How to get your ACL surgery canceled
Nobody wants to need surgery, but when you do - if you’re at all like me - you want to get it over and done with as fast as possible so that you can start on the road to recovery. As it turns out, though, that can be easier said than done. Being on the surgery schedule, completing all pre-op requirements, and even being hooked up to an IV in the surgical center are not guarantees that you’ll actually get sliced.
So, if you’re trying to avoid speed bumps and make sure your surgery goes off as planned, or you find yourself having second thoughts after you’ve been scheduled to go under the knife, here are a few author-tested ways to get your surgery canceled, or at least postponed.*
* I think this goes without saying, but I am NOT a doctor and do not have any medical training. This list is based on my personal experience and research, and should not be considered medical advice. In fact, my sarcastic rantings probably shouldn’t be considered advice of any kind.
Get Knocked Up
Being pregnant is a guaranteed way to get your elective surgery canceled. Because of the risks to the fetus, surgeons are SO strict about not operating during pregnancy unless it is absolutely necessary, they administer a pregnancy test to anyone over the age of 12 with a uterus.
How I know this: By the time I was scheduled for my ACL replacement last January, my partner and I had been trying unsuccessfully to get pregnant for 6 months. When we found out I needed surgery, we stopped trying for a baby and started prepping for my recovery. So, naturally, at my pre-op workup, we found out that I was pregnant. We were overjoyed at our success (if a little confused about how it had happened), and we pivoted to physical therapy to sustain my knee until we could reschedule my surgery safely.
The pros of getting rescheduled because of pregnancy: you usually find out a few days before surgery at your pre-op appointment, so you avoid the hassle of fasting, driving to the hospital, and getting all drugged up. Also, if you’re hoping for a baby, congratulations, you’re one step closer!
Length of delay: until you’re no-longer pregnant or breastfeeding (they try to avoid passing narcotic painkillers to newborns…)
2. Re-injure the injury
If you’re an active person, the last thing you want is to be side-lined by an injury. So if, like me, you are able to heal enough with PT to resume being active between the initial injury and surgery, you might be tempted to push it. Let’s say your doctor unequivocally declares, “no skiing until this is fixed.” You - the strong, badass PT star that you are - might interpret that as, “If you wear a brace, you can take your newly-jacked glutes and quads for a spin on some green runs with your beginner-skier spouse as long as you don’t fall.” After all, what are you going to do, tear your knee again? Well, as it turns out, you might, and that would suck.
How I know this: After the pregnancy that canceled my 2021 surgery ended in miscarriage, I NEEDED to get back into my body, and to get my body into the outdoors. I’d diligently completed PT, passing my discharge test with flying colors. I’d established an exercise routine to keep my quads and glutes strong enough to support my injured knee, and I’d followed the run-walk protocol that my doc recommended I use if I insisted on getting back into running. So, I figured I’d see how far I could push it. I started hiking. And trail running. And doing yoga. And a playing with a slew of other activities that had been on the pre-surgery no-no list. I was careful, I listened to my body, but I definitely pushed my limits. By the time I decided I was ready to slow down and go under the knife (read: when snow fell and I realized, despite my summer indiscretions, there was no way I had the lady balls to take my busted knee skiing) I headed back to the surgeon for an exam. And he sent me packing, saying that my knee was way too inflamed for him to schedule surgery. I needed to wait 30 days for the swelling to go down and my range of motion to be restored before he could evaluate me and get me on the docket.
The pros of re-injuring the injury: as long as you haven’t grievously hurt yourself, you’ll likely just get postponed until any swelling subsides, which is roughly a month. The cons: If you worsen the injury enough, it could change the procedure that needs to be performed. In my case, there is a chance that all my activity worsened my meniscus tear enough that it’ll take two surgeries to repair the meniscus and ACL. Different/more complicated procedures mean higher risk and longer recovery.
Length of delay: ~ 1 month
3. Cut yourself shaving
Less commitment-intensive than pregnancy and less risky than re-injuring yourself, getting a nick from shaving (or really any type of cut or scrape in the area of the surgery) is an unexpected option for getting surgery postponed. It makes sense if you think about it. Infection is a risk with any surgery, and even though the chances are super low (0.5-1% with ACL replacement), surgeons take it really seriously. For this reason, any abrasion near the incision site raises a red flag.
How I know this: A year after my original surgery date, I was no longer pregnant and my knee was inflammation-free, so we decided to try this whole surgery thing again. I’d completed my pre-op checkups, passed my COVID test, and followed every rule in my pre-op instructions. Those instructions, which were comprehensive, specifically stated that it is OK to shower within 24 hours of your surgery. So, since I’m a civilized dirtbagger, I hopped into the shower the night before, washed my hair for the last time til my sutures are removed, and shaved my legs. My logic: my surgeon is nice enough to fix my knee; he shouldn’t have to wade through stubble in order to do it!
Now, I’ve been shaving daily since I was 15, and I think I am pretty damn good at it. Some would even say expert. On this particular evening, though, I was exhausted from a hectic day trying to wrap up loose ends at work, shaky from an aggressive last spin on the bike trainer, and a little stressed about the prospect of fasting until 5 pm the next day. My hands shook, my razor slipped, and I slashed a nice gash through my leg, right next to my operable knee. After getting over the initial shock of what had just happened - I NEVER cut myself shaving! - I toweled off, slapped a bandaid on it, and hit the sack.
