Banner - Hide this banner





Author Topic: ACI and HTO on 10/22/07-It's going to turn out great!!  (Read 38048 times)

0 Members and 1 Guest are viewing this topic.

Offline casey2291

  • SuperKNEEgeek
  • *****
  • *
  • Posts: 1011
  • Liked: 0
  • User's Text
Re: ACI and HTO on 10/22/07-It's going to turn out great!!
« Reply #30 on: November 17, 2007, 12:45:27 AM »
Kathy...sounds like you have a good PT.  I hope that he can help you get your pain levels down.  I start PT on monday.  I already know my PT from working with him after my last scope and also for an old back injury.  He already requested that I get a copy of a rehab protocol from my OS so that is good. 

My pain levels have decreased significantly.  I am off of all pain meds and the extreme pain that I was having is almost all the way gone.  Only every once in awhile when in the cpm do I get a really extreme pain, but it seems to go away quickly.  I'm extremely happy that my pain is getting better.  I tried again to do a SLR, but I could do one today.  I must have worked my muscles a little too much yesterday with the SLR's.  I did about 30-40 of them yesterday.  Just another lesson to teach me to be patient during this recovery and not over do it.   :P

Here is some interesting info.  I got a statement from my insurance company which told me how much the bioservices corporation (genzyme) charged for my surgery.  The statement was for $65,271.00  I did a double take when I looked at the statement.  I'm not sure if this includes the cost of the whole surgery or just the cells.  I know that there was someone present during my surgery from genzyme so I'm not sure if that is included in the cost or not.  I'm curious to see how much everything will cost with the HTO and the surgical center costs, cpm, etc.  I was told by genzyme that if the surgery was not paid for that I would get a bill for $26,000 for just the cells alone.  I'm praying that I meet all the qualifications for my surgery to get paid for.  My insurance company would not pre-approve the surgery because it was an outpatient procedure and my lesion had to fit within specific guidelines (which I think it did) in order for them to pay.  I won't know anything until my doctor submits info to the insurance company if everything will be covered.  I was given pretty good confidence by my doctor's office and genzyme that it was likely that everything would be covered, but I still had to sign a paper stating that if my claims were denied that I would pay. 
LOA #2 and hardware removal 12/15/08-new cartilage from ACI looks "GOOD"
LOA on left knee 3/18/07
ACI and HTO on left knee 10/22/07
scope of right knee on 6/21/07
microfracture left knee 3/18/05

Offline kathat

  • SuperKNEEgeek
  • *****
  • *
  • Posts: 1520
  • Liked: 1
  • Aussie, Aussie, Aussie
Re: ACI and HTO on 10/22/07-It's going to turn out great!!
« Reply #31 on: November 17, 2007, 11:28:46 PM »
Crap! What a thing to have hanging over your head. You'll be relieved when it's finally settled!!

You're right, I have a wonderful PT. He's really on the ball and he's nice to boot! I see some of the other PTs come out and call for their next patient, then march off without checking to see if the person is keeping up. Mine comes up to you if you are not watching for him and then waits for you and chats while walking. I reckon he learns a lot from watching some of his patients walk into the room. He certainly picked when I was having pain issues. He also spends the whole time in the room - no setting me up doing something and walking off. If he gives me an exercise he shows me how to do it then tells me how much he wants me to do it at home. I don't waste any time doing things for him that I could do at home. I hope he hangs around long enough to at least see my through ACI. I trust him to follow rehab protocol, and to look up what he doesn't know.

I reckon you overdid it with the SLRs!! That's an awful lot to do when you haven't done one for so long! Your muscles have probably gone on strike  ;)

Kathy

Offline Peg Leg

  • Forum Faithful
  • ****
  • Posts: 495
  • Liked: 0
Re: ACI and HTO on 10/22/07-It's going to turn out great!!
« Reply #32 on: November 18, 2007, 02:55:42 AM »
Casey,

I just got my EOB and I was billed $49,375.00 by US Bioservices.  This is the fee for Genzyme's part in the whole procedure.  Insurance pays them a discounted amount of $22,303; which is what I was told in the beginning.  Mine was also an outpatient basis, or less than 23 hours; so hopefully this is standard procedure and your Ins. will pay.  Mine paid and they have been real butts about almost all of it so far!!  Good Luck to You!!

