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Author Topic: I have had an improvement!!  (Read 16995 times)

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Offline tanyap

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Re: I have had an improvement!!
« Reply #30 on: October 22, 2007, 10:28:14 AM »
Dont worry about the EMG testing - I just read up on it there too - I wouldnt imagine its too bad at all.
You definitely sound like youre just not firing. I hope they give you e-stim - its worked a treat for me. Obviously my strength is still rubbish but I can make the muscles contract now which is a big change!!!
Ask your PT about e-stim.

Ill give you the link for the e-stim I use - I dont know if its available outside of Ireland, but it might be - and youre only across the water so it might be a place for you to start if you need one, at least you can read up on it.

www.kneehab.ie

Ah sure, pain reminds me Im alive :)
xxx
Tanya

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

Offline Sore knee

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Re: I have had an improvement!!
« Reply #31 on: October 22, 2007, 01:27:29 PM »
Thanks Tanya, we aren't that far away at all :)

Phoned my PT who is speaking to the OS this morning and wants me to come in on the 30th as there is a Donjoy rep in and they want me to try various types as my legs are not very big as he put it. I have long legs but they are fairly slim and probably one is now very wobbly with no muscle tone. So he says I would need to try them as one that is not correct fit would be worse.

So he will phone later today after he confirms things with my OS.

The joys, I don't know where its going at all. I am concerned about the whole mobile patella issue and the fact that they feel my knee can't grasp the new biomechanics since the LR. I hope something changes soon !!!

Well at least your pain is a good pain - thats a result in itself. For every pain you know something has worked !
11/5/07 LR right knee and cartilage tidied up
6/8/07 Knee aspiration, steroid injection- more physio
22/8/07 Knee to be scoped for answers
16/5/08 Patella stabilisation for  subluxations
24/6/08 Infection -hospitalised for a week. Debridement surgery
21/11/08 Repeat patella stabilisation performed

Offline kathat

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Re: I have had an improvement!!
« Reply #32 on: October 22, 2007, 01:45:49 PM »
Hey Joanne,
Have just read that you have been having pains behind your knees. I've noticed a lot of LR people who have complained of the same thing. I've had them in both knees.To start with I had stabbing pain behind my right knee that was so bad I couldn't walk. Then I got it in my left but not so bad (my left is my better knee in general). I was wondering if it was due to muscle strength. I have had swelling in a small pocket behind my knees (hard to find) and my PT thinks that something's getting irritated. The pain has eased off recently though. Just hope it stays that way! What sort of brace are they getting you? I'd be interested to see if it helps. Will keep my fingers crossed!

Tanya - hope things are still on the improve. Has the pain eased any? What's e-stim? And EMG testing? I guess I'll have to look it up and stop being lazy!!  ;D

Bye for now,
Kathy

Offline tanyap

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Re: I have had an improvement!!
« Reply #33 on: October 22, 2007, 01:50:33 PM »
Ive heard good things about Donjoy braces, dont have one myself.

Can you see the difference between your two legs and the muscle bulk on them?

What did they do your original LR for?
Im sure something will change, if you can just get those muscles firing you will start making progress.

Kathy - Im less in pain and more just tired leg the past couple of days. Honestly since VMO started moving my knee feels so much more tired after exercises - I guess before the muscle wasnt getting used at all so it didnt tire - now that Im using it I keep getting that fatigued feeling in it.
e-stim is electric muscle stimulation - its a device with sticky pads that you stick to muscles and it sends a small electric pulse into the muscle causing a contraction. Can be useful to get muscles firing again.

xx
Tanya
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

Offline Sore knee

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Re: I have had an improvement!!
« Reply #34 on: October 22, 2007, 08:44:36 PM »
I went o the OS because my knee was sore, any time I was on my feet a long period or did activity it was really sore that night. It felt at times as if it was clicking and just didn't always seem right. I went to a chiro who x rayed it and they said the patella was way out of alignment. So I went to the OS who said I had a tilted patella and thought I would be doing good if I wasn't down to bone on bone. They done the LR and they said inside looked pretty good and wasn't as bad as they thought.

