MPFL reconstruction April 4th 2012

[Tiggs1986]

Hey guys I figured I'd post my operatative and post-op experiences for those who are looking for some info about it. My story up until this point is  http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=59145.0    SOO here we go.

   PRE-OP  My surgery was April 4th, I checked into the surgery center at 630am, crutches in tow. A few minutes later I was called back to be officially admitted and prepped. In my waiting room I as greeted with a "get well soon" balloon and card from a friend/ coworker of mine.(I'm a nurse on the surgical unit of the hospital I went to so many people recognized me). I changed into my gown and cap, health history and allergies were gone over, protocol preggers test done, and then anesthesia came in to talk about which anesthesia we should use (I chose spinal due to lower risk of complications). THe anesthesiologist told me they'd give me some sedation before the spinal was done and I could ask for more during the case so I wouldn't get anxious or bored. The IV was placed (with the RN joking about how I could probably do it myself.) And my family was sent back into the room.

  OR- By 915 I was escorted to my OR suite. I glanced up in time to see the nurse anesthetist give what I'm assuming was the sedation. I then sat up and bent forward for the spinal administration. The last thing I remember is being told to lean forward more and someone grabbin my arm because I couldn't to it myself then assited back to laying down and my arms being strapped into place. I was completely out the entire surgery. Waking up in time for draping to come down and to see my floppy, dusky leg in the air getting the immobilizer on. It was the weirdest thing I realized it was my leg but at the same time had no idea it was there (if that makes since). The PA told me they only had to do the MPFLr and not the TTT or LR (which is fabulous). I was then assisted to a cart and taken to PAR. On my way out of the OR one of the nurses I used to work with (b4 she went to OR) wished me luck.

     PAR-Once I got to PAR I was greeted by all the nurses (whom I know well as I'm usually taking patients from them up on surgical floor). When my PAR nurse asked if I was cold I said no and recieved a weird look from the nurse who then ran for warm blankets wrapping one around the top of my head and shoulders and placing the others over me (it was then I realized I was shivering). We chatted until I was deemed stable enough to be brought upstairs (about 1140).
      POST-OP SURGICAL UNIT-Once I got to my room I and the PAR nurse got me into bed (as we knew the two of us would be able to do it with the patient mover). My nurse came in and report was given in the room (which was nice since I wanted to know what all had happened while I was in lala land). The routine checks then started (vital signs, pain level, sensation, pulse checks, dressing checks) I gained motion in my toes fairly quickly, sensation came a bit slower. Oddly enough my spinal wore off enough that I was able to stand to be helped to the commode about 3 but the muscles that controlled bladder function still didn't work properly. I don't think I've had to work so hard to pee in my life! It was kinda strange too because the nurse that awnsered my potty call was my supervisor! I also accidentally disconnected my IV and got blood everywhere! (they had placed it in my dominant hand). My supervisor ended up having to clean up my bloody mess (literally). I had recieved IV fentanyl a few times for pain rated 4-8. And eventually convinced my nurse to let me have a percocet (I had very rare bowel sounds but the fentanyl would make me zone out for a few minutes and shortly help with pain but wouldn't last the hour). The percocet worked wonders. Pain was 1-6 with that (depending if I was moving or not.) I got a few fellow nurses pop in to see how I was doing and had a hard time sleeping that night (I'm so tuned into the alarms that I woke up everytime one on my end of the hall went off). There was even a code blue called that I woke up to thinking I was working and went to respond only to realize my leg was heavy and painful (it was then that I remembered I was a patient this time  ) Late in the night my bowels decided to wake up (finally!) I was gettin nervous, as were some of my nurses that I'd gotten an ileus-we say that if an employee or family member has surgery SOMETHING always goes wrong) PT visited me in the morning to teach crutch walking and working with stairs.
 
    DISCHARGE AND HOME- The PA I had originally seen came in and spoke to me about the surgery and my discharge. I was discharged about 1045am. Went to pick up my prescriptions and was in a world of hurt by the time I got home (it took 45min for the scripts to fill then the 20min ride home.) My puppy was so excited to see me but my kitty didn't  want anything to do with me. I took my percocet as soon as I could and napped like I haven't napped in a long time. Since I woke up my pain has been tolerable  (from 2-4) and will continue to routinely take my pain meds at least for the next couple of days. Sorry this one was SOOO long but it's been a busy couple of days! shorter posts and hopefully pics of the surgery too come!

[oohheykate]

Glad your surgery went well! I can't believe you got to stay overnight, I'm jealous. When I had my MPFLr done, I was in the PACU for six hours. I wish I got to stay overnight.

