KNEEtalk

DIARIES => Post-op diaries (50-100 posts) => Topic started by: Teacher2Many on June 27, 2012, 04:25:27 AM

Title: Bilateral MPFL Reconstruction-7/25
Post by: Teacher2Many on June 27, 2012, 04:25:27 AM
Hi all...I have had far too many orthpedic surgeries on the hips/knees over the last 5 years [if interested, see my thread entitled "Derotational Femoral and Tibial Osteotomy (Right: 7/8/10 and Left: 6/16/11)]. I am undergoing bilateral MPFL reconstruction via hamstring allograft at the end of July. Was wondering if anyone has undergone this procedure previously and can share some info regarding pain, rehab, limitations, etc.? I have read a bit about what others have experienced with this procedure but am interested in particularly hearing the perspective from someone who's had it done bilaterally (both knees at the same time) but any advice, input, etc. would be helpful!

Thanks in advance!!!!!
Title: Re: MPFL Reconstruction-advice, info, etc.
Post by: lisa424 on June 27, 2012, 05:06:05 AM
I had both of my legs done (not together) with hamstring allografts. In my experience the mpfl hurt more than my TTTs and lpflr.  Not sure why. But I have a high pain tolerance and only needed painkillers for a week. I was full weight bearing, no brace, and had full range of motion in 6 weeks. I started pt at 6 weeks as well.
Title: Re: MPFL Reconstruction-advice, info, etc.
Post by: oohheykate on June 28, 2012, 02:11:40 AM
I've only had one of my knees done but I agree with Lisa, it definitely hurt. My OS uses screws and I think that's what was causing the most pain and why I couldn't get off crutches for five weeks. I was WBAT from the start and was supposed to be in a brace for six weeks but it ended up being three months because of weakness and not being able to bend my knee. PT (started at 3 weeks) is crucial for this surgery. Bend your knee whenever you can because I ended up with an MUA.

Good news is, over a year later, my knee feels wonderful!
Title: Re: MPFL Reconstruction-advice, info, etc.
Post by: Teacher2Many on June 28, 2012, 05:06:01 AM
Thanks for the info!  I know I will be full weight bearing without crutches but wearing bilateral braces for about 6 weeks-locked in extension for the first two weeks 24/7 including when sleeping, then unlocked to about 30 degrees for weeks 3 and 4 and not needed when sleeping and then unlocked to 45 degrees for weeks 5 and 6.  Pain is not a stranger to me due to all my previous surgeries but was more concerned with limitations, etc. especially due to my job, which I will be back to around week 4.5.  PT will end the day before surgery and will begin again at 10 days post-op.  Any other info, advice, helpful tips, etc. would be greatly appreciated!
Title: Re: Bilateral MPFL Reconstruction-7/25
Post by: Teacher2Many on July 30, 2012, 02:56:13 AM
On 7/25, I underwent bilateral MPFL reconstruction using donor tissue as a way of finally settling the issue with the subluxing/dislocating.  My surgeon was (and always has been and always will be) awesome and was understood that he was to fix anything else he found wrong, particularly the cartilage defects from the ACI procedure done in 6/2009.  Surgery was short, maybe 1.5 hrs. total and also consisted of the hip doc coming in and doing the cortisone injection via flouroscopy while under anesthesia.  Waking up in recovery was horrible-the pain was immense, emotions were high, and breathing was a bit difficult.  But this has been the course for me as each surgery seems a bit harder to come out of.  However, when my surgeon came in when I was fairly coherent and free of pain (compliments of a femoral nerve block on the left leg), his comment was that the patellas were extremely hypermobile (which was reassuring to hear that my thoughts were accurate) and he did some trim work on the ACI site but that everything else looked good.  I am in bilateral knee braces/immobilizers for 6 weeks with the first two being locked in extension and then slowly opened.  I am set to return to work in 3 weeks to prepare my classroom with a start date in 4 weeks so hoping things progress so that I can get back to my kiddies.  I've heard/read of many people to have a MUA done after this procedure as ROM is hard to get back due to swelling and tightness but since my joints are typically hypermobile, I'm hoping this isn't an issue for me.  It's only been 96 hrs. post-op and I am off pain meds, unless I need one at night to ensure a pain free, good-night sleep and am finding the greatest pain relief with the use of the cooling/compression machine.  Walking is awkward, which surprises me as I was in the same protocol with knee braces, etc. after the bilateral ACI was done and am wondering if it's because my bones are now straight, making it harder to ambulate (before, they were so excessively rotated, my legs were already at that awkward angle to swing them out and around when walking-not so much anymore).  Swelling is still intense, making my previous surgical scars look more hideous than they already do and the bruising is pretty nasty as well.  But no signs of infection or of blood clots, which is great news.

I return to my doc on Thursday to have stitches removed, Rx for PT given, and hopefully less bulky braces but that's yet to be determined. 

Only 1 more surgery on the horizon, which would be the hip one and only if the cortisone shots don't cut it, so keeping my fingers crossed I am done frequenting the OR multiple times each year, after just having had my 24th and 25th surgical procedures!

Happy summer,

Beth
Title: Re: Bilateral MPFL Reconstruction-7/25
Post by: oohheykate on July 31, 2012, 02:23:14 AM
Glad your surgery went well! I can't believe you're already off pain meds but you've had so many surgeries your pain tolerance has been built up. I hope you continue to be pain free. Definitely bend your knees as much as you can tolerate once you're allowed to because I'm extremely hypermobile (which is why I had the MPFLr) and still ended up with an MUA.

If you end up having hip surgery and it's a scope, it is nothing compared to any knee surgery I've had. It's the easiest surgery I've ever had!
Title: Re: Bilateral MPFL Reconstruction-7/25
Post by: emm10161301 on July 31, 2012, 09:35:31 AM
Hey :) I had both my knees done mpfl at the same time 1 month 5 days before you its under mpfl and lr on boths knees 20thjune2012. Found out yesterday my rehab is going better than expected so if you are stuck or need to vent some frustration I'm sure I've been there! :) good luck with your recovery!!
Title: Re: Bilateral MPFL Reconstruction-7/25
Post by: Teacher2Many on July 31, 2012, 11:29:48 PM
Oohheykate:  I was quite surprised about being off pain meds so soon but surprisingly, it doesn't hurt!  I firmly believe that the ice/compression machine helps drastically with the pain and is my saving grace!

I've been bending my knee since the first day post-op and am sure once I start PT on Friday, the bending will hopefully increase (& am sure the pain will increase then as well).  Just wondering what the parameters were in regards to deciding to do the MUA?  Are there guidelines that you had in regards to flexion at a given time frame (ie by 2 weeks, x degrees of flexion)?  The swelling seems to definitely be impacting my ability to bend it and it isn't going down much; did you have that same issue as well?

What type of hip surgery did you have?  I believe if this is done it'll be done via a scope bit than is just as bad-3 weeks on crutches with a brace for 3-6 weeks and rehab for 3-6 months!  But can't imagine it'd be worse than the hip ones I've already had.

emm10161301:  I've read your posts; sounds like rehab is going well for you.  Am I remembering correctly that you did not have any braces post-op?  Haven't come across those who've had this done bilaterally so it was nice to find at least one person who has.


Title: Re: Bilateral MPFL Reconstruction-7/25
Post by: emm10161301 on August 01, 2012, 09:48:29 AM
Hey yea, ice and hot water bottles worked better for me, I found that my muscles got cramped so hotwater bottle relaxes it :) and yup no brace I was given a sort of brace for one leg, but I didn't used it as such, maybe if I walked far I'd shove it on my left leg but I mainly went without it. Flexation rates surgeons have different expectations, usually if u can get to 90o by 6 or so weeks that's grand. My surgeon was pleased as I had managed to do all my bending with full ROM on right and 90-100isj on the left in well I'm 6 weeks post op today :) he told me I'm miles ahead and expected me to be a madhouse case as its such a painful op, in all honesty the pains I have they're sore I don't deny that, but I get pain free spells and I'm ok :) sitting on somewhere like a high bed and sliding forward is fantastic to get the knees to bend. My habit I need to break is the whole lifting my legs with my hands because the right doesn't have that problem I can lie on my back and lift it into the air nearly onto my head and tuck my knee into my chest. I think it progressed quickly as I didn't wear the brace on it and that held my left knee back. But everyone heals differently, I proved it as nothing in your body is symetrical. I read a diary that a girl recovered in 2 weeks with one leg done. I couldn't ever I am too forgetful and maybe should remember to do my knee exercises as often as advised and I'd be further (I manage maybe the full amount of 1 in a day) but sure I managed to make the physio think I'd done more with my progress lol. Happy healing everyone and teacher to many you'll be fine you can do this its doable!! :)
Title: Re: Bilateral MPFL Reconstruction-7/25
Post by: Teacher2Many on August 02, 2012, 04:33:13 PM
Stitches came out today and the awful braces that went from my thighs to my ankles are gone-now I simply have bilateral Hely Weber braces that help keep the patella from shifting laterally.  I am to wear them whenever up and about but no longer need them from sleeping (insert smile here)!  Swelling and bruising still there but hopefully once PT starts tomorrow and motion starts improving, the swelling will decrease.  Maybe returning to work in 3.5 weeks will actually be doable!
Title: Re: Bilateral MPFL Reconstruction-7/25
Post by: oohheykate on August 03, 2012, 01:10:23 AM
Ice is amazing! I used my ice machine religiously for about six months after my surgery. As for the MUA, after nine weeks, I had about 80 degrees flexions. I was supposed have full ROM by six weeks post-op. My knee was definitely swollen but I could feel tightness and just a general stuck feeling in my joint when I tried to bend it and when my PTs bent it. I had a scope along with the MUA to clear out scar tissue.

I had a labral repair via scope on July 6th. I was NWB for 12 days and I'm 50% weight bearing now and I have a brace that stops my flexion at 75 degrees. I don't even need crutches, pain wise, but everything needs to heal.
Title: Re: Bilateral MPFL Reconstruction-7/25
Post by: Teacher2Many on August 03, 2012, 09:40:07 PM
First PT visit today, well okay it was the PT eval with treatment starting on Monday.  Right passive flexion measured at 65 degrees and left passive flexion measured at 45 degrees.  Right knee is bending nicely when walking but left just isn't quite there yet.  Hopefully by the end of next week, after 3 good PT sessions, that will be different.

