Bone breaks around the knee :
Swelling after patellar fracture - - Posted by jab105 (jab105), 11 January 2003
Ok, overall I'm doing good, staying positive, getting sleep and the end is in sight and all that...got the emergency room bill (what the heck!??!), but that's my own fault for not having insurance....anyways....
I seem to not be able to get anything out of my ortho, I swear, it's like, here is a minute of my time, ok, goodbye, I wasn't able to ask one question when I went, he just left.....I tried to ask questions today over the phone, but only got "ice it" out of him....anyways....thought I'd come here for some help, as you guys are probably the only people who can help:
1. I am swelling more than I have ever before at my knee, this in itself isnt bad, but when I walk around it feels like there is MAJOR pressure down onto my kneecap, very uncomfortable, combined with the fact that I have bumpy mexican tile throughout my house....it doesn't look like anything is dislocated, its just huge!! I iced, but didn't see much of a difference when I got up again....still huge!
2. I have the Bledsoe brace, with the knee area open,and the rest fit snuggly...I noticed that even though its locked, it does move slightly, a little click, which I definitely feel when I walk...help!!
3. Is it swelling because the bone is actually healing now, I've read that it really starts to heal at around 4 weeks, and I'm just over the 4 week point, so could that be it? Trying to think positive calcium bone forming thoughts right now!!
4. I'm supposed to be full weight bearing, should I be doing it with crutches, or without, I'm not so confident without cause my leg has to be completely straight....
5. What is happening to my joints through all of this, I'm taking massive quantities of glucosamine chondrotin MSM, but at the side of my knee(mostly the inside), it feels heavy pressure, it feels worse every day...really just a hurt....it feels like the joints are REALLY wanting to bend and its like the bottom bones are tired of the top bone (femur) pushing down on them all the time...I dont know if this makes sense....
6. Is there a diffference as far as helping bone growth between calciums...I have Citrical (Calcium citrate) and a Calcium (carbonate)/magnesium/zinc...I'm almost out of the Citrical right now (went through 100 pills in 4 weeks, wowsers!!)
Anyways, I guess my main thing is that this swelling is freaking me out, it has never swelled this much before, even though I'm now undoing to velcro when I'm laying on the bed, its annoying because I really want to walk around more, but the pressure the brace is putting on my knee (feels like its a dead weight going down on my knee with the brace on the swelled knee)really hurts! I've even taken the brace completely off to lay down, which feels great, but then when I put it back on, it swells even more.....I put it on pretty tight, cause then my leg doesn't wiggle as much, but I'm so thin anyways (5'11" and about 125-130), that my leg right now is really really skinny so I'm afraid that the brace will fall down into my knee if I dont do it really tight.....
Any ideas??
Today I was bored and uncomfortable, so I did a bad thing...I called the ortho and said that I needed to move my appointment, cause it wasn't convenient for Matt (not really).....anyways, I moved it up to Monday, Janaury 27th...for no particular reason except that it is SOONER!! And today I really needed SOONER!!
Also, even though I tried to make the ortho acknowledge that I may be seeing bone growth on the xray done on Monday, all he said was that he wasn't looking for bone growth yet...but, what I saw, and please tell me if this is right was that the ends of the break (the sharp points) were getting a little fuzzy (I directly compared the first xrays to these, I wasnt imagining it, for real)...anyways, at that point I was at 3 weeks post-break...do you think I'm unrealistic to think that I'll be significantly more healed in another three weeks (on the 27th)...does bone growth go that fast...I will be really upset if I cant bend at that point...I know everything will be ok once I can bend my leg....ugh!
Sorry for venting, again....I know you guys have it a lot worse than me...I'm really doing ok, but this swelling thing is not happiness, and I have to miss going to a toy show in Orlando with Matt tomorrow cause its all about walking around the convention center with like 20,000 people (not fun at this point)....
Tonya
Posted by Pat_A.E. (Pat_A.E.), 11 January 2003
First, I think you need to find another OS. My spouse is in the medical field and we have many friends who are also medical people and all of them, from Rehap MD's to OS to PT's have said that patella fractures are unusual and they don't see many in their practices. Therefore, your OS maybe dealing with something he/she has little experience with and maybe stonewalling because he doesn't know the answere and doesn't want to acknowledge that fact. The althernative is your OS has lousy communication skills. Either way, [b][/b]. I don't think most of us on the webboard are orthopedic specialists and no one can diagnose from afar so you really need a dr. who will see you and answer your questions.
I was alarmed with the swelling in both my knee and my foot. The foot doesn't swell much anymore, but there is still swelling in the knee, 3 months post op. I use ice at least once daily, more if I can fit it in. Swelling was reduced once I stopped using an imobilizer about 1 month ago. Neither the PT or OS are concerned about it at this time. PT thinks it is prohibiting increasing the ROM which is currently at 115.
