My 1st Journey to Cincinnati

My journey to Cincinnati began in the Spring of 2004. After hearing from my OS that there was nothing more he could do, no one he could refer me to and nothing more, anyone could do, that he hadn't already otherwise, I was told to live with it ! I was not going to settle for a life of not being able to do ANYTHING active in my life,painful walking, this constant tightness and patella pain. I had asked him if scar tissue could return after 4 mos post op and he said, NO. I knew then I needed a better opinion. I felt I was too young at the age of 48 to live like this.
 By now, I had been having surgeries and rehabbing for 4 years. A physical therapist I had used, gave me the name of Dr Frank Noyes, in Cincinnati. She said this is the doctor you need to go see. He handles complex knees and scar tissue. She said my knee problems were the worst she had seen.
The first step I did was establish contact, by email, with Dr Noyes Director of Clinical Research, Sue B. Westin. I found out I did not need a Dr's referral to see him. We exchanged several emails. I couldn't believe the prompt reply to my emails. They were answered in less than 24 hours. I told her my knee story. I asked if my knee problems qualified for his criteria for complex knee problems. She said, "yes" and that he would be more than happy to give me an evaluation. I asked her questions about cartilage repair options, since this was an area I was interested in persuing. One thing I did find out was that my age was NOT a factor. My hometown OS said I was not a candidate and age was a factor (I was too old). She said my age was not a factor. She told me I needed to bring all my medical records, xrays, MRIs, surgery reports and photos/videos and to write up a summary, in chronological order,of all my surgeries, for him to read. I also had to fill out several long forms, from their office, These were forms or questionaires on my knee pain, activity levels, work, sports, and other basic medical information. Some were forms for the Noyes knee rating system.
 My husband and I decided Cincinnati was where I needed to be. A commitment was made to travel a long distance, to seek treatment from this doctor...not once, but over several yrs. This included check ups, post-op checks, surgery and rehab , even one emergency appointment. I've made about 20 trips to Cincinnati, since I began seeing Dr Noyes. I trusted no one else with the care of my knee.
This was a very scary step for me to take. It was hard to leave town and go so far the unknown. I remember shaking, as I called and made my appointment and what a relief it was, that I finally had done it! It was 2 mos away, at the end of June. The kids would be able to go with us, since they would be out of school. It took me 2 mos to gather all the medical records together, for the appointment.
 Finally, the time had come. We drove 700 miles to Cincinnati. I was to see Dr Noyes at his office, located at Deaconess Hospital, across from the University of Cincinnati. We made reservations to stay at a hotel nearby. Cincinnati is a town up on the bluffs of the Ohio river. Deaconess Hospital is in an older section of town. This is a very hilly area and not knee friendly. We walked down the hospital hallway and that's where I first saw the Cincinnati Sports Medicine logo, on the door. I checked in. Everyone in the office was so friendly. After a long wait, I was placed in an exam room. I didn't care how long this would take, because there was only one reason we travled so far and that was to be here in this office.
We waited for about 20 min, then Dr Noyes came in to introduce himself, shook my hand and my husbands hand. He apologized for the length of time it was taking and said he would be in to see me, after the next patient. A short time later, one of his Fellows came in to interview me and perform an examination. We went over my history, which took a long time. He examined my knee , moving it around, examining the patella. He then left. I could hear him consulting with Dr Noyes in the hall. They were going over all my xrays, notes, surgery pics, etc. Dr Noyes came in and had me go over my history. He performed a very thorough exam of my knee, testing all the ligaments and stability, moving my patella. Asking where it hurt, what made it hurt. He asked me what my activity level was like before I got hurt and what it was now. No doctor had ever asked me what my activity level was before my injury, or even cared !!! He had me walk. He also had some more xrays taken of my knee. This exam took a long time, probably 45 min. I was not used to an OS taking more than 5 min time with me !!!
After the xrays came back he came back in and said we needed to conference. He said my knee and leg had been thru a tremendous amount of trauma. He said the damage on my patella was very extensive and really not salvageable. He went over the options available to me. The first option was to do a pallectomy, which was removing the patella. He did not recommend I do this because I would lose about 40% of my quad strength. I had read on the internet that this was not a good thing to do. The second option was an osteochondral allograft. This was cartilage repair using cadaver tissue. He said he would need a piece large enough to cover the entire backside of my patella. He said this was very hard to do, finding tissue that large and only had a 50/50 chance of success. Those were not good percentages. He said my only choice was to have a TKR.
He went on to explain what a TKR was, how it would benefit me, how the surgery was done, the implant to be used on me, the rehab, etc. He gave me a booklet of info on the TKR. I think he spent another 45 min with me explaining this. He said to think it over. I asked about my Delee osteotomy and how the TKR would affect that. He said if he needed to, he could revise it, if it was a problem with the tibial cut for the TKR.
I left Dr Noyes office a bit overwhelmed. I had alot of info to digest. I do know one thing, I was completely impressed with Dr Noyes, his office and all his staff. I had excellent care. Dr Noyes spent an unheard of amount time with me , did a very thorough exam, and explained all my options, with the "whys" and "why nots". Over the next couple years that I have seen Dr Noyes, I have always received the same excellent care from him , his office, each time. I found his rehab dept to be absolutely tops in knowledge and practice.
I went back home , very satisfied with my visit to Cincinnati and the investment of traveling so far. I had alot to think over the next several months. I began doing several months of research on TKRs before deciding on doing it. It was a major decision and commitment from my family for me to travel and spend 3 weeks in Cincinnati to have the surgery and do rehab there.
I took a big step and called to schedule my surgery. It would be in Jan 2005, a little over 6 mos since I had my consult with Dr Noyes.

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