The CPM is pretty cool. In fact, it’s a whole lot more comfortable than propping up legs under your knee which is a pain and uncomfortable. I’m to set the machine at 0 degrees extension and 60 degrees flexion and increase 5-10 degrees every day. After checking with my papers of instructions I received from the Lenox Hill Physical Therapy unit I notice that this is to be increased by that amount every other day. Makes sense. I cannot believe I’ll get such high rate of motion differential so quickly.

The ice-man is also pretty nice although it isn’t so easy to keep on. A cryo-cuff is much easier to use and this one has an extension that looks like a pancake. The “cuff” is like a tube or band that goes around your leg and fills with ice water and the pancake looks like, well, a pancake that has been misshapen with some “veins” in it that hold water. Not so easy to keep in place. I recommend the manual “cuff” if you’re going to get any kind of ice machine.

Physical Therapy Session 1: Well, the “Lenox Hill Physical Therapy Method” is to have your first physical therapy session within 24-48 hours. I have to scramble to get to my PT, Athalon Physical Therapy and Jason takes great care of me. He has been doing so the last 2 months as I recovered from my injury to walk again without pain. Wow… the swelling isn’t as bad as I thought and the wound looks pretty neat and rather cool. I have four holes in my knee, most covered up with these little yellow gauze strips and the one on the bottom and inside of my knee is held in place with two white strips. Those are the ones with which to be most careful and you must make sure NOT to take off or get wet.

Dad drives me to the city to Athalon for physical therapy. Getting out of the car is a real challenge. While I’m not feeling much pain, getting around with the bulky knee brace and not wanting to put weight on my bad leg can be challenging.

Jason, my man at Athalon, says we will do some very limited PT today. He takes off the bandages and it doesn’t look to bad! A bit of swelling but not much more. He performs a brief Lachman test 2-3 times and my knee seems strong, same as or if not better than my right knee! He says that we will just do the following five steps that I should do twice a day at home this weekend:

(1) Take a towel and wind it up so it is like a big string or use a long elastic strip and hold the ends. In the middle of the towel, place the ball of your foot and lean back. Push the towel forward with the ball of your foot so you feel your calf working. It’s the same as calf raises. Do this 100 times.

(2) Sit down with your legs straight out. Put the wrapped up towel dircectly under your knee. Try to press down with your knee hard and you’ll feel your quads flex. Do this ten times.

(3) Place a book or two under your heel and straighten our your leg. Let it hang there and try to straighten your knee as much as possible. Do this for five minutes.

(4) Use the CPM machine for at least 4-6 hours a day (I use it way more than that… it’s addictive!)

(5) Ice the knee down after your workout.

We do the obvious four of five items and then I’m done. We schedule PT for Monday and Wednesday although the following week it will be 3 times per week for the next 15 weeks. Wow!

Next we talk about walking with crutches. I’m supposed to put the heel down of my bad leg first and place 25% weight and the rest should be in my arms in the crutches. Little by little I will be adding extra weight as I feel appropriate and my body can support it. Excellent, we are ready to go. Jason follows me down the stairs and makes sure I can use the crutches properly to climb up the stairs and into the car…

I get driven home by Dad and the numbness is still in the leg. Picked up a pair of Sketchers slip on sneakers that feel like slippers but built more like sneaker shoes. It’s great not ot have ot lace up. Feeling great although since surgery am incredibly hungry every few hours. I have dinner, have my required milk shake, am drowsy like before, get into the CPM machine, pass out eventually earlier in the evening this time…

I am hungry… man am I hungry! The nurses are laughing with me (I’m joking around with half coherence) and I am offered graham crackers and Canada Dry ginger ale. Tasted better than any other I have had in a long, long time. Man… did I say that I was thirsty? Well, the nurses are surprised that I’m doing so well just 2 hours after surgery (mine was at around 1pm) that I am ready to be released by 3:45 or so. Before then I believe Dr. Kelly came by to see how I was doing briefly and I’m doing far, far better than I ever would have anticipated.