I did sit in the front seat today of the car today (had previosly been long sitting across the back seat) and man, good thing there wasn't some type of emergency that I had to get in/out quickly.  Was hoping to be able to drive by Monday but not sure that's possible unless the bending improves a lot over the weekend but if not this Monday, for sure by the 13th.  Getting into the driver seat will be easier than the passenger seat as I'd be leading with my right leg which is cooperating more than the left.  We'll see how things progress!

Back to work to set up the classroom in 2 weeks and then to start the school year in 3...here's hoping I can keep up with my kiddos!
Title: Re: Bilateral MPFL Reconstruction-7/25
Post by: YogaGirl on August 14, 2012, 07:02:16 PM
Hows it going now? Driving, teaching, PT, how are you holding up? Good I hope!
Title: Re: Bilateral MPFL Reconstruction-7/25
Post by: Teacher2Many on August 14, 2012, 07:32:31 PM
2 weeks and 6 days post-op...

I am officially driving!   ;D I like having my freedom and although I have no intention of going anywhere but PT for right now (mostly because walking causes swelling/pain and hate to be stuck at a store because I can't bend the knee enough to get it into the car to come home) , it's nice to not be fully dependent upon people (I HATE being dependent)! Not the easiest getting in/out of the car but easier to get in the driver's seat than the passenger seat as the left knee is the one refusing to bend and when getting in on the passenger side, it has to bend more because the space is smaller. I can drive for maybe 1/2 hr. tops-the knee starts to get really painful from being bent after about 30 minutes and it would then become a safety issue. But 1/2 hr. is more than enough time in the car to get me to/from therapy, to/from work, and to/from any stores to run errands. Going out to see my sisters and nieces/nephews would be an issue as they live an hr. away so mom or dad would have to drive for that one.

I am heading back to work next week to start working in my classroom and getting everything set up. Mom is coming with me as she has since I started teaching in 2006 and with surgery every summer starting in 2007, it's become a tradition. I don't foresee it being too much of an issue unless I have a ton of new stuff that got ordered that I need to unbox, assemble, and find a place to store. Teaching preschoolers with moderate-severe disabilities is so rewarding but also requires so much STUFF in my classroom! Our 'official' first day at work is 8/27 and I am keeping every joint I can crossed that I can manage to get through each day. My bigggest worry is stairs-none to get into my buildling but when we have meetings those first few days, sometimes they are on an upper or lower level in one of the schools so we'll see how that goes! And of course, there's the worries pertaining to being with my students-getting them to/from the bus, playing with them, chasing them around the room, etc.

PT is rough to say the least. I have been through h*ll and back with all of these surgeries and have to admit, this is the hardest and most painful rehab. Didn't think that would be possible after surgery last year (both hips, both knees, 2 blood clots, peroneal nerve damage, and foot drop). Granted I read a lot about MPFL and how hard it is but really didn't think it could be worse than last year-guess what, I was so wrong! The R knee is coming along nicely with approximately 80 degrees of passive and active ROM at 1 day shy of 3 weeks post-op and with small gains each PT session. However, the L knee is stubborn beyond belief. Only 60 degrees of active and passive ROM and this has stayed the same for the last week or so. I see my surgeon next week Thursday and this is going to be a huge question, as no specific guidelines were provided as to what ROM at what week post-op. He did specify no forced flexion so we'll see if that changes next week although honestly, forced or not, I don't think it's going to go anywhere. We'll see how PT goes tomorrow and if it's no better at all, I might just send him an e-mail to let him know what's going on. Really makes me worried about returning to work, unless there are huge gains in the next two weeks.

But I have been free of crutches since 3 days post-op, in small braces since 8 days post-op (more like patella supports than actual braces), and even do a bit of walking around the house w/no braces (only small bits, like if I'm going from my bedroom to the bathroom, which we share a wall so it's really not a huge distance). The braces will start to be weaned at the 4 week post-op mark (so figured I'd start a little weaning now) and probably gone completely at 5 weeks.

Pain is intense with flexion but manageable otherwise-no pain meds since 4 days post-op except for the occasional one at bedtime (maybe once/week). Sleeping is horrible due to the hip issues, foot drop, and knee pain but doable. My cooling/compression machine is a godsend for pain control and sometimes works better than the actual pain meds. But I also have a fairly high pain tolerance due to so many previous surgeries and tend to just ignore the pain and continue with what I was doing or what I plan to do. I am a big believer in the 'no pain no gain' philosophy and refuse to let pain control my life; it just requires some modifications!

Until next time (with hopefully increased ROM on both knees instead of just the R)...
Title: Re: Bilateral MPFL Reconstruction-7/25
Post by: Xeplasma on August 15, 2012, 02:05:33 AM
Yay to driving! I can't wait to regain that freedom! I feel like I could but still a bit nervous since it is my right leg which has to do most of the work, maybe in a week or two.
I have to say my goodness you've been through so much! You have a great attitude which will definitely impact rehab in a good way and from ehat you're saying it is showing already. Your results are already amazing at just 3 weeks post op.
Keep up the good work!
Title: Re: Bilateral MPFL Reconstruction-7/25
Post by: Teacher2Many on August 17, 2012, 11:14:04 PM
So today is the one day during this d*mn recovery that I am allowing myself to have a pity party!  Therapy this week has caused an immense amount of pain and even required an occassional pain pill, as the ice machine when I got home just wasn't cutting it.  Heel slides on the wall measured at 77 on left and 83 on the right but heel slides on the table are still crappy.  Passive flexion leaves a constant stream of tears down my face and she had me sitting off the edge of the table with my legs dangling (right leg wasn't too bad, left was supported by her and still with horrible pain).  My PT feels horrible-we've been through a lot and I think this is the first rehab that leaves constant sharp pains.  Don't get me wrong, there were tears every now and then with the other ones but regaining motion has never really been an issue.  So I cried and cried and then cried some more.  I brought my ear buds today so that I can try to self-soothe while doing the heel slides by listening to music, as there are certain songs that provide a great sense of inner peace and tranquility-helped a bit but not enough.  Getting in/out of the car is bad; driving isn't though so once I get in I'm fine until I need to get out.   ;D

Ran to Officemax after PT to pick up some laminating that I dropped off before hand and to take advantage of the 20% off coupon I had and then headed home.  Unfortunately, my garage is coated in these stupid flying bugs that are coming from the tree.  They are harmless but creepy nonetheless and I have a HUGE fear of bugs.  It's silly as I'm a million times bigger than them but it's still a very strong fear.  So I sat in my car trying to figure out how to get out, as they were on the door to get out, crawling on the ground, and flying like crazy.  I was essentially paralyzed with fear and then felt stupid for it too.  But it didn't matter how hard I tried, I just couldn't do it.  Probably because I couldn't get out of the car fast enough, nor could I walk fast enough to get out of the garage.  So I ended up pulling back out of the garage and parking on the street.  Came inside, hooked myself up to ice, and cried like crazy-partially because of the pain, partially because of the stupid fear of the bugs, and then because of the frustration.  I am supposed to be back at work next week getting everything for my kiddos ready and I am so limited.  Not sure how to manage stairs yet and although my classroom is on the first floor with a ramp (or 3 stairs) to get into the building, all of our meetings are held upstairs in the library, as it's the only room with AC.  Those first few days are nothing but meetings so this should be fun.  This is so not fair...my kiddos deserve better than this!

Okay, done ranting and time to wrap up this pity party!  Tomorrow will be a better day...after all, not sure it can get any worse than today!
Title: Re: Bilateral MPFL Reconstruction-7/25
Post by: emm10161301 on August 17, 2012, 11:50:27 PM
Awk :( I wish I could give you a big hug and a box of tissues!! I know exactly how you feel, I've been there and its rotten. That's the problem with this sugery, the drs tell you you should be able to bend, but the pain prevents it. You are doing awesome! You really are! Be proud of yourself!! And as for the bugs, I'm the exact same! If you get bug spray, spray it. Jus in the garage like an airfreshioner and they will slowy kill them all. This also kills any other creepies like spiders and all. As the weather is up and down here with heat we leave the back door open to let air in. And flies come in, so my gramps sprays some bug spray about the house and they die within an hour even if its been a few days from its been sprayed :) just put today down to experience and look at tomorrow as a fresh new day :) a day for success :)
Title: Re: Bilateral MPFL Reconstruction-7/25
Post by: YogaGirl on August 18, 2012, 01:07:01 AM
So sorry you had such a rough day! Em is exactly right, don't dwell on this one, give it up... it happened and now you get to move forward. I suggest putting on your favorite comfort movie, wrapping up in a good blanket and calling it a day.

And don't stress yourself out worrying about school yet or the kids. You will either get to the meetings or they will figure something else out. Those are the options... They will either excuse you from them, give you an expedited version, or move the meeting. I don't see them firing you because you literally can't bend your knees. (Helllllo lawsuit!) So that will work itself out. And the kids do deserve the best, the fact that you're worrying about them right now, instead of yourself, shows that they have a damn good teacher.

Focus on NOW and you. You get to be selfish right now, in fact you have to be, or else you wont get better. No worrying about the future, its coming no matter what. So make good decisions now to get yourself in the best state, physical and mental, for whats ahead. You got this!!  :D
Title: Re: Bilateral MPFL Reconstruction-7/25
Post by: Xeplasma on August 19, 2012, 09:41:54 PM
((teacher2many)) I am in hug giving mode right now( probably because I need some myself) and wish I could just give you a real one. This PT thing does $#ck! I was all excited to have moved to 60 on Thursday only to wake up to a swollen painful knee on Friday.
I hope you're feeling a bit better today and things look a little brighter. Hang in there.
Title: Re: Bilateral MPFL Reconstruction-7/25
Post by: Teacher2Many on August 19, 2012, 10:31:21 PM
So Friday was indeed a crappy day but yesterday was not so crappy!  :-)  Sometimes I think the frustration just gets the best of me, especially since there are so many orthopedic issues and just when one starts to resolve, another one either flares up or surfaces.  The fact that my shoulder (I had part of my scapula/shoulder blade surgically removed in Jan. 2012 as it was catching and when it'd 'pop' back in, it'd dislocate my ribs) has been progressively getting worse isn't helping-it was a fear of mine that has now become a reality and rightfully so as the arms are doing more work than they should right now.  So when I see my surgeon this upcoming Thursday, we are addressing both knees and trying to figure out how to calm the shoulder down a bit.  And then I'll investigate the hip options as well.

