Here are the exercises that I am currently doing to maintain some strength in my quad/hamstrings and knee; along with flexibility. [Week 1,2,3...]
Warm Up
- Heel Slides (20x, work to 30x)
- Calf Stretch, seated (with strap or band)
Exercises
- Quad Sets (3-5minutes, flex & hold quad for 5sec intervals)
-- At PT I do the quad sets with the E-Stim and do 10sec intervals
- Leg Lifts, with bolster under knees (30x)
- Straight Leg Lifts (laying down, right knee bent, 30x)
At Home I also add:
- Abduction Leg Lifts (30x)
-- Lay on 'good' side and lift 'bad' leg up. Works outside muscles of thigh.
- Adduction Leg Lifts (30x)
-- Lay on 'bad' side, cross good leg over and across, lift bottom leg up. Works inside muscles of thigh.
- Seated Leg Extensions (30x)
-- If you can sit on edge of bed/table & if you can bend to 90deg
-- Sit with legs hanging and knees bent to 90deg, extend leg up and into the straight 0deg position
Final Stretches
- Hamstring Stretch, with strap or band. Lay on back, pull leg (straight) up, toward head. 3x/30sec
- IT Band Stretch, with strap or band. Lay on back, pull leg (straight) up & then across body. Keep foot pulled up toward head. You should feel stretch along outer thigh from knee to butt. 3x/30sec
Keep the rest of your body stretched. You will get sore from crutches (arms, hands, shoulders, back) as well as possibly right leg and hip/glute. Take care of your body - heat and ice work wonders!
**Make sure that you have a pillow or bolster between knees and be very careful of your incision.
**Do not perform if you are in pain or are putting direct pressure on incision.
***Do not worry if you can't do 30x right away. Work up to 10x, then 20x, then 30x... (Most important are the straight leg lifts. Don't worry if you can't do sets of 10 - work to 30 with as many breaks as you need. It's okay to do 2-3, break, do 2-3more. Push to 30 - you can do it!)
DON'T GIVE UP & DON'T GET DISCOURAGED! YOU CAN DO THIS!
Showing posts with label Reconstruction. Show all posts
Showing posts with label Reconstruction. Show all posts
Tuesday, June 5, 2012
Week 2 - Progressing...
I wanted to share some overall comments about how my first 2 weeks post-op have been.
On the day of the surgery - I was surprisingly awake, came home, and did very well. Day 2 was definitely the hardest. I would say that the most difficult days were day 2 - 5. As I was told and read in several places - STAY AHEAD OF THE PAIN. Take the medicine every 4-6 hrs, elevate constantly and ice 4-6x day. I found that for me, until day 6 I had to take the pain meds every 4 hrs. I tried every 6hrs at first but it would take too much time to kick in. Taking them every 4-5 hrs allowed the medicine time to get in my system before the last dose completely wore off. My day 6 I started to take 1 pill instead of 2 and move to every 6 hrs. By Day 8 I was no longer taking meds during the day. I still take them to sleep at night so that I don't move and get some deeper sleep. Also - make sure you're elevating when you sleep!! I was also given medicine for nausea along with a stool softener. If you take the nausea meds (even if you're not nauseous) it will intensify the pain meds and also help you sleep. I made sure I did that at night in particular. Do take the stool softener too with a lot of water. You're whole body is not used to being shocked by pain meds or anesthesia. It can affect your whole body for several days. I noticed that it hindered some of my digestion and also dried out my skin and face. This is normal. Plus, showering is difficult so I was not keeping up with my usual regimen of washing my hair as often, washing my face in am and pm, or applying lotion everyday. I could definitely tell the difference after the first week. However, you have to just accept it and allow yourself to rest and take the meds for the first week or so until you're body can adjust and detox.
Some other things you can do to help your body: Drink A LOT OF WATER. I also recommend adding lemon because it naturally helps to cleanse and detoxify your body. Probiotics and digestive enzymes can also help your overall stomach/intestine/digestive health if you take them as directed. I take a probiotic in am and pm (on empty stomach) and digestive enzyme with each meal. I am also gluten intolerant and dairy sensitive so watching what I eat is imperative, particularly now that I've just been through surgery and am on strong medication!
