New Member of the Knee Fracture 'Club'

[pinkstripes]

Thank you all for the warm welcomes.

Fsugirl--I braved my first shower yesterday. I used the duct tape/garbage bag method. We have a shower stall in our master bath so I didn't have to do any crazy manuvering like you would need to, but it was still a bit scary.

I have my first post-surgical OS surgery tomorrow.

[Rollerblader]

Hi All- so sorry to find you all here

Yes, Jeffy does have one of the best diaries there is.  He covers so many things that helped me and it was funny, too!  The showering info is priceless!  I broke my right elbow and right patella, so I was paranoid of the tub.  I was afraid I wouldn't be able to get out!  Lol. One thing that helped me with showering, was the nurse suggested that I keep the first immobilizer (the lightweight white one) that I had from the surgery (I got a black hinged brace 10 days post op) and put it on when I showered and then just hang it to dry afterwards.  It was great and I never had any problems except a fear of tripping over the lip of the shower stall.  The thing that I've never been able to wrap my head around is that the nurse said her sister kept her brace to use to shower and to wear to the lake!  The lake, seriously?  I think I was so shocked about seeing all of those staples in my knee and elbow that I didn't ask any questions.

Everyone take care and keep your sense of humor and stay positive.  You will get better and most of this will just be a distant memory.  You may ever be exactly back to normal, but you can get close and that is something to be thankful for!

Take Care!

RB

[webster1661]

Well, I'm catching up on all the recent posts here!
Pain: I am now 8 weeks post-op ORIF (2nd time, same knee), started back at pt 2 weeks ago. At first I was gaining rom pretty quickly: 70 to 90 in first week! But now at 90, I'm experiencing much more pain than first time round during the "let's bend your knee" game! I'm applying heat before and ice like crazy after but there's a pain in the back of my knee I haven't had before. I have 2 screws and cerclage wire. Still taking Tylenol regularly but nothing else. OS told me to avoid ibuprofin as it can interfere with bone growth. I know everyone experiences pain differently and advances at own pace....

Bone growth stimulator: Has anyone in this club had one before? My OS has me using a Physio-Stim device that uses Electo-magnetic field pulses to ultimately stimulate bone growth (my gap is very slow to heal; I'm thinking i probably qualify as a "non-union" fracture). It's a simple device that fastens around the knee (painful being right on the fracture area!) and emits its "magic" for 3 hours every day! I'm told to use it for the next 3 months. Follow up in 1 month for progress.

Confidence: I can tell it's going to take a LONG time before I feel confident and trusting my knee: on stairs, on uneven ground or if anything unexpected gets under foot (dog / cat!). I know as I build up more strength in quads, etc. this will improve, but it is not easy.

work: I am scheduled to start back to work 4 days a week starting April 30   (and build up to my full 5). While the bordom being home is one thing, I'm nervous about getting back into the workforce, although I do have lots of support there.

I will update after some more physio re: rom and pain progress. And I will be reading here to see how the rest of the gang is doing too! I wish a good night of sleep to all!!!

[fsugirl]

Checking back in here myself!  (and, I have to admit, not having such a good day , so it's good that I have this place to come to )

Thanks so much everyone for your feedback and your shared experiences!!  This really is a great place!

Pain - Fortunately, this finally started to subside for me two weeks ago.  I was able to do some major tapering off and, as of last week (5 weeks post-op), am now taking no pain medication (though I did take one Percocet before my follow-up appointment yesterday because I was a little scared about what they might do... and I had a bad experience with x-ray tech the last time).  About x-rays.... I have now learned that many of the x-ray techs are not our friends - they have no idea what we are going through & what kind of care we need.... and some really don't care.  I almost passed out after my last x-ray session because the guy (who was aggitated from the 'get go') had me take off my brace at the door and move across the room... and because he had no patience for me, I was pushing myself a little to do what he needed and not saying much.  On the way back to the examination room, I asked him for water and while he spent forever trying to figure out what was going on, I had to leave him and got to a sink to start scooping the water with hand! Uggh!  Once I was back in the room and on the bed, he managed to find me a TINY cup of water....  So... Yesterday, I did NOT let this happen.  I had a different tech and I made sure to let HIM know what I CAN and CAN'T do.  It was MUCH better.  By the way... I have a very weak stomach, so my reaction was probably a little abnormal... but I know not to mess around when I start feeling like that (like I'm going to pass out).

