So starting this diary a little late in the game but wanted to write down everything I can remember to acknowledge how far I have come since this surgery and how far I still need to go. Hopefully it will help those out there considering this type of surgery or have already had it and are experiencing issues like me.
September 27, 2010 - Slipped and fell in the kitchen. When I fell my left knee went one way and I went the other. I heard a loud crunch coming from my knee. This is not normal. I have been experiencing dislocations since the age of 15 in this knee. The patella would dislocate to the lateral side and I had a severe case of maltracking. When it would dislocate I was usually able to straighten out the leg and put it back in place myself. However this time was different. I was not able to stand back up on my own and fell back down. The patella seemed to be hanging on the verge of dislcoation and would not go back into place.
September 28, 2010 - Black and blue on my left side I went to the Urgent Care center. I was swollen and in severe pain. I thought I might have broken something. The doctor who was on call said I tore my ACL and he had a great knee surgeon who fixed his knee so I should go see him. SO I asked if I could get by without surgery and he told me the bad news. I would need surgery to fix the damage. I dropped a very loud F bomb. He also took xrays to make sure I hadn't broken anything. Xrays were extremely painful and I said a lot of choice words through the ordeal. I was glad no children were within ear shot of this mess. Nothing broken so that was a bit of good news. The doctor gave me the number to the OS and said, "Call him as soon as you leave here."
September 29, 2010 - First appointment with my OS. He confirmed my knee acted like a torn ACL but ordered an MRI to see what was really going on inside the left knee. I told him I would like to know as well and didn't want him flying blind in the operating room.
October 4, 2010 - MRI after work. Tech says she is unable to comment on the results but says "It doesn't look that bad."
October 13, 2010 - Follow up with OS to discuss results of MRI. MRI confirms lateral patellar tilt and an abnormality wedged underneath medial side of patella. ACL is fine but stretched to capacity and looks more like a V than a U. LCL and meniscus both look great. OS and myself schedule surgery to remove abnormality and correct maltracking.
November 4, 2010 - The BIG DAY. Mom flies in the night before to help out (she is an orthopedic nurse thank God). When I wake up my OS is standing over me shaking his head. He had to do A LOT more than he thought. He cleaned out the abnormality which was a chunk of cartilage. He had to open me up on the table. SO total count is patellar realignment, lateral release, open debridement, cartilage implant, medial reefing and patellar resurfacing. I would also be in a straight leg brace for 5 weeks which kept me immobile to protect the graft and implant.
I had a femoral block so I felt fine after surgery until later that evening when it started to wear off. The next few days were spent vomiting from the anesthesia and pain meds. My Mom changed my dressing for the first time the day after surgery and it hurt so bad I cried uncontrollably. I had an iceman ice machine (also called a cryocuff to some) which ran 24/7 for the first few days also. THIS MACHINE IS A GOD SEND. DO NOT HAVE SURGERY WITHOUT IT!!! Did frequent ankle pumps and had to wear TED stocking on good calf to prevent blood clots.
November 6, 2010 - Showered for the first time. It felt so good but I had to wear a trash bag over my straight leg brace which was weird. I was only able to stay in for 5 minutes as my good leg was starting to protest.
November 7, 2010 - My Mom flew back home in the morning and my Dad flew in that afternoon. Dad is a cardiopulminary specialist. I feel quite fortunate to have parents in the medical field...although Dad doesn't know Orthopedics like Mom.
November 10, 2010 - Dad takes me to my first post op with OS. OS explains what he has done (I was out of it when he was standing over me in recovery) and my Dad and him start chatting about medical mumbo jumbo. Dad asks if a cadaver implant was used for cartilage and OS says he used a new synthetic plug which yeilds much better results. Good thing to know. Glad I didn't have to sort out how I would feel about some dead person's cartilage implanted into the top of my tibia even though I am an organ/tissue donor myself.