My niece and nephew came by yesterday to visit with my dad for a belated birthday visit and it was nice to see them.  Really wanted to go for a walk around the block with them but I know my limitations so instead, opted for some bubble blowing fun instead!  Today I ran a few errands and had a heck of a time getting in the passenger seat after the first errand.  The knees swell with the smallest bit of activity, making it that much more difficult to bend them.  Hoping one day I'll wake up and things will have turned the corner-hopefully!  Actually if I can just get a full night sleep, I'll be happy.

Was in contact with my PA yesterday to inquire about what type of goals they wanted to see at my appt. this week and there was mention of wanting full extension (yay on that one-extension is never really an issue for me as I always have about 5-8 degrees of hyperextension) and flexion to 90 (insert tears here).  There will be a discussion on pain relief options for the knees; does anyone have any experience with other options other than pain meds (ie pain patches, etc.)?  Trying to find other options to help with pain other than meds, especially since I'll have a bunch of little ones to teach in a matter of a week or so and want to avoid the pain pills as much as possible as they make me too 'foggy' and only work to dull it, not to rid it completely.

Xeplasma-sending virtual hugs your way as well!  Sorry to hear about the bad day you had and the continued pain and swelling; I know how frustrating the setbacks are but hopefully it's just a setback and once things calm down a bit, you can regain some of your flexion.

YogaGirl-unfortunately, my district can put me on leave if I cannot perform my job duties.  They are very strict with having restrictions at work and you end up on FMLA if there are any.  So although they won't be able to 'fire' me, if I cannot 'fake' getting through a typical day, they can force me to go on leave until I get clearance from my doctor.  So my philosophy with all of these past surgeries is 'what they don't know, won't hurt them'.  I had no choice with the shoulder, as that was done in January and was on lifting restrictions for about 3 weeks and since my kiddos all have moderate-severe disabilities, lifting them is a given.  But I'm going to do my best to get through the days with the help of my assistants-unless there are MAJOR improvements over the next week or so, can't envision my days at work being successful.  Thanks for the support!!!!  And I think the website with yoga ideas will be great!  We've done a bit of that and pilates as part of PT but those positions are a bit impossible but right now but as soon as flexion becomes more of a reality than a vision, I think yoga would be very beneficial all the way around!

Em-thanks for the support!  Bending is not my friend and since they want to see flexion at 90 come my 4 week mark this week, this should be interesting.  But we'll see how things go in PT on Monday & Wednesday.

Time to ice the other leg and attempt to get the swelling down before I shower otherwise I fear I'll be showering with one leg in and one leg out of the tub!  :-)
Title: Re: Bilateral MPFL Reconstruction-7/25
Post by: joanfan123 on August 20, 2012, 10:06:19 PM
On the topic of pain patches I know my grandma uses them for her arthritis in her knee, and sometimes her hip too. They help her walk without a walker pretty well. I also used some during a trip I took in April for the plane rides, I personally found they didn't help with deep pain, but mine were not prescription.
Title: Re: Bilateral MPFL Reconstruction-7/25
Post by: Teacher2Many on August 21, 2012, 03:53:23 AM
Quick update before I go 'veg' on the couch with a cup of hot tea before bedtime!

Headed to work today for day 1 of classroom prep and holy cow....!  The pain and stiffness set in after about 20 minutes on my feet and I took many 'sitting' breaks throughout the day.  Trying to get down to a chair was hilarious-the knees won't bend enough and most of the adult chairs are on wheels so every time I'd start to brace myself with my arms and lower, the chair would start to move.  Not really sure how I'm going to manage getting down to the little kid chairs that are about 18" high off the ground but we'll see.  Maybe I'll just sit on the tables!   ;D

I am definitely worried and concerned about heading back to work but not going, feels like I'm failing my kiddies and I already feel like I'm failing in this rehab so that would just make it that much worse.  I see my OS on Thursday so hopefully the 'no forced flexion' rule will get thrown out the window and some different perspectives, advice, suggestions will be given.  Maybe after a week or two of being able to 'force' that knee to bend whether it wants to or not will help.  And if not, so be it.  My goal is to try a week or two with the kids and see how it goes.  If it's manageable, great, and if not, I'll have a conversation with my OS re: leave of absence until things improve but I can't just give up the fight without trying.  Those kids mean the world to me and they deserve to have someone in their life who is absolutely crazy about them and who will do anything and everything for them and unfortunately, they don't get that at home.  So if I can give that to them for the 2.5 hrs/day that they are with me, I consider myself lucky and honored to be that one person in their life.

Flexion today was a bit worse than Friday which I knew it would be as PT was at the end of the day after being at work all day.  Think the L measured at about 67 and the R at about 78.  So the gap is closing between the two sides but I found out from OS office that they wanted to see flexion at 90 come Thursday-oops, think they're going to be a wee bit disappointed!!!

Time to sign off-seeing my PCP tomorrow so we'll see if he can shed any light into some of the sleeping issues (which I know are from the pain and irritation) and the overall 'drained' feeling-perhaps the anemia is rearing its ugly head again! 
Title: Re: Bilateral MPFL Reconstruction-7/25
Post by: franny on August 21, 2012, 09:31:21 AM
Aw bee! I know the worry you're going through, I'm a teacher too. I teach teenagers with learning difficulties and am quite energetic in my approach, I was once described as 'bouncy'. Erm, well that's not the case at the moment! I feel like they are going to get a rubbish version of me, walking around makes my knee swell enormously and sitting with it bent in front of me makes it so stiff that I can't move when I stand up!
I sometimes think people don't realise what an energetic job teaching is. Do you have good classroom assistants? If so could you brief them with the kind of help you will need. I'm lucky that my college are being quite supportive and I always have a good support worker in the classroom.

On a positive note, I was having a real problem with flexation and it has suddenly get a lot easier - still don't think I've reached 90 yet though and I'm at 7 weeks! It doesn't feel as terrible when I bend it now though. You should be really proud of how great you are doing!

Good luck with sorting out your sleep and pass on any tips as I have not had a proper night since I had the op. I wake up every time I move!

Good luck with your physio, you are amazing!
Title: Re: Bilateral MPFL Reconstruction-7/25
Post by: YogaGirl on August 22, 2012, 08:04:41 PM
Hey Teach, how's it been going lately? I'm hoping no news is good news... You make it to 90 yet?
Title: Re: Bilateral MPFL Reconstruction-7/25
Post by: momma-cat on August 22, 2012, 09:02:02 PM
Teacher,

I thought I would hop onto yours diary and see how you are holding up. I am also a teacher but I teach online. However, I feel your pain in the up-and-down aspect because I am a PCP to about 1400 children so I am up and down constantly. I go back to work on 1/2 days in two weeks. I know a lot of teachers that sit on the sides of their desks - maybe an option?

As for sleep, I take Trazadone. It is a really, really old antidepressant. But it doesn't work too well as an antidepressant but it has a great "side-effect" for drowsiness thus is now used for insomnia.

You are doing much better than me on angles - my right knee is only at 46 degrees as of yesterday. But PT really put a hurt on me yesterday and still paying for it today.

Keep your chin up - this too shall pass - only downhill from here.....can't think of any more at this moment.

Momma.cat
Title: Re: Bilateral MPFL Reconstruction-7/25
Post by: Teacher2Many on August 24, 2012, 01:55:56 AM
So, quick update...

I hit the 4 week mark yesterday and had a post-op visit today.  Got the okay to ditch the braces (and trust me, I ditched them but honestly, I've been walking without them for about the past week, with this week wearing them very minimally at work and yes, I did tell them that today too).  I was supposed to have 90 degrees of flexion by today but only at the 70's bilaterally but doc isn't TOO overly concerned.  He did mention something about maybe needing a 'flexionator' at the next visit if things still aren't at full ROM.  Sounded horrible and all I can think of is the commercial for the 'baconator' burger at Wendys!   ;D   He's hoping that in another 4 weeks things will have greatly improved-so am I!

He prescribed tramadol to help with the pain and gave the ok for PT to push flexion, as we were restricted with no forced flexion.  Like the fact that tramadol is not a narcotic but still weary as to its effects.  Took the first dose about 7 pm tonight so that'll give me a few hours to see how I react (dizziness, etc.) and also to see if it makes sleeping any easier.  Contemplating restarting taking magnesium at bedtime to help with sleeping (worked wonders the last few times as it supports healthy nerve and muscle growth) but we'll see how things go with the tramadol.  It is only once/day so I think I'm going to take it at the end of my work day so that it can kick in before I get to PT but will still be in my system for work the following day as it's an extended release tablet lasting about 24 hrs.  But this weekend will be the test and if it doesn't work that way, I may just switch it and take it at lunchtime (providing it doesn't cause too much drowsiness or mental fog) so that it can kick it for PT but that way, I'm only having to get through half a work day in pain (my AM session).

The classroom is almost set up.  Was going to go back tomorrow to get some paperwork done but as I was leaving, many HUGE boxes of new materials arrived so I'm adding that to my list for tomorrow.  Not sure why we get them at the end of our 'set up the room' week but at least we get them before our kids start.  Still doubting my success at work, especially since I found out today that one of my assistants is not with me this year and I'm not sure if they're replacing her or not. I'll find out if I can or cannot do this soon enough!

I did run to Target after work to drop off/pick up the rx and was crying in the store!  The pain was just ridiculous and the swelling was horrible-a bit of a vision of what life will be like starting Monday.  But I came home and immediately hooked up to my ice machine-not sure how long I'll still have it so I'm definitely taking advantage!

Hope all are doing well; fingers crossed for increased flexion tomorrow at PT! 
Title: Re: Bilateral MPFL Reconstruction-7/25
Post by: Xeplasma on August 26, 2012, 01:10:44 PM
This flexionator thingy does not sound much fun. Although associated with the 'baconator' it does sound better, haha
. I'm stuck at 70 ROM myself and it's been a bit depressing. They have not been pushing at all and can't even imagine the pain it would bring.
Do you have to return the machine? I hope/believe mine is a purchase, now it makes m nervous, I'd better check the paperwork.
I so wish I could drive but lifting my leg side to side is still pretty difficult.
Title: Re: Bilateral MPFL Reconstruction-7/25
Post by: Teacher2Many on August 31, 2012, 04:09:22 AM
So, just a quick update!  Today was my first day at work with the kiddos and it was far more difficult than I anticipated.  I have a very energetic and mobile group of kiddos coupled with their moderate-severe disabilities.  Getting in/out of a chair, just to sit and play/talk with them is horrible, yet alone trying to 'chase' them down the hall.  Luckily, I have 2 great program assistants who did a lot of the 'quick' movements which helped ease my mind of some of the safety concerns as they can easily outrun me!

