My Patellar Realignment Surgery Nov 4, 2010

[Countess]

Thought I would pop back in here for a moment and write down my observations on what I can do now.

I can get up from a chair or couch with both feet on the floor and use my bad leg to help with standing.
I can sit on the toilet using both legs instead of just my good leg.
I can raise my bad leg and easily prop it on pillows after a workout.
I can get in and out of bed easier.
Stairs are still challenging but I am finding them a little less scary and am getting better at one stair at a time without freaking out.
It is getting easier for me to go around an entire store more quickly than before using a shopping cart as a walker.
I walked around unaided at my favorite makeup shop this past weekend. I was really slow but it was the first time I was in there since having surgery.
My gait is improving...at a snail's pace but improving.
I can get to 0 extension.
I can get up and down on the PT table with no problems on either side.
I can do straight leg raises.
I can turn over onto my stomach.
I can sleep on my right side. Left side is still a little painful but I can lay on it for a bit.
I can go to the store by myself.
I can get in and out of my vehicle easier on either side.

It helps to be reminded of what I have accomplished so far and what I have gotten back since my surgery for those no good very bad days.

I have PT tomorrow night so we shall see where I am at on flexion.

That's all for now.

[Countess]

My therapist is still on vacation. Luckily I got a floater who I have dealt with before and I like her so I was able to relax while she worked on me. She told me my quad tendon was still tight and my knee was still a little swollen. She massaged everything and did some patella mobes which felt good. I told her that knee was probably swollen because I just worked it for 2 hours. Then she stretched me out and kept looking up at me to ask if I was ok. Her approach is much gentler than my therapist's but I am not her patient so she was probably just taking it easy. She didn't have her measuring tool with her so we couldn't see where I was at but on my own I was still at 90 so I haven't lost flexion. I just worry about my knee being stuck. She asked me to push into her like I was kicking and I actually moved her hand! She told me that was really good. I then got all excited and told her I just got that back a few weeks ago. I thanked her several times for working on me and helping me. I always try to remember to thank whoever is working on me. My therapsit always gets so apologetic when she makes me cry. I know she feels bad but I still thank her and tell her it's ok because I know she needs to push.

I tried 30 seconds 4 times on wall sits last night. My legs were shaking when I got done but I did it. My therapist's assistant said he didn't feel sorry for my legs and I said that I didn't either. We both laughed. He told me he can't wait for me to get tripple digits on flexion soon. I can't either. It was nice to not hurt so much right after therapy.

After I got home I propped my leg up and iced it down again. That's when the nerve thing started which I HATE. I know they are trying to repair themselves too but firing down into my foot is just not a nice feeling. Then when I would get up to walk they would fire again every time I tried to use the knee so I limped severely. This time it's where the reefing was done. I noticed in PT that I felt stretching there which I haven't felt before. It hurt a little bit. So I decided to just go to bed. My nerves kept me up for about an hour before they calmed down and I was tender on my medial side. I woke up this morning really stiff. I had to get on the recumbent bike just to get myself stretched back out. My thighs are sore. My knee is swollen on the medial side. At least my knee isn't hot.

I am going to have a nice relaxing weekend. I know my therapist will come back from vacation rested and ready to inflict pain. I am going to keep working away as always and hopefully next Thursday we can get those tripple digits.

Bye for now...

[Countess]

Just got back from lunch with a few friends and it felt good to get out and about. I had a really great time and it's been a while since I have laughed that hard. It was difficult after sitting there on a bar stool for a couple hours as my knee started to get stiff. Once I got up for a bit it seemed to calm down. I am finding that I am walking ok...still limping but not as bad. My knee isn't hurting as much anymore either. Still slow going...not walking as fast as everyone else but improving.

I was able to stand on my bad leg today in the shower for a good minute and it held my body weight. My leg is getting stronger with each day. I am hoping with the strength comes bending. Recovery is right around the corner for me...I can feel it. I want to be better so badly. Summer is coming and I want to be active...I want to do all the things I love to do.

After lunch and a few beers I went to get some ice cream by myself. It's so liberating to do things on my own even if I am not fully healed yet. For once I almost felt normal again....almost free. This is the first time I have felt that since my surgery nearly 5 months ago.

Now it's back to the same ol same ol. Exercises...rest...ice...repeat. But today...today was a very good day.

Cheers!

