KNEEtalk

The WAITING ROOM => GENERAL KNEE QUESTIONS and comments (good for new threads) => Topic started by: friendsfan on July 03, 2007, 12:32:17 PM

Title: just back from physio
Post by: friendsfan on July 03, 2007, 12:32:17 PM
hi all,

ive just got back from pt and she has given me a letter to give my OS when i see him on friday...i had her permission to open the letter which i have done and it reads like this.....presenting with MASSIVE restriction of movement to L knee and hip, physio has been very unsuccesful and there is very little we can do with her. it also states she is at a loss as to where to go from here..  
the thing is though now im really scared as she hasnt voiced these concerns to me, i know i have no ROM but i didnt realise she is at a loss† and has no idea what to do.

any advice greatly appreciated

friendsfan†
Title: Re: just back from physio
Post by: shortyclairebear on July 03, 2007, 12:42:14 PM
HI THERE,I HAD DIFFERENT OP TO YOU BUT ALSO HAD NO ROM AT ALL WHEN I FIRST STARTED PT,MY PT HAD NEVER DEALT WITH ANYONE WHO HAD THE SORT OF OP I HAD HAD AND REFERRED BACK TO MY OS A FEW TIMES TO CHECK WHAT SORT OF THINGS I WAS ABLE TO DO.
IT MAY BE THAT THE PT FEELS ABIT OUT OF THEIR DEPTH AND DOES NOT WANT TO DO ANYTHING TO CAUSE ANYMORE PROBLEMS.
I INITIALLY STARTED OFF DOING VERY VERY BASIC STRETCHES TO TRY AND IMPROVE ROM,IT WAS A VERY SLOW AND PAINFUL PROCESS BUT I HAVE PRETTY GOOD ROM NOW.
I WILL DROP BACK IN LATER TO POST MORE AS IM ON MY DINNER BREAK AT WORK AT THE MOMENT!!

CLAIRE X
Title: Re: just back from physio
Post by: Linds on July 03, 2007, 02:15:55 PM
Please view this letter from your PT to your OS as a positive thing. When I changed PT's to one outside of the sport medicine clinic that my OS runs, my new PT wrote a couple of notes and called my OS a few times to get feedback. When things he didn't think should cause me pain were and when I was having trouble building up quad strength at all. All that came of it was positive things as my OS had ideas for him and my OS maybe got to see more of what I was going through, as he would only see me for 5 minutes at a time in clinic where my PT was seeing me 2-3 times a week for an hour.

Goodluck on Friday.. hopefully you'll get some help.

Linney
Title: Re: just back from physio
Post by: shortyclairebear on July 03, 2007, 06:30:29 PM
HI JUST THOUGHT ID SEE IF YOU HAD POSTED AGAIN.
GOOD LUCK ON FIRDAY,PLS LET US KNOW HOW YOU GET ON X
Title: Re: just back from physio
Post by: friendsfan on July 03, 2007, 08:01:10 PM
hi claire.

I forgot to mention in the last post that my physio explained some of the routes  the OS may suggest these are
1) another MUA, which im not keen on, because when i came round last time it was agony
2) more surgery....which obvisouly i dont want either
3) just continue with physio.. this is the one that im happier with but physio isnt working

And to top all this crap off off i have just been to tesco and one of the tips on my crutches broke and i slipped.... and i somehow managed to get round the rest of the shop on one crutch

I hope you soon feel better.. it must be this weather we are getting

friendsfan
Title: Re: just back from physio
Post by: shortyclairebear on July 03, 2007, 08:11:02 PM
HI AGAIN THERE,
REMIND ME HOW LONG HAVE YOU BEEN GOING TO PT?? SORRY I CANNOT REMEMBER!
I FOUND THAT THE FIRST FEW WEEKS I STARTED GOING TO PT I MADE VERY LITTLE PROGRESS,I WAS GAINING ABOUT 10 DEGREES A WEEK WHICH DID NOT SEEM MUCH AT THE TIME BUT IT WAS A START TO NOTHING!
I HAVE PRETTY GOOD ROM NOW (ALTHOUGH THE WEATHER WE HAVE BEEN HAVING MAKES IT WORSE) AND AM WORKING AT TRYING TO STRENGHN MY MUSCLES UP AGAIN NOW (ALTHOUGH MY KNEE HAS OTHER IDEAS!)
I WOULD TRY AND STICK AT THE PT AND HOPEFULLY YOU WILL IMPROVE,IT IS A SLOW AND LONG PROCESS BUT IM URE YOU WILL GET THERE.
I CAN UNDERSTAND YOU NOT WANTING THE MUA IT SOUNDS HORRENDOUS.
IM SORRY TO HEAR YOU BROKE YOUR CRUTCH,I HOPE YOUR KNEE IS OKAY,I WENT AND BASHED MINE TODAY ON MY CHEST OF DRAWERS AT WORK AND COCKLED OVER ON THURSDAY AND SPRAINED MY MCL,DOES THE FUN EVER END!!??
Title: Re: just back from physio
Post by: friendsfan on July 03, 2007, 08:18:49 PM
hi

ive been going to physio for nearly 2 months now and hydrotherapy for 3 weeks and there has been NO improvement at all... im convinced that the surgeon missed something when i had the arthroscopy itsonly meant to be a simple MCL tear there shouldnt be all this hassle from that.

sorry to hear about you bashing your knee..

