Facing upcoming Lateral Release

[Silkncardcrafts]

Sorry to hear, Cari. Definitely let your surgeon know the knee cap went in a different direction. Could make a difference.

Hope you are ok.

[CariG]

Thank you!
I've emailed him with the details, and my GP has already faxed through to him her notes re: travel.
I was observing while a friend moved house yesterday...oh, I better explain that. I was kidnapped and plonked, quite delicately, at my friend's new home and told to supervise as her family were bringing her belongings over. She'd even written a list out for me as to what was to go where.....brilliant way to save me from cabin fever!! Anyway..... back to my original line of thought....whilst I was observing, her brother joked that now I've got a real talent, as my knee can travel in both directions.
I actually laughed when I thought about it...much later. He copped a cushion to the head at the time.
Back to the GP tomorrow morning for her verdict, and hopefully all clear for surgery so we can move ahead and get me on track again. I HATE COLD & FLU SEASON!!!
Just putting it out there.
Here's to us all having a FANTASTIC Monday.
Cari!

[JTB]

I have (does it ever go away?) "Patellofemarol Arthritis" too and had a lateral release (and chondral shave) done over six months ago and am still getting my strength back. Did it improve my condition? It's still too early to say for sure and even if I improve beyond the point of my function before I went in, it would probably be incorrect to say that the lateral release was the sole reason, particularly in light of the condral shave. There are also the studies that find no difference in outcomes for those with PA who elect to forgo lateral release.

Anyway, at this point, 6 months out, I am still not at the point of health I was when I was operated on: my knee still hurts (when not iced), my mobility is limited and the affected quad/IT band is still weak, although I was fairly fit when I went in for the procedure.

My advice: Ask more questions (what grade is my degeneration?), get more info, maybe another opinion and scour sources for more info stilll. A lateral release is not to be done lightly and requires much vigilance for full recovery. Good luck.

[CariG]

Thank you JTB for your kind words.
I have sought two further opinions independently of my OS, for the very reason that I wasn't up to speed on what my options were at that point in time. We'd gone in expecting to be told that the only procedure would be a repeat of my reconstructions, as my first OS had done and was preferring to stick to, though my condition has worsened considerably over the past few years.
So, when I was originally informed of my options for the LR prior to a TKR, both my partner and myself were totally blown away. Thankfully we booked another appointment for the following week, to allow ourselves to get our heads around the new situation and to do a bit of research. That's something I'm still continuing to do, and will continue to do so....I firmly believe in being pro active in my health, instead of taking things at face value.
With the level of damage to my patella, damage to both the medial and lateral cartilage, as well as a severe patella tilt the PKR is out of the question. That was one of the first questions, and preferably my #1 option for any form of replacement, being the wuss that I am. But, with that being out of the question, I've looked at the other options I do have open to me.
There have been in depth discussions with my PT as well, to get his opinion, and to ensure that I'm doing everything physically possible under the circumstances to tackle this head on.
Realistically, even my OS has informed us that my post op recovery is going to be intense...hence the delay due to the recent chest infection. It's put things on hold for the past month and a bit, which is frustrating, but I'd rather do this once, than have to repeat the procedure because my body couldn't do what was required post op due to illness.
If I come up with any other questions, can I pick your brains?? Seeing as you've recently gone through what I am facing? Oh, my partner just asked, if you had it over, would you do it again??
Thanks for sharing!
Cari! 

[CariG]

I'm sure I'm in the process of going batty....it's just after midnight, and here I am still up with cramp like pain through my knee and the intense urge to scratch!! I've actually loosened up the splint, just a little, to help ease the situation a fraction. And am removing all temptation from arms reach for an attack of midnight munchies.
Honestly, I'm worried. The "what if's" are paying a visit, and the mindless searching game I've been playing for the past hour isn't destroying my remaining functioning brain cell.
My man has just gotten up to get ready for work....so thankfully I can resume taking over our bed without fear of disturbing his sleep. I've been cuddling my cuddly puppy dog (my friend gave him to me when I had my first reconstruction) and am hoping Mr Sandman will visit soon...just hope this crampy feeling will take a hike....really soon would be awesome!
Big day ahead, and I will tackle it with my usual mix of sarcasm, humour (great to hide true feelings behind both, as my PT pointed out to me) and whatever else it is that pulls me through. Not looking forward to dealing with people whilst I'm on crutches, though more for their sake than mine.
Nope, going to be positive.....I'll get the all clear from GP, my lungs are doing wonderfully, I actually had an asthma attack today, which is great news, as I only get exercise induced asthma, so obviously my exercising, though limited, was enough to set one off which hasn't happened for a very long time. My man is off to the dentist in the afternoon for some reconstructive work.....stupid coffee has taken it's toll, but fixable with the minimum of fuss, and my brother in law has just asked me to escort him to an interview he has with some business bigwig (no offence meant to any bigwigs out there) regarding something I don't totally understand, but heck, if he wants me there, I actually feel honoured. And everything is going to go smoothly and be successful.
And then, once I have the all clear for surgery to proceed, I'm going to treat myself to a haircut, get my eyebrows waxed and let my friend know she can now book in our joint pedicure/manicures as it won't be long till that's out of the equation for a bit. Oh, and call my OS to book in the next available date...that would help a fair bit wouldn't it???
And if I'm not given the all clear?
I'll come home and bawl my eyes out, probably moan and groan and then ask the universe/creator  how to cope with yet another set back?
Heck, I'm more nervous about later today than I normally am when I go to the OS......silly, silly me. By this time tomorrow morning I'll be laughing at myself and wondering why I was so concerned.
Sorry for dribbling on....and hope I haven't bored anyone to an early grave. Fingers crossed Mr Sandman is about to pay me a visit so I can cuddle up with my stuffed puppy....who is still un-named...ooh, how lax of me. I'll add that to my list of accomplishments for later today.
Take care!!