Showering - Sadly, I just took my first shower this past Sunday.  I got in the shower with my immobilizer on (my husband just stood behind me to make sure I didn't fall over while hopping into the tub) and then took it off while in there.  My husband was so worried about me because I was adamant about keeping my brace where I could reach it - though he was concerned about it getting wet.  It's so sad, but it's become like a security blanket. :/  It all went well and I dried and put the brace back on before I got out of the shower.  Then.... getting out.... At first I was not sure how I would do that... Finally, I figured out I could sit on the side of the tub and work my way out that way.  It all went fine, but honestly, I'm still very uncomfortable with it.  Rollerblader - that is an excellent idea!  I just got a new brace yesterday, so I could totally use the old one (though I am still a little attached to it and feeling a little like I may not want to get it wet ).... The other thing, though, is that I am far enough along that I do want to get that leg wet; however, I suppose it might be worth it to just continue to wash that leg outside of the shower as I have been.  I'll report back if I try your method.  Thanks!

New brace, sleeping & PT - So, here's the part where I'm feeling a little down now.  Yesterday, I had my first follow-up appt. since I got my sutures out on 4/2.  X-rays looked good, the doc said everything looked good and that I was healing well.  He also bent my knee just a little to see how far it would go and said I was at about 20/25 ROM.  They prescribed me a new, flexible brace and put in my referral for PT.  He said my goal will be to gain 30 degrees ROM a week and that I should be walking, without a brace, into his office for my next appointment June 4th.  This was all great and I was feeling pretty good about the progress and the future!  Then.... I got the new brace.... First, it is much more uncomfortable to me than the immobilizer (which I was starting to hate and was ready to get out of).  And.... here's where another issue comes in for me.... and I'm wondering if it's just me...  Since my accident, I have only worn shorts (whether PJs or regular ones in public).  I have only worn shorts because (like showering) I have only gotten dressed with my brace on.  It freaks me out a bit to think about getting dressed without my brace; however.... I realize I'm going to have to now for two reasons: this brace will be more comfortable and soon I will be going back into the office and can't wear shorts there.  Am I the only one with this experience/issue?  This new brace is also less comfortable while sleeping (I forgot to ask yesterday, but I'm assuming I'm supposed to be sleeping in it since I don't want to do anything stupid in my sleep).  And.... until I go to my first PT appointment, it's locked straight, so it's really no better than the immobilizer right now.   Now, this brings me to PT.... To make a long story short, I called this morning to schedule my PT appt. and was told I will have to call back on Friday!  I have military insurance and it has to do with their processing, but I've got a feeling I got someone lazy on the phone this morning, so I'm going to try again tomorrow.  When I heard "call back on Friday," all my good feelings about progress and being able to walk by June 4th went right out the window... and I started to cry.  It also upset and stressed me because I have been talking with my work and planning to get back in the office soon... and this just meant to me that I would have to push that back more also.  Luckily, I work with good people and they calmed me down.... told me to not worry about it.... to take care of myself... to not push myself... and to keep doing what I'm doing for now (working from home).  So, that definitely helped.  Hopefully, I'll get into PT... somewhere... soon!  Oh - another question I forgot to ask yesterday, but thought I would get answered soon when I started PT.... How many times a week is typical for PT?

I think I'm going to leave it there for now with my stuff.... 

Webster - About confidence - I know where I am, so I can only imagine how paranoid you might be having broken the same knee twice.  We have a cat right now and I've thought about how nervous I would be if we had a dog (especially since I love dogs and have had them a good bit of my life, but just inherited a cat).  Since I haven't started PT, I don't know anything about the bone growth stimulator, but it sounds interesting.  And... like you.... though I've been working at home - I'm a bit reluctant about getting back into the office.  I also have a long drive to get there, so I'm thinking I might just start out by riding in with someone (fortunately, I have someone that is close enough to me that understands my situation & can accomodate me and my gimp self )... though it is not my ideal situation.

