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.
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| 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. |
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| 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. |
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.
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| 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.
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| 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.
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.
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