KNEEtalk

DIARIES => Post-op diaries (50-100 posts) => Topic started by: hopeful1 on April 23, 2004, 02:01:05 AM

Title: Hopeful1's post-op!
Post by: hopeful1 on April 23, 2004, 02:01:05 AM
Hello, all...I'm new to this site, but not really new to knee surgery.  I had a TTT, lat. release, VMO transfer and a new trochlear groove dug in my right knee about 22 years ago.  MAN - that was the dark ages.  I was hospitalized for one week, full leg cast for 6 weeks, then an immobilizer four weeks.  I had a "frozen joint" and PT for two years to get back to mobility.  My Left knee was in need of repair, but I chose to alter my lifestlye, rather than go through THAT again!  Not much pain, and only a few subluxations in my Left knee over the course of twenty years was pretty good!  About a year ago, however, I slipped on ice ,had a "frank dislocation".  I had to shove that darn knee cap back in.  That began the deep spiral leading to surgery on Tuesday.

WOW - what a difference technology makes. I had a TTT, Lateral realease, meniscal repari and a debride ment of numerous osteophytes and rough cartilage. Out-patient surgery, knee brace, no cast.  A three-inch scar (my other scar if 18 inches long!).  The pain is not nearly as bad as I was afraid, but MAN, I feel like I'm rushing it.  Is it just me?

Also, While I think I'm doing pretty good, just two days post-op, I am having trouble getting what I need from my significant other.  Don't get me wrong- he's feeding me, getting me drugs, etc.  BUT, I have to beg and bargain to get the extras.  He tells me to take it easy when I get up to go to the bathroom, but questions EVERY pill that goes into my mouth, saying"it was just an arthroscopy - You shouldn't be hurting this much".

I don't mean to sound so stupid- but am I being a baby?  Did any of you guys need 5 or 10 mg of oxycodone (or the equivalent) every three or four hours?  Again, I thinkI'm doing pretty good - but I kind of feel bullied.  And this is SO new.  THis guy has been a PRINCE, he's my soul mate - but this is REALLY pushing us apart.  I am not getting sympathy or empathy that I can recognize...but I'm sure it's there.    Is this a GUYS "scared: response, because he feels out of control??"  I don't recognize this at ALL??!?!?!?

I'd really like some input! I've been with this guy for  year and a half.  He helped me a year ago when I fell, and was the best caregiver - backrubs, just did stuff, offered himself.  I NEVER asked for anything - not even ONCE.  Does anyone have any insight about this change????

Always,
hopeful....  :'(
Title: Re: Hopeful1's post-op!
Post by: Heather M. on April 23, 2004, 02:24:09 AM
Why don't you show him some articles on what was done to your knee?

Show him on his knee how the bone surrounding the insertion point of the patellar tendon (that lump below the kneecap at the top of the shin) was BROKEN out of the tibia with a saw, moved over, and fixed into place with two 2-4 inch long screws.  Then the soft tissue sinews on the outside of the knee were cut with a laser scalpel, leaving behind a good bit of bleeding which gathers in the joint.  Then show how the muscle insertion point at the inside of your thigh was cut away, had severa mm to almost an inch cut away, and then the two pieces were sewn back together again.

Frankly, he needs to understand that there was no 'just an arthroscopy' about it.  In fact, since you have a three inch incision, it was actually an open surgery.  If you had 'just an arthroscopy' then you would only have 2-4 small puncture marks.  The fact that you have an incision and hardware in the knee change things considerably.

I had my appendix out, with complications.  So I had a six inch incision in my belly which was closed with staples.  It took over a month before I could sit up in bed.  That was a CAKEWALK in terms of pain compared to my last arthroscopy.  You had major open surgery involving broken bones and hardware on a weight-bearing joint.  What's more, it's very important to keep the pain under control because if you don't, the quad can actually shut down and leave you in a world of hurt with a subluxing kneecap.  Further, if you can't keep the joint moving once it's time to do so, you could end up with scar tissue and a frozen joint again.  

Your significant other is reacting the way guys do to pain and/or illness--he's wondering why you can't just tough it out.  But no one gives a medal to the person who takes the least pain meds.  In fact, failing to properly manage the pain can result in significant complications.  So you really need to explain to your SO what you actually went through, and that this was not some little nip and snip like a torn meniscus where you're expected to walk out of the hospital.  Many people are actually kept in the hospital for 3-5 DAYS post op so they can have intravenous pain medication...this is usually morphine.  The doctors would not prescribe this if they did not expect significant pain.

You can send him to http://www.patellapain.com and go to the surgery section.  Have him look up the Fulkerson procedure (generic TTT) and look at the pictures and read the text (it's pretty gory).  You may also want to bring him in to the next post-op meeting you have with your OS, and have the doctor go over exactly what he did.  Have the OS explain that it could be 6-12 months for return to activity.  Have him explain that this is open surgery involving broken bones and screws and changing the way your body bears weight on that leg.  It hurts, to put it plainly.  

Some people have less pain than others.  That's great for them, but as I said, it's not a contest to see who can grit their teeth and take the most pain without showing it.  Nobody gets a medal for white knuckling it.  I call it better living through chemistry  ;D  And I take way more medication than you do on a daily basis just to be able to put weight on my knee.  

Maybe he's concerned about addiction?  If so, please disabuse him of that notion!  Your situation is short term, people who are taking meds for significant surgical pain do NOT become addicts, and letting the pain continue can have very negative effects on your recovery.  It's pretty simply, actually.

If he doesn't get it, then you can tell him that as soon as he goes through the procedure himself he can give you advice about pain management.  Or when he gets his MD degree--whichever comes first.  I actually had a bit of this behavior from my dad at first--it must be a guy thing.  So then he went fishing in Alaska and rapped his knee hard on the side of the boat when a wave hit.  He had a bruise.  That's all, a bruise.  And he whined endlessly and winced when he put weight on it.  My mom said it was quite the spectacle.  When he got back, he said he had new respect for what I went through every day, and that he couldn't believe how the knee pain affected everything from sitting, standing, bending, walking, turning, even sleeping.  He was much more sympathetic after that.

Here is a link to another site that explains what was done to your knee (among other things, this just desribes the TTT part).  It also has an x-ray of the screw placement, so you can see how big those puppies are!   Again, you may not want to view it--but it's kinda cool, actually.

Here's the link.  If you want, I can actually post the image itself.
http://www.wheelessonline.com/image7/knnee3a.jpg

http://www.wheelessonline.com/  Go to this link, then to the T section of the alphabet, then click on tibial osteotomy.

Good luck.  I've found the best way to explain to someone who's never gone through this is just to give the the medical details of what was done.  You are NOT being a baby, you had major surgery.  It's not unusual to take pain meds for MONTHS after this procedure.  It hurts.

Heather
Title: Re: Hopeful1's post-op!
Post by: 2soreknees on April 23, 2004, 03:36:20 AM
Hopeful1

I agree with Heather, your guy is being a male...something about those chromosomes makes then just not get it.  That is why THEY don't give birth!
Anyway, hang in there take your meds.  You are not being a baby, in fact I am surprised that this was outpatient.  I had mine last year and was in the hospital for a couple of nights on a morphine drip.  Yes I took Oxycodone and Percocet for some days after surgery.  No I didn't get addicted I just knew I needed the relief and it helped me relax and sleep which was what I needed to heal.  

I like Heather's idea of letting him see what you went through.  Having a bone cut and moved is brutal and not "just anthro"!  It might just help him to see something concrete about what you went through.  I must say when I showed my husband my screws he went pale!  (He's a carpenter so he really understands what screws do).  Arg!

I regulated all my own meds after surgery.  I took a piece of paper and divided it up into days and meds.  I would record the time I took each one so I wouldn't get confused.  It wasn't the most readable thing but it helped me feel more independent and have some control over my pain.

Good luck and keep in touch.  This is the most wonderful site.

Tery


Title: Re: Hopeful1's post-op!
Post by: hopeful1 on April 23, 2004, 04:52:27 AM
YOU ARE TERRIFFIC!  Thanks for replying.  Very helpful stuff.  We had a chat, and he helped me take off my dressing, and put on "ted" hose.  I think seeing the VERY bloody dressing, and the stiitches were a slap of reality. Also, seeing that my knee was bulky from SWELLING and not from BANDAGES was eye-opening.

I KNOW better, about keeping on top of the pain, and I've promised myself to be better about taking meds!  That way, I just might not be as grouchy!

Thanks again!

L.
Title: Re: Hopeful1's post-op!
Post by: stgiles16 on April 23, 2004, 08:31:28 PM
Hopeful, it is definately a guy thing. After this last surgery , I told the OS that this one hurt worse than child birth ( and I was NOT  kidding) He laughed and said no way. When was the last time he had a kid? and better yet, when did he have all this stuff done to HIS knee??  Do what is best for you, he just doesnt understand (and if he is like my husband, he will never fully get it) I dont think anyone can unless they have been throuch it themselves.  Good Luck, you sound like you are doing great. ;D
Missy
Title: Re: Hopeful1's post-op!
Post by: gimp on April 23, 2004, 09:11:52 PM
My HTO is about as similar as your procedure as I've had.  Without the pain meds, nerve blocks, etc. I would certainly have been a pathetic blubbering mess.  I tried to tough out my ACL recon several years ago.  Bad idea.  

Hopefully you will begin to feel less of a need to the meds soon.  For me it took about a week before I was completely off.  You always want to stay in front of the pain and are not being a wimp for taking what the doctor prescribed.  Hopefully you'll find that soon you only need them to help you sleep.

I am however looking forward to telling my wife that my pain was worse than childbirth.  Thanks for the ammo, stgiles16!

John
Title: Re: Hopeful1's post-op!
Post by: hopeful1 on April 23, 2004, 11:13:12 PM
Thanks everyone!  I'm trying to be patient with him, and take care of myself!  I have been better about staying "on top of the pain", and that helps me.  It doesn't at all help with him, though.  He just shakes his head.  It got better after I showed him my knee, but he still thinks it's "just an arthroscopy". Now, he just has the attitude "if you're in so much pain, get the damn drugs yourself".  Not helpful.  Oh, well.

The advice and encouragement of everyone here helps! At least I don't feel like a junky, when I am "still" taking pain meds three days after surgery. John, it's good the hear that even a guy can feel pain.  Apparently, mine never has...

Bitterly,

not-so- hopeful
Title: Re: Hopeful1's post-op!
Post by: Heather M. on April 23, 2004, 11:27:38 PM
So when he tells you to get the d**n drugs yourself, tell him "That's really mature.  I'm so glad I have you around to comfort me after my surgery."

Then point out that he will get sick/ill/have surgery at one time or another, and you have a very long memory.

Seriously, don't let this fester.  Ask him what the heck is up with the attitude, when you're the one who had her leg broken, laser scalpeled and sutured.  Does he really think he's helping?    Tell him that you were counting on him to be there for you, and if this is an example of how he stands by you through sickness and health....well, you know, it's not necessarily going to get easier any time soon.  Yes, your pain levels will decrease.  But you'll be on crutches for weeks, in a brace for at least that long, doing formal physical therapy, etc.  It's best to hash this out now, as unfortunately your life is going to be in upheaval for months to come.  That's not to scare you, but just to point out that even the fastest recoveries take 6-8 weeks, and those are abnormal.  It's usually more like 4-6 months before absolute return to self-sufficiency.  Do you feel like biting your tongue for that long?

He probably doesn't like to see you down and hurting, and like a typical guy shows it in strange ways....

Heather
Title: Re: Hopeful1's post-op!
Post by: 2soreknees on April 24, 2004, 04:02:22 AM
Hopeful1

Don't give up on your guy.  There is a reason why you two were drawn to each other.  Definitedly talk to him about his less then supportive attitude....maybe he needs a little time away to get things in perspective (my husband goes camping with his buddies)  yes you might end up by yourself for a couple of nights but maybe he needs a bit of male bonding.  I know my husband cannot do the caretaker thing for long, makes hime cranky.  DO you have a girl friend that could come syay with you for a day or so?  A little "girl time" might help you too.  

Whatever you do don't make any decisions about your relationship while you are on these meds.  

Just be good to yourself, you won't be laid up for too much longer and life will get back to normal soon.

Yes there is a reason why guys don't give birth.  My TTT made childbirth look easy and I was in labor for 41 hours!  Of course maybe that is because I ended up with a beautiful daughter from childbirth and only a scar from my TTT.

Good luck!
Tery
Title: Re: Hopeful1's post-op!
Post by: soccerdoc on April 24, 2004, 05:45:23 AM
Hopeful,

The Heathers on this site are very helpful, there are at least eight and several honorary that I can't keep track of.

First off, it is not a guy thing as a broad stereotype.  I have been involved with the treatment of chronic pain for both men and women for years and they experience it differently.   Fact is men are not the greatest caretakers and nurturers by nature.

Secondly, adequate pain control is what is optimal and if he doesn't understand it there are some good materials on the American Pain Society website or the American Academy of Pain Management.  Heather K is right about no one giving a medal to the one who takes the least pain meds.  There are often other things that get triggered in a partner, male ofr female when their perception of what should be happening and what is happening are very different.  Often this is out of lack of knowledge and fear, fear that the person won't get better, that they will develop a problem with medications, that they think they could handle it bette, yes I have seen women feel their male partners couldn't handle pain because they needed medication.

As to labor pain, it is so different thatn acute psot op pain.  No I have never had a child and I think men are lightweights as it takes alot to go through a pregnancy and childbirth...bones softening ligaments stretching weight gain change in body image.  Men do ultra events to compensate for their deficiency in this area imho.  BUT labor pain is different and involves a different set of neurochemical responses that make it unsuitable as a pain typoe to compate to a TTT or HTO or ACL or sinal fusion or phantom limb pain, etc etc.  BTW, female surgeon sare no better at assessing pain and need for medication based on a study in one of the pain journals.

2soreknees is right about not giving up and not making decisions about the relationship while you are taking significant doses of pain meds.  He may need time with his buddies, he definitely needs to understand major surgery even if it's done arthroscopically.  Cutting bone is painful.  

Stay o top of the pain, it's not his leg and he doesn't have to deal with it.  talking to him about it when he is open to it.  Fact is he doesn't really know what he is talking about although I doubt he would admit that.

This is a very good place to get support and information, even fromm a guy sometimes.

Take care, hope things go well.