I am also 36 days post-op today and my R leg FINALLY reached 90 painful degrees of passive flexion.  The L is at 83 and still tighter and far more painful than the R.  I told PT that I only want it measured every Wednesday in honor of the weekly anniversary of surgery as it was getting far too depressing to not see significant improvements when it was being measured every PT session, not to mention I felt it was better to have a specific timeframe of at 5 weeks, x degrees of flexion obtained, 6 weeks, 7 weeks, etc.  I will be e-mailing the 6 week measurement to my doc next week and we'll see what he says.  And even etter than the 90 and 83 degrees of flexion was the fact that today was the first tear-free day of PT since rehab started 4 weeks ago!  Now don't get me wrong, it hurt like heck but I found deep breathing was helping to get through those really painful times.

I also stopped taking the tramadol-last dose was this past Tuesday.  This was not the game plan of the doc but I didn't feel comfortable having it in my system while being responsible for the little ones, although I have yet to notice any side effects except for some drowsiness when it first kicks in.  And I wanted to see how I did at work without it and more importantly, if it made a different at PT without it.  And none of those happened; the only difference I noticed was a poorer quality of sleep due to constant pain and more irritation/pain all day but I didn't notice any difference in flexion as measurements yesterday and today were the same (I had her measure both days as yesterday was 5 weeks but today was the first day on my feet all day with the kids and wanted a baseline of what those days would look like, as that's how measurements would be taken from here on out-no difference noted on either side regarding flexion, only with edema and swelling).  So we'll see how it goes; if sleep is still horrible tonight due to pain I may take 1 tomorrow night to see if it makes a difference or not, especially considering it's a long weekend.  It might be a play it by ear situation too-really bad days might require a bedtime dose whereas painful but tolerable days won't.

I think that's it...a cup of hot tea is in order along with some of the giant birthday cupcake my PT gave me!
Title: Re: Bilateral MPFL Reconstruction-7/25
Post by: Xeplasma on September 03, 2012, 03:22:05 PM
Yay for the beginning of school year!! It's always been a favorite time for me( nerd anyone?).
90 ROM sounds dreamy at this point. Congrats!!!
I hope you feel better this week.
Title: Re: Bilateral MPFL Reconstruction-7/25
Post by: Teacher2Many on September 07, 2012, 03:14:41 AM
Super quick update before the president comes on for his speech:  yesterday marked 6 weeks since surgery.  Passive ROM was measured at 100 on the R and a little shy of 90 on the L.  Not sure how accurate those results are as they were measured by someone different so the consistency isn't there; will have the other PT measure tomorrow just to be sure (nothing like getting your hopes up for 100 just to find out next week only at 94 due to inaccurate measurement).  The pain has been HORRIBLE...the left is absolutely miserable, the right a bit better.  I've been questioning if I should have returned to work due to the pain and limitations but when I see those little smiles, all seems better until I try to move my leg again.

The L is giving me so many problems-medial pain is brutal, quad sets cause immense patella pain, quad weakness is ridiculous (esp. when compared to the R), and definitely has a lot more sharp stabbing pains and pulsating pains than the R, etc.  Any kind of pressure, either on the medial or lateral side, really hurts.  Now don't get me wrong, the R side isn't perfect but a lot of these issues are either only present on the L (such as the quad weakness and patella pain w/quad activiation) or if they are on the R, they are greatly diminished in severity and intensity.  Flexion seems to be at a stand still, gaining maybe 5 degrees a week if I'm lucky on the L, maybe a little more on the R.  Sleeping is still painful and difficult, waking up maybe 2-3 times/week in pretty bad pain and an overall feeling of being 'uncomfortable'-clearly the pain is too much for the meds to combat.

There is a pretty significant pocket of swelling on the R side along the anterior tib-PT thinks it might be from overuse due to the pain/weakness on the L and the foot drop on the L as well=lots of compensation with the R.  It does worry me at times from the past history of blood clots post surgery so it's just something I keep an eye on and watch for intense redness, swelling, warmth, fever, etc.  So far so good but always in the back of my mind.  There's still intense swelling of both knees-worse towards the end of the day with pitting edema present.

The L hip has been acting up as well and I knew it would once returning to work as my 'lazy' days of chilling at home ended.  Need to figure out when to address that so suppose an e-mail out to my hip OS will be sent in a few days to get the exact protocol for surgery, rehab, etc. so I can see if it's doable over winter break or if I should try post-poning it until the summer (although the thought of being on crutches in the winter with tons of ice and snow doesn't sound very good).

For those who have been on or are taking pain meds, what have you tried that you've found worked?  The meds I've been taking aren't working for the pain anymore, which I think is due to intensified pain from increased activity levels.  Wanted to see if there was anything others have found more helpful.

Hope all have a splendid weekend!
Title: Re: Bilateral MPFL Reconstruction-7/25
Post by: franny on September 07, 2012, 10:05:15 AM
Hi Teach2Many,

Sorry to hear that you are in pain. I too have returned to work and am really struggling - I'm a few weeks further on from you (2 months post op) and I'm still struggling with swelling and pain.  I dont know about you but i just cna't make myself sit down much whilst im teaching! Sleeping is a nightmare for me too! At the moment I'm taking a combination of ibroprofen and codine which is hardly touching the pain.

The only suggestion I can make is that I am going to take an ice pack into work as we have a kitchen in one of the classrooms (with a freezer), I'm going to try to ice at lunchtimes. I dont think I will manage this all the time as I usually seem to be rushing around trying to sort one problem or another but I'm going to try and make a concerted effort to make time to ice! 
I'll let you know if it makes any difference to pain levels.

If I can think of anything else I'll pass it on.

Have a lovely weekend.

F
x
Title: Re: Bilateral MPFL Reconstruction-7/25
Post by: Xeplasma on September 08, 2012, 03:57:52 PM
Let's try this again. I wrote a lengthy reply yesterday only to realize that I had lost my Internet connection( and phone!!!) when came time to post.
I hope this finds you in less pain today Teacher and your hip starts behaving a little. :(
Standing in front of/ teaching to a full class is hard enough, having to do all the extra physical things you're faced with( lifting children) is unthinkable to me. Lots of hugs to you.
Title: Re: Bilateral MPFL Reconstruction-7/25
Post by: Teacher2Many on September 08, 2012, 07:34:50 PM
Thanks for the virtual hugs!   ;D  This week has definitely been trying-increased amounts of pain, most likely due to being back at work full time which equates to increased amounts of tears and crying in PT!  ROM is increasing but very slowly:  L is at 88 hanging over the edge of the table and it should have been at 90 doing that 2 weeks ago.  R is a bit better with passive flexion measured at 102.  I'll be sending my OS an update at the end of next week with measurements, pain update, limitations, etc. just to give him a heads-up of concerns, issues, etc. prior to my appt.

If my left hip can talk, I can only imagine the nasty things it would be telling me every day!  Clearly, the cortisone didn't do anything, which I doubted it would, and since I am flexing my hip more to compensate for the limited flexion of the knee, it causes increased impingement on an already aggravated hip.  My hip OS will be getting an e-mail sometime this weekend requesting specific info on the surgical procedure, rehab, etc. so that I can start thinking about that decision while being more informed.

I am off to my niece's 3rd birthday 'fiesta' as she's having a Dora theme complete with a taco bar, flan, etc.  Wondering how I'm going to get there, as she lives on the second floor.   ???
Title: Re: Bilateral MPFL Reconstruction-7/25
Post by: Teacher2Many on September 12, 2012, 03:15:59 AM
Quick update:  7 weeks post-op tomorrow and it feels like it should be more than that!  Today ROM on the right measured at 105, the left is still about 88-92 with the same issues present on the left; severe pain, limitations, etc.  The knees have been buckling more which I know is due to weak quads and increased physical demands-the muscles just can't keep up as they tire so easily due to their atrophy and weakness.  Still unable to do a SLR on the left but the right is okay.  The left knee has been having this sense of 'impingement' ANYTIME going from flexion to extension.  Used to only be after long periods of sitting but now even just bending and then straightening out the leg causes this very sharp and intense pain on the medial side, weakness, inability to put weight through that leg, etc. but only for a few minutes and then it passes.  Very similar to the impingement in the hip and in the shoulder but not sure if you can get impingement in your knee.

There has been a large 'pocket' of swelling on the right along the anterior tib-PT thought it was due to overuse of the anterior tib to compensate for walking, etc.  The last few days it's gotten a lot worse and is now on the left leg as well.  So I talked to PT today (not the one I usually see but have seen him quite a few times) and asked what he thought about it.  Nothing that I do seems to help-meds, icing, elevating, etc. and since it's getting worse, clearly it's something to address.  He thought it was lymphadema due to all the surgeries I've had and scar tissue being built up around my lymphatic system and he consulted with one of the other PTs there who works with patients with lymphadema and she agreed.  So they applied a 'spiderman like web' on both legs out of kinesiotape to help the draining of the swelling through the lymphatic system.  Need to keep an eye on it to ensure it's not compartment syndrome, as that was mentioned as well, but hopefully this will help.  It is tender with pressure but not necessarily to the touch.  The added in using the graston (sp?) tools today and also hooked up stim to the quads with it going on/off bilaterally while doing wall squats.  So not comfortable-told my PT there should be a reverse therapy day where patients treat the therapits and hook them up to all of these weird types of contraptions.   ;D

Sleeping is still difficult and painful; can't lay on my side at all-laying on the right kills the medial portion of the left leg and laying on the left kills the lateral portion of the left leg and the left hip so I'm stuck on my back but that still causes pain and issues.  Would love nothing more than a full night sleep, even if only 6 hrs.-one without pain and interruptions from the pain would be heaven!  Stopped taking pain meds since I couldn't find one that actually helped and figured why take them if they're not really doing much good.  I return to my OS on 9/24---hoping for a good report and one that doesn't include the need for a flexionator.
Title: Re: Bilateral MPFL Reconstruction-7/25
Post by: YogaGirl on September 12, 2012, 07:40:15 PM
Man, Teacher... You are just not catching a break on this at all are you?? That stinks.  :( I can't imagine the lack of good sleep, especially going on 7 weeks now. When I lay down tonight I will send good sleep vibes your way!

Its good to hear you're still cracking jokes in PT and going to 3 year-old's parties (did you get there, by the way?). Its so important to have those moments to just laugh and release that power that we can sometime let an injury hold over us.