My x-rays showed fusing at 3 weeks. By 6 wks there was complete fusion on the underside but still some filling in needed on the top. I have an appt 1/13 which I hope will show total fusion. My guess is you were reading your x-rays correctly.
Once I was weight bearing I didn't use the imobilizer (this is probably very similiar to a Bledsoe) but did use a single crutch for about a week. Anyway, if you aren't confident walking with just the brace, use a crutch on the opposite side for support. Also I stopped wearing the brace at night and also took it off whenever I was sitting. Keep in mind that my knee is wired and there is less chance of the bone seperating.
I take lots of gluecos. and some calcium (I don't tolerate the calcium well). My OS said this won't speed up anything now but is good for the future.
I don't know what is happening to joints, but I do know what is happening to muscles, and it isn't good! What I have thought to be bone pain in most cases has actually been muscle related. Your muscles are atropfieding (sp?) and that is why your leg is getting thinner. I had the same problem with the imobilizer sliding down because my leg kept getting smaller. The pain moves around the knee as muscle starting getting used again. The worst was the quad just above the knee. When that started getting used again it felt like a hot knife and sometime would fire up suddenly. Now since the ROM is better the tendon on the bottom of the knee is acting up. The PT has been great helping identify why and where the pain is coming from.
Keep the faith and stay positive. Most of all demand the proper attention from your health care providers, you are paying them! 
Posted by jab105 (jab105), 11 January 2003
LOL...oh, this one is a REALLY long story...I live in a small town, Gainesville, FL...it has the University of Florida, and thats about it....anyways, originally when I hurt myself, all I wanted was a doctor to look me over and let me know what to do, the University of Florida didn't have any openings for days, so I just kept calling around, and found an opening at this other place in town.....the dr. took one look at my xrays, didn't even touch me, said to go get an xray to make sure everything was in place, checked the xray and said goodbye, and that was that...for the next week, I was walking around by sticking my butt out and swinging my leg, cause he hadnt given me any directions at all on how I should be walking.....
So, the next week, I went down to my parents house for Christmas, and during the 6 hour trip, I was in major pain, the whole last hour, all I did was cry....not to mention that I stubbed my foot on this little step that I didn't see at a rest stop, and my cat jumped directly onto my kneecap...so I demanded that I go see a dr. while I was down there....I really liked that dr., he said that it was borderline for surgery and touched around my knee and made my hold my leg out to make sure my extensor muscle was ok...I was able to do it (though a bit weirded out that the other dr. hadn't even touched my leg!!)...he told me that I should be walking as normal as possible, which helped and told me I could do ankle pumps...he took about 30-45 minutes with me....very nice.....I asked if he could suggest anyone up here(cause I liked him so much better than the dr. up here that I had seen), and he recommended one of the doctors affiliated with the University of Florida....
So I got back up here, and ccalled that dr. for my follow up appointment, well, the secretary took my info...asked which insurance I had, to which I responded that I had none, the very next thing she said to me was that "I'm sorry ma'am, we dont except people who cant pay"...$#@!*&!!!...even though for EVERYTHING that I've had, I've paid up front!!....and then she went on and on about it, and I couldn't get a word in edgewise...so I asked who could accept me, and she said that no one through the University of Florida would accept me either....I tried to call the sports medicine department, and they transferred me back to that $#*(@ lady....anyways, I was crying pretty bad at that point, so I just called the dr. that didn't do anything back and made an appointment.....
So that's my story, there is no one else in the town who will accept me, so I'm kinda stuck with this guy....I will ask my mom to make an appointment when I go back to Ft. Lauderdale in the middle of February with the good guy, but that'll be at the 9 week mark, so if something is wrong, it will have been wrong for a while...
I feel pretty helpless, dont particularly like settling for less than I want but am powerless to get the dr. I want.....
That's my story why I'm dealing with an OS who doesn't talk to me!
Tonya
Posted by Ross (Ross), 11 January 2003
Tonya, one thing that sales teaches you is the art of sidestepping secretaries! Write the guy you want to see a letter, detailing how you came to hear of him and a bit about the injury. If you're really sneaky and can find his email address (possibly through the university directory) you ensure that the "guard-dog" doesn't get a whiff of the action 'til the connection has been made! 
A bit of lateral thought and some perseverence will get you through. If the "guard-dog" catches you in the act send the guy a letter to his home address and explain why it has been sent there! Who knows? You may get a part time job as his receptionist keeping other persistent people off his collar!
Even in your dealings with the existing OS I would be inclined to try a bullet point type list of concerns and request his written response if he's not very talkative at your appointments. He's filling out a file card for you anyway, or typing stuff into his computer, it's a means of getting him to share the information with you.