Jim

Title: Re: Hopeful1's post-op!
Post by: hopeful1 on April 24, 2004, 08:25:13 AM
Jim,

Thanks for your wise words.  Pain is not very translatable, is it?  I know not to make any changes right now - especiallly on pain meds.  And, even though it is tempting to snap back at him when he's being a grump, I try really hard to understand.  This guy really is sensitive, and I think he just can't stand the thought of me in pain, so he gets mad, in general.  Then I, in a bit of a stupor, take it personally.  BUT he also could beahve in a manner which is more supportive.  I hope I didn't offend, with the "guy stuff", but it does seem that men are more likely to respond in the way he is, and , women are better nurturers!  

I think I need visitors, and good, "chick-flick, and some chocolate!  Perhaps that is a concrete request he could handle!??!!

Thanks, again!

PS- this is all getting better by the hour!  Took a quick shower, and feel much more human!  

Linda
Title: Re: Hopeful1's post-op!
Post by: soccerdoc on April 24, 2004, 08:54:54 AM
Linda,

You are right about pain being difficult to translate.  It also changes how one thinks about things.  It is nice to hear you say he really is sensitive.  One of the things that is difficult about pain in a relationship is that the person without the pain can't really know what the person in pain is experiencing and it often creates a feeling of helplessness.  Now men in particular do not do well with a sense of helplessness.  Anger is also a great way of protecting oneself from being emotionally close during a difficult time.  No you didn't offend with the guy stuff.  I have just seen the same thing in reverse over the years which to speaks more to how pain changes a relationship and really requires taking communication to a new level to keep the relationship as healthy as possible during that time.

Hope you get the visitors, a chick flic and the chocolate.  We have a great chocoalte shop..."Euphoria Chocolate"

Take care.

Jim
Title: Re: Hopeful1's post-op!
Post by: 2soreknees on April 25, 2004, 12:29:34 AM
Jim

Sorry about the "guy bashing" ...I hope I didn't offend.  
You seem rather enlightened about this pain thing I guess it is because you have experienced it.  I admit that I have been pretty gouchy of late because my pain level had been way up there. :P

My OS told me that people with light hair and light eyes have a lower pain tolerance...( I am blonde. blue eyed)  maybe he was trying to tell me something?

Have a good day.

Tery
Title: Re: Hopeful1's post-op!
Post by: stansey on April 25, 2004, 01:23:21 AM
Hi, hopeful1.  I don't know what 's with your guy but I think you need to somehow have a quiet talk with him.  If you had that experience with him in the past where he was great, and is not now, something must be different.  Is it strictly related to the amount of meds you are taking, is that  a problelm for him somehow?  I think with my sig other it's like, once you're up, you must be fine.  So, go back to normal.  I know they mean well, but I think they can't stand it when we're not 100%.    And he should be a prince, after all, don't you deserve it?  Wouldn't you take good care of him if he were the one hurting?
Title: Re: Hopeful1's post-op!
Post by: Helen_uk on April 25, 2004, 01:44:31 AM
Hi there whils my other half is very good we have to have blow outs every now and again because I have had so much surgery and generally cope well and am very independant he assumes that I am always that way infact since my last op two weeks ago he has only done two meals and one of those came from the local curry house... i think venus and mars come to mind in these situations . My hubby goes to bed with a sore throat and dabs the door with blood to warm all who enter he may not have long for this world Heh eheh
may be your other half is worried or simply sees that youa re coping and doing well so maybe assumes you dont need help so a gentlr reminder may do the trick failing that crutches arent just given for walking shuff em where the sun dont shine LOL ::)
Take care and good luck
Love H xx ;D
Title: Re: Hopeful1's post-op!
Post by: hopeful1 on April 25, 2004, 03:56:10 AM
Sound advice from all!  

It turns out a good threat worked like a charm!  I told him that I would call ALL my grilfriends and have them come over for a good chocolate binge and a crying jag, if he couldn't be more understanding! HAHA - he said he'd do ANYTHING to keep that from happening!  I need to focus on the positive, solid practical things he does for me, and look harder for the signs of the soft, TLC stuff.  Keeping up with the right pain med regimen is helping, too.  

My OS wanted me to start on gentle ROM  (no more than 90 degress) two days post-op.  THAT doesn't help with pain control right now, but I am confident it will help down the road.  I can get to almost 60 degrees today -  I just have to make sure I'm ICE COLD and nice and loopy from pain meds.  I over-did it yesterday, and was VERY swollen last night, but the pain over-all was not increased as much as I was afriad of!  Over-all, I think it is going great!  

I admit to getting boared - I have lots of work to do, but find that writing scholarly papers and studing for final exams is not productive while I'm under the influence of narcotics! (I am a grad. student - I don't think you'd guess by my whining, but I am a nurse!)

Thanks again, all of you - this helps!!

Linda
Title: Re: Hopeful1's post-op!
Post by: Janet on April 25, 2004, 04:26:38 AM
You may find he understands better as time goes on and he realizes that this is not something you'll "get over" in a few weeks. When I had open surgery to repair a torn quad tendon, neither my husband or I really understood how big a surgery it really was (if only I knew what I know now!). But I could feel it every time I tried to move. He couldn't. He was sure that if it were him, he'd just "make it work." As weeks and then months went by, he began to understand. I had a lot of complications along the way, which he was sure wouldn't have happened to him. But over the last five years, he has become very supportive....in fact, sometimes "too" supportive as he doesn't want me doing things I actually can do. Keep the dialog open and see what evolves. Good luck!

Janet
Title: Re: Hopeful1's post-op!
Post by: Marie on April 26, 2004, 08:19:35 AM
Hi Linda,

I have a bit of an amusing story... I was dating an OS (he does spines, not knees) at the time of my surgery. He'd recently moved away at the time, but we went on vacation 10 days before my op, he kept me on the phone right up until I fell asleep the night before my surgery, and he was also the first person to call post-op to check-in on me.  Wonderful, right?  Well, I thought so until he suddenly got dreadfully doctor-ish rather than good-boyfriend-ish when we spoke right after my surgery.  He asked me soooooo many technical questions that I didn't know the answer to, that it just furthered my frustration of the post-op experience... I was already furious that I didn't get to see my OS after the op and have all those questions answered myself (plus my videotape of the surgery didn't work!), so talking to him just made me all the more angry.   Plus I felt like he wasn't being sympathetic in the slightest!  Then he completely disappeared when I needed him the most (somehow in my drugged up state I forgot that he was going to see his parents for a few days on his way to visit ME).   It all began when I ended up being in so much pain that I went back to the hospital on the day after my surgery for 4 days... I left COUNTLESS messages on his answering machine and then he finally showed up on the day I got out of the hospital and I realized how silly I'd been.    ::)  That night he stayed up with me until 5 a.m. and was wonderful at taking care of me when I couldn't get up to pee b/c the bloodrush was so bad that night.  (Talk about embarassing!!!  :-[)  Anyways, the motto of my story is that I had to tell him that I just needed someone there to hold my hand and tell me that everything would be okay.  And I had to learn to understand that it was part of his nature to question what the other doctor had done b/c he cared about me and wanted to make sure that I was getting the best possible care.  Most likely your husband is just scared by seeing you in so much pain, that you're going to get addicted to painkillers (there's been a lot of media hype recently about percocet in particular) or that he's not able to help you.  Either way, I'm glad to hear that your situation has improved since your first post.  Hopefully it's still improving...  

I'm a pharmacology grad student and my worst fear after the op was getting addicted to drugs or mixing the wrong drugs, etc... but I didn't.  AND I learned first hand the necessity of pain-killers... there's a reason why they are legally manufactured and prescribed to patients post-op, and this type of surgery is an opportune circumstance that demonstrates why they are necessary in healthcare worldwide!!!  I survived my TTT w/LR & medial plication & microfracture & scope, and I got off the drugs ASAP w/o any addiction.  In fact, I had a chem-free month in March in order to detox my system (we're talking no tylenols, advils, alcohol OR caffeine even) just to prove a point.  In retrospect, I should've taken more drugs in the days immediate post-op!  Next time I would!  That pain is not worth it!  Seriously, I never thought such pain was possible, but oh boy is it ever real when you're experiencing it.  I wouldn't wish that on my worst enemy!  

Anyways, I'm shocked to hear that you're trying to do some work already.   It took me weeks (probably about 4-5) before I could read anything with a clear head, so if you're starting to already, that's incredible!  My brain was complete mush until I was entirely off the narcotics and my pain was diminished enough to concentrate... I kept trying to go into my lab from about 2 weeks post-op, but couldn't last longer than 2 hours.  

My advice is to watch lots of movies to ward off boredom (this is a great excuse for doing ROM exercises... btw, good job with your progress so far!). Definitely eat chocolate (& popsicles) & have the girls over at some point, even if your husband has to leave the house.  

Ok... so you're doing great considering the circumstances... try to stay positive.  I'm glad you have that quote up about "be good to yourself"... it's a great motto.   ;)

Take care... lots of hugs,
Marie
Title: Re: Hopeful1's post-op!
Post by: hopeful1 on April 26, 2004, 09:08:38 PM
That's a great story, Marie!  HAHA.  Thanks for the encouragement, too.  I am beggining to get a better picture of rehab than I did from my OS.  He said it was "no big deal" - that is why my boyfriend is seeing this through different eyes.  He is going by what the Dr. said. Further, they sent me home on enough narcotic for about four days - and a prescription of Motrin.  Yeasterday was day 5. I had an old Rx for Loretab,which I took, but It made me sick! Not a good day. Plus I felt like I had the Flu.  has anyone else felt flu-ish post-op?  No fever, but "feverish" chills, aches, vomiting???

Today is much better!  I have a call in to the OS to change pain regimen. I am sure this is all normal stuff - but it's nice to turn somewhere for help!

What about you guys?  How long before back to work, etc.? My OS said that most of his patients are back to "desk jobs" in a week, but more like 6 weeks for someone "on their feet", like a nurse.  My job is somewhere in the middle. My OS also thought I'd be back to classes in a week, provided I didn't have tests or papers to write.  But, I can't imagine being able to sit in a lecture for three hours in two days!  My professors are being incredibly supportive - all have offered to give me an Incomplete - so I just finish the work this summer, without having to take the WHOLE semester over again.  They all also gave3 me extensions on final papers, and my onw final exam is in another ten days - I should be able to handle that, no?

Play nicey!

L.

PS- I tried to work on a paper yesterday. As I wrote it, I thought I sounded quite profound!!  I proof read it this morning, and OH GEEZ!  No more paper writing while under the influence!!  I sounded like I was HIGH!!  It was hilarious!!!

Title: Re: Hopeful1's post-op!
Post by: Marie on April 26, 2004, 11:47:13 PM
The surgery seemed like a HUGE deal at the time... now I feel like it wasn't so bad and that I could probably live through anything.

You may be feeling sick from the meds change or b/c you're taking too high a dose of the Lortab... (when you're ready you could try cutting your pills in quarters and taking 3/4 instead of a whole pill if the pain isn't too bad)... anyways, it's more than likely that b/c you just stopped your current prescription "cold turkey" that you've been flu-ish feeling.  When I began weaning off the narcotics I felt sick a lot, and took a lot of Gravol.   I would also feel sick if I took a higher dose (i.e. just before physio), so I think that you can get nauseous for both for withdrawal and for taking too high of a dose.  Anyways, I hope you get the meds you need today and start feeling better.   If your OS is too busy, pharmacists are great to talk to about pain control & balance with feeling sick/dizzy/etc...  you might also want some OTC laxatives if you're not taking them already.

Regarding your grad work... Take the time off and the incompletes for now!  If you're being offered the summer/extensions to finish your courses, do it... you won't be sorry.   It certainly sounds reasonable.  Maybe do one hour of lecture per day if you can handle it and you have adequate transportation to/from your classes... 3 hours is a bit much, and with a pretty straight leg that will likely throb if you're keeping it anything but hiked up in the air and w/o ice, you're going to have a tough time staying comfortable in a lecture hall.  I'd recommend getting notes from a classmate or your professor.

I found my school/supervisor/students, etc. to be extremely supportive, and started back at lab work when I could go crutch/cane free safely (at about 9 weeks).  Honestly, though, I didn't do a whole lot until at about 14 weeks (after Christmas).  The good news is that a lot of people get back to work sooner.

LOL... I also accomplished some FINE post-op writing.  ::) You're right that it's pretty amusing to read it the next day!   ;)  I actually wrote that I had a "symbiotic relationship with health" on a scholarly application... pretty sure it was the drugs talking.  Haha.

;DMarie
Title: Re: Hopeful1's post-op!
Post by: hopeful1 on April 27, 2004, 09:25:41 PM
WOW- what a difference a day makes, and new drugs! NO MORE PUKING!  Yeah!

Getting around much better, not as 'stoned' today. New pain meds work GREAT, I've had a few darvocet since yesterday, but MUCH less than before!   Also, off Motrin and on Vioxx.  This is a HUGE difference!

So, now that I'm better off, I;ve been working a bit more on mobility.  I'm still around 60 degrees.  One concern I have is a "clicking" underneath my kneecap when I do isometric quad sets (I can't do leg lifts, yet).  I had this before- but not nearly this bad.  Do you suppose this is just an adhesion-related thing?  I see the OS for my first post- op visit on Thursday AM - I will check then.  Have any of you had more cliking anf grinding after surgery??

Happily,

Linda
Title:  
Post by: Holly on April 27, 2004, 09:30:15 PM
Dear Hopeful1:

You might want to take a look at my posting on this same thread (2 weeks post double osteotomy - Yeah!), where I have just the OPPOSITE problem, with a spouse who is OVER-PROTECTIVE and is CONSTANTLY OFFERING ME PAIN MEDS although I DON'T WANT THEM!  The problem here, I think, is a Significant Other who is not hearing us...who loves us, cares about us, is sensitive, but is listening to something inside himself that is screaming a different message than the one we are trying to send to him.  Your SO does not hear your fears (incapacity, pain, loss of freedom of mobility, change of lifestyle, change of body image) and nor does mine (same issues).  These are difficult issues for our menfolk.  They treaure our minds, our souls, but certainly, also, our lovely bodies which pleasure them and reaffirm their images of themselves and their abilities.  During our recoveries, as our own bodies betray us in ways with which we are unfamiliar and which may, indeed frighten us and negate our usual sense of self-worth and value, our men find their own ways of lashing out against this change.  This is not a viciousness or unkindness.  It's not neanderthal or stupid.  They just want to reimpose the status quo.  So if drugs appear to be what's changing that...they want to remove them from the quotient...if pain is the supposed cause, let's remove THAT.  Our men adore us, G-d bless them, and they cannot bear for us to suffer.  Try to understand that while you are trying to logically attend to your situation and address it appropriately, your man is trying to FIX IT, FIX IT, FIX IT...FAST!!! So that you can be his woman again because he loves you.
I know I may sound different than the other advice here on these boards, but I'm half a century old and I know some things.  Men are good stuff!  Hang in there and take care of yourself.  Trust yourself.  You're doing the right thing!!