It’s closing in on quarter of 4. The staff are ready to dump me out of the recovery/waiting room and do so right into a wheelchair. I need a little assistance but not much. Before you are released you have to get dressed and I haven’t forgotten that I must return to that frigid room and get rid of the robe and frilly gown. I came in with my “snappy pants”—tearaway pants with snaps on the side, similar to those you see worn by basketball players during warmups. It is a great invention and a worthwhile investment and in my state am thrilled that my pants don’t have to be pulled on one leg at a time. I’m told that I need to go to the physical therapy area of the hospital before release where I’ll be fitted with my knee brace, given crutches and taught how to use them.

After I’m assisted with dressing (actually, I think I did this myself although it’s difficult to remember) I am wheeled to the PT area and I get brought this ridiculously bulky knee brace, the Breg knee brace. I’m told later that you can cut the excess padding if it is too long, and I am fitted right into the brace. I can extend my knee straight (extension) and my bending limit (flexion) is 60 degrees. I’m told that I need to use it whenever I am “ambulatory” aka walking. Not a big deal going to the bathroom but still should wear it whenever possible.

I’m fitted with crutches and taught to use them. Intuitive—step forward with your bad leg and brace hourself using the crutches moving forward. Going up stairs, good leg first which pulls you up the stairs. Going down it’s crutches first, bad leg second, good leg third. Simple to remember—“Up with the Good, Down with the Bad.” I mastered it immediately and we were ready to go and beat traffic out of Manhattan. We got into the car at roughly 4:20—not bad after getting out of surgery only 2 hours ago!

I am nauseous, very much so. And hungry. We get out of Manhattan and pick up pizza and a vanilla milkshake while we wait for my meds to be filled at the pharmacy. I’m to get hydrocodone 500mg (take two every 4-6 hours) to fight the pain and 100mg of Celebrex (twice a day) to reduce swelling… Man, I love milkshakes, just the essence of life along with chocolate milk, sushi, superb pizza, and perhaps add in a sublimely prepared orange sherbert or frozen yogurt with chocolate sprinkles. Man, my diet is a mess but the cold milkshake really takes care of the nausea. End up getting home shortly thereafter, watching the movie “Intolerable Cruelty” with the folks to pizza and ice cream and then take the hydrocodone just to make sure I don’t wake up screaming along with the Celebrex.

OK, I’ve been in and out of drowsiness and I’m ready to pass out. I don’t feel anything in my leg since it is still so numb. I want to elevate it but the instructions say to put pillows under my ankle. It’s uncomfortable and I feel like my knee is hyperextending a bit. I put the pillows under my calf and others tell me that this is fine. I ice the knee on the wound (the top of the knee just below your patella on the inside) but don’t unwrap the gauze (which smells like rot) or the ace bandage on top of it. Can’t feel the cold anyways because I’m so numb. I eventually get rid of the ice and totally pass out.

I notice that I sleep in 4 hour intervals, roughly the time the pain meds last. I get on the PC and jump to Bob’s Knee Board for a while, check my web site TheLaw.com and then feel myself getting drowsy again. Not in pain at all, don’t take meds. Fall asleep for another 4 hours. Get ready for this symptom to repeat for 2-3 days…

I make it to the office, send out a couple of emails and then get the call from the folks that they are waiting downstairs. I get down to the bottom and need to make two trips to the car and amuse the security guards, all of whom know me, being the amicable guy that I am. They wish me the best of luck and I hop into the car with Dad and Mom. Ah yes, I forgot to mention that I balanced my Tae Kwon Do black belt certificate under my arm on the way down the stairs and made sure not to put my stuff in the trunk. I instruct Mom and Dad that laptop bag and TKD certificate must not be left in the car and must be brought into the hospital (you never know what gets stolen in this crazy New York City.)