Novemeber 17, 2010 - Back to the OS. Got the stitches out and it hurt like hell. Some of the skin had already started to grow over the stitches. His MA had to rip them out...and didn't use any numbing anesthetic whatsoever.
I am still on crutches and weight bearing but still in a lot of pain.
November 26, 2010 - Drove for the first time!! Went to go see a movie. The theater was wheelchair accessible so I was able to maneuver around ok but noticed things sure are different while in a wheelchair vs walking. Most folks are nice and offer to help by opening doors, etc.
November 29, 2010 - Back to work. In hindsight this was too soon even though I have a desk job. Still in straight leg brace and find it difficult to do daily tasks. Still in pain...still on crutches.
December 1, 2010 - Back to the OS again to check progress. OS tried to bend my knee and I cry out in pain. Then he says I will have a "fun time" in PT and orders it.
December 6, 2010 - Meet with my physical therapist. She tries to put my leg up on the table and my thigh spasms so bad I almost cry. Finally get the leg on the table and she takes a bunch of measurements. She then has me do a bunch of stretching.
December 16, 2010 - Back sliding in PT. ROM is going backwards instead of forwards. While on wall slides my PT says she is going to take a measurement and drops my leg. It hurt so bad I cried uncontrollably and begged for the pain to stop. The whole gym is looking at me.
She tells me she doesn't like to lose. I told her between sobs that I don't either but that I have been doing all of my home exercises faithfully and I don't know what else to do. I left without ice this time and never wanted to go back there again. I hated my therapist and felt there were other ways to accomplish ROM without this barbaric treatment. However I went back because I knew I had to. I also bought a recumbent exercise bike to help at home.
December 22, 2010 - Another post op follow up with my OS to see how I am progressing in PT. He says progress is ok and he is worried about flexion. I was at 0 degrees extension and 50 degrees of flexion. He threatened that he wants me at 120 flexion by our next appointment or we will have to talk about an MUA.
Right after the new year I started noticing little things that I was getting back. I ditched my brace, I could stand to put my pants on like a big girl and I could drive without the aid of a step stool to get in and out of my vehicle. (I drive an SUV so it's higher off the ground). I went from 2 crutches down to 1 crutch which made life a tad easier. Still in pain though. Still having problems with flexion. Therapist decides to order me a JAS device.
February 2, 2011 - Met with my OS again. Flexion at 75 and extension at 3. Still progressing in PT at a snail's pace but not back sliding. I told the OS progress is progress and he agrees...deciding to take a conservative approach and try the JAS. He tells me if things are still slow going by our next appointment an MUA is needed. I told him I had already been thinking about it and armed with knowledge from this site asked him how his MUA's are done. Found out it was a closed procedure and told him it was not recommended especially if I have developed secondary AF due to being immobilized for so long. He expressed his concern about going back in and causing more scar tissue. I told him I didn't want that either but if we are going to the operating room anyway then I want an LOA with a gentle MUA afterwards. He then said, "We will do it however you want. You have done your research and are making a good decision regarding your knee."...which quite frankly surprised me. I knew right then we were on the same page regarding my care and he really listened. He took his patient's well being into consideration.
So here I am today. As of last night's PT I was at 85 flexion and still at 3 extension. I have been walking with a cane for this past week and ditched the crutches completely. Last night my therapist took my cane from me and said "WALK...YOUR KNEE CAN BEND." I took my first steps unaided. Granted I have a severe limp but am walking around the office today without the use of my cane. Words cannot describe the sense of accomplishment I feel.
This has been a long and painful journey. It has taken over my life. I live and breathe this knee. I still wake up every night in the wee hours in pain. Nothing has come easy and I have had to work hard for every little thing. I have bad days with a few good days sprinkled in. I get severely depressed. But no matter how bad it gets I still push forward through all the pain mentally and physically. I still have the willpower to say to myself "This will not beat me...I will beat this." Make yourselves that promise. No matter how bad it hurts you must continue on.
More to follow....