I hope your recovery goes smoothly

[Tiggs1986]

Post-op Day 1 and 2 @ home!
    So my pain level WAS doing fabulous, until I went to get into the car in order to go shower.  Didn't realize the seat wasn't all the way back so my leg ended up hanging in the air for what felt like forever in the worst pain i've ever had in my life! Since then I've been fightin with keeping the pain undercontrol as it's fluctuated between 4-9 out of 10 since then. Percocet 1-2 every 3 hours is now FINALLY catching up to it. On the bright side my kitty decided my need for some lovin out weighed her attitude and has been snuggling on my lap with her paw gently on top of one of the hinges on and off throughout the day. She also has decided I can't be trusted to go to the bathroom by myself and escorts me there, does a  walk through of the the bathroom (to check for monsters of course  ) before she lets me in, checks on me every 10seconds or so and then escorts me back to my chair.  For those wondering  about the shower I didn't have to cover anything up, just gently wash with bar soap and a clean cloth then make sure it was completely dry before putting the brace back on. I also used a shower stool to sit on and covered the sites with a little gauze to protect them from my pets' fur. I've spent most of today sleeping or trying not to cry due to the pain. Don't get discouraged though. I'm sure it's mostly because I got into the car wrong last night (stupid me i should know better since I help and teach people how to get into the car after knee surgery  ) Anywho we'll see how the next few days go! TTFN tata for now!

[yc_angel]

Hey tigs,

I had my mpfl done on the 5th of April so recovery wise I'm at 2 days PO.....hows the pain now?
I'm surprised your allowed to take your brace off....I sometimes confusing that so many OSses have to many different protocols..lol....i'm not allowed to take it off anytime soon.....my PT takes it off at 2 weeks when i go in for my checkup at my OS office....so i'm very exited to see what my leg looks like...

Is yours blueish and super swollen?

Xx

Angel

[Tiggs1986]

the PA said I could remove the brace and dressing 36hours after surgery to shower (and ONLY to shower)  I was very careful to not allow it to bend, wearing the brace until i sat on the shower stool and putting it back on once i was good and dry before attempting to stand. My knee is very swollen though most of it I'm sure is the fluid used to inflate it during surgery. The entire knee is extremely sensitive lightly dabbing it with the washcloth about made me jump off my stool. I'm hoping to shower again 2nite maybe get a pic on here if I can figure out how. Painwise I'm a lot better this morning. It took a lot of time and pain meds to catch up but this afternoon I was able to wean myself onto the Hydrocodone 7.5/325 from the Oxycodone 5/325. The thing I've discovered that's the most helpful with the pain is my iPOD. I had made a playlist of mellow songs to listen to in the hope that I wouldn't hear as many alarms and be able to sleep during my hospital stay. I've found the songs help me shift my focus from the horrible pain I was having to the songs and have been lulled to sleep a few times.

[krunzer]

I hope you are feeling better now.  I remember the first time I tried to shower after my surgery...lol....I almost passed out when I put my arms up to wash my hair.....after that I started to bathe all the time.  I found it way easier, it was way more relaxing and was easier to get into and out of the tub, the water wouldn't splash all over my wound and cause pain and I could take my time and clean the wound properly and keep my leg very straight.  It was never submerged under water I just propped it up on the edge of the tub kept it straight.  It was great!  I would get out dry off and put my zimmer splint on again then gimp my way back downstairs to sit in my chair!  It was very monotonous for a long time, chair to watch tv, get up for something to eat, bathroom, bath, chair, chair, chair, lol and then bed.   Get up and do it all agian the next day.  It was nice because I was off of pain meds after three days just taking extra strength tylenol and I only used my crutches for two days then I gave up and just started walking on it.  I had a LR and Medial plication, not the exact same surgery as yours but fairly similar.  Take care!

[Tiggs1986]

Post-OP Day 3-5
    Just when I thought I had a good handle of my pain the spasms set in. Knee and thigh spasms that were so strong my leg would jump. A few of which caused my entire body to jolt, never have I ever had such pain. I took some flexaril i have from a back injury to help get me through the weekend and called the clinic as soon as it opened this morning. They wouldn't let me talk to the surgeon or PA (or just have them call me back when they have time). Nope, a vistaril script was called in (which is nice) and I was told to call if it didn't help for fear of blood clot. Got a call back like 5min later saying Doc wants me in urgent care immediately to rule out DVT. Which makes me wonder just what the nurse told him cause I wasn't showing ANY signs of DVT . Get to the clinic for a US and the first thing the nurse and Clinic doc say is "so your having cramping, tenderness, swelling and reddness in your leg?" um no just spasms. Then my US order read spasms in knee and hip (why don't people listen! this is why I wanted to talk to the surgeon or PA myself!)Anywho I was scheduled for a US for like 2 hours later (apparently I can't be scheduled until I'm seen which is ridiculous because Ortho ordered it) anyways I ended going to the hospital so I could be done sooner (cuz sitting in a clinic chair for 2hours wasn't gonna work and sides if someone wants to rule out a DVT I'd think it should be priority). So got that done, no signs of clots (big suprise) and was told that maybe I'm low on calcium and magnesium (I haven't had much appetite for the past month, especially the last week AND had taken some MOM this morning and about an hour or so after the spasms stopped) Also with all the running around today I figured out that sitting in the back seat of the car is SOOOO much easier and more comfy!