We arrive at the hospital—Lenox Hill on 77th and Lex, surgical home for many famous athletes, especially the Knicks and Nets—and I am required to show ID and check in. Incredibly I actually need the ID since I walked right into the other branch without someone so much as asking me a single question. We go up 3 flights in the elevator and arrive at pre-admittance. Mom gets to hold all of my electronic items and valuables as I go into a frigidly cold room to change into a gown and robe along with these ultra cool socks (that was a joke—they are these throwaway black socks.) Then I get to go back to the waiting area pre-surgery where I get my pulse checked, heart rate taken and all those questions about allergies and what you’re having done asked of you.

The waiting area where I was in is actually also a release area which contains about four beds across from us where patients are released after surgery. Some of them are moved into the chairs when they feel better and looking at the patients in bed, they didn’t all look too thrilled, lol!

I was seated between two very nice women. On my right was a lovely older black lady, approximately 55 named Ms. Green. She had problems with her left knee and Dr. Michael Kelly, apparently performed an arthroscopy on her and she has been thrilled with it. She has no clue what is wrong with the left but is back to have it checked since it hasn’t healed in over 6 months. She cannot climb the stairs out of the subway and this cannot continue, nor the pain that accompanies it. She says so many nice things about Dr. Kelly both his skill and personality, and tells me not to worry about my knee, which seems to be some serious surgery.

On my left was a strawberry blond woman whose face I could not completely make out because I didn’t have my glasses but I could see her very warm smile. She said she just had her 45th birthday but didn’t look it. She hurt her leg at 16 when she fell into a hole and since then, coupled with numerous ski trip injuries, has damaged cartilege several times. She too raves the same about Dr. Kelly both about skill and satisfaction with the surgery as well as his nice treatment of her and family. She also reassures me that my surgery will go superbly. I’m not sure if she already had her surgery and whether they moved her from one of the beds.

My worried mother (more worried than I) gets pulled into the room to see how I’m doing. Soon I’m removed since they need my chair. There are also beds ahead of me where recent patients are placed and I see one man who looks a little pale and as though he went through a lot worse than me. Later I found out he had a full knee replacement so that explained his look of bewilderment and general grogginess from being pumped full of meds. Well, can’t look too long because I’m sent back into the waiting room, gown and all.

I chat with my nervous parents for a while until Dr. Kelly’s anasthesiologist comes out to ask me a few questions. Super nice guy, looks a little young but I feel very confident with him. Thereafter Dr. Kelly’s “fellow” comes out who will perform the surgery with him. She lets me ask her questions about anything and everything including the allograft surgery. I ask again if this is really the right thing to do versus a patella autograft. She says that the “gold standard” is no longer really such a true gold standard, especially over the past few years, 2 in specific. I’m not so crazy about some of her answers and I’m wondering if she’s just mollifying me before surgery. Whatever, I’m doing what I’m doing and Dr. Kelly recommended I go allo and he’s no quack. Dr. Kelly comes out and smiles and asks me how I’m doing. I’m at a loss for words and just say I’m doing well. He’s a good guy. I have no more questions. I’m ready to move.

The female Fellow writes “BAD” or something like that on my left knee and also provides me with one last piece of paperwork. I may have a torn meniscus and in addition to the ACL reconstruction, I must give permission to my main man, Dr. Michael Kelly, to perform the surgery. He told me after reading the MRIs that he is reluctant to perform surgery unless necessary. He saw what might be a “tiny tear” that may require either (a) nothing since it is so small to heal by itself or is just a fleck on the MRI, (b) a tiny “tug” that will start the meniscus tear to heal or (c) suturing the small tear together or trimming it if necessary. I’m hoping for choice “a” of course.

I sign the papers and we’re ready to rumble. I walk down the hall into an incredibly bright white room. It’s all illuminated and some modern pop music is playing that agrees with me. I joke about it. I’m placed on the table which has two arms across reminding me of the crucifixion. It’s all so symbolic and I wonder whether I will die during surgery at that romantic moment, being somewhat affected by the death of my friend, Joel Kirshner, who died for no apparent cause, perhaps asthma, just 2 weeks earlier. I decide that since I am Jewish, crucifixion should not apply (or rather, since Jesus was Jewish it does) so I further decide that I am making myself CRAZY but I am really rather calm other than that melodramatic moment.