Make sure that you start moving and stretching ASAP. I'm non weight bearing - but that doesn't mean I can't do leg lifts for strength and work on my flexibility. (I will post my current PT workouts soon). My brace is unlocked so I'm working up to 90deg. I was able to do this by the end of the first week. That is my limit still at week 2.
Once I began the second week, along with physical therapy my energy levels began to improve. Because I was doing PT prior to my surgery and I have a good grasp on what to do and my body limits, I've chosen to do PT twice a week. I can do the rest at home. I know when I begin walking again I will need to go at least 3x/wk to utilize more of the equipment and machines.
I spend a lot of time on the couch (not the most fun, I know). I keep my leg elevated most of the day unless I have an appointment or need to run an errand. The rest of the day revolves around trying to cook my food and plan when I need help during the week.
I think I am progressing well. I have my week 2 follow up tomorrow - my sutures will come out from the arthroscope but not the 2 larger incisions. I'm doing my best to keep my outlook positive and do my exercises each night. I will say that the overcompensation is affecting my right leg/hip. I look forward to when I can begin proper weight transfer again.
6 weeks until I'm weight bearing!!
On the day of the surgery - I was surprisingly awake, came home, and did very well. Day 2 was definitely the hardest. I would say that the most difficult days were day 2 - 5. As I was told and read in several places - STAY AHEAD OF THE PAIN. Take the medicine every 4-6 hrs, elevate constantly and ice 4-6x day. I found that for me, until day 6 I had to take the pain meds every 4 hrs. I tried every 6hrs at first but it would take too much time to kick in. Taking them every 4-5 hrs allowed the medicine time to get in my system before the last dose completely wore off. My day 6 I started to take 1 pill instead of 2 and move to every 6 hrs. By Day 8 I was no longer taking meds during the day. I still take them to sleep at night so that I don't move and get some deeper sleep. Also - make sure you're elevating when you sleep!! I was also given medicine for nausea along with a stool softener. If you take the nausea meds (even if you're not nauseous) it will intensify the pain meds and also help you sleep. I made sure I did that at night in particular. Do take the stool softener too with a lot of water. You're whole body is not used to being shocked by pain meds or anesthesia. It can affect your whole body for several days. I noticed that it hindered some of my digestion and also dried out my skin and face. This is normal. Plus, showering is difficult so I was not keeping up with my usual regimen of washing my hair as often, washing my face in am and pm, or applying lotion everyday. I could definitely tell the difference after the first week. However, you have to just accept it and allow yourself to rest and take the meds for the first week or so until you're body can adjust and detox.
Some other things you can do to help your body: Drink A LOT OF WATER. I also recommend adding lemon because it naturally helps to cleanse and detoxify your body. Probiotics and digestive enzymes can also help your overall stomach/intestine/digestive health if you take them as directed. I take a probiotic in am and pm (on empty stomach) and digestive enzyme with each meal. I am also gluten intolerant and dairy sensitive so watching what I eat is imperative, particularly now that I've just been through surgery and am on strong medication!
Make sure that you start moving and stretching ASAP. I'm non weight bearing - but that doesn't mean I can't do leg lifts for strength and work on my flexibility. (I will post my current PT workouts soon). My brace is unlocked so I'm working up to 90deg. I was able to do this by the end of the first week. That is my limit still at week 2.
Once I began the second week, along with physical therapy my energy levels began to improve. Because I was doing PT prior to my surgery and I have a good grasp on what to do and my body limits, I've chosen to do PT twice a week. I can do the rest at home. I know when I begin walking again I will need to go at least 3x/wk to utilize more of the equipment and machines.
I spend a lot of time on the couch (not the most fun, I know). I keep my leg elevated most of the day unless I have an appointment or need to run an errand. The rest of the day revolves around trying to cook my food and plan when I need help during the week.
I think I am progressing well. I have my week 2 follow up tomorrow - my sutures will come out from the arthroscope but not the 2 larger incisions. I'm doing my best to keep my outlook positive and do my exercises each night. I will say that the overcompensation is affecting my right leg/hip. I look forward to when I can begin proper weight transfer again.
6 weeks until I'm weight bearing!!
Items to Make Limited Mobility Easier
It's been quite a few days since I wrote a new post. I've been busy and my energy each day still varies quite a bit. Now I've got some catching up to do!