Pinkstripes - I'm glad you were able to take a shower.   I hope you are doing well.

Ok... I think I'm done rambling for now.  I need to check back in here more often!  Hope everyone is doing as well as possible!! Thanks so much to all about the comments regarding keeping the faith!!! They are much needed and appreciated!

[ShoeCrazy]

I remember how terrified I was to be without the immobilizer. After 6 weeks it was my security blanket. Plus my entire leg had wasted away. The first night "without" it I still had it opened up under my leg to sleep. So afraid of hurting it somehow. But once it was off I was never putting it back on!! You will be cautious for a while yet. That's ok. The tears and rough days are hard to handle too but somehow make you stronger. The good days will come and you will be thrilled with little things once taken for granted. Like a bigger choice of clothing to wear!!!Especially when shorts don't always work in certain climates!

Fortunately my experience has restored my faith in medical care. That it is there when you need it and there are very admirable people who truly love their profession. The ones who don't, stand out more than ever and make it very clear to me who I am willing to have work with me. I know sometimes you don't get a choice. But we all learn from our past experiences and hopefully(like you did) have better ones in the future.

PT will be your next challenge. Good and bad weeks ahead. But you can do it! I am still not out of the woods but have come a long way. Even after my post last week( things were feeling great!) I find myself on Monday sore and having to pop some Advil and ice my knee. Don't think I can pinpoint anything different that would cause it.  Bit of a rollercoaster ride this injury.

Best wishes for good days ahead in your recovery

[webster1661]

Well, I survived 2 days being back to work this week! That's driving about an hour (fx left patella, so no manual transmission for a while! too bad, cause I like driving my mom's car from time to time).
Now for another (torture) pt session tomorrow. I'm really hoping I get past 90 rom.

Pinkstripes and fsugirl: glad you were able to shower! I remember being terrified too without my immobilizer. My knee would be really wobbly and I'd be afraid it would give out on me or somehow bend backwards!  I actually used a bath seat for the longest time! You know one of those plastic ones with holes in it for the water to drain (available from medical supplies places). I would then use the handheld shower attachment. I still had to get hubby to wash and dry the toes on the injured leg! (What do people do who don't have a partner or a supportive one?). I am happy to report I am now standing for my showers, bending my knee 90* for drying toes!! But I still need to sit on edge of tub, swing good leg out first, and then stand up and work bad leg out carefully. It is definitely an art.

(There is something weird happening when I try to type a long response.... so I will post this and continue in another one right after...tbc)
C

[webster1661]

me again... part 2:  I got a chuckle about the shorts comments! Last summer when I first broke my knee I lived in shorts and t-shirts. This time it was winter and I lived in pj-type pants. One trick I learned tho' was it was easier to wear the immobilzer OVER THE PANTS. This served 2 purposes: 1) it stopped the brace from slipping further and further down my leg!, and 2) it was obvious to other people that I was injured.
Now that I'm back to work some days, I'm having to choose a slightly different wardrobe, but still basically wearing loose-fitting pants so I can hike them up and put on ice packs throughout the day (and show off the scar to people who can handle it!).

fsugirl: I'm glad you got stronger and more confident to tell the xray techs what you can and can't do and to say what you need. Some are really good, but others can be really "ignorant" for lack of better words! THEY DON'T KNOW OUR PAIN!   I hope you get things sorted out about your insurance and get clearance to start pt soon. As for your question of how often.... they are typically in it for a business so they will want you coming as much as possible! Depends on your insurance coverage limit, how much time (off) you can afford to go to the appts, and also how dedicated you are to following thru with exercises at home (if you do them regularly you can probably go less often). I started 2x a week only for 2 weeks to try to get my knee moving/bending quicker but now I'm going 1ce/week (to make my insurance $ go a bit further; and due to shortage of time, but I'm faithfully doing my exercises 3x a day at home).

I hope this helps... everyone should decide how often in consultation with their pt, OS, and any other specialist they are seeing, but ultimately it is YOUR BODY adn you will know what rate you should progress at.