After the LR I had continual swelling and pain, catching and slipping feeling. So in Aug a new OS said there must be mischief and done a scope. He said it looked fine and just cleaned up some rough areas behind the knee cap. All seemed good for a couple of weeks but then the swelling increased again and now my pain is increasing again. I get sharp pains behind the knee cap especially on stairs. I get aching in the knee and tightness down the outside between my thigh and calf and still feel as if I have slipping inside at times.

So they done biofeedback, strap sticky electrodes on my muscles in my quad to see if they are working. I contract them and it measures. It showed they were not working ( my PT became a bit more sympathetic now as prior to this I think they thought I wasn't trying enough). Now they want to put me in a brace but want the Donjoy rep to come to see me at a PT session on the 30th provided my OS agrees to it. They have also talked of EMG testing which I believe is where they stick needles directly into the muscles and use these needles as electrodes. Its meant to feel like an intramuscular injection and can be stingy and uncomfortable but not unbearable.......ooohh I am so excited about that one ....not  ;)

So my PT said he would call me back after speaking to my OS again, so at present I am just waiting to see what happens. This cold weather (or at least the change of hot on holiday to cold here) leaves me with a constant ache in my knee.

Happy days, roll on VMO activity like Tanya. I must admit Tanya even my PT feels they are stabbing in the dark and they said they didnt want to discuss more options until we do this. What is the 'more options' thats what is rattling round my head. I wonder if the LR actually solved my problem or gave me one  ???
11/5/07 LR right knee and cartilage tidied up
6/8/07 Knee aspiration, steroid injection- more physio
22/8/07 Knee to be scoped for answers
16/5/08 Patella stabilisation for  subluxations
24/6/08 Infection -hospitalised for a week. Debridement surgery
21/11/08 Repeat patella stabilisation performed

Offline kathat

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Re: I have had an improvement!!
« Reply #35 on: October 22, 2007, 11:53:18 PM »
Oh boy, changes in weather. Yuk! We've just had a cool change come through and boy are my knees giving me trouble. On top of the weather ache, the dog ran into my knees causing them to hyperextend, so that has only added some extra stiffness and swelling to the mix  :( Oh, and I return to work tonight, just to complicate matters more!

I felt that things had loosened in my knees after the releases. I am guessing that I had no VMO action to hold things in place, wilted quads, and now I have no retinaculum holding them in place on the other side so they're bound to feel a bit slip-slidey. I have had more problems with buckling since the releases, but not a lot of pain, just aching - but I am down to bone so I think that will never go away until I get the knees replaced. If your last scope showed all is well then it's probably all soft tissue problems. Hopefully as your knee gets used to the change in position of the patellar and you get those muscles working better then things might improve. Swelling compresses a lot of things too. I was amazed at the amount of pain I had from the small patches of swelling behind my knees. I am lucky I don't swell much at the best of times, so it has eased off fairly rapidly with massage and rest. And my patellae weren't lots out of alignment so there hasn't been a huge adjustment either.

Just remember that you have had two lots of surgery fairly close together and your knee could be one that takes any interference as a major insult. Try to rest when you can (I know, I hate being told to rest too) and hope that once your muscles are working as they should then things will improve.

EMG testing sounds like so much fun!!! NOT!! Hope my PT doesn't suggest it. Haven't started VMO work yet. Am trying to correct my overpronation first, before it causes more damage. My lower legs constantly ache from all the exercises to realign things, and I get all these weird stretchy feelings around my knees as things move differently to normal during the exercises.

Tanya, I can understand why your VMO is feeling fatigued - I'd feel fatigued too if I hadn't worked in years and suddenly I was asked to work several times daily!! Great to hear it's still working though and wasn't just a flash in the pan. Things are on the up and up!

Offline tanyap

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Re: I have had an improvement!!
« Reply #36 on: October 23, 2007, 09:42:39 AM »
Hi Joanne and Kathy,
Joanne - particularly because of the biofeedback results it does sound like your muscles are (a) switched off and (b) not yet used to doing their new job since the LR.
I understand what you mean about the PTs thinking youre just not doing your stuff, that happened me for ages, and Id be sweating away at home then back into PT for another round of 'geez - youre just not making any progress'........
I think your OS is gonna have to give some input here about next steps for you - mine jumped in at the news that my VMO just wouldnt fire and insisted on an e-stim and then called me back in after 2 months to see was the muscle contracting after 2 months new physio and e-stim. He told me on the second visit that he had feared the muscle was paralysed - he hadnt told me that first time, but once he ascertained there was some activity - no matter how small he said it was just a matter of hard work and e-stim from me for the next 6 months to a year. That was just over 2 months ago and although everyday life is no different Ive got a visibly different leg now and hopefully someday soon the VMO will fire automatically. I did discover a new trick last night - I can extend and straighten my leg in the bath, as though its in mid air except its in water, and it feels more stable. Up to last week I would only ever extend it with my foot on the ground or my thigh on a chair. So its progress, small but progress.


