Week 1

The following is a general day-by-day summary of my first few days following surgery.  I have tried to cover the main issues/topics that may be of concern to people.  If you have questions, please feel free to leave a comment and I will do my best to respond.  

Day 1: 6.6.18

Sleep: I woke up every hour predominately because of the discomfort of sleeping with my legs elevated on a couch cushion. When I woke up at 5:00 a.m. the blood rushed in my leg after de-elevating but pain subsided shortly and I was able to comfortably fall back asleep.  After taking meds at 5:00 a.m., I slept about 3 hours in a row without waking up.  

Pain: I had no desire to endure pain.  I took 2 norco (10-325) every 6 hours.  I figured that in the early stages there really was not any harm in being extremely precautionary about pain prevention.  I took the anti-nausea pills and stool softener as well.  

Appetite: Fine.  Probably too good :)  

ADLs: I generally felt good waking up, washing my face, brushing my teeth, etc. It helps that I can had limited weight bearing as opposed to completely non-weight bearing. It gave me just the right amount of autonomy; however, my mom is taking care of a lot in terms of getting me water, food, etc.  She has been a real trooper and I am really thankful that she made the trip to help me out.  For those wondering, if you were in my position and could be weight bearing post surgery and would not have live-in assistance, you could do this on your own.  The day after surgery, I could have attended to my own needs.  It would have been pretty damn difficult but it was doable.  Basically, when the brace is locked, you just move around with a peg-leg.  If you are non-weightbearing (like for femoral defects) that likely changes the dynamic and I would imagine that it is much, much, much more difficult.  Lastly, even on day 1, the boredom was highly foreseeable but I was pumped to wake up and watch the French Open on the Tennis Channel.  One of the few times in my life that I'm able to wake up on a week day and watch European tournaments in the morning. I'll take it. 

CPM: My CPM regimen was to start at 30 degrees and to increase 5 degrees each day as tolerated.  I was instructed to sit in it for at least 4 hours each day. 

• First session:  (2 hours) - I was sore in the beginning and took two pain pills at the start. I started at 15 degrees; moved to 18; then 20, 25. The last 45 minutes I was at 30 degrees.  I had a burning sensation in my knee after I was finished. 

• Second session: (3 hours) - Gradual increase up to 30 degrees.  I spent 1.5 hours at 30 degrees. 

• In general, it feels like I’m going to tear the stitches when it gets to the top of the flexion.  At the top, it makes me squirm a little bit as the degrees increase with flexion.

Physical complaints:

• Starting to get muscle spasms in my quad 

• Woke up with a really tight calf 

Day 2: 6.7.18

Sleep: I slept 🛏 better and longer, about 9.5 hours total.  I did wake up periodically and one time with spasms but overall I felt pretty good.  

Pain:  I tried just taking one pill in the middle of the night.  It was maybe a little soon for that.  When I woke up with spasms I was in pain so I'm going to continue taking 2 every 6 hours.  I figure there is no trophy for enduring pain and I have nothing to do but recover so I would prefer to do it pain free. 

Appetite: My appetite is fine but I feel extremely dehydrated from the anesthesia.  I feel like I cannot drink enough water which is fine but when you are immobile, getting up to use the restroom is challenging.

Icing:  I stopped using the ice machine today. I can not feel the cooling through my bandages so for now I am just elevating my leg.  

CPM:

• Started at 20 and went up to 25 and 35. I tried 40, which was a little sore at the top.

• Sitting in the CPM makes my back sore/uncomfortable; my gluteus are sore too from sitting so much.

• I did 5 hours total in the CPM.

Physical complaints:  I feel dirty but I did wash my hair for the first time and it felt great.  

Day 3: 6.8.18 

Sleep: Sleeping is going pretty well overall. Sleeping with my leg elevated is uncomfortable but it is part of recovery 

Pain:  I did not take any pills before bed, but I took one at 2:00 am. Overall, the pain is tolerable. I am planning to try and just take it towards the end of the day, which will help prepare for work days when I cannot take anything in the morning 🗂as I will be working.

Appetite: No problems except wanting to eat🍽 when I am bored.   

Icing: I am using the ice machine again now that I can feel it although I do not believe it gets as cold as I would like it to.

CPM: I made it up to 40 degrees.  I started at 25 and progressed upwards for a daily total of 4 hours.  My complaints are the same as Day 2.