i dont think the fun ever does end, its good for the PTs and OSs they go home at the end of the day and forget about us lot having this fun   
Title: Re: just back from physio
Post by: shortyclairebear on July 03, 2007, 08:21:18 PM
WHAT SORT OF EXERCISES ARE YOU DOING AT PT??
Title: Re: just back from physio
Post by: friendsfan on July 03, 2007, 08:24:54 PM
just really simple basic ones from every angle. but my knee just isnt budging.. 
Title: Re: just back from physio
Post by: shortyclairebear on July 03, 2007, 08:44:20 PM
HI SO YOUR ROM HAS NOT MOVED AT ALL??
HMMM.......NOT SURE WHAT TO SUGGEST.
I JUST STARTED DOING VERY VERY BASIC STRETCHES LIKE SITTING ON THE FLOOR WITH MY LEG BENT AS MUCH AS IT WOULD (WHICH WAS NOT MUCH) AND I HAD TO ROLL A TOWEL UP INTO A "SAUSAGE" LOOP IT ROUND MY FOOT AND TRY AND PULL MY LEG AS CLOSE TO ME AS I COULD,TO TRY AND BEND IT,INITIALLY I WAS SO "LOCKED" IT SEEMED POINTLESS BUT AFTER DOING THIS AND A FEW OTHER EXERCISES I IMPROVED OVER THE FEW WEEKS FOLLOWING.
HAVE YOU BEEN ON A CPM MACHINE???
I GOT TO THE STAGE I WAS "STICKING" ABIT AT 90-110 DEGREES AND DID NOT SEEM TO GET ANY FURTHER AND USED THE CPM FOR A COUPLE OF WEEKS AND IT DID HELP ME TO GET OVER THAT STAGE..............NOWT SURE I THIS WILL HELP YOU???
Title: Re: just back from physio
Post by: friendsfan on July 03, 2007, 08:53:10 PM
hi
 no my ROM hasnt moved at all its been 17 weeks in exactly the same poistion, we have done the exercises you have mentioned....... not done the cpm machine i dont know why.. ive had the ultrasound treatment... im just so scared i really dont know what they will do now   
Title: Re: just back from physio
Post by: shortyclairebear on July 03, 2007, 09:29:08 PM
hi i found the cpm quite good,would it be worth asking if it may help you??
Title: Re: just back from physio
Post by: friendsfan on July 04, 2007, 08:02:43 AM
my physio mentioned about using a cpm machine yesterday, but says i am too far gone now to  use it, she will use one if he says i need more surgery..(thats after surgery) its all just waiting to hear what the OS says
Title: Re: just back from physio
Post by: shortyclairebear on July 04, 2007, 12:30:20 PM
hmmm!!
how come they did not start you doing exercises sooner after the op??
i went nearly 7 weeks with no exercise at all and was in a full leg immobiliser,set straight for some of those weeks and it was a long painful process but i did get my rom back,there were many days i wondered if i would though
Title: Re: just back from physio
Post by: friendsfan on July 04, 2007, 02:56:31 PM
i really dont know its just been one mistake after another... i dont trust my OS now im going to see what he says on fri but then ask for asecond opinion... as it was only yesterday from my physio i found out i had a MUA whilst i was having arthroscopy.. he just isnt being honest and is hiding something from me 
Title: Re: just back from physio
Post by: Linds on July 04, 2007, 05:08:07 PM
Hey
I definately think you should get a second opinion. You said you've lost your trust in your OS, and once you've lost that, valid or not it's very difficult to get it back. 
I had to leave my OS back in February. Not because he actually did osmething wrong but I couldn't trust him anymore... So I got a second opinion and went with that OS!
GOodluck
Linney
Title: Re: just back from physio
Post by: shortyclairebear on July 04, 2007, 06:04:12 PM
hi i don't like the sound of what your OS did at all.
i agree with linney,get a second opinion,it is your health after all and it is you who is having to live with these complications!
Title: Re: just back from physio
Post by: friendsfan on July 04, 2007, 06:10:40 PM
im going to get a second opinion but its going to  be tough because ive worked with these people, but it is my health and got to look after it....im just so mad after finding out he did a MUA and not informing me, theres no wonder now looking back why i was in absolute agony after the surgery.
Title: Re: just back from physio
Post by: shortyclairebear on July 04, 2007, 06:14:10 PM
definatley,i think its terrible you were not informed,i can understand how awkward it is if you work with these people but you can not carry on with this OS having no trust in him and also he is not doing much to help you get better.
get that second opinion!!
if work becomes awkward its easier to get another job then another knee!!
Title: Re: just back from physio
Post by: friendsfan on July 04, 2007, 06:28:38 PM
i dont know whether to attend my appointment on fri or just ring the hospital and ask for another OS, its a catch 22.. u know how hard it is to get a appointment on NHS but why go when i dont trust him 
Title: Re: just back from physio
Post by: shortyclairebear on July 04, 2007, 07:34:39 PM
hi there,
you could always attend and tell him now you feel about things and ask him why things are not getting better (it would be interesting to see how he reacts as to question whether he thinks this is normal how things re for you after so long)
get his opinion on why things are not getting better and what he would intend to do about it from here.
i then would get the second opinion and see what that OS has to say,advise him what your current OS has said and compare.

was you told of any complications you may get after the surgery?

it does sound though as though this OS you have now is not too good at all.
i cannot say i would be happy having something like MUA done without my knowledge.
i definatly would not want him performing anymore surgery on me.
i would also want to know if the MUA could have caused any of the problems i was having if i were you.

keep us posted!!
Title: Re: just back from physio
Post by: friendsfan on July 04, 2007, 08:53:10 PM
have u any ideas for questions i can ask him? i really wanna put him under the spotlight coz i know he doesnt hold up to well under questions from patients......... it feels like someone is stripping him of his God complex
faye
Title: Re: just back from physio
Post by: shortyclairebear on July 05, 2007, 12:28:27 PM
i personally would have a sit down and think about what you want to know the answers too and write them down as questions.
i often felt abit rushed on OS appts and my mind would go blank when i got there and i would feel mad afterwards that i never asked certain things,i did this when i visited my OS last time,i think he felt abit interogated by me but i got the answers i needed.
i would be asking him why you are still so limited in ROM and what does he plan to do about it?
i would also want to know why he performed the MUA and has this made you worse??
was the result you have now from the surgery expected (im sure it wasn't)
if o what went wrong?..............etc etc

i would have so many questions if i was you he would definatly feel stressed if he saw me!!
i like to know the far end of everything!! initially i do not feel i asked my OS enough questions before the op but have not become alot more aware of what went on in there during the op now and as they say knowledge is power! (or something like that!!)

do you have anyone who could go to the appt with you???
i think that this would be a good idea as you may feel a bit braver then going on your own.
my boyfriend came with me on some of my appts and even though he is a big softie he is very tall and big built.i think the OS was abit on edge but he gave me more time on those appts then when i went on my own!!
Title: Re: just back from physio
Post by: Linds on July 05, 2007, 02:14:06 PM
I agree with Clairebear,

Think about what you want to know.. and then put it in the form of a question.

You want to know what he thinks is causing this? What can be done? What his plan is.. because in my opinion as  a patient having NO Range of Motion is  a problem a big problem... and not one that should be taken lightly in the slightest.   He may feel threatened, as some OS's seem to when you come armed with questions wanting answers, however this is YOUR body and YOUR life... you need answers.