Hugs!

Holly
Title: Re: Hopeful1's post-op!
Post by: hopeful1 on April 27, 2004, 09:46:48 PM
Holly - thank you for your thoughful reply! It is hard to step outside of your own pain, and think of the pain of others!  And I agree - getting back to the balanced way we were is a BIG motivator.  My SO does so many tanglible, things - good cookin', helping with showers, ice, books, drinks, etc.  I needed the, TLC - the nurturing - but I wasn't even acknowledging all the wonderful things he was doing.  Things have been MUCH better! The other piece, that you alluded to, is the physical stuff!  WOW- the other night, he slowly started to snuggle up to me in bed (for the ifrist time since last week) and asked if it hurt when he did that!  He was affraid that ANY touch might be painfu. That night, he just laid his head head on my shoulder wrapped his arms around me.  I cried.  He slept soundly for the first time since last week.  

I find the best moments are when we both selectively forget about "THE KNEE" for a minute, and act "normal".  Those times are brief right now - but they happen more and more.  He is trying to focus on the "usual" and "normal", as you said the "status quo", and I've been focusing on my lame, currently useless, scarred, swollen bruised leg.  Slowly, but surely we are both coming around - and I'm not sure if he is actually being MORE loving and helpful, or if I['m recognizing more and more.  Either way, it's working!
Title: Re: Hopeful1's post-op!
Post by: Holly on April 29, 2004, 06:36:18 PM
Good for you!!

Sometimes us oldies know stuff.  Anyway, I know it has always helped my guy and me when we can let our "naked skins" (as he loves to say) just snuggle together and reconnect as they have for the last 27 years...sometimes it's just such magic!  And, when you're ready, some of that good old ***magic*** doesn't hurt either ;) - whatever returns you to your sense of "normal."  In the meantime, continue to be kind to yourself, listen to what you need, give yourself time to heal and be glad you have a sweetie who's doing his very best for you (even if it's sometimes wrong  ;D).

Best to you!

Holly
Title: Re: Hopeful1's post-op!
Post by: hopeful1 on April 29, 2004, 09:01:01 PM
Yeah! Things sure do improve over time, huh?  About my SO - here's a true story of love...yesterday, I was to return to classes.  I have been having HORRIBLE nausea and vomiting, but I felt pretty good yesterday am (one week + day post-op), and I really should have been able to go to a couple of classes for a few hours!  BUT ALAS - the vomit bug hit me, and as we were pulling in to my building, I tossed my cookies.  Forcefully.  ALL OVER myself and the back seat of the car.  My SO gently laughed, wiped me up, and took my assignments in to my professors.  He took me home, cleaned me up, cleaned my clothes, cleaned that back of the car, called in sick to work, and sat by my side all day.  He kept a seet smile on his face, and his wicked sense of humor, and didn't let me out of his sight. At night, he snuggled right up to me, head on my shoulder again! THAT's love! UGH! Enough of the MUSH!

Wow - Today was my first Post-op Doc visit, got my stitches out and 1st post-op x-ray.  All looks good.  A bit of cellulitis and bad bruising in my shin (I thought that was to be expected, by apparently it's not), so I'll work on that with moist heat.  But, I can bend to 45 degrees with NO PROBLEM, and to almost 60 with a bit of time, pain and struggle.  I think that's OK!  And I got to see the pictures!  MMM - a nice breakfast treat for a puker like me!  Nothing I didn't expect, excpet a HUGE groove on my femur (into the bone) that had been dug by HUGE osteophytes on both my patela and tibia!?

All in all, the clean healthy looking "after"pictures were worth it! I can now bear wieght, go crutchless when I can stand it, and I start PT in three weeks!  And my OS is such a great guy, he gave me a T-SHirt for "surviving"!

Thanks to all here for the support!  This place is a god send!

L.
Title: Re: Hopeful1's post-op!
Post by: soccerdoc on April 29, 2004, 09:33:53 PM
Linda,

I am glad to hear things are going well, in spite of the nzusea and vomiting.  Geez I whish I could have been crutchless that fast but I didn't go stir crazy over the 6 weeks on crutches and NWB.

I think this threead has had some very important things for pre-and post op patients to consider regarding pain control, communication, the different ways men may cope with pain in their SO etc.

Keep up the good work, glad things are improving.

Jim
Title: Re: Hopeful1's post-op!
Post by: Marie on April 29, 2004, 11:40:29 PM
Linda,

Sweet story.  Glad to see that stuff is improving for you.   :)  With any luck the sickness won't last long.

Take care & try not to overdo anything,
Marie

P.S.  Jim is right... there's a tonne of things that you couldn't possibly consider before having a knee operation/accident that this board brings into focus.  I think it's truly helping people to deal with peripheral situations related to the physical problems and that's AWESOME (I know it's certainly helped me!).  Keep it up KG friends!
Title: Re: Hopeful1's post-op!
Post by: hopeful1 on May 01, 2004, 10:00:24 PM
Wow- things just get better in leaps and bounds, huh?  I am just on Ibuprophen with an occaisional Darvocet at night.  Seems the pain is worse at night, but you know, even that it's really not that bad anymore!

ROM is sort of stalled, at about 60.  I need to be better at working that out.  That's something the PA noted - that I should  go ahead and medicate for pain (with Ibuprophen)  just so I can keep up ROM and do Quad Sets (those stll hurt - ouch!) and keep down the swelling.  I am hobbling around with the house without my crutches (as recommended), and doing pretty good!

N & V are GONE gone gone!  I am enjoying food again, and may bake some cookies this afternoon!  I figure I deserve it, even though I have NO WAY of working off those extra calories! HaHa ::)

Now, I must study for finals and write a few papers  (Now that I have a clear head!!).  Hey, that reminds me - one of my professors is frustrated with my progress (or as she says, LACK of progress).  She tells me that her husband had an ACL reconstruction and was FINE by the next day and back to work and off crutches in one week!!??   She told me that what I had done is NOTHING compared to what her husband had done, and that I need to "get it together!". Hmmm - either her husband is SUPERMAN, or I'm a miserable failure ten days post-op!!  I belive the truth is somewhere in the middle.  

Does that sound right to you guys?? I don't really know how to compare procedures, but it seems that an ACL repair would be as involved, if not more, than a TTT w/ LR, and chondroplasty (grade 3-4 chondromalacia)??!!
I just said I was taking it as it came, and dealing with my porgress as everyday presented.  I apologized profusely for having to miss ONE CLASS. But now that I think of it, I'm kind of mad at her.  She's a NURSE! You'd think she'd be a bit more understading!! Or, do I really need to "get it together??

Anyone have any suggestions on how to deal with this negative force????

Again, thanks to all!

L.
Title: Re: Hopeful1's post-op!
Post by: Marie on May 01, 2004, 11:08:22 PM
Hi Linda,

For 10 days post-op you're doing about as best as anyone could be doing.  Someone on KG once described a TTT as "open heart surgery for the knee", and I think that about sums it up.  While an ACL reconstruction is also major surgery, there are no broken bones or severed muscles.  It's ligament surgery.  I'm sure it can be painful and an ordeal in itself, but the TTT w/the added bonuses may just be a bigger deal.

Sounds like you should go back and read Heather M's first post to this topic again.  You should nicely tell the prof that conversely to her belief, what her husband had done is apparently NOTHING compared to what you had done, and along the lines of what Heather M. said maybe SHE can give you an adequate comparison of how long it takes to recover from these surgeries after she has BOTH of them done.  Ok, I know may be a little unrealistic to say that to her, but maybe if you tell her that everytime you put weight on the leg it feels like you bumped into a table HARD with your shin she might understand a little more.  Not all nurses are nice & caring (sorry, I know you're one... no offense!)... and if this is a prof she may be so lost in the realm of academia that she may forget about the patient empathy bit (and maybe that's why she's teaching and not on an orthopaedics ward).

Anyways, you sound like you've 'got it together' and you should take pride in the fact that you've made it this far and that you're making the effort to get back to your school work.  Don't let anyone tell you that you should be further along in your recovery ESPECIALLY at this point.  You're doing just fine.  

If you continue to have problems with her, I'm sure it's nothing that a doctor's note and a talk with her superiors (the dean, head of dept/your program) wouldn't be able to fix.

Good luck... I'm pulling for you!
Marie
Title: Re: Hopeful1's post-op!
Post by: Heather M. on May 02, 2004, 12:31:06 AM
Guess it's a good thing they're there to help you, otherwise you might be laboring under the impression that you spent 2 hours in the OR having your leg broken, having a chunk of bone screwed into a place it wasn't previously located, having highly enervated and vascularized soft tissue on the lateral part of your knee severed to physically relocate your kneecap, having a chunk cut out of your VMO and then sewing the two halves back together again, and having a chisel taken to your trochlear groove and handled somewhat like digging a trench to lay cable.  

Really, Linda, I don't understand what your problem is--I think you should sign up for that local 10K run next week.  Quit slacking, all right? ::)

Anyway, I was trying to think of how to explain to these ignorant people who have no compunction about commenting on things and judging others without having walked a mile in their shoes.  You have to find something they can relate to, like childbirth or something.  Last night--I saw a discovery channel special where the first-time mother-to-be in the hospital had been trained in hypno-birthing and so had NO epidural or pain meds.  Women in the beds next to hers were screaming for their epidurals or more pain meds, or were groaning and panting through the contractions.  She was listening to music on headphones and doing deep breathing exercises.  So, if your professor has had kids, I think you should in all earnestness tell her that you know of a woman who had no medication during her labor and still had no pain.  If your professor has had kids, she was probably slacking and whining when she had her epidural and drugs, right?  And so we should all judge her and find her behavior lacking...we should be 'disappointed' in her, right?  

It is literally impossible to compare different surgeries in different people, regardless of whether they were on th the same body part.  Unless someone has had both procedures himself or herself, I'm not too interested in their analysis.  And even then, I take it with a grain of salt, because (and I've said this before) some people out there seem to have the nervous system of a invertebrates!  I mean, some have reported taking only advil after a TTT, but there's no way that you can make a blanket statement about TTT's not being painful, for crying out loud, based on a few people.  

Heather
Title: Re: Hopeful1's post-op!
Post by: Heather M. on May 02, 2004, 01:12:41 AM
It's me again--I was thinking about how you can't compare pain from person to person.  And I realized that it goes further than that--even in the same person, the same procedures give dramatically different pain levels post-op.  

For example, I had a lateral release almost 3 years ago.  It was done arthroscopically, and I had a huge hemarthrosis afterward.  It was a bleeder--a gusher.  I almost was rushed back into surgery to cauterize everthing.  On arriving home, I very nearly passed out (and took about 10 years off my dad's life, he tells me,) when the loss of blood got to me.  My knee was about 18 different colors of blue, black, green, and purple before all was said and done, and the area of bruising was about 6 inches wide by over 12 inches long...yet by day 3 post op I was no longer taking pain meds every four hours, and was limping around the house without crutches.  I told everyone that the surgery hadn't been too bad--in fact, I said I'd had more painful root canals.  Other people on this board have spent weeks on crutches after the lr, unable to weightbear or do ROM exercises, literally in agony.  Does this make me a better person?  No, it just makes our experiences different.

I've also had lysis of adhesions (scar tissue removal surgery) done several times on my left knee.  Once I had my knee frozen at 30 degrees of flexion post op because of unbearable pain.  Last time, I had 135 degrees of flexion the day after surgery...so even in the same person having the same procedure, the post-op pain levels vary dramatically.  You simply can't extrapolate across people for surgeries.  

If your professor mentions it again, give her a printout from www.patellapain.com on what you had done.  Then tell her that the only similarity between her husband's procedure and yours was that they both involved knees.  Other than that, you had gouging, digging, sawing, cutting, stitching, stapling, and cauterizing of soft tissue, muscle, and bone.  He had work done on a ligament which had little to no enervation.  Heck, he probably had more pain from the donor area for the graft...that's got to tell you something....and if that still doesn't work, explain how after TTT most people are kept in the HOSPITAL on morphine drips--not because it's fun, because it's brutally painful.  Whereas most ACL recons are done as outpatient surgery with vicodin for pain management (god help them!).  Night and day.

Ignore these folks.  Bad vibes will only bring you down--and you might tell these people that.  Then ask them why they feel the need to make you feel bad about yourself...is there something lacking inside of them that they have to feel better at the expense of others?

Heather
Title: Re: Hopeful1's post-op!
Post by: hopeful1 on May 02, 2004, 01:32:28 AM
You all are great! Heather, have you had dumb people say the same kind of dumb things?? What gets me is the blatant ignorance!  I mean, I am sure I could be more brave, and were not for the post-anethesia N & V, I would have felt better, but it did hurt - I am NOT gonna lie about that! And I am lucky!  I have had this structural problem my whole life, but no pain, and a handful of dislocationd over the source of twenty years is NOTHING compared to what most people have been through.  I found the pictures of a TTT under Cat's thread (pictures), and I'm going to show my professor those,  and I'm going to bring in my own digitals of my surgery - they are impressive.  Sort of a "show and tell".

And, you know, you're right Marie - Nurses can be incredibly harsh, especially to their own.  We always joke about how "Nurses devour their young" - older nurses are notoriously mean and harsh towards newer nurses.  That might part of this, too! I am not offended by your statement - it is correct, not all nurses are the warm and fuzzy types - especially not the academics.

Really, I just need to be more secure in my own progress, and just let her biting remark go! So, I've resigned my self to leaving it at the door and doing the best I can.    And I am going to hope the ice cream part of her icecream cone falls and lands in Australia!

