My December 15 Denovo NT with TTT

[cdubb]

Martialartist/Dan,
You need over 20 posting to send a PM.  I sent you one earlier with my docs information also. Did you get that?

[KW]

Martialartist/Kasiany - You need to have 21 posts in order to send a PM.  It is a safety feature to make sure you are a real lift human being and not a Spambot.  If you go play in the games room you will get to 21 posts in no time.

Happy Healing,
Karen

[kasia_ny]

Hello Everyone,
I had my first PT tomorrow.  I was afraid of the whole drive and crutching into there, but it turned out to be okay.  I am actually pretty good on crutches!
PT evaluated me and did some of the same exercises I am supposed to do at home.  It helped a lot in a sense that now I am not afraid to do them on my own.  He wants me to do as many quad sets as I can, try straight leg raises, ankle pumps, 30-degree flexions and hyperextensions 4-5 times a day and see him next Monday.  Also, I am supposed to increase my CPM from 30 degrees to 40 by that time.

Courtney,
I do not experience "blood rush" while going vertical at all.  I can see that it happens to many.  I wonder is it because of the pain meds, or it is just not happening to me?  Being on pain meds, my pain level is at 3 out of 10 right now.  I am not inclined to try weaning off them yet.

Dan,
I will send you the info once I can!
Kasia

[cdubb]

Kasia,
I didn't get them until about 6-7 days out, but I was told that was uncommon.  I would also only describe it as pressure increase, but others describe severe pain.  It was about the time I was starting to reduce pain meds though...so maybe that's why I began to experience them at that time.  3/10 is about where I floated at for a while.  I wouldn't start weaning off yet...and when you do, do it slowly and don't go cold turkey.  I was a little over 2 weeks out and I woke up feeling okay, so I decided to not take any.  About lunchtime (12 hours since no pain meds), I began to feel awful. I was nauseaus, headache, full body aches and felt like I was getting the flu.  About 5 pm that day, I took some Norco and everything resolved in about 30 minutes.  I am pretty sure I was experiencing some mild withdrawal.  So, then I decided to drop from taking 2 Norco, down to 1 Norco and then space out the 1 Norco and then ultimately discontinue.  So...moral of the story...reduce your dosage before you just stop. 

Good luck in PT. It's pretty boring for a while...well...I'm 6 weeks out and it's still boring... it's a slow protocol and I think a patella Denovo/TT protocol is probably very similar to a patella ACI/TT.  Protect the WB to allow the TT to heal, avoid shearing forces to protect the graft and restore quad control.   It seems like I'm so far ahead of you, but in reality, 6 weeks for this surgery and recovery isn't really too much.  I've heard Denovo seems to recover quicker than ACI also...so I'll be interested to see if you pass me up or not. 

[kasia_ny]

Courtney,
This sounds like a withdrawal.  I was warned by the doctor not to do this this way.  I was also told to stay on my meds at the comfortable level.  I think that is where I am at now, the overall level is 3 out of 10, but I am also having pulsating bouts of pain from time to time around my kneecap. 
Today I woke up and felt really stiff and felt like doing the CPM right away.  Funny, but I like being on it more and more.  I also increased from 30 degrees flexion to 33 today.  The goal from my PT is 40 by Monday.  How long did you do the CPM for?  I have it rented for 3 weeks (insurance covers it). The ice machine I somehow use less.  It makes me really cold very quickly, despite the heavy comforter, so I just use it for 20 minutes every 3-4 hours or so.
I have the pictures from my surgery.  They are pretty cool.  If you want, I can send them to you once we scan them.
I hope you are doing well today,
Kasia

[martialartist]

Courtney, I did receive your PM thanks.  I cannot reply to it.  Glad everyone is healing well.

[cdubb]

Kasiany,
I would absolutely want to see surgery pics...I still like looking at mine, so I'd love to see somebody elses to look at. 

I liked the CPM also, but sometimes it was cumbersome to get in the 6-8 hours/day.  Although, it's not like I had anything else to do for the first 4 weeks. My docs protcol used the CPM for 6 weeks, so I was just able to ditch it a week ago.  I was told it was more just about motion itself than regaining  ROM, so it wasn't until I was 4 weeks that I moved it past 45 even though I easily could have.  Moving it to a higher degree earlier would have been bad for the graft.  To avoid getting too stiff, I was also instructed to dangle my leg (using my other leg for support to lower it) to 90 degrees a few times per day for about a minute or so.  I was about 7 days out when I first tried and it was difficult, but the next day, got down to about 90.   I stayed there pretty much until after 6 weeks (some days stiffer than others) and then my range just started coming back. I'm about 110-120 now for flexion and I haven't really worked too hard to get it back. It's just coming back on it's own. I never lost extension.  I loved my ice machine (I had a Gameready), but stopped using it about 9-10 days post op because it gave me an ice burn type rash on the area that the wrap went on.  It did provide a lot of pain relief though.

