Author Topic: Fulkerson TTT & Possible MPFLr for June 14 (Read 3893 times)

2cutekiddos · « **on:** May 15, 2012, 01:23:32 AM »

So exactly one month from today I will be having my 3rd knee surgery and 2nd for my left. This will be my biggest procedure by far! Needless to say...I am pretty scared!!!

I have been to numerous OS's in my life and every time I move I usually seek out a new one. Well, last year I moved, so in the fall I found an OS I REALLY liked! He of course mentioned the Fulkerson which I wasn't surprised about (OS's for the last 5 years have been mentioning it, but with small kids I wasn't ready, my baby is now 5). When I asked about how many he had performed he said one. He really wanted to perform my surgery...said he meticulously prepares for surgery and was up for the challenge. My brain said,"Uh, I don't want to be a challenge!". He was really conservative and had wanted me to be in the hospital for 3 nights.

So, my quest for another OS landed me at Georgetown University in DC with an OS who has done 100's of osteotomies and said he had a 90% success rate! I thought this must be the guy for me...until I wanted to discuss things like "Do I have femoral anteversion?" "You say you have your own technique for a MPFL, can you explain it to me?" or "Do I have trochlear dysplasia?". He was so arrogant, smug, and condescending and he acted like I was too inferior to him. He gave me the line...you sometimes have to just trust the guy who has studied this and done it for 20 years. I of course agreed but then pointed to me knees and said, been there done that and that is why I am talking with you now! It got a lot uglier. If the man had just taken the time to help me learn about my unique knees then I could have trusted him! He was less conservative and was going to have me stay 1 night at the hospital.

These two doctors lead me to Dr. Fulkerson and he is who my surgery is scheduled with. I know he is skilled and knowledgeable in this area of orthopedics, so I am not worried about the procedures. My worry is because he does his surgeries as out patient. Now, both prior surgeries were out patient and I know what to expect but this will be different. I am out of state (7 hours away) having this procedure and completely worried about traveling home right after the procedure!!!

Can anyone who has had these procedures or traveled a distance immediately after surgery give me some tips or try and calm my nerves!!

I figure I will map out hotels and hospitals along the route but I am so scared of complications!!! Fulkerson's office staff suggest leaving while the femoral nerve block is still working...I just can't imagine how "with it" I am going to be right after... HELP...any advice would be greatly appreciated!!!

kianiblueangel · « **Reply #1 on:** May 15, 2012, 02:06:17 AM »

Hi,

I am traveling next Monday (well really Sunday) to see Dr. X at Emory College. I know from my first three appointments that were all wrong that it is worth waiting to see a specialist. I have heard of Dr. Fulkerson but we have not tried his office yet.

My dad has something in his knee last time he had surgery. He has suffered through 8 TKR's and they put something called an ON-Q in/on his knee. It was basically two bulbs of medicine with two tubes that went right into the knee. The bulbs lasted 3 days and he replaced them twice after getting home. Basically, it was about 9 days of relief.

My dad has had more than twenty some major surgeries and his tolerance for pain medication is very high. This really helped him for the first time because so many of the nerve blocks failed. If they don't get the block right you wake up suffering. He really liked the nerve block if it works. He will not let them put him to sleep until he is sure the block is working.

I hope your trip goes well and let me know how you make out with Dr. F.

Kiani

2cutekiddos · « **Reply #2 on:** May 15, 2012, 02:15:59 AM »

Thanks Kiani, I have never heard of an ON-Q...I will have to look into this. I wonder if it is something you have to ask for or the doctor just does it? I too am worried the femoral nerve block won't work..I am a little chicken of getting it though. I have had an epidural (for childbirth) and it wasn't bad so I hope a femoral nerve block would be about the same???

Good luck with you Kiani...I have read your post and numerous ones by your dad! I definitely think Dr. T or Dr. Mark would be the doctors for your knee! I will be anxious to hear how that visit goes!

Oh...I forgot to mention I will be traveling by car! Has anyone done that a long distance? I am trying to picture how to elevate my knee while traveling. I will be riding in my Dodge Durango, so plenty of space in the back.