[allyd]

Sounds like a rough day! And a lot of commotion for signs/symptoms you weren't necessarily displaying. Better safe than sorry I suppose. My OS automatically sent me home with a script for Vistaril - which for me was almost more useful than the narcotics. Defnitely found it helpful for the initial spasms the first week, and than as I got deeper into PT when my leg would get cramped up and tired from the work... worked like a charm to relax it up at night.

Hope things have settled down for you!

[Tiggs1986]

Week 2
    The spasms are sooo much weaker and infrequent now. thank God! Still using Vistaril at night since it seems the spasms act up when I'm trying to sleep. Lortab only at night and mid-morning. Also this morning I decided to try no crutches around the kitchen (since I was starving and no one was home). Worked well for short distances. I wasn't told much about what I should do with the crutches (as far as when I can ditch one or both) so I'll probably keep one with me around the house and two for longer distances. Still can get through the ortho nurses to speak to a PA or my surgeon regarding questions I have regarding my brace (does it STAY locked for 2wks or have been supposed to be unlocking it and moving it around? when does PT start etc) teh nurses take the side that "everythings peachy and just the way it should be." but I've been REALLY questioning their competence (espescially since the whole prescription direstions and DVT thing). One of my coworkers got me the head of PT's work number to ask her opinion and my surgeons cell number (which I don't wanna use unless I ABSOLUTLEY have to). Hopefully Erin (the head of PT) will call me back. It's nice that I know these people professionally and maybe have an "in" as far as that goes, kinda scared for those that do this and don't have that relationship and contacts. I WILL be talking to the head of the Ortho clinic about how the nurses are treating me though, it's completely unprofessional and frankly unsafe. Anywho off my soap box. Tonight I willl be attempting to scale the steep stairs that lead to my basement apartment (I have some friends visitin this weekend!) if it goes well enough I'll be moving outta my parents recliner and into my own bed/apartment! Wish me luck! 

[yc_angel]

Wel your healing is coming along nicely...I'm sorry the nurses are giving you a hard time...you should defenitly say somehting about that....I had my own run in with a total Idiot of a nurse this week and I'm glad my OS set her straight...she was giving me a hard time about my meds....

I hope that like you my spasms go down by week 2...cuz the ones i get at night are awfull

Anyways i hope you get to move onto your own bed succesfully

Xx

Angel

[allyd]

I’m always a little surprised at how some OS’s (or probably more so their staff) don’t communicate what needs to happen the first couple of weeks. I distinctly remember my OS giving me the 3rd degree on all this info right before they wheeled me back to the OR. [this was an unfair convo as I was already in la-la land] I’m pretty sure she wasn’t going to operate until I re-iterated all of my instructions from my pre-op appointment to her satisfaction, and she was confident I had post-op appts set up with her, her Nurse and for PT. I hope you get a hold of someone soon and get a plan in place. Do you have a post-op appt coming up w/ either the PA or OS? You may get more direction there.

For what it’s worth, I ditched one crutch after 3-4 days in doors – and only used 2 when in public, or outside. Started PT 1 wk out, which is when I start working ROM. But didn’t get my brace unlocked at all until about week 3?  Unlocking was at the discretion of my PT based on my progress w/ strength.

[Tiggs1986]

thanks allyd,
   I was worried I'd missed out PT-wise. The therapy department actually rearranged their appts so I can be seen ASAP. Appt with PA on Wednesday hopefully get a plan in place. I'm wondering if it's so messed up because my surgery was upped a couple of weeks? IDK it's been frustrating to say the least.

[WalkeruK]

How you feeling Tiggs? Ill be four weeks post OP on wednesday.

[Tiggs1986]

having more and more "good" days. stairs went well. the weekend was fun but sitting through Grand March at my brother's prom was a little much for me. Some friends came by this weekend with boredom busters. (my fav being a sega emulator!) yay! 1st PT session 2morrow, ortho appt wed fingers crossed all goes well.

[Tiggs1986]

1st PT session complete. When I was finished I was tired, nauseaous, dizzy and had a headache, my leg also decided to twitch back and forth freakishly while I was icing. Knew I was in for it when the therapist gave me a pep talk as soon as I sat down. On the up side I finally got some questions answered regarding my brace. Question though, Is doing straight leg raises supposed to hurt?All of my other exercises are peachy but that one I wanna scream.