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Author Topic: opinion needed re 13 year old daughter's knee  (Read 56332 times)

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Offline upset mom

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Re: opinion needed re 13 year old daughter's knee
« Reply #45 on: May 20, 2005, 01:33:12 AM »
Hi Trekker,

When she was in PT they had her lie on the table on her stomach and had her bend her knee, which hurt her so much.  That was the last time we were at therapy and stopped therapy after that as she was crying so badly when we got in my car to go home.  So I am a little skeptical to try it myself at home because of how it made her feel in therapy.  She was trying to show me some marks on her leg, near her knee.  She thinks they look purple in color - though I did see something, it wasn't alarming to me.  I am beginning to think she has a tear and that it didn't show up on any tests.  I hope I'm wrong.  I don't know what to think anymore.  May I ask you what do you think it will show if she did the exercise you suggested.  It seemed like they were trying to strengthen her muscles at PT.  Unfortunately her pain level stopped her from doing PT and that's when the doctor said stop the PT.  I just hope that something soon helps this kid.

Thanks for writing!

Hugs,
Lisa

Offline upset mom

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Re: opinion needed re 13 year old daughter's knee
« Reply #46 on: May 20, 2005, 01:37:36 AM »
Hi Jillo,

Thanks for writing.  I believe the OS she is seeing does see a lot of kids.  He is a team doctor for one of the High Schools up here, which really doesn't mean anything.  The first OS we saw was team doctor too and he said her knee always looked like this and I didn't notice.  I think these doctors are only good for putting casts on broken arms.  She is going to take a pain killer tonight, if it kills me lol.

Speak to you later.  Thanks again for caring!

Hugs,
Lisa

Offline upset mom

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Re: opinion needed re 13 year old daughter's knee
« Reply #47 on: May 20, 2005, 01:45:03 AM »
Hi Blackbelt (so Heather is your middle name (smile) :

Thanks for writing.  I agree that the longer nothing is done, the worse it is.  That's why I am stressing.  I don't know about the medical profession any more!  Thanks for your encouraging words.  I wish I could make all her pain go away.  Think I need to pray a whole lot harder!  The OS does see kids - if you read the other post I just wrote.  Oh well, onward as they say!

Hugs to you and to Heather M. who I forgot to give a hug -sorry!  Typing so fast I forgot.

My daughter Heather said all Heathers should change their names lol.  I actually think it's a pretty name but gosh think it's also an accident prone name (big smile).

Offline brattkids

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Re: opinion needed re 13 year old daughter's knee
« Reply #48 on: May 20, 2005, 03:47:13 AM »
I sure hope your daughter gets some relief from the pain med!!!!

 Its heart breaking to hear that someone  so young is going through so much!!! My 6 yr old son had someone fall on his knee this winter and I was lucky to have one of the best OS (mine) he also see's kids. He listens to what we have to say and if you hurt he helps you!!! It turned out my son had a strained MCL and a bone bruise. He still has pain to this day and I cry for him!! The OS did give us pain med for him when he hurts so that is a bit of relief.

My thoughts and prayers are with you guys!!! Hang in there and see as many doctors as it takes to get relief!!!

Paulette
4/04 microfracture
5/04 debris removal
8/04 OATS with synthetic plugs
11/04 OATS traditional autograft medial femoral chondyle
05/05 debris removal and OATS assessment
6/05 Cadaver Allograft OATS lateral femoral chondyle
9/05 OATS redone could not save allograft plug
12/2006 2007 and 2008 scop

Offline upset mom

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Re: opinion needed re 13 year old daughter's knee
« Reply #49 on: May 20, 2005, 05:01:10 AM »
Hi Paulette,

Thanks for writing.  May I asked how they found out that your son had a strained MCL and bone bruise?  I appreciate your concern and heartfelt words.  I have to try and stay strong for my daughter and not let her see me cry when she's crying.  One of us has to stay strong and guess that's me.  I hope and pray we find a good doctor who will help her.  I hope your son's knee will be alright as he grows.  It's terrible how one quick injury can do so much harm.  Have to take one day at a time and try and stay as positive as I can, though it's hard when I look at her knee and watch her hobble around on the crutches.  There's an old saying that is so true - "There but for the grace of God, go I". You never know when things are going to happen.  We'll get through this somehow.  This is a wonderful site with such caring and sharing people.  My heart goes out to everyone who posts here.  I know there are many worse conditions than knee problems but right now this is my biggest dilema.  My thoughts and prayers are with everyone here.  It's bad enough when injuries happen but when it happens to a child it seems even worse.

Take care and thanks again!

Hugs,
Lisa

Offline tanyasparks

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Re: opinion needed re 13 year old daughter's knee
« Reply #50 on: May 20, 2005, 05:07:17 AM »
Upset mom and daughter,

Just wanted to send prayers and good luck wishes for tomorrow.  I have been following this thread even though I have not posted in it before.  I hope and pray that God would just allow whatever is wrong to just pop out on that bone scan and allow her quick healing. 