Andrea

KW · « **Reply #3 on:** May 15, 2012, 02:39:09 AM »

Quote from: 2cutekiddos on May 15, 2012, 02:15:59 AM

Oh...I forgot to mention I will be traveling by car! Has anyone done that a long distance? I am trying to picture how to elevate my knee while traveling. I will be riding in my Dodge Durango, so plenty of space in the back.

Umm....Pillows across the back seat + a CryoCuff IC with a car adapter.

captainruss · « **Reply #4 on:** May 15, 2012, 09:09:38 AM »

Andrea,

The ON-Q thing is not new, but I had so many troubles as Kiani indicated that I would wake up in recovery screaming. I have an implanted dilaudid pump and because of it, the anesthesiologist would not give me much medication in recovery. My OS was there and I remember of TKR #7 him shouting "Bomb him....just bomb him so he stops hurting!" He came up with the idea. I guess it is old school. They use it in shoulders, etc. Very simple in design as you have a strap that goes around your neck holding the two bulbs of topical medicine. It goes right into the joint wound and is adjustable by either the doctor or the patient. My doctor adjusted it and I did nothing. I awoke in recovery with pain, but not excruciating pain. The system cam be used for only nine days as it can damage tissue if used too long.

The femoral block is the bomb if the anesthesiologist is not a horses butt. If they don't use ultrasound to find the nerve, they must poke you until your foot twitches. Just because your foot twitches, does not mean he put the needle with the med in the same spot. Most times they like to do this when you are asleep so you don't react to being jabbed multiple times. This keeps them from having you try to move the leg. Normally, the doctor will be waiting for me in surgery so they rush through it or they get impatient because they don't find the nerve.

If it works, the block is the best. I can't get doctors to NOT put me to sleep first. I get so angry, but the On-Q is fantastic. The doctor simply pulls out he catheters like he does the drain or you can do it. I did mine.

I will find the paperwork and try to get you the web site. The thing about the On-Q is it works, it is adjustable if you need more or less, and it gets you over the bad part. After the first five days, we seem to handle the pain better.

Russ

2cutekiddos · « **Reply #5 on:** May 16, 2012, 02:20:22 AM »

Thanks Russ for the info on the On-q...I am hoping the femoral nerve block will work. My epidural with both my children worked so I am hoping a femoral nerve block will be similar. I think I will take my chances and hope they put me to sleep before putting it in. I am a chicken when it comes to needles!!!

Thanks KW for suggesting pillows. I thought I would get some body ones too! I was looking into a wedge style one to help elevate my leg too. I am trying to see how I could jimmy a sling to be able to hold my leg up for me...anyone have ideas?

Did anyone have outpatient done by Fulkerson? I called his office to see when PT might start and the front office person said around 4 to 5 weeks post op...does that sound right for what I am having done?

Good night all!

captainruss · « **Reply #6 on:** May 16, 2012, 04:19:04 AM »

2cute,

The On-Q has no needles. It has two soft tubes or catheters that are sewn up in the wound and dispense pain med into the joint. The nerve block requires being poked by a needle sometimes multiple times. Please don't get me wrong, when the nerve block works it is heaven ! The only problem I have is the anesthesiologist has trouble finding the nerve. If the surgeon is waiting and he cannot find the nerve, they have sent me to surgery without the block. The block is excellent, but usually with someone my size it takes an ultrasound to find the nerve. He then must hit the nerve with the needle.

If he does not keep you conscious until you can make sure your knee/leg is completely numb, you have no guarantee of pain relief after surgery.

The On-Q is a simple anesthetic that goes right into the knee and reduces the pain short term (6-9) days. Just think about it. The catheters can be put in easily during surgery. If you get to recovery and the block is ineffective, they simply attach the On Q bulbs and start the relief.

After the 9 days, I simply yanked them out like you would yank out a drain. If feels funny, but not painful. Just a thought....I won't have another surgery without trying the nerve block AND the On Q.