Some items that I have received lately that help immensely (and I highly recommend!):
1. Shower Chair (with back): This makes taking a shower much less uncomfortable. It fits in the shower properly. I don't have to sit partially on the shower curtain to make sure water isn't spewing out onto the floor. The back supports me and allows me to sit up and not awkwardly lean back, especially when I am washing my hair. A hand held shower head with hose is a MUST. The back on the chair also helps because you can drape the hose on it and keep it closer to you. I can't wait until I can stand up to shower - and more than anything, just let the water run down on me for the entire shower. It gets cold sitting there and only being able to wash small parts of your body at a time. I definitely recommend putting your shower items as low as possible so you can reach them (and don't forget a trash bag to cover your knee!).
2. Wheelchair: If you're home as the space, this has been a lifesaver! I was able to get a script to rent the wheelchair until I am weight bearing again (2mo). The place where it is the most helpful is in the kitchen. For me, I was able to move my bedroom to the main floor for the time being. My wheelchair only can fit between the kitchen, living room, and dining room. Due to the layout of our stairs and where my bedroom is, I can't fit it through that particular hallway. However, I can tolerate using my crutches around my bedroom. In the am, once I'm ready I crutch to the main part of the house, and then I can transfer to my wheelchair to use for the majority of the day. It makes cooking much easier since I am able to sit instead of stand awkwardly on one leg for an extended period of time which causes me pain in the foot of my injured leg and the hip of my good leg. It did take some getting used to in terms of maneuvering. You have to be strategic how you move and how to place things to cook. But, once you get a few major items arranged in the kitchen to where you can reach them - you are able to cook for yourself. (This is imperative for me because I live alone!) I won't lie - cooking is much more time consuming this way. My stove is in an awkward location so I do a lot of turning and rotating to cut/chop food and then transfer and stir things on the stove. I do my best and try to make fairly simple dishes. One of the most important goals for me is to still eat healthy and make sure I have my veggies.
3. CrutchBuddies!: I recently ordered a set of crutch covers, grips, and a pouch from Crutchbuddies.com These have been another lifesaver! The covers for the part of the crutch that goes under your arms is so soft and cushioned. It also has a fleece covering so it is soft against the skin. This has really helped calm the irritation and chaffing I was getting. The hand grips are also very soft and comfy. Lastly, I got a pouch as well. It is a great way to be able to carry my phone, keys and other small items that I take around the house and into and out of my bedroom. I got mine in leopard print! Gotta be stylish!!
4. Lap Tray (for wheelchair): If you get a wheelchair - I recommend getting some type of lap tray/table as well as possibly as pouch or bag. The tray for me is helpful because I can carry drinks and food that is hot much more easily from room to room. My set up doesn't allow me to eat in the kitchen so I have to take my meals to the living room so I can sit comfortable with my leg elevated. If I have a plate that isn't hot, I just set in on my lap - but that's not always the case so the tray is very helpful. And now I can bring hot tea to the couch and enjoy it at night! The pouch is nice here too - just as it is with the crutches.
5. Temp Handicap Parking Tag: Luckily, I can still drive because my surgery was on my left leg. As I've mentioned, I live alone so I don't have anyone to drive me to regular doc and physical therapy appointments. (Yes, I do have to recruit people to take me grocery shopping because I can't carry things into the house). I spoke with my doc about a temp parking tag so that while I am non weight bearing I can park closer when I am at the store, etc. Being on crutches is exhausting in itself, and even more so when you're non weight bearing. If you're able to get this - it's a great help and also a good way not to over strain yourself while you're in the most important phase of recovery.
Do you have any at home items or layouts that have helped assist you when you're in the recovery phase??
Some items that I have received lately that help immensely (and I highly recommend!):
1. Shower Chair (with back): This makes taking a shower much less uncomfortable. It fits in the shower properly. I don't have to sit partially on the shower curtain to make sure water isn't spewing out onto the floor. The back supports me and allows me to sit up and not awkwardly lean back, especially when I am washing my hair. A hand held shower head with hose is a MUST. The back on the chair also helps because you can drape the hose on it and keep it closer to you. I can't wait until I can stand up to shower - and more than anything, just let the water run down on me for the entire shower. It gets cold sitting there and only being able to wash small parts of your body at a time. I definitely recommend putting your shower items as low as possible so you can reach them (and don't forget a trash bag to cover your knee!).