I joke with the Fellow who is shaving my hairy left leg for surgery. The anasthesiologist says that “this is going to pinch and sting for a moment” and I totally agree with him that it will. After asking whether the fellow should shave my other leg so I have a matching pair I have absolutely no recollection of the next moment, nor whether I will see Joel while I am out because I am.... at a lost until I wake up in Part 2!

I’m a little nervous but otherwise way too calm. I’m about to have my knee invaded in the worst way and I’m just going to allow those medical professionals to do so. I’m still up in the air about the allo and being told I will only truly be happy with auto results. Some have said absolutely yes, others have said no. I’ll see how I feel tomorrow morning. Right now I still need to finish packing all my crap. Do you have any idea how much “stuff” someone can accumulate over the course of a year? How about seven? OK, I’m going to just have to toss most of this stuff into boxes and deal with it when I get to the new apartment.

Hopefully I’ll get 4-5 hours sleep. Since Lenox Hill is a short trip away from work, I’m going to cab myself along with all my junk there and then have Mom and Dad pick me up and go to The Hospital. You have to fast from midnight before surgery so I went out and gorged myself with vanilla fudge ice cream and a half gallon of lowfat chocolate milk… yum yum!!! I’m not going to bother doing any more ACL research. I’ve read myself to the death and just want to get this thing over and done with. Good night.

There is a lot to do today. In addition to clsoing up business at work and providing contact numbers to everyone, I also need to clean out my apartment since I hope to move into an elevator building at month’s end. I’ve found out that I’ve bought a little extra time tomorrow, as surgery is scheduled for 12:30 although I have to be at the hospital for admittance by 11am. Plan is to stay at my apartment, take a taxi across town to work where Dad and Mom will pick me up at 10:30 to reach the hospital in time. Note that you must have an “escort” with you at the hospital to ensure that you leave the hospital in someone’s care. They will not allow you to proceed without one.

A taxi will probably not be sufficient for “safe passage” because I have heard that the anasthesia will do some funky stuff to both your brain and your stomach. In fact, I have heard that the nausea from the anasthesia is even worse than the pain that you might suffer from teh actual surgery. I’ll believe it when I feel it.

OK, I need to be off to get other things done. I’ll jot down my thoughts tonight and we’ll see if I’m really as calm as I am now—well, at least about the surgery. I’m more panicked that I won’t have everything done by the time I need to leave for surgery and migrate to my parent’s home as is the current plan. They will take care of me for a week after surgery and through Thanksgiving, if my sanity doesn’t go first.

I was glad that Dr. Kelly was still there, per his message. He was generous with his time and told me that his primary concern about performing autografts using the patella tendon was arthritis. His preference (as with many other surgeons) is to use age 35 as a cutoff point for which to make a decision to use the allograft. He said that if he were in my shoes, he would definitely go with the allograft, now that he has had more experience as not only a doctor, but also as a patient at a later age.

In addition, he feels that the allograft rate of success and satisfaction has greatly improved. In fact, I was surprised by the same sentiment being echoed by a patient of the well known Steadman Clinic (of Kobe Bryant fame as well) on Bob’s Knee Board, a well known resource. I had gotten into a little discussion with him about his twenty-something knee (young ‘un) being reconstructed with an allo achilles graft. Wouldn’t you know it, he was right—the achilles tendon is the strongest tendon in the body. Apparently the rates of satisfaction and success are much higher these days—and for the past two years—with the allografts.

So… what would you choose? My ability to hopefully return to small pond big playground superstar success with potential for serious chronic knee pain? How about the choice behind curtain number two, return to small pond potentially as a big playground superstar or at worst as a mortal with much higher risk of not having serious, chronic knee pain and scarring in your patella tendon. Yup… as much as I am hoping that the New York Rangers are still interested in my hockey talent and the rumors of my rare softball skill, power and speed are still active, I have chosen curtain number 2.