Take care, hope everyone manages to get a GOOD NIGHt"s sleep!! I'm back to my pt tomorrow.
(p.s. my "reply" is now jumping around on my screen again... does this happen to anyone else???)
 posting now...C

[lostpirate]

I can answer some of the PT questions.

I am not surprised it's taking a little while to get that 1st appointment scheduled. I remember when I started PT, it took a full week for me to get that initial appointment ironed out and made. A lot of that is because with that 1st appointment it is basically an evaluation of your knee. They want to see where you are. How much initial ROM do you have? Can you walk without your immobilizer,? Etc. It's kind of a baseline thing to see where your starting out at and what kind of program they need to build for you. Also, the 1st therapist you see may not be the one you will be working with. With my 1st appointment I saw the head therapist. He did my evaluation and they next time I came in I was given to a different therapist and she was the one I worked with. Part of why it took them a week to get me in was because that 1st appointment had to be with the head therapist and he had a pretty full schedule.

Once I began therapy I went twice a week. How often you go depends on how your recovery is going. If things are going slow they may bump you up to 3 times a week. I went 2 days a week for about a month and then one of the pins in my knee slipped. My OS took me out of PT then. About the only thing he let me do was work on my ROM. A month later he went in and removed the pin that slipped. After that he said no PT except for ROM and non weight bearing exercises until all my HW was removed. 3 months later he removed the rest of my HW (the other pin and wire) and said I could begin PT again. This time, though, he said I did not need to see my therapist and could do it all on my own at home.....In hind sight, THAT was the worst decision I made in my recovery. For about a year I did stuff on my own at home and progressed slowly. After a year I was pretty upset at where I was and talked to a friend that is a therapist and she said if my OS did not think I needed PT and did not want to give me more to get a 2nd opinion. I did and my new OS said I needed more PT and hooked me up with a new therapist. Once I got with my new therapist my recovery really took off. He had me jogging, jumping and skipping in 2 months! All things I never accomplished in a year working on my own!

When I started seeing him. I went once a week for about a month, then he dropped me down to once every 2 weeks for another couple of months. After 3 months with him he released me. He said my knee was back to about 95% and that I could do anything I wanted to on it, provided I could overcome the mental blocks. And trust me, those mental blocks are HUGE. As you progress in PT it becomes more of a mental thing then a physical thing. Even though, the fracture is healed you will still be scared to try things for the 1st time. Your leg will be able to take more then your mind thinks it can. You got to convince your mind to "just do it".

One thing I will say about PT. If you are not happy with your progression or not comfortable with your therapist get a new one! Once again, with hind sight, I think my 1st therapist didn't really know what she was doing. I think I may have been her 1st fractured knee. She pushed me hard and I think that is part of the reason my pin slipped. She also pushed my hard enough that I pulled my hamstring at the end of a session one day and that knocked me out of PT for almost 2 weeks! I had told her my leg was getting sore, but she had me keep doing things. I should have stopped her and ended the session, but I thought she knew best.

When I got with my new therapist things were a lot different. It was apparent from the get go that he had dealt with injuries like mine before. I actually requested someone who was experienced with knee injuries this time around. He knew things my 1st therapist didn't. When you are immobilized all the muscles in your leg weaken and they all need to be strengthened. A very common source of knee pain and weakness is the hip. Weakened hip muscles force the muscles around the knee to compensate and that can cause problems. Such was the case with me. My hip was weak as was my VMO. For the 1st few weeks he had me doing nothing but working on those muscles to get them caught up with my other ones (My 1st therapist didn't seem to know any of this, she just focused on my leg muscles and never did anything with my hip). Once my hip and VMO caught up he then had me doing things that worked all my leg muscles together and that is when things took off. And things came quickly then. Jogging, jumping, skipping all came one after the other for me in a matter of about a month and half. And, he really keep a tight rein on what I did with him. He never pushed me too hard in a session. He was always asking me how my leg felt. If he saw me getting fatigued or If I said my hammy felt a little tight, that was it for the day. He shut me down, iced things and told me to take it easy for day before working on the exercises he wanted me to do at home. I wish I had gone to him form the start. Messing around with that 1st therapist and then doing things on my own probably set me back about a year. Had I been with a therapist like my 2nd one from the beginning I probably would have recovered a year earlier then I did.