2. Wheelchair: If you're home as the space, this has been a lifesaver! I was able to get a script to rent the wheelchair until I am weight bearing again (2mo). The place where it is the most helpful is in the kitchen. For me, I was able to move my bedroom to the main floor for the time being. My wheelchair only can fit between the kitchen, living room, and dining room. Due to the layout of our stairs and where my bedroom is, I can't fit it through that particular hallway. However, I can tolerate using my crutches around my bedroom. In the am, once I'm ready I crutch to the main part of the house, and then I can transfer to my wheelchair to use for the majority of the day. It makes cooking much easier since I am able to sit instead of stand awkwardly on one leg for an extended period of time which causes me pain in the foot of my injured leg and the hip of my good leg. It did take some getting used to in terms of maneuvering. You have to be strategic how you move and how to place things to cook. But, once you get a few major items arranged in the kitchen to where you can reach them - you are able to cook for yourself. (This is imperative for me because I live alone!) I won't lie - cooking is much more time consuming this way. My stove is in an awkward location so I do a lot of turning and rotating to cut/chop food and then transfer and stir things on the stove. I do my best and try to make fairly simple dishes. One of the most important goals for me is to still eat healthy and make sure I have my veggies.
3. CrutchBuddies!: I recently ordered a set of crutch covers, grips, and a pouch from Crutchbuddies.com These have been another lifesaver! The covers for the part of the crutch that goes under your arms is so soft and cushioned. It also has a fleece covering so it is soft against the skin. This has really helped calm the irritation and chaffing I was getting. The hand grips are also very soft and comfy. Lastly, I got a pouch as well. It is a great way to be able to carry my phone, keys and other small items that I take around the house and into and out of my bedroom. I got mine in leopard print! Gotta be stylish!!
4. Lap Tray (for wheelchair): If you get a wheelchair - I recommend getting some type of lap tray/table as well as possibly as pouch or bag. The tray for me is helpful because I can carry drinks and food that is hot much more easily from room to room. My set up doesn't allow me to eat in the kitchen so I have to take my meals to the living room so I can sit comfortable with my leg elevated. If I have a plate that isn't hot, I just set in on my lap - but that's not always the case so the tray is very helpful. And now I can bring hot tea to the couch and enjoy it at night! The pouch is nice here too - just as it is with the crutches.
5. Temp Handicap Parking Tag: Luckily, I can still drive because my surgery was on my left leg. As I've mentioned, I live alone so I don't have anyone to drive me to regular doc and physical therapy appointments. (Yes, I do have to recruit people to take me grocery shopping because I can't carry things into the house). I spoke with my doc about a temp parking tag so that while I am non weight bearing I can park closer when I am at the store, etc. Being on crutches is exhausting in itself, and even more so when you're non weight bearing. If you're able to get this - it's a great help and also a good way not to over strain yourself while you're in the most important phase of recovery.
Do you have any at home items or layouts that have helped assist you when you're in the recovery phase??
Wednesday, May 30, 2012
Week 1 - Follow Up & Take a Look at the Incision!
At my Week 1 Follow up I got to see my incisions for the first time. The surgeon also reviewed all the scope pictures, xrays, etc with me. There are 2 larger incisions and 3 small incisions from the arthroscope.
If you're unfamiliar with this surgery, or haven't read some of my other posts. I had MPFL Reconstruction and Microfracture. MPFL (medial patello-femoral ligament) Reconstruction consists of attaching a new ligament from the femur into the patella for lateral stability. Microfracture is an "articular cartilage repair surgical technique that works by creating tiny fractures in the underlying bone. This causes new cartilage to develop from a so-called super-clot." (Wiki) Essentially this creates a form of padding because you cannot replace/add or regrow actual cartilage. I had this done on the lateral femoral condyle portion of my femur. I had severe cartilage damage in that location from when the patella would dislocate and upon snapping back in place it would hit and scrap the outside of my femur. I also have a lot of cartilage damage on the underside of my patella but there is really nothing they can do (along with some small fracturing). I will have to be conscious of my knees in the future because I am a candidate for early arthritis.
Below are the pictures of my knee 1 week post surgery along with the brace I will be in for the next (at least) 3 months.