GOODLUCK hope you do get some answers so you can decide what your next move is.

Linney
(http://www.kahleyvalecavaliers.com/Kahleyvale/kahley/goodluck_Bear.gif)
Title: Re: just back from physio
Post by: shortyclairebear on July 05, 2007, 06:40:03 PM
hi faye!
good luck with the appointment and let us know how you get on!
i hope you come up with some good questions and get the honest and open answers you deserve!

i think the "no ROM" thing is a big problem too.
initially after having my immobiliser taken off i had no ROM at all but it did improve after starting PT and i have more or less full ROM now on a "good day"
please let us know how you are getting on and we are here for you to "vent" too and to help if we can!!
take care.
claire x
Title: Re: just back from physio
Post by: friendsfan on July 06, 2007, 01:27:40 PM
argh!!!!!! ive been to see the OS today, long story will try and explain it simply....
my OS says there is absolutly nothing wrong with my knee, as when he did a MUA it moved
he decided to send me for a xray of my hip, which revealed nothing, but they have found a cyst and my good right hip
he has now referred me for a mri and to the pain clinic (pain isnt the issue) its the no ROM and he says push on with physio
so im still no wiser, i said i think you† are missing something he said we're not... i then said could it be scar tissue he said no
its just everything i said to him he dismissed.....or when i asked him a question he dismissed it
faye
Title: Re: just back from physio
Post by: friendsfan on July 08, 2007, 07:45:24 PM
got to go back for hydro therapy on tuesday when my physio and i will decide where to go from here
Title: Re: just back from physio
Post by: shortyclairebear on July 08, 2007, 07:49:31 PM
hi faye!
definatley go for another opinion!!
how ignorant to totally dismiss your questions!
i think he realises that there is a problem but is trying to avoid the situation.
i would not trust him as far as i could throw him!
you cannot carry on like this and something needs to be done!!
demand to see someone else as you are not going to get anywhere with him!
Title: Re: just back from physio
Post by: friendsfan on July 08, 2007, 08:00:27 PM
hi
its so distressing what he has done and said because ive seen 3 PTS and they have all said that they can feel my joint not moving that there is something blocking it,

Title: Re: just back from physio
Post by: shortyclairebear on July 08, 2007, 08:08:07 PM
if something is stopping it moving though he should know what it is!!
he does not sound to me as though he is competent to be operating on people!!
i would give him a wide berth and see someone else!!
he cannot expect you to be like you are now forever!
Title: Re: just back from physio
Post by: tanyap on July 09, 2007, 02:15:06 PM
hi friendsfan,
please please go for a second opinion!!!

and bring someone with you to the appointment - i always get my boyfriend to come with me - he doesnt even say anything much but its more intimidating for the surgeon to have to address 2 people and less intimidating for you to have someone supportive there with you.

also get your PT to write a report explaining what they think.
Title: Re: just back from physio
Post by: friendsfan on July 10, 2007, 12:06:23 PM
heres the latest ive just got back from hydrotherapy and my PT is totally stumped as to what to do now, she really doesnt know how to deal with it..ive no problem with her and i know she is very competent.. im upset now coz if she doesnt know where to go from here how the hell i am going to get better
Title: Re: just back from physio
Post by: shortyclairebear on July 10, 2007, 12:23:11 PM
HI AS I MENTIONED BEFORE AND TANYAP AND LINDS,YOU NEED THAT SECOND OPINION.
YOUR PT MIGHT BE COMPETENT BUT THE OS DEFINATLEY ISN'T!
IF YOU WANT YOUR KNEES SORTING YOU NEED TO SEE SOMEONE ELSE!
SORRY IF I SOUND BLUNT BUT I DON'T SEE THINGS IMPROVING WHILE YOU ARE UNDER THIS OS!
Title: Re: just back from physio
Post by: tanyap on July 10, 2007, 12:27:39 PM
see a new OS. dont just sit back wondering if things are going to improve or what should you do. you are not an OS - you cant know how to fix it. and either can PT - PT can only help you strengthen muscles. if theres a mechanical problem only an OS can fix it.

OS has to be able to give you a reason why you have no ROM. its just not good enough to say that there is nothing wrong when clearly there is!!
Title: Re: just back from physio
Post by: friendsfan on July 10, 2007, 12:48:58 PM
i have just had a call fro hospital asking meto attend a mri scan on 23rd this month....how do i get another OS?
Title: Re: just back from physio
Post by: tanyap on July 10, 2007, 01:54:23 PM
ask your GP or local doc to refer you to someone else - explain the problems you are having and that you are not comfortable with your current OS and get your GP to refer you to a new one, cancel the appointment with the current one and tell the new ones secretary to get the MRI results from the hospital.

If you need any of the medical records that the current one has ring his secretary and ask for them to be forwarded to you.

Alternatively you can see you current OS and tell him you want a second opinion and ask him to refer you to someone else.

Where are you friendsfan - UK or the states?
Title: Re: just back from physio
Post by: friendsfan on July 10, 2007, 01:58:12 PM
uk.. i think this mri is urgent as ive only gotta wait 11 days..i hope they find something.... what would you do personally wait for mri results or just switch OS?
Title: Re: just back from physio
Post by: tanyap on July 10, 2007, 02:54:33 PM
when is your next OS appointment?

And what way do they do MRI results where you are (where i am they send the results to the OS who ordered the MRI)?
If they give them to you then just see a new OS with the MRI results.

how do you feel about it yourself? you dont seem fully sold on getting a new OS - is it a lot of hassle to do it or do you feel one is as good as another? or are you just confused about it all!!! (like me a lot of the time :)
Title: Re: just back from physio
Post by: friendsfan on July 10, 2007, 05:19:38 PM
ive just seem to have lost all confidence in the medical proffesion (even though i work for them) its not too much hassle just confusing and the lack of faith thing... i didnt get another OS appointment and i dont know what will happen wtih the results
Title: Re: just back from physio
Post by: tanyap on July 11, 2007, 09:40:49 AM
dont lose hope or faith. its important to persevere with this.
just because you have had a bad experience with one OS dont let that colour your view of all OS's - you could find a new one who is GREAT. try to remember that surgeons prefer to deal with unconscious people - a lot of them dont have great people skills. It IS confusing but you need to battle on to discover whats wrong and find the pathway to fix it.
Title: Re: just back from physio
Post by: friendsfan on July 11, 2007, 10:57:08 AM
i just really feel like giving up, ive been 18 week without any ROM and just had enough.... my physio said if im left much longer then there will be irreversable damage... 
Title: Re: just back from physio
Post by: Silkncardcrafts on July 11, 2007, 01:09:47 PM
Hi Friendsfan,

I know what you are going through right now. Felt exactly like that about 9 years ago. I've found writing in a diary to be very helpful.