Physical Complaints: In general I feel pretty good. As good as I can be all things considered. Mentally, thinking about starting work from home stresses me out but I have to start on Tuesday. 

Post-Op Appt:

• Today was my first post-operative appointment and things went well. Swelling, mobility, pain, etc are all within normal ranges or better. 

• Bandage and steri-strips were changed 

• Clarified that the following are all normal: Popping in my knee, Spasms in the quadricep, light pressure in the joint on the patella.

• It’s normal to feel some pain in the joint. Some bending in the knee is fine so long as it’s not a loaded movement. 

Plan:

• Generally , it was suggested that I try some light stretching and quad sets. Nothing intense, just some preliminary work before I start PT. 

• I might try and develop a routine of stretching, upper body work and quad sets/lifts 

Day 4: 6.9.18

Today was the first day without my Mom or any assistance.

Sleep: I slept 9.5 hours and got up once around 2:00 am. My discomfort is primarily attributable to the brace and not being able to sleep on my side. 

Pain: I have not taken any pain pills  since yesterday around 6:00 pm before my CPM session. Trying to only take them, if at all, in the evenings. I am going to attempt to not take any tomorrow unless I am in pretty bad pain. 

Appetite: I'm trying not to eat because I am bored.  I have been drinking a lot of coffee because I have been so tired.  I had some friends come over and we had chinese food and ice cream.  This has got to stop.

Icing: This has gotten much better now that I can feel it.  I take the ace bandage off and use two gel packs with the cryo-cuff around them.  I try to do 30 minute sessions with some elevation.

ADLs: I’m doing well moving around my apartment. I live in a small one bedroom apartment in the Gold Coast so there isn’t too much space to cover. Overall, I’m able to get up when needed and get a cup of coffee, make food, etc. I have needed help to take out the trash, do laundry, etc. 

CPM: I got to 45 degrees comfortable and sat in it for 4 hours. I feel really encouraged with my progress thus far with the CPM. I feel confident that by two weeks after surgery I might be near 90 degrees. 

Day 5: 6.10.18

Sleep: I slept in my bed for the first time.  It was generally OK but I miss being able to sleep on my side and freely move my leg.

Pain: I took some pills for comfort in the CPM and I made great progress. I’m going to try being pill free now and see how it goes. 

Appetite: Too good. I ordered pizza but it was worth it . I’ve gotta be more strict. People keep bringing me comfort food which is nice but I have to reign it in. 

Icing: Same as the day before. 

CPM: This is what I’m most proud of. I think I got roughly 4 hours in but I got up to 70 and it was pretty comfortable. I think I’m able to make larger strides than just 5 degrees per day so I may challenge myself to try larger increments, so long as the pain is tolerable. When I start I like to build it up; i.e. start lower and then make my way up. I also need to figure out a way to keep my foot against the back platform.

ADLs: I had a friend come stay with me which is nice. She’s a nurse so she’s fascinated by the procedure. She encouraged me to try higher degrees in the CPM which kinda nudged me to try for more. Once she leaves in a few days I’m totally on my own. I should be fine but I’m a little apprehensive  

Day 8: 6.13.18

Sleep: The brace is so annoying. I’ve tried sleeping on my side with the bad leg up with a pillow in between. It was ok but not how I want to sleep.

Pain: I'm not taking any pills and I'm trying to stay off them until I start formal PT.  I am still sore sometimes after the CPM.

CPM: I got up to 90 today! It’s tight when I get to the top but generally not too painful.  

Icing: I’ve started doing ice cups which is essentially ice directly to the knee. It’s faster and colder quicker. 

ADLs: I started working yesterday at home. Finding balance is really really hard. I found myself at 5:00 p.m. today realizing I had not sat in the CPM at all. Likewise, I did not ice either. I slept in late since I’ve generally just been tired. I have to get myself on a better and more productive schedule. Otherwise, I’ll set myself back both physically and professionally.

Week 1 Observations 

I am so much better off than I ever expected. Both the pain and physical limitations are completely tolerable. With that being said, now that I have to start working again I’ve realized how much this recovery truly entails. I need to start doing some rehabilitation on my own and trying to fit that in with work, the CPM and icing feels impossible.  Literally, it does not feel like there are enough hours in the day.  I’ve started to wonder if I should have put off the procedure until I was eligible for FMLA leave so I could take off six full weeks to dedicate towards rehabilitation and recovery.  However, this procedure was never going to be easy and there will never be a "convenient" time to do it so to some extent, diving right in was not a bad idea. You will always find a way to make it all work. You don’t have a choice. 