If you're unfamiliar with this surgery, or haven't read some of my other posts. I had MPFL Reconstruction and Microfracture. MPFL (medial patello-femoral ligament) Reconstruction consists of attaching a new ligament from the femur into the patella for lateral stability. Microfracture is an "articular cartilage repair surgical technique that works by creating tiny fractures in the underlying bone. This causes new cartilage to develop from a so-called super-clot." (Wiki) Essentially this creates a form of padding because you cannot replace/add or regrow actual cartilage. I had this done on the lateral femoral condyle portion of my femur. I had severe cartilage damage in that location from when the patella would dislocate and upon snapping back in place it would hit and scrap the outside of my femur. I also have a lot of cartilage damage on the underside of my patella but there is really nothing they can do (along with some small fracturing). I will have to be conscious of my knees in the future because I am a candidate for early arthritis.
Below are the pictures of my knee 1 week post surgery along with the brace I will be in for the next (at least) 3 months.
 |
| Original Ace Bandage with Knee Still Wrapped Beneath from Surgery |
 |
| With Brace |
 |
| Top View, Left Knee. 2 Large Incisions with 3 Smaller Scope Incisions |
 |
| Side View, Left Knee (from Inside of Knee), Better Shot of Two Incisions |
 |
| Side View, Left Knee (from Outside of Knee), sorry for the upside down photo! |
Wednesday, May 23, 2012
Day 1 - Post Op
As expected, today was definitely more difficult and painful than yesterday was. After coming home from the surgery yesterday afternoon I was sore, but it was tolerable and I stayed awake the entire afternoon and evening. I took my pain meds every six hours as prescribed. I was due for another dose at 1am - I knew I wouldn't make it through the whole night without them. I tried going to bed around 11pm...but set an alarm for my meds. By midnight I was already uncomfortable in bed and took my Lortab an hour early so that it would have time to kick in.
I did get some sleep, but woke up at 3am in a lot of stiff and pressure type pain. I had to wake up my boyfriend so he could get me wrapped up in ice. That alleviated some of the issue. I stayed awake for a good hour before I was able to doze off again. I made it until almost 730am when I needed another dose. Elevating the leg really does help. And for as much as it hurts to be standing and having the pressure and weight of my leg/bandage/brace it is necessary to change positions as much as tolerated so the leg doesn't lock. I've been doing my best to keep my foot and ankle moving to keep up the blood flow and prevent additional swelling or potential blood clots.
Once I ate breakfast and got back up to the couch I was a little better. I did doze off more often today. I'm much more tired and sore. I can feel more pain in the area of the incision and have been taking the meds closer to every 4 hours. I also started to feel some of the nausea. It's hard because you need to eat with the meds - but you also don't want very much either. I also have noticed I'm a lot more shaky and irritable (the lack of sleep probably isn't helping either!).
Tonight we attempted a shower...it was so difficult because I can't get my leg wet. Good thing I just got a nice hand held shower head and that I have some good core strength! My boyfriend had to help me a lot. I did my best to leave my bad leg out of the tub and sit on the edges. Then trying to do my hair without washing tons of water out and all over the floor was quite a challenge. The whole ordeal exhausted me. Hence why I am currently back in bed awaiting some dinner with my leg wrapped back up in ice.
Hopefully I will sleep through more of tonight and tomorrow will be better....
The doctor who called to check on me earlier today said that if I take the pain meds - followed by the nausea medication (even if I'm not nauseous) 2 hours later - the combination should enhance the pain medication and also put me to sleep. I'm going to try that before bed because I have yet to get any kind of deep sleep since 2 days before the operation.
I did get some sleep, but woke up at 3am in a lot of stiff and pressure type pain. I had to wake up my boyfriend so he could get me wrapped up in ice. That alleviated some of the issue. I stayed awake for a good hour before I was able to doze off again. I made it until almost 730am when I needed another dose. Elevating the leg really does help. And for as much as it hurts to be standing and having the pressure and weight of my leg/bandage/brace it is necessary to change positions as much as tolerated so the leg doesn't lock. I've been doing my best to keep my foot and ankle moving to keep up the blood flow and prevent additional swelling or potential blood clots.
Once I ate breakfast and got back up to the couch I was a little better. I did doze off more often today. I'm much more tired and sore. I can feel more pain in the area of the incision and have been taking the meds closer to every 4 hours. I also started to feel some of the nausea. It's hard because you need to eat with the meds - but you also don't want very much either. I also have noticed I'm a lot more shaky and irritable (the lack of sleep probably isn't helping either!).