I'm doing okay today. I'm having some nerve pain at night in my foot and still walk with a marked limp (I really should be using one crutch, but am kinda stubborn about it since I can bear full weight at this point 7 weeks out), but overall I think I'm doing pretty well for the major surgery this is.

Hope you meet your goal of 40 by Monday!

[kasia_ny]

Day 8

I am getting sore from the brace.  I have a BREG brace, it does not provide much padding.  The knee and the ankle are swollen, but nothing crazy.  Yesterday I had this strange sensation on the left side of my knee (my op was on left knee) for a while. It started as an itch and then it was burning.  No idea what it was, it lasted about an hour and then went away.     

Did you guys get Lovonox or other anti-clotting injections?  I have to take them every day for 14 days.  I am anxious to do them myself.  I had the first couple done by a retired nurse that is in the family, my husband tried to do it once, did something wrong and it hurt pretty bad.  Did you do them yourselves?  The nurse will come a couple more times, but next week I am on my own...

 

[kasia_ny]

Ok, I have to admit something.  It has been 8 days and I still haven't seen my scar.  Funny, because I have seen the op pictures a few times.  My husband changes the dressing and I just do not feel like looking at it... It is so not like me!

[martialartist]

I have had to inject myself with levonox for two different DVT's not related to knee issues.  Its a bit strange I must say. The only way I found to do this is just do it. Grit your teeth, get ready for the uncomfortable feeling that will come, and just do it.  Going in slowly, and without confidence will prolong it and make it hurt more. Go carefully, steadily and with purpose.  Thats not to say rush through it, but be confident and dont be wishy washy. Hopefully this makes sense. Its not that bad if you accept you need to do it. 

[Melissa S]

Kasia
I didn't have to take anything for clots.  I am thankful that I didn't too because I hate needles and don't think I would want to give myself a shot.  How long do you think your scar is?  Mine is only about 3.5 inches long so it is not too bad.  You had a TTT too so yours is probably a bit longer.  You can do it, take a look!

Melissa

[cdubb]

Kasiany,
I only had to take an aspirin a day for 2 weeks for anti-clotting.  I asked ahead of time if they used Coumadin or Lovenox and unless you have other risk factors for clots,aspirin is all they request.  Don't worry about the injections though. I've done 3 egg donation cycles and had to give myself 1-4 injections/day in my stomach or thigh for each cycle from 12-21 days depending on the treatment protcol that the doc had me do.  It's not bad at all to inject yourself.  It was a little strange the first time, but then I just got used to it and prepped my meds, lined up the syringes and did one after the other.   Just pinch the skin, put the needle in and inject! 

I took my dressing off at day 2 post op and slapped a Tegederm patch on it to shower and left the Tegederm in place until it was removed at my post op.  I had no stitches that needed to be removed because it was closed with dissolvable sutures and glue I think.  My scar is about 8 cm long starting at the top of my kneecap and going down about 4 inches on my shin. I would suspect our scars are similar in location/size since we had the same procedure, but just different material to repair the defect.

The sensation on the left side of your leg was probably nerves.  My knee is numb on that side and I was told it would be based on the way they do the incision.  I had an Ossur brace and it was all foam padded, around the support.  Sorry your brace is making your sore. 

[kasia_ny]

I decided to be brave and looked at my incision this evening.    It is 17 cm which is almost 7 inches (I measured).  It begins in the middle of my kneecap.  There is also another small scar to the left of it, like from an arthroscopy.  It is all stapled, and the staples are going to be removed on my post-op visit on January 4th.  It does not look bad at all, it was my husband's reactions that made me anxious about looking!

Tomorrow I am leaving the house for the second time since the surgery (first time was PT).  We are going to visit family for Christmas Eve dinner.  Luckily it is only 10 minutes drive, so it is very easy.  I am really looking forward to it, I am getting bored with being in bed all day. 

Happy Holidays,
Kasia

[cdubb]

Good job looking at the scar!  Wonder why your scar is so much longer than mine? Maybe I should measure mine and perhaps mine is longer than I think.....  Interesting staples were also used?  Must just be a doctor preference on size of incision to visualize what they need to and the type of closure.  My doc doesn't actually do his own closures  and I doubt most of our surgeons actually do and just have their resident's and fellows finish up....although that could be the case only in a teaching hospital?   Do you mind me asking who your Dr. is?  If you don't want to post you can e-mail or PM me. 

Have a good Christmas Eve with family and Happy Holidays to you as well!

[kasia_ny]

Day 10

I just had a major scare.  I was going up the stairs to my room and I slipped (there are three steps).  Thankfully my husband was behind me and he caught me, but still I supported myself for a second with a bad leg It hurt.  I freaked out.  I do not even remember how I get back into bed.  I just hope everything is okay with the knee.  It feels now exactly like before, so hopefully I did not damage anything.  All my Christmas mood is gone... I feel like crying.