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Author Topic: 4 Weeks Post Op - Couple of questions  (Read 3242 times)

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Offline Dave G

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4 Weeks Post Op - Couple of questions
« on: February 09, 2005, 01:42:04 PM »
Hi there I fractured my patella (6) pieces on the 8th Jan and am now in recovery due for a followup next week. I have a couple of questions though

1) Pain - occasionally i get a stinging pain in my knee only tends to last for a second or two any ideas ?
2) Swelling the swelling is going down but i feel that the patella is bigger than it was could it be that its all slipped out of place ? would i feel pain if it had  My leg is in a cricket bat splint not a cast. In my first review 2 weeks they did not xray the joint just removed all the padding to allow the scar to heal in the air.


Regards


Dave

08 Jan 2005 Accident Patella Fracture 6 Pieces
09 Jan 2005 Operation (2x 1.5mm Wires 1x2mm Wire & Tension Band)
11 Jan 2005 Xrays  & Rebandaged Splited with Cricket Bat Splint.
13 Jan 2005 Allowed Home
20 Jan 2005 Followup & Stitches Removal.
09 Feb Slight Pain occasionally
Next appt 11 Feb

Offline Jinnyd

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Re: 4 Weeks Post Op - Couple of questions
« Reply #1 on: February 10, 2005, 12:24:19 AM »
HI
Sorry but i couldn't help but write to you, my husband did the same thing to his knee on 29th Jan had surgery day later and is still in lots of pain were you at this stage?
He is very dependent on me and struggles to get up down, went back to hospital monday and asked if this was "normal" and all they could say was he had been through a lot so pain is to be expected? ( didn't help at all!)
We are in the uk and have to go back in 3 weeks for x rays and see if he can start physio which he is dreading.
Hope to hear from you
Jinny

Offline Dave G

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Re: 4 Weeks Post Op - Couple of questions
« Reply #2 on: February 10, 2005, 11:06:07 AM »
Hi jinny thanks for your reply.

I managed to swing the stick of influcence and had my xrays this morning. I have been told by the Consultant that they are fine. what is happening is that as the swelling is going down the skin is obviously tighter and the ripples in the patellar structure are starting to be noticible when felt with the fingers. I am having a slightly uneven swelling reduction but this is nothing to worry about. I have suffered slight nerve damage to the offside of my right knee where it is really strange.

Pain wise I must have been very lucky the most painful part for me was being put on the stretcher for the ambulance. I think i must have a strange tolerance for pain.
It subisded quite quickly during the post op period. and I was prescribed some ibuprofen should I need it. (I had stopped taking the painkillers within a week of the accident)

I spent saturday night in a bright orange emergency splint unable to roll over or sleep on my side or front as I usually do. Sunday had the operation between 3pm and 6pm I think i spent about an hour and a half on the table according to my notes. I was then xrayed on the tuesday and discharged thursday morning.
Having damaged my knee in Manchester I had to be refered back to Stoke on Trent so an appointment was made for about 10 days. after attending that they diddnt really do much apart from take the stitches out and told me to air the joint to allow the wound to heal in the air.

Physio are due to phone me either today or tomorrow to arrange an appointment to see them. I expect that this will be the most painful part in all. I can get to about 45 degrees flex on my own at the mo but cant yet perform a straight leg lift or extend my leg without help due to the muscle wastage.

Everyones pain is different I think I have been lucky and missed a lot of nerves your husband may have caught more nerves and that is resulting in pain. I still get the occasional (ow that hurts feeling) but its more an ache than acute pain. If you have any major concerns for gods sake ask or speak to your GP. The community care nurse is able to come out and change the dressing if required. I was in a cricket bat split and found that it slipped every so often.

Stairs are a nightmare ! i will assume that he has been told to toe touch only at the moment. I found that going down was much easier than up. going up if he puts his weight on his crutchs and uses one hand on the banister then its possible to "hop" up. down is easier as the immobilised leg follows the hop to the lower stair. you will feel like your going to fall flat on your face and its good to have someone round until hes comfortable with it. Im young (24) and have fought to regain independence fiercly. He will find a techniquie he is comfortable with soon. I try to minimise the number of trips up and down stairs. Ideally coming down in the morning and back at night.

Right im off to do some exercises again keep in touch if you have any questions ask me ive got a partial medical background and loads of people i can ask if needs be.

Regards & Best Wishes

Dave
08 Jan 2005 Accident Patella Fracture 6 Pieces
09 Jan 2005 Operation (2x 1.5mm Wires 1x2mm Wire & Tension Band)
11 Jan 2005 Xrays  & Rebandaged Splited with Cricket Bat Splint.
13 Jan 2005 Allowed Home
20 Jan 2005 Followup & Stitches Removal.
09 Feb Slight Pain occasionally
Next appt 11 Feb

Offline Jinnyd

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Re: 4 Weeks Post Op - Couple of questions
« Reply #3 on: February 10, 2005, 01:39:34 PM »
Dave

Many Thanks for the reply, Good news about your swelling then. How did you swing an Xray at such short notice??