Tanya "Sparky"
25yrs. old
Left Knee LR in 1997
Right Knee Grade 3 MCL Tear 4/15/05
Now experiencing Locking in Rt. knee, Kneecap dislocating.
Finished with the pt and still no better
LR and Chondroplasty surgery suggested. 
Second opinion OS appt. went bust!
Waiting to see first OS for surgery.

Offline morgan515046

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Re: opinion needed re 13 year old daughter's knee
« Reply #51 on: May 20, 2005, 06:30:24 AM »
good luck with the bone scan heather!!!!!:) ill be thinking of ya
-mo-  ;D :D
*14 years old*

3/29/05 Track hurdle incident
7/6/05 surgery for menisectomy
8/9/05 Possible RSD???
10/11/05 Patella Tendonitis from not rehabing all the way.

VOLLEYBALL ROCKS!!!

Offline Heather M.

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Re: opinion needed re 13 year old daughter's knee
« Reply #52 on: May 20, 2005, 06:42:52 AM »
Lisa,

One important thing you need to get across to Heather (and it will be hard, as we Heathers are stubborn!) is that when you body has pain that is not addressed or alleviated, the nerves in the affected area can actually keep dialing up the levels again and again--until the brain and body involved finally do something to stop the pain (like resting, icing, using crutches, etc).  That's why it's important to take the medication, and to give it a chance to work.  Naprosyn is a GREAT anti-inflammatory, and it should really help her--but she has to give it a couple of days, and remove the other aggravating factors (like walking and inappropriate PT where they tug on her leg!).  So I know she's reluctant to take the meds, but the doctor prescribed them for a reason.  I used to be very reluctant as well...I'd go all day gritting my teeth against the pain as it got worse and worse...then, when it was out of control, I'd crumple up and take the meds.  Well OF COURSE they didn't work at that time!  That's not how the meds are supposed to be taken--you have to take them before the pain levels get out of control, because they work to kind of intercept things before they get too bad.  Once I finally accepted that I had to take the meds and took them as prescribed, I found I was getting TWICE the relief from only HALF the dosage--all from just taking them correctly for once.  So while we all want to avoid taking meds, sometimes they are necessary, especially if she is crying in pain.  When you have that level of agony, the muscles around the joint just kind of draw up and go into protective mode to keep the joint from more damage.  That's bad!  It makes everything tight and stiff, keeps the knee mechanics from working right, and makes your daughter miserable.  Constant, chronic pain also alters the balance of chemicals in the brain, which can affect sleep, lead to depression, increase sensitivity to pain, and even perpetuate the nerves sending pain messages long after it is appropriate.

So yes, you need to get the right tests and the right doctors and the right PT's...but your daughter also has to do her part and fight the good fight.  Take the anti-inflams.  Ask the pharmacist or doctor if it's appropriate to add Tylenol (but don't do that with the codeine script, as it likely has acetaminophen already--check with the pharmacist always!).  And fill that prescription.  Have her take it when she knows she has to be on her feet and/or before PT.  Keep the crutches around, because if she's having that much pain she should NOT be walking on the limb.  Let the pain be her guide, and yet don't be afraid to take the medications to address it as well.  The meds shouldn't be used to mask pain--like she wants to go to the mall or something so takes some painkillers...that's counter-productive.  But so is sitting on the floor crying with pain.  The stress and drain of the pain will really take a toll on her brain chemistry and hormones--which are already dicey at her age.  So if she's not getting relief, go to the GP again and discuss what combo of over the counter and prescription meds can help her.  And ask the OS/PT what modalities can be used--ultrasound, e-stim, ultrasound with cortisone cream (phonophoresis), gentle tissue manipulation by a trained professional (someone trained in myo-fascial release, not just a massage therapist), patellar taping, bracing, ACE wraps, and so forth.  Ask the OS about LIDODERM PATCHES--they can likely bring about a significant reduction in her pain levels within a few minutes of putting them on--they are completely non-narcotic, non-pill-based lifesavers for a lot of us--you just cut a square out of the main patch and apply it directly to the knee, where it can stay for as long as 12 hours.  As is a home TENS unit, esp. one that has an e-stim or strengthening mode.  Mine is a BMR Neurotech, and when the pain is out of control I put that on with some ice and sit in the recliner.  It really helps.