My physio at the time had given up on me and said that my knee surgeon couldn't do anything for me. One of my Mum's friends was a physio and said I needed to go back to my knee surgeon as he was the one that did the initial operation. I went back to him and he referred me to one of his colleagues for a second opinion. It helped him see the woods from the trees as I'd already been seeing him for about 4 years at that time. I changed physios before my operation to get my knee much stronger and made a real difference. My physio recognised that I had a bad problem with recurrent instability and agreed with my surgeon that the only thing to do was operate.

Like the others have said I would get another opinion ASAP. Make sure the surgeon you sees specialises in knees, particularly patella problems.

Whereabouts are you based in the UK ? I went to a great sports medicine clinic in London when I lived there for a couple of years. They have links to some of the best OSs in the country. Their website is www.puresportsmed.com and phone number is 0870 2000 878. At the time I was really struggling financially with all my medical bills so they reduced my sports physicians' consultation fees. I also believe you can see sports physicians/doctors on the NHS now. They would have a much better understanding of your problem and be able to refer you to someone good.

At present I have medial instability of my left patella and am waiting to see my knee surgeon for the next steps.

Chin up ! It will only get better.  :)
Title: Re: just back from physio
Post by: friendsfan on July 12, 2007, 11:38:59 AM
ive made a appointment for later today for a private consultation with a physio.... im hoping that a new set of eyes will reveal something
Title: Re: just back from physio
Post by: friendsfan on July 12, 2007, 12:29:22 PM
i know this is going to sound dumb.. but what do you mean by specialists? do u mean OS?
Title: Re: just back from physio
Post by: tanyap on July 12, 2007, 12:39:46 PM
i agree with shortybearclaire - i dont know if a new physio is going to bring anything new to the table for you.

a specialist is an OS who specialises in knees.

a new physio is still going to only be able to help your muscles - but if the joint doesnt move due to a mechanical problem a physio will not be able to fix that.
Title: Re: just back from physio
Post by: friendsfan on July 12, 2007, 12:55:57 PM
my current OS is the only knee specialist at my local hospital.....i know this sounds like im making excuses.. i need another OS but they all read from the same notes so they'll all cover each others backs
Title: Re: just back from physio
Post by: tanyap on July 12, 2007, 02:16:53 PM
i disagree.
they do not all cover each others backs.

Ive seen many different OS's in my time and I have found that they disagree with each other opinions, some are more willing to investigate further than others, some are easier to deal with than others.

Ive seen the 'best knee surgeon in Ireland' - he told me to go to physio and not come back unless i wanted surgery. He ordered no x-rays, no mri, no follow up.

2 years of very little progress in physio I saw a different OS, he agreed that I needed physio but went into great detail with me about the type of physio, the areas to concentrate on. he ordered an MRI, x-rays, and arranged a follow up appointment to check progress. he sent me to a physio who specialised in knee problems, she asked me what exercise program id been on before and when i told her shook her head and said that the real problem had not been getting addressed at all and effectively pointed out the same things as the new OS.

your current OS has been dismissive with you, has refused to consider other options, has not explained to you what is causing your problem, has performed a procedure on you without your permission and tells you that there is nothing wrong.

if you want to accept that opinion then thats your choice.
what you are being told on this site from a number of people is that they would advise another specialist opinion. if you feel that there is no point in that, or that all OS's are the same or whatever then thats up to you.

i hope you find some relief soon. i appreciate that its a very frustrating time for you.
think about what you would advise a friend in your position.
Title: Re: just back from physio
Post by: friendsfan on July 12, 2007, 02:25:40 PM
OMG!! you are all totally right.. i really need people to be blunt with me,  im going to make a appointment in the morning to see my G.P to get him to refer me to another OS... THANKS to all of you, you've made me see sense   
Title: Re: just back from physio
Post by: tanyap on July 12, 2007, 02:37:05 PM
good stuff - do let us know how you get on.
Title: Re: just back from physio
Post by: friendsfan on July 12, 2007, 05:11:17 PM
YES.....went to see the private physio today and a tiny breakthrough she managed to extend and flex my knee 10degrees...im so pleased, she has given my different exercises to do. she says my quads are completly wasted. im going back to see her next week... but i can see a tiny light at the end of the tunnel       
Title: Re: just back from physio
Post by: shortyclairebear on July 12, 2007, 06:18:45 PM
hi i agree with everything tanyap has said in her post at 2.16pm today.

i also have seen more then one OS (specialist) and do not believe they are all the same either.
in a way that is like visiting a country finding one person unhelpful there and saying the whole population there is  unhelpful.
you cannot judge a whole group of people (ie;OS's) as the same because you have had a bad situation with one.

even though you may have seen a little improvement today in the PT, they are not going to cure you and are not qualified to sort out what is going on inside your knee.

if you have been able to see a private consultant at a physio why not go and see a private OS?
i have paid out before to see a private specialist as i was not happy with what an n.h.s one had told me (this was not a knee matter though)

sorry again if i sound blunt too, but you and only you can do something about this and if you feel bad enough with your knee you will do it!!

i also hope you find some relief soon.