You're doing great, it probably doesn't always feel like it, but you are. Keep thinking positive thoughts, and even find positives in the lows... You'll be feeling better soon  :)
Title: Re: Bilateral MPFL Reconstruction-7/25
Post by: Xeplasma on September 13, 2012, 07:23:57 PM
Hang in there Teacher!!
I'm hopeful for you that OS will not go 'flexionator' route, it seems that you're making good progress in spite of pain.
Sending you a new wave of virtual hugs. 130 ROM is getting closer everyday and hopefully all this taping is going to get rid of the lymphodema.
Title: Re: Bilateral MPFL Reconstruction-7/25
Post by: Teacher2Many on September 13, 2012, 11:13:15 PM
Thanks for the wishes ladies!  I too am hoping that the 'spiderman' taping helps but yesterday the legs seemed more swollen than ever with increased pitting edema so we'll see.  Taking the tape off tonight when I shower to wash thoroughly (& shave) so that they can retape tomorrow.

Getting the 'flexionator' would not be my ideal choice but if that's what it takes to get those final 20-30 degrees of ROM than I'm game.  The limitations at work are killing me (as is the pain) and I think ROM needs to come first before strength can fully be addressed.  We'll see-1.5 more weeks until my OS appt.

YogaGirl-Yes, I did get to the party.  Slow & steady was the key with going up/down the stairs-had to lock the knees in extension when going up as it was too painful to bear weight with them in flexion but we managed, which is good, because I wouldn't have missed it for the world!
Title: Re: Bilateral MPFL Reconstruction-7/25
Post by: Xeplasma on September 18, 2012, 10:25:29 PM
How is it going Teacher? Is the taping working?
Title: Re: Bilateral MPFL Reconstruction-7/25
Post by: Teacher2Many on September 19, 2012, 03:05:35 AM
Thanks for checking in...things are going.   ???  Work doesn't seem to be getting any easier with all my little ones and am getting a new little one on Monday of this upcoming week (which of course I won't be there for as I'm taking off that afternoon for my post-op visit).  My AM class is a handful with a lot of aggressive behaviors and my PM class has a few runners so I'm never sitting/resting for more than 5-10 minutes at a time.  The knees hurt all day every day and seem to be getting more irritable at bedtime probably because of all the activity during the day.  The kinesiotaping does seem to be help with the lymphedema when it's on.  However, when it's off (ie I take it off when it starts to peel/come off and it then gets reapplied the next day at PT), the swelling returns right away but at least it helps when it's on.

There has been some clicking/popping in the knees a few times which I always attributed it to swelling and/or muscle weakness.  This past Friday, PT was pushing the R knee to bend to measure ROM and it very loudly 'cracked'-he heard and felt it, as did I.  Since then, the R knee has been popping/clicking like crazy (countless times/day) and I've had to realign it a few times.  Really hoping it's due to swelling, etc. and has nothing to do with a failed MPFLr.   :-\

But I go back to the doc on Monday and am excited to get some answers.  I sent him an extremely long e-mail this past Friday, as I had a question on the ice machine (the company called and said they had new orders to deliver it-thought maybe PT requested it due to swelling but ended up being a paperwork mix up) and sent a very detailed and lengthy update for his info, not expecting a response.  He said to bring a copy with on Monday and we'll go over all of it and he'll have answers to all my questions.  Biggest concerns are the limited ROM, continued pockets of swelling, immense pain in the left knee, and overall pain interferring with sleep, daily activities, etc.

Hopefully some answers...and something to help with the pain!
Title: Re: Bilateral MPFL Reconstruction-7/25
Post by: Teacher2Many on September 20, 2012, 03:38:24 AM
Feeling defeated...8 weeks post-op today and with passive ROM, the R measured at 100 and the L at 99.  Neither are making much progress and the R has been around 100-102 for the last 2-3 weeks. 

Hoping for answers on Monday!
Title: Re: Bilateral MPFL Reconstruction-7/25
Post by: Teacher2Many on September 25, 2012, 12:44:34 AM
You know it's never good when your OS uses the 'f' word during an office visit!

8 weeks, 5 days post-op and after 30 direct minutes with my OS, we are all definitely perplexed as to what's going on.  No definitive answers at today's appointment but a cortisone shot was done in the left knee in an attempt to see if the pain is coming from within the joint (if it is alleviated with the shot, then the answer would be yes), a script for a Medrol dose pack given to see if that helps with the pain (he was quite upset to hear about the significant high pain levels and the meds that should work that aren't...his reaction and comments when I told him that the oxycontin doesn't even touch the pain were a bit humorous), and am scheduled for bilateral knee MRI on Saturday with a return visit to go over the results and figure out a plan of action next week Monday.  He's not sure if the pain is coming from inside the joint or from the area of the graft, if the screws are contributing to the pain, if there's an issue with the actual graft, etc.  Fingers, toes, and eyes crossed that the MRI shows something (not that I want anything to be wrong but I would like to have the answers as to why things are the way they are).

Per OS orders, PT is canceled for the rest of the week and we will see what Monday's appointment holds before canceling any more.  Wasn't too happy about that, as I know how hard it is to get back flexion after a long weekend without PT and the thought of going 1.5 weeks without PT isn't great, but I think there is a fear of making things worse with therapy since we aren't really sure what's going on.
Title: Re: Bilateral MPFL Reconstruction-7/25
Post by: Xeplasma on September 26, 2012, 08:00:58 PM
Oh man, crossing fingers and everything for you here. :(
I really hope he(/you/they/someone!!!!) figures it out very quickly for you. Sending you tons of virtual hugs!
Title: Re: Bilateral MPFL Reconstruction-7/25
Post by: Teacher2Many on September 28, 2012, 12:07:21 AM
Thanks for the hugs!  MRI was today...never shed tears before during an MRI but having to keep those legs that still and in that position for 1.5 hrs. killed! 

Got the CD with images and the only thing I could definitely make out was the screw from the MPFL, all of the screw holes from the multiple other surgeries, the tibia fracture line from the past surgeries, what appears to be some fluid within the joint (or at least that's what I'm thinking from past images), and a big black blob on each knee.   ;D  The rest I can only speculate on what I'm seeing based on what I know from past imaging, surgeries, etc.  Radiologist in training I am not!  I should get the radiologist's report sometime tomorrow so that will give me time to review it over the weekend before my appt. first thing at 7:45 am on Monday morning.  Keeping fingers & toes crossed that although I don't want there to be anything majorly wrong, would be nice if something showed up to explain all of the issues, symptoms, etc.

Should have some answers in less than 24 hrs....   ???
Title: Re: Bilateral MPFL Reconstruction-7/25
Post by: YogaGirl on October 02, 2012, 02:36:31 PM
Hey Teach- Its Tuesday... so what'd you hear??
Title: Re: Bilateral MPFL Reconstruction-7/25
Post by: Teacher2Many on October 03, 2012, 01:45:39 AM
So yesterday I met with my OS to go over things after the MRI.  Summary of the visit:  "I don't know."  The things he was looking for on the MRI were okay-the graft is good (no tears, etc.) and the screws are still in place (possibility of them pulling out).  So who knows!  The MRI report stated there was swelling within the joint (worse on the right than the left) and some femoral condyle cartilage damage (worse on the right than the left) but neither of these findings were mentioned yesterday.

I guess it's a good thing-wasn't really wanting there to be anything wrong but at the same time, an answer would be nice.  We did talk about flexion as I'm only about 95-105 depending on the day/knee at 10 weeks post-op.  He said that full flexion isn't typically gained until 4-6 months...my response "oye"!  Seriously, why did that never come up in any other prior visits or in any pre-op discussions?  He won't consider doing any other type of manipulation, clean-up of scar tissue, etc. until I hit the 4 week mark so I'm just to keep on trucking, continue with PT 3 days/week (tried to push for 5 but he didn't think that was best due to the swelling), and just push harder with the pain, etc.  He gave me a new prescription to take nightly-one for percocet.  Never had this one before but had to try something.  Took one last night and it did seem to help slightly; at least I slept a little bit more.

The downside to this all is that I'm back to popping those knees back into place 10-20 times/day.  Granted, much better than the 50 times/day it was prior to surgery but didn't think I'd be doing it at all.  Still hoping that part of it is due to fluid within the joint and surrounding tissues so we'll see if this improves over time or not.

I go back in 6 weeks for another visit so we'll see what is said then (and the cartilage issue will be addressed then as well, especially if the patella pain symptoms persist).  Until then...more tears will be shed trying to get these darn knees to bend which is fine...dealing with the pain is nothing if it means limitless mobility in a few months! 

Sometimes you just got to suck it up and keep on trucking...
Title: Re: Bilateral MPFL Reconstruction-7/25
Post by: YogaGirl on October 03, 2012, 02:49:08 AM
Whoa whoa whoa... Hold on.
Are you saying that your kneecaps are dislocating again? While swollen and post-surgery?! 10-20 times a day?? I'm hoping I'm reading this wrong because I don't think you had previously mentioned new dislocations since the surgery...

Well, I'm glad to hear the graft is still healthy and where it needs to be. I feel your pain about wanting some kind of answer. But, I guess a new med and working through PT might just do it for you.

How's work going? Keep on trucking is right!! Definitely more virtual hugs to you! Keep it up, you're doing amazing :)
Title: Re: Bilateral MPFL Reconstruction-7/25
Post by: Teacher2Many on October 03, 2012, 02:53:21 AM
Indeed they are...not full dislocations but definitely subluxing multiple times/day.  I'm really hoping it's due to the swelling and muscle weakness.  The R was shifting a bit with bending, such as stairs, but this past weekend they were both back to the subluxing.  :-(

Can't get worried about that though...it's the least of the issues!  Whether the surgery worked to fix that issue or not isn't my main concern (as odd is that is to say that)-got to get rid of the pain and the limitations with flexion first!
Title: Re: Bilateral MPFL Reconstruction-7/25
Post by: YogaGirl on October 03, 2012, 03:11:30 AM
Oh man. I'm so sorry. You're right though... work on getting the swelling down and then worry about if the surgery was a success... though it seems iffy at this point. But you could be right maybe things need to strengthen. One step at a time! I'm pulling for you!!
Title: Re: Bilateral MPFL Reconstruction-7/25
Post by: Xeplasma on October 03, 2012, 04:01:01 PM
Oh my, just read about the subluxations.  :o  This is a scary thought and just cannot believe it is happening to you right now.  :'( Does your OS agree they will stop or reduce in frequency as your strength improves?
Ice those babies and let's work on getting these super duper extra muscular legs that shall never dislocate again!!!!
Title: Re: Bilateral MPFL Reconstruction-7/25
Post by: Teacher2Many on October 04, 2012, 04:06:47 AM
Thank you everyone for your concern; what a ridiculous journey this has been just to have come to the realization over the past 48 hrs. or so that it may all have been for nothing!   :'(

I had not consulted with my OS about the subluxations as I felt at this point, it would be pointless.  There's nothing that could be done to 'fix' it and I need to focus on the two major issues that are wreaking havoc on my life-pain and limitations with flexion.  I figured I would address it prior to my next appt. at six weeks (usually I send an update via e-mail about a week before) which would give me time to figure out if it is really subluxing due to a mechanical issue or if it is simply due to swelling and quad weakness.