These are just a few additional ideas for pain-relieving modalities.  But she should also take advantage of the pain relief she's already been offered--the GP wouldn't have given it to her if she hadn't thought it was for the best.  Maybe she can just take the codeine at night when she's done with her homework and can just relax and focus on herself for awhile?  Believe me, nothing is worse than the stress of school and then having constant pain.  When I broke my sternum, I was a college-bound junior who was three weeks out from AP exams.  I did it all on ibuprophen, and I really don't recommend it.  It was one of the worst times of my entire life...and because I didn't have appropriate pain control, I was constantly hunched over like a vulture to take the stress off my shoulder and fractured sternum (breastbone).  So I healed that way, hunched over, with adhesions forming and my muscles taking on a new shape and position.  It is something I still struggle with today, over 18 years later!!

Hope Heather feels better soon.  Keep pushing the doctors, and don't ever doubt her.  Her pain may be getting worse because it's not being dealt with, not because she's reading stuff on the web!  Remember, she's only on the web because she's in pain....

Heather
Scope #1: LR, part. menisectomy w/cyst, chondroplasty
#2-#5: Lysis of adhesions/scar tissue, AIR, patellar tendon debridement, infections, MUA, insufflation
#6: IT band release / Z-Plasty, synovectomy, LOA/AIR, chondroplasty
2006 Arthrofibrosis, patella baja
http://www.flickr.com/photos/hmaxwell

Offline sparkle999

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Re: opinion needed re 13 year old daughter's knee
« Reply #53 on: May 20, 2005, 08:09:18 AM »
I read on an earlier post that the PT said your daughter was the most tense person he'd seen. Is that right?

I have had unexplained flexion problems for 9 weeks since the injury and got a new diagnosis testerday. My os says my quads and hamstrings are firing together(not supposed to) as a response to pain and the injury. Th hamstrings should work to flex the knee while the quads relax and when straightening it should be the quads that work while the hamstrings relax. The PT's didn't get this so when I go on Sat they need to call him for the explanation so they can treat me correctly. My Os says it's quite hard to diagnose because the muscle contraction is usually where the swelling is and hard to see.

Just a thought but the knee muscles hold the patella and with all the pain she's having, maybe Heather's brain has done what mine did and set up a safety mechanism for the knee. It would explain the tension and the need for pain relief. Perhaps you could ask about it? My OS says it's very unusual but he has seen it before. He was only happy to make the diagnosis after doing a scope and seeing how my knee behaved when the muscles were inactive under anaesthetic. He says he did NOT do MUA because once the muscles relaxed I had full and easy flexion.

Heather has different knees to me, I know, but what I'm saying ties in a little with Trekker? in an earlier post about looking at the muscles.

Good luck with everything. You need support just like Heather does. I've said it before but watching your child in pain is one of the hardest things to suffer. Hang in there for Heather's sake. Maybe she'll grow up to be  PT or a knee surgeon!!!

xx

35 y/o
ACL rupture
loose body under kneecap
impaction fractures
injury 19th march 2005
scope 9th may
recon 24th october 05

Offline trekker05

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Re: opinion needed re 13 year old daughter's knee
« Reply #54 on: May 20, 2005, 12:11:49 PM »
Lisa,

Sparkle999 and Heather M. both brought up points that tie in with what I think may be a possible cause of your daughter's knee pain.  Sparkle999 is right about her condition tying in with what I was talking about.  There is a neural phenomena known as "reciprocal inhibition"; simply put, if one muscle on one side of a joint contracts, a neural signal is sent to the opposite muscles telling them to relax; this is what allows us to move.  My guess is that your daughter's Rectus Femoris is in spasm, and is not responding to these signals.  When this muscle is too tight or spasms, a condition known as patella alta may occur, where the patella is pulled up in the trochanteric groove.  This can lead to subluxation ( dislocation ) of the patella.  Whereas I think your PT had her flex her knee while the upper leg is just laying on the surface, I am suggesting that she contract her glutes and hamstrings before bending the knee.  If it hurts, try having her keep the leg straight by raising it just slightly off the floor.  What I am trying to do is inhibit (relax) the R. Femoris by contracting the muscles with the opposite action to it while trying to put minimal stress on the R. Femoris.  I have found that the best way torelax muscles is similar to what Heather M. mentions in terms of myofascial release, and that is active release or trigger point release.  The next best is a form of PNF, or contract- relax stretching.  What I describe is not as effective, but simpler to apply, and may help in relieving some of her plain. Give it a try.

Offline upset mom

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Re: opinion needed re 13 year old daughter's knee
« Reply #55 on: May 21, 2005, 04:48:36 AM »
Hi Tanya,

Thanks for the prayers!  We will know the results of the bone scan on Monday.  My friend took her for the scan as I had to work.  Heather said after they were looking at the scan on the monitor they had her take xrays of her hips to compare the right hip to the left hip.  She also has pain in her hip which could be from the way she has been limping around.  I hope and pray the scan shows something.  Can't wait till Monday to hear the results.  Will keep the  board posted.  Thanks again - there is definitely power in prayer.  It has sustained me through many a hard time in my life for sure.  Take care and thanks for caring!

