Bilateral lateral release and patella smoothing(?) done today May 3rd 2012

[colettefl]

Now on day 10 I think.

The last couple of days have been quite calm really. I have been coming down the stairs each morning and up to bed each evening. It is still a tricky and painful manoeuvre, particularly on the left knee and I need a rest afterwards!

I got the letter from the consultant saying that both knees were in fairly good condition apart from the tightness of the kneecap and associated problems and that just a lateral release was done in both. He mentioned my left knee bleeding more so that may be why it is so much more swollen and sore than the right one.

The movement in my right knee is really pretty good and the pain in that knee is not significant and I can take weight on it without a problem.  The left knee though is still quite swollen and sore, it hurts a fair bit to weight bear and the range of movement is quite restricted.

I have a telephone follow up with the hospital on 22nd so after 2.5 weeks and i think that is all i get from the hospital unless i have problems. 

I am starting physio on Thursday with my private physio who I have seen previously.   I am hoping that she will reassure me that all is ok with the left knee as they really are significantly different.

I have also been offered a cheap exercise bike, I would presume that will be good for my rehab eventually but not having seen my physio yet I haven't been able to check. Any thoughts? (obviously I wouldn't use it until the appropriate point and on instruction from physio)

Pain wise, the right knee twinges every now and then but is not too bad, the left knee still needs regular painkillers throughout the day. I am still elevating and icing when I think of it a few times a day.

I will be braving the shower again shortly, the idea of a bath is bliss Krunzer but the idea of getting in or out of it horrifies me so that will wait a while!!

All in all, progressing fairly well for now I think  . I must must remember that progress is not linear and so not to be so disappointed when it gets trickier again.

[krunzer]

Getting into and out of the bath is easier than you might think!  Sit on the side of the tub and put one leg in the tub.  Then you can  put your other leg up on the side of the tub and lower yourself down with just your arms.  Getting out just do the reverse. 

[Tinkerbell11]

Hey ur very brave getting the 2 lr I had my right one done 4 months ago and thought that was tough ! Good to see ur doing well and things will start to feel a little better when u start physio its hard work but makes all the difference as for the exersise bike its a brilliant idea to get it for me the bike was brilliant for range of movement in the knee and good for the quad muscles which because mine got so weak knee gave way on me through recovery so keep them as strong as possible. U might have a few ups and downs through ur recovery period I had a few which my os expected when I told him so don't panic if things suddenly set u back wish someone had told me amount of times rushed to emergancy department thinking something was really wrong like krunzer said the bath is quite easy and always think nothing better than soaking in a hot bubbly bath helped me before bed 2.. U will feel the difference with ur knee and doing the physio but after physio rest and ice ! I always made the mistake of feeling like superwoman well good luck and stick in its tough but gets easier and well worth it ! Xx

[colettefl]

Thanks Krunzer and tinkerbell.  Your bath method does sound good but I have an extra deep bath and at the moment don't think I can lower myself in or get out so it may be a while, not as long as I thought though hopefully.

Thanks for the input tinkerbell, I have been reading your story and have been pleased to see that more recently you feel it's been worth it. I think for me the most shocking thing is the difference between my two knees which have supposedly had exactly the same done to them,  if both had been like my right knee I'd be walking around fine by now I'm fairly sure! I tried to bring physio forward to tomorrow but there are no free appointments, I'm just keen for someone to check the left knee to see that all is actually ok. I think deep down I know it is but can't get over how bruised and swollen (and sore)  it is compared to the right knee which you'd look at and not think anything had been done to. I am not convinced the left knee actually feels any better than it did when I came out of hospital and it hurts up the IT band too. Of course I don't know what 'normal' is, I suspect I have one at each end of the scale!!

Thanks for the advice re the exercise bike, I think I'll go ahead and get it.

Thanks again all, will update again in the net few days

[Lottiefox]

Hi there

Glad to hear that things are going relatively smoothly! I agree on the bath with two bummed knees - bit of a challenge even with a strong upper body! I think it sounds like the left one has some more bleeding going on so it is worth getting it looked at when you can. I remember the notes said there was more bleeding on that one - after a LR the site of the release can bleed into the joint and sometimes its needs to be aspirated, but sometimes it just takes much longer to settle down and stop swelling. PT might be able to help but if you have any concerns then perhaps see your GP or practice nurse if only to put your mind at rest! It does indeed sound like you've acquired the two extremes of post op recovery in one go!!

Bike is always good for knees, PT can guide you but even using one with no resistance can help with your ROM and general blood flow. You're doing fab, keep us posted and hope that leftie settles down this week!