Day of Surgery

I arrived at the hospital, Presence St. Joseph, at 8:00 a.m.  Upon arriving I was almost immediately busy filling out paperwork, meeting with my surgeon and the anesthesiologists and getting "hooked up" to various machines.  Collectively, it was a welcomed distraction so I did not get myself worked up about what was ahead.


I was originally informed that I would have a 23-hour admission and basically stay over night for observation.  However, when I arrived my surgeon explained that I could go home that afternoon so long as I felt OK and assured me that I would not have to leave if I was not feeling well. I sent a few text messages to my good friend who was able to come pick me up that afternoon. 

Prior to entering the operating room, I was given some sedatives to relax and at least one administration of fentanyl.  They also gave me a femoral nerve block and it did not work.  They tried again a second time, like right before I entered the operating room, but I do not know if it ultimately ever worked.  I told the anesthesiologist that it did not work because "I have nerves of steel."  That joke was likely a product of the fentanyl they gave me.  

I believe I entered the operating room around 10:00 a.m. (ish) and the procedure lasted approximately 90 minutes.  When I woke up, I was in a recovery room and boy, oh boy, was I woozy.  I'm not sure if woozy is a technical term but it is accurate.  I quickly got my bearings and realized where I was, what had happened, etc.  I have never been anesthetized that deeply before as my prior arthroscopy was much shorter.  While I felt like I was a belligerent fool, multiple nurses commented on how communicative and articulate I was under the circumstances which was comical to me because I felt anything but that. 

After getting acclimated to my surroundings and feeling like I could communicate, the nurses were really helpful in getting me everything I needed.  I am a cherry coke zero addict so I packed one with me and began eating graham crackers.  Around 2:00 p.m., I decided that I would target my discharge for 3:30 p.m.  As such, we began the discharge process and I received discharge instructions, pain medications, got changed, etc.  They force you to urinate before you leave too.  

I was wheel-chaired to the front entrance and my friend drove me home.  I really did not have too much pain until about 8-9 p.m.  Ultimately, I was glad that I went home.  My friend stayed with me until my mom arrived around 5:30 p.m.  That evening my mom and I just caught up and watched a movie.  Another friend of mine had Cold Stone ice cream delivered to my door!  Fortunately, I do not have adverse reactions to anesthesia and did not feel nauseous but I did not have much of an appetite.  I did have a small dinner and the ice cream because my general philosophy is that calories do not count on surgery day.  

That first night, sleep was a little rough.  I woke up about once per hour as I was just uncomfortable.  I had my leg elevated on a couch cushion but removed the cushion around 5:00 a.m. when I took some pain pills.  While I was exhausted, sleep was just not that easy.  My knee was quite tender and even the smallest movements caused pain and discomfort.  

In general, I was pleasantly surprised with how I felt.  I had pictured myself being in profound agony but I was predominately just really uncomfortable with manageable pain so long as I took pain pills every 4-6 hours.  I knew what I had signed up for so all things considered I was pleased without the procedure went and my general physical condition.  

Preparing for MACI Surgery

There are a number of things to consider and plan for when having MACI surgery, of which have varying degrees of importance.  Some are more for comfort while others are vitally necessary.  I hope the following are helpful!

1.  HELP!  My Mom came to stay with me for four nights.  In general, she provides a source of comfort because she is the best in the Mom game.  But she also helped with rudimentary tasks such as getting me food and going to the grocery store.  It was also nice to have someone around "just in case."  I was relatively "OK" when I left the hospital but everyone is different and I would recommend erring on the side of safe versus sorry.  For example, one blogger mentioned waking up in the middle of the night to use the restroom and noting feeling profoundly dizzy from the medications.

2.  Toilet Riser/Stool:  I purchased a five-inch riser seat for my bathroom.  Your leg will be locked in a brace for many weeks and sitting down may be difficult.  I ultimately have not needed to use the riser seat because the set up of my bathroom is such that I can simply lower myself down by essentially doing a tricep dip because my sink is right nearby.   Others may not have a similar set up or the upper body mobility.

One blogger had this set-up in her bathroom.  My sink was right next to the toilet so I could push myself up without needing an armrest.  

3.  Shower Chair:  You will need a seat for the shower.  This is a MUST.  Standing in the shower will be nearly impossible and if you do not have a walk in shower, things can be tricky.  For safety reasons, you should absolutely have one.  Basically, I get in the shower with my brace on and then take it off and start the water.  