Hugs,
Lisa

Offline upset mom

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Re: opinion needed re 13 year old daughter's knee
« Reply #56 on: May 21, 2005, 05:18:50 AM »
Hi Heather,

She didn't want to take anything before going to sleep tonight.  I am going to suggest she takes the Naproxin tomorrow.  The tylenol is tylenol with codeine.  I don't know to tell her to keep her foot off the ground when using the crutches or to put pressure as tolerated on it (that's what the OS and PT had said, but you know my faith in them).  They have me so confused!  When she was in PT they said she should try walking on the leg and the OS said the same.  I think she should stay off of it until we figure out what's going on.  God knows when that will be!  Hopefully, the scan she took today will light up the problem.  To top things off I now have a problem with trying to get her on my health insurance at work.  She currently has BlueChip which is State Health Insurance for children.  My job can put her on my insurance June 1st but claim they first need proof that she is not on the BlueChip insurance.  I called BlueChip and they said I had to request this in writing and then they will mail me a letter saying she's discontinued.  But they couldn't guarantee when that letter would arrive.  Being it comes from the State it could go past June 1st, in which case my job couldn't enroll her until July 1st and that would leave her with no health insurance if the other stops.  This makes no sense to me at all.  It's one problem after another so it seems.  I'm going to speak to my job on Monday and see if anything can be done, but the telemarketing firm I work for has strange policies to say the least about the job!  I am going to mention the LIDODERM PATCHES you mentioned to the OS on Monday when we go in for the results.

I feel for you for the struggles you've been through for so many years, but you sound like a strong survivor!  I printed out your post so I can write down some notes for the doctors.

Thanks so much for all your advice.  They say knowledge is power.  The more informed we become, the more we can sort out what is the best thing to do.  And yes, the hormones are really "dicey" in the teenage years.  You can't imagine how it is dealing with two teenagers - one 13 and one 14 and added together with all this stress.  It's a miracle I'm still sane, or am I?  Just kidding.  Right now it is after midnight and I am really tired from the whole day or I'd write more.  Will post Monday night, hopefully and prayerfully this bone scan and xrays will come up with something.  But knowing myself I probably will go for another opinion.

Hope you have a good weekend - as pain free as possible.

Hugs,
Lisa

Offline upset mom

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Re: opinion needed re 13 year old daughter's knee
« Reply #57 on: May 21, 2005, 05:33:11 AM »
Hi Sparkle,

Thanks for writing.  The doctor did say, I believe, that she set up a safety mechanism by saying she was favoring using the other leg and thus walking with a limp to avoid the pain.  As a result her hip has been hurting her as well as her knee.  Probably why they scanned the hip also.  I think she definitely has to strengthen her muscles and we will deal with that after I hear what the OS says on Monday, mull it over and go with my motherly instincts (my gut feelings) regarding his diagnosis.  Thank you for all your support.  I'm really exhausted right now mentally and physically so am going to be brief.

Good luck with "your" knee and with the PT.  Hope you get more relief each day.  And on the light side, don't think she would want to be a PT or knee surgeon (smile) - she wants to be an actress - she'll certainly have lots of experiences to apply to that field:)

Will keep you informed Monday as to the results.

Hugs,
Lisa

Offline upset mom

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Re: opinion needed re 13 year old daughter's knee
« Reply #58 on: May 21, 2005, 05:48:56 AM »
Trekker,

Hi - When you say have her keep the knee straight by raising it just slightly off the floor, I'm a little confused here - should she be lieing on her stomach when she does this?  Or standing up?  I am not an expert by any means in PT and don't want to hurt her in any way.  Wish I could take a course in PT - seriously.  I am going to mention the terms you wrote - reciprocal inhibition and rectus femoris  to the doctors.  It sounds like this is what she is experiencing.  Do you think she could've done any serious damage to her hip in these past two months, as it is beginning to get more painful?  I'll post and let you know what the OS says on Monday and would appreciate your opinion as well as anyone else on this board.  This OS has a very low key personality and it's like I have to pull words out of his mouth, so hopefully he will make some sense to me.  Sometimes I think they are afraid of malpractice suits.  We live in PA and there has been an exodus of doctors here due to so many lawsuits.  I really hope I can get her on other insurance before too long.

Thanks again for all your advice.  You sound so knowledgable - are you a PT?  I don't remember if you mentioned that or not.

Take care and have a good weekend!

Hugs,
Lisa

Offline upset mom

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Re: opinion needed re 13 year old daughter's knee
« Reply #59 on: May 21, 2005, 05:53:07 AM »
Hi Morgan (Mo),

It's Heather's mom - she's sleeping as I'm reading this at almost 1 a.m.  I'll tell her you posted and wished her luck. She'll probably write to you tomorrow.  Hope you feel better.  Think positive because you will definitely get better sooner than you think!  Hang in there - you're not alone!

Hugs,
Lisa
















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