Peg Leg
10/06  Miicrofracture Rt knee on mfc
defect was 1.3x2, small defect under patella
04/07 Arthroscopy/Cell harvest for Carticel
06/28/07 Carticel surgery ,Rt. Knee
12/27/07  Scope to debride Patella lesion,Rt. Knee
4/17/08  Fulkerson AMZ, Rt. Knee
6/25/09 ConforMis BiCompartmental Knee Replacement

Offline kalyjoe

  • Forum Faithful
  • ****
  • Posts: 185
  • Liked: 0
  • User's Text
Re: ACI and HTO on 10/22/07-It's going to turn out great!!
« Reply #33 on: November 18, 2007, 03:50:44 AM »
Congrats on the SLR!!  It's funny how the baby steps with this recovery mean so much.  ;D  I know you are anxious to get started on PT and I'm sure that will also make you feel lilke you're accomplishing something.  I also think it's great you are so comfortable with your PT.  It makes a difference if they know your history, yk?

Great to hear the pain levels are decreasing.  Time is almost flying now isn't it?   Sounds like you are on the right road...but yes...remember not to push it too hard.  Funny coming from me, I know.  But like I said...lesson learned. 

As far as me, yes I have a scope on the 29th.  It is part of the clinical trial, to compare the before and after and the progress that has been made in a year.  They'd be doing it whether I had any problems right now or not.  My knee has been catching a lot lately, so I'm really hoping there's some overgrowth or something that he can just snip and make all better.  I know, I live in fantasy world right now.   ;)  But there's no sense in stressing about what I can't change.  I just have to see what he finds and then explore my options.  I need to move forward. 

I completely understand the disgust at the cost of this surgery.  A lot of my surgery was covered in the trial, but what wasn't still totalled almost $40,000.  And that didn't include the doctors fees and all those "incidentals" they charge you for.  It really is ridiculous isn't it?   This next scope is paid for completely by the trial thank goodness.  I really hope your insurance company agrees to cover yours.  I did have to pay for some of mine and actually just finished my last payment last month.  It took me two years to pay off my portion of my microfracture in '04.  <sigh>  Who knew we'd spend so much on our knees?   :-\

Have a great week!  Good luck with PT!

Kristi
2 x 1.2 cm defect of right medial femoral condyle
Microfracture, right knee, October 18, 2004.
MACI using CaReS, same knee, November 30, 2006

Offline casey2291

  • SuperKNEEgeek
  • *****
  • *
  • Posts: 1011
  • Liked: 0
  • User's Text
Re: ACI and HTO on 10/22/07-It's going to turn out great!!
« Reply #34 on: November 19, 2007, 09:10:09 PM »
kristi...I'm keeping you in my thoughts for the 29th!  Be sure to let me know how it goes.  I'm really hoping you just have overgrowth and not a failed ACI!!

Robin and Kristi....Isn't the cost of this surgery just CRAZY?  Robin...I'm wondering if the cost of the surgery has gone up that much in the time difference between when you had your surgery and I had mine.

Kathy...keep up the good work in PT.

I started PT today.  I didn't do a whole lot because there is not a whole lot that I can do at this point.  My PT received the rehab protocol from my OS and he is already following it and had reviewed it before I got there today.  I am only allowed to do passive ROM, so my PT did some bending of my knee for me.  I am at 76 degrees flexion and my extension is perfect.  I'm pretty happy with my flexion at this point considering I started at 30 degrees just one week ago.  My PT would like for me to get to 90 by the end of the week.  I did SLR's in all directions with the brace on and some assistance from my therapist.  I was also given some hamstring and calf stretches and I am supposed to do isometric quad exercises with a rolled up towel under the knee.  In a couple of weeks once I can start weight bearing, I will start pool rehab.  I'm a little worried about the pool rehab only because I am worried about slipping on wet tile while on crutches.  Maybe there is not tile around the pool but something not slippery.  I don't know.  My PT keeps talking about respecting the healing and taking things slow so that makes me pretty happy that he is going to be cautious with my rehab. 

I am driving my car again.  I got my car back from my fiance's house yesterday.  Driving is going just fine.  I only plan on going to therapy and no where else just because I am nervous about getting in an accident while being on crutches and with my big old brace.  Getting in and out of the car is a bit of a challenge with my leg completely straight, but it is managable. 

My good knee (if you want to call it that) is starting to rebel.  The lesion on my medial femoral condyle has been very sore these past two days.  I've been icing but I think it is just stressed out from having to do all the work while I am on crutches.  Just the thought of having to go through this on the other knee makes me sick! 