Title: Re: just back from physio
Post by: friendsfan on July 13, 2007, 07:42:40 PM
hi

ive been to see my GP today who is referring me to another OS, it will be a wait though.. but im hoping to be able to get some money together within the next week, then i will go and see a private OS.. get to the bottom of this damm thing
Title: Re: just back from physio
Post by: shortyclairebear on July 13, 2007, 07:53:31 PM
wishing you luck with it!!
Title: Re: just back from physio
Post by: friendsfan on July 13, 2007, 07:56:49 PM
thankyou very much :)
Title: Re: just back from physio
Post by: tanyap on July 14, 2007, 08:07:59 PM
thats excellent news friendsfan - hope you get a quick appointment and that its the beginning of the road to recovery for you.
Title: Re: just back from physio
Post by: friendsfan on July 17, 2007, 12:05:47 PM
just back from hydro pool again, she says there is very little change, she is now off for the summer holidays so i'll will be seeing another physio..(again)   im still hoping that i will be able to see a private OS in the very near future... MRI scan next monday on my knee and hip, not looking forward to it 
Title: Re: just back from physio
Post by: tanyap on July 17, 2007, 02:26:02 PM
hi friendsfan,
grrrr - i hear ya - i hate changing physio - i always feel a lose a couple of weeks while the new one comes up to speed.
mind you - you always run the chance of getting a better one!

dont worry about the MRI - its not scary, and it will hopefully show what exactly is wrong so the OS can decide what to do to fix it!!
Title: Re: just back from physio
Post by: friendsfan on July 17, 2007, 02:31:53 PM
the thing is though i get my physio back at the beginning of september..just seems pointless...the main point of the mri is the OS has found some sort of growth on my good hip they are just doing my knee whilst im there
Title: Re: just back from physio
Post by: tanyap on July 17, 2007, 03:12:20 PM
but if there is anything wrong in the knee they will find it with the MRI. hopefully.
at the very least an explanation of why it is stuck in position is needed - with a prognosis of what to expect and how long it should take to get better!



Title: Re: just back from physio
Post by: friendsfan on July 18, 2007, 04:30:03 PM
hi. im just here today to vent im really struggling to mobilize, im still using elbow crutches all the while...my walking is getting worst my left knee and hip are really twisting inwards now. it is so painful to get anywhere or do anything....any ideas what to do from here??? do i see my G.P? push for more physio? or see my very incompetent OS?
Title: Re: just back from physio
Post by: shortyclairebear on July 18, 2007, 08:30:28 PM
hi sorry to sound like a broken record but have you not tried to get that second opinion yet?
i can understand you feeling frustrted but you have to try and help yourself too.
you need the opinion of a specialist,the one you have now is getting you nowhere and as me and others on this thread have advised you a PT can not help to sort out what is happening inside your knee,only someone who specialises in knees can do that.
Title: Re: just back from physio
Post by: friendsfan on July 18, 2007, 08:40:44 PM
im just trying to get the money together to see a private OS but this is just in the meantime, what can i do whilst waiting??  i went to GP last week he is referring me to another OS but it could be a long wait..its just what will come first the money or the nhs OS
Title: Re: just back from physio
Post by: tanyap on July 19, 2007, 09:53:34 AM
hi,
well youre having problems with your hip because youre not using your leg properly - knee problems spread their tentacles to the next joints along, i too get a sore hip from not using my knee properly.
There is really very little you can do until you get a second opinion - your physio is doing as much as they can under the circumstances but no amount of physio will help with a mechanical problem - if thats what you have.
youre GP isnt going to be able to do anything for you.

how long is this going on friendsfan?
you might speak to your physio about trying to keep good muscle tone in the areas that are also being affected - there may be hip exercises that you can do. Its worth asking.
Title: Re: just back from physio
Post by: friendsfan on July 19, 2007, 09:57:44 AM
its been 19.5 weeks now with my knee stuck in the same position. i really wanna help myself but i just dont know who to turn to whilst im waiting for a a second opinion
Title: Re: just back from physio
Post by: tanyap on July 19, 2007, 10:06:47 AM
i hear ya! its very frustrating.
before i had knee problems i thought if something went wrong with the body you got taken into hospital and looked at and set on the right path in short order.
now i know that you can be left weeks and months trying to cope with problems before you get to see anyone.
i really dont know if you CAN do much to help yourself.

Just to clarify - youre knee is stuck in one position right? - is it painful to try and move it or is it just immobile?
What happens if you try and move it more yourself?
Title: Re: just back from physio
Post by: friendsfan on July 19, 2007, 10:15:29 AM
currently im estimating its stuck at about 20 degree my toes touch the floor but my heel doesnt......at physio they work on me for 45 mins and get a extra 10 degree, but i soon loose this...they really have to manipulate it to that 10 degree... when i try to bend it myself it just wont budge no matter how i try...
so in answer to your questions.. id say yes it is stuck in one postion, its painful to try and move it but i can breathe through that and take painkillers so its not really  a pain issue     
Title: Re: just back from physio
Post by: tanyap on July 19, 2007, 11:25:24 AM
what does it 'feel' like to you?
does it feel like something is preventing the joint from bending or does it feel like you dont have the strength to bend it?
And when they get the extra 10 degrees out of it - how does it feel after that - does it hurt, or swell up?
Im asking you these things because for ages and ages recently I couldnt get my knee to bend into a kneeling position - it just hurt too much, felt like I was stretching things and it would be so sore afterwards, but I just kept doing it, bit by bit it stopped feeling like i was 'stretching' - but it didnt feel like there was anything preventing it from bending except pain.

does your knee itself hurt you a lot - just sitting around, is it aching?
Title: Re: just back from physio
Post by: friendsfan on July 19, 2007, 01:37:25 PM
hiya, yes it does ache just while im sat down...its actually both i know i havent got the strength there for me to move it, but at the same time it feels like something on the outer side of the kneecap restricting movement
Title: Re: just back from physio
Post by: tanyap on July 19, 2007, 03:37:07 PM
yes of course - you wont have strength after 19.5 weeks of not using the muscles.

can you tighten your quads (despite not being able to move your knee?)

Title: Re: just back from physio
Post by: friendsfan on July 19, 2007, 04:23:23 PM
I can just about tighten my quads not much but i can do it
Title: Re: just back from physio
Post by: tanyap on July 19, 2007, 04:26:10 PM
what does your physio say about your muscles - does she say that they are wasting?
and if so what can she get you to do to address that?
Title: Re: just back from physio
Post by: friendsfan on July 19, 2007, 08:29:16 PM
she says my muscles are wasting..she has me doing home exercise which i do religiously..
Title: Re: just back from physio
Post by: tanyap on July 20, 2007, 09:24:24 AM
i think thats probably all you can do until you get a second opinion.