Today was a horrible day and I stopped counting how many times I had to pop it back into place (usually just subluxations) after 25 and that was well before my lunch time at work.  The left had gotten 'stuck' and it took me a while to get it unstuck.  So when I got to PT, I had mentioned this to my therapist mostly out of frustration.  Actually I think my exact words were "you now have my permission to push flexion really hard since there is no need to worry about babying the graft since I had to pop it back into place at least 25 times each knee today.  Why be careful to not harm the graft?"  She asked if I talked to my OS about this and I told her no, I see no point right now to discuss it as treatment options wouldn't change and we need to get the pain and flexion rectified.  Little did I know that while I was doing my heel slides, etc. she had sent him an e-mail to get his input as to what's going on.

I was LIVID when I found out.  Granted, I know she was doing it out of best interests to get to the bottom of this but really, I didn't want this addressed right now.  And when he finds out that it's been going on since Saturday and yet I didn't say anything when I saw him on Monday, I'm sure that's not going to sit well.  I've been working with my OS for the past 4 years (okay, it'll be 4 yrs. in November) and now it's as if that patient-dr. relationship/trust is thrown out the window because he heard it from her and not me.  Maybe not but that's what it feels like.  So we'll see if he replies to her e-mail and if he does, if she sends me the reply, as she's out of town on Friday so I won't see her until Monday.

One of my OS who did the derotational osteotomies felt that both the MPFL and LPFL needed to be rebuilt on both knees.  My OS here doesn't do LPFL and after conversations back and forth, it was decided that MPFLr should be enough BUT my other OS said we won't know for sure until it fails and then it's too late.  You always go for the least amount of work and hope for the best...now I worry if the least was enough.

And so I keep on trucking...pushing through the pain and flexion, being the best teacher I can be for my kiddos, despite my crappy mobility, and hope that one day (preferably sooner rather than later), all of these knee issues that I've dealt with for the past 6 years with 16 surgical procedues done over those 6 years are rectified and resolved on a more permanent basis!
Title: Re: Bilateral MPFL Reconstruction-7/25
Post by: Teacher2Many on October 11, 2012, 03:47:48 AM
So by this time next week I am hoping to have some answers!  I am heading back up to MI on Tuesday to see my OS who did my derotational osteotomies.  My concerns about my knees subluxing/dislocating were a tad 'blown off' with comments of it's virtually impossible following MPFLr.  I'm concerned as the sensation is the same as prior to surgery and surfaced at about 9.5 weeks post-op (was completely non-existent for those first 9 weeks or so post-op).  Also while I was reviewing my previous e-mails to my various OS, I saw that my OS in MI had originally recommend both MPFLr and LPFLr and possible deepening of the trochlea groove  so am wondering if the MPFLr just wasn't enough to provide the stability.  So I decided I needed confirmation in either direction-either I was right and the instability is back or my OS is right and it's not instability but rather something else (and hopefully he can tell me what the something else is).  Plus I need to consult with him on the hip and follow-up with him on the nerve damage in the foot so it's going to be a thorough ortho appt.  Leaving my house around 7 AM and hope to be back home by 11 PM.

Not looking forward to the 5 hr. car ride, especially since the knee gets pretty unhappy after about 30-60 minutes so I'm sure many steps will be in the plan just to stretch/straighten out the leg.  Might pick up some of those instant cold packs as well (the ones you crack and shake) just to help with some of that discomfort as ice really does seem to help.  We'll see how things go.

On an off note, I took my percocet on Monday night (as I've been doing for the last week or so) and ended up staying up a bit longer than usual afterwards (made my hot tea too hot so had to wait for it to cool off).  Anyhow, I as literally going crazy.  I became so hypersensitive to noises (the water running in the shower, tissue paper being crumpled up to get a present ready for the next day, etc.) that I laid in bed until after 2 AM crying because those noises physically were painful.  I then became afraid to take it so I didn't last night and was up constantly in pain so I guess I will go back to my usual routine of taking the meds, then a shower, then hot tea, and right to bed.  Hopefully it was just a fluke but either way, not something to repeat.

On a plus side, at 11 weeks post-op the R measured today at 120 and the left at 114 with much pain and tears.  Active flexion is not nearly as good (tried kneeling today while getting up off the floor and think I was at maybe 75-80 degrees)and is something that we will be addressing but it was nice to get there.  I did tell my 2 treating PTs that I really want them to push flexion and they did (although while doing so, I really wanted to scream 'mercy' and have them back off but I knew that wouldn't accomplish anything so instead, I just cried while they pushed it).

Hope everyone is healing well and enjoying the start to fall!
Title: Re: Bilateral MPFL Reconstruction-7/25
Post by: YogaGirl on October 11, 2012, 02:42:16 PM
What a nightmare.  :'(

I am so sorry that you've had to go through so much crap. But hopefully this trip will give you lots of new things to consider, plans, and a better outlook. Let us know what your old OS says.

We're thinking about you! Lots of hugs!
Title: Re: Bilateral MPFL Reconstruction-7/25
Post by: Teacher2Many on October 14, 2012, 10:28:14 PM
Getting things put together for Tuesday's road trip to MI, as I won't get home tomorrow night from PT until about 8:00 pm and don't want to run the risk of forgetting anything.  Getting nervous as well-either way, the info can't possibly be good.  Either the knees are indeed subluxing or they're not and they have no idea why they are the way they are. 

On another note, I reviewed the info for my hip surgery and didn't get what I requested so now I need to e-mail that OS for the specifics-his AA must not have understood what I wanted.  The part that isn't sounding too good is spending 2-3 hrs./day on my stomach.  I hate being on my stomach to begin with-so uncomfortable and painful on the knees.  We'll see what he says in response to my questions-originally, he told me in a brace and on crutches for 6 weeks but this paperwork is saying you're off of both by 3-3.5.  Makes a big difference when you're trying to plan surgery around Christmas/winter vacation from work.

Hope all are doing well-quite an icky day here with rain and wind; makes me want to cuddle under a blanket and take a nap!
Title: Re: Bilateral MPFL Reconstruction-7/25
Post by: Teacher2Many on October 19, 2012, 04:01:20 AM
And just when I thought it couldn't get any worse....

Was diagnosed with shingles tonight, probably reared its ugly head due to the emotional & physical stress from surgery, rehab, & pain.  Let me just say that this pain is intense, relentless, & unbearable.  I'd rather have all my past & present ortho pain combined as at least then it goes away with rest, positions, etc.; this pain shows no mercy.  On anti-viral drugs & was given the ok to up the Percocet to two at bedtime for a max of five days to help with the pain so I can sleep.  Any type of rubbing, breeze, touch, etc. is electrifying-if this is what RSD feels like, I feel for those w/that dx.

On the bright side, my pain receptors are so busy w/the shingles pain that I haven't noticed the knee pain too much today although would rather deal with the knee pain right now.

Taking tomorrow off from PT-not going to do any good if they can't touch me due to the hypersensitivity. 
Title: Re: Bilateral MPFL Reconstruction-7/25
Post by: Teacher2Many on November 08, 2012, 01:09:18 AM
So realized I haven't updated in a while, probably because there isn't really much to update.

15 weeks post-op today; passive flexion is improving (think around 120 now) but the pain it causes is still making me see stars and active flexion a little more than 100 with increased pain.  Swelling is still an issue but oh well.  Strength is improving but the limitations with flexion and increased pain are making functional activities difficult.  Still hard to get in/out of chairs and the car, kneeling is impossible due to the pain from bending the knees to 90, hard to get on/off the floor and sitting on the floor is difficult due to not being able to cross the legs, etc.  Stopped taking all pain meds-just not good to be on them, body becomes too sensitive and pain gets exaggerated, and don't want to risk dependency.  Plus if the pain gets really bad, I need them to work and if I take them regularly, that isn't going to happen.

But such is life...hoping it gets better but if not, I will just learn to manage.  I'm picking up some speed with my kiddies at work, probably because I keep getting new ones so I have to learn to be quick.  By the end of the day, I am so sore with elevated pain and swelling but proud of what I do, regardless of the cost to my health/rehab/etc.

Back to the doc on Monday-we'll see what he says.  Hopefully good news as I need to start looking into scheduling the L hip for December and then the R for the summer of 2013 and if needed, try to double it up with any future knee surgeries.

Hope all are healing well!
Title: Re: Bilateral MPFL Reconstruction-7/25
Post by: joanfan123 on November 08, 2012, 12:49:48 PM
I also have hip impingement and I was trying to do both my hip and knee at once and told I couldn't since the rehab contradicts each other too much. For example you cannot do SLL after hip surgery. I was also told I could not do both hips at once either:(
Title: Re: Bilateral MPFL Reconstruction-7/25
Post by: Teacher2Many on November 12, 2012, 04:22:31 AM
Follow-up visit with my OS tomorrow at 15 weeks 5 days post-op!  Eager to see what his thoughts are on the flexion and continued pain, as well as swelling, AND the notion of possible chondral defects causing the clunking in both knees.  2:45 pm tomorrow can't come soon enough!
Title: Re: Bilateral MPFL Reconstruction-7/25
Post by: martussa on November 13, 2012, 09:31:36 PM
let us now how your appointment wend, I'm curious about clunking issue.
Title: Re: Bilateral MPFL Reconstruction-7/25
Post by: YogaGirl on November 15, 2012, 05:48:28 PM
Hey Teach! Hoping the appointment gives you some answers and some next steps!
Title: Re: Bilateral MPFL Reconstruction-7/25
Post by: Teacher2Many on November 16, 2012, 05:05:15 AM
Quick update before I call it a night:

Saw my OS this past Monday and he is still perplexed as to why the significant amount of pain, as well as issues with limitation and daily activities.  He prescribed another round of meds to take as needed at bedtime, which is nice to have for those really bad days when OTC meds don't cut it.

