The WAITING ROOM => Emotional/Spiritual help and encouragement => Topic started by: Sheiabah on March 14, 2014, 11:24:58 AM

Title: How to Deal with Work and recovery and not getting stressed/depressed?
Post by: Sheiabah on March 14, 2014, 11:24:58 AM
So I am now in my 6th week post key hole surgery for my grade 3 meniscal tear and fluid on the right knee (28th January 2014), I had a Duralane injection on Friday 7th March and have been into the office approximately 5 times since my surgery, all part days.  I have had a total of 5 days off sick as I am in a very lucky position that I can work from home when I want. 

However, that doesnt stop me feeling stressed about not going in, about misinterpreting the no doubt totally innocent questions from my colleagues about when will you be in the office, why cant you come in, can't you catch the bus if you arent up to driving questions.

That said if I couldnt work from home as much as I do I can only think that I would have to have gotten signed off from my GP for all of this time.  I can currently walk about 100 metres without pain, my knee is still swollen and painful and unfortunately still feels as if it is locking.  The Duralane injection set me back almost to post surgery again and I feel house bound and have been using a stick to even navigate around my house.  Before the injection I could manage about 400 metres without pain.  I have to walk very slowly, not overextend my knee and use a stick.

My Consultant is not very good at information, I asked him how long for recovery and all he said was 3 months, did that mean I wont be able to spend a full day at work for 3 months, or I should consider that I wont be able to walk without pain for 3 months and so suck it up and go to work in pain or that I should just sit on my sofa and watch day time TV for 3 months?  I didnt feel comfortable asking him those questions as he makes me feel insignificant and that my questions are pointless.   I know everyone is different but it would have been helpful to have some idea of how much time I will need to be flexible on working arrangements whereas at the moment it is a day to day thing depending on whether I can get downstairs or not. 

Should I have actually taken a good couple of weeks as sick leave after my operation and spent some time getting my knee back up to speed, taking it easy but exercising rather than being stuck sitting at my laptop for hours, forgetting to get up and move and do my PT exercises during the day as I currently am working at home?  I can at least sit with my legs up, rather then a jerry rigged box of photocopier paper at the office but I still sit for hours at my makeshift home desk on my bed and I am sure this is not good for my knee either.

My boss is understanding however I get the feeling that is wearing thin as the weeks drag on, I mean if I were my boss I would be thinking that its just key hole surgery so its minor surgery so why is it taking so long for them to be back on their feet?  If I am thinking it, I can only imagine they are too.

I feel like everything I read on the procedures I have had and the problem with my knee, the cases are all up and about much quicker than me, they are back to pain free knees and going for long walks with their families (I dream of this).  I am starting to get depressed, starting to feel pain in my other good knee from all the strain it has been taking since last year when this started and the months of limping about and starting to feel that I will never be able to spend a full day at the office, keeping stride with my colleagues when walking to meetings and sitting for hours in meetings with my leg bent down and touching the floor.

I am sorry for the depressing rant but I needed to get this off my chest, I hope others have a better time of it but even tho I wouldnt wish this on my worst enemy I also have a little bit of hope that I am not alone in this?

Title: Re: How to Deal with Work and recovery and not getting stressed/depressed?
Post by: Vickster on March 14, 2014, 12:36:59 PM
Sorry to hear you are having a rough time.

I had a lateral partial menisectomy in February 2010, my surgeon signed me off work for 3 weeks, and no driving for the same. I used crutches on and off for about 2 weeks after going back to work. Office job, around a 20 minute drive from home.  I don't think I could have gone back much sooner.  I had a further scope in December 2010 and went back after 2.5 weeks, that was a tidy up and a durolane jab at the same time.  The stiffness is the worst thing really, just need to keep moving around and try to have leg elevated.  Also use painkillers as required, anti inflammatory and paracetamol.  I can't take the stronger stuff during the day as they make me too dopey!

Hard to say how long recovery after each op, after the menisectomy probably a good 3 months although the mechanical problems which led to the scope were resolved quickly. The second op, I was back on the exercise bike after 3 weeks and on the road about a month later.

It sounds like you may be having a fairly difficult recovery, but 6 weeks is still not long given the trauma to your knee.  Use ice, anti inflammatories, are you working with a physio or at least doing home exercises? Do you have swelling still, how is the range of motion In terms of bending and straightening.

I do know how you feel about the work thing, I had a cycling accident in mid February, 3 weeks after starting a new job! I ended up with an infection and needing two operations on my leg (open) to remove the infected clot. I have had 8 days off, all unpaid, again, I have been able to work from home, luckily as I receive no pay right now while off sick

I would go back to the consultant or talk to your GP and explain exactly what is going on.  You also need to talk to your employer about making arrangements for being able to have your leg up etc at the office.  They have a legal obligation to make sure you are safe at work

Good luck :)
Title: Re: How to Deal with Work and recovery and not getting stressed/depressed?
Post by: Sheiabah on March 14, 2014, 01:22:44 PM
Thanks for your response, I am beginning to see that I should have been signed off work for longer after the operation, as it was I took 2 days sick only after the operation and a futher 3 days for the injection (one for the day of the injection and two after as I was back post op pain in my knee and on the big pain killers which like you make me go a bit dopey and not really fit for work).

