Heather's L knee scope, TTT, and PFJR on 1/26/09

[Heathers new knee]

Hi All:

I started this horrid adventure in May 07 when life turned topsy-turvy on a dime in some very dense fog. SUV versus a ditch and the dashboard won. I suffered a severely communited, displaced patella fracture (approx. 20 fragments) along with alot of subsequent damage to the patellofemoral compartment.

Healing took place post-ORIF and I have had many, MANY months of rehab. I've come a very long way but, pain is still part of my daily life 24/7 to varying degrees throughout the day. Lots of issues with grinding, standing/walking, stairs, etc, etc. I had a consult with my surgeon in Oct and another opinion that month, as well. The bottom line is that the leg is badly needing more rehab but, I've plateaued. A patellectomy was the only surgical option at some point later on.

I was at a cross-road in searching for a patella specialist for more PT input (especially with the quad atrophy) and came across a wonderful OS. He reviewed my x-rays and I set an appt. to meet with him. Completing his own set of BOTH knees, it is quite obvious that maltracking, baja, and the rough/jagged surfaces of the patella (the femoral side doesn't appear to have much cartilage, either) will not improve with PT at this point.

New plan to scope the knee (clean it up, possibly a LR/medial tightening and get a view of how things look), a TTT to correct the baja, and finally the PFJR.

If anyone has advice/suggestion, please do post them! I am expecting about 1 yr of additional rehab and would like some advice as to how to make the most of this. My job requires me to be on my feet 50-60 hours/week, along with crouching, bending, squatting, and occasional kneeling.

Heather 

[Marjan]

Hey Heather.........Ya got your own thread!  WOOHOO...............We'll be here, with you all the way............

marjan

[digginit]

YAY!!!  I think someone earlier called for a party at Heather's thread.  I think now is the time!!!!

I have nothing more constructive to add at this time....

~dig

[Heathers new knee]

Thanks a big bundle Marjan!  

Hey! We can party hop all over the place now Dig! Sounds like fun, it is time for a bit of that, isn't it?

Yeah, I figured I'd better stop being so shy and figure out what I need to know before I take the plunge, aye?

Am I petrified, absolutely yes! I don't know if this will top that post-ORIF OMG! "somebody shoot me" pain but, I'll betcha this doc has some better ammo. He's talking femoral block here. Hmmm....yup the big guns! (I like him, he's my kind of sawbones  ) I'm gonna need it to keep this ROM in check, me thinks. NO MORE MUA's, please.   I'm wondering if I'll have to jump right back into PT the next day like I did after the 2nd surgery, though.

I sure do hope somebody "like" me comes around to tell me they've had all of this and won! I'm thinking spinal versus general again..it was a piece of cake and I liked waking up to numb legs. Wonder if the femoral block could be used later?

Take care and hope you're feeling up to speed real soon! Thanks for your support here!!! Cheers to better Velmo days!

Heather  

[JoniF]

Hey Heather,

How are you feeling?  I'm soo happy to hear you finally have a plan.  I truly hope this is the answer to all of your pain.  I'm still undecided and getting very nervous for my upcoming OS appointment.  Not sure which rout e to take.  I think I will try and put off surgery as long as possible.  How long do they expect your down time and rehab to be?  I'm sure you'll do great  .

Take care and hope to talk to you soon,
Joni

[digginit]

HAHAHAHA!!! What do you mean, you wonder if PT will start the next day.  Mine started the SAME day...lol.  But you are THE woman.  You can't hurt steel. 

~dig

[Heathers new knee]

PT the same day of surgery Dig? Yoweee!  I was beggin' not to have to go the day after the 2nd surgery. Even though the ORIF was horrid in every sense, I still managed to get up the next day, put on the Shox, and GO!! Now that ya mention it, rehabbing new parts would be better than nasty old parts. Something awkardly sexy about being a partially metallic chick, isn't there? Nope! you can't hurt steel...LOL!

Joni:

Lovely to hear from you...I missed ya!!  Please remind me, when is your appt? I was VERY nervous the day I had to see the new doc...felt like doomsday. Even though he'd seen previous x-rays, I was convinced he'd say it wouldn't work after he saw me. Nope! There is a slight risk of failure with the patellar component but, he's done about 137 PFJR's. (I trust him!) He took lots of x-rays that day and still came out with the same plan with one more addition... The TTT!!! Blaha baja, guess it needs to be brought back into orbit as well as centered, too.

Well, I don't think there's an actual set down time on this. It's a go at your comfort-level thing. Immobilization will be for about 2 weeks and crutches for a month or so. Given the condition of my leg going in, rehab will be about another year. That's ok, the pain with it should improve drastically! I was told that if I delayed surgery, the problems could definitely worsen...set me into gear to say Go for it, ya know? I hope you get some good news. Please keep me posted too, ok?

Heather 

[Caroline109]

Heather has her own thread!
Heather has her own thread!


If I hadn;t had to wait in the recovery room 7 hours for a bed, I would've had PT the same day as the surgery too. That was one reason I spent an extra night at the hospital, to get in another PT session, making sure I could go up stairs with my crutches. You'll probably get the same treatment.

[digginit]

HAHA!!  You stayed an extra day so you could conquer the stairs.  I stayed an extra day so I wouldn't come home to my son!  And when I left, it was via rhe elevator...lol. 

I was supposed to be discharged on Thursday, but my son (who was leaving Friday to visit my mom -- remember his first piloting experience?) visited on Wednesday night.  Sawbones was agreeable when I asked for one more day in order to avoid parenting a hyperactive child so soon post-op.