Title: Re: just back from physio
Post by: friendsfan on July 20, 2007, 10:48:19 AM
i went again yesteray to see the private physiotherapist..waste of time now she is seriously concerned about my knee but she wont see me again until the surgeon has done further investigations as she feels she cant do anything.........so its all down to A OS again now
Title: Re: just back from physio
Post by: tanyap on July 20, 2007, 11:17:11 AM
make the appointment for a private OS, you wont have to pay until the appointment comes up, but the longer you wait to make the appointment the longer before you see someone.
Title: Re: just back from physio
Post by: friendsfan on July 20, 2007, 04:39:17 PM
hi again...ive decided on a plan of action im not going to get a private consultation until i see what the MRI scan reveals that i have on Monday, im starting to worry about this now, not only because of my knee but im really anxious to find out what this growth is on my hip....
Title: Re: just back from physio
Post by: tanyap on July 23, 2007, 09:48:09 AM
MRIs dont always reveal everything. Do you think you will be given the results of it? I wasnt given the results of mine - they have been sent to my OS - I know in different places procedures are different.
Will you understand the results without an OS interpeting them?

If I were you I would have made a private appointment weeks ago - you posted on the 6th July that your OS dismissed everything you asked and gave you very little information - between then and now you could have had your second opinion!

Title: Re: just back from physio
Post by: friendsfan on July 26, 2007, 04:15:50 PM
ive had my mri just waiting on the results now,dont know how long that will be.... due to a change in financial circumstances i wont be able to see the private OS so its just a matter of waiting for the second opinion... but im going to keep pushing for it as ive been off work for 21 weeks with my knee and i just need to get back to work
Title: Re: just back from physio
Post by: friendsfan on July 27, 2007, 10:30:01 AM
will scar tissue show up on the mri scan?
Title: Re: just back from physio
Post by: tanyap on July 27, 2007, 12:38:15 PM
i dont know for sure, i would be inclined to think yes, but i could be wrong
Title: Re: just back from physio
Post by: friendsfan on July 31, 2007, 06:41:33 PM
ive been for my last hydrotherapy session today with a new physio, she has told me the basic results of my MRI scan which reveals everything is normal.... so why is my knee not moving?? i have a appointment to see OS on friday 10th august its still the same incompetent one. im not going to face him alone this time either my physio  or my mum will be going with me so i'll have support and im not leavin his office till i get a solution for my knee stiffness
Title: Re: just back from physio
Post by: tanyap on August 01, 2007, 12:08:26 PM
excellent news!! on all fronts! normal MRI - thank god for that!!!
and great that youre seeing your OS with someone. if possible bring your physio - she will be much better qualified to talk to him. your mum would be brilliant for moral support, but the OS wont listen to her professional opinion - whereas he might listen to your physio.

i think thats all very positive. im seeing my OS the day before you - ill look forward to hearing how we both get on.
Title: Re: just back from physio
Post by: friendsfan on August 04, 2007, 06:05:48 PM
my PT says on monday she is going to try me on a CPM machine, i think this is too late, ive been stuck in this position for 22 weeks.. so i dont think a CPM machine will help
Title: Re: just back from physio
Post by: friendsfan on August 06, 2007, 12:11:59 PM
ive been on cpm machine today OUCH!!!
we got my flexion to 90 degrees and my extension to 30 degrees,
my PT is unable to come on friday as she has a training day but is writing a letter to my consultant
this is the most ive had in 22 weeks, but my PT says she reackons i will need some more surgery
Title: Re: just back from physio
Post by: tanyap on August 07, 2007, 09:53:31 AM
well done on the movement!!!
what exactly is a cpm machine?

thats a shame your pt cant go with you on friday but if she writes a letter thats good, and you can bring along your mum or someone just as moral support so you dont get intimidated with your OS. make sure you write down a list of questions for him so you dont forget what you mean to ask when youre in there.

have you still got the movement or is it only in the machine?
Title: Re: just back from physio
Post by: friendsfan on August 07, 2007, 10:20:30 AM
thankyou. i can get a fraction on my own but it is just a fraction....
a cpm machine is a  continuous passive motion machine and while your leg is strapped in it genlty moves youe leg/knee.
Title: Re: just back from physio
Post by: tanyap on August 07, 2007, 12:39:41 PM
yeah but your quads must be totally wasted at this stage, its a very positive sign if the machine can move your knee joint, at least something mechanical is not preventing movement. in time surely you will be able to get your muscles doing what the machine did.
i hope it helps your brain 'remember' that your knee is there to act like a hinge - and not just stick in a locked position.
what did your physio have to say about it when the machine actually got your leg moving? was she happy with some progress at least?
Title: Re: just back from physio
Post by: friendsfan on August 07, 2007, 12:50:53 PM
yes she was pleased but she isnt convinced... she still feels as though there is something blocking the full movement....
also that private physio who i saw a couple of weeks back has actually rang my OS and spoke to him about this...so im staying positive and hoping he will now do something.. he will have that letter from my nhs physio
                                  a letter and phonecall from private physio
                                  a letter that he had last time from my other physio
so there will be 3 proffessionals that have got in touch with him telling him the same thing   
Title: Re: just back from physio
Post by: tanyap on August 07, 2007, 02:06:17 PM
3 professionals AND you.
i dont think he can ignore that.
its important you make a good connection with him, dont feel he is brushing you off, you must listen to what he says and question him, i sometimes feel like my OS brushes me off but he just isnt a great people person, and says things that i dont want to hear but which ultimately turn out to be true.
the main thing for you is WHY IS MY LEG LOCKED IN POSITION!!! and then onto - what can be done to make it move, if he says physio refer him to the letters he has been given from 3 different physios and ask him to refer you to a physio that can actually help you.
Title: Re: just back from physio
Post by: friendsfan on August 07, 2007, 03:40:54 PM
yup,i dont think he can argue with me anymore, there will be way too much evidence lay in front of him...
Title: Re: just back from physio
Post by: tanyap on August 07, 2007, 03:53:37 PM
i hope you dont mind me saying this but i think it would be helpful for you to forget your previous experience with your OS and go in with an open mind and be willing to listen to what he has to say.

i know that they can have dreadful interpersonal skills etc.. and i know you can be made to feel like theyre not listening or theyre brushing you off etc... (been there done that have left many an appointment tut tutting to myself).