Russ

lululocket · « **Reply #7 on:** May 16, 2012, 06:56:07 PM »

In the UK, (at my hospital anyway), they normally just do a femoral nerve block with a needle and they do sometimes miss (not often, but occasionally. They put it in after you're already out, so they don't check it's working. This happened to me the first time - it's normally not a big deal, they just give you morphine/whatever and you get through the pain with something else instead of a nerve block.

Unfortunately I reacted really badly to morphine (hello food I just ate...) and so when I had my TTT on the second leg I asked if there was any other option. They said that they could use ultrasound to guide in the needle for the femoral nerve block (as captainruss mentioned). It is more expensive and slower, but has higher success rates. It also means they don't have to keep you awake to check that it worked. Given you have to get in a car, maybe you could request ultrasound to help, or anything else that will increase the reliability of the nerve block.

For me, since I knew I wanted to avoid morphine if possible, they were happy to make a note and prioritise the extra time to do the ultrasound since the first time the morphine made me so sick, I had an extra night in hospital. It's pretty unusual to react like that though, so don't worry!

This time, I asked to speak to the anaesthetist in advance. I talked over all the nausea and pain issues I'd had the previous time with the anaesthetist on the phone about a week before the procedure, and we made a plan for other painkillers, including this ultrasound. And then on the day, he checked in with me before scrubbing up and I made sure it was on my notes to take the painkillers we discussed. After that extra time planning, it all went like clockwork. I had my procedure late in the evening and stayed overnight (that is always my OS's protocol as he operates from 6pm onwards in that hospital). Outpatient would have been okay too if I didn't have an option to stay overnight.

allyd · « **Reply #8 on:** May 17, 2012, 02:45:28 AM »

My Femoral Nerve block worked great. Like mentioned in previous posts, ultrasound works the best. They used it to guide the needle into the nerve, in addition to visibly watching my leg twitch in the right places. I was still awake when they did all this, in pre-op. Took maybe ten minutes start to finish, no big deal. I think every anesthesioligist just has a preference on how they do them. Probably will be the way to go for you. Mine lasted 10+ hours before I could REALLY feel my leg under my own power. Start taking the pain killers right away so that there isn't a gap between it wearing off and getting the drugs in your system. It won't be a 'fun' trip, but you'll manage.

2cutekiddos · « **Reply #9 on:** May 21, 2012, 01:20:06 AM »

Thanks Russ, Lulu, & allyd for your responses!!!

The On-q doesn't sound as scary now that you have described it Russ! I will talk to the anesthesiologist about it and having the ultrasound for guiding the nerve block in. I definitely want to talk to him about pain killers that are easy on the stomach. I have thrown up on Vicodin and Darvocet with past procedures. They offered me percocet with when I had a c-section but I refused any for fear of throwing up!

I have read some posters who have taken fentanyl... is it easier on the stomach? Anyone have some great pain killers they would like to suggest? I would love a list to talk to the anesthesiologist with.

As June 14 is nearing I am trying to get as many things lined up before hand...so I called Dr. Fulkerson's office to ask if I will need a CPM (I had one with both prior surgeries) and they said no. Didn't concern me too much since I have read a lot of posts of people who didn't have one. Then I asked if I would get an ice machine/cold therapy unit (cyro cuff) and again she said no and that the Dr. doesn't use them.

Now this made me wonder why? Especially since most on here rave about them! So I did a little research because if a well known Dr. doesn't use them I sensed there must be a good reason. Upon my research (Google) I found that there have been many problems with incorrect use of the machines. Some people have been burned, frost bit, and even had nerve damage. Some articles suggested that in appropriate use could contribute to developing CRPS!!!

I am not sure my research has lead me not to use a unit...but I thought it was pretty interesting. Obviously, I would only use it as directed. The articles said the biggest problems were that patients were numb from surgery and could not feel if the unit was too cold and also from leaving the unit on for too long.

I am looking into buying the Breg Polarcare Kodiak with the battery pack (so I can use it on the way home!). I would love to know everyone's thoughts on this unit and if you think a cold therapy unit is a good or bad idea???