Anyway....good luck with your PT! And remember, you will have a lot to do with how quickly you recover. Your therapist will have lots of exercises for you to do on your own at home. How hard you work at home on those exercises will have a lot to do with how quickly you recover. Those that work hard at home recover faster then those who don't. Some people don't like to do much on their own at home and it takes them longer to recover. A therapist is basically a coach. Every time they see you they see where you are and then tailor a specific exercise regimen for you to work on at home. As you work on those exercises and your leg gets stronger your regimen gets changed. More advanced and demanding exercises get worked in. PT is like practice for a sport. Those who practice every day and work hard get better and better. Those who don't take it seriously and take lots of days off from their PT at home don't....

[pinkstripes]

lostpirate: great information about PT. Thanks!
fsugirl: I've only worn shorts or pajama shorts since I broke my patella.  And like you, my next OS appointment is June 4th.

A brief update on me:

Fracture/patella: I broke the bottom portion of my patella into three main pieces which the OS used one big screw (no wires) inserted perpendically through the pattella. Based on the type and location, my OS says it most likely will not have to be removed. I had internal sutures so no

Pain: don't have that much pain anymore and don't take anything regularly other than an occasional motrin. I only tend to have pain when I've been on my feet walking around and it's usually the leg muscles not my knee.

Activity: I was directed to weight-bear as tolerated from the get go. This is a saving grace for me as I enjoy baking and have been able to bake a lot while being homebound. Similar to most of you, I was very active prior to my fracture (biking 40 miles a day, running marathons, etc). To keep some semblance of activity I've been doing crunches, push-ups, and arm weights. I occasionally attend a TRX suspension training class at local studio.

Work: I was completely off work for the first 3 weeks post-fracture. Now I'm cleared to work from home for up to 4 hours a day until June 4th when I will return to the office (and stop wearing shorts!)

Post-surgical follow-up: yesterday (5/7) I had my first post-surgical x-ray. I was a bit nervous about it because I was afraid that it would show i'm not not healing correctly. When I went in for x-ray, the tech said my doctor wanted a bent leg view. I was laughing with the tech because it was the firs time I've bent my leg in weeks. Per x-ray, I'm healing fine and am cleared for physical therapy. I don't need to wear my brace all the time (yay!) and can bend my leg as tolerated and to use heat/ice. My doctor said my ROM is 70 degrees. My next appointment is June 4th.

Physical Therapy: At my first post-surgical visit (4/18), my doc made the referral for physical therapy for twice a week for 4 weeks pending my clearance at yesterday's appointment. The physical therapy office should call me by tomorrow to schedule my first appointment.

I'm amazed at how much my quad atrophied. I measured the difference between my legs yesterday and it's about an inch and half.

In other news, my wedding is on 5/19 and the half-joke for awhile was that Paul would walk down the aisle instead of me. But I've been practicing and now that I can go braceless I'm good to go. It's a smallish (60 ppl) casual backyard wedding, so not a long aisle. My dress is scheduled to arrive today. I hope it fits okay. I ordered it prior to my fracture and it's knee length. I've been eating healthy, lots of fruits and vegetables and my clothes (at least my shorts) still fit.

[Rollerblader]

Pinstripes, I'm curious to hear about the wedding . Hopefully everything went smoothly, and if not, it's a good funny memory.

Take care,

RB

[fsugirl]

^^ I was just thinking the same.  How did the wedding go, Pinkstripes??

I also must tell you I am so jealous of your recovery.  I am currently stuck at 60 degrees ROM and starting to get a bit frustrated and depressed.   Though jealous, I'm happy you were able to get so far along before your wedding.  I hope it was fabulous!!

