Ruptured Quadriceps Tendon

[Stuart Rulka]

Omar. Hope you had a good night and are now prepared to face the long process of rehab. Please keep on with your updates.
Fishy. Snow has arrived on our local mountains, so I had to wear spikes whilst hiking this morning. I use a rubber overshoes with carbide spikes that slips on over my trail runners or boots. These might work for you. Sold usually to jiggers and seniors!

[santosomar]

I was not able to sleep at all last night. It was like someone turned off the switch for the femoral nerve block I was given for post-surgery pain. It was the most pain I have ever experienced in my life.  Even taking 2 percocet tablets every 4 hours.

The doctor instructed me and my wife not to take the bandages and brace until my next appointment on Nov 25th. I feel that these bandages are brushing against the wound and also feel like a big cement block is on top of my knee. I am contemplating taking them off... Well, going to try to rest now. Just wanted to give a quick update to my friends and family, since they are following this blog.

[Stuart Rulka]

Omar. Sorry to hear of your pain.i admit I can't relate to that but I do relate to the friction of the dressing against the wound. The cement block analogy is probably the result of inflammation so you may have to get used to it. I wouldn't mess with the dressing however. My regular MD's office claimed not to be able to change the dressing properly! Needless to say I have not been back!
 Remember   RICE

       Rest
       Ice
       Compression
       Elevation

Another tip I haven't seen mentioned is to make up a sling you can loop over your foot to get in and out of bed,or a chair, and keep a bucket by the bed to pee into. Much easier than trying to make it to the bathroom

Fishy. That should have read joggers ( darn autocorrect ) and should those overshoes appeal but not be available let me know and I will find you some. After all BC is right next door!

[Frank550]

Hi Omar,

welcome back from your procedure.

Like has been said, leave the dressings alone, the last thing you need is an infection getting in to the wound.

I can absolutely relate to your pain, during my first night I climbed the walls with the pain, I was still in the hospital, and although I did have to wait hours to get my Oramorph, I did get it. The pain subsided quite soon, so rest assured that will ease off eventually.

Keeping a pillow under your knee might also help.

Use your family/friends in these early stages, do not feel too proud to ask for help.

The next stage is your rehab, now there are so many differing points of view to this, from my experience you need to start gradual movements soonish, rather than leave it weeks and weeks like I did, I have nurtured lots of scar tissue now because of it, plus I think I may have pushed weight bearing too soon causing swelling and heat in the joint which encourages scar tissue formation. As Stuart stated -  RICE, ice is your friend, as is elevation, swelling reduces if you can get the swollen area higher than your heart, in the early stages this is a must - and also remember swelling after such a surgery can sometimes last 6 to 9 months, some folks its much less, and some even more, its just your body's reaction to being messed with!!

In any case Omar, all the very best to you and yours and Im sure we all wish you a speedy recovery.

Stuart, Im sure like anyone, snow and ice fill me with dread, in fact I will probably stay in as and when the snow comes here!

[SE27Eagle]

Hey Omar - really very sorry to read of the post-op pain being so bad.  Not sure about Percocet - Wikipedia doesn't explain it brilliantly - but you might want (a) to let your surgeon know about the pain if it is still continuing and (b) make sure s/he knows the analgesia you left with isn't enough.  I left hospital with nothing because nobody remembered to do anything about it, and I "borrowed" the Tramadol from my wife, who didn't like it when she had surgery on her foot earlier this year but hadn't thrown it away.  There's much less precision about painkillers than other parts of the process and you need to scream (no pun intended) if it isn't working.  But fingers and toes crossed you're more comfortable now.

Can't agree enough with the others about leaving that dressing alone - again, call for International Rescue if it continues to feel that bad but don't let infection in.  Also the elevation point is critical - what comprises the "swelling" is basically viscous and fluid, so the reason for having "the wound above your heart" is so that the venous system drags it back away from the site.  I found with my wrist that the physio was spending quite a lot of time gently working it back into the lower arm in a way I could replicate quite effectively with a Dyson airblade hand dryer - it's liquid enough for that to work in real time.  But unfortunately you can't do that with your knee right now (and in any case, you shouldn't be touching it), so ice and elevation are what's left.  Having said that, on no occasion has anyone suggested ice to me immediately post-operatively, but instead only when physio started.

Stuart - the sling!  Quite forgot that - used a variety of things to do that  last time (belts, ties, legs of pairs of jeans I'd not really put away very well).  This time the leg is much lighter.  Also I note that I can cheerfully swing it unaided to the right (bed/sofa mounted from the left, as it were) but not the other way round.  Reading through my notes I see I had quite a big tear to the medialis vastus (one of the four horsemen of the quadriceps) and I wonder whether that's why.  Don't know if others have similar experiences/memories?

As for the snow - well, I keep getting snowmail alerts for the French Alps where we're heading in a few weeks.  Feel a bit ambivalent, really - love the place but will have to confine my efforts to being an in-house cook this year.

[fishy]

Omar. Hope you had a good night and are now prepared to face the long process of rehab. Please keep on with your updates.
Fishy. Snow has arrived on our local mountains, so I had to wear spikes whilst hiking this morning. I use a rubber overshoes with carbide spikes that slips on over my trail runners or boots. These might work for you. Sold usually to jiggers and seniors!
[/quote
Fishy here....I have a pair of those I keep in my truck. Running I would install screws on my running shoes.  Hiking with pole's (a recent purchase)..... my legs are getting stronger but I need to work on both inside and outside of quads with weight training.... ps, where do I find a "jigger"?  Lol

[Stuart Rulka]

Got an e-mail back from my OS and he appears to agree with the prevailing mood on this forum.
"I think physio can push the envelope as long as the patient does not suffer. There are many approaches to quads ruptures and I think with the newer sutures and  techniques protocols for recovery should be upgraded."
Our collective experience would seem to suggest that the sooner mobility is returned the easier the recovery! Individual differences will always need to be taken into account.