Lastly, tomorrow I go for my pre-op physical!! It is starting to get real for me...

oohheykate · « **Reply #10 on:** May 21, 2012, 02:10:51 AM »

2cutekiddos,

I have the Polar Care Cube, it's like the Kodiak but bigger and without a battery pack. I love it and it still works over a year later after using it almost every day for six months for more than 12 hours a day. You shouldn't get ice burn if you use a protective barrier-- I use an ace bandage and have never had a problem. I adore my ice machine. The compression plus ice is an amazing feeling. It made recovery so much better. I actually bought another accessory for it so I could use it on my hip. It's definitely worth getting one if you can afford it. Also, if you decide to get one, use frozen water bottles instead of ice. It saves a ton of money and stays cold much longer.

Good luck!

2cutekiddos · « **Reply #11 on:** May 21, 2012, 02:32:56 AM »

Thanks Kate! Glad to hear the ice machine was a success for you! About how long did you keep it on your knee right after surgery? I hope my doctor doesn't get mad at me if I buy one... I am hoping he doesn't prescribe them for liability reasons only!!!

...by the way, I have read all your diaries and posts and they have been very helpful!

Andrea

oohheykate · « **Reply #12 on:** May 22, 2012, 12:37:18 AM »

Andrea,

I'm glad my posts have been helpful to you! About the ice machine-- I woke up from surgery with the ice machine running and had the pad around my knee 24/7 for about twelve days until I had to go back to school, then I just used it as soon as I came back from school. I even slept with it on. Most advice is to ice for 20 minutes per hour but my OS didn't have a problem with me icing that much and I didn't have any ill effects from it. When I started becoming more mobile, I only iced throughout the night.

2cutekiddos · « **Reply #13 on:** May 22, 2012, 04:19:45 PM »

Yipee...just spoke with Fulkerson's office and they said if I bring my own Cold Therapy Unit with me then they will put it on in the operating room!!! Since the Kodiak is the only model with a battery pack, I am ordering it right now! The best prices I have found on machines are at MMAR medical distributors. http://www.mmarmedical.com/Breg_Polar_Care_Kodiak_p/106xx.htm.

Thanks Kate, I am glad to hear that you used it for long periods of time with no problems! ...has anyone had any issues with these devices?

Also, I would love to know of painkillers that people thought were easy on the stomach. I hate throwing up because of them!!!

oohheykate · « **Reply #14 on:** May 23, 2012, 01:26:37 AM »

I'm assuming you've tried taking anti-nausea medications along with pain meds? I've never had any problems with pain meds other than getting ghostly white, as my father put it, when I take them on an empty stomach. If narcotic pain meds are a problem, in general, Tramadol is a great alternative. It's non-narcotic but still provides great pain relief. I was using it when I went back to school about two weeks after surgery because I wasn't allowed to take Vicodin there. I honestly didn't feel any difference between taking the Tramadol and Vicodin. I'm also able to take that on an empty stomach and feel perfectly fine.

2cutekiddos · « **Reply #15 on:** May 23, 2012, 02:44:51 AM »

Hi Kate,
I know it may sound stupid, but no they did not give me anti-nausea meds for my surgeries!!! I was 19 & 22 with my first surgeries and it was pre internet so I wasn't as knowledgable about these things. I have heard others mention Tramadol so I will definitely be pushing for it! I saw your super cute pic for prom...glad you had a good time! Graduation is wonderful and there is so much more adventures to come! I can't believe I will be having my 20 year reunion this September! I hope to be walking somewhat normal then and hopefully without a brace!

On another personal note...I just had to share a pic of my youngest graduating from Pre-K this past weekend!!! He is half the reason I have waited so long to get this procedure done or maybe he was my excuse as I am completely scared out of my mind for it!!!

Well, I hope this isn't the last image of me ever kneeling again!!! Please tell me that someone out there has full ROM after these procedures???

oohheykate · « **Reply #16 on:** May 23, 2012, 03:29:17 AM »

It's not stupid! I never had anti-nausea meds until my last two surgeries. I was given Zofran and it worked wonders. And thank you! I know there are wonderful things that will happen after high school, I just love high school so much. I'm sure I'll say the same about college. I get attached to things and hate change.