Tonight we attempted a shower...it was so difficult because I can't get my leg wet. Good thing I just got a nice hand held shower head and that I have some good core strength! My boyfriend had to help me a lot. I did my best to leave my bad leg out of the tub and sit on the edges. Then trying to do my hair without washing tons of water out and all over the floor was quite a challenge. The whole ordeal exhausted me. Hence why I am currently back in bed awaiting some dinner with my leg wrapped back up in ice.
Hopefully I will sleep through more of tonight and tomorrow will be better....
The doctor who called to check on me earlier today said that if I take the pain meds - followed by the nausea medication (even if I'm not nauseous) 2 hours later - the combination should enhance the pain medication and also put me to sleep. I'm going to try that before bed because I have yet to get any kind of deep sleep since 2 days before the operation.
Tuesday, May 22, 2012
Surgery Day! (22 May 2012)
Surgery today actually went really well. We reported to the hospital at 0545 - bright and early! Things moved along very quickly. I was checked in and prepped almost immediately. Then, before 0645 I was back in the OR Holding room to start my IV, etc. I was quite nervous (I don't do well with hospitals and needles) but everyone was really nice and caring. The only time I can say I really started to not feel well, besides basic queasy nerves, was the first IV bag of meds - I think the drip rate was way too fast. Once they slowed it down I was fine, but initially I started to feel very light headed, nauseous, and also very hot and sweaty.
I did opt to have a femoral nerve block along with the general anesthesia. It is supposed to block feeling to my leg and last longer than a general pain med. The doc was great about explaining it, taking me through it and showing it to me on the ultrasound. Essentially they give you some 'happy meds' so you don't even know what is going on, and they have a special injection that goes into a nerve bundle near your groin to block the leg to be operated on.
I was the first person of the day wheeled back into the OR. I believe I was into surgery just after 0700. Next thing I knew, it was just after 1000 and I was in the Post-Op Recovery room. The 'block' wore off a lot quicker than anticipated. I could move my ankles/feet/toes right away and needed meds quickly to dull the pain to make it manageable. Overall, I woke up and came to easily and quickly. The surgeon came in quickly, then went to talk to my boyfriend almost right away. The surgeon will call me tomorrow; he had to get to another surgery asap. He said everything went very well. Ligament was a donor and that portion of the MPFL reconstruction went exactly as planned. I did have significant cartilage damage though. Therefore he did have to perform the micro fracture on the lateral femoral condyle. (This mean he drilled small holes in my femur to allow blood supply to flow through and clot; it creates an additional padding since cartilage cannot be added or repaired). This means that I will be non weight bearing for 8 wks.
Soon after I was brought back to my room where my boyfriend was waiting for me. They tracked my vitals for an hour (which was required) and made sure the pain was manageable and under control. I was able to start eating and drinking right away with no nausea which was very good. They let me dress and try to go the bathroom. That was very hard at first - standing sent a lot of pressure to my leg. Also - trying to not bear any weight on my leg was difficult considering my whole body was tired and shaky from all the medications.
Around 1230 we left the hospital to head home. Got some food and I've been relaxing on the couch with ice since. I still feel quite awake and good. The soreness and stiffness is definitely starting to increase though. I'm sure that will be the hard part for at least the first few days.
My boyfriend and a few other close friends are going to begin moving my bedroom up to the main floor tomorrow. There is no way I'm going to be able to live downstairs and go up and down daily solely with crutches/no weight for 2 months!
Current prognosis: non weight bearing for eight (8) weeks, wear brace every day at all times for 3 months expect when doing range of motion stretching, start physical therapy (PT) right away (already made an appointment for Friday afternoon), take pain meds and elevate and ice 4-6x day.
My 1st week follow-up is Wed. May 30th. Luckily my boyfriend will still be here to take me to that which is great (before he leaves that afternoon). I will leave my dressing on and in place until that time. I can't see anything really. My entire leg is covered in an ACE wrap over the wound dressing and I have a nice, new and large adjustable immobilizer style brace. I'm interested to find out what the scar actually will look like.
I think that's about everything. Hopefully things will continue to get better from here. Today was what I was the most nervous about and that is now over. I'm hopeful that if I follow the doctors orders and take it slow I will make a full recovery by the end of the year (they have given me a 6mo timeline until full 'unrestricted' recovery.
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