[Rollerblader]

FSU girl- I'm so sorry your ROM is coming along slower.  It's very frustrating to feel like you are lagging behind.  I was at only about 35 ROM at nine weeks.  How is your PT working out?  What type of therapy are you doing?  Do you ride a stationary bike?  Sounds impossible, but I got a recumbant bike and my PT had me ride around as far as I could go and then ride it backwards around till I couldn't go further.  I'd push trying to bend it farther.  You need to set it in a close position to make your leg bend more instead of trying to get your leg straight.  My Pt told me to do this 3-5 times a day for 5-10 minutes each time.  Another thing I did that helped was to hang my leg off the bed and take my good foot and push the foot on my bad knee down.

Is your PT pushing you very hard and is it painful? 

Sending healing rays and extra ROM your way!  Keep your head up!  It will get better!

Take Care!

RB

[fsugirl]

Thanks SO much, RB!!

PT is going well.  At first, I don't think she was being aggressive enough; however, since we're moving slowly now & becoming kinda stagnant... and because my OS said something at my last check-up... she's been more aggressive.  Yes - it hurts!  We do the stationary bike.  I don't do it as much as you said you did, but maybe I should start trying to do it more often.  My husband laughed at me the first time he saw me do it.... I made a big deal about going to the gym.... Then, when we got there and he saw what I was doing, he was like, "That's all you came here to do?!" LOL  Just wait until I can make a full circle!! He'll really laugh then!  We don't have water therapy at my PT office, but since the pool is now open in my condo complex, I've been trying to get down there a good bit.  I think those things help, but what I think was really holding me back.... and now that I've acknowledged... is really helping me progress (just 2 degrees today, but still progress ) is... I think I have been propping and keeping my leg straight too much.  I also wasn't paying close attention to 'how' I should be bending/walking when I walk.  I'm now making a concerted effort to pay attention to my good leg and walk the 'right' way (even exaggerating the bend/kick when I walk)... and trying to not 'prop' my leg as much... and doing more of the kinds of thing you mention.  In PT - we've been starting each session with my leg over a bolster (heat before and ice after), and putting a weight around my ankle.  When at home, I'm trying to do more of that sort of thing... letting my leg hang more... bend more... etc.  I really think that's what makes a difference.  It's nice that I've been surrounded by such great support, but I think that is what has also held me back a bit.  Really starting to puch myself more now.

Thanks again for the words of encouragement!!! It really does make all the difference!!!

[Rollerblader]

It sounds like things are improving.  You are right about hanging your leg.  It's the little things... My PT one day asked me if I was propping my leg up and I said yes, when I'm sitting, which was alot of the time.  She told me to stop propping my leg when I was just sitting around, unless I needed too.  So I started letting my leg hang down and I used a little stool  6-8" high stool to rest my foot on before my foot would touch the floor.  I would also scoot forward on my chair until my foot was on the ground and then I would kind of lunge my knee forward with my foot stuck to the floor.  I tried to do this constantly when I was sitting, just trying to gain more ROM.

We ended up buying a pre-owned stationary bike, so I'd hop on it every change I could get.  My kids laughed at me, too!  I remember my youngest, though, she was so encouraging when I finally made it around!  What a celebration!  We had to text my hubby.  It's easier to go around on a recumbant bike than an upright.  The upright was really torture to me when I couldn't get around. 

Keep up the work!  Stay posative!  If you have an iPhone, there's a pretty accurate app that measure ROM.  I used it alot.  It sort of was a quiet encouragement to me so I could check my progress.

Take Care and keep us updated!

RB

[fsugirl]

Thanks again, RB!!  And thanks for your posts about your MUA and recovery.  I'm not getting past 63 degrees, so I'm likely looking at an MUA VERY SOON!!  To be honest... I was much more upset and worried until I started reading all of the posts on here... especially yours.  Monday, I go back to my OS to find out what's next.  I'm hoping it's MUA and that he doesn't have to cut me open again, but we'll see....

So far, I haven't looked into too many details of the MUA, but rather read some of the posts here for - reassurance that it's ok, it's normal, it happens to many of us, and to know what to expect afterward.  I figure, other than knowing those things.... ignorance (about the specifics of the procedure(s)) is bliss.

It's SO easy to get down & frustrated, so thanks all!!!