but if you can change your mindset going in you might have a more productive appointment. im not for a moment suggesting that you have a lovely OS and that you just dont like him, but i was thinking about my own impending appointment - last time i kinda felt that he wasnt too 'nice' to me and that he wasnt really listening to me and he was just sending me back to physio - same old same old... but then i thought about it afterwards and although his people skills werent great, he was very thorough, he examined me, looked at x-rays, listened to history, moved my leg around, and then announced that i needed more physio. because i didnt want to hear that my immediate (internal) reaction was 'what! no, ive been doing loads of physio, there must be something more you can do!!'. and for a little while i just kinda slumped there and just didnt want to listen to him cos i wanted him to say 'yes, we have a small operation that will fix you up in no time. forever'.

but unfortunately there is no small operation to fix me and since he sent me to a new physio i have had a good bit of improvement. so he was right. and perhaps he seemed dismissive to me because i was being dismissive of him...

i dont know if any of that makes any sense - but im certainly going back in on friday with a more open mind, because i realise now that despite me hearing things i didnt want to hear - they were the right things for me to hear. and he wouldnt be in the position he is in if he wasnt an expert in knees.

most of all - good luck with your appointment.
Title: Re: just back from physio
Post by: friendsfan on August 07, 2007, 04:02:33 PM
i understand what your saying and i will try to go in with an open mind on friday..there are some physios refusing to treat me anymore as they feel physio isnt helping. at the moment im fighting for physio as id rather be seen to be doing something than sat at home doing nothing and just waiting
Title: Re: just back from physio
Post by: tanyap on August 07, 2007, 04:12:59 PM
yes - my current physio has told me she wouldnt have taken me in only for she has respect for my OS and he sent me to her.
physios are good - but theyre not surgeons. its really up to your OS to send you for the best treatment.
Title: Re: just back from physio
Post by: friendsfan on August 07, 2007, 07:55:05 PM
here is a pic of my knee, my surgeon can look at that and say its fine, whereas it looks deformed to me, BTW its the one with the scars
Title: Re: just back from physio
Post by: cudos on August 07, 2007, 09:46:53 PM
Sorry to hear of your struggles, the pic of your knee looks exactly like mine, wasted quad and all. Although I am only 9 weeks out I too have ROM issues and a very stiff knee. Any gains I make quickly disappear. I have been told from my OS that I do have scar tissue. I thought my knee was swollen, its not, thats scar tissue.

It sure sounds like scar tissue is your main problem. Scar tissue is amazingly tough to break down. I can literally bring myself to tears trying to improve my flexion from 90 to 120 but it quickly disappears and I start the whole process over then next day. I can't seem to get better than 5 degrees extension either. Does your knee feel warm most of the time?


I hope you get some answers real soon.
Title: Re: just back from physio
Post by: tanyap on August 08, 2007, 09:11:30 AM
it looks very swollen - although as cudos says - that might be scar tissue? it just looks like its a big mound of flesh - theres no definition, cant see the outline of bones - especially compared to the other side.
you can clearly see your wasted quads too - youve probably also lost some muscle on the good side too just from not being able to use your legs properly.
theres absolutely no way it looks 'normal' but the OS will be viewing that from the perspective of how it should look after injury as opposed to how it looks compared to a good knee.
definitely ask about scar tissue.
Title: Re: just back from physio
Post by: friendsfan on August 08, 2007, 09:46:27 AM
hi cudos, yes my knee does feel warm most of the time and alot of the time its kinda purpley from lack of movement, what surgery did you have?? and im glad someone else has the same kinda looking knee

tanyap, when i mentioned scar tissue to him last time he totally dismissed it.. how do i get him to take a little notice?? although i think he will do this time after speaking to my private physio he will know how willing i am and how hard ive been trying (espically if im willing to pay £37 for 40 minutes of physio)
Title: Re: just back from physio
Post by: tanyap on August 08, 2007, 10:07:02 AM
well ask him what he thinks is causing the problem - and if you dont understand what he answers, ask him to explain it to you.
ask him about scar tissue and if he is dismissive, ask him why he feels it is nothing to do with scar tissue?
Title: Re: just back from physio
Post by: cudos on August 08, 2007, 03:08:41 PM
I had Patella tendon ACL reconstruction and meniscus repair. My OS has been doing knees exclusively for over 25 years. He knew instantly after seeing me at 8 weeks post op that I had scar tissue. If your OS cannot give you a logical explanation as to why he does not think you have scar tissue I would def look for another opinion.

Make sure you ice as much as you can, I ice when sitting, after PT, before PT, anytime my knee feels hot I ice if possible. Inflammation does not help your situation. 

Cheers
Title: Re: just back from physio
Post by: tanyap on August 08, 2007, 03:28:42 PM
cudos - what can be done for the scar tissue - do you just have to battle with it or is there any procedure they can do to get rid of it?
Title: Re: just back from physio
Post by: cudos on August 08, 2007, 04:39:29 PM
Well I do know that scar tissue becomes more fibrous (solidifies) as more time passes. Working hard on keeping inflammation down and ROM improving are crucial. I'm not sure how far out you are from your surgery? The sooner you can breakdown the scar tissue via ROM exercises while it is still in its pliable stages the better. If the scar tissue goes unchecked and ROM is limited it it likely you will need a MUA (manipulation under anesthesia) to bust it up, improving ROM or surgery to remove it. Both procedures have their own risks of course.

How aggressive is your physio? are you pushing your limits trying to regain ROM. Remember its all relative. Pushing the limits for one person may not be the same for another. For me and my limited ROM (scar tissue thanks very much) I push the ROM exercises quite hard. In physio as well my PT almost gets me to tears. But unless you can make gains on a weekly bases you may be headed for surgery or MUA. I can make gains but they seem to disappear, I'm hoping that because I can get there eventually it may stick. I think theres a difference between making gains and regressing and not making any gains at all.

How hard do you push yourself on the ROM exercises? do you make any progress while doing them. If you are 6 months or further along from surgery and cannot make gains I think you are likely headed for alternative measures. Also remember the sooner scar tissue is dealt with the better. (Assuming you have scar tissue) I've heard 6 months is the outer limits for optimal results in dealing with surgery or MUA.

You do have youth on your side however (-:, get a definitive diagnosis on that knee one way or the other!, if not scar tissue what it is? if its scar tissue get a game plan asap. If you don't get a good gut feeling about your current OSP get another opinion right away. Don't underestimate gut instinct.