Got the check my cookies, now!!!! ::)
Title: Re: Hopeful1's post-op!
Post by: Leentje on May 02, 2004, 01:44:24 AM
Hey! What's this about nurses?? ;D ;) Don't say bad things about me! :D
BTW don't compare surgeries, not even TTT's! Everyone is different, everyone handles pain differently, I see that everyday. Just "wait and see"...
~Helena

PS I was back to work full time 11 weeks post-op after my TTT!
Title: Re: Hopeful1's post-op!
Post by: hopeful1 on May 02, 2004, 02:09:08 AM
Hey -I'm not saying anything bad about you, dear Helena!!  I am a nurse, too!!  But, like TTT's, not all RN's are alike! ::)

I have a "research"  (read: DESK JOB) right now, but I do have clinicals to make up from this semester (about 8 days, total).  I've told my professor that I'll have them completed by the Middle of August.  That means I'll start in July, and do a day and a half a week.  I'll be able to do that , AND enjoy a summer break!

Sorry if I offended!

Linda
Title: Re: Hopeful1's post-op!
Post by: hopeful1 on May 02, 2004, 04:47:30 AM
You know- I forgot to ask you guys something.  I get these muscle twitches in my quad - they come on quick, and make my leg jerk.  Is this common?  It seems like I remember this from before - It doesn't really hurt, just feels wierd...

Thanks!
Title: Re: Hopeful1's post-op!
Post by: cat on May 02, 2004, 05:20:29 AM
Linda,
Do you want more scary pics to show your prof?

Here's a link with pics:

http://www.rcsed.ac.uk/journal/svol2_1/20100005.html#SURGICAL%20PROCEDURE

And here's one where a guide is being used to do the cut. It's figure 6 on page 453.

http://web.uccs.edu/sports_medicine/PFS%20Tx%20(AJSM).pdf

BTW, when are you going to show us your pics?? ;D

cat
Title: Re: Hopeful1's post-op!
Post by: Leentje on May 02, 2004, 11:01:29 AM
Hehe it was meant like a joke! Sorry if it sounded the other way round... :-/

~H :-*
Title: Re: Hopeful1's post-op!
Post by: Leentje on May 02, 2004, 11:04:06 AM
Cat!
The first link works ( 8)),but the second one says page cannot be found... Who is sabottaging our pictures and links ;D ;D ;D ;D ;D ;)

~H :P
Title: Re: Hopeful1's post-op!
Post by: Marie on May 02, 2004, 08:52:47 PM
Hey Linda,

Those quad muscle twitches are pretty common from what I understand.   Personally I didn't really have them except when I was trying to work the VMO at physio right after I was un-hooked from the e-stim.  PT kept asking me about them and the OS said to expect them, but I really didn't experience it too much.

::)Marie
Title: Re: Hopeful1's post-op!
Post by: Marie on May 02, 2004, 08:58:47 PM
About that second picture link of cat's.  Copy the ENTIRE line (with the .pdf) into a new web browser window and then it opens as an Adobe Acrobat document.

Cat, good job finding this stuff!

Marie
Title: Re: Hopeful1's post-op!
Post by: cat on May 03, 2004, 12:18:58 AM
Marie,
I'm glad you are more computer literate than me! Thanx for bailing me out with the additional info. ;D
Did you see the AMZ guide then? I can't believe they can stretch your skin that much too use one of those HUGE things! No wonder there is pain and swelling afterwards!

cat
Title: Re: Hopeful1's post-op!
Post by: Leentje on May 03, 2004, 12:29:09 AM
Quote
About that second picture link of cat's.  Copy the ENTIRE line (with the .pdf) into a new web browser window and then it opens as an Adobe Acrobat document.

Cat, good job finding this stuff!

Marie

Should have know that but it was still early this morning and i was probably still asleep... ::)

~H ;D ;D
Title: My SO
Post by: hopeful1 on May 03, 2004, 01:47:51 AM
Thanks. Marie, for commenting about those twitches.  It seems a normal reaction to having thing cut-up!  I just wanted to be sure!

Wow- I've got some great gory ammo!!  You guys are great! I have to admit - I am VERY squeemish - so those pictures about did me in!  I don't have any pictures of my knee- I'm still trying to deny some of  this a bit, and dont like to look at it. I think it looks like everyone elses.  Swollen, three poke holes, and a flat little "smile" over my Tibial Tuberosity!  LOADS of swelling and bruising on the middle of my shin.  Hairy - cuz I haven't shaved  around the surgical sites, or where it's still numb and tingly when I touch it! Frankly, it gives me the willies to touch it - everything feels so different!  Even just doing quad sets feels really WEIRD!  Did anyone else get squeemish about looking at or touching their knees post-op??  I know it's kind of silly, but true!  My SO teases me - saying  I need sensitization therapy.  He said I should just set aside time every day - just like I do for Ice, ROM, etc., and touch it and look it.  I get the giggles, because he dramatically added "you need to love your knee again", in a very "Oprah-like" tone! (The funniest part is that he's an engineer and computer science guy - not exactly the type you think of as being "in touch"- though he is!)

Love to all!

L.
Title: Re: Hopeful1's post-op!
Post by: Marie on May 03, 2004, 02:28:04 AM
Linda - Actually, haha... if you ever want to start shaving that area again  :o you probably should start sensitizing the scar (but you don't have to look at it if you don't want to ;))!  Just use something soft (like a towel of fuzzy shirt inside) & rub it back & forth on the scar site for 1-5 min at a time (whatever's tolerable).  Your SO is right... it probably does need a little TLC.   :P

Cat, that AMZ guide was amazing... I don't know why I didn't find it earlier.  I'm not squeamish about anything (or at least I didn't think I was), but I have to admit that looking down at my leg and considering how it looked opened up is RIGHT GROSS! and I had to work up the nerve to look at stuff in detail.
Title: Re: Hopeful1's post-op!
Post by: hopeful1 on May 04, 2004, 08:16:43 AM
So, today, my knee is hairless!! I got over my squeemishness, and just did it!  Felt WEIRD!!!  Looks BETTER!! ;D

Can't wait to drive!  I am getting cabin fever like crazy!  I have been sitting out on the back deck with a nice view of the mountains, but it's not the same as playing in them!  I am sure it won't be long!!

Cheers  :-*
L.
Title: Re: Hopeful1's post-op!
Post by: hopeful1 on May 07, 2004, 08:14:54 AM
WHEW - finals are over!!!

I'd like to thank everyone for your ideas about how to deal with my insensitive prof.!  I saw her on Wednesday - my first day back to class (for the Final Exam - heehee).  I had forgotten the gruesome pictures, and I was kind of bummed about that, but it all turned out fine.  When I saw her, I was standing behind a high desk.  She came around the corner, took a quick glance down (I was wearing shorts), and said - "huh, there really isn't much swelling - didn't think there would be!". To which I replied "yeah, not much, it's gone down quite a bit..." as a awkwardly turned round to show off.  She yelled "Oh my Gosh - why is the back of your leg SO Bruised?" At this point, I sat down in a lobby chair, and propped both legs up on a small coffee table, to play show and tell.  Seeing my legs next to each other like that, her eyeborws shot up and said, 'WOW - I was wrong - your knee really is quite swollen"   -  DUH  - Then I showed her the "smile" scar over my TT, and she looked puzzled.  She said "why do you have a scar - this is always done arthroscopically".  I reminded her about the TTT, and said that my OS doesn't know how to saw a chunk of bone off my shin, move it over and screw it down with two inch long screws.   I pointed out the bruised hand-print on my shin where I was "man-handled". She looked incredibly remorseful, put her arm on my shoulder and said "you know, I was thinking you had some sort of MICRO-surgery, or something- this was NOT AT ALL like my husband had.  I had NO IDEA".  I'll take that as an apology!

Speaking of bruising behind the knee - has anyone else had that problem.  It's kind of hard back there too - not like swelling, it feels dense to touch it. It hurts more than my shin, at this point, but responds quickly and well to moist heat!  Gravity does wonders, huh?  

Hey - ROM = 65 degrees, and I've made it an ENTIRE WEEK with out puking!! Yeah for me! Yeah for you all!

L.
:-*
Title: Re: Hopeful1's post-op!
Post by: cat on May 07, 2004, 05:56:23 PM
I'm glad to hear your prof has a heart after all! ;D I don't know about the bruising. I had very little of it and certainly no hand print! :o Keep up with the ROM,
cat
Title: Re: Hopeful1's post-op!
Post by: Marie on May 08, 2004, 02:47:38 AM
Yay!  Oh what a wonderful story!  ;D  I hope your exam went well... glad that you seem to be doing a lot better.

Keep smilin'
Marie

P.S.  I STILL have bruising behind the knee, so I'm not sure if I can help you there.  If moist heat works, keep at 'er... probably gets the circulation going a bit better when you do that.
Title: Re: Hopeful1's post-op!
Post by: Sharon on May 08, 2004, 06:25:09 AM
I'm glad to hear that your professor is being much more understanding-now that she knows what you REALLY went through! I hope your exam went well! As far as the bruising behind your knee-I had the same thing after my TTT. My PT did some massage on it and even though it wasn't the most comfortable thing, it did help with the bruises. So that might be an idea to try. Anyway, keep up the good work with the ROM! It sounds like you're doing much better!

:)
Sharon
Title: Re: Hopeful1's post-op!
Post by: hopeful1 on May 08, 2004, 11:35:32 PM
Thanks fro the support!

Hey - I have another question (a concern, really).  I am not in PT, yet  - I start May 17 - but I was given DC instructions to get my ROM to 90 degrees before I start PT.  I don't really know how to effectively do that.  Right now, I just try to bend it, physically applying GENTLE pressure, letting gravity help, too -  a couple of times a day. It's get's REALLY hot and swollen when I do this, so I ice down before and after! I was doing OK the other day, but it REALLY hurt and it took about 20 minutes of continual bending, flexing, etc. to get it to almost 65.  I figure that's how it's SUPPOSED to go.  

Last night, however, I could only get to about 30 degress, and IT HURT - BAD!  Today I am at about 45, after a 20 minute struggle.  And IT HURTS BAD again.  Is this the way it goes?  I asked my OS's assisstant about it yesterday, and she said it's a "good day/bad day, two steps forward/one step back kind of thing".  I'll buy that, but I don't like this regression!  

Any hints?  I really am trying, but I'm confused. Is the pain supposed to be a limiting factor, or do I just tought it out and work through it.  Any other hints would be really helpful!! Is the icing OK - many years ago, they always had me in a hot whirlpool before doign ROM, but that was in the dark ages, AND it was about 3 months post-op, so I am not going to go by the past!!!

THanks guys!

L.

PS - I had a very emotional day, yesterday - loads of bickering, and accusations of being a junky, etc., because I "still" need darvocet at night. My guy, at one point, said he REFUSED to ENABLE me by picking up the re-fill of darvocet that my OS called in (I went through 30 pills in 17 days including the immediate post-op period --??) I lost it, threw a MAJOR tantrum about his brand of caring, and his mistrust, etc. It all worked out OK - we ended up talking aobut a LOAD of stuff that had to be hashed out (ie pain controll, controll issues in genereal).  It seems the kind of dependency stuff that happens with this kind of surgery REALLY throws relationships out of WHACK!!!

My point is -  I wonder if I am just tense, so my knee is, too??  
Title: Re: Hopeful1's post-op!
Post by: hopeful1 on May 14, 2004, 06:45:40 AM
UGH!! This ROM thing is frustrating, eh?

I've been spending a geat deal of energy focused on gaining ROM (though I don't really know what I'm doing).  I got back up to 60d two days ago, then couldn't put any weight on it, it was about doubled in size from sweeling, hot, constantly sore yesterday...you've all heard or experienced this, I'm sure.  I've been reading all the discussion boards, and it seems like I'm not alone in this kind of thing. Yesterday, I got to 30d with alot of patience.  Today I'm at 45d again, after much patience.  I also started back to work for a few hours at a time, and that may have added to the swelling.

I am starting PT on Monday (at 4 weeks post-op), and I am "supposed" to be at 90.  Well, THAT"s not gonna happen!  But I'll just keep on with the RICE, and doing heel slides, etc.  Wish me luck in PT - I haven't started, but I feel like I'm already a dissappointment

On that self-pitying note - (I think I need to take my own advice tonight!!!)

Cheers!

L.

:-/
Title: Re: Hopeful1's post-op!
Post by: Holly on May 14, 2004, 06:02:54 PM
Alright you, it's time to be as kind to yourself as you've always been to others here on this board! ;)

Listen, L...when I've been down and frustrated about pain, lack of progress with ROM (which I think really stands for "really outrageous mangling") and everything else, you've always told me to go easy on myself and to remember how far I've come.  You've reminded me that progress is two steps forward, one step back and it's the net gain that counts.  Well, I'm reminding you of that now.  You've done GREAT so far and you should be extremely PROUD of everything you've accomplished - not just with your surgery and recovery, but in your LIFE!!  We can all learn a thing or two from your example.

So imagine yourself getting lots of gentle, caring hugs from every one of us here.  You deserve them and you need them now.  Good luck in PT and TAKE IT EASY!  It will all come in due time.

Holly
Title: Re: Hopeful1's post-op!
Post by: cat on May 14, 2004, 07:57:46 PM
Hey Linda,
Don't worry too much about the ROM goal. I never met my therpast's goal of 90 by his deadline either and he didn't beat me up of kick me out of the program. ;) It just takes time and more of that for some of us. I think that swelling makes it harder too so just keep up with the magic RICE.

take care and stay positive,
cat
Title: Re: Hopeful1's post-op!
Post by: Marie on May 15, 2004, 02:30:52 AM
Hi Linda,

Ok, what your SO is saying is ridiculous... if I were you'd I'd be taking some pain meds BEFORE starting to work ROM every day.  This bending again is serious stuff, too, and the earlier the better.   Being in pain is just going to prevent you from being able to bend further.   And nooooo, you're not going to become a junky at this stage!!!  I'm willing to bet that the pain IS real and that there's no way you could ever describe it to someone else who hasn't felt what you're feeling.  You may need to take something to relieve the pain (even if it's half or a quarter of a pill) just to take the edge off when you're trying to increase your ROM.  For me it was VERY painful, and I took meds just before PT for the first 2 months following my TTT.  Both PT and my OS said this was perfectly fine to do... in fact, they told me to take something, but at first I wouldn't listen & tried to be the stubborn one for about a week.  Then I just gave in, and it really helped a lot.

At the stage you're at, you can try dangling the bottom of your leg off a table/bed/couch letting it just bend naturally from the knee, and if you have someone that you trust, you can have them hold your foot & gently move your leg through a small range of motion while you're in this position.  Other than that, I guess the exercises about in the "gym" section should suffice.  The ROM was a bitch to get through... I worked at it for 1-3 h (if not more) every day in the initial weeks following the operation.  Don't worry, you'll get there.  