Lottie x

[colettefl]

Thanks Lottie.

You're right about the bleeding in the left knee, I am just about to go to the hospital with a suspected burst haematoma. I went into the kitchen an hour or so ago, went and sat back down to find blood all down my left leg.  Soaking wet sock, blood in trails in every direction.  I put my leg up, phoned my husband to come home and phoned the hospital. The bleeding is now just a trickle as my knee is up but I am fairly sure it'll start flowing again when I stand up and move.  The sister at the hospital was good and they are fitting me in at 2pm.

Whilst I'd rather not have had the shock of seeing lots of blood, I am glad really that it probably explains a lot of why my left knee is so swollen and sore.  I am hoping that they will get as much blood out as they can when I am in there before they re-dress it. I am not looking forward to someone poking around in there though, it might be a couple of tramadol before I go in!

Wish me luck!

[colettefl]

Just back from the hospital. Yes it was a burst haematoma, they weren't worried at all, just cleaned it up and redressed with initial dressing then bandages and compression bandage.

I have to leave the bigger bandages on for 2-3 days then remove and just leave the smaller dressings. As long as it doesn't bleed through all the dressings they are not worried about it bleeding, if it does go through all the dressings then I have to go to the GP and get it redressed.

Swelling should go down in the next couple of weeks. I was told to elevate, ice and move around so that any blood underneath the skin comes out "better out than in" as the nurse said.   I will see the physio on Thursday and see whether she says I can start anything on that leg yet or just concentrate on the right one.

I will update again after the physio or beforehand if anything else happens (I hope not!) 

[Tinkerbell11]

Glad its nothing serious ! Things like that just happening I have been to emergancy room 3 times sinice the lr it will get easier and better ! And will feel the difference with physio ! Xx

[Lottiefox]

How is that left knee feeling after its spontaneous draining?! As they said - better out than in!! Hopefully things are settling down in it now.....keep us posted....good luck with the Physio tomorrow..

Lottie 

[colettefl]

Well physio was interesting! I went in, explained the history of the last couple of weeks and we were brave enough to take the dressings off my left knee.  She pointed out that it was quite warm and obviously a lot more swollen than the right. It was nowhere near as warm as it had been previously though. She then asked to see me walk. I can't walk without crutches so walked with, she noted that the left leg wasn't weight bearing at all.

She then got me up on the bed and wanted to check my range, she was pleased with my right leg but obviously less pleased with my left knee.  At this point I was feeling really quite faint and then my left knee starting oozing again.   I almost passed out and ended up laying there in a cold sweat with my legs in the air, feeling like a real wuss!

She said she thought I had an infection and she was quite concerned about the left knee still oozing and not having healed properly, so sent me to the emergency doctors. She was great actually as she phoned them up directly and insisted they see me (my GP receptionists often fob you off if they can).

I went to the GP and now have strong antibiotics, and am meant to take double dose if my stomach can handle it.  A one week course and a telephone GP follow up in a week.

In the meantime I have heel slides to do, and have also got to concentrate on getting the left leg fully extended as it really isn't great. I am going back to physio next Thursday too.

So, all in all, am feeling a bit crap but glad that hopefully I now have the answer as to why my left knee is so sore and stiff and am doing something about it.  Here's hoping the next few days are less eventful!!

[Lottiefox]

Boo on the infection, but great that the Physio spotted things and got you to the doc's immediately. Hitting it hard with a double antibiotic dose should kick it into submission soon! I guess its hard to get it straight when it is so swollen and still oozing. What have they suggested for the extension? It is still early days and I think you're doing great with both knees out of action pretty much!

Keep up with the elevation and take plenty of rest too if you are battling an infection, I guess you're feeling a bit below par because of that too. Lottie recommends some posh chocs or an internet shopping splurge....after my foot op I became a little too keen with ebay purchases of new handbags, scarves, skincare, and books!! Not good when you're self employed and therefore not earning but I liked hopping to the door to greet the postman! 

Keep us posted,

Lottie x

[colettefl]

Haha Lottie, I am self employed too but worked my socks off in March and April so will have to get spending!! To be fair, I did buy an iPad pre surgery and have bought new bedding and curtains for our bedroom so far.  Am just debating a laz y spa for the garden.... Well as you say, there's not a lot else to do!!

For the leg extension she suggested sitting with pillow under the ankle and letting gravity help along with knee 'braces', so putting a towel under the knee, straightening foot then lifting ankle up for ten seconds. I am to do it 3-4 times a day, 10 reps on right leg and 2-3 reps on left. Also I have to work on putting my heel down when walking on the left foot, as at the moment I am walking on the front of the left foot (ok on right though).

