Get Practical

Get Practical

Take control of the first part of the recovery process by watching the video and reading the personal story and recommendations for coping with the challenges that follow ACL surgery.

Tips for Conquering ACL Surgery and Rehabilitation:

What You Can Do After Surgery

• Make sure that you eat when you take your pain medication if instructed to do so. You might not want to, but it’s in your best interest. Otherwise, you might get sick to your stomach. Rice cakes are a good choice. They aren’t filling and don’t spoil easily, so they can be kept by your bed. A few graham crackers and a glass of milk are also good, if you feel like venturing out to the kitchen. Pain medications can be constipating, so it is useful to keep fruit (fresh or dried) on hand.
• Because caffeine is a diuretic, you may wish to lay off caffeine for a while after surgery to cut down on the number of trips you need to go the bathroom.
• Keep in mind that being on crutches is a major effort. Allow extra time to get around and for doing things. Remember that being on crutches can be very exhausting. That quick trip down the block to mail a letter is likely to be a major job.
• Be prepared to be up a lot at night. It can be tough to sleep that first week or two after surgery. Plan things to do in the middle of the night that won’t wake up the rest of the house. And realize that you might be catnapping during the day.

Taking Your Pain Medication

The following recommendations should be considered with respect to taking your pain medication:

• Take it as prescribed. You may be feeling fine soon after surgery, but if your doctor recommends pain medication, there is good reason to take it. There is a time delay from the moment you take the medication until it finally kicks in. So if you wait until you’re in pain to take the medication, you could find yourself in significant pain while waiting for the medication to catch up. Some people are afraid of becoming addicted to the pain medication. But the real risk of addiction from medication after surgery is exceedingly small—about three hundredths of one percent!
• Narcotic pain medication can impair both your judgment and your ability to respond. You should not drive or do anything that poses a safety risk to yourself or others while taking narcotics. It is also in your interest to avoid any important decisions, whether they are business or personal in nature, while you are taking your pain medication.
• Although you are going to feel pain from time to time, medication should control it. If you are in significant pain, call your doctor’s office. This is not reason for alarm (anxiety or panic can increase the sensations of pain), but it may indicate that you need more pain medication or a different type.
• Although you are going to feel pain from time to time, medication should control it. If you are in significant pain, call your doctor’s office. This is not reason for alarm (anxiety or panic can increase the sensations of pain), but it may indicate that you need more pain medication or a different type.
• Neither alcohol nor “recreational drugs” should be consumed while taking narcotics.
• The most common side effect of narcotic medication is constipation. (Drinking six to eight glasses of water a day, eating plenty of fruits and vegetables, and taking stool softeners, if necessary, can help to offset this effect. Prunes are particularly helpful.) Other side effects of pain medication may include nausea and itching.
• Caffeine can increase the sensation of pain. Be prudent about your intake of caffeinated coffee, soda, and tea.

Getting Support from Friends and Relatives

• You are going to need help—at least for a short while—after you have ACL surgery. For starters, you will need someone to drive you home from the hospital or surgery center. Once home, you may need someone to prepare a meal…to help you get to the bathroom…to get you ice…to give you the television remote, book, or telephone…to get your crutches. If you live alone, you will have to either ask for help or hire it. Many doctors advise that individuals should have someone with them for two full days once they arrive home. And for weeks after surgery, you may be dependent on others to drive you wherever you need to go.
• Relying on others for so much is not easy. It is especially difficult in a culture that values independence so highly. Not surprisingly, the feelings of dependency that the injury and the surgery create will cause some people to feel depressed. Therefore, it may be more important than ever for you to get reassurance that others still care about you and will be there when you need them.
• A common problem for people who have never been dependent on others is that they don’t have much experience asking for help. This can be a good time to practice. If you expect others to read your mind, even other people who love and care about you, you will probably be disappointed. If you need something, ask for it as clearly as possible.
• Many of us are very appreciative when a friend helps us out. But it’s easy to take an act of kindness for granted when it comes from our husband or wife, mother or father, daughter or son. Keep in mind that your new state of neediness might be just as difficult for them as it was for you. Although the people around you may be glad to help out, chances are they would still like to hear that you appreciate the extra work they are doing. Many of us think that when we feel grateful, it must be apparent to the person who is helping us. However, that’s not always the case—and it never hurts to express our appreciation. The surgery and convalescence can create tension and distance, or it can be a vehicle to move closer to the people we care about most.
• Those of us who are in couples need to be careful not to expect our primary partner to fill all of our needs. The partner has probably had to pick up some of the slack already. Maybe he or she is now doing all of the housework, picking up the kids, paying the bills. One way to ease the strain on your partner is to figure out, before surgery, what chores can be transferred to willing friends or relatives.
• It is best to talk with the people you want to help out before surgery. Try to be as specific as possible—“Could you drive me to physical therapy on the Tuesday following surgery?” Or let them know that you might call on them—“I’m not sure what I’ll need, but would it be okay to ask you for help?” By asking in advance, the individuals who are going to help can plan accordingly. It will be one less thing for you to worry about, and it will offer them a chance to express their caring for you.