Good luck.  You're doing well so far!  You've been through so much, so you should be proud for what you've accomplished with school & your rehab so far... Holly was right.  ;)  Give yourself a little slack!    

Take care,
Marie
Title: Re: Hopeful1's post-op!
Post by: hopeful1 on May 15, 2004, 06:25:21 AM
Thank you, Holly, Cat & Marie!  Your word of encouragement mean a lot!  It is hard to keep perspective in the middle of it! I know I can be terribly hard on  myself (hence, my motto is more like a mantra!!).  I do get terribly discourged, but I do need to "keep it real".  I don't think my OS's expectations are completely off base, but this guys is an OS for the olympoc ski team, and he is used to fixing hard-core athletes.  Me - I hike.  That's it.  No previous biking, running, etc. because of this silly, forgetful kneecap that did not read the users guide about staying put!!!  I think my lack of conditioning, my  terribly weak, dystrophic quads and nearly non-existant VMO just add to all this.  I can't really expect to be where the athletes are, I guess!  I just need to focus on being positive!  I don't know why that is so hard for me, right now!  I think I just have WAY too much time on my hands! I - like most of you, I am certain - usually just go at it!  I have a hard time without a HUGE, vastly important project looming over my head.  And now that classes are done until fall, I feel a void.

I need a project (besides worrying about all the things that cold be going wrong!!).  I'll work on that , and be nicer to myself - I promise.

Thanks again, all of you, for reminding to play nice!

L. ::)

PS- back to 65dg today!  That helped my mood a lot!
Title: Re: Hopeful1's post-op!
Post by: hopeful1 on May 21, 2004, 10:51:42 PM
YIPPEE for PT!!

FINALLY, after 4 weeks, I started PT on Monday, had three sessions this week!  Progressed from not even being able to figure out how to do a leg lift, to doing ten "eases".  My forgetful muscles are still too weak to acutally lift my leg, but I can hold it up and ease it down once someone lifts it up for me!  Went from 50 dg ROM on Monday (according to PT's measurements) to 74 dg by Thursday!  Now that I have much more effective means of increasing ROM, as instructed by PT, I am confident I'll get to 90 by next week!

I know that the struggle is just beginning, but I somehow feel more accomplished affter this week!  PT is the best, plus my therapist had a major ACL reconstruction a few years ago, so he's been through some of this drill.  That's really helpful!

Love to all!

L. :D
Title: Re: Hopeful1's post-op!
Post by: cat on May 22, 2004, 05:18:39 AM
Way to go, Linda! ;D
Keep up the good work and the great attitude!
cat
Title: Re: Hopeful1's post-op!
Post by: Holly on May 22, 2004, 05:41:28 AM
Hooray, Linda!

There's nothing better than a really good PT who's been through it herself and knows what it feels like! ;)  It feels soooo good to make some progress in PT and to discover new ways of working toward your goals, doesn't it?!  It's such a boost to the old morale and we can all use that.

You'll have good days, bad days and great days ahead...just remember to continue to be patient with yourself.  You're doing great, kiddo!

Hugs!

Holly
Title: Re: Hopeful1's post-op!
Post by: hopeful1 on May 28, 2004, 08:37:03 AM
Well - as always, thanks for the support!  PT is going ok, still.  The muscles are improving in leaps and bounds!!  ROM - not so much.  Promised myself I'd get to 90 by the end of the week, but, for some unkown reason, my knee sweeled up like a baloon on Tuesday, and delayed my ability to bend.  Got to 85 dg today, but with much efffort and pain - and right now, it's a balloon again!  MY PT and I can't figure where all this swelling is coming from. He teased that it's my advancing age (I turned 39 last weekend - HeHe). Well, it WILL eventually go down, but each week it continues to be swollen I get a little more discouraged.  My PT agrees that I "should" be much further along in my ROM, but he said I've made huge progress, considering.  Gotta take credit where it is due, I suppose!

Well, Cheers, everyone!  Is it me, or has it been raining just about everywhere???  I miss the sun
8)

L.
Title: Re: Hopeful1's post-op!
Post by: hopeful1 on June 07, 2004, 09:46:55 PM
Weeellllllllll....

I saw the OS this morning, and I am not sure if I am feeling better or worse.  He was VEYR kind and understanding, and told me that PT called him last week, and told him about the swelling and "popping" and "shocky" pain I get when doing ROM.  The OS prodded my knee a bit, agreed about the swelling, did passive ROM, and attempted to get ot "really bend".  He sais it felt WAY too stiff and "crunchy" and that he felt it was due to signifcant scar tissue.  He also said there is a good chance I have a mild synovial infection.  He does not want to do anything more until he gets in there with a scope ASAP.  He said he ground down two "huge" osteophytes, but that he may need to grind them down more, and clean up even more of the chondromalacia (grade III to IV "tri-compartmentally").  He was afraid to get too agressive with that clean up, as he was affraid he'd just dig into the bone.

I am scheduled for lyses of adhesions and MUA this Thursday.  He explained that his procedure is to first look around then clean up adhesions, then passivly bend my knee.  When he feels resistance, he'll go back and look for more tissue. He consideres it done when he is satisified with both the range and smoothness of motion.  

Afterward, I will have a CPM, NO weight bearing for 48 hours, then I'll start PT on Monday.  Maybe everyday the first week.

Honestly, he and his PA were so kind about all of this.  They were quite compasionate, and both said that PT should be uncomfortable, but the stiffness of  ROM and the pain I was feeling is a BIG red flag to look for scar tissue.  I've read a lot about MUA on this board, and that has helped.  My OS explained most of the sensations (bad quad pain, worse swelling post-op, etc), so I feel pretty prepared for this.

Anyone else have any hints????

L.
Title: Re: Hopeful1's post-op!
Post by: Holly on June 07, 2004, 10:18:07 PM
Wow, L, you and I are on the EXACT SAME PATH!

I'm going in 2 days (on Wednesday) to discuss the VERY SAME THING with my OS.  I have the same symptoms and, although I can get to about 115d active ROM in PT, I have tremendous swelling all the time, lots of severe popping and locking and a constant feeling like there is duct tape strapped across my knee cap and PAIN!  I just have no more patience with this and must go back to work, so I want the MUA and lyses (sp?) NOW so I can get on with my life!! >:(  I love my OS, but he's always telling me to be patient...that I'm pushing myself too hard.  That was O.K. in the first few weeks, but now I really have to get going!  My husband is about to lose his job (the end of June), and I can't AFFORD to be out of work any longer! :o

Aaanywaaay...You'll be having your procedure before me, I'm sure, and I wish you the very best of luck!  I'm sure it will go well and that you will have great results.  I have read a lot about this procedure, and I think it will really address your problems.  Remember, though, that this IS another surgery.  Make sure that you have people to help you and that you give yourself permission to TAKE IT EASY!

I'll be looking to hear from you post-op...and sending you lots of warm, gentle hugs and best wishes!

Holly
Title: Re: Hopeful1's post-op!
Post by: Heather M. on June 07, 2004, 10:59:43 PM
L and Holly,

Go down to the soft tissue healing problems section, which is where the scar tissue sufferers lurk.  You can do a search on 'lysis of adhesions' and 'scar tissue surgery' and you will find at least 5 very long threads.  

I just urge you to go slow and be patient.  Scar tissue does NOT respond well to being pushed.  In fact, usually that is the WORST thing you can do.  Unfortunately, arthrofibrosis (excessive scar tissue) is a very rare condition.  Less than .05% of knee scope patients develop this condition, so not a lot of doctors have had experience with it.  It's important to see a doctor who has dealt with the scar tissue before.  Most OS's would do a manipulation, which isn't necessarily the most effective way to take care of the adhesions.  I'm encouraged that both your doctors are doing the scope first, then manipulation--that is a much safer way to do things, and more effective, too.  The trick now will be to make sure that your adhesions don't return.  I had 4 surgeries before we found the right PT regimen (and new doctor!) that prevented the adhesions from coming back.

However, most people develop scar tissue because of traumatic procedures like the ones you both have had, and so they are usually okay after the lysis of adhesions.  I have a genetic problem with forming too much scar tissue, so it's tougher in my case to keep the stuff from coming back.  In all cases, it's important to remember that the PT after is just as important as the surgery itself--if not more so.  Please follow the doctor's instructions regrading being non-weight-bearing--I was on crutches for over 5 weeks last time, because every time I tried to put more weight on the knee it ballooned up and really hurt.  The gentle, non-weight-bearing and passive PT stuff is vital to getting the knee ROM back without forming more adhesions.  The rule of thumb is to get the ROM up and swelling down, then SLOWLY add in weight-bearing activities.

Anyway, go down to the scar tissue section and read up on the condition called arthrofibrosis.  It can cause a lot of permanent damage, so you two are lucky that your doctors are addressing it quickly.  My OS waited over 5 months (doing conservative stuff the whole time) before he went in again with the scope and found a TON of scar tissue.  He kept saying "I've never seen anything like this," and that should have been a warning to me!  I finally got in with a doctor who does lots of work with scar tissue and has written several seminal articles on dealing with arthrofibrosis and keeping it from returning.  Unfortunately, by then I had permanent and irreversible changes in my patellar tendon, which has led to bone on bone contact in my knee.  I'm so glad that both of your OS's are dealing with things proactively!

Take care and be sure to ask questions.  There is literally days worth of reading on scar tissue in the soft tissue problems section, so don't be overwhelmed.

Heather
Title: Re: Hopeful1's post-op!
Post by: hopeful1 on June 07, 2004, 11:21:44 PM
Thanks, Holly and Heather!

I feel pretty confident with my Dr.  He was aware that I had a problem with my last surgery, so he had said early on that if I was "still stiff at all, and not to AT LEAST 90 by 6 weeks", he was going back in .  He admitted that he's only had a couple of patients get "frozen", but he said he just had the feeling after my surgery that he'd have to go back in, so he's already consulted a few "sepcialists" about scar tissue, and feels confident in his treatment.  I appreciate his honesty and his pro-active approach!  He said he did not even want to wait another week.  He believes in using techonolgy to the fullest, and in being agressive with treatment.  AMEN! I am just so surprised he wnats to do it THIS WEEK!!!  I don't have much time to prepare!  And, wouldn't you know it - I have promised to write an article for my boss - due by Monday.  Grrrrr.  He said I have time to get it done before Thursday!!

I have been reading the threads since my PT mentioned it a week or so ago.  I am AWFULLY discouraged, but I am SO GLAD that my OS and his PA were kind, and not at all judgemental.  They were both hopeful, but "matter-of-fact" about it, and the OS was almost appologetic, as he hoped he wouldn't have to "go back in ". :-/

I DO have a BIG case of the blues (still), and am trying not to label myself as a failure.  My boyfriend is being more supportive, and optimistic so far - he knows I was TERRIFIED of having to get a second scope!  He's been through this before with me, now, so he knows what to expect.  He requested that I get a spinal instead of genreal anesthesia!!  If you recall, I PUKED all over my car and HIM, and he had to clean it up!!  HeHeHe!!  I told him he has to be extra-nice, or I'll do an encore!!  :o :P

Hopefully yours,

L.
Title: Re: Hopeful1's post-op!
Post by: Holly on June 08, 2004, 04:42:00 PM
Heather:

Thanks so much for you advice and recommendations for further reading!  As it happens, I have been reading up in that section about arthrofibrosis and all the threads concerning lyses of adhesions and MUA's because, although I have had many surgeries, this is the first time I've been "frozen."  I figured it was because of the extensive nature of this particular last surgery.  Even though my OS and my PT were pleased initially with how far I was coming with ROM, and certainly with how HARD I was working at it, I haven't progressed more than an additional 5-10d in ROM over the last month and that is a "red flag" to both of them.  I do nearly 4-5 hrs A DAY of PT, both at home and with my PT, and it is quite gruelling and painful, but seem to have hit a standstill no matter what anyone does.  That's why my OS is talking about scoping out the scar tissue and possibly doing the MUA.

Last night in PT, I had a long talk with my PT, Kim, who is absolutely WONDERFUL!!! ;D ;D ;D  She cautioned me about the possible consequences of MUA, the ligament and tendon issues, her belief that some doctors use it as a "fix-all" rather than using it in conjunction with a scope, the fact that it is not without a somewhat painful rehab and that rehab is PARAMOUNT to the success of the procedure (as you said, Heather).  Kim is probably the most knowledgeable PT I have EVER worked with and I wouldn't be as far as I am without her. (Not to mention she's the sweetest woman ON EARTH!  She can actually make me laugh when I really want to SCREAM :o)

Anyway, I feel pretty well prepared for the whole thing, and actually WANT to go ahead with it and hope my OS will schedule me SOON!

Again, Heather, thanks so much for your wonderful words of wisdom.  And Linda, a spinal sounds like a good idea - that much puke sounds pretty awful!  Be sure you get sufficient pain meds to handle things post-op and to h*ll with what the boyfriend thinks about that (if I remember correctly, he's given you some sh*t about that before!)  You take very good care of yourself, and make sure he does too...or I'll come down there and kick some *ss, even if I have to do it with just my one good leg! ::) ;D ;)

Love and hugs!

Holly
Title: Re: Hopeful1's post-op!
Post by: hopeful1 on June 08, 2004, 11:55:21 PM
Oh, Holly - what a great memory!  YES - I had a LONG chat with the guy about the medication issues.  He is actually worried about me, but just has a sort of backward way of showing it!!  I gave him the choice of 1) staying off my back about meds or 2) CONTINUAL back foot rubs for me, while he listens to my cry about the pain.  He is opting for #1.

He wonders what the CPM what will like...where it will go.  That is a good question.  Can that thing be set up on a couch??  Is it loud??  Will I have to sleep alone for awhile??  I should have asked the OS yesterday, - but I was SO STUNNED by the proposition of a second scope!!!

L.
Title: Re: Hopeful1's post-op!
Post by: Holly on June 09, 2004, 12:07:59 AM
Hi Linda...of COURSE I remember, you had such a hard time!