Cari

[JTB]

Maybe because of some of the differences in our ailments, comparing lateral releases is a bit like "comparing apples and oranges."

I can only give you anecdotal information based on my experience, which is related to what ailed me: grade 3 patella and medial femoral condyle degeneration. If I could do it over again I would have rehabed and gone to PT longer than the 7 months that I did and tried to implement some holistic life-style changes. For example: eliminate artificial sweetners, look into possible environmental factors that might be causing an auto-immune response, such as mold or food allergies and work on controlling my stress levels. I know some of those suggestions might seem a little "out there," but once that cartilage is taken out, it ain't growing back, so it's worth casting about, in my opinion- Try to be somewhat scientific in your approach, so you can know what helps (one variable at a time).

It's likely that what ails you is purely physiological/biomechanical, genetic, or some combination. But it could be a combination of other factors too.

And in my case, no, I wouldn't have had a lateral release done, at least not in the sequence and time-frame that I had it done, or at the same time as the chondral shave.

   

[CariG]

Thank you for your response....and your honesty.
I just breathed a sigh of relief as I've been doing PT for the past 10 months specifically for this upcoming procedure, as much as possible, and it's had some positive effects, and then there are times when it feels like I'm going backwards (ie: the last few days)....but there are days like that, so just keep doing what needs to be done and believe it's all going to aide my cause.
Part of my problem is purely genetics, from my maternal side. This has only come to light in the last few years, as I was adopted and only recently on the time scale had a reunion with the biological family. On the one hand this has helped having the knowledge now that it is partly genetics, but that doesn't mean I've taken a more accepting attitude to the situation.
Over the past few years, as we've all noticed my travelling knees are not improving, I've changed my lifestyle considerably, including most of the measures you mentioned JTB. No, those approaches are not 'out there', not by a long shot. This is my health, and I only get one life to enjoy and share with those that I love, so anything that gives me more time, and opportunity to do just that, it's worth it.

On the plus side, am certainly feeling better than I was a few hours ago. The 'what if' mentality that paid me a visit earlier this morning has been replaced by the "nothing to lose" attitude, well, the only thing I could lose today, fingers crossed, is this splint!! (won't be sad to see that go either!)

Here's to a brilliant day ahead......

Cari!! 

[CariG]

 
Yay!!! After what has been a hectic day, the end result is all worth it!!
Sadly, my GP was running behind schedule today.....a patient came in as an emergency after dislocating his knee on the escalator in the shopping centre. Can certainly understand the delay in being seen under those circumstances.
Splint can remain off when I'm at home, perhaps keep it on while I'm in public, just for the extra security it offers. GP would prefer me to use crutches when I'm out and about, just to ensure I don't put too much pressure on either knee, which I can understand, even though I don't like the prospect of using two legless buddies. Nah, not gonna get me down today. 
I PASSED MY SPIROMETRY!!! Apparently I'm healthier now that I was prior to getting sick....YAY, YAY, YAY!!!
Made it home with 10 minutes to spare before heading out the door again to be moral support whilst my man was at the dentist....the sitting down today has really done me in. By the time I actually got home and was able to rest up, I was so pooped I had a looong nanna nap!!
Seeing as I've had such rough nights lately, my GP has written some sleeping tablets for me...if I still wake up in pain in the wee hours of the morning, she's happy for me to take one extra Tramadol tablet....every now and then, and don't make a habit out of it. 
Oh, and the strangest thing today.....when I came back home prior to dentist, I was informed we had a surprise visitor....a possum came in through the window and has been sitting on the curtains since!! Still up there now, and it's nearly 10pm.
Well, another chilly night ahead.....so time to head back into the warmth of the bedroom with heater and cuddly puppy dog...hope you've had a great day too!! 