Your son is adorable!

The only reason I can't kneel is because I have nerve damage to the skin over my entire knee and it hurts to put pressure on it. I got that when I had the medial reefing done. Nothing changed after my MPFLr. I'm sure I would be able to kneel if I tried and kept doing it but I don't because I couldn't kneel before any of my surgeries so I'm used to it. But since you're having a TTT you might not be able to kneel until you get the screws taken out, if you decide to. Do you have any nerve damage from your MR? You might also be able to kneel if you gradually start kneeling on different surfaces after you're allowed to. My PTs used to do that with me. And I actually have full ROM now! When I was released from PT in August, I had about 125 degrees but, in January, I realized I could finally bring my foot to my butt for the first time in years. If you have the MPFLr, you'll have to be more proactive about regaining ROM but I think regaining ROM after a TTT alone isn't as difficult since the work isn't done on something that prevents bending...but I could be wrong!

2cutekiddos · « **Reply #17 on:** May 25, 2012, 02:17:38 AM »

@ Kate...glad to hear you regained ROM!!! That is encouraging!! I am lucky enough to say that I gained back sensation (on both sides) after my MR/LR surgeries. It did take some time though...those surgeries were 16 & 19 years ago (boy do I feel old...yikes!), so I am a little foggy as to when the sensation fully came back. It was weird to kneel when they were numb and I HATED shaving my legs! I was so worried I was going to cut myself because I couldn't feel the razor!

Thanks for the Zofran suggestion...I am adding it to my list of items to discuss with the anesthesiologist.

Well tonight I was carrying that adorable son of mine and guess what happen...yup left knee gives and we go tumbling! I usually never say dislocate or sublux because it is a little bit of both! My patella already sits in a rather subluxed position and when it "dislocates" it slides completely off and then reduces on its own like a rubber band.

My question is to those whose knees sublux/dislocate, what is your experience when this happens?

When I was young (ages 7-18) and my knees "went out" I would cause some definite damage and my knee would swell up and I'd be on crutches for two weeks. Then something happened...when they would "go out", yes I would be excruciating pain but after a few minutes I could get up and go on as usual. I also have never counted how many times my knees have subluxed/dislocated over my lifetime but I am starting to wonder what is a lot? I mention that my MR/LR surgeries were failures due to the fact that my knees still sublux/dislocate but the number of incidents were reduced (I guess that is a positive right?). Prior to my Rt knee procedure it "went out" at least once a week and now it is maybe twice a year. Sounds great but the cartilage damage and arthritis are my consolation prize! I am going forward with the left knee first because it "goes out" between 3 and 5ish times a year (estimate because I just don't keep track).

I am starting to have those thoughts that say "Maybe I shouldn't do this surgery...I mean yeah my knees still sublux/dislocate but it isn't as bad as when I was young and I don't swell up anymore when an "incident happens". Like tonight, I went to a Zumba class and had no problems with any of the moves. My knees are a little achey but I have been dealing with that for 20 years.

I keep telling myself that I am doing this procedure to not only provide my knee stability but to off load the forces on my lateral articular cartilage so I can hopefully stop future cartilage loss and damage. Another worry I have is that if I do nothing that my local mild arthritis will turn into osteoarthritis...and that a TKR will be my future.

I read everyone's posts on here and think, wow most people seemed to be in a bad way (pain) prior to surgery and it makes sense that they went ahead with it. But for me, I don't know any different way. I have ALWAYS lead a modified lifestyle (I have never ran, I hold railings down stairs as I have gone down many because of my knees going out, I guard my knee around others as being knocked from behind has caused them to give way, I hold onto nearby objects when roads are wet or icy, etc). At the same time I have not let my knees limit me either. I have enjoyed fitness and physical activities too because for me I never know when my knee will "go out". I could be walking and turn one direction and whammy I am on the floor and other times, like tonight I was cha-chahing at Zumba and had no problems.