This is the chair that I purchased.  The main thing I needed was the two arm rests to help lift and lower myself into the chair.

4.  Entertainment:  YOU WILL GET BORED.  I bought an iPad before surgery so that I will have access to books, magazines and videos essentially at all times.  I also have two smart TVs.  If you can get your friends' and family members' log-ins for streaming (legally of course), do it.  Get recommendations for shows, movies, books, etc.  

5.  Physical Activity:  Get yourself in good shape before surgery.   If you need to lose some weight, lose it.  If you need to work on strength and conditioning, do it.  MACI surgery will take a toll on your body and months of inactivity following the surgery will lead to atrophy.  Additionally, one of your main goals in PT following surgery will be regaining quadricep strength in your surgical leg.  The stronger it is going into surgery, the quicker it will "bounce back" after surgery.  

6.  Balance/Yoga:  You will be on crutches for many weeks. During this time it is essential not to fall or stumble on your bad leg since the graft is very fragile.  Having good balance is of the utmost importance.  It highly unlikely that you will never stumble or trip while on crutches so having the ability to balance will really help with this.  If you have never been on crutches make sure to practice beforehand.  However, if you are at the point of doing MACI surgery, you have problem been on crutches before.  

OK, you do not have to become a full blown Yogi, but you get the point.  Work on balance however you see fit. 

7.  Return to Work:  I may make this the subject of an independent post because of how much it affected my life.  I am an attorney and I work a lot of hours.  However, I will be taking one week off of work followed by two weeks of working from home.  My employer purchased a computer for me so that I can work from home remotely.  After discontinuing pain medications, work to some extent gave me something to do but at the same time was an added pressure on making sure I sat in my CPM, did my exercises and iced.  

This is me at the office; i.e. sitting on my couch in the CPM and reviewing records on a lap top.   

8.  Driving:  I live in Chicago and do not drive.  Obviously, after taking pain medications you cannot drive but I have heard that people are comfortable to drive around the 3-4 week mark.  My graft was on my right leg (driving leg) so it could be longer in that case.  

9.  Pain medication:  Take at the first on set of pain.  Don't wait until it gets really bad.  It is much harder to get rid of pain when it is very uncomfortable because the pain meds take awhile to work.  So far, my experience has been different than most others.  I have read blogs where the patient was taking pain medication for months.  I took it for 4 days around the clock and then only took it in the evening for two additional days.  I have taken it sporadically since then.  Pain is a highly subjective thing so experiences will differ depending on the patient, location of the graft, co-morbid conditions in the knee, etc.  

10.  Have a social network:  Invite friends/family over.  Although you may feel bad and think you look terrible (I didn't shower much in the beginning) don't turn down social visits.  They definitely will lift your spirits.  My mom stayed with me for a few days after surgery and then a friend came to visit from Michigan.  I also have friends in my neighborhood that stop by.  Again, my experience has been "good" so far and I was able to go out to dinner (two blocks from my apartment) ten days after surgery.  The following night I even went bourbon tasting with a friend.  Yes, I was off the drugs at that point. 

11.  Wheelchair:  See if your insurance will cover a rental.  Some people find it handy and it can assist with your ability to get out depending on your recovery.  Thus far, I have not been in a situation where I would need one. 

12.  Stairs:  If you have stairs in your house I recommend moving to one floor.  Stairs are doable on crutches but if you can avoid them, it's better.  It's not worth risking a fall and damaging the graft.  I honestly could not fathom going up and down stairs on a daily basis.  

13.  Considerations for Women:  I got my legs fully waxed before surgery and fully stocked up on dry shampoo.  Frankly, even when you can shower, it is a big task and feels exhausting.  At the same time you do not want to feel utterly disgusting.  Small things can help you feel more comfortable even when you are not and for me, not having hairy legs was a small comfort.  Additionally, following surgery I was instructed not to take NSAIDs as there is a concern that they may interfere with graft adhesion.  This meant that I could not take ibuprofen for menstrual cramps and that has been an issue for me.  I caved one night and took some but the following three days I just took the norco I had been prescribed.  This helped with the cramps and lasted through the night so I could sleep.  

14.  Prepare your home:  I essentially prepared for surgery as if there was a zombie apocalypse upon me.  Stock up and every day items such as toilet paper, kleenex, etc.  Stock up on non-perishable foods too.  Ensuring that I had everything I would need resolved some stress I had going into surgery.  While I felt like I spent a ton of money, the good news is that you are really buying things that you will end up using so you really are not wasting money.  