Good questions to ask start with "if it was your knee, what would you do about ..... ?" Try to involve him in the solution rather than letting the b@stard sit on the sidelines while you get better on your own.
Posted by jab105 (jab105), 18 January 2003
Thanks so much for your responses, Pat, I did just what you said, GOT A NEW OS!! and at least psychologically, it has helped...this guy that I am seeing now is the one that I saw in Ft. Lauderdale after I first hurt myself, its a 5 hour drive, but well worth it, since he spent about 30 minutes weith me telling me exactly what to do, I absolutely loved him!!
last week was pretty painful, this week not as much...I always have the brace on when I walk, but I began to loosen all the straps when I'm sitting or sleeping...since at this point the leg is not going to move by itself, I cant figure any danger in doing that, and it has majorly helped with the swelling...I think the fact that my leg had shrunk so much, and was being squeezed even tighter with the brace was making the swelling in the knee look all the worse...so I'm very happy with this!! Also, when I took a shower, my knee barely swelled at all!! YEAH!! That made me very happy too...
All in all, a break through week in my opinion...walked 1/2 a mile today cause I felt so good, am a bit uncomfortable now, but only about a 2 on a scale of 1-10, which is nothing compared to how I felt just sitting last week!!
The next OS appointment is next Monday (the 27th), with an OS that I TRUST!! Am excited, though very nervous that he may be a bit more conservative about starting PT then I am
Today is 5 weeks, yea me, even for worst cases scenario, this should be past the half way point!!
YEAH!!
Tonya
Posted by Rhonda (Rhonda), 21 January 2003
Hey TOnya-
Glad to see you got a good doc!
My knee was always very swollen for many months.. Took 5-6 months for it to somewhat resemble a knee. My oS said to expect it to have swelling afor a year.. It went down pretty well as far as usual appearance- but every so often blows right back up if it's aggravated..
Walking a half mile is great... only 5 weeks? I was just going back to work after being on disability at the 5 week mark.. Had to take cabs to and from work for another month.. It was a while beofre I could walk to the train station on my own (train is about .5 miles away)..
THis stuff just take time, but it sounds like you are doing well, and will be doing even better now that you have an attentive doc..
Good Luck!
Posted by Pat_A.E. (Pat_A.E.), 21 January 2003
Tonya, You go girl! My OS is very conservative and he started me on PT at 4 weeks, but I have hardware, so you maybe different. Even so, I doubt he would let you go much beyond 6 weeks to start PT. Great news that you are walking almost pain free. I have found that the more I attempt the faster the recovery. Believe me, sometimes the pain gets kind of tough, but within a few days I have made progress. I would say at 3 months post op, I am at about 85% back to were I was before my accident. Not bad for a 55 yr.old!
Warning about PT since you are paying for it yourself. In my area, suburban Chicago, the PT's charge in 1/4 hr. increments. The price ranges from $40 - 49 per qtr. hour. Now I don't mind paying for the actual time I am with a therapist, but they were charging me for riding a stationary bike, for the time I spent doing leg raises, etc, and for sitting with ice on my knee. These are all things I can do at home or in the gym I belong to. Check on billing practices before you start!
Good luck 
Posted by jab105 (jab105), 21 January 2003
Rhonda, I was walking WITH crutches...about 75% weightbearing...I wasn't just up and walking for real
LOL, I have to 
bashfully admit...I paid for my walk after I did it, the next two days, it hurt quite a bit, and then Monday and today was better...I've kinda convinced myself that I started the little broken bone emittors to say hey lets get to work quicker on this, so I think its just healing faster...ugh, then today, the mailman came to the door, and I forgot that I hadnt used my leg in so long and practically jumped out of my chair...OUCH!!
Last night I was concentrating for a while on exactly what I was feeling in my knee, and in my big wide world of my vivid imagination (and hopefully its true!), I think that one side of my knee is healed (it feels really secure, doesn't hurt at all now, and it was only about 1mm or so apart to begin with, and I saw fuzzies on the xray at the 3 week point)...anyways, and I think that the side that has the big 2.5mm space between the breaks is bridging the gap, cause it feels like stuff is going on in there, juices are flowing, feels "tighter"...its hard to describe....
Anyways, I'm now putting the crutches at the door of the bedroom and walking when I'm in there (its carpetted)...
Well, my appointment is MONDAY, less than I week away...I'm going to be pretty insistent about bending, as I'm going to be 6.5 weeks by that point, and that is a really LONG amount of time to not bend my leg at all...by far, that is the hardest part...
Here's to hoping that it goes well
Tonya
Updated Thu Apr 29 2010