Shane my husband is 33 so a bit older than yourself he normally is like you and has a high pain barrier when he had the accident i called the ambulance as he couldn't move the knee he was not in that much pain he was even laughing and joking with the ambulance people and was in very little pain considering, as soon as it was in that orange splint thing he hardly felt it, he even hopped to the ambulance before being put on the stretcher!  Just shows how different we all are with pain!!

We got to the hospital where the doctor said he had split the patella in 2 without even doing an Xray.He had the Xray and was sent to a ward the next morning he had surgery and was put back on ward, the next day a physio came to see him to get him up on crutches then the doctor came and said he could go home so 24 hours after surgery i was bringing him home. Too early i think!
The biggest problem we had was the orthopeadic (Cant spell!) ward was full so he was on a general ward where the nurses didn't know how to deal with broken bones everytime we asked for some advice about how much he could do at home they just said "It wasn't there field!" they sent us home with nothing but a bag full of painkillers they didn't even book a follow up appointment.
We had the nurse visit every 2 days to check dressing he had lots of bleeding after and she is coming tommorow to remove stitches. She couldn't beleve he was sent home so soon and without any advice sheets.

Went back to hospital for follow up on monday and asked the question is this pain normal and was told yes he split the tendons and ligaments aswell as the bone and they have screwed wire into his shin bone to try and hold the patella in place so they told him to expect Pain !! (Didn't help really !) he is on loads of painkillers and is on a bed in the lounge only gets up 1 or 2 times a day for the toilet.
When he gets up i have to hold his leg out then bring it down when he stands do you have to do this?? and if i lift too high or low he screams is that like you?
Also you said about "Toe Touch Only" shane is not sure and does put his weight on the leg when he's stood he can't cope hopping on the other leg with crutches do you think he shouldn't be putting weight on yet? (should of asked doc monday but forgot it when we got there !)
Sorry i seem to have gone on a bit just trying to fish for help really are you still on crutches??
I'll let you go now
Jinny



Offline Dave G

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Re: 4 Weeks Post Op - Couple of questions
« Reply #4 on: February 10, 2005, 10:02:28 PM »
General advise is to toe touch however as the patella doesnt bear the body weight its not as bad but considering the tendon damage and the screws into the femur I would check with the hospital or consultants team. I was told to NWB (toe touch) in my notes so stuck with that. I have been lucky and not damaged any of the tendons much even though it was 6 pieces.

Is he on Elbow crutches or Shoulder Crutches ? U get used to standing on one leg very quickly especially while having a decent wash. I made a point of putting a kitchen chair in the bathroom to allow me to sit if it got too much.

When it comes to lowering the leg I quickly got in the habit of either using my crutch on the opposing arm to "hook" under the heel of my foot and rotating my backside round off the sofa. after a while i managed to get this techniquie perfected using my left leg as a hook. Crude but effective in my case.

I have now confined one of the crutches to the spare room and use the other more as a walking stick now. I take the brace off while doing sit down work while exercising to regain the flexion (bending) I have been advised that because the leg muscles are so weak that i need to put the brace back on when walking more than a couple of paces incase my leg colapses under my weight (im 16 stone)

I found that my biggest pain time was being sat and rotated on the stretcher for the ambulance ( that gas makes you go funny hehe) as I sat on the stretcher they think a small piece got stuck and stopped the knee from extending fully so stuck a rolled up blanket under it where it stayed in that damn bright orange brace for the rest of the night.

Give my regards to Shane both of you stay strong and if i can help more let me know.

Regards

Dave


08 Jan 2005 Accident Patella Fracture 6 Pieces
09 Jan 2005 Operation (2x 1.5mm Wires 1x2mm Wire & Tension Band)
11 Jan 2005 Xrays  & Rebandaged Splited with Cricket Bat Splint.
13 Jan 2005 Allowed Home
20 Jan 2005 Followup & Stitches Removal.
09 Feb Slight Pain occasionally
Next appt 11 Feb

Offline Jinnyd

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Re: 4 Weeks Post Op - Couple of questions
« Reply #5 on: February 10, 2005, 10:32:44 PM »
Hi
Shane cringed at the thought of hooking his bad leg with the crutches!
We really struggle getting him up, he keeps his leg straight and i have to slowly lower it as he rises which works ok but getting him back down is a different story if i dont raise the leg enough or lower it slightly as he is putting his backside down then he is agony and screams did you have this? keeping the leg straight i  mean not  bending it just lifting the whole leg up or down.
Got him up for the loo last evening and he ended up in so much pain we have not tried to move him from bed today.
(good job he is on so much codeine or he would have to go daily if you no what i mean!)