Okay...thanks for letting me rant, my nervous are getting the best of me. I know these are the right procedures for me but I can't help having my reservations!

allyd · « **Reply #18 on:** May 25, 2012, 02:42:29 AM »

I also regained full ROM - was at 135-40 before surgery (8 months), and can get there no probs today. Got back to full ROM somewhere in between month 2-3. Kneeling, not so much yet for the same reason Kate stated. Just to numb yet from from the incisions... but no pain when I do kneel, just to odd to not feel the ground beneath me. But I like to hear yours dissapeared from your earlier surgeries!

My experience w/ dislocations, etc is sort of opposite yours. When I was 12-18, my left knee would go out - and I'd be up and running hours later. I like you don't count "subluxation" as an event. I need to be on the floor in pain/shock for it to count.

10 years later, my right one went and recovery was weeks each time. Before I had surgery, I could function with-in daily activity, and modified fitness. But what fun was that? My main goal with surgery was to remove modification from my life. The stability is amazing, and I didn't even realize how much I modified my daily life - how I got out of my car, the railings, walking/turning a corner, etc. It's sorta nice not constantly watch where I walk. I by far thought the same thing in reading other stories - I'm not in that bad of shape - I'd only had a couple dislocations; yeah, I felt it shift, slip and slide everyday, but it was manageable, didn't have a lot of pain. I did my best to try and talk myself out of it. Best decision I've ever made - both long term and short term. You'll probably be suprised at how much you have actually modified because of the instability, time to learn a new normal!!

2cutekiddos · « **Reply #19 on:** June 05, 2012, 01:10:13 AM »

@allyd...that is great that you were able to get back to full ROM that is one of my main goals!!!

So...I am now on the count down, 10 days to go. I am really starting to get nervous, every now and then I get twinges of a nervous belly and doubts start to creep into my head!

I am trying to get everything ready for my surgery. The portable battery pack for the Polar Care Kodiak has arrived but the machine hasn't yet...hopefully tomorrow! My mother flies in from California on Wednesday and will be staying with me for the next two months!!! What an awesome mama...plus she will be taking care of my two little ones for me!!!

We will be traveling from Northern Virginia area to Connecticut. I am debating on routes and would love some input. Google directions say the fastest route is to take the 95 which will make us go through DC, Baltimore, Jersey, and New York. I am worried about traffic. The other alternative is to take the 81 north and go through Pa on the 84 E to NY and finally Ct. It is an hour longer but we don't have to go through major metropolitan areas so I would hope traffic is less.

Anyone drove these routes before?

Thanks!

RLE · « **Reply #20 on:** June 05, 2012, 01:59:45 AM »

I know you're nervous but wow, to be getting your surgery done by the guy who invented it? How lucky is that. Surgery isn't exciting I know but this kind of is. I'm so happy for you that you know what you need and you're going to get this great surgeon.

2cutekiddos · « **Reply #21 on:** June 11, 2012, 08:17:33 PM »

Well...tomorrow my mom and I leave Va for Ct! We decided to take the 81 North to the 84 East. Even though it is longer we hope to miss big city traffic like NYC! I see Dr. Fulkerson on Wednesday and Surgery on Thursday.

I had my pre-op interview with the surgery center today...I am soooooo nervous.

Unfortunately I had a horrible headache all weekend that turned out to be one of my upper molars. So I had a "wonderful" root canal today. I can only take tylenol now before surgery...bummer because I am such an advil girl!

RLE · « **Reply #22 on:** June 11, 2012, 08:26:51 PM »

Post your updates when you're feeling up to it. I hope you have an easy recovery.

Oh, and what a cutie your little one is!

lisa424 · « **Reply #23 on:** June 12, 2012, 01:25:24 AM »

Good luck with your surgery!

am7800 · « **Reply #24 on:** June 12, 2012, 01:52:08 AM »

Good luck with the surgery!! Hoping everything goes smoothly!

allyd · « **Reply #25 on:** June 12, 2012, 03:32:59 AM »

Good Luck! Hope everything goes as planned!

oohheykate · « **Reply #26 on:** June 12, 2012, 10:49:37 PM »

Good luck with your surgery!