Bathing

• The surgical area must be kept dry and clean. If your surgeon gives you permission to shower, place a plastic bag around the brace, binding the ends with tape or rubber bands to ensure that water does not permeate. Alternatively, you can purchase a knee cast cover at most surgical supply stores.

Eating

You will recover more quickly if you eat well, drink enough fluids, and rest properly. Following surgery, it will be easier on your body if you return gradually to a regular diet. Hospital dietitians often suggest that patients go from clear liquids to all liquids (this includes milk-based foods), to soft solids (such as scrambled eggs, applesauce, pudding, and oatmeal), and then to a regular diet. If you’re nauseated, don’t push yourself to eat. Avoid high fat foods, since they can be difficult to digest.

Here are a few additional nutrition guidelines:

1. Stay well hydrated after surgery. Drink 6-10 cups (36-64 ounces) daily of beverages such as water, seltzer, and herbal teas. It is important to replenish your body’s fluids after the stress of surgery. By drinking a sufficient quantity of liquids, you also help to minimize the constipating effects of medication. Avoid caffeinated beverages (coffee, tea, soda), as they actually deplete the body’s supply of fluids. Diet soda depletes calcium.
2. It’s critical to consume enough protein to rebuild tissues that have been broken down by the surgery. Chicken, fish, beans, tofu, and certain cereals are excellent sources of protein. If you’re having trouble digesting solid foods after surgery, milkshakes made with milk, ice cream, and extra milk powder contain lots of protein. Soy milk is also an excellent source of protein (rice milk is not).
3. Whole foods are best—fruits, vegetables (especially dark green leafy vegetables and broccoli), and whole grains (including whole wheat bread, oatmeal, and cereals such as Shredded Wheat, All Bran, and Raisin Bran).
4. Sugar and alcohol impair the healing process in many ways, including their effects on the immune system, on the liver, and on metabolism.
5. Supplements—Ask your surgeon about the use of dietary supplements to assist in the healing process. Nutritionists often recommend that surgery patients take a high quality multivitamin and mineral supplement, as well as additional vitamin C. Five hundred to two thousand milligrams of vitamin C is typically suggested. Calcium, magnesium, and zinc may facilitate wound healing. Glucosamine and chondroitin sulfate may help to reduce pain and inflammation in the knee.
6. Taking a B vitamin complex (meaning a single pill that contains the various B vitamins) can help you cope with the stress of surgery. Many megavitamins do contain twenty-five times the recommended daily allowance of the B vitamins.
7. If your diet is especially poor and you feel unable to make substantial changes before surgery, you may want to supplement it with commercial products that are designed to provide comprehensive nutrients.

Driving

• Many people are anxious to know: How soon after surgery can I drive? Though people all heal at their own rate, and surgeons have different criteria about when a patient should drive, some rough guidelines can be offered.
• If the surgery is on the right leg, some patients will begin to drive after three weeks. But keep in mind that it is not unusual for surgeons to recommend that their patients wait six weeks postsurgery to drive. If surgery is on your left leg and your car has an automatic transmission, you will be able to drive sooner: in this case, patients are frequently advised that they can drive when they are comfortable, off pain medication, and capable of handling the gas pedal and brake with the right leg. If your own car has a standard transmission and your operation is on the left leg, you may want to swap cars with a relative or friend who has an automatic transmission or rent a car. Otherwise, it may be six weeks before you can drive. When you return to driving, experiment with the angle of your seat, as well as how far forward or back from the steering wheel you are when depressing a clutch with your operated leg (if relevant). You may find it unwise for the kneecap to engage your leg in this repetitive extending-pushing motion until after 12 weeks.

 

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