Anyway, the CPM (at least the one I have) is about 4 feet long and about 1 foot wide and you CAN set it up on your couch.  You can also set it up on your bed, which is what I did in the first couple of weeks after my surgery when I wasn't ready to be downstairs among REAL PEOPLE quite yet.  You have to be able to plug it into a socket, and it has a little "remote" thingy to adjust ROM (flexion/extension), which I upped each day by 5 degrees flexion.  Mine was VERY QUIET and I had to be on mine 8 hrs a day, so I did it in 2 hr. shifts 4x a day.  Since I was VERY TIRED (and somewhat drugged), I was able to sleep through some of the shifts - had someone wake me up when my "shift" was over.  When you get into the higher degrees of flexion you DEFINITELY CAN'T SLEEP, since you're really feeling the PUSH - but that's later on.  So...no, you don't have to sleep alone if you don't want to.  My husband wouldn't sleep with my after this last surgery...but that was because he was afraid he'd "snap me like a twig" (you remember, I had that awful double osteotomy - tibia and femur right leg...my hubby's a BIG GUY...so on and so on...), but he finally came back to cuddle me and "you know" about 6 weeks ago.  WOO-HOO!!! ;D ;) ;D

Aaanywaaay...the CPM is a wonderful thing.  You don't have to work so hard, and your knee is kept moving so you don't build up scar tissue all over again.

Talk to you soon!

Hugs.

Holly
Title: Re: Hopeful1's post-op!
Post by: Heather M. on June 09, 2004, 01:46:59 AM
Linda,

The CPM will be a lifesaver.  The usage has varied from doctor to doctor.  Here's what I was instructed to do--keep in mind that other patients of the same doctor had different regimens as well!

I was told to stay in the CPM whenever I was not in the shower, eating, in PT or on the way to PT.  I figure I spent 18-20 hours a day in it.  I slept in it all night, and had to ask my doctor for Ambien to help me stay asleep--otherwise it just wasn't an option.  With the Ambien, I slept 8 straight hours in the CPM without any problems, pure unconscious bliss.

When I was awake, I was told to keep the CPM at 0-70 degrees.  While sleeping I was told to set it to 30-70 degrees, because the motion was more important than the range.  *Keep in mind,* however, that I had 135 degrees of flexion the day after my surgery, and got to 145 within a week.  My extension from the time I woke up was -2 (not that CPM does anything for extension).  Again, my OS stressed that the real benefit of the CPM was for flexion (it keeps bands of scar tissue from forming and reducing bend) and for stimulating the production of synovial fluid and lubricating the knee, keeping it loose and limber.

The other things I did to keep the scar tissue from coming back included:

1.  patellar mobilizations--these are critical
2.  ROM work including CPM, wall slides, towel exercises, recumbent bike with 0 resistance
3.  Delayed strength training--only straight leg raises and quad sets allowed.
4.  formal PT within 2 hours of waking up from surgery (UGGH!)
5.  PRO-ACTIVE PAIN MANAGEMENT (this is critical), along with other medications like Advil or Celebrex.  Others got cortisone, but OS refused to use it on me  :'( because of previous infections.
6.  ice and more ice--get a Breg Polar Care unit and keep it stocked.  You can control the temp of the water and keep cool water moving around the knee around the clock at the beginning.
7.  being completely non-weight-bearing for over 10 days, then on crutches for 5 weeks.  Every time we added a bit of weight-bearing, the PT and OS were all over me checking for increased swelling and pain.  If I had these, it was back on crutches.

You can find a lot of stuff in my posts from after the last surgery--I put a lot of details there.  Janet also has great info in her posts, as do Soccermom, Sarah, Jennifer, Margaret, and I can't remember how many more post-op threads there are.  There is so much good information there.

Anyway, back to the CPM--it's a lifesaver.  It absolutely makes all the difference in the world in my opinion.  Last time I had it for 4 weeks, and the only reason I gave it up was I returned to my home state and had to leave the unit in Colorado.  I called the CPM the "Rack of Death" and "the Torture Rack" but it really helped.

Heather
Title: Re: Hopeful1's post-op!
Post by: Holly on June 12, 2004, 12:48:10 AM
Linda? Are you back?  Are you O.K.?

Hope your MUA and lysis went well...

Heather:  Thanks for the detailed advice for post MUA and lysis care...I think it will really help.  I saw my OS yesterday, and he went ahead and scheduled my surgery for Monday (3 days from now).  While he's "in there," he's going to take out my tibial screws.  I've never been unscrewed before - this should be fun! ;)  Anyway, he knows I want to be back at work in about 3 weeks and he thinks I can do it.  I'll be having PT 5xweek after this op, a CPM at home, and doing lots of praying and finger crossing.

Not much else I can do, since I'll be the only breadwinner come July...

Wishing everyone great knee days and happy recoveries!

Holly
Title: Re: Hopeful1's post-op!
Post by: hopeful1 on June 12, 2004, 07:09:14 AM
So, I did it!

I posted a brief update on my other thread, but thought I'd post an up-date here.

All went well with the MUA, I guess there lots of adhesions, but not a ton of scar tissue.  That's curious to me, because I thought scar tissue formed the adhesions???.  Pain control is GREAT!  CMP is great, too!  I like the slow rhythm - it feels  very soothing - ecept for the little while after I've increased the flex.  I am -5 and 70 dg.  I am to do this about 6 hours a day - more if I can take it.  ALso I am to increase the flexion by 5 dg/day, tiny bit more, if I can tolerate it.  On my own, I get 60 with NO problems or stiffness (that right there is a HUGE difference.)  I have not tried to push it yet, but will by Sunday!!

Thanks to all of you for your support!!

Linda
Title: Re: Hopeful1's post-op!
Post by: cat on June 14, 2004, 01:30:15 AM
 Linda,
Glad you're back and doing well.
;D cat  ;D
Title: Re: Hopeful1's post-op!
Post by: hopeful1 on June 15, 2004, 05:57:31 AM
THANK YOU THANK YOU!  To ALL of you who answered questions about CPM, MUA and infections. And thanks for all your prayers!

I went to my first PT session after the MUA.  I got to 85 with NO problem or stiffness, and to 100 with my own force, and encouragement from PT.  What a huge difference!! I can move my knee so freely now!  PT didn't want to push it today, because it did start to get warm and swollen, so we stopped, and iced!  I am now plugged into the CPM, with my cryocuff on!  And in about ten minutes, the mepergan will kick in and I'll be off to mars! HeHe.

My OS wants me to be weight bearing ASAP, but I find I get pretty swollen when I put even a little weight in it.  I am choosing to take Heathers advice and keep the weight off.  I am WAY more concerned about ROM, and will deal with proper walking later!

Flexibly yours,

L.



Title: Re: Hopeful1's post-op!
Post by: Heather M. on June 15, 2004, 11:56:22 AM
L,

You may want to talk to Jennifer about the weight-bearing as well.  She's one month post op for lysis of adhesions, and I'm not sure if she's walking on it yet or not--I don't think so.  I'm sorry you're getting swelling if you put weight on it--is the increase noticeable, or is it more of a difference in the way it feels?

All in all, it sounds like you're doing much better than before the surgery.  I know it's hard to figure out what to do with all this advice and stuff--some of it contradictory.  I know Jennifer is having PT at the same exact place I did, for the same surgery, yet our protocols have been quite different.  The common denominators have been focus on ROM, passive exercises (i.e. seated or lying down, no resistance), and non-weight-bearing on crutches  But you should definitely talk to your doctor and most importantly, listen to your body.  I think you're really in tune with it--it takes a lot to recognize that PT isn't working and push for answers to the questions you have about that.

Keep it up.  And I'd really be interested in knowing the pain level comparisons between osteotomy and lysis if adhesions...I may be facing an osteotomy to deal with the mechanical changes scar tissue has caused in my knee (how ironic is that--you get scar tissue from a TTT, and I may need a TTT to fix the damage the scar tissue did!).

How's the SO doing in terms of supporting you?  Hopefully you two have worked it all out.  We won't talk about things like pets....

Heather
Title: Re: Hopeful1's post-op!
Post by: Holly on June 15, 2004, 06:09:26 PM
Hey Linda!

I've been so excited to read about your post-MUA progress!  It sounds like you're really moving along well and taking very good care of yourself...listening to what your body needs and not worrying about meeting anyone's pre-set expectations.  I agree with you about taking care of the ROM issue first and foremost, since that was the reason for your MUA in the first place.  You'll get to the walking in due time!  Like you, I've relied quite a bit on Heather's great advice on this issue, and even printed out the post-op procedures she followed so I would have it handy when I got home yesterday.

I hope you are as proud of yourself as I am proud of you.  I know you've had a very rough go of it, but you've stuck it out and persevered and look how far you've come!  I've always said that I didn't want to just be a survivor...I wanted to be a PREVAILER!  And now I have you as an example to follow.  Keep up the good work, and I'll try to do the same! ;)

Just for laughs, did I tell you about my screw removal joke and my incredibly HOT orthopedist?  I'm always kind of flirting with him (I can't help it...he's really THAT HOT!).  During this surgery, he was also going to remove my 2 tibial screws so I told him I'd never been "unscrewed" before and wondered how that would feel? (wink, wink!).  Apparently, he told my husband while I was in recovery to ask me if I enjoyed "unsmoking" a cigarette afterward! ;D  Thank god he's got a good sense of humor!

Be well, honey.  Hugs!

Holly
Title: Re: Hopeful1's post-op!
Post by: cat on June 15, 2004, 10:01:00 PM
Holly,
You crack me up! That' s hilarious!  ;D ;D
cat
Title: Re: Hopeful1's post-op!
Post by: hopeful1 on June 15, 2004, 10:44:31 PM
Holly, you tell some great stories!  

So, today I'm pretty swollen!  Must have over done it yesterday.  I woke up twice in the night, needing pain meds.  Bummer.  It has taken a few hours on the CPM to get back to 80.  Oh, well - I STILL better of than before!

The SO has been supportive, in that he is just staying out my way.  I REALLY lit into him for taking the CPM control away from me.  He is worried that I'll have to have another scope.  Under it all, he believes is helping me, and looses sight of what is important to ME (like pain control - or just control in general). He is still worried about addiction, especially now, since this new stuff WORKS.  And I've noticed I behave differently on this stuff - more like I'm drunk.  If I'm not sleeping, I am sort of "chatty", I slur my words and have trouble following a conversation.  I know that scares him.  I think it also bugs hime that our hose looks more like hospital now.  We live in a small 3 room  duplex, with 2 bedrooms an open kitchen/living room.  When you walk in the door, you see the CPM and Cryocuff set up on one of the couches.  It's GOT to bother him!  Also, he took last friday off to take care of me, and his office was closed yesteday, so he was here 4 days with only a few hours out to hit the mountain bike trails.  He is back to work today, and I am sure he's relieved!!;)  I know I am!  :o

Going mobile,

L.
Title: Re: Hopeful1's post-op!
Post by: Gab on June 16, 2004, 05:49:11 PM
Quote
During this surgery, he was also going to remove my 2 tibial screws so I told him I'd never been "unscrewed" before and wondered how that would feel? (wink, wink!).

(http://forums.clubsi.com/images/icons/laugh1.gif) haha were you all drugged up when you said that!?

Glad you're doing good Linda :)
Title: Re: Hopeful1's post-op!
Post by: Holly on June 16, 2004, 08:31:35 PM
Hey guys!

No, actually, I wasn't drugged up when I said the unscrewed thing...that's just how I am! ;D

Linda, sorry the pain has been so bad for you.  I can really relate, though.  The night I got home (Monday night) I was really struggling, I guess.  Even got up to take pain meds, which is unusual for me.  The next day in PT, my husband even told Kim that it was the worst he'd seen me including after the double osteotomy - that I was moaning in my sleep and everything!  Of course, after the osteotomy I was on oxycontin for a week, so I'm sure I felt a LOT less pain!  Anyway, today it's MUCH BETTER and I really feel it was worth it - I'm glad you feel that way too!  It's awful to have gone through a surgery and then wonder if you did the right thing. ???

I know you've had issues with the SO about your pain meds...but it sounds like he's managing to at least keep it to himself this time.  You know it's important to stay ahead of the pain so you can do the work necessary to maintain the ROM you had the surgery for!  Try to keep Heather's good list of instructions handy - and show it to your boyfriend if necessary.  When my husband thought I was overdoing it (he ALWAYS thinks I'm overdoing it!), it helped me a lot to show him the list.

Hang in there, my friend.  You can do it.  All of your fellow kneegeeks have faith in you, honey!

Hugs, hugs, and more hugs!

Holly
Title: Re: Hopeful1's post-op!
Post by: hopeful1 on June 17, 2004, 10:36:40 PM
Thanks for your words of encouragement, Holly!

I had my second PT visit last night, got to 105d, and went on the recumbant bike for a little while.  That was pretty exciting to me!!  unfortunately, I have stepped back today.  I could not get my knee to BUDGE past 60 this am.  After creeping up the ROM on the CPM, icng and pain meds, I can get to 80.  WHAT IS THIS??? It really isn't more swollen, though, and doesn't hurt more than it did, it is just incredibly stiff!!

I have my post-op visit this afternoon, and I was hoping to impress my OS!!  I may have over done it, yesterday.  Anyone have any hints???

I have another concern, that I will address with my OS this afternoon, but I am wondering if this happens to everyone else...  The problem seems to be circulation in my knee.  Someimes, seeemingly out of the blue, it turns a ruddy, mottled color from mid-thigh down.  My toes, in fact become a deep shade of purple.  It has slowly worsened over the past few weeks.  It ALWAYS happens after doing ROM.  In fact,  The reason I usually need to back off on ROM is because my foot falls alseep - feels completely numb.  I think is is beacuse I am not activily using my leg muscles, so they don't contract and don't pump the blood in my velns.  Any one else have this problem??

Thanks!

L.
Title: Re: Hopeful1's post-op!
Post by: Heather M. on June 17, 2004, 10:47:27 PM
L,

Having color changes is not surprising at all.  One of the definitions of a knee with scar tissue is one that turns red, purple, mottled, or warms up with any activity that the patient does.  Scar tissue can also affect circulation.  You must talk to your surgeon about the foot numbness.

As for not having swelling--I hate to tell you, but it takes a LOT of fluid in the knee capsule before it starts to actually bulge out.  When you have visible swelling, that means the knee is truly inflamed.  But you can have swelling intra-articularly and not show a lot of external signs of swelling.  Internal signs can be picked up on an MRI, or you can palpate the back of the knee and usually feel a tautness there.  And as you know, swelling can cause all kinds of insanity in the form of popping, quad inhibition (leading to mal-tracking), pigment changes and palpable heat in the knee, and so forth.

