquid going in, but as soon as the anesthesia kicks in, I can’t feel anything from my stomach down. I’m knocked out once the spinal injection is done.

3. Are you asleep during the procedure?

Yes, but you do wake up in the middle of the operation. I could talk, watch the monitor, listen to what was happening, but I would fall back asleep. The doctors ask me things.

4. How long are you in the hospital?

I was there at around 10 am and we got to leave at around 7pm. 9 hours tops.

5. When does the pain start?
A couple of hours after I got discharged. I was able to have dinner out with my folks at Lugang Cafe- post to follow. It was around 10 pm that the pain started getting bad.

6. How painful does it get?

On my pain scale of 1-10 it goes up to a 12.  It’s this constant intense pain that demands for your attention.  At the worst part of the night I just cry and pray to fall asleep.

7. What painkillers do they give?

I’m not sure what they administered via IV before I got sent home, but orally I took 120 mg of Arcoxia the first night, then for the next two days.

8. How much was your hospital bill?

46, 184.00- 7,389.44= 38,794.56 PHP for hospital charges.  Doctors fees and the screws for my knee are to be paid separately.

Thanks Mom for taking care of my hospital bills. This would completely wipe my savings out. Although I did ask her if she wanted me to pay for it, but I don’t have a checking account, soo… Thanks mom. I love you for waiting through not one but two of my ACL surgeries. I love you for never saying that I should stop playing just because I got hurt.

Love,

Bertha