The next day I rolled out of bed, hungry and dehydrated, and drove the hour through a snowstorm to the OR. 2 hours after checking in, hooked up to numerous leads and an IV, I chatted with my surgeon about the procedure. As he walked me through a standard questionnaire, one question elicited a very un-doctor-like smirk. “Now, I have to ask because we’re in Boulder… do you have hairy legs?” “No!” I shot back. “They’re silky smooth… in fact, I cut myself up good getting them that way for ya!” His grin faded immediately and was replaced with a look of concern. “Let’s see it,” he said, suddenly very matter-of-fact. Confused, I pulled back my hospital gown to reveal a small, half inch scrape on my inner knee. At the sight of his expression, my heart sank. Something was clearly very wrong.
Patiently, he explained to me that a cut in the vicinity of the incision increases the risk of infection. For a graft like he is performing, it can double the risk. While the odds are still pretty low, he stressed, the consequences of infection are major. “I’ve given you the information, but I need you to make the call,” he said. “I’ll give you a few minutes to think it over.” The conversation with my partner that ensued featured crying, cursing, and a lot of second guessing. Finally, we concluded that regardless of the odds, if my badass surgeon wasn’t stoked on it then neither were we.
When we gave the doc the news, his relief was palpable. “I didn’t want to pressure you,” he admitted, “but if you were my daughter, I wouldn’t have let you have the surgery.” And so, just two hours from when I’d have been discharged, they detached my IV and the leads, returned my clothing, and sent me home with a promise to get me back in the following week once my cut had healed.
The pros of postponing due to a cut: you can get rescheduled as soon as the cut heals. The cons: It is really damn easy to get cuts and scrapes near your incision site, so if you are gung ho about getting your surgery (like I was), this reason for scrapping it really sucks. Ironically, within hours of getting home, my cat jumped onto my lap and sank her claws right into my operable knee. I cursed, cleaned the punctures with peroxide, and vowed to wear knee pads in the days leading up to surgery!
Bonus: The hospital updated their pre-op instructions immediately after they discharged me. The top shot is my original instructions. The bottom shot is the version I received today for next week’s surgery!
Runners Up: Other things that can put your surgery in jeopardy
Getting COVID
This one hasn’t happened to me personally, but I’ve had a few friends who have been rescheduled because of the dreaded Rona. You see, the beauty of elective surgery is just that… it’s a choice. Which means that during a pandemic, when doctors and hospital staff are highly motivated to avoid spreading the disease, a positive COVID test can be your undoing. I was required to take a COVID test the Monday prior to surgery and then quarantine until my procedure. That seems easy enough on it’s face, but when you realize that the test you’re getting is a PCR test, and highly sensitive PCR tests can detect infections that happened as early as 30 - 90 days prior, the needed quarantine period becomes a little ridiculous. Out of an abundance of caution, we quarantined for 2 weeks prior to my COVID test in hopes that avoiding catching Omicron immediately prior to my test would be good enough, and it was. Were we maybe a little too paranoid? Perhaps, but I’d hate to end up on the no-go list because I just couldn’t handle skipping a dine-out date night.
Taking forbidden meds
As I mentioned above, the list of pre-op instructions are long. Among them is a list of medications to avoid prior to surgery. Some of those restrictions start as long as a week before your procedure. If, like me, you received your pre-op instructions 72 hours before surgery, you could be in violation and not even know it. Instructions surely differ based on procedure and hospital, but mine advised patients to avoid painkillers that are also blood thinners (Aspirin, Ibuprofen, Motrin, Aleve, etc…) for 7 days prior to surgery. They also recommended discontinuing ALL over the counter medications and supplements for the week prior. I’m not sure that popping an Ibuprofen after a taxing weekend workout or taking your daily multivitamin would be enough to get you axed from the surgery schedule, but it’s definitely not recommended. And marijuana use anytime in the 24 hours prior to going under the knife is sure to have repercussions, as it can mess with your anesthesia, and who wants to risk that?!
Wearing makeup, lotion, or your grandma’s lucky earrings
For my outdoorsy, dirtbaggy friends this one might be a non-issue, but if you’re like me and you like to go into shitty situations looking and feeling good, this is one to pay attention to. I am not usually much of a makeup person, but after reading numerous accounts of how crumby I’d feel after surgery, I decided I’d follow a practice I started in my early 20s days in Advertising. After grueling all-nighters spent prepping for last minute pitches, I’d go home, hop into the shower, get all gussied up, and come back to work not having slept but looking like a million bucks. It helped me get my head in the game when my body really wasn’t feeling it. When it came to surgery, I figured I’d go in looking my best and hope that I came out the other side feeling crummy but capable of dealing with it.
Luckily, my pre-op instructions clearly spelled out the perils of makeup (it can hinder doctors’ ability to monitor your health via your appearance and flecks can get into places where you don’t want them), lotion (risk for infection), fragrances (can be an irritant for the folks working on you and you don’t want them sneezing into your gaping wound, plus some fragrances are apparently flammable?!), and metal jewelry (can impact electrocautery, the technique routinely used to electrically seal bleeding vessels, and cause burns).
It turns out, the best strategy for the big day is to toss on some sweats and a sports bra and your favorite race t-shirt and embrace it!