[Countess]

For the past few days I have been stiff due to the weather. We have gotten snow here and it has been colder than usual. My knee definitely does not like it. I have been discouraged also. The JAS brace isn't helping...at least I think it's not helping. I got up to third rung but now every time I try to use the damn thing it doesn't fit right. There is always too much of a gap in the thigh or calf cup so when I try to crank down for flexion it it slips off the thigh. The velcro isn't as sticky anymore either. It also hasn't helped that I got a $500 bill in the mail for this piece of crap which is my portion the insurance didn't cover. 

I have also been trying to manually let gravity bend my knee by picking up my thigh and leaving the rest of it at a 90 degree angle in the air like wall slides but with no wall or bending down from a standing position. Nothing works. It's like my knee is stuck. I am trying to go all the way around the recumbent bike while not hiking my hip and I still can't do that. Frustrated is an understatement. Slow and steady wins the race...but I don't feel I am gaining at this point. I think I am stagnant which is not a good thing. When I improve it helps me to stay motivated. When I am at a plateau I don't feel like doing anything. I am still limping...still not walking right and still slow. I want to get to 110 so my OS will release me and I can work on other stuff in therapy. I am so close...but 110 feels so far away. I just need 20 degrees!! 20 damn degrees!! I have come such a long way and have fought so hard for this. I have pushed myself to the limit and endured more pain than I thought was possible. Why can't my knee give me the 20 degrees??? I DESERVE IT FOR GOD SAKES!!

I want to wake up one day and have this all be over with but it's like groundhog day!! Every day I deal with the same crap. WTF?? **UGH!**

Anyway...not looking forward to PT on Thursday. That is another whole world of hurt I will be in for. I just know it.

Bye for now...

 

[Countess]

PT Update -

Last night PT was well...enjoyable...as much as PT can be. I can't believe I just said that but it was. My therapist, bright eyed and bushy tailed back from her vacation, was in a great mood. She was working on another "lifer" as we call ourselves (there are 3 of us) and she was putting these needles in her shoulder. I asked them about it and my therapist told me it's manual nerve stimulation to release the muscles. The gal told me it really helps with her range of motion. Then my therapist looked at me and told me it would probably help my tight quad. Let's do it!! I will try anything at this point!! So it was weird...I am not going to lie and say that it was a pleasant experience but by no means was it awful...just uncomfortable. We passively measured before the treatment...75. Then she sticks these really small needles where the nerves are in my quad one by one to get them to fire. A couple of times I had shooting pain down to my toes but she wiggled the needle around and it went away which she said is what we want. I looked up towards the ceiling as she was doing this...she said at one point it was weird cos my patella moved up and down. After she was done we measured again...90 easy!! Without any pain!! I couldn't believe it. She said today I will feel like I worked out really hard but by tomorrow I should be ok. Some parts are sore like right around the top area of my patellar tendon. Other parts are ok. What I have noticed is I CAN BEND MY KNEE!! Walking slow...but not limping!! I AM WALKING NORMAL!!! I can stretch my thigh muscles!! I really...can't believe this!! I dropped a napkin on the floor and I bent down to pick it up!! Granted it's not perfect and I can't go all the way down yet but I haven't been able to do this since my accident back on Sept 28, 2010!!    I almost cried with joy!! I called my Mom immediately and she was so excited for me. It's been such a long and hard recovery.

My therapist told me she hopes what I call this weird voodoo acupuncture thing will help and that it will be a turning point for me. I am really hoping so too!! It seems to have made a huge difference so far!! Everything feels really relaxed and not tight at all. 

When she stretched me I felt no pain. It was so wonderful not to cry for once in therapy. She also is having me do new exercises and TOOK AWAY THE TORTURE CHAIR!!! YEAH!!! She also took away all the extension stuff. I am at 0 and have maintained that so there is no reason for me to do it anymore unless I back slide. So brand spankin new protocol:

Recumbent Bike 10 mins
Box Sits 5 mins
Wall Sits 30 sec x 4
Calf Stretch 1 min x 3
Balance Board Heel to Toe 2 mins
Balance Board Side to Side 2 mins
Leg Press 50lbs 3 reps 15 times
Step Ups with a 4" platform 20 times with bad knee (this one freaked me out at first but I pushed through the mental aspect and did great. PT Assistant was very impressed!!)
Heel Slides 5 mins
Heel Digs 20 times
Wall Slides 6 mins
Prone Thigh Stretch 3 mins
EStim with Kick Outs 10 mins

Hope all of you out there are doing well. Cheers!

[cdubb]

Great job! Looks like you're doing pretty well at this point!  I can't believe you're doing leg press??  What are kick outs?

[Countess]

Thanks for the encouragement cdubb!!  Honestly, without folks like you guys here on this board I don't know how I would have made it through sometimes!!