How did you do your knee? Shane fell off a stool he will use a ladder to stand on next time !

 

Offline Dave G

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Re: 4 Weeks Post Op - Couple of questions
« Reply #6 on: February 10, 2005, 11:52:05 PM »
I must say that it sounds as though his pain is a few orders of magnitude higher than mine. I get occasional pain but nothing that a single ibuprofen 400 cant cure.

Is he in a splint for the leg ?

I did mine going across a car park tripped on a kerbstone and landed hard on the other kerb.
08 Jan 2005 Accident Patella Fracture 6 Pieces
09 Jan 2005 Operation (2x 1.5mm Wires 1x2mm Wire & Tension Band)
11 Jan 2005 Xrays  & Rebandaged Splited with Cricket Bat Splint.
13 Jan 2005 Allowed Home
20 Jan 2005 Followup & Stitches Removal.
09 Feb Slight Pain occasionally
Next appt 11 Feb

Offline Jinnyd

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Re: 4 Weeks Post Op - Couple of questions
« Reply #7 on: February 11, 2005, 12:01:39 AM »
OUCH!

That sounds painfull
Shane is in a brace like thing lots of velcro and metal down the sides!
How long do you think you will be off work?

Shane is LGV Driver so looks like he will be off a while Can't see him jumping out a lorry cab for a time like he used too!

Jinny

Offline Dave G

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Re: 4 Weeks Post Op - Couple of questions
« Reply #8 on: February 11, 2005, 12:11:03 AM »
What are you doing online at this time !

Sounds like hes got a similar immobiliser to me 6 velcro straps and 4 metal bars two underneath and two at teh side. ( i had to adjust mine when the swelling went down by splitting it into two and reducing the opening to stop pressure oin the side of the knee at night

As for working hes going to be off for a while especially as things like the climb into a cab and the stiffness of a clutch and or brake depending on the leg. With something like this I would not be able to put a guesstimate on it.

I run the office at a Commercial Vehicle repair centre so have quite a bit of experience inspecting vehicles etc. something i wont be doing for a while either.

Building the strength back in the Knee is the most difficult part im told you both need to be prepared for a lot of work.

Cant believe how positive I am at the moment wasnt on wednesday night couldnt sleep worrying that the xray would be wrong. It will be ok in the end think of it as a long holiday.

Regards

Dave

dave @ golik . co .uk

08 Jan 2005 Accident Patella Fracture 6 Pieces
09 Jan 2005 Operation (2x 1.5mm Wires 1x2mm Wire & Tension Band)
11 Jan 2005 Xrays  & Rebandaged Splited with Cricket Bat Splint.
13 Jan 2005 Allowed Home
20 Jan 2005 Followup & Stitches Removal.
09 Feb Slight Pain occasionally
Next appt 11 Feb

Offline Jinnyd

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Re: 4 Weeks Post Op - Couple of questions
« Reply #9 on: February 11, 2005, 02:42:16 PM »
Hiya

I did give up and go to bed in the end last night!

Sounds exactly the same brace as shane, the nurse on monday adjusted it to allow for the swelling that had gone down then she did it too tight and we had too pull it all apart and loosen it,

Had Nurse today to take steri-strips off one had been bleeding badly and has made skin go mushy so she coming back on tuesday to check again put a gauze on it for now.
Shane said it is the weirdest feeling when someone is touching it really numb is yours like that??

Sounds like you will be off work a while then.
Shane has got redunduncy (Can't spell!) coming up aswell which isn't good, god knows how we will manage then at least we get paid sick at the moment i feel really sorry for the people in US for example who have to pay for there treatment at least we don't have that worry over here

Catch ya later
Jinny
 

Offline Dave G

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Re: 4 Weeks Post Op - Couple of questions
« Reply #10 on: February 12, 2005, 11:02:11 PM »
Hi missed this reply to the thread for some reason teh board diddnt email me.

i have a numb patch on the right hand side of the patella no feeling at all in it must have caught a nerve or two. really strange sensation when you know you are touching it but cant feel it.

Ive found a little bit of stitch which diddnt come out fully under the skin got the district nurse bringing a stitch kit to sort it on monday. nothing major just need a sterile blade to hook it out.

Im finding getting the muscles in my leg working again hard gotta be careful not to put to much on the knee for fear of snapping the wiring. still got some swelling which is affecting the leg lifts. I can sit at a table with bent knee though now ! and thats 3 days after having the brace removed.
08 Jan 2005 Accident Patella Fracture 6 Pieces
09 Jan 2005 Operation (2x 1.5mm Wires 1x2mm Wire & Tension Band)
11 Jan 2005 Xrays  & Rebandaged Splited with Cricket Bat Splint.
13 Jan 2005 Allowed Home
20 Jan 2005 Followup & Stitches Removal.
09 Feb Slight Pain occasionally
Next appt 11 Feb

Offline Jinnyd

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Re: 4 Weeks Post Op - Couple of questions
« Reply #11 on: February 12, 2005, 11:51:09 PM »
Hi
Shane has got exactly the same numb feeling on the right hand side the other side is alright how strange
He has a strange pain like something sharp inside, rubbing not sure if it in his mind but it comes and go's on one side of knee
That's good that you can sit at a table at only 4 weeks and the brace removed!! Were you advised to remove it? Any physio yet?