Cheers,
Title: Re: just back from physio
Post by: friendsfan on August 08, 2007, 06:40:25 PM
i had surgery may 2nd so im guessing thats about 12 weeks
but ive had no/very limited ROM since my original injury march 5th
we tried aggresive physio making very small gains but losing them straight away e.g. i had 90 degree flexion on monday on the cpm machine and i have none now, im totally stuck again.
my PT† and i will pretty much bring me to tears in physio and at the moment im not having much physio as there isnt any real improvement..they arent prepared to keep doing physio until my OS does something knee wise† †
i am currently waiting for a second opinion but still seeing my other OS whilst im waiting
Title: Re: just back from physio
Post by: tanyap on August 09, 2007, 01:52:15 PM
friendsfan - good luck tomorrow.

i had a positive appointment with my OS this morning, i am to continue physio til i have my bad leg up to same strength as my good side. he reckons 6 months to a year more for me. my MRI results show very little degeneration, some 'scraping' where patella meets knee joint, but its not bone on bone and shouldnt be for a long time if i get it strong.
so another 6 months to a year punishment for me :)

he was very thorough and interesting, brought out anatomy charts, joint models, drew diagrams, basically gave me a full lesson on the physiology/chemisty/biology/mechanical structures of the knee and supporting muscles. he said he had feared my VMO was paralysed because it was totally invisible 7 weeks ago but when he examined me he had a eureka moment where he shouted 'YES, I CAN FEEL IT!!!'. so he is now satisfied that the physio is producing muscle growth and strength.

he did tell me something interesting about wasted muscles - that the nerve fibres die with wastage but with physio and e-stim they grow again, and that some day they will reach critical mass and suddenly the muscle will start working automatically again - as opposed to me having to 'think' about it to tighten it. he said it is literally a 'miracle' moment, one day i will wake up to a working muscle!! so im looking forward to that day!!!
Title: Re: just back from physio
Post by: friendsfan on August 09, 2007, 03:07:16 PM
tanyap... that sounds like great news, kinda the beginning of the end because youve got a rough timescale im really happy for you.
i hope i can come out with the same kinda news
what is VMO?
Title: Re: just back from physio
Post by: tanyap on August 09, 2007, 03:40:00 PM
yeah it does feel like the end is in sight now!!!
mind you it would have been nice if they had done the whole education bit years and years ago - cos i just ignored my leg for years when it didnt hurt!!!

VMO - part of the quad set, its the main stabiliser of the kneecap - its located (roughly) above your kneecap a little towards the inside of your thigh. its extremely difficult to isolateto strengthen it. you can find it by sitting on a chair and with your leg at 90 degrees press your heel into the ground, the muscle that tightens towards the inside of your thigh is the VMO.
ive had so much atrophy because over the years ive so many dislocations that my brain went into permanent 'muscle guarding' mode - so my muscles stopped working, and then theyd atrophy, causing further injury, more atrophy etc...etc....
Title: Re: just back from physio
Post by: friendsfan on August 10, 2007, 12:17:25 PM
just back from my OS appointment, (i saw a different OS)
after my OS spoke to my physio the other day and reading the other reports he has already referred me to the Queens medical centre in nottingham to see the best knee surgeon in the area.. this is all i was told today but it feels like progress
Title: Re: just back from physio
Post by: tanyap on August 10, 2007, 12:34:12 PM
that IS progress.
when are you seeing the new guy?
Title: Re: just back from physio
Post by: friendsfan on August 10, 2007, 12:55:40 PM
i should hear from them within a week, i now at least feel like they are taking me seriously 
Title: Re: just back from physio
Post by: tanyap on August 10, 2007, 01:33:39 PM
im in the middlle of frustration as well. my OS said yesterday to continue my rehab program, keep getting the isokinetic testing done in my physiotherapists and that the goal is to get my bad leg 5% stronger than my good one.

so i phoned the physio when i left the OS and the receptionist said 'we will call you back'. never called back so i phoned again today and she said 'yes we will contact you', and still no appointment made!!! im at a loss to know why i cant just make an appointment!!! im also suspicious about the non communication from them - the head physio in there kept telling me that she would not have taken my case on only for the OS referred me to her and that in her opinion i need surgery, and that she doesnt think physio is the answer - so now im wondering do they just not want to continue working with me?
and the are the only place that has that isokinetic testing machine so its not like i can just go elsewhere.
Title: Re: just back from physio
Post by: friendsfan on August 10, 2007, 03:49:02 PM
deja vu....why do we have to fight to get treatment???
do you feel like physio helps you?
my PT is very reluctant to see me, but ive fought to have it as i feel a bit better when i leave
my PT is saying the same, she thinks i need surgery, just got to see what this specialist says
are you on the NHS??
Title: Re: just back from physio
Post by: friendsfan on August 13, 2007, 05:10:41 PM
ive been for physio today, and she has now passed me onto another PT through occ health at work (i work for NHS)
and he is going to try accupuncture and get me back in the hydro pool......however i dont see him till 23rd august
Title: Re: just back from physio
Post by: tanyap on August 14, 2007, 09:16:11 AM
oooh - ill be interested to hear how the acupuncture goes for you!!! do post your experiences.
how are you feeling these days - are you more hopeful you are being taken seriously and that something will be done for you?
Title: Re: just back from physio
Post by: friendsfan on August 14, 2007, 09:29:57 AM
im hopeful that he has referred me, but im upset that ive been passed onto yet another PT....i just need to find out whats stopping me knee
and ive got a appointment with a pain nurse on the 23rd august
Title: Re: just back from physio
Post by: tanyap on August 14, 2007, 09:53:20 AM
im replying to you in 2 threads now :)

i think its good you got passed to another pt if the current one feels its beyond their capabilities. the new one might have more magic to work.
are you in a lot of pain? you poor divil - its not been an easy time for you.....
Title: Re: just back from physio
Post by: friendsfan on August 28, 2007, 08:34:35 PM
my physios are now refusing to see me and give me any more treatment until the OS has done something about my knee as there is no improvement
Title: Re: just back from physio
Post by: tanyap on August 29, 2007, 09:15:15 AM
when are you seeing the new OS?
Title: Re: just back from physio
Post by: friendsfan on August 29, 2007, 07:43:12 PM
im still waiting to hear from them, i managedto contact my OSs secretary today who says she will chase it up
so im just waiting
Title: Re: just back from physio
Post by: tanyap on August 30, 2007, 09:49:58 AM
did your physio recommend anything for you to keep doing until you see the new OS?

keep chasing that appointment!