As for the clunking, he agrees it is a chondral defect.  He thinks it is the same defect as in the past but I'm thinking it's a newer defect as the crepitus has almost completely resolved from the original defect and when he did the MPFLr, he looked at the defect and they were looking good.  The clunking didn't start until 8 weeks post which leads me to believe it's a new issue.  But since the symptoms, sensation, etc. are completely the same as prior to surgery, I can't 100% convince myself that they are not subluxing and the only way to tell for sure is stress radiographs under anesthesia. 

He is hesitant to go back in and do any surgery on them due to the immense number of previous surgeries and the fact that some didn't work.  But at the same time, knows there's issues to address.  So I have surgery scheduled for mid-February which I'm trying to change for the end of January due to work meetings in early-mid February.  The plan is to scope the knees, clean out the scar tissue, and some sort of release/manipulation of sorts to help with flexion.  He says he'll only do one knee at a time with a minimum of 8 weeks in between surgeries but I'm hoping he'll change his mind and agree to doing both at once.  No brace or crutches and back at work on Monday (surgery will be on a Wednesday).

After tremendous tears flowing in the parking garage, I sent a follow-up e-mail with a few thoughts, etc. after I had some time to process everything.  He is sending me to see a colleague of his out of IN for consultation on the MPFLr in hopes that he can see something we're not.  I saw him a few years ago, again per my OS thoughts, and he's the one who first noticed/diagnosed the excessive femoral anteversion so for that alone, I have faith in him and that this appt. will prove useful.

I was able to get in right away so am heading to IN on 11/26.  It's about a 3.5-4 hr. ride so not as long as when I went to MI but dreading it with it being the Monday after the holiday.  Thankfully the shingles have almost completely resolved so that is not going to be a contributing factor like it was for my MI trip.

Still contemplating when to fix the hips...will be sending out a few e-mails to inquire about dates as well as to my MI doc to see if he'd do them both at once.  And just when I thought the surgeries were done...facing at least 4 more!  :-(
Title: Re: Bilateral MPFL Reconstruction-7/25
Post by: Teacher2Many on November 28, 2012, 02:44:18 AM
So here's the latest scoop, for any that are interested:

Went to see another specialist yesterday, one that my OS highly trusts, and he, just like my OS I saw in MI, feel that the graft placement is wrong on both sides, sitting either too high or too anterior, which is what's causing all the pain and difficulty with flexion-the graft simply can't stretch that far due to off placement.  Treatment would be to completely redo the MPFLr-hate the fact that it's something that two well respected OS have mentioned as the cause but at the same time, love the fact that they mentioned it as an it's easy fix and more importantly, it's fixable.  My OS doesn't feel that's the case but doesn't know the answer either.  So I go back in about 6 weeks to see him, he'll do some thorough xrays, and then figure out what the plan of action is.  Either way, surgery is set for 1/23-if MPFLr is needed, it will have to wait until the summer as I refuse to subject my kiddies to a sub for at least four weeks.  Would be different if I could have timed it with winter break but no such luck.

This specialist also feels that I might need patella resurfacing due to the cartilage damage.  His recommendation is to cut off my icky part of the patella and then using a donor patella, cut off their healthy patella/cartilage and resurface mine with that.  Doesn't really sound fun to me!  When my OS does the diagnostic arthroscopic surgery on 1/23, he will be looking at any and all chondral damage to see if this recommendation is something to pursue or if there are other options.

The hip issue will have to wait-4 weeks on crutches (minimally) meant too much time off of work for now.  So it'll get postponed for the summer.  Ah, who needs to sit comfortably anyway; highly overrated!  :-)

Christmas is in less than a month (which will mark 5 months post-op as well)...man, how time flies when you're having fun!
Title: Re: Bilateral MPFL Reconstruction-7/25
Post by: YogaGirl on November 28, 2012, 01:23:58 PM
I know it would be hard, but is there a way you could get the MPFLr done by the doctor in IN or MI? I mean, they seem to be on the same page, which is great... and your OS that may have placed the graft wrong isn't... I know the travel would be crappy, but if it meant getting it right and by people you trust, maybe you should look into it? Just a thought.

I can't imagine how frustrated you must be, but you've had a great positive attitude throughout this whole process! Keep it up! Its good to hear that they think its an easy fix!! Hopefully the patella and cartilage look better than expected in January! :)  My thoughts are with you, only a few more weeks til you get that holiday break!!
Title: Re: Bilateral MPFL Reconstruction-7/25
Post by: Teacher2Many on November 29, 2012, 03:35:50 AM
Honestly, I didn't really care for the doc in IN.  I am eternally grateful as he's the one who noticed the rotational abnormalities two and a half years ago which sent me down the right path for that but those first impressions mean a lot.  Driving 3.5 hrs and I didn't even get his undivided attention, as he was checking in on other patients at that time.  The doc in MI would work but he is booking out a year in advance.  The travel would be bad for all-time off of work for my parents, hotel expenses, etc. but if needed, then it's something to consider.  For now, we are pushing harder in PT (and my burning eyes and extreme headache are proof from all the tears shed today) so that when I go back in January, I can say with 100% certainty that we're doing everything possible.  And I have no objection having it done again by my OS-he is wonderful and I trust him immensely.  Difficult right now only because it's hard to convey the magnitude of pain and limitations, etc. to someone else but only 6 weeks until my appt.-think I make it and WILL get answers by then!

Longing for the holiday break...so much on my to do list!
Title: Re: Bilateral MPFL Reconstruction-7/25
Post by: martussa on December 12, 2012, 09:33:41 AM
Hi Teacher, I hope you're all okay!

I've got one question to you. As far as I remember you have good ROM and it isn't your problem. Now I'm around 110-110 at two months pst-op and my PT therapist gave me one exercise to improve it - and, to be honest, I really really hate it. I asked her about another one but she said it is the most effective and ended the topic. Maybe you know different exercises?
I'll explain mine: lay on the bed on a stomach with your healthy leg outside a bed. Put on your feet some belt and bend down to the buttock.
Title: Re: Bilateral MPFL Reconstruction-7/25
Post by: Teacher2Many on January 03, 2013, 02:32:54 AM
Haven't updated in a LONG time, mainly because there really hasn't been much to update and it gets pretty depressing to report the same 'sob story' of sorts.   :-[  I am undergoing bilateral surgery 3 weeks from today.  I was 'kicked out' of PT on 12/21 due to lack of progress with flexion, as the R has been stuck at 105-115 (active vs. passive) for the last 6 weeks without 1 degree of improvement either actively or passively.  Pain is still a huge factor as is tightness and limited flexion.  Flexion on the L is around 135 but it is definitely quite painful.  Both knees are catching and clunking quite a bit-subluxing vs. chondral defects; not sure but will get the definitive answer on 1/23 (I think more subluxing, doc thinks more of a chondral defect).  Surgical plan is to do a capsular release, clean out any scar tissue, and do a thorough scope to look at any and all chondral defects.  Nothing will get 'fixed' or 'repaired' until the summer when I am off to allow for a full recovery without wreaking havoc on my students' lives by taking extended time off now.

The L hip has been really bothering me lately and am regretting my decision to not have it fixed over Christmas break.  Doing so would have landed me on crutches for at least 4 weeks (doc was thinking more like 6 due to past surgical complications and bone healing issues), which meant at least 2 weeks off of work and I couldn't justify it.  My kiddos always have and always will come first and the thought of leaving them with a sub was absolutely horrifying, especially due to some of the challenges my particular group of kiddos have.  But at the same time, knowing that I will probably be having more knee surgery this summer, not sure when the hip will get done.  If this becomes reality vs. probability, hoping that they can do the knees and hip(s) at the same time.

Hope all enjoyed their holiday season and are starting the 2013 year on a great note!
Title: Re: Bilateral MPFL Reconstruction-7/25
Post by: Teacher2Many on January 14, 2013, 02:15:58 AM
10 more days till surgery and more importantly, till we get some answers and a final plan in place!  So excited!!!!
Title: Re: Bilateral MPFL Reconstruction-7/25
Post by: Summer007 on January 14, 2013, 08:25:25 PM
Hiya Teacher2Many,

Good luck with your surgery when you have it! Hopefully you will get the answers that you want. I am also facing more surgery, just waiting on a date.

Please keep us updated with how it goes, my fingers are crossed for you!

Summer :)
Title: Re: Bilateral MPFL Reconstruction-7/25
Post by: Teacher2Many on January 17, 2013, 02:05:26 AM
This time next week I will be recovering at home after surgery and doped up on pain meds AND will have the answers as to what's going on...the plan to fix it will come at my post-op appt. on 2/4 if not sooner!  Excited beyond belief, which I'm sure many think are weird to be 'excited' over surgery.

Hoping they'll do an injection in my hip and/or shoulder as well but might not get that lucky!
Title: Re: Bilateral MPFL Reconstruction-7/25
Post by: Summer007 on January 27, 2013, 03:31:50 PM
Hiya Teacher2Many,

Hope the surgery went well and that you have finally got some answers to what is going on! Fingers crossed for you on your post op appointment too!

Please keep us updated as and when you can. Summer :)
Title: Re: Bilateral MPFL Reconstruction-7/25
Post by: Teacher2Many on January 28, 2013, 12:22:51 AM
Surgery was on the 23rd first thing in the AM and only took maybe 1-1.5 hrs. in the OR for both knees.  Bilateral LOA and MUA performed, along with a very thorough diagnostic scope to find any underlying issues that could be contributing to the other symptoms.  Post-op conversation with the doc is pretty foggy, which is a first for me as I usually remember everything quite clearly but think the pain med I took orally, in conjunction with those via IV, made me a little foggy in my recollection.

But from what I remember, the bilateral ACI sites looked good, which was a huge relief.  Not sure if there are other chondral defects that will need to be addressed as I can't remember clearly enough what he said.  I know going in that's what everyone was thinking (my OS, my OS in MI, and the one I consulted with in IN) was the main contributor to the painful crepitus, catching, and clunking, which is a million times worse now but I know in my head part of that is due to all the swelling.