 
« Last Edit: November 19, 2007, 09:26:27 PM by casey2291 »
LOA #2 and hardware removal 12/15/08-new cartilage from ACI looks "GOOD"
LOA on left knee 3/18/07
ACI and HTO on left knee 10/22/07
scope of right knee on 6/21/07
microfracture left knee 3/18/05

Offline kathat

  • SuperKNEEgeek
  • *****
  • *
  • Posts: 1520
  • Liked: 1
  • Aussie, Aussie, Aussie
Re: ACI and HTO on 10/22/07-It's going to turn out great!!
« Reply #35 on: November 19, 2007, 10:34:56 PM »
I am thinking that I'll have to go bilateral when my time comes, or at least do them close together. I don't think I'd ever get around to having a second surgery. The first one would use up all of my leave from work. I have heard of someone who had one knee done and she swears she will never get the other one done because it was such a long recovery. Are you planning on doing the other knee? Will you do it soon after you have recovered or wait? I don't know how the payment system works here in Australia. I have private health insurance, and I think ACI is covered by them, but I am not certain. I am very glad we took out health insurance.

Offline casey2291

  • SuperKNEEgeek
  • *****
  • *
  • Posts: 1011
  • Liked: 0
  • User's Text
Re: ACI and HTO on 10/22/07-It's going to turn out great!!
« Reply #36 on: November 19, 2007, 11:22:42 PM »
Hi Kathy,
Right now, I don't know what the future holds for my other knee.  I had it scoped over the summer and my OS (not the same one that I have now) said that I have two small lesions under my patella and also a lesion on the MFC.  I have known about the lesion on my MFC for about 1 1/2 years now and it doesn't seem to have gotten any worse during that time frame.  It gets aggravated from time to time but usually calms itself down.  I worry that since I have misalignment on that leg, that it will only be a matter of time before it progress to a point of surgery.  The only way I will have this surgery done again is if this ACI comes out successful and if the pain on the other knee gets much worse or if the lesion begins to grow significantly. If this ACI is successful and it allows me to return to the things that I love, I would consider having it on the other knee.  I am fortunate that right now I am working in a school system and we have this wonderful thing called a sick bank and if you are a member of it, once you are out of medical leave days, you can borrow from the sick bank and still get paid.  Thank goodness for the sick bank or I would be going quite a few days without pay.  I know that it has been done, but I can't imagine having ACI done bilaterally at the same time.  I'm not tough enough to endure that.  I admire those who do it!
LOA #2 and hardware removal 12/15/08-new cartilage from ACI looks "GOOD"
LOA on left knee 3/18/07
ACI and HTO on left knee 10/22/07
scope of right knee on 6/21/07
microfracture left knee 3/18/05

Offline Peg Leg

  • Forum Faithful
  • ****
  • Posts: 495
  • Liked: 0
Re: ACI and HTO on 10/22/07-It's going to turn out great!!
« Reply #37 on: November 20, 2007, 01:06:53 AM »
Casey,

So glad to hear that things are progressing well!  My surgery was the end of June, so I would be surprised if it had gone up that much; but you never know.  Hopefully it will all work out for you.  As for getting in the pool, most pool decks are concrete, but can still be slippery; just be careful!!  Once you get in, it's great!!  I could do so much more in the pool than on land.  I could work my muscles without putting too much stress on the knee and the pool walking was great practice for someone who hasn't walked normally in 15 months!! Keep up the good work and happy Thanksgiving  ;D!

Peg Leg
10/06  Miicrofracture Rt knee on mfc
defect was 1.3x2, small defect under patella
04/07 Arthroscopy/Cell harvest for Carticel
06/28/07 Carticel surgery ,Rt. Knee
12/27/07  Scope to debride Patella lesion,Rt. Knee
4/17/08  Fulkerson AMZ, Rt. Knee
6/25/09 ConforMis BiCompartmental Knee Replacement

Offline casey2291

  • SuperKNEEgeek
  • *****
  • *
  • Posts: 1011
  • Liked: 0
  • User's Text
Re: ACI and HTO on 10/22/07-It's going to turn out great!!
« Reply #38 on: November 20, 2007, 01:30:37 AM »
Thanks Peg Leg.  Happy Thanksgiving to you as well.  I've been following your post-op diary.  It has been helpful to me to see how you are doing at each week of your recovery.  I think it is finally sinking in what a long recovery I have ahead of me.  Today, my PT told me that since I am off of work, that I can make rehabing my knee my full time job...and he was not joking!!!  :P
LOA #2 and hardware removal 12/15/08-new cartilage from ACI looks "GOOD"
LOA on left knee 3/18/07
ACI and HTO on left knee 10/22/07
scope of right knee on 6/21/07
microfracture left knee 3/18/05

Offline Peg Leg

  • Forum Faithful
  • ****
  • Posts: 495
  • Liked: 0
Re: ACI and HTO on 10/22/07-It's going to turn out great!!
« Reply #39 on: November 21, 2007, 12:32:04 AM »
Casey,

Glad to be of some help to you; it helps me, also, to be able to write this long process down and interact with others who get it!!  I sure hope that your recovery goes much smoother than mine has!  These lazy quads of mine are beginning to wear out their welcome >:(.  Your PT is right, it is a full time job.  At least I know that I have done everything that I can to make myself better; apparently, it just has not been enough. :'(

