Bone breaks around the knee :

Ouch my damned knee!!! - - Posted by mofo28 (mofo28), 13 October 2004

I'm a 21 year old female and I am approximately 6 weeks post-op. This is my first posting, and I just want to share my experience so far.

I factured my patella in late August, 2 days before I was to start my senior year of college - pefect timing (hint of sarcasm).

So for the past 6 weeks Ive been experiencing some really hard times.

Week #1: I spent 3 days in the hospital and then the rest in Vicodin-land.

Week #2: It was back to reality because my body had gotten used to the painkillers and then I thew out my back. Even Better !!! My OS also yelled at me for using a wheelchair (while waiting for 4 hours for my appointment) and for not being able to do a SLR. Joyful encouragement, doc!

Week #3: I was told to bend the leg. At this time my at-home PT told me to rent a CPM machine. This was probably the best thing that happened to me. In the first days I was doing great. Then I had a huge set back. Either I had tried to do too much at once, or trying to move into a new apartment took its toll.

Week #4: I was in so much pain I couldnt even stand for 5 minutes.

Week #5: Luckily by the end of this week I could bend my leg without excrutiating pain. Finally something had clicked!

Week #6: I began outpatient physical therapy. I have about a 115 degree bend now. Which I assume is pretty good, however my quad is shot. I have to get electro-stim, among other various forms of Pain and Torture!  However, now that I am trying to buildup my quad I feel like I have a sharp pain at where the knee cap and quad join. I guess this must be the pins that were put in. I just hope that the pain will eventually go away.

I'm still using crutches and a knee imobilizer because my leg is too weak.

I'm just looking forward to the day I can walk normally and hopefully be back in school for January (about 4.5 months post-op).

I know recovery depends on the individual, but if anyone has shared a similar experience let me know.

Thanks!
Posted by mofo28 (mofo28), 13 October 2004

I also forgot to mention that last time I went to my OS, he wanted me to raise my leg from a bent position to straight. When I couldn't, due to weak muscles and some pain, he diagnosed me with RSD.
Which stands for (Blank/Not Sure) Sympathetic Distrophy. It was described to me as a nerve response which is caused my an imabalance in brain chemicals. I guess that this syndrome affects the same pathways that are triggered duing a stress response (fight or flight). I didnt necessarily believe that I had this problem because my pain had greatly reduced since the beginning of this process. But i guess since I am young and I was still in pain that the OS thought there must be something wrong with me.
At that point he prescribed an anti-depressant which is supposed to balance my brain chemicals. However, I took the meds for 4 days and I have decided to stop taking them due to the side effects. I was sleeping almost the entire day and I was having horrible mood swings. Not to mention my new outpatient PT looked at me once, and he said with firm conviction that I did not have this disorder.

If anyone has shared this or a similar experience - let me know!

Thanks again!!!
Posted by jennwren (jennwren), 13 October 2004

My roommate got RSD from a car accident and the doctor nor any of the research we did on it said anything about a chemical imbalance. What I did learn was that basically it's nerve damage.

I do know a few things about antidepressants, they do not start actually helping for 2 - 6 weeks. The being tired all the time for the first week or so, goes away. Mood swings are also common when you first start taking an antidepressant but they also go away. The nice thing about them is they do help somewhat with how you handle the pain. Don't give up yet sweetie..  Don't let your OS bully you hon. If you need to rest, then you should rest. Your body will tell you very clearly what it needs. You've gone through a lot with the fracture and then the surgery.. so don't push it.

Hugs,

Jenn
Posted by Timo (Timo), 14 October 2004

Hey mofo

I am 22 (21 when I shattered patella)

Eight weeks post op

You said:

" Week #6: I began outpatient physical therapy. I have about a 115 degree bend now. Which I assume is pretty good, however my quad is shot. I have to get electro-stim, among other various forms of Pain and Torture!  However, now that I am trying to buildup my quad I feel like I have a sharp pain at where the knee cap and quad join. I guess this must be the pins that were put in. I just hope that the pain will eventually go away.  "

I got exactly the same sharp pain as you last week so week seven for me, my physio has told me that I overdid the SLR's and knee bends a bit so I had a couple of days rest and it went away. Luckily my quads were OK so I nailed an SLR pretty quick after getting rid of the cast.

I can walk now without leg mobilisers and just the one crutch although I can only go slowly as my bend is only at about 90 degrees although this is improving all the time!

Like yourself just looking forward to walking (and hopefully running) normally again soon!

Good luck!
Posted by hmaxwell (Heather M.), 14 October 2004

I would also not be too worried about the RSD card being thrown out--orthopedic surgeons seem to like to do this to explain how the problems are not mechanical (orthopedic) in nature and how they couldn't possibly be the OS's fault!  It's usually a garbage diagnosis, especially when you have several other perfectly reasonable causes of pain right in front of the doctor's face.  RSD is pain that is out of control and out of proportion with the patient's physical presentation.  I wouldn't worry about it, except to say if your OS keeps throwing it around then you need to find another one.

There are people out there with RSD, and it is a severe and debilitating condition.  But I really feel like when it's thrown out like this it's a big red herring.  I've heard the same from 3 doctors who didn't want to take on my case--so they said my problems were neurological and walked me to the door.  I do not have RSD in any way, shape, or form, and I'm sure you are just recovering from your traumatic injury.  Keep an eye on it, watch for any unusual symptoms:  extreme sensitivity to touch (fabric brushing the knee hurts, sheets on the bed at night, can't wear denim, etc.), inability to tolerate ice on the knee, burning pain, different color compared to other knee, different temps (cooler, usually) compared to other parts of the lower body, and so forth.  Usually RSD is extreme pain when there are no mechanical problems--you just had a major fracture!!!  That's called a mechanical problem....RSD is usually a diagnosis of last resort...when all else is ruled out, RSD and nerve damage is what remains.  You can't rule out other issues because you are barely into a prolonged rehabilitation...don't worry!

Other than that, it sounds like you're doing fairly well.  I haven't had your injury, just wanted to respond to the RSD card being thrown out.

Heather

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