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Author Topic: Suggestions on symptoms and patient history-help please  (Read 862 times)

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Offline chrystee

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Suggestions on symptoms and patient history-help please
« on: June 18, 2007, 04:15:47 PM »
Hello! I am scheduled to go to my first OS appointment on Wed. June 20th. Someone on here (sorry I don't remember who) suggested that I write out list of my syptoms etc. to take to my appointment. I just finished typing it up. I was wondering if anyone had any suggestions or if it seems okay.

Thanks so much!

Surgeries

Tonsillectomy-age 9
Arthroscopic scope right knee-1998-trimmed fat tissue under knee cap due to impingement
Laparoscopy-Sept. 2000-drain right ovarian cyst
Laparoscopy-Sept. 2000-removed cyst
Laparoscopy & Appendectomy-2002

Prior Sports & Activities

Involved in sports beginning at approximately age 6.  Dance (only for 1 year or less), gymnastics (only for one year or less), soccer (only for one year or less), softball, basketball, cheerleading (only for one year-age 12)

Symptoms & Injuries

At age 12 (approximately) suffered from knee pain when running and jumping. Doctor at the time told my mother that I was not to play any sports that required a great deal of running and I was not to participate in cheerleading past junior high level due to the fact that my cartilage was soft. Knee pain went away for the most part. .

January 1998-twisted ankle and knee while at work. Ankle pain went away. Knee remained swollen and painful. Began physical therapy for the knee issues.

April 1998- stopped physical therapy as there was no improvement. Orthopedic surgeon recommended scoping the knee to further evaluate the situation and found that the fat tissue under the kneecap was pinching and most likely the source of my pain. No other issues regarding my knee were discussed. (This was a workman’s comp. case) Pain subsided after the scope was performed

As I got older squatting and climbing stairs, especially going down, bothered me but was not painful

March 29, 2007- stepped on one of my children’s toys and twisted my leg. My knee was very swollen the next morning however, did not hurt. Approximately 3 days later it did begin to hurt but it was tolerable. Approximately one week later I did go to the doctor because the level of pain had increased and the swelling had not decreased at all. I was told that it was sprained and I needed to stay off of it and take ibuprofen to help with inflammation. If there was no improvement come back in 3 weeks to get re-evaluated. About 2 weeks later I went to the ER on post because the pain was A LOT worse. The doctor that examined me told me that I should try steroids for one week to see if that would improve my knee. She said if it did not improve that she would recommend that I get x-rays and a MRI. I was prescribed steroids and pain killers. I finished the steroid treatment but found no improvement.

May 24, 2007- was seen by my PCP and she sent me for x-rays and to schedule an MRI. The pain level was tolerable and I could still walk without limping, however the knee was very swollen.

June 3, 2007-had MRI. After all of the walking I did that day my knee was VERY swollen and hurt considerably more than it had previously.

June 7, 2007- was prescribed tramadol for pain management, which at times is somewhat in effective.

At times knee has hurt so much that I limp. Pain increases with inclines and CAN NOT go down stairs because the pain is to severe-must take steps one at a time instead of walking down them normally. Pain is increased going downstairs, the pain is not as bad going upstairs, grinding is felt both going up and down stairs. Kneeling is painful as well as squatting.

At times over the last 3 months my knee has felt as if it was “going out” just in the middle of walking, occurs infrequently, approximately 5 times over the last 3 months. Over the last week or so it has felt as though something is catching when I walk occasionally. PCP recommended crutches and to stay off of my knee as much as possible. To try and maintain my range of motion I do try and use my right leg while using the crutches, which does seem to help as all of the weight is no longer on my right leg.  Getting up from a sitting position is becoming uncomfortable but tolerable. Knee seems to get stiff and tight after sitting for 30 minutes or more.

Currently taking 600mg of ibuprofen 3 times a day for inflammation and tramadol as needed





redtoblack

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Re: Suggestions on symptoms and patient history-help please
« Reply #1 on: June 18, 2007, 08:05:19 PM »
Sounds good.  I’ve found that a lot of the Dr’s want you to specifically tell them the types of activities you do day to day that you can no longer do or find it very difficult to do.  You did mention the stairs and kneeling, but does it affect your job or your ability to drive/do daily tasks/change your normal exercise routine?  Also, a lot of them want you to rate your pain from 0-10 (0 is feelin great and 10 is emergency room).

I wish you the best of luck with your appointment!

Jordan

Offline chrystee

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Re: Suggestions on symptoms and patient history-help please
« Reply #2 on: June 19, 2007, 12:00:15 AM »
Thanks for the input Jordan! Luckily

I am not working but I am a stay at home mother of three...one of which is a toddler. At times it's hard to carry the baby. I am glad that my older boys are the ages that they are because they are a HUGE help at times. I see what you mean about talking about daily activities. There are times that driving is uncomfortable but bearable...walking that is a different story. Cooking dinner at times is quite a task...I could go on and on...LOL.

But I also know that it could be so much worse. I just want to be able to take my kids to do things and play with them on a normal basis without being in pain or down for a couple days because of my knee.

Anyway, thanks again for your help! I hope that all is well with you!

Offline tanyap

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Re: Suggestions on symptoms and patient history-help please
« Reply #3 on: June 19, 2007, 11:20:15 AM »
Hi chrystee,
good list, Os usually wants to know both level of pain and type of pain - is it aching, sharp pain, feeling of pressure. A lot of the time I cant distinguish - it just HURTS. but if you can try to distinguish level, type and where in the knee youre feeling the pain that will help.
When you say going down stairs bothered you but was not painful - what do you mean? Do you mean you didnt have enough strength to use your right leg properly or that you simply could not pass a certain level of bending without pain coming or your knee feeling like it was going to give out?
I think he will be interested in exactly what happened when you 'sprained' your knee. What position you were in - exactly what happened, what direction your leg went in, was there any noises? I say noises because if you damaged one of your ligaments that can be accompanied by an audible 'pop' or 'crack' - not just audible - you can feel it too. On my first dislocation at age 12 I was reported to have said 'my knee popped, i heard it pop' before I passed out from the pain - apparently that went a long way towards helping them diagnose the damage done.
Do you think you have used your leg less since the 'sprain'? this could contribute to it weakening and you feeling like it is going to 'go out' walking could be general weakness from misuse (not misuse on purpose, but just you having too much pain to use it properly).
Some of your symptoms could just be follow ons from whatever is actually causing your problem.
OS appointment for you tomorrow and your MRI will give him more info - hope you get a clear diagnosis and an obvious treatment plan!!
My own GP told me that surgeons want to hear about your level of difficulty performing ADLs (activities of daily living) - the less you can do the more important it is you get fixed up. So try to impress upon him that your daily life is being interfered with.
Best of luck tomorrow Chrystee - will be waiting to hear what the OS says.


1986 - recurrent dislocations of right patella began
1988 - Modified Hauser Procedure
1991 - dislocations started again
2005 to 2007 - 150 dislocations in 2 years - OUCH!!!
June 2007 - new OS, new physio
Oct 2007 - VMO woke up
Mar 2008 - big quads, still dislocating
Apr 2008 - next OS app