Kathy - oooh I hate the changes in weather too!!
I think that loosening sensation is real - i always thought it was from weak muscles letting everything slide around much more. If you get the muscles up big and strong you should be less slidy?
Have you tried glucosamine for your bone on bone? It might help....its only herbal so worth a try.
I get the weird stretchy feelings too - I dont like it!!
Yeah the VMO is DEFINITELY controllable now - I just wish I didnt have to THINK to contract it each time. But Im sure that will change as it gets bigger and more nerve fibres etc.... Its like playing a musical instrument - you have to think about your hands and what they are doing while you learn and then one day you just forget about your hands and they play the notes without you telling each individual finger what to do. Its my favourite muscle memory analogy :)
xxx
Tanya



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

Offline Sore knee

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Re: I have had an improvement!!
« Reply #37 on: October 23, 2007, 03:44:20 PM »
My PT phoned I go next Tuesday at 11am and the Donjoy rep will be there with several braces to try. My legs are pretty thin so they are concerned about getting one with a good fit. My OSa was happy enough with this, however my chiro gave me a brace to try over summer when I went to visit family and wasn't making progress with the PT. It didn't do any good then or at least there was no difference in swelling or pain etc. Maybe a new brace may help I don't know.

trying to stay positive but when they are telling me they don;t know what to do, my OS has been approached and he has just told my PT to try this and if it doesn;t help go to EMG testing.......will that tell anymore than the biofeedback ?????

This just seems to be never ending saga now. I have more pain now than I had 6 months ago. I don't seem my patella maltracking, but then I think I would only notice it if it ws jumping out of place. I do feel a crunch or mild grind at times though so don't know. I just really am having a fed up day. Do you know what I hate most, the fact that in everything I do i notice my knee. Like you get up and you don't feel your elbow so to speak, its there but you dont notice it. I hate that when I open my eyes...even actauuly alseep I feel my knee, when I wake up. It just aches .

Anyhow I have fingers and toes crossed that the VMO / brace etc will work.

Anyhow hope you guys are having a good day with all that working out :)
11/5/07 LR right knee and cartilage tidied up
6/8/07 Knee aspiration, steroid injection- more physio
22/8/07 Knee to be scoped for answers
16/5/08 Patella stabilisation for  subluxations
24/6/08 Infection -hospitalised for a week. Debridement surgery
21/11/08 Repeat patella stabilisation performed

Offline tanyap

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Re: I have had an improvement!!
« Reply #38 on: October 23, 2007, 03:52:44 PM »
aw joanne - Im with you there - I always say to myself 'i wish the forgetting would begin' - as in - i wish i could forget i have a knee like i forget i have an elbow!!!
you only notice cos its so achy. im exactly the same as you.

on the subject of things we hate - i hate people saying 'hows the knee?' - i mean how do you explain.......

new brace might well help. different braces support in different ways, and the correct size is vital. its worth a try anyway joanne - anything conservative is worth a try.

I assume he means if this doesnt work - as in if it doesnt help get your muscles firing again? He could be right here - if the brace helps with the pain, the muscles might not be so inhibited, and may start doing their stuff.
If not - then the emg tests are the next logical step. Im not sure exactly what they tell but they must be worth something else they wouldnt be a step on the path right?