I can't believe I am doing leg presses either already. The assistant got me into the machine and once I started doing them he asked me how much weight I thought I was pressing. I told him I didn't know...like 5 pounds?? And he laughed and said "No...it's 50 pounds." 50 pounds?? I stared at him for a moment in disbelief but he showed me the weights and sure enough...50 pounds. Seriously...it felt like 5 pounds!!

Kick outs are with a bolster under your knee while sitting on the table and you kick out using your patellar tendon (like you are kicking a soccer ball or something with your foot). I have to hold my calf/foot up during my estim contraction after I kick out. When I first started kick outs they were so difficult and hurt!! Now when I do them it's more like hurting from muscle fatigue after I get done.

This past Saturday I went out to lunch and shopping afterwards. I felt almost no pain from the acupuncture. I actually did a lot better and my knee wasn't whining really badly at the end. It still stiffened up but as soon as I was headed for home it relaxed again. Yesterday it was snowing so it was a good day to do laundry and other chores around the house. Last night I was moving the joint and it popped again. I notice that my patella feels clunky every once in a while when I am riding the recumbent bike. After it pops then it's a smooth motion again in the femoral groove. It's kinda neat to watch it move up and down while I am doing ROM exercises. I hope the bending keeps getting better. I also noticed last night that I can get my leg straight while standing.

Well time to go do my 3rd set of exercises for the day. Take care everyone!!

Until then...

[Countess]

Last night in PT was pretty painful. In addition to my new protocol they now have me doing wheelchair digs...where I take a lap around the gym in a wheelchair using both of my legs. I can't alternate legs yet because I don't have the ROM. I told my therapist her weird voodoo acupuncture thing really helped and asked her to do it again. She laughed and said she was adding "VOODOO" to her title. This time she used bigger needles and when she stuck my VOM I nearly hit the roof. I told her I didn't mean to be a cry baby but that REALLY hurt. Then she went up and down my thigh as there were other areas which were so tight and contracted it was restricting my flexion. I felt like a pin cushion after she was done but I got to 90 again by myself and she bent me to 95. This time feels different than last time. Last time there was relief and I could bend my knee. This time there is no relief and I am so sore doing my home work is very painful. I am limping worse today than I have been. **SIGH**

Today I hurt...much worse than last week. It's like I worked out so hard that my muscles just can't take any more. My knee collapsed backwards this morning right after I got out of bed. It felt like mush. It was my fault because I misstepped but damn it hurt. I have been noticing that my quad just gives out randomly too....like it forgets what it is supposed to do and doesn't follow through mid step. I know it's due to weakness but scary nonetheless when it happens.

The only good thing that happened last night was I finally got all the way around without hiking my hip on the recumbent bike...which totally made my PT assistant's day. My therapist said that I couldn't get off the bike until I went all the way around so I said ok and did it. She was so excited she ran over to her assistant and he asked if I was hiking my hip. NO!! So he came over and looked...then a huge smile cracked across his face. He told me they were just talking about that before I got there and he was wishing I would get all the way around. I said "Bring it!!! Wish granted!!" He laughed.

I am worried that I am at a plateau in recovery. I can get to 90 by myself if I push it but that's it. If I try to bend it further it acts like it's frozen or something. But then my therapist can bend it past 90 and can get to 95 but she can't get past that. It's too painful. I wish something would break loose in there. It has been at 90 for about 2 weeks. I got another passing grade that I am still progressing but it's slowed down even further. I have an appointment with my OS on Weds. I am going to talk to him about it and see what he says. It's been 6 weeks since I saw him...I should be at 100. I'm not back sliding...but I don't feel I am progressing like I should be. But then again what do I know? Nothing about this surgery has been normal including the recovery. When is it time to do the MUA??

April 4th was my 5 month anniversary and I have been feeling down this week. My current condition doesn't help matters. I really try to stay positive but sometimes my knee sucks the life right out of me. It's just so disappointing to be so close...and feel like I will never get better...that I will never get over this hurdle.

Dear knee...I hate you. Quit throbbing.

Meh...  

[cdubb]

Kick outs sounds like short arc quads.  I'm restricted from open chain extension activity, so that is probably why I am not doing those.

Sorry to hear you're struggling lately.  Just think of how far you have come though!  Go back through your diary and look at where you were at a few months ago, that should help encourage you! 