Anyway, recovery is a breeze compared to the past 19 knee/hip surgeries I had done (yes, these two marked number 20 & 21 for the knees/hips, #26 and 27 for all surgeries).  I used the crutches just to get from the house to the car and then ditched them as soon as I got inside.  Took pain pills on the surgical day as prescribed, on Thursday I took one at 3 and one at bedtime (the knees were getting pretty sore around 3 from catching up on lesson plans, etc.), one at bedtime on Friday, and none since.  Surprisingly, the knees don't hurt at all!  My quads, however, are absolutely positively killing me!  Any kind of flexion or even resting something on my lap, such as my laptop or iPad is brutal.  Turns out that's a side effect of the manipulation-not one that always happens but not uncommon either.  Apparently my quads had gotten pretty tight from not being able to bend the knees fully and since he was able to get the heels to the butt with the MUA, that caused an excessive stretch on the quads and now I'm paying the price.  Hopefully that pain will let up over the next few days or hoping that I can at least find something to help.  Ice, nor the pain meds, nor heat seem to be doing the trick!

Swelling is ridiculous though, probably worse than the MPFLr; joint line is hardly visible and my kneecap well...let's just say it's lost in all the swelling!  Active flexion while supine is about 66 on the L and 54 on the R but I know a lot of that is due to the swelling and due to the quad pain, as I can get it further just letting it hang over the edge of a chair/bed when the quads don't need to work to get it to bend.

Post-op set for 2/4 and will get more answers to all my questions.  Should get the OP report sometime this week so I can 'review' everything and formulate more specific questions.  Not sure if more knee surgery will be done or not, as that depends on the findings.  But if not, I will be scheduling the hip surgery for sure for the summer and hopefully can get them both done either at the same time or a few weeks apart.  But the knees have to come first since the hips will leave me non weight bearing on the operative side putting all the stress/strain on the knee.  And since the L hip needs more attention and work than the R, that will get done first and the R knee is the one giving more problems so it has to get better before I can even contemplate getting the hip done.  But no worries...only 1 more week to go until I get a tentative plan in place and then back to PT on 2/5. 

Will be an interesting conversation with PT-they kicked me out on 12/21 due to lack of progress with flexion, as the R was holding steady at 115 with a ton of pushing and aggressive PT.  Was worried that the lack of them pushing 4x/week would cause the knee to regress but they refused that that would happen.  On the surgical day, R knee flexion was about 94 degrees.  I had lost 20 degrees of flexion in 4.5 weeks because they discontinued service.  So for those of you out there whose PTs seem to be giving up, fight for continued service.  It may not be making it better but who is to say it's not preventing it from getting worse.  In this case, I was clearly right (& will be sure to hold that over my PTs head every now and then too especially when I want to push harder and they are too 'afraid' of what will happen, like my request for doing shuttle jumps which will probably start up at about 3-4 weeks post.  But no fret, we have a great relationship so I can do and say things like that and we'll both laugh about it and then I usually end up winning, as I don't give up very easily!!)

Heading back to work tomorrow, as I took Wedn., Thurs., & Fri. off last week for surgery and two days of recovery.  Dreading the long walk from my classroom to get my kiddies off the bus and then back inside (long hallway with a super long playground to cross), especially as it is extremely icy here!  Did some shopping at the mall yesterday and then Target & groceries today and the knees held up well.  Some soreness and tightness from increased swelling but I hate sitting around all day and doing nothing-there is no worse mentality or medicine then succumbing to knee pain!  And I use my history of blood clots as a 'must' for getting moving ASAP, even on icy days like today; the darn Lovenox injections are making my belly look like you're playing connect the dots and the injections are twice daily for 2 weeks this time around!  Ugh!  Good thing it's not bikini season!  :-)

Will update after my post-op appointment with hopefully, marked improvement in this quad pain!
Title: Re: Bilateral MPFL Reconstruction-7/25
Post by: Teacher2Many on February 16, 2013, 03:33:04 AM
Almost 3.5 weeks post bilateral LOA & MUA and figured I'd pop in and update.  Flexion is dramatically different-still quite painful but the fact that it's bending more is a good thing.  L is at 135 and R at 126.  We are measuring only weekly, as I was too afraid of measurements changing for the worse when done daily (due to stiffness, more swelling, etc. on any given day) and thought it would be too discouraging plus would cause unnecessary panic when numbers stop rising (after all, you'd probably see a jump of at least a few degrees every week vs. maybe 0-1 degrees every day).

Medial quads and hamstrings are a great cause of pain and PT feels that it is a big limiting factor with flexion as well.  So he's digging in there trying to loosen them up with some massage, ART, etc. and I just lay on the table and cry.  Thankfully, the new clinic I'm going to (same PT but he changed clinics) is nowhere near as busy so maybe there's only 1 or 2 other people there when I'm there so it's not as embarassing to sob like a baby.  But my surgeons words when I talked to him at 2 weeks post op where "have them push the hell out of it", which is what I told him to do and definitely what he's doing.

The popping sensation is ever so present-I still question if it's shifting, even slightly.  My OS wants me to duplicate this sensation at my next appt. on 4/1 so he can try to figure it out.  And if he can't figure it out and come up with a plan to fix it, he'll find someone who can.  He said he's not giving up and knowing my case is difficult with the past dx and surgeries, makes him want to work even harder to come up with a solution.

Hoping to have that on 4/1 because if there is no plan for the knees for the summer, I am booking surgery for the hips (and maybe the R shoulder as well).  There is some discussion on trying to obtain a flexionator as that extra push for the knees at home and also to work on dorsiflexion on the L foot as that is the one that got damaged with surgery in 2011 and still presents with limited dorsiflexion and immense weakness making walking, running, etc. difficult to say the least.  Need to do some more research on that though-was thinking a hinged AFO/night splint would be better as it's not me pulling it to work on flexion and hence inflicting pain (after all, how hard do we really push knowing how much it hurts).  Will revisit the conversation again with PT on Tuesday and then probably e-mail my OS afterwards to see what he has to say.

Hope all are enjoying the last month or so of winter-the bulbs are starting to grow and show through the mulch and just hope we don't get a bad enough freeze to kill them!
Title: Re: Bilateral MPFL Reconstruction-7/25
Post by: Summer007 on May 31, 2013, 04:39:05 PM
Hiya Teacher2Many,

Just thought I'd pop in and see how things are going now with your knees- I hope all is well.

Summer :)
Title: Re: Bilateral MPFL Reconstruction-7/25
Post by: Teacher2Many on July 10, 2013, 03:39:23 AM
Thanks Summer!  Sorry for the late reply-things have been very busy with the end of the school year, moving into my condo, etc., etc.  I am undergoing more surgery on 7/24 for the L hip and R knee (trying for both knees but we'll see what he says).  The hip doc is going to fix the torn labrum and correct the impingement.  My knee guy is going to undo the MPFL in the R knee in hopes of getting rid of the pain and tightness with flexion.

This surgery was originally scheduled for 6/26 but on 6/24 it was decided that I needed emergency spine surgery on 6/26, which I had, and therefore the hip & knee got pushed back four weeks.

What's the latest update with your surgery?  Still planned for the 30th?  You should be able to resume classes in the fall so will keep my fingers crossed for you!
Title: Re: Bilateral MPFL Reconstruction-7/25
Post by: Summer007 on July 10, 2013, 04:25:09 PM
Hiya Teacher2Many,

It doesn't sound like your having a very good time of it at the moment! I'm sorry to hear about your back, it doesn't sound nice at all. I hope your making a speedy recovery! Good luck for your surgery on the 24th, I'll be thinking of you- I hope it all goes well.

Yes, its still the 30th for me- so just three weeks away. I'm hoping I'll be able to go back to classes but as it is only 5 weeks after my surgery, my surgeon isn't too keen on the idea of me going back straight away. I'm doing a course that is two days a week at college and then the other three days a week at a children's nursery so he doesn't want me going back to soon.

Again I wish you the best of luck, hopefully the surgery will improve your situation. Summer :)
Title: Re: Bilateral MPFL Reconstruction-7/25
Post by: Summer007 on July 25, 2013, 08:29:00 PM
Hiya Teacher2Many,

Thought I'd pop in and see how surgery went the other day. I hope you are making a speedy recover and that you aren't in too much pain.

Best wishes. Summer :)
Title: Re: Bilateral MPFL Reconstruction-7/25
Post by: Teacher2Many on July 30, 2013, 03:05:50 AM
Hi Summer,

Thanks for posting!  Surgery went well-took longer in the OR than they thought as they originally said about 2.5 hours total and it ended up being about 4.25 hrs. total.  Got home late in the evening and started PT two days after, as you've got to keep the hip moving right away to prevent tightness.  The bruising is the worst ever but the pain isn't all too bad.  I went without any pain meds all day yesterday but was feeling it today so I guess I'm not quite ready for it.  So I'm taking one at bedtime and one before PT and then OTC tylenol as needed.  The ice machine and CPM and guidelines are leaving me confined to the floor-4 hrs. in the CPM, 2 on my stomach, and then a few in the ice machine.

The hip was in worse shape than they thought so it took longer to get the job done and it's not all done so I'll probably head back in for round 2 on the left hip over Christmas break and then get the right hip done over the summer of 2014.  The R knee was manipulated, a medial release of the retinaculum was performed, and the suprapatellar pouch was released as well.  There is great pain in the upper quads and inner thigh that PT is keeping an eye on as that's where one of the larger veins runs through and with the severe tenderness to the touch, they want to make sure it's not a blood clot (especially with my history of clots-once you get them once, you're more prone to get them again).  Hopefully it's just from swelling and forcing those quads to bend under anesthesia! 

I get my knee stitches out & post-op on Thursday, return to my spinal surgeon for a 6 week post-op on Friday and then to my primary for a post-surgical check-up thereafter, and then my hip stitches and post-op on Monday!

Work resumes in about 3 weeks and I WILL be ready to go back! 

Hope all are well!
Title: Re: Bilateral MPFL Reconstruction-7/25
Post by: KMont on November 08, 2013, 02:58:20 AM
 on: Today at 02:54:23 AM
How long did it take most of you to do an unassisted straight leg raise after surgery?

Mpfl reconstruction & removal of small bone & cartilage pieces on 10-18-13.
Title: Re: Bilateral MPFL Reconstruction-7/25
Post by: Teacher2Many on November 08, 2013, 03:06:45 AM
I think it took maybe 4-6 weeks but don't remember 100%.  My quads atrophy quickly due to many surgeries and I don't think they ever regain their full strength before the next surgery.  Can you do a SLR with the brace on?  what about in other positions (prone vs. supine vs. on your side)?