[santosomar]

Stuart, Frank, SE27Eagle, Fishy, et all.

Thank you folks!!! I am really really glad that I found this forum before my surgery. You guys really cheer me up!! I feel MUCH better today and the pain is calming down a bit. Huge difference from yesterday.

I really like the RICE concept and trying to be disciplined and abide by it everyday.  I also like the idea of the sling. I tried a couple of things already. My poor wife's back hurts from helping me lift and lower my leg every time that I need to go to the restroom or move around. I am 6'3" and 260 lbs. So one of my legs weight almost as much as she does ;-)

SE27Eagle, WOW! the French Alps!! I have been in France a couple of times, but never made it to the Alps. I bet they are beautiful!! Hope you enjoy your trip, despite the circumstances!

Thanks again folks!

Regards,
Omar

[SellaVee]

Omar, you can buy something called a "leg lifter" which is a reinforced webbing strap with a loop at the end for your foot.  I found it very useful.  Tramadol and Paracetamol taken together were my painkillers of choice.  I'd also say leave the dressing alone and hold off on the ice until later.

SE27Eagle, I used to live in SW London but I'm now in NW England.  Don't have insurance anymore so going to a private physio at my own expense.  I think it's money we'll spent as she's making such a difference.

Stuart, I'm probably one of the least active on the board but even I have been doing more than my NHS physio suggested, so I'm interested in your surgeon's comments.

Frank, hope your op goes well.

I've gone back to work, very much part time, so I'm spending less time on here.

[Stuart Rulka]

Omar. My wife made me a sling from the shoulder strap of an old sport-bag. The shoulder pad fits under your heel and the clips make it adjustable. Experiment and improvise!
Have a good week everyone.

[mojocpa]

Omar, another suggestion for when you get to go home is to invest in a recliner chair that has good solid arms to help you when you go to get up. When I was in the hospital I spent a lot of time in the recliner there. With my double I find I need all the help I can get. 

[SE27Eagle]

So - back from the orthopaedic surgeon and two week wound inspection and check-in.  Dressings off and there is my knee again with its remarkably well healed cut line.  Strict instructions to keep in the locked brace but off to the physiotherapist in two weeks' time, albeit after another two weeks of the anticoagulant because I am somewhat insanely still on to fly to the US for work purposes in the same two weeks' time (there's a bit of overbooking in the offing here).  One reason I am still thinking seriously about this is that airports are one of the few places where they really do have routines and machinery to make life easy for the person on crutches.  I'm even hopeful of getting a few free chocolates and some drawing books with the unaccompanied minors if I get to board early.

More clinically speaking, plan is for gentle passive mobilisation (to about 40 degrees) on the table in a fortnight, but no pressure through the joint for another month (so locked on zero when ambulatory all of that time).  Back to surgeon in three weeks' time to have a look at it moving.

Omar, how's it going?  One other left field thought for you and later readers of this epic thread is that 6 and a bit years ago, and partly because we needed a spare single bed for the box room anyway, we acquired this let's-play-hospitals bed from IKEA for my recovery.  It elevates at top and bottom with a little remote control but it cost just under £300 rather than £3,000 for a real one.  Needless to say (and this is where an accountancy training comes in handy), I've been genuinely excited by the amortisation over not just one quads tendon recuperation but two bunion operations for Mrs SE and now - the icing on the cake - a SECOND quads tendon recuperation.  The cost of this bed is just coming down and down.

 

[Stuart Rulka]

SE. Not to get your hopes up but on one occasion whilst travelling as an unaccompanied minor my House-Master failed to show to pick me up, so the Stewardess (as they were then called) took me Home with her! Always was a jammy %#^+*!
 I accept that your recovery is in good hands but I feel compelled to say that your OS seems to be thinking tactically about the success of his procedure rather than strategically of your overall recovery, given that my Physio had me on a bike at three weeks. If you are going to be in the States for two weeks you have little choice but don't be afraid to ask questions. Even my OS admits Protocols need to be revised!

[santosomar]

Hi folks,

Thanks again for all the suggestions!

Stuart/SellaVee: Bought the "leg lifter" on Amazon yesterday and should be here tomorrow morning. Thanks again!

mojocpa : absolutely!! as a matter of fact, I am not able to sleep at my bed... very uncomfortable for some reason. However, I have an L-shape Lay-Z-boy sofa with 4 recliners built in. That's where I spend all day and also where I sleep at night. This was well-worth the investment. Who would've known that I will be using it like this now. :-(

SE27Eagle : that bed really sounds good and especially for the price!! I will keep my eyes open and see if I can find something similar here in the US.

I feel much better today and continuing to be positive. Thanks again everyone!!!

Have a nice week!!!

[fishy]

Hey, SF27Eagle, after reading your post on "amortizing the Ikea bed", I had to chuckle.  My lady had hip replacement surgery 5 weeks before my accident, and we commented that the walker, toilet riser, crutches, cane and some bandaging left over from her operation were now getting an extension on use.... who knows, if I fall on the ice here in Alaska they might get used a third time!!  Don't you just love savings like that.....lol.  Keep your sense of humor up and adversity will subside...