I am feeling a bit disgruntled the past couple days also.  Not about my left ACI/TT knee though...that is actually doing pretty well.  Not perfect or anything, but I walked last weekend at the zoo for 5 hours and I did quite well.  A year ago, I couldn't do that.  Yesterday though, my right knee flipped out on me.  It has the same problem, but the left just really flipped out last year requiring it to be done first.  The right has just kind of stayed stady it it's typical state of agitation..until yesterday.... it is feeling like the left did last year at this time which started this spiraling issue of knee surgery.  I was just given the okay to golf recently though too (I don't golf, but it is a sport I want to take up).  My doc's PA gave me the go ahead to do it and I was scoping out clubs and everything.  The way my knee has felt these past 2 days, no way can I golf...  hoping it's just a small exacerbation and it will go back to it's typical state of irritation soon.  I'm going to try walking for several hours again at the zoo tomorrow again to test it.   I'm only 5 months out (Nov. 3rd), so I'm not really physically, mentally or financially prepared to go through this again now.  Really wanted to get to next winter or even longer. 

[Countess]

Thanks cdubb for the reminder! I did re-read my diary and I have come a long way...I just don't know if I can get these last 40 degrees I need or not on my own. I may need an MUA like kasia_ny to get over the hurdle. I am so glad that helped her and she is doing so fantastic. 

I am worried though about your other knee cdubb. Were you able to test it walking at the zoo again? What was the outcome?? I completely understand about not being prepared to go through another surgery! I hope it all came out ok and you can wait a bit.

As for me...things have gone from bad to worse I am afraid. The knee is still the same but my personal life has taken a beating because of it. I have a lot of friends with birthdays this past weekend and they were all having parties. Well I know my knee and I know I can't attend all of them. I have to pick one party and that's it. All the rest have to take a rain check. If I do too much my knee swells, gets hot and hurts. I pay for it for at least 3 days afterwards if not more. I feel badly but it is what it is right now.

The thing is...it wasn't even my friends who got upset because I couldn't attend...it was my husband! He got really argumentative and told me I need to stop using my knee as an excuse. He said that I am not the only one who has had knee surgery and everyone else has healed up completely fine so he doesn't know why I am not better by now. He also said that there is only so much my OS and therapist can do so it has to be my fault why I am not better! According to him I should be able to and I quote "just get up and walk normally." He told me "you just sit there on your recumbent bike until the time is up so how can you expect to walk right if you don't do anything." I was dumbfounded! How can someone who is supposed to love and support me say such hurtful things to me?

I told him how dare he say that...everyone heals differently and they all haven't had the same surgery as me so how does he know. And another thing...if I don't do anything then why am I up an extra hour before work every morning, I work out every day on my lunch hour then come home and work out twice every night. If I am sitting there on my bike it is because I am stretching my quad and trying to bend my knee further...I'm just not doing nothing. I told him I enjoy going to therapy to cry because it hurts so badly, it's a great time being poked with needles and that this (holding my leg in the air which my knee only bends to 90 degrees and stays there) is really MY FAULT!!!

I was so angry I didn't talk to him all weekend and slept in the guest room. Last night we had it out again. He wanted to know why I was so mad. He says I am the one who is trying to pick a fight with him and that he was just trying to "motivate" me. SERIOUSLY??? 

In the end I told him not to worry about it anymore. My knee is MY problem and now I know how he really feels. Anyway...sorry everyone if what I have said is TMI...I just really needed to vent.

I hope everyone else is fairing better. I will have another update once I see my OS on Weds. Maybe I will beg him for the MUA just to get things progressing along a bit faster.

Bye for now...

[Countess]

OS Update -

I went to go see my OS this morning. He is not happy with my ROM. He says it's just not good enough despite my very slow progression. He is not happy that I can't do SLR's all the way straight at 0 degrees even though I am at 0 extension while on the table. I can do them...just with a slight bend.  But that isn't good enough either cos my strength isn't where it should be. The patella is still tracking beautifully so that is good news.

I am scheduled for an MUA this coming Monday.

I know...be careful what you wish for right. At least I know I gave it my best shot. Now I have to mentally prepare for another procedure which I am just not ready for. I had them order me a CPM so that should help. I am not giving that scar tissue a chance to come back. This is it. It has to be.

The official diagnosis is Ankylosis.

[kasia_ny]

I am so sorry to read about your problems.  I know how you feel... I really hope that the MUA will turn things around (I wrote you back in my thread).  Your husband is probably frustrated with things not getting better and he took it out on you.  Men like to fix things and if they can't do that they get upset (not that it is an excuse, he acted like a jerk IMHO).  I am fortunate that my husband was through a tough ACL surgery and can somewhat relate to what is going on with me.  Most people have no idea how much it sucks to have had this surgery and you have it even rougher than most... do not let them get to you. 

