Reconstructive ACL surgery: Why I’m having it done

Posted on December 7, 2011

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After figuring out the benefits of reconstructive ACL surgery (link), and debating over whether it’s worth it (link), I’m going to talk about my decision to have it done on my own leg.

Firstly though, I tore my ACL over 6 months ago, why the hell am I just now finally getting it done?

1) I didn’t know it was torn

Playing sports for 15 years growing up exposed me to plenty of people who tore their ACLs. One former football teammate of mine described it as, “Like I was stabbed with a knife. By far the worst pain of my life.”

I really didn’t have that much pain when I tore mine. I laid on the ground for a few minutes, primarily because my toes went numb which was interesting, but it wasn’t like I was writhing in pain. I was actually up and walking around within a half hour or so.

I mean, I dislocated my elbow when I was in college and THAT was pain. I felt like my arm blew off. (I mean, half of it was disconnected.) I was on morphine and all kinds of fun for that.

My ACL though, just not that bad. The next day was pretty hard. Enough to go to my second home, the ER. I went primarily to get crutches though. Adding to me not knowing it was torn, the doctor there actually did a couple tests trying to see if the ACL was torn and didn’t notice anything. Of course it wasn’t until a couple of months later I found out he did the test wrong and an orthopedist knew my ACL was torn in about 5 seconds.

Between being told my ACL was ok and not being in much pain, I didn’t put my injury much past a sprain. It wasn’t until a couple of months went by that I knew my leg just wasn’t the same.

To the next issue:

2) I had a lot of trouble getting a definitive diagnosis

Here’s how my first appointment with an orthopedist went:

Ortho “So you tore your ACL, no doubt about it, and you’re going to need surgery. I don’t even need to do an MRI.”

Me “Whoa, whoa. I have very good health insurance. An MRI costs me literally nothing.”

Ortho “Ehh, alright, you can do it if you want.”

Between the brevity of my appointment and this guy not suggesting an MRI (also very odd to me) I’m already very skeptical.

About a week later I get a call with my MRI diagnosis:

Receptionist “Hey Brian, got your MRI results here. Report says you have a large tear in your medial meniscus….”

….

Me “Uhh, is that it?”

Receptionist “Yup, that’s all. Everything else is fine. ACL, PCL, all good.”

Me (Thinking many expletives) “Are you sure? Dr. Jerk-off was adamant I have a torn ACL. Has he seen the MRI?”

Receptionist “Uhh, uhh….I’ll call you back.”

As you can tell, this is REAL assuring.

Two and half hours (!) go by and I still haven’t gotten a call back yet. It’s 4:30 and still no call. Knowing the place closes at 5 I call them back:

Receptionist “Oh yeah, hold on Brian.”

Dr. Jerk-off picks up the phone (This is very unusual. Getting the Dr. on the phone is like an act of god): “So yeah Brian, me and my guy looked at the MRI and you definitely have a torn ACL. No doubt about it. You need surgery. I’ll switch you back to schedule your surgery.”

Receptionist “So when is good for you? I have a week from today.”

Me “Yeah, I think I’ll hold off on that.”

Between this, then getting the MRI report myself, which said “Normal ACL” with an addendum written at 4:15, THE DAY I CALLED THEM BACK, saying “Partial ACL tear” despite the Dr. Jerk-off telling me “complete tear” on the phone, there was no way in hell I was getting that surgery with that doctor. Talk about a world class example of how to not treat your patients.

Needless to say I needed a second opinion. When I went home to New Jersey in October I was able to see an orthopedist of mine who I had known for many years. This gave me a lot of comfort knowing it was somebody I trusted. Also, I knew he had no incentive to tell me I should get surgery because he wouldn’t be the one performing it.

Finally I got the definitive diagnosis (we’re now at 4 months post injury) of a torn ACL and a much better explanation of what the hell was going on with my knee.

3) I have had back experiences with anesthesia

Suffice to say, I wake up when I’m supposed to be knocked out. I wake up a lot. I was supposed to be out for 60-90 minutes when I had my elbow put back in place and woke up after 15! I woke up to the nurse saying, “Oh shit, I think he’s waking up.” Even with a greater dosage I still woke up another 30 minutes later.

I’ve had issues with local anesthetics as well. Not a problem I want to encounter when a power drill is being used on my leg.

4) I have an active job

Pretty simple here. My job entails that I stand around 8 hours a day. I don’t know how well I’m going to be able to do that after this surgery, I don’t get paid if I don’t work, and I plain hate missing work.

5) I have great knee function

I actually have zero pain in my leg currently speaking. I haven’t had pain since the initial injury really.

I just went on a 3 mile hike a few weeks ago and had zero issues. I can lift weights, jog, work for 10 hours on my feet, etc. all without issues.

I had to take a good hard look at how much a surgery like this would benefit me. Somebody who has a level of knee function 95% of people would enjoy.  The first posts in this series are the result of that long, hard look. Finding all those papers, reading them all, analyzing them all, figuring out which ones suck, which ones are good, took quite a while.

After finding out as much as I could about the surgery I still had to decide if the benefits were worth the whole process to me.

 

Bringing us to:

Why I’m having it done

1) My age

As I’ve mentioned, and as the non-delusional know, age does matter.

After playing recreational sports 3 times a week for two years I’ve actually enjoyed the forced break I’ve had the last 6 months. Taking away those rec leagues, I really haven’t had any alterations to my life due to my torn ACL. Nobody even knows I blew my knee out unless I tell them.

However, at 25, I know I’m not going to be content sitting on the sidelines the rest of my life. Two years ago I never thought I’d love playing dodgeball and taking people’s heads off, and two years from now I might want to play some other crazy ass sport. I don’t know.

But I do know if I want to play those sports at a high level, and put my knee in a safe position long-term, I need an ACL.

2) My meniscus

As I’ve discussed ad nauseam not having an ACL and playing high impact sports put you at risk to either 1) Tear your meniscus or 2) Make the mensical tear you already have worse.

I already have a torn meniscus, one that can hopefully be repaired, and I don’t want to make that any worse.

3) It makes sense

The surgery is logical to me. I’m missing a ligament in my body. Logic would tell you it’s advantageous to not be missing that ligament.

4) My knowledge and commitment to the rehab process

I am very aware of what this rehabilitation looks like. One of the perks of knowing this stuff is it puts you in a better position to have a good long-term outcome. I’m able to understand the techniques, I know where to find them, I know how to best implement them, etc.

5) My environment

Also, I work in a gym 6 days a week. My environment is conducive to facilitating a good rehab process. I don’t have the issue of “trying to make it to the gym.” I’m already there. I don’t have any kids. Since I’m not playing sports right now I have a lot more free time than I used to. A lot of things about my lifestyle will benefit me in the post-op phase.

Finally, and most importantly

6) That 10-15% of extra physical ability is worth it to me.

I still have way too many heads to take off on the dodgeball court.

(Fast forward to the 6:10 mark and watch for about 20 seconds)

 

Surgery is December 23rd. I’ll see you fuckers around August.

 

Next up: You’re getting the surgery, what type of graft should you use?

 

 

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