The WAITING ROOM => GENERAL KNEE QUESTIONS and comments (good for new threads) => Topic started by: soozles on September 16, 2010, 11:22:23 PM

Title: How soon to travel?
Post by: soozles on September 16, 2010, 11:22:23 PM
I'm scheduled for a PCL reconstruction on November 23, but I am also a 4th year medical student in the US, and am going to need to interview at residency programs. Obviously, I know it will be difficult, but from the experience of people who have had knee surgeries in the past, should I be off the Percocet and be cognizant at interviews a couple weeks after the surgery? I will be taking one of my family members with me to drive me (since it's my right knee) or fly with me if need be. I'm trying to schedule the interviews I need to fly to for earlier, before the surgery, or later in the season, around end of December/January if possible. Unfortunately, I can't miss too many days off of the rotations I'll be on, so things get a little tricky. So does anyone think I can fly about 3 weeks after the surgery, and road travel in 2 weeks after the surgery? I figure interviewing on crutches will just make me memorable  ;D
Title: Re: How soon to travel?
Post by: eaglemom on September 17, 2010, 04:21:37 AM
I think you need to discuss this with your surgeon now, prior to setting up interviews.  Obviously we all heal at a different rate and have different pain levels, but I think you are really pushing the envelope of reality here.  Riding in a car ANY distance at 2 weeks won't be pleasant - period.  As for flying I doubt you are cleared to do that until later on - its simply not worth the risk. Now I'm not a medical professional, but been there done that with surgery #4 and you certainly won't make a good impression, in my opinion, writhing in pain at an interview. Hopefully you won't be, but you will be uncomfortable, plan on it.

As an aside, I was 8 weeks post op and rode in the car (surgeon approved) over Labor Day weekend.  We stopped faithfully every 1 1/2 for me to get out of the car and move around. It was a 10 hour trip made longer because of all the stopping but my pain level was very much increased, lots of swelling, etc.  At pt it took over a week to get swelling down and be at at level I was prior to car trip.  Now, I'm not trying to pee in your bowl of cereal but really do you think you'll be "on your game" so to speak to present yourself for residency programs that soon post op? I'm not trying to discourage, but I think your asking something pretty impossible of yourself.  Good luck, eagle
Title: Re: How soon to travel?
Post by: soozles on September 17, 2010, 06:52:30 PM
eaglemom, thanks for your response. When I scheduled the surgery, I asked about interviews. He told me I should try to stay home for at least a week, but that it was really up to how I was feeling. He did think I could be partial weight bearing by 2 weeks time, and he wasn't worried about flying, since I'm young and otherwise healthy, so the risk for a DVT is not something he's worried about. I flew 4 days after breaking my wrist, and was put in a removable splint where I could adjust the straps, as swelling was the concern there, and while it was painful with the pressure changes, it was manageable. Of course, I don't know how a knee compares with a broken wrist.

I should probably also mention, I won't be going on any long car trips or plane rides. If I'm driving, than it's generally going to be less than a 2 hour drive. If I'm flying, then it's about 1-1.5 hour flight. My top choice program is about 45 minutes from home, it would take me that long to get to my surgeon for follow up visits. Also, seeing as how the interview season runs from November-mid January, it's impossible to schedule them all before the surgery. I'm still doing rotations in the hospital and I can't miss that many days. I can't have the surgery at another time, since I'm having it at the start of my vacation month, so it's either now or after I graduate, but that means starting residency on crutches, which is even more difficult.

I guess I just can't imagine still needing Percocet or other narcotics after 2 weeks. When I broke my wrist, I only took Aleve or Advil. I actually had a previous wrist surgery, and was prescribed Percocet, but never needed it. I don't know if I was just lucky, or have a higher pain tolerance? I know people that went back to work after a week, so I was extrapolating from that if I waited 2 weeks, I should be OK to interview. Does anyone else have any other input?
Title: Re: How soon to travel?
Post by: Kaputt_Knee on September 17, 2010, 07:17:47 PM
Perhaps to err on the side of caution you could ask your surgeon about blood thinning treatments for post operative use?

 Here in Germany you are on anti-DVT blood thinning injections for as long as you lower leg is not being used properly. This reduces the tendency of the fluids that pool in the calf during immobility to coagulate and possibly lead to a DVT. A PCL rehab always includes a distinct post-operative period of relative inactivity as far as I have observed and read. This means that the natural return pump of the calf (gastrocnemious muscles) for arterial blood and lymph that moves into the lower limbs under gravity has no mechanism for returning to the core for renewal and re-absorption. With the best will in the world you cannot do ankle pumps continuously during this period of relative immobility  ;D

Remember that each operation and its associated immediate post operative rehab should always be viewed separately. Past reactions can only ever be a possible indicator of current bodily responses, not a promise. ;)

Good luck with your interviews and on getting a residency. Who knows your situation may actually work in your favour  ;D

Title: Re: How soon to travel?
Post by: eaglemom on September 17, 2010, 09:43:46 PM
I certainly hope I didn't sound "grumpy."  I wish you nothing but the best and to be pain free.  However, to compare a wrist and leg they aren't the same. In an airplane your wrist isn't an issuse - bending that leg/knee to sit in tight seat - that's a whole different thing.  I too have a high tolerance for pain - I can handle it during the day - but at night when its keeping me awake from pain its time for pain medication.  Just don't not take the medication and let the pain get ahead of you - then you are in a world of hurt - literally. 