As for the SLRs I had that problem too for a while - I tried to do them with my husband supporting the ankle and helping at first to make sure the leg is straight.  After a few days I managed to do them with a straight leg by myself.

Hang in there!  And take some rest this weekend.  You deserved it.
Kasia

[Countess]

Thanks Kasia. It is comforting to know that you guys here on this board really do understand because not many people do. I have had several people act suprised and say "Wow...you're not better yet? Wasn't your surgery like last year sometime?" Or complete strangers who just look at me and say "What's wrong with your leg?" It is really annoying and quite frankly I am sick of explaining it. Yes I know I don't walk right and yes I know something is wrong with me. Sometimes it is difficult to not let them get to me. I am sure you can relate.

I feel my husband acted like a complete jackass and when I was telling my friend about it today he thought the same thing. He said there is a right way and a wrong way to deal with things. Even though my husband may be frustrated with the situation then just say that. Don't try to disguise how you really feel about it by trying to pass it off as "motivation" and placing blame. Call it like it is. That is definitely the wrong way to motivate someone. We haven't spoken about the incident since then.

I have heard from my OS's MA and from the CPM folks. My CPM will be delivered tomorrow evening and the guy is going to set it up then show me how to use it. So everything is set. I just haven't heard from my therapist yet. I am not sure what her plans are for me. I was scheduled for therapy this afternoon but had the secretary take me off the schedule yesterday and left my therapist a voicemail...telling her what has happened and to call me back. That is the last piece of the puzzle.

I really hope the MUA turns things around as well. All I can do is wait at this point. I am sad that I have to dig out my crutches. I haven't used those things in a long time. I have to get my station set up again too. I will try my best to rest this weekend and take it easy but it's doubtful with all the running around I have to do. On top of everything I am having my family over for Easter Sunday. My sister will do most of the cooking but I have to get all the shopping done before the MUA. I know I just won't feel like dealing with the grocery store next week.

**Sigh**

[kasia_ny]

Countess, I can totally relate!  People drive me crazy too.  I do not know how many times I was asked if I had a meniscus or ACL done.  What is more, people that had the meniscus give me all this advice, as if they can relate.  I know they mean well, but I want to be left alone.  The most annoying one is "make sure you go to PT and do your exercises" as if I didn't!  The new comment I get is "you are lucky you did not have it when we had all this snow"...

What is your exercise protocol for post-MUA?  I was in PT every day (except weekends) for 3 weeks + 2 hours on max setting CPM 3 times a day.  In addition, bending by myself at home 3-5 times a day - CPM only goes to 125 degrees.  For me, the best position for practicing bending after the MUA was while lying on my back, I would let it hang while bent and also I would push it with my hands for more flexion. 

[Countess]

OMG I get the exact same questions!! I also get "Oh did you have a knee replacement?" That one bugs me the most because I'm not old enough for a TKR!! **GGRRRR**

I hate it when people open their ignorant mouths and try to offer me advice. Once I tell them what I had done they usually get really quiet or sympathetic. It's quite amusing actually.

So I finally heard from my therapist last night...or rather her assistant. He told me to come in every day next week. I asked him if they got my fax for the new PT script and he said it was probably in his box but he didn't look at it yet. It made me kind of irritated because I had to explain everything again...about how my OS wants me to go 3 days for two weeks and then done. Her assistant said she can't guarantee I will be done done and I told him we had to be because after that I am out of PT visits that my insurance will pay for. He says it depends on how the MUA goes. But they will have to release me if I can't pay so 

I have been looking at gyms to join that have a pool so I can work on my gait, etc there. My therapist also told me that I could self pay but I don't know how much that will be. I know she bills my insurance $200 a pop and I can't afford that. I would rather join a gym for $44 a month. If I self pay at PT that means I can use all the equipment and they can monitor my protocol to make sure I am doing it correctly...but my therapist can't touch me...at all...so what's the point really in that?

I got my CPM delivered earlier and the trainer showed me how to use it. They said protocol is in the machine for 2 hours...6 hours a day but to ask my OS if that's what he wants me to do. My husband laughed and said how boring! I guess he was hoping for a little more of a dramatic effect.

How did you manage 6 hours a day in the CPM when you went back to work? I am struggling with this solution. When I do go back to work I have to be there at 8am, don't get off until 5pm and it's not like I can lug that thing to work with me. 

Thanks for the tip!! I will try the hang thing. I already try it now but it stays at 90 and won't go much more. Keep your fingers crossed that the MUA will get me where I need to be.