2cutekiddos · « **Reply #27 on:** June 13, 2012, 12:10:08 AM »

Thanks everyone for the well wishes! I am here in beautiful Farmington CT. I am trying to think positively but the nerves are winning...not eating much! I am anxious to meet Dr. Fulkerson and see exactly what he thinks of my knees in person!

Forevergimpy · « **Reply #28 on:** June 13, 2012, 01:26:56 AM »

Best wishes to you on surgery day. Just think you are just hours away from working on recovery!

I know you asked the questions much earlier on this thread, but I always have done well with phenergan as an anti-nausea drug to accompany my pain meds.

Let us know how you are doing when you are feeling up to it.

2cutekiddos · « **Reply #29 on:** June 14, 2012, 01:53:21 AM »

Dr. Fulkerson was very personable! He talked to me first about my history of my knees, about my life, and what I am hoping for! It was nice to have a doctor look at me as a whole person rather than a joint that needs to be fixed.

He did a physical exam and then went out to look over my MRI. He was gone for about 10 minutes. When he came back in he said I definitely need the TTT and a MPFL. The TTT is needed since my TT-TG offset is over 20mm and the MPFL is needed since I have trochlear dysplasia and lax ligaments. I feel very calm now and completely believe
these are the right procedures for me!

I go in tomorrow at 9am EST and in the OR at 10:30am. We talked about using Tramadol so my tummy is happy and he completely is fine with my Polar Care Kodiak unit!!! One of the big pluses to Dr. Fulkerson's office is Donna in his front office. After my visit while I was signing papers I turned to my mom and said, Darn I forgot to ask about removing the loose body and the baker cyst, Oh well I will ask him tomorrow. Donna said, Oh we will just get the Dr. over here and ask him. I said I didn't want to bother him and it would be fine tomorrow. She said oh please, you traveled all this way, you deserve to ask your questions. She pulled me back to where Dr. Fulkerson was. I quickly asked and he pleasantly answered! I LOVE this office!

I hope tomorrow goes smoothly...I will take any positive thoughts tomorrow around 10:30am EST!!! See you all on the other side!!!

2cutekiddos · « **Reply #30 on:** June 17, 2012, 11:41:53 AM »

Well I am finally able to log on and give an update on my surgery. Wow...I can't believe how well the surgery went!!! Dr. Fulkerson is part of the orthopedics of Hartford group and they have their own surgery center. I cannot say enough about what a great place it was! Everyone was geniunely kind and made me feel soooooo calm.

I was given versed to take the edge off of the nerve block. They used ultrasound to guide it in. It wasn't too bad. Then I waited for it to take effect...and thank goodness it did!!!

I went in at 11am and came out at 12:15. I awoke around 12:40 and my head was clear by 1:15pm. They told me that I tolerated the procedure well and that the nerve block was a success. I asked how could you tell since I was out during the surgery and they said that if the nerve block isn't successful the patients heart rate goes up.

I asked Dr. Fulkerson to check my right knee out while I was under and he said I definitely need the same procedures...I am not surprised!

At 2:00 I was dressed, had used the bathroom, and was discharged! I couldn't believe how fast I recovered! My pain level was about a 3...just a deep ache.

We then went to the hotel where I started to ice and elevate. My sleep was intermittent which I expected. The next morning I was still numb from the nerve block!!! I was concerned and call the Dr. to check on it. They said they gave me an extended nerve block...it lasted 27 hours (thank god).

We decided to drive home on Friday. I started out good since I was still numb but about 4 hours into the drive, yup you guessed it, the nerve block wore off! HOLY COW my pain level was a 10! I took two tramadols that helped but the drive was excruciating because of the horrible roads!

We got home to Virginia around 7pm and it was a rough 8 hours until I got my pain under control. I have been doing cannon balls and swirling my ankle (can't remember the names).