It does sound like you overdid it, and it's a bit disturbing that you can't bend past 80 degrees.  90 is usually the milestone.  HOWEVER, it is often expect that the patient will LOSE SOME ROM after having a manipulation or lysis of adhesions.  Sometimes it's just the way the knee goes.  So when that happens, and you get swelling, you go back to the basics--walking with crutches and no weight-bearing, wall slides, CPM for as long as you can stand it at a setting that is intense but NOT painful, patellar mobes, and all of the passive work that the PT has you do.  Passive meaning you don't use your own muscles or force to achieve ROM, but instead let gravity do it (wall slides) or have someone very gently bend and straighten without use of your muscles.  This can be done by PT or CPM.

Hang in there, you are only a couple of days post-op!  It took weeks for your knee to get into the state it's in, so please don't lose your positive, can-do attitude, okay?  And just keep in mind what I told Holly--not everyone responds well to the standard knee protocol, so please talk to your doctor about tweaking for your particular case.  The focus is gentle ROM and NO SWELLING, so talk with your doctor about how you can achieve those.  I know you can do it.

Also, keep in mind that you've just had general anesthesia, so your body is going to be tired, your mood may be blue, and you will get frustrated quicker than normal.  Understand this and go with it.  Cry if you want.  Just keep doing gentle, non-irritating exercises and you will ride out this rebound swelling and pain.

Take care and keep posting.  I find it unbelievable that you and Holly could both be having such bad problems at the same time, so let's be optimistic and assume that this is a NORMAL part of the 3 steps forward, 2.8 back that we see with scar tissue, okay?  Hang in there.

Sending you good vibes from the land of positive energy (no joke--look up Sedona AZ on the net!).

Heather
Title: Re: Hopeful1's post-op!
Post by: hopeful1 on June 18, 2004, 06:39:27 AM
Thank you, Heather!  You are such a wonderful resource!

I saw the OS, and - after complaining this morning, because I couldn't get much past 60 - I bent my knee (all by my legs own strength) to 95 without so much as a wince!  GO FIGURE!  Got the stitches out, reviewed what happened in OR.  They (the PA & OS) showed me a couple of pictures they took.  Apparently, most of my knee was pretty clean, except a BIG wad of scar tissue glueing the inside , top part of my patella to my femur.  The before picture was one mass of lumpy cottage cheese.  The after was 2 distinct smooth shapes.  That was the only spot of scar tissue they found, they say.  :o

They are encouraging weight bearing, and want me off crutches "ASAP".  The PA did stress, however, that if ANY warmth or swelling occurs after weight bearing, or exertion of any kind, I am to STOP, Ice and elevate.  Then go back to the last activity that did NOT cause swelling, and try to advance in another few days.  So, while they said to get rid of the crutches ASAP - they expect that I'll be without crutches by my next visit in 3 weeks.  

CPM will continue until the next visit. 6 to 8 hours for the next week, then down to 4 - 6 hours for the next two.  Also, if I can arrange transportation, they'd like me to have PT 4-5 times/week.  Since I am still not driving, and my SO works, that may not be on option (the PT is only there until 5 p - so the last appt is 4 pm).  

All in all, I am progressing.  The blues are easing up, too!  I have a bad habit of foreseeing the worst thing that could happen - I really have to cut that out ;)


Cheers!

L.
Title: Re: Hopeful1's post-op!
Post by: hopeful1 on June 20, 2004, 10:54:32 PM
Hmmmm- I keep reading all these posts about the emotional roller-coaster, and How progress is often 2 steps forward, one step back...it is still is hard to accept day in and day out!

I did 2 loads of laundry, and walked around the kitchen island once with ONE crutch to support me.  I felt SO proud.  I still did about 5 hours on CPM, and went to bed, feeling great.  I woke up on hour later, with a throbbing knee - needed a MAJOR pain pill!  Two hours later, needed another one.  This morning, couldn't get past 45 dg, knee is HUGE!!!!  After four hours (with a a few potty breaks) on the CPM, slowly inching up , I am at 80. (yesterday I was at 95).  Icing as much as I can stand - NO weight bearing, and  "taking it easy".  UGH!!!!!! >:(!!!!!

So - I am trying hard to keep perspective, and hope that I haven't lost any serious ground.  I vented to my SO, and he said "I think you just stick to the couch, get doped up and crank the machine up as high as you can stand!"  Kind of a shocker coming from him, but he's right.  So, I am waiting for the words to blur, and the pain to subside, so I can get some of my lost ROM back. :-/

Trying...

L.
Title: Re: Hopeful1's post-op!
Post by: hopeful1 on June 22, 2004, 08:55:04 PM
Well...

Saturday was a blur!  I worked HARD on the CPM, and did WAY more ROM than I usually do.  Even though I said i was going to take it easy, I didn't.  In fact, I really worked my knee hard - after I popped a pain pill or two.  Went to bed with it throbbing, again.

Here's the curious thing - I woke up with LESS swelling and WAY more ROM.  I rested on Sunday, still following my usual CMP/stretch/ROM/take a break/Ice/repeat routine, but not pushing hard with ROM.  Got the CPM machine up to 105, with NO problem!  I felt like I made great strides with my ROM, too!  I can't figure an effective, acurate way of measuring ROM at home, but I guessed it was past 100d!

PT yesterday - 115d, with NO PROBLEM, just a little time.  My PT was so impressed, we just did other stretching, (calves, ITB) rather than dig in hard at the ROM.  I got on the recumbant bike for about 7 minutes.  I had to lift my "cheeck" off the seat to get my darn leg aorund, at times, but it felt GREAT!!  

My PT said that I may make better gains if I do HARD ROM work several times a day (like I did Saturday), and push my knee to the limit on days I DON'T go to PT, then basically rest and save my energy for PT on PT days (I go M-W-F).  Has any one else had this same experience?  I had sort of been doing it the other way around.  Saving my energy for PT.  

Also, I am wondering about this pain. It is pretty bad - I still need a couple of darvoect during the day, and I need Mepergan at night - because the pain is predictably awful at night.  I ALWAYS wake up in the middle of the night in pretty bad pain, requiring a pill.  Nighttime is the WORST! In fact - just the SHEETS touching my knee at night can cause a LOT of pain!  And, sometimes, I opt for shorts over pants, becuase the cloth sometimes hurts my knee. The OS and PT both tell me that MUA's are notoriously painful, and they are not surprised at my consumption of pain meds.  In fact - everyone is encouraging me to take MORE - around the clock, so I make sure that pain is not a limiting factor.  I agree that I should take a pain pill, and get moving, rather than lie still on the couch in pain.  But still - it's been almost 2 weeks.  

Well, must get "plugged back in".  I'd be interested to hear about pain levels from other MUA grads!!

Smoothly,

L.
Title: Re: Hopeful1's post-op!
Post by: Heather M. on June 22, 2004, 09:30:21 PM
L,

After I had MUA and Lysis of Adhesions for my frozen knee (less than 90 degrees ROM) the pain was relentless.  The more I worked the ROM, the more it hurt.  I was also encouraged to take meds around the clock and keep moving.  Sometimes, ROM work can actually help the swelling--when you're not producing a whole lot of new inflammation, you can actually pump the old stuff out by bending and straightening.  A lot of people with big knee surgeries find that their swelling doesn't go away fully until they are walking and bending almost normally.

Of course, when the swelling interferes with bending it's another issue entirely.  I think as long as you are not feeding the severe swelling--as long as pain is the only complaint and you are progressing--you should probably keep working on the ROM as your PT says.  And I mean aching pain afterward, maybe a tightness during.  Don't crank on your knee until it goes POP! and you get 15 more degrees...I've done that, and it's not recommended!

So I guess I would say as long as you are struggling to regain normal ROM, pain is to be expected and fought with everything you have!  Meds, ice, elevation, rest, CPM, an ace wrap if you have to go somewhere, etc.  Don't let fear of pain meds keep you from regaining your ROM.  There is literallly nothing that I've done that's more painful than recovering after the scar tissue has been debrided and trying to get ROM on a frozen knee.  Nothing.  I had a laparascopic appendectomy go to open laparotomy in about 10 seconds when my surgeon severed a major artery--the mesenteric artery.  It took 2 hours to get my bleeding under control and suture the artery together again, pull out all the abdominal organs (EWWW), sponge them off, put everything back, and irrigate as much blood as possible out of my abdomen.  I had peritonitis by the time they got to the surgery, so there was infection in the peritoneal cavity.  I had a 7 inch vertical incision from belly button straight down...and the pain didn't come NEAR to recoverying from knee scope for scar tissue.  Not even close.  It was more than a month before I could get out of bed using my abs, but still...it was nothing compared to my knee.

So don't be shocked, surprised, or dismayed at how rotten the recovery is.  Be glad that your PT and OS are supporting you instead of undercutting you...I've had that and it's no fun.  My first OS cut off my pain meds because he didn't believe my knee could be as painful as I said it was.  The next time he got in there, he was appalled.  He even apologized to me in post-op, if you can believe it!!  Said he was sorry, he hadn't understood what was going on in my knee.  My second OS said he'd expect me to take pain meds around the clock for about 10 weeks post-op, and then still need them for PT after that.

Hang in there.  It will get better, I promise.  You just have to keep pushing, doing the supportive care (pain meds, ice, elevation, etc.), and you will get through the Why the Heck Did I Do This to Myself phase, trust me.  It lasts a good long time, but there is a light at the end of the tunnel...and it's not the headlamp of an oncoming train.

Keep the knee working, and as long as you are making advances without massive heat or swelling, you are on the exact right track.

Heather
Title: Re: Hopeful1's post-op!
Post by: Holly on June 23, 2004, 05:27:33 AM
Oh yes, the pain meds issue!

My OS does not believe in prescribing them much...I get 30 tylenol with codeine for 15-21 days.  That means I can take 2 or fewer a day.  I'm a tough lady and don't really WANT to be on the meds, but like Heather says, this has been the most painful surgery I've ever had - worse, I think, than my double osteotomy.  It seems upside down to me, but that's how it really feels.  And when I see him tomorrow, I KNOW he's not going to want to prescribe any refills because it will have been 10 days since the surgery and I SHOULD STILL HAVE SOME LEFT.  Believe me...I don't...and the yesterday and today have been HELL as a result.  It's just that I've been so eager to get off them in the past, that I can hardly believe how badly I need them this time, and I'm afraid to really PUSH for them when I see the doctor tomorrow.  I'm afraid of how it will look to him.  Like I'm addicted or something - which is probably impossible after only 10 days, but what do I know?

Heather, as always, you are an amazing source of information and inspiration.  I think all OSs should take a course from you in how to counsel patients and how to listen to their fears and frustrations - and then how to give ENCOURAGING suggestions and advice!  Thank you, thank you, thank you!!! ;D ;D ;D

Linda, I've always done that "work the knee hard on days I'm NOT going to PT, and take it easy on PT days" plan.  I figure Kim will practically kill me in PT, so it's up to me to kill myself on those other days.  Like you, I go to PT on Monday, Wednesday and Friday.  Also, I'm glad your SO seems to have finally gotten the right idea and is being supportive of what you need to do to get your knee back.  Sometimes guys really can locate their brains, dust them off, and use them! ;D

Hugs!

Holly
Title: Re: Hopeful1's post-op!
Post by: Heather M. on June 23, 2004, 05:58:52 AM
Holly,

If one of your children or your husband or your best friend were in exactly your situation with respect to the painful recovery and the supply of pain meds running low, what would you tell them?  If you were with them in the room with the doctor, what would you say to the doctor if he balked at refilling the meds?

So when you see the doctor tomorrow, pretend that you are someone else and defend yourself and stand up for yourself as vigorously as you would your children, okay?  Explain to the doctor (I did this as well) that you went off pain meds after a freaking osteotomy because you didn't want to take them, and yet this time you need them or the pain keeps you from working on ROM.

Hopefully, your OS will just pick up on the fact that you've been working hard and will refill the meds with no questions asked--and more than a measly 2 pills per day.  Furthermore, you should NOT let them run out.  You shouldn't stop taking them suddenly because it can make your pain rebound--and it can make you sick, as well.  

Good luck and let us know how it goes.  Believe me, I've been there with the clueless OS...this is the same guy who said a lateral release was 'no big deal' and that I'd be back at the gym in a month.  HAH!  I'd like to perform the surgery on HIM and see HIM back in the gym in a month.  And cut HIM off pain meds when his knee is frozen and can't bend and heats up enough so that you could toast marshmallows on them....don't get me started.  Injustice and indifference to suffering really pisses me off!

Heather
Title: Re: Hopeful1's post-op!
Post by: hopeful1 on June 23, 2004, 07:14:42 AM
WHEW!

What a relief! I mean -  I am sorry anyone EVER has to go through this- but I don't feel so alone in this incredible pain thing!  

Holly and Heather, thank you SO much for your support!  It reall helps me get through this!

I keep hoping that each day is better - and it is, from an ROM and functional capacity.  But the pain is NO better.  In some ways, it's worse - as my mobility and function improve, I do more.  I do more, I hurt more.
Things really are OK with meds on board, but I get incredibly LOOPY!!!  Tonight, for example, I had my frist night out in a long time.  WOW- we went to a deli downtown, and didn't carry out.  I was brave, and ATE THERE! HeHe! Idid fine - but laughed too loud.  And I had the really odd feeling that my leg was still  -S-L-O-W-L-Y- going from -5 to 110.  It was sort of, like a dizzy feeling.  :P That happens when I've been on the CPM for more than 1 1/2 hours at a time!  ::)

I'm elated to have gone out tonight, but am paying for in throbs!! Must ice!!

Dizzily,

L.
Title: Re: Hopeful1's post-op!
Post by: hopeful1 on June 28, 2004, 11:37:35 PM
So,  I posted my success on another thread, and wanted to give a brief update, and vent about healthcare prioviders!!

My knee really is doing GREAT, as long as I take Darvocet.  It still can really get sore!! That is a bit dissappointing, but, when the pain is under control, I can do GREAT things in PT, and at home.  When my knee doesn't hurt, I can walk around without crutches, and I can bend my knee to almost 135, with NO pain or stiffness.  I ran out of it this weekend, and have relied on Ibuprophen and tylenol.  I know, I should have planned ahead and requested a re-fill before the weeken, but I did not anticipate that my last PT session would leave me INCREDIBLY sore for a couple of days. I took a few more pills that usual!  