I had a partial meniscectomy for a grade 3 tear which I know isnt insignificant so I should cut myself some slack however I didnt expect to have this constant ache in my knee which I would peg at about a 2 going up to 4 pain sometimes constantly.  I also didnt expect to still have the sharp pain in my knee joint when I walk distances, I expected the operation to have fixed that.  I also didnt expect the feeling of unstableness in the knee joint with often a crashing sensation when i walk like all my bones are crashing (audibly to my family even!) together.  I think I was probably just not given the right information.

My knee swelling is going down slowly, it flared up a lot after the injection however the ache behind and above my knee is worse and the range of movement is worse, I can bend it quite far albeit uncomfortably due to the full feeling in my knee  (I have hypermobility) however my Physiotherapist suggested that I should keep to within a normal range of motion rather than what I can actually do, I can't actually fully straighten the leg though with my knee joint just refusing to get 100% flat and being painful if I sit with it flat so I tend to rest a yoga block or something under my knee to keep it bent when working.

I suppose I want to know if I am being weak and should be going into the office more, I want to go back to my surgeon and say it doesnt feel right but he (threatened?) suggested the only option next is open knee surgery for replacement meniscus with 6 weeks non weight bearing on crutches.  To be honest I am beginning to wonder if that is not the route I am headed anyway so perhaps I should have just gone with that to start with.
Title: Re: How to Deal with Work and recovery and not getting stressed/depressed?
Post by: Vickster on March 14, 2014, 01:44:13 PM
Everyone is different, if you don't feel able to go back to the office, then that's what you are like.  The worst thing you can do is compare yourself to others.  Maybe you did go back too soon, maybe you didn't, you'll never know so don't beat yourself up about it.  I would go to work and ask for a meeting with your boss and HR to discuss working arrangements.  I found that a full written explanation of what happened to my leg has helped soften my boss's attitude (although my situation is different being in the probationary period)

 Everything I have read on here, suggests that meniscus transplantation is far from perfect.  There are only a handful of surgeons in the UK (I assume you are here) who do these, so only go down that route with one of those guys, and not without a lot of discussion - these are extremely painful for starters, and if it fails, you open yourself up for all sorts of issues down the line. 
How much meniscus was removed?  How old are you?  I don't know what a grade 3 tear means, not seen grading of meniscal tears, only articular cartilage

Frankly, given your surgeon's attitude, I'd be asking to see someone else, I wouldn't want someone using major and experimental surgery as a threat gong anywhere near my leg!  Where are you based?  Do you have private HC as I am not sure meniscus transplant is done much on the NHS as NICE aren't keen on funding new, unproven procedures

Have you had a post op MRI, if unable to straighten, there could be meniscus still blocking the joint, or scar tissue?

I'd get another opinion
Title: Re: How to Deal with Work and recovery and not getting stressed/depressed?
Post by: Sheiabah on March 17, 2014, 12:40:16 PM
Ok so I went back to my surgeon for more information as your comments made me think something wasnt right and also your suggestion about information for work was a very good idea... his response is:

At the time of arthroscopy you were found to have a large osteochondral defect on your medial femoral condyle. This was treated by abrasion chondroplasty - in other words shaving it down to a smoother surface finish. Subsequently you underwent a Durolane injection which is a lubricant to help calm your symptoms. 

So you did not have a significant meniscectomy but the area of damage on your femoral condyle amounted to about a third of the weight bearing surface which a fairly substantial amount.

So the replacement he suggested was for the articular cartilidge not meniscus, my mistake.

I am 42 years old with a fairly active life, I work full time and have 4 kids and I used to like doing Yoga!  Currently I cannot walk up/down stairs without pain so have to do the one foot shuffle action, I can't walk further than 400 metres without pain and locking sensations and I cant sit with my knee down for any period without the full feeling and discomfort in my knee.   I use a stick to walk any distance.

I know everyone is different and I am still fresh from the procedure but I am getting a bit obsessed with my knee and I guess trying to come to terms with whether it will ever by like it was before.   :(

I am very glad this site exists and reading some of the other people on here I know I am not alone and actually there are a lot of people worse off than me!
Title: Re: How to Deal with Work and recovery and not getting stressed/depressed?
Post by: Vickster on March 17, 2014, 01:04:47 PM
Unfortunately, your knee will not be the same again, it is very difficult to repair articular cartilage successfully, especially if a large surface.  You need to find a specialist who is expert in cartilage repair, there are a few larger centres which offer this on the NHS. Where are you based?  You won't want to rush into anything though as these are also big painful operations.  I started down the road, and although not deemed suitable in the end (due to damage on the opposite surface), and that surgeon told me it would be at least a year to get back to where I was pre op and another year at least to actually see benefit!  6 weeks not weight bearing in a brace, tough physio rehab.  I should think that would be even harder with 4 children

An alternative option would be a partial knee replacement or an osteotomy to offload the damaged part of the femur, but these are obviously big operations too, and again you'd want to find specialist surgeons.  It does sound like you knocked off a big chunk of the cartilage (I have a defect on the wb lateral condyle, these are a pain), the durolane may well help, but it will take several weeks for it to all settle down.

It is very easy to obsess, and knee issues really can take months and months to settle and longer to get back to where you were.  It may be that you'll need to modify your activities, find so etching different, swimming is pretty knee friendly for example.

There'll always be someone worse off, but that doesn't mean what you are going through is easy :)

I have all sorts of damage in my knee, but cycled 2500 miles last year on it, mostly without any issues, so it can be done, just need to work at it and deal with the ups and downs.  I am off the bike at the moment following surgery on my shin after being knocked off but I fully intend to ride again as soon as the wound is healed more!