Have agreed to buy the exercise bike now too so will get that in the next week or so. Obviously I won't get on it until I'm told to though.

Colette xx

[colettefl]

Day 19 now and feeling a bit better.

The swelling in the left knee has gone down a fair bit and the movement is getting better. Bruising is also going down but the knee remains very warm, particularly in comparison to the right one.

Pain wise, I am taking tramadol at night time only now. I am also taking ibuprofen regularly to help control the swelling but not needing paracetamol or tramadol during the day.

Movement wise, I can now flex the right knee well past 90degrees, I would guess at 100-110 although that is my wild estimate as it hasn't been measured.  The left one cannot quite get to 90 but is probably at 75-80 at a push. I think I have almost full extension on the right and getting better on the left, not there yet but definitely improving. 

Both knees are achy but I am fairly sure that is a direct result of the Physio so I am not overly worried about it.

I am still on both crutches but have managed a short walk with none, although I'm a bit afraid to show anyone that in case they think I can come off the crutches which I don't think I'm ready for as it is walking with a fair limp and is very uncomfortable. Definite improvement though as this time last week there was no way I would have attempted that.

With regard to the infection, my gut feeling is that the antibiotics are calming the problem but not actually fixing it. The left knee has calmed a lot but is still too warm compared to the right and still stiff.  I suspect it will flare up again when the antibiotics finish on thursday.

I have the follow-up with the hospital tomorrow by phone, so I will tell them what has been going on and hopefully they will not sign me off at this stage. 

[colettefl]

Day 22 - Op was 3 weeks ago today.

Feeling good  I have been to the Physio this morning and she is really pleased with my progress and the way the left knee has calmed since last week. I can get to 110-120 degrees on my left knee and almost full flexing on my right. My left knee doesn't have full extension but not far off and my right is at full extension.

I am going down to one crutch at home but sticking to two outside for my security.  She is hopeful she will sign me off to drive after next week if I keep progressing at the same rate

I had my follow up with the hospital on Tuesday and they were really reassuring, they offered to see me tomorrow if I felt necessary but I didn't think it was necessary at the moment.  I can phone them if I want to see them at any stage but I don't have any fixed appointments.

I am seeing the Physio again next week and have some added exercises to do, in addition to the ones I already have. New ones are based on going up and down a step and also on small controlled squats. She said I can try and get on the bike if I feel like it in a few days time too.

So generally very happy today 

[colettefl]

4 weeks post op

I had Physio again today and she was pleased that progress is being made, it is not as speedy progress as the previous week but she said that progress always slows down as healing moves on.

I am using one crutch most of the time now with occasional times of using no crutches indoors as suits. The Physio thinks it'll be another 2-3 weeks until I am rid of the crutches completely. For now though and until then it is as comfort dictates.

I stopped doing the mini squats after a couple of days last week as they started to hurt and then I got a sharp pain in my left knee, so I am not yet ready to do them. The Physio agreed with that.

Painkiller wise I am still taking ibuprofen with meals, but otherwise only occasional painkillers before Physio and before or after doing a lot of movement.

My left knee is still fairly stiff but definitely improving, just slightly slower than the right knee.  My flexion is full on right knee and nearly there on the left.  Again, my extension is full on the right knee and whilst I can get it full on the left knee with knee brace exercises it is not automatically going straight when I walk, hence the limp that still persists. 

Physio wise, I have the following exercises: a variety of 'funny' walks including walking backwards and sideways!, knee braces, Steps up and down on bottom stair, exercise bike on minimal resistance for 10 mins max at a slowish pace, Heel slides still, Lying on my back bringing foot up to buttocks, standing hamstring stretches (lifting foot back up to buttocks). I may not have the right words for all of those as she just tells me what to do, doesn't always give it a name.  I am also massaging my knees once or twice a day to help to reduce scar tissue.

Today in Physio, we did exercises and she did quite a lot of patella mobilisation work, and ouch the knees both hurt now! I am icing and elevating as I type, Physio combined with lunch out has really knocked it out of me!  I am officially signed off work until today but it is half term next week so in my head I will start work again after half term.  I am fortunate in that I work for myself so can largely time work to suit myself.

Physio says I can try sitting in a car stationery and see how I feel about the pedals.  She thinks I'll be driving in a week or two realistically. Part of me is nervous to drive as, silly as it may sound, I am worried that people will think I am suddenly 'better'.  I guess it's the same as walking without crutches, which I've only done in Physio and on my own at home. That said, the Physio very much said today that I really need to take it carefully to avoid doing too much and aggravating the knees.  Such a hard balance!