Yesterday I was in and out of sleep from the pain killers but really needed the rest.

Well...that is my update and I will probably start a post op diary now. I am scared to see what is under the ace bandages especially since there is some bleeding coming through! I go for my post op appointment on Friday!

I will post some pics from surgery day and from the procedure later! I am so glad I went to Dr. Fulkerson he and his staff are phenominal!

oohheykate · « **Reply #31 on:** June 18, 2012, 01:03:28 AM »

Glad you had a good experience! Too bad the pain hit you like that when the block wore off

I hope you are doing well now!

am7800 · « **Reply #32 on:** June 18, 2012, 03:26:43 AM »

So happy the surgery went well! Hope you are comfortable and getting plenty of rest!

2cutekiddos · « **Reply #33 on:** July 01, 2012, 07:55:49 PM »

Well I am scared to already report that I think my TTT & MPFLr is a failure! I had been having muscle spasms since about the 8th day post op. I usually get them right as I am about to fall asleep. Last weekend and then today I had a muscle spasms so bad that I felt my knee sublux and then get pulled back by the graft. I am worried this means my surgery didn't work. Has anyone had something similar happen to them but it got better? I am very down in the dumps...

Andrea

allyd · « **Reply #34 on:** July 01, 2012, 10:02:29 PM »

I think the worst thing you can do is think it's a failure at this point. FAR to early to tell in my extremely unschooled opinion. I had a lot of muscle spasms the first couple of weeks as well, and had some similar scary episodes w/ my MPFLr - between the spams and your muscles shutting down some, I don't think some movement and poor tracking is that odd early on. Look at it this way, the graft stopped it! lol.

Give it time, get your legs strong again, and see how everything works together with strong quads, hamstrings, glutes, hip flexors, etc. - Muscle strength is just as important to stability as the ligaments themselves.

oohheykate · « **Reply #35 on:** July 02, 2012, 01:34:29 AM »

I agree with Allyd, it's too early to tell if it's failed or not! Don't be too worried but do tell your OS about what's going on. I don't remember when it happened but it was later in my recovery when I was walking around, my kneecap subluxed and it scared the crap out of me. My OS told me it was just from muscle weakness and my knee hasn't done so ever since!

KinnaMarie · « **Reply #36 on:** July 02, 2012, 02:03:27 AM »

I had a surgery fairly similar to yours a year and a half ago (seems like I just had it a month ago..time flies!) But even now I have muscle spasms and it feels as if my knee cap pops out of place. My OS tells me I have lost a lot of muscle which is why my knee gives out and spases, but it really isn't my knee cap coming out...he thinks. So my advice is to as soon as possible get your muscle back because I obviously waited to long and now am stuck.

lisa424 · « **Reply #37 on:** July 02, 2012, 06:12:54 AM »

It's definitely common to feel some instability due to muscle weakness. I also feel like my new mpfls have to work too hard right now because of all the muscle atrophy.
As for the spasms, make sure you stay hydrated and get enough potassium. I don't know if your doctor will give you muscle relaxers...some won't. But they can help as well.

2cutekiddos · « **Reply #38 on:** July 02, 2012, 03:02:19 PM »

Oh thank you everyone for your replies! You all are lifting my spirits and hope that it is due to muscle weakness rather than a failed surgery. The weird part of the two subluxations was they happened when I was asleep! Now I am nervous to go to sleep and therefore I am not getting much! Thanks lisa424 about the potassium suggestion...I will increase banana consumption!

I am going to call my dr. office later to tell him about my episodes and my other issue! I tend to be one of those who has weird skin reactions and I am having one right on my incision site for my TTT. On Friday I had my staples taken out and then the nurse applied what I believe was betadine on the incision. Well Friday was fine but I woke up on Saturday itching like crazy! Itch cream didn't help, benadryl hasn't worked, the only thing that takes the edge off the itch is to ice it constantly! Yesterday raised bumps have appeared in the shape of a rectangle that outlines exactly where the betadine was applied.

Anyone have suggestions to help relieve my itching...it is killing me!!!

Andrea