15.  Your Doctor:  Make sure you are comfortable with your doctor.  This really goes without saying but it is of the utmost importance.  MACI, and its predecessors like ACI, are relatively new-ish procedures in the United States given that they did not receive FDA approval until a few years ago.  As such, there are not a ton of doctors that perform this surgery; i.e. not every orthopedic surgeon will perform this particular procedure.  Additionally, I believe you should personally feel comfortable with your doctor because the road to recovery is a long one and you want to be working with someone that you trust, can communicate with, who answers your questions and you generally like being around.  To be blunt - you're going to be physically compromised for some time and if your doctor is a jerk it is just going to make those visits all the more frustrating.  My doctor is Dr. David Guelich with Chicago Orthopaedics and Sports Medicine.  There are not enough wonderful things that I could say about him.  He is profoundly intelligent and talented and on an interpersonal level he always makes me feel comfortable.  Unlike some physicians, he embraces my questions and takes the time to make sure I can make informed decisions.  I never felt pressured to go forward with surgery and he has always tried his best to give me options.  And, while it may not make a difference to some, he is just a nice person to be around and does not exude the superiority (and narcissism) that other physicians do.   

Making the Decision to Have MACI Surgery

Deciding to have MACI surgery was pretty easy:  I wanted to play tennis and without MACI surgery, that was not going to happen.

While it sounds quite black and white for me, it may not be the same for everyone else.  For me, I had a number of factors that weighed in favor of having surgery aside from my desire to rip fuzzy green tennis balls across a net.

Of note, the following factors weighed in favor of going forward with surgery:

• Age:  I was thirty-five years young at the time of operation.  
• No co-morbid conditions:  Aside from the cartilage defect my knee is remarkably intact. 
• Weight:  I am generally of a healthy weight aside from my ever present desire to "lose five pounds."
• Personal Commitments:  I am not married and do not have children meaning that I can devote a lot of time towards rehabilitation without concern of detracting from other personal commitments.
• Professional Commitments:  The law firm I work for has been pretty understanding about the procedure and time I will need to take to rehabilitate this injury.  

I should add that I am likely in the category of people who technically fall within the category of "purely elective" when it comes to this surgery although it never felt that way for me.  What I mean is that pre-surgery I had a pretty decent activity level.  Days before surgery I "ran" four miles.  (The quotes around the word ran are intentional as I would not want to overstate what this looked like).  I was working out at least 4-5 days per week.  I could complete relatively challenging HIIT workouts and I was doing challenging pilates workouts at Studio Lagree.  Side note - if you have not tried the megaformer at Studio Lagree, do it:  http://studiolagree.com.  Chicagoans, you're welcome.

Studio Lagree is THE spot to go to in Chicago for reformer pilates.  The classes are so challenging (in a good way) and are perfect for anyone with a knee injury because they are non-impact.

However, I was not able to do the main thing I wanted to do:  tennis.  But adding to that was the fact that some routine daily tasks were becoming increasingly more difficult.  For example, walking down the stairs to the subway to work hurt.  And, if I was wearing heels - ugh.  Getting into an uber/cab was difficult, trying to get cleaning supplies out of a low shelf hurt and getting up off the floor was the worst.  While my desire to play tennis overrode every other consideration, the fact of the matter was that this injury began to affect many aspects of my daily life and it was only going to get worse.  

In theory I could have continued my activity level and life but it was not what I wanted for myself and I was really not happy about it.  While going to pilates was fun, I missed tennis on a daily basis and was tired of having to mentally prepare each time I encountered a flight of stairs.  So, I scheduled surgery and never thought twice about it.  

My Background, Injury and Course of Treatment

Ever since I can remember, I have loved sports.  My Dad is a sports junkie and as a result, sports have always been a big part of my life both as an athlete and as a spectator.  In high school I was a two time all-state track and field athlete and went on to run track at Central Michigan University (Division 1).  For one reason or another, high jump just came naturally to me.  

Even after leaving competitive athletics, I have generally always made fitness a priority.  Alright, technically that was not true my last year of law school but give me a break, law school was time consuming.