Well… at least for now. Wait til’ my fickle mind, feeble with weary anticipation really starts to kick into gear tomorrow…

Things got a little rough when one of the yellow belts was feeling his oats and decided to kick back during sparring. Being that I am a black belt and had just received my certificate that I earned in January (or was it March?), I decided to show off. I did a couple of spinning back kicks after roundhouses (with my bad leg but standing on my good one) to ensure the yellow that he knew his place.

Oh yes, I did connect. It’s a beautiful sound and feeling to hear your booties hitting the plastic vest of your opponent. Problem is that on one of the half dozen spinning back kicks I performed I realized on one of them just how important your ACL really is. Apparently I rotated just a tad too much and felt a twinge in my knee of pain that was a reminder for the rest of class. Practically paralyzed me but I kept going and didn’t do another back kick after that, spinning or not. Adrenaline kept me going but I’m hoping I didn’t tear my meniscus. What a moron you are, Michael.

The class is great and I really miss it. I’m going to have to take things very, very slow when I get back. I’m not taking that part too well either. OK, stop thinking about this. Have so much to do for tomorrow since I have a trip to Boston. Additionally, I realize how stupid it will be to see if I get back in time to play in our New York City Corporate Softball Championship game for our third straight appearance. I was told by the coach that I will likely not be playing no matter what, if not because of my injury then because of my being out of practice in comparison to the other dudes who will fill out the team. We have won two straight championships and yours truly had home runs in five straight games this season before going out with the torn ACL. What a major bummer and inconvenience. OK, I have way too much to do. I’m out of here for now.

1) Hospitality: Consider staying with someone for the first 3 or so days. It will make a big difference. Even if you think you can get around, the “inconvenience factor” when you are still woozy, numb and nauseous from the anasthesia can make a big difference.

2) Garbage Disposal:  If living in a walkup apartment, take down all garbage before you leave the premises!!! Actually, if living in any premises, take out your garbage!

3) Invest money in a backpack. When on crutches it will be your third hand. When off the crutches it is a fabulous piece of equipment to evenly distribute weight of items you need to carry.

4) Prepared Food: If not staying with someone else who can care for you and for the time when you will be weaned off that personal care—make sure you have plenty of frozen or prepared food ready for you to eat!

5) Menus: Speaking of food, if you are planning on ordering in frequently, get plenty of menus from local venues and make sure you have sufficient cash on hand in your apartment!

6) Cooling Device: Cryo-cuff/ice machine/coolgel or ace frozen icepack or frozen mixed vegetables. After dealing with this more regularly I’d say that the electric ice machine is just OK and the cryocuff is better, but you might just do as well with frozen veggies. However, you’ll need 3 or so of these since you’ll forget to replace one in the freezer, etc. I’d also say that the convenience factor with the cuff is very nice for the first few days (I had the DonJoy IceMan which I felt couldn’t be held tightly as could the manual cryocuff or the blue ace ice packages.) I was told to put on the ice for only 20 minutes at a time but it’s hard to tell what is right at the moment.

7) Work Materials: Take all needed items from work/office home so you’ll have access to your materials. You will not go back to work for at least 3 days. For me, I’m in surgery Thursday but feel I might be able to go into the office for a while Monday. The real challenge is not having your leg elevated or being horizontal for a period of at least 8 straight hours. That can feel like an eternity after your knee and leg start to throb due to gravity…

8) Clothing: Bring or have prepared sufficient laundry. I would highly advise getting a pair of “snappy pants” which are also known as tearaway pants such as the basketball players wear during warmups. You can pull the pants apart at the sides as they are held together by snaps. They are utterly INDISPENSIBLE when it comes to ease of putting on and taking off your knee brace if you want a pair of pants that will hide the brace. Also is of great help in changing the bandage, ice, etc. Also a good second is “zippy pants” that will zip on the sides about 1/5 the way up the side of the leg. Same advantages although not as easy to access the whole leg at one shot.