Shane goes back to fracture clinic 02/03/ and they gonna re xray and decide if he can start physio but they have booked him an appointment for the 04/03 so hopefully he can start then.
Funny how they all do things so different at the hospitals!
Jinny

Offline Dave G

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Re: 4 Weeks Post Op - Couple of questions
« Reply #12 on: February 13, 2005, 12:29:27 AM »
Yes I was told to start exercising the leg by the consultant on thursday. I have to put the splint back on though if walking any distance greater than a couple of hops due to the risk of my knee colapsing under my weight.

Exercise is easier today a lot less throbbing but still quite a bit at the top of the patella where there is still swelling. which is making leg extensions painful. If i lie on my side i can slide the leg forwards just but not lift it. Im supposed to be doing heel slides and trying to get the leg lift sorted.

The rubbing pain he describes may be all the nerves settling back from the swelling i had some really strange feelings in my knee after the operation. Occasionally like a deep ache or funny really wierd pain and my mind telling me to move but my leg not wanting to. it wasnt pain as in the normal sense of fight and flight reflex pain. oh sod it he will know what I mean :-) 

Physio is booked in a week on monday. I am unlucky enough to have NHS Employed parents dad is GP and Mum is a Nurse :-) and my GP also does the fracture clinic with the consultant. I still like doing my own research and have this annoying habit of not asking questions when I should.

Found out today that E45 or that Eucerin dry skin cream makes a lot difference in making the skin more flexible for the flexion exercises. However dont put any on unless the wound has healed completly. and be careful not to distrurb anything pressing too hard etc...

Sorry to hear about the redundancy looming at his works. Note they cant just give him redundancy if hes off sick etc if they do without proper consultation then its possible that they are going to be liable for an unfair dismissal claim. Employment law is a quirky thing if the worst does loom get some advise from the Citizens advise bureau etc..

Im going to try to get another good nights sleep without my brace tonight :-) hope that your hubby gets to the same stage soon.

Warmest regards

Dave
08 Jan 2005 Accident Patella Fracture 6 Pieces
09 Jan 2005 Operation (2x 1.5mm Wires 1x2mm Wire & Tension Band)
11 Jan 2005 Xrays  & Rebandaged Splited with Cricket Bat Splint.
13 Jan 2005 Allowed Home
20 Jan 2005 Followup & Stitches Removal.
09 Feb Slight Pain occasionally
Next appt 11 Feb

Offline Jinnyd

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Re: 4 Weeks Post Op - Couple of questions
« Reply #13 on: February 14, 2005, 11:59:39 AM »
Hi Dave

How did it go without the brace? Can't wait to get past the stage we are at now where we can start going out again.

Glad to hear the strange pains are normal, Must be great to have a doctor/nurse in the family bet they are a great help to you at this time.

I rang the surgery this morning to get a repeat prescription for diclofenec as the nurse advised to carry on with it for a bit longer and they say i have to put the request in writing and a doctor will deal with it. The surgery change there minds every week.

Take Care
Jinny

Offline Dave G

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Re: 4 Weeks Post Op - Couple of questions
« Reply #14 on: February 15, 2005, 08:25:36 PM »
OK i just checked the thread and thought i replied back to you ... mind you ive been confusing reality and dreaming these last couple of days...

Right heres the reply ...

Ill start with a crap joke What goes click click click ow click click click .. the answer is me when im walking  :(

Most surgeries do need to have it in writing some will accept an email or fax but others have a prescription line where you can call wth your name etc and they play it back once or twice a day to sort it.

The brace is now relegated to teh corner of the living room where i can get it if i need it. Straight leg lifts are still impossible but i can lift the leg in the bath so were getting there. Walking is odd If i walk with both crutches i dont limp however if I walk with one I do and click. i think thats due to the height of the crutch might adjust it tomorrow.

Right im off to enjoy my bag of fruit pastiles.

Regards

Dave
08 Jan 2005 Accident Patella Fracture 6 Pieces
09 Jan 2005 Operation (2x 1.5mm Wires 1x2mm Wire & Tension Band)
11 Jan 2005 Xrays  & Rebandaged Splited with Cricket Bat Splint.
13 Jan 2005 Allowed Home
20 Jan 2005 Followup & Stitches Removal.
09 Feb Slight Pain occasionally
Next appt 11 Feb















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