Fast forward a few years, I move to Chicago and begin my professional career as an attorney.  Once I settle in, I really started to miss competing in any sport.  I began thinking about how much I wanted to learn how to play tennis but never did.  I figured my speed, agility and decent hand/eye coordination would translate easy into the game.  But for some reason I never tried it out. So, on my 30th birthday I decided it was time to finally learn to play.  I took one lesson and was hooked immediately.  

I played a few times a week for roughly three years when I started to feel some pain in my right knee.  I began noticing the problem in early March 2016.  As an athlete, you get bumped and bruised along the way so I just brushed it off as something that would work itself out; i.e. rub some dirt on it and walk it off.  Over time, the pain got worse and was more frequent.  I had a trip planned to Greece in June 2016 so I figured that my two weeks overseas would give my knee enough of a break that when I returned, I would be fully recovered.  That did not happen.

I first sought out treatment in July 2016.  Given my symptoms, I was initially diagnosed as having Jumpers/Runners Knee which is a general diagnosis for patella-femoral pain.  I was instructed to start physical therapy which I did for approximately two months without any relief.  As such, I subsequently had an MRI which revealed inflammation in the joint for which I was given a steroid injection.

The injection provided some immediate relief and I thought I was healed!  I felt the best I had felt in months.  I even went to Arizona and played tennis at an awesome resort with The Tennis Congress.  However, a few weeks later I was back at my doctor's office asking him to do another steroid injection.  My request was politely declined and he explained that at this point, surgical intervention would be necessary.  

In December 2016, I had arthroscopic surgery to essentially clean up/out any inflamed or damage cartilage and to remove any plica that were present but not visible on the MRI.  My doctor also advised that he would take a small sample of cartilage from a non-weight bearing part of my knee "just in case" we had to do another surgery.  Following surgery, again, I went to physical therapy to rehabilitate the knee.  

Here is where we begin the profoundly frustrating part of the story.  Following my surgery, my knee never felt better.  I can confidently state that I worked hard and definitely fulfilled my end of the bargain in terms of rehabilitation and a home exercise program.  Frankly, I like to work out and I was desperate to get my life back so I was diligent in doing everything I could in terms of getting quad strength back so as to regain proper patella traction.  After a few months, I was still symptomatic so I returned to my doctor and he suggested doing a series of three hyaluronic acid ("HA") injections.  

The HA injections restored some knee function but did not relieve my ultimate symptoms.  I believe the HA injections provided some general knee lubrication which relieved some symptoms that were a consequence of surgery, as opposed to the cartilage injury, which was helpful but did not ultimately resolve my injury.  

I continued to do physical therapy and a home exercise program and even did a second series of HA injections but it was obvious that conservative options were not going to get me back on a tennis court any time soon.  

So, as you guessed, I elected to go forward with the MACI procedure.  I had surgery on June 5, 2018.  

Introduction and Blog Purpose

Hello!  My name is Sara and I have a love for Indian food, travel, whiskey and sports.  But above all else, I love playing tennis.  I started about five years ago and was hooked immediately.  My background in track and field and softball easily translated into a decent tennis game.  And, let's be honest, the skirts are adorable :)

I want this LBD more than anything.

 Consequently, it is my love for tennis that likely is the reason that I recently underwent matrix-induced autologous chondrocyte implantation ("MACI") surgery in my right knee.  The cartilage defect I have/had was on my patella.

My sole reason for starting this blog is that the decision to have this procedure, or its predecessor ACI surgery, is a big deal.  It is a big commitment and will test you both mentally and physically.  When I was in the process of deciding whether or not to have the surgery, like most people, I began googling every combination of related search terms that you could think of.  In fact, I should be awarded an honorary degree from WebMD for how much I've read about patella femoral injuries and their treatment.  I digress.

What I learned is that there is not a ton of information from the patient's perspective about the procedure and subsequent rehabilitation.  I truly believe that my doctor did a great job ensuring that I understood the commitment I was making and to set realistic expectations about the outcome; however, I wanted to know details, like day-to-day details.  Thus, I turned to the internet and found some blogs that I found to be helpful.  In fact, if you find yourself reading my blog, I highly recommend that you read Megan's too:  http://megansacicarticelsurgery.blogspot.com

Lastly, I should add that this blog will simply explain MY surgery and recovery.  I emphasize that point because as cliche as it sounds, everyone is unique.  Your defect, surgery and rehabilitation will be different than mine and everyone's outcome can be affected by a myriad of different factors.  I just hope that this blog can provide a general overview of what to expect and hopefully a few helpful considerations to keep in mind.

I hope you find this blog helpful.