~dig

[Heathers new knee]

Caroline:

Wow! I'm sorry!!! What was the hold up on your room? 7 hours in post-op recovery is a long time. I hope you were comfy!!  

Then again, that would've been plenty of time for me to say ok, I'm checking myself out here...LOL! I hate sleeping in hospitals. With or without pain, I just can't sleep, ya know? < 24 hrs post-ORIF, PT came to my room and said Ready? Ok, so I hit the PCA, ambulated X yds and used the crutches on stairs and called the OS office (from my patient phone, hee-hee!) to say I'd met my discharge criteria. Home now please!   They were a bit stunned but, I went home 2 days early.

Were you immobilized at all or just ace-wrapped? This is gonna be a whole different ball-game, I think/hope.

Ahhh Dig...I know what you mean! Peace and quiet and solitude is the key to recovery. My mother took my youngens ALOT! God bless her, she even cooked for us! I owe her, BIGTIME!!

Have a great night folks! Time for some shut eye before gimpy knee alarm clock decides to awaken me after 3-4 hours of slumber...pretty typical! It also prevails over the new pillow, darn it!!   Ya know, I think I did better on stairs with crutches than I do without 'em now. What's up with that?

Heather 

[rottenkid]

triple  T's they must be huge!!!!

ok my minds out of the gutter well sort of. My PT started 12 hours out of surgery with a Range of Motion machine and how to walk with a walker class. As far as kneeling I am 12 months post op and it still hurts like hell if I don't have my gel knee pads on. I hope yours turns out better.

Heather's own thread

[Plumb]

I decided to stalk your thread Heather  hehe..   My 2 cents is do your exercises and take your drugs and stay in the hospital until the very last second.  I stayed 4 days 3 nights in the hospital.   I was not off and running.  I was crawling and numb at my first walk.  I took a big  ten steps and than was exhausted.   Ask about the cpm machine.   I found it very comfortable I went to sub acute rehab (prob the type of nursing home situation dig visits)   The foot doctor gave me a foot rub and did my toe nails.  The spa..  This way I got to be bent as a pretzel in the morning session and afternoon session.

I stayed away from work for 12 weeks. After the 12 weeks I started to notice increased pain in my hip back but that started to straighten out and than and well other knee started to go to crap. But somehow I am doing fine.  Grumpy at times but fine.  Restless with trying to be patient.   Spoiled maybe that my first implant went so well.

Bottom line  this may sound strange but You been in so much pain for so long.. I am sure this additional surgerys will be a walk in the park pain wise.   I think the longer you have pain the more you get used to it.

 One day your knee will be great

[ghost]

Hey Heather,

Good to see you have you're own thread.

You're going to do great and I bet you'll see a huge improvement in the pain.  I haven't walked down stairs normally in the past 15 months and have been told that I'll never kneel again.  Ain't that grand?  I'm definitely in your camp and will be following closely, as you know from other posts I was told on Christmas eve that this MFX might not work due to the size of the defect so I may be the next one in line for this proceedure.  For the moment, I'm going forward with the deluded belief that this will work and researching the new sawbones recommendations and his proceedures.

No more strange cars in the yard one hopes.

Sue

[Caroline109]

Thing is, after 4 previous knee surgeries, I knew how to do the stairs (especially since the 4th one was only 7 months before and the 3rd one 11 months before) but didn't know that's what we would be doing at that 2nd hospital PT session. I got stuck in the recovery room because there wasn't a bed for me available where the hospital outs ortho patients. I spent the 7 hours mostly sleeping, periodically chatting with the nurses, whom I kept hearing on the phone telling someone that their very nice patient (me) needed a bed, and I threw up once. Hopefully all of that won't happen to me. And when I finally got to leave the RR, the nurses gave me a small plant and some Crabtree and Evelyn body lotion because I had been such a patient patient waiting for my room.
I was just ace-wrapped. For a while, during my stay there, I was in an immobilizer brace which sits now in my bedroom closet. I also spent a few hours in bed with the -can't think of the name of thing that helps move your leg----what is is it called?:?? Someone will say and then I'll say "oh yea."  The ace-bandages stayed on all the time for a week, then weaning from it slowly. By the beginning of the 2nd week, I couldn't stand it and I didn't seem to need it so I stopped (PT guy would remove it for the first week of PT and didn't say anything, so I guess it was okay, when I stopped arriving at PT with it on).
One other helpful bit of advice. I made a bunch of food ahead of time and froze it so my husband, who does like to cook but doesn't sometimes have the time with work. I made chicken soup, stew, and a batch of beef burgundy (with some of the stew meat) and stuck everything into the freezer labelled so all he would have to do is get it defrosted.

[JoniF]

Hi Heather,

It's good to hear from you as well.  I ended up with the flu and the poor me's for awhile as I was in soo much pain from the stupid knees.

I go to the OS Jan 15th, getting very nervous.....I'm glad you were able to find a doc that you trust.  I had a TTT in 1996.  That's great that there is only a slight risk of failure and that your doc has done soo many.  I really hope this is the answer to all of your pain issues.  It sounds like the rehab won't be as bad as we initially thought which is good.

You're going to do great!!!  I'm happy that they are not making you wait too long until surgery, for me the waiting is the worst part.  When I had my major reconstructive surgery back in 1996, I was trying o hold off until I accured enough time off of work and it was coming close to Thanksgiving and my OS was like what are you trying to save it for a CHristmas present.  What a jerk he was.  I'm glad I no longer see him.

Hope all is well on your end.

Take care,
Joni