ACL Repair Day 2 + 3

The drugs have been ROUGH. I switched to T3's, which aren't as strong as the hydromorphone, but still make my stomach hurt, my head gross and dizzy, and I'm still nauseous. I quickly went to half tabs of T3's every 4 hours. Every time I had to take them, I felt like I was being sent into a cognitive dungeon of terror. It reminded me of when I was a kid and frequently had to take medication because I was sick regularly. I would hide at the medication intake intervals and my parents would have to find me. I eventually made up a routine that I did every time I took medicine, which seemed like much of my childhood. I had a little dance, # of cartwheels, # of run laps around the room, rode a toy horse for a few seconds, and made everyone else in the room sniff my medication before taking the cocktail of pills and liquids. Now, as an adult, I close my eyes, take a few deep breaths and tell myself it will be over soon.

My knee however, is doing great. I think. The surgeon had said I'm ahead of schedule and don't need a brace which has allowed me to work on moving on crutches with some weight bearing. The bandages and swelling constricted my ability to move a bit. On day 3, I went to my first physio appointment and she took my outer bandages off, moved my knee around to straighten and bend heel to butt. While stiff and challenging, this is where my hypermobility has an advantage. By the end of the session, I was able to move a bit more was happy to hear her say it seems like I'm doing ahead of schdule and would have a strong recovery.

Many of my friends seem to think I would have a lot of time to do art and read, but recovery is a lot of work! Between being messed up from the drugs and clawing to regain reasonable consciousness, I have a schedule of on the hour icing, painkillers every 4-6 hours (including throughout the night) and mobilization exercises every 20-40 min. I also haven't found a way to position myself so I can draw and paint easily as I need my knee elevated and my brain is mushier than ever. Somehow typing here is easier cause laptops are made for this, and I can dictate and edit later if I feel the need to.

A lot of the day is pain and drug management. I switched off the the painkillers pretty early because they cause me more distress and discomfort than the pain they take away. My knee has felt better progressively over the days. While I can feel the pain in my knee and leg, the pain of puking, my head spinning and whole body nausea is worse. The drugs also seem to trigger some PTSD flashbacks and anxious spiraling. Granted, this may be because I was experiencing those badly before my surgery anyhow, but the drugs seem to make them worse.

Other notes: The pre-surgery sheet warns about rashes, reactions and constipation from the drugs. And all those warnings are real and true. My back started having a rash the 3rd day, my gut has been unhappy and bowels have been non-existent.

Drugs, Vitamins and Supplements I've had so far:

Fentanyl: Administered through IV at time of surgery.

Hydromorphone: Administered through IV at time of surgery, and in tablets after surgery.

Gravol: Administered through IV after surgery to help with nausea.

T3's:

• Acetaminophen (300 mg): A non-opioid pain reliever and fever reducer (the active ingredient in regular Tylenol).
• Codeine phosphate (30 mg): A narcotic (opioid) analgesic that changes how the body feels and responds to pain.
• Caffeine (15 mg): A stimulant often included to enhance the pain-relieving effects. *The caffeine explains why I can't sleep! These make me groggy and gross, and anxious all at the same time.
• Tylenol Extra Strength: 500 mg acetaminophen. Over the counter
• AOR Triphlax 750: Tried using this natural non habit forming laxative first. Took it 3 times but didn't seem to be working.
• Restoralax: Habit forming. Had it once so far.
• Sennalax and softener: This combined with the above seemed to do the trick. Also habit forming.
• Vitamin C: Doubled up on dose. Reduces inflammation and helps with immune response (https://www.drprathaportho.com/the-role-of-vitamin-c-and-collagen-in-ligament-repair-after-knee-surgery/)
• Living Alchemy Your Flora Probiotic: Supposed to help gut replenish flora after antibiotics.
• Living Alchemy Milk Thistle Alive: with fermented turmeric. Supposed to help support the liver which goes through hell with stress and drugs. I think I've been feeling mine ache.
• L- Glutamine: An amino acid that fuels the immune system. White blood cells use glutamine to protect you from infections and keep you healthy. It plays a key role in processes that repair damaged tissue
  (source: https://my.clevelandclinic.org/health/articles/glutamine)
• Hydrolyzed Collagen: Protein that assists in cellular repair in tissue and ligaments. Hydrolyzed collagen is broken down in a formate that is better asorbed (sources: https://pmc.ncbi.nlm.nih.gov/articles/PMC6055239/, https://www.drprathaportho.com/the-role-of-vitamin-c-and-collagen-in-ligament-repair-after-knee-surgery/)
• Omega-3: Reduces imflammation.
• Protein powder (plant based): Helps with rebuilding and repairing tissue. (source: https://pmc.ncbi.nlm.nih.gov/articles/PMC6055239/

My drug schedule and notes

Day 0 - Hydromorphone every 4 hours. Cut to half dose by evening.
Day 1 - Full T3's for most of the day. Alternate half tab T3 + full tab T3 in the evening. Every 4 hrs.
Day 2 - Half tab T3 every 4 hrs most of the day. Half tab T3 every 5 hrs later in the evening. Before bed, Tylenol Extra Strength only.
Day 3 - Tylenol Extra Strength every 5 hours.

Exercise, Icing and Cleaning

Having the outer bandages off is helping to move my leg more and the fluid drain out. I'll need to be careful about keeping the wounds clean but they are mostly dried. I found some bleeding here and there, but it's mostly dry. I'm hoping to be able to wrap my leg in plastic and have a sit bath soon. I haven't had a proper bathing since before my surgery; I've been towel washing with help since moving and bending has been a challenge. But following a practical order of cleaning priority, it's worked fine.

If I haven't mentioned it already, the ice machine is a must. No soggy broken bag of frozen peas or constant ice cube making. My fridge has an ice cube maker so it's easy to get ice, but without it, I think using frozen ice packs with water in the machine would be the way to go. The icing really give relief to the heated inflammed parts. I'm trying to do this diligently 15 min every waking hour.

Given how unfunctional I am on meds combined with the challenges of a newly operated leg, I really don't think I could do this myself without help. I'm very fortunate to have a caring, loving supportive partner helping me at home and the generous offers for help from friends, which I will be taking them up on given the amount of appointments I have coming up. I have been instructed to see the physio twice a week for the first month, so planning for that.