[CariG]

  Surgery is booked for next Thursday....so we're all systems go. Now my main priority is to spend time with family and friends, and take care of those little things that make me feel confident in myself.

Take care!!

[CariG]

  just realised last night I have to Cari Proof the house before next Thursday! I had a good look around, and saw just how many 'little' things there are that could cause an issue...and seeing as for the first few days at least I'm going to be too hazey to really pay attention, I better get cracking and stuck into fixing these things before bigger problems arise.
My friends have organised to come over next weekend to help keep my man sane, as he deals with me being a total and utter sook....and to bring some food over for me to eat!
Yep, I've requested comfort food already.....and plenty of it!! My man has already arranged a special dinner date for us for Wedesday night, before he goes to work, kind of like a death row last meal. Great mental picture isn't it??  Is he trying to tell me something???
Oh well, better get started, just gone 9am here....here's goes nothing!!
HAVE A GREAT FRIDAY!!!

[CariG]

Yep, still 'nesting'.
My cyro/cuff knee & cooler arrived today....am now in heaven!!! Never, ever underestimate the power of cold!! Going to look great next week, freezing, chilly weather, and me with an ice cuff around my leg! 
I've finished organising my clothes, so anyone coming to help out can easily find everything I need. And I've placed all my medications in a bag next to the bed, with my TENS machine, ice/heat packs, massage ball all in a box on top of said drawers. The fact that I've marked the box 'Pain Box' means absolutely nothing!!
Think I might've just annoyed one of my friends who wanted to drop by tonight after work. On total isolation currently, but she wanted to stop by and visit.....the only ones who are allowed to (by order of the Man) are those who we know for a fact aren't in an infection risk state. Everyone else is getting turned away.
Sadly, she didn't seem too happy with this, but I'll call her tomorrow and explain. I could always say "It's not you, it's me"....
Oh, and I've had to mark my pre/post surgical body wash which was only put in the shower this morning. Someone has already attacked it.  The Man wasn't happy about that....someone's head is going to roll over the weekend by the sounds of it!!
Lounge room is now officially Cari Proof....but for how long??? Million dollar question right there!
Hope you're Friday is going smoothly!!
Cari       

[momma-cat]

CariG,

I am a Nurse Practitioner in the States. Lateral releases are great for patellar tilt but have nothing to do with arthritis. I had an LR on my left 4 years ago and had to get a Fulkerson done 18 months ago. The release was a waste of time for me because of how much cartilage damage that was already there. LR's are great if you have stage 1 or 2 chondromalacia but after that, doesn't do very much. My Fulkerson was great and I have the typical weather-change pains but otherwise, no problems. I do wish you all the success in your surgery and I am glad to see you are getting everything in place to make the most of it.

I am facing a TKR or PFJR in the next couple of weeks on my other knee in which I have stage 4 chondromalacia with bone marrow edema and menisci degeneration. Kinda freaking out a bit. My OS will let me know in the next couple of days which surgery, recovery time, etc. Sometimes being a medical practitioner is not a good thing (know too much of what can go wrong).

Good luck!!!

[CariG]

Hi Momma-cat,

Thank you for your insight, and advice. And will keep everything crossed for you this week. I don't envy you in your position of knowledge.....it is a double edge sword.
For me, I've found knowing what is actually going on, and what can be done with it, is a relief to know what 'it' is that's happening. But on the other hand, too much info and it's not difficult for me to go running to the hills. 
On the plus side, we're not expecting the LR to improve the arthritis, and have gone into this knowing that the pain levels (most likely) won't improve....but my ROM and ability to move around should. It'll also give him a great chance to have a good look around and determine how much time till I do face a TKR. Honestly, I'd rather not be awake for that assessment.
The house is completely Cari Proof...all that's left now is the kitchen/dining room floors (guys don't know how to use a steam mop), and the loungeroom floor, which I'll do Wednesday night, and clean the bottom of the shower on Thursday morning before we leave. At least then I know it's done, and we can get away with them for a few days.
So, here's to a relaxing Sunday ahead!! 

[CariG]

Well, house is Cari Proofed, and as of tomorrow I'm on strike/sick leave as far as the house is concerned! Tomorrow I'm off to visit my friends, and my Godsons for a bit of a catch up, and to give the Man a break.
Been taking it easy between getting things ready. No swelling, well no excess compared to normal.
Time now to settle in and watch the next episode of Downton.
Have a great night!! 

[CariG]

21 hours to go....and after making the radical choice to take only nurofen or panadiene forte for two days pre op, I'm in my own pain bubble.....and feeling like a herd of elephants has used my body for tapdancing lessons.
BUT......
the end is in sight. So, going to wallow in my bubble again today and will see how things go. Time to watch Blues Brothers me thinks.

hugs to all