It does not hurt all the time, but when I go to bend, or put weight on it, it does.  After nearly 48 hours without pain meds, I am back to just over 90 d, without pain, and I top out at about 105.  I called the OS office first thing this morning, but it is thier policy to take 24-48 hours to get an RX refilled.  No exception. I left a message this morning expaining the situtaion asking for a refill today.  I did not hear back, so I just now spoke to my OS's assistant (she is a medical assisstant, not an RN), and she read me the riot act for DARING to ask for an exception to thier "48 hour rule".  The said, quite curtly, "I'll see what I can do, but this really is inconvenient, and I may not be able to do this for you. Good bye."  She hung up.   I think that is a bit inhumane!  And RUDE!  

ARRRRRRRRGGGGGGGHHHHHHHH!!  I have been a nurse for quite awhile, and I used to work in a clinic, where I handled all the patient calls.  I NEVER behaved like that. True, some requests were "inconvenient", however reviewing a medical chart, chatting with a Dr. and calling a pharmacy is FAR LESS inconveninet that being IN PAIN, or needing anything, for that matter.  How dare that medical assistant treat me that way!!  I will be sure to mention this to the OS at my next visit!  He goes the extra mile to make sure his patients needs are met - he needs to know that his staff does not share that saem value!!


WHEW!!  Thanks for listening!! I have a short fuse today - thanks for allowing me to vent my frustration!!

I'm trying,

L.    >:(
Title: Re: Hopeful1's post-op!
Post by: hopeful1 on June 29, 2004, 09:23:03 PM
Having a much better day, after getting some pain relief last night.  I relayed my story to my PT after he watched me get pale and saw my knee get that shiney-red-purple motled color it does when I am in pain.  He called my OS after I left, and I got an appolopegetic phone call from the PA.  He said that the Medical assistant didn't let them know of my re-fill request was inexcusable.  It is not the first time this has happened, and I am sure it won't be the last.  I really hope that women NEVER has to face pain like this, and being told that remaining in pain for 48 hours is the only option.  

I actually did ok in PT yesterday - even without adequate pain relief!  I got to 130+, and rode the bike.  I am back to work today - the first day with out major hours on the CPM.  We'll see how the day goes.  I feel pretty darn good right now (lunch time), so think all will be fine!  My boss is out, and I have NOTHING to do, however, so I may just stay home, plugged in for the rest of the week.

Thank you all for reading this roller-coaster posting!

L.

Title: Re: Hopeful1's post-op!
Post by: Holly on June 30, 2004, 12:56:23 AM
Hey Linda!

Boy, have you EVER been on a rollercoaster! :o  I'm always amazed at the obnoxious and insensitive attitude of so many medical support staff.  It's like they ENJOY making us suffer so that we know how IMPORTANT they are!  Seriously...did they used to work for the KGB?!  Glad you finally got your pain meds, because I know all too well how much damage it does when you can't do the work you need to do (in PT and at home) because it's just too excruciating!

On the plus side, I'm so jealous of your ROM!  Is the 130d active or passive ROM?  I can't get past about 120d active ROM, but I think I'm doing somewhat better when Kim pushes it for me.  Of course, I kind of want to hit her (no one really ENJOYS being pushed in ROM), but I know she's doing what needs to be done, and she does it as gently as possible.  It's funny, isn't it, how much more the MUA hurt than your other "MAJOR" surgery.  Mine too!

Keep up the good work, and DON'T OVERDO AT WORK!  It's great if your boss is out on and off so that you can try to take it easy.  I start a new job on July 19th (if my OS releases me) and I'm kind of dreading the pain I may have at the end of my 9hr. days.  I have a very physical job...but what can you do?

Hugs to you, honey.  You're doing GREAT! ;D

Holly
Title: Re: Hopeful1's post-op!
Post by: maxfactor on June 30, 2004, 03:12:59 AM
Wow. I admire everyone on here who wouldn't tell this guy to go @#$% himself. I guess I've been in pain so long that anyone who dares question me is risking their life. My whole family thinks I'm drug addicted. I'm under pain management and I can tell you that I'm at a 6-7 on a scale of 0-10 24 hrs a day. I take time-released morphine (1 every 8hrs) and it doesn't last more than 3 or 4 hours. And even then I don't think it touches the pain. I think it convinces my brain that I can handle it. My PM doc was going to give me methadone. I told him I have a full time job and a 10yr old son. I had to function. My whole life is about how many steps something is going to take before I even move from a chair or couch. I guess because I'm not writhing on the floor, it's hard to believe I really hurt. I get tired of telling my family I don't want to go anywhere. And I remember ALL 12 of my surgeries. Some of those were arthroscopies and they hurt too!! As soon as everything wears off it's excruciating. You'll still want the meds through physical therapy too! I call them physical terrorists! Keep your meds close to you and then he doesn't have to know what or when you're taking them. If it bothers him ask him to keep it to himself. I think I might've hit him already, sensative or not. I think I'm having a bad day. I still have 45 min left from work and my legs are killing me. I'll probably down 10 tylanal even though my PM doc said I would be breaking the contract I signed with him. He says my liver/kidneys are going to start to fail. Like anyone in pain really cares about that. GEEZ! I hope your recovery goes well. And please take your meds as directed. Even if you don't feel you need them at the moment. It's hard to control the pain if you wait until you're in so much pain. Sorry for the rant. I sure appreciate this site. I was so arrogant to think that no one in the world knew what I was going through. Thanks everyone.

Jane
Title: Re: Hopeful1's post-op!
Post by: Holly on June 30, 2004, 04:32:13 PM
So here's the thing...I want you to give us a "hit list" of all those miserable S.O.B.'s who have been making your life a living hell (medical staff, boyfriend who resents your pain meds, dumb-*ss father, etc.) and I'll come on over there and give them some of their OWN pain to see how they like it!  Seriously...I was a brown belt karate student before I got run over by the car, and I'm pretty sure I can still hurt someone.  It may take me 45 minutes to walk across the room to strike them, but if they don't mind waiting I'll get there! (LOL)

As Maxfactor says, you need to stay AHEAD OF THE PAIN!  Don't wait until it's excruciating, because then you spend hours playing "catch up."  You're not addicted...you just NEED them.  That's fair, considering what you're going through.

Warm, gentle hugs are coming your way...together with a promise to mangle anyone who needs it! ;D

Holly
Title: Re: Hopeful1's post-op!
Post by: hopeful1 on June 30, 2004, 07:11:50 PM
Thanks for the support, maxfactor and Hollly!  And thanks for the offer to mangle that nasty medical assistant who was SOOOO nasty!  As a Registered Nurse, I ALWAYS get upset when medical assistants or nurse assistants call themselves "Nurses".  My OS assistant refers to herself as his "nurse" - and she is a medical assistant.  That just ads insult to injury.  Petty?  It may be, but to me it is a VERY personal professional issue, when someone so incredibly ignorant and - yep - maybe incompetent - puts herself in the same class as ME.  OOOOH - that gets me going!!!!

I am doing great, again - now that I have some meds in me! I know, that remark has the potential to make me sound lke a junkie - but it is true!  I only need 2 a day - one in the afternoon before PT (formal OR  at home - which I do failthfully!), and one at night.  Funny, my SO has been the most supportive of controlling my pain, now!  He was INCREDIBLY upset the other day when I couldn't get the os's office to re-fill!  He sweetly and quietly noted how he can tell when I need some pain meds.  I joked that it must be because I get grouchy.  No, he pointed out - "you get quiet, and EXTRA sweet, and pale and your lips look thin and grey, and your knee gets shiny and purple, and you sit really, REALLY still, but you still smile, and say nice things!".  I think I WILL keep him!!

My ROM continues to improve daily.  In the morning, active ROM is still only 95 or so, but last night, active was 120 or so, and I get an extra ten or so with help!  I was pretty stiff last night after work, but it was not NEARLY as bad as I thought it would be.  A good icing, and a few hours working the ROM up on the CPM, and I was back to the usual by 8 pm!

Comfortably yours!

L.

Title: Re: Hopeful1's post-op!
Post by: Holly on June 30, 2004, 11:11:00 PM
That's great Linda!

It really helps when the SO is in tune with your needs and feelings.  I know it hasn't always been that way for you, but better late than never.  The way you describe him now, I would have to agree that you should KEEP HIM!  By the way, isn't it interesting the difference in the way men and women react to pain or discomfort?  Men get grounchy and sometimes even mean and short-tempered...women get EXTRA NICE and VERY QUIET.  Hmmm?

I was a little disappointed in PT today because I thought I was doing SO much better with ROM.  However, when I asked Kim how far I was with passive (forced) ROM she said "100d!"  Either she's guessing way wrong or I seriously overestimated myself.  She has to do new measurements to send to my OS next Wednesday, so I hope she was off - and I was right! ;D  All I know is that when I do it myself just during my at-home PT, it certainly looks like more than I was getting before the MUA.  Other than that, PT is going well.  Since I switched to noon appointments now that I'm driving myself (rather than the 7PM I had before), I've brought in bagels and cream cheese for the staff on a few occasions (today included).  Kim says she thinks I just do that so she won't hurt me! (lol).

Treated myself to a pedicure this afternoon.  I had to caution the operator to be careful of my incisions (although I don't know how they could miss them?!), but the pampering was OUTSTANDING!  I know I shouldn't be spending the money ($19 plus tip), but I guess if I do this every 4 months or so it won't bankrupt us!

Keep up the good work, Linda!  I'm very proud of how far you've come...and you should be too. ;D

Hugs!

Holly
Title: Re: Hopeful1's post-op!
Post by: hopeful1 on July 01, 2004, 05:53:18 AM
Holly.

I know it's so easy to get caught up on the numbers!  I think it's important that you FEEL like you've got more mobility, too!  I know that I don't feel nearly as stiff, and I while it is GREAT to watch my numbers go up, it is even better to feel like I don't have a layer of duct-tape on my knee!!

I must confess - I have discovered a secret weapon during "Passsive PT time" (AKA Torture time!).  TOOTSIE POPS!!!! :o ;D ;D :o. We use them to distract me - and it WORKS great.  I just stick that sucker in my mouth, and I am so busy, that it really distracts me from my "magical exploding kneecap" (as my PT calls it).  When I take the sucker out of my mouth, my PT knows it is time to back off, and that I am actually in pain, rather than just that uncomfortable over-stretched feeling.  Maybe I should post this tip under :"things you can't live without" !! 8)

Sweetly!

L.
Title: Re: Hopeful1's post-op!
Post by: Holly on July 01, 2004, 06:42:16 PM
Hey Linda!

I love the idea of having something to distract you during passive ROM...but I'm more likely to have a thermos of margeritas with a straw than a tootsie pop!  (Just kidding.  I actually rarely drink, but it SOUNDS like a good idea! ;D)  My PT, Kim, usually keeps me talking through that part and can tell when it's beyond the beyond when I can no longer gather enough breath to speak.

You're right, though.  Even if my numbers aren't what I thought they'd be, I do appreciate the difference in feeling - that "duct tape" feeling is almost totally gone.  Plus, being able to get around without a crutch most of the time (except when I have a LOT of walking to do) is incredibly exhiliarating!

As always, you have my best wishes and lots of hugs to help you through your recovery...

Holly
Title: Re: Hopeful1's post-op!
Post by: hopeful1 on July 06, 2004, 09:30:30 AM
YIPPEEEEEEEEEE!!

No more CPM!  I saw the OS today for my one-month post-op visit, and with an ROM of around 140, I'm taking that machine back!!  He said he is "blown away" with my progress,  THAT is something I've NEVER heard before!!!  WOOO-HOOOO --- yeah for me! No more tootsie pops in PT either- I am ALL into those margarita's, though!!

The focus in PT is now on strength and gait.  I am one-crutching it most of the time when out in public, still two-crutching on long treks.  NO BRACE, ever! At home, I am NO crutching it about half the time.  I still have trouble with strength and control, so I am better off with the help of a crutch or two, rather than develop a chronic limp - or so my PT and OS keep telling me when they watch my odd gait without crutches!   :o  I am on the bike, WITH RESISTANCE!! As many of you understand - I get downright emotional, when I actually get my heart rate up from a stationary bike - I haven't been able to turn those wheels without pain for about 25 years!  AMAZING!!!! ;D ;D ;D

Proudly,

L.

PS - For Holly, and all my other Lysis/MUA pals, my OS explained it to me like this...."It's like your knee was constipated.  I just gave your knee an enema.  It's kind of like a good dump, ya' know.  Painful at the time, sure - but you feel SO MUCH better when all is said and done!".  Profound stuff.
Title: Re: Hopeful1's post-op!
Post by: Gab on July 06, 2004, 06:45:47 PM
Hey Lisa and Holly, I just caught the last page of this thread and it seems like you are both doing great.

Congratulations and keep up the good work! It's good to know that all that pain and "discomfort" is paying off.  :)

Cheers,
Francois
Title: Re: Hopeful1's post-op!
Post by: Holly on July 06, 2004, 07:30:20 PM
Hey Linda:

HOORAY FOR YOU!!! ;D ;D ;D  I am absolutely ASTOUNDED at your ROM...140!!  You must be so PROUD!! I don't know that I'll ever get there.  I mean, I'm happy to be at 120 - and that's with a lot of painful pushing from Kim.  But even if that's as far as I ever get, I feel like it's still progress because my quads are getting much stronger and my gait is getting pretty good most of the time.  Except when I'm really tired or when I first get up in the morning and I'm really stiff.  Then I walk like a peg-legged old pirate!  Yaaarrrgh!  This week, though, I've done 2 days in a row without my brace or any crutch at all - very liberating!  Sure, by the end of the day I'm awfully sore and tired.  But then I ICE, ICE, ICE and take a pill and go to bed.  And after that I go to sleep. (he-he-he!)

Keep up the good work, my friend!

Holly
Title: Re: Hopeful1's post-op!
Post by: Leta_MT on July 06, 2004, 10:46:46 PM
Oh Linda!

That is so great! I can't wait to break a sweat on a bike or anywhere else, for that matter. This is such good news for you! I think you and Holly are smart not to cut the cord with the crutches too soon! Use them when you need them and don't when you don't. Pretty soon they will be wall ornaments displayed as the spoils of war!

Dr. C has a sense of humor I see! Very cool!

Good work and stay the course. Victory is at hand!

Leta  :D :D