So, what's your area of concentration for your residency?  Might we have another ortho? You could help all of us!  Beswt of luck and keep us informed.  eagle
Title: Re: How soon to travel?
Post by: KW on September 17, 2010, 10:21:17 PM
My imput....

I fly a lot for work...I've had a lot of knee surgery (12)

Able to go on short flights at 3 weeks...Probably.  You will probably be uncomfortable and have additional swelling by the end of the flight.

I was on a x-country flight at 3.5/4 weeks post-op Fulkerson TTT (they broke my tibia) with minimal issues aside from swelling.  On a 2.5 Hr flight 5 weeks post-op partial replacement with no additional swelling or issues.

A few things to keep in mind...
1)You can't sit in the emergency row when injured,  so don't plan on it.  Some airlines have "upgraded" economy that give additional log room with out being in the emergency row.  Just have to pay a little more (less then business)
2) Call the airline ahead of time and arrange wheelchair assistance.  They will get you right to the gate and be there to help getting off the plane.
3) To help combat any additional swelling you can take a empty Zip-Lock bag on the plane and get ice from the Flight Attendant.     

Good Luck!
Title: Re: How soon to travel?
Post by: soozles on September 17, 2010, 11:57:42 PM
eaglemom, you certainly didn't sound grumpy, just honest. And I know that a wrist and leg aren't the same thing, I was already prepared to pay more for bulkhead seating if need be. Most of the flights would probably be on jetblue because the airports in those cities just happen to be serviced by jetblue, and I know that you can pay extra for more legroom. As far as specialty, I'm going into pediatrics. I enjoyed being in the OR, but once I realized that doing anything surgical meant being in the OR for the rest of my life, I very quickly decided against it, too many intense people, too much nastiness that goes on in the OR. Pediatricians tend to be nicer people. But a good friend of mine just started his ortho training, although the first year is only 1 or 2 months of ortho, and the rest is regular surgical stuff. So maybe he can help us all out. :)

KW, thanks for those tips. Didn't think about the zip-lock bag, although it makes sense. When I flew with my wrist, I did actually have to ask for ice, the only thing they could put it in was a rubber glove.

Interview season is kind of an evolving process, almost. As I get more invites, I'm cancelling some others. I already decided to cancel 3 invites that I had scheduled a couple weeks after the surgery, one was 2 hours away, one 4 hours away. Whenever I can, I'm trying to schedule them for later in January, but not every program goes that long. The good thing about all this is trying to figure out the scheduling is giving me such a big headache, it is making me forget my knee pain.
Title: Re: How soon to travel?
Post by: soozles on October 12, 2010, 01:30:07 AM
Hey, this is just a little bump to ask for some more advice. So just as a quick catch up, I am having a PCL repair on Nov. 23, which happens to be the middle of interview season for residency. I cancelled all the interviews that would require flying, as I got interviews at other places I would rather go that are closer to home. I also managed to change it so my first interview post op is about 3 weeks out, and relatively close to home.

Now, here is my current question. Turns out, I have some unexpected time off at the end of January, during which my boyfriend and I were thinking of going on a cruise vacation together. By that point, I'll be about 8 or 9 weeks post op. The only thing is, we would have to fly to the cruise, and it's about a 2 hour flight. I figured we could just pay more for the bulkhead seats or the seats with more leg room on Jet Blue, and the possibility for getting wheelchair assistance if I need it is still there. I figured for the airport, we could always check in online and then do curbside checkin for the bags to avoid those lines. So the only line would be security and a potentially long walk to the gate. But I could always request wheelchair assistance closer to the date if I will need it. Same for when we're there, right? My boyfriend can carry my suitcase for me, and once you're at the pier, you turn it in to the porters.

At the cruise terminal, I'm not so concerned because I am a platinum member on this cruise line, which means we get to go to the front of the security line, and go into seperate VIP boarding, which has no lines. If there is a wait, then they take your name and you wait in the comfy couches enjoying your complimentary coffee until they call your name. You're also the first one on the ship, so no standing in line waiting to board. The cruise also has 2 dining rooms, one in the back of the ship, one in the center. I figured I could request one in the center to minimize the distance I would need to walk on the ship. During the days, I don't do much activity anyway, I'll lie out on the Lido deck, watch some of the events going on, maybe play Bingo, go to the casino, relax in the spa. Basically, I'm very lazy on cruises. Same at the ports, I've been to all of them so as long as I am on a sandy beach while it's cold back home, I'm happy. Same for my boyfriend. I know I'm still going to be in the knee brace, but hopefully I'll be on the upswing towards recovery.

My surgeon said medically there is no reason I shouldn't be able to go, as long as I don't push myself and keep up with the PT exercises on the cruise. He also told me by that point, I may not need the crutches anymore either, but I would bring them with me just in case. But I was hoping other people might have some insight. Any chance this will be an enjoyable vacation, or will I be in too much pain to enjoy it? Will I still have lots of swelling on the flight by that point? I'm really not so worried about the cruise itself because I don't anticipate needing to move too much, lol, it's more the flight that concerns me. I didn't book anything yet, my boyfriend said it's up to me if I feel like I would be ready by that time. And I am aware that certain things are out, probably can't dance in the disco or go zip lining, but I can still go to the spa, watch the shows and games, enjoy the beaches. So anyone want to share an opinion?