Im having a sore day.....but only when I walk its sore, not just sitting around so thats not too bad......
xx
tanya





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

Offline Sore knee

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Re: I have had an improvement!!
« Reply #39 on: October 23, 2007, 04:23:12 PM »
That sounds like a grand excuse to me to sit , feet up with a cup of coffee or glass of wine tonight Tanya. You have earned it :)

Thanks for all the input, if only I could jump to the end chapter of this sorry saga and be as bright and cheery as you. You are indeed a shining star to so many here .
11/5/07 LR right knee and cartilage tidied up
6/8/07 Knee aspiration, steroid injection- more physio
22/8/07 Knee to be scoped for answers
16/5/08 Patella stabilisation for  subluxations
24/6/08 Infection -hospitalised for a week. Debridement surgery
21/11/08 Repeat patella stabilisation performed

Offline kathat

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Re: I have had an improvement!!
« Reply #40 on: October 24, 2007, 01:04:04 AM »
Hi all,

Tried to post you guys before heading off to work last night, but the stupid internet connection pooped itself and I ran out of time. At least I achieved my goal of distracting myself from the nerves of starting back at work!! Work wasn't too bad. I didn't have to do anything I shouldn't, unless you count moving around when my knees were saying REST!!

My knees are telling me I've overdone it this morning. I pottered around the house yesterday, then worked overnight and man has it played havoc with the knees. I tried to put them up at work, but I have coccyx pain and the chairs weren't the right angle for me to put my feet up and not get a pain in the proverbial  :P So I let them dangle and am paying for it. The cooler temperature on nights doesn't help much either. I think I've pretty well accepted the fact that I need a job change, as long as it's on my terms and I don't get forced into leaving work due to my knees. I am seriously thinking of getting a cane for days like today. I tried to do my SLRs and barely squeaked out a few trembly ones on each leg. I will be sleeping soon (once the pain relief kicks in) but I don't always have the luxury of resting when my knees are like this. Some support would be useful as it won't take much to knock me over or trip me up when I'm like this. And my knees buckle more when they're having a bad day. Will have to ask my PT about it. I don't want to cause problems for myself later on. I bet he'll tell me that I have to take time to rest when my knees need it - I bet he doesn't have kids!! Or a husband  ;D !!

Crikey how I hate that question "how's the knees?"  >:( They usually turn off once I tell them the surgery went well, and they don't listen to the "but". My offsider at work (we have two of us on each ward) happily told me to rest while she did a lot of the work, but I'm sure that'll get old pretty quick and they'll start resenting my limitations. I don't mind doing my fair share, but it was obvious last night that I was aching and not up to being on my feet too much. I am just hoping that the LRs have reduced the pressure on my patellae and slowed the progression of the OA, as I feel that not much else has changed. The OA ache is back and the knees still buckle and crunch. So much for the year or two of relief the OS suggested I might get.  :'( To give him credit, he didn't make any promises and I think even he had no idea that the OA had progressed so far. He did a fantastic job of the surgery, so I have no issues there. I certainly don't feel any worse, apart from lateral stiffness (which improves with stretching) and slippy knees, which I think is due to the release itself loosening things up and muscles not grasping this yet (they will adapt eventually).

Oh dear, I am starting to dribble crap again and half of what I type has to be corrected. I think the pain relief is sending me gaga  ;D Goodnight. I think I was leading somewhere but I don't know anymore...oh well...I might think of it later. What a saga this has turned into. Better go. Bye bye.

Kathy

Offline tanyap

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Re: I have had an improvement!!
« Reply #41 on: October 24, 2007, 09:22:38 AM »
Hi all,
Joanne - I want you to be my new consultant, suggesting glasses of wine and rests for me - youre a great consultant!!!
Sure Im only in the middle of the book as well, my final chapter will probably be the one where Im on the deathbed surrounded my dozens of great grandkids all shuffling to try and get a deathbed promise of my riches and Ill manage to wheeze out 'will someone take that ice off my knee now please...........' :)
OR - we'll all live so long that medical technology will have advanced to the point where they grow you a new limb if necessary and we can then complain to each other 'yeah, I really preferred my old right leg to look at, the toes were neater....' :)

Kathy - well done on going back to work, and YES definitely get a cane if itll help you!!! For sure, youre way better to protect your joints for the long term. What about wearing standard knee support braces - just the neoprene type that you get in a chemist - would that help you for support?
Work will get easier as you get more used to it - but you probably do need a job where youre not on your feet so much - can you transfer within where you are now to a desk based job? The only thing is, the more youre on your feet the stronger those muscles will be - its catch 22 isnt it?
Im really glad you got through the first night anyway.
And yes - the muscles will adapt to their new roles.