9) Entertainment Unit: Buy the big screen TV. LOL. OK, maybe not essential, but make sure you have a TV or some entertainment device around that has a remote. During some periods you will want to have some brain drain to pass the time.

10) Exercise Gear: Buy/rent exercise bike or other equipment—not really necessary. You can improvise and your PT will tell you what you can do. I am told that access to a swimming pool may come very much in handy down the road. For the first few days your exercises will be mostly simple ones and even afterwards you don’t require anything elaborate.

11) Toiletries: Ensure sufficient toiletries/pharmacy items. If you are staying by yourself, would it be a travesty if you ran out of toilet paper, lol. Make sure you have tylenol or acetominaphen so that you can wean yourself off of the hard drugs sooner rather than later. I am told that they are addictive and also can cause nausea, which they do. Get saran wrap for your leg as you will need to cover your bandage or at least the place where you have had your sutures placed for when you want to shower.

12) Telephone: Buy extra phone for bedside and cordless is priority. Just do it. Having it by your side is so much easier than having to worry about dealing with ones of the corded variety. Make sure to bring your cell phone accessories for your trip, charger and sync cable if applicable.

13) Portable Multimedia: I-Pod? (I have a laptop and loads of MP3s as needed!) It’s nice to have portable entertainment devices to keep near you wherever you may go (or stay for longer periods of time!)

14) Universal remote (optional) Nice to have all your electronic devices controlled by just one unit. Even better when you are laid up. Good but not necessary.

15) Materials: A good collection of books and movies.

16) Pharmaceuticals: Fill prescriptions you may need no later than the day before surgery. At the hospital you’ll get more prescriptions for the “good stuff” (I received “hydrocodone” which I took 4 and stopped promptly) and potentially celebrex.

17) Cash on Hand: Lots of small bills as reiterated above (A GREAT IDEA!!!)

18) Reclining Device: Massaging unit or comfy chair. I found that the CPM machine (constant motion which bends your knee) vibrates and provides massaging. But given the amount of time in a chair or on your back, comfy is good!

19) Water Bottle: Screwtop unbreakable bottle. Need water for survival and best to have a bottle nearby that won’t break, spill or cause a mess easily.

20) Bathroom Necessities: Rubber mats for bathroom and shower. Saran wrap or plastic to wrap the bandaged areas for the first 10-14 days after surgery to protect your sutures and stitched areas from getting wet.

21) Emergency Numbers: Numbers of car services and emergency numbers

22) Insulated Containers: Coolers, thermoses for stockpiling drinks

23) Crutch Carryon: Bag with handle/clip to attach to crutches—this may be more convenient and easier to use than the backpack.

24) Keys: Copies of keys for nearby friends/neighbors

25) Extensions: Extension cords/surge for all appliances nearby

26) Snacks: Not just Snickers but other little munchies, hopefully not too caloric.

27) Straps and Bandages: Velcro strap to hold down ice packs or veggies, ace bandages do the trick well too although may take a little longer to roll.

28) Some people recommend a walker as opposed to crutches. I am able to walk around gingerly after 2 days but this varies according to your doctor.

29) Wireless Router: If using a laptop, you can use a corded connection but really nice to have a wireless router to use so that you can play with the laptop wherever you may be around the house.

30) Fill in the blank. Currently not provided and thought that 30 was a nice, rounded number with which to end the list!

Well, I called Dr. Kelly’s office and left a message with his answering service to call me back on Monday or Tuesday, although I just realized that I’ll be flying on Tuesday to Boston. I remarkably calm because deep down in my heart I KNOW I am going to go through with the surgery and I’m just having the usual fears that come with the unknown. Right now my leg feels stronger than it has been since the injury and I can almost run or at least I feel that I can jog. I tried to run across the street to beat a traffic light but I wasn’t so confident I my feet. I’m not sure I’m that strong.

Yes, I will get the surgery. I can’t be sure that this is the way I want to go through life and it’s taken me 3.5 months just to think about running across a New York City street.