Im pretty good today - feel more stable but have soreness. My muscles may be adapting to the wake up call but they know how to complain aloud!!!
Drivings been hurting the past couple of weeks - never did before - its cos Im actually engaging that darn VMO that all this pain is here - but Im sorta welcoming it cos it took SOOOOO long to get it going.

xx
Tanya

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

Offline kathat

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Re: I have had an improvement!!
« Reply #42 on: October 24, 2007, 10:51:49 AM »
Howdy everyone!

I have got neoprene braces - I live in them. I find I have to take them off at intervals to give my skin some air and relieve the areas where the hole over the kneecaps are. The holes seem to invite all surrounding flesh to drop in for a visit and I get bulges of flesh hanging out of the holes getting puffy! Maybe the braces are a bit snug, but they feel ok and the PT was the one who got them for me.

Love the image of that icepack on the knee till the very last! I think if I come back to haunt everyone then I'll bring with me the faint odour of thawing peas and sweaty neoprene!!  ;D

Book me in for consultant Joanne - I like her form of therapy!!

I am going to see how work goes with time. Currently I think I have got good balance between activity and sitting, so it'll all depend on what's expected of me regarding manual handling. I managed to help turn people, as I can lift the beds up so that I just get a mini mini squat happening, and then I grab hold, lock my knees in place, and lean back, using my bodyweight to do the work. So far that's all the manual handling I have to do with our current patients, and not often. They are pretty mobile in general. I plan to keep my eyes and ears open for a job with no manual handling, but I think I have some time up my sleeves yet. I think if I get a desk job then I'll have to be vigilant about exercise - walking, exercise bike, SLRs etc. I think I need some activity in my job though, as sitting down for too long is just as bad as standing for too long.

My knees have stopped aching for the time being, but the sharp pains are lurking. Must get busy massaging. It seems to help.

Well, need to go and clean up cat sick in my son's room.

Kathy

Offline tanyap

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Re: I have had an improvement!!
« Reply #43 on: October 24, 2007, 11:46:53 AM »
hehehehehe - how did you know I carry round the odour of thawing peas and sweaty neoprene???? I reckon its a very attractive combination!!

I hate wearing the neoprene cos I start getting itchy behind the knee, in the crook, and it drives me MAD!!! I also get the puffy extra bits of flesh hanging out, and for some reason my skin inside goes all sort of clammy and dead person like......

Youre so right about the working - part of my problems are cos I have a desk job now and I drive, i used to have an on my feet job (10 years ago) and when I got my desk job I cycled to work for a few years - but the past 6/7 years I havent had much in the line of daytime activity. You do need to keep up some form of exercise - I did use an exercise bike for the past few years but my VMO had already been quietly atrophying away......

get your son to go get sick in the cats room - let kitty see how it feels :)
xx
Tanya

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

Offline Sore knee

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Re: I have had an improvement!!
« Reply #44 on: October 24, 2007, 01:58:28 PM »
 ;D I have cats too and funnily enough they were sick yesterday...I was in bear feet and almost walked through it. The joys.......

Now as for me being a consultant, here is what I prescribe. The three of use could go somewhere hot(ish) and rest, enjoying a few well earned drinks from fruit smoothies to cocktails...between the painkillers of course and all delivered bu our handsome waiter at the poolbar :)

Ahhhhhh it sounds appealing, at least we could walk like bookens with a limp or two between us :)


Hope you are all doing ok. My knees are sore today. I'm getting more pain even just walking sort of behind the knee cap down towards my lower leg bones and I definitely feel more of a slip or click or whatever it is today. I laugh about it today as I am tired of groaning, phoned my doc for heavier painkillers so hope to get those tomorrow.

How are you all ????? ( Go pack your cases, we leave for virtual vacation - for rehab purposes of course - tomorrow :)  )

11/5/07 LR right knee and cartilage tidied up
6/8/07 Knee aspiration, steroid injection- more physio
22/8/07 Knee to be scoped for answers
16/5/08 Patella stabilisation for  subluxations
24/6/08 Infection -hospitalised for a week. Debridement surgery
21/11/08 Repeat patella stabilisation performed















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