Hang in There!  Peg Leg
10/06  Miicrofracture Rt knee on mfc
defect was 1.3x2, small defect under patella
04/07 Arthroscopy/Cell harvest for Carticel
06/28/07 Carticel surgery ,Rt. Knee
12/27/07  Scope to debride Patella lesion,Rt. Knee
4/17/08  Fulkerson AMZ, Rt. Knee
6/25/09 ConforMis BiCompartmental Knee Replacement

Offline casey2291

  • SuperKNEEgeek
  • *****
  • *
  • Posts: 1011
  • Liked: 0
  • User's Text
Re: ACI and HTO on 10/22/07-It's going to turn out great!!
« Reply #40 on: November 21, 2007, 07:40:54 PM »
Peg Leg...I hope things get better for you and that you are able to get your quad strength back!!  Let me know what your OS says after your PT talks to him/her.

Each time I go to therapy, I realize what a LONG LONG road of recovery I have ahead of me.  Even though I read up on this procedure, I think there was a part of me that thought the rehab was going to be similar to my microfracture rehab.  There is nothing similar about it.  Today was my second session of PT and it was hard work.   I hate when the PT bends my knee to work on my ROM.  Oh my gosh, today I was slowly inching my way up the table as he pushed as I was trying to get away from him.  It is so uncomfortable.  I'm struggling with SLR's.  I can only do them going straight up (and that is with some help getting started) and on one side.  Pain is preventing me from doing them on my other side and my stomach.  My leg is just so incredibly weak.   The PT worked on having me hang my leg over the side of the table today and I was close to 90 degrees which I was happy about.  He then had me use my quad muscles to straighten my leg to about a 40 degree angle.  It was tough but I did it.  I have to admit that I am starting to wonder if I made a mistake and if I was in enough pain before surgery to justify such major surgery.  But, what is done is done and now I have to just keep positive and move forward and give it my all. 

I'm having lots of trouble sleeping.  My body is so tired of sleeping on my back and I keep waking up about every two hours.  It is too uncomfortable to lay on my side with the brace on and it is sore on the knee.  Last night I slept on my stomach and it was only for about an hour but I don't think it was good for the knee because when I woke and wanted to roll back over, my knee hurt so bad that I wasn't sure if I was going to be able to move. 

On a VERY positive note, only 14 more days until I see my OS and hopefully I will get to start weight bearing.   
LOA #2 and hardware removal 12/15/08-new cartilage from ACI looks "GOOD"
LOA on left knee 3/18/07
ACI and HTO on left knee 10/22/07
scope of right knee on 6/21/07
microfracture left knee 3/18/05

Offline kathat

  • SuperKNEEgeek
  • *****
  • *
  • Posts: 1520
  • Liked: 1
  • Aussie, Aussie, Aussie
Re: ACI and HTO on 10/22/07-It's going to turn out great!!
« Reply #41 on: November 22, 2007, 01:19:45 AM »
Oh Casey, I so feel for you. Sleep problems are so draining, and you certainly need your sleep at the moment. I am terrified of coping with ACI rehab. I really don't know how I'll decide when I am ready for it. I am currently having problems with deep, gnawing pain in my knees. I have had problems sleeping some nights, and sitting at work for 10 hour night shifts has been torture at times. My GP is a lifesaver and today he gave me scripts for several different pain killers, so I can mix and match and see what suits.  ::) One of them comes in a slow release form, so if it works then he will look at how much I am taking of the quick acting form and swap me over to the appropriate dose of the SR form. Then I should be able to sleep better, without waking up to take pills. I am praying that PT will do some good. Surely it will. I have quite wasted muscles in my legs, so there's room for a lot of improvement there. Hopefully it will equate to less pain. Certainly the pain increased as my muscles wasted. At least I hope it was that way around. It could have been increasing pain that caused my muscle wasting  :P Goodness, it must be self pity day - time for a pity party!!! I will keep my fingers crossed that you get the OK to weight bear at your OS appointment. Nothing like something positive to bring you out of a slump.
Kathy

Offline Peg Leg

  • Forum Faithful
  • ****
  • Posts: 495
  • Liked: 0
Re: ACI and HTO on 10/22/07-It's going to turn out great!!
« Reply #42 on: November 22, 2007, 03:26:32 AM »
Kathy,

Ooh a pity party, can I join in?!!!!  I have been to a lot of those these last few months!! At least you got some great new drugs, hopefully that will help you to feel better.
I sure hope that PT helps you with those muscles; I think it helps to be working on the exercises, both mentally and physically. I prefer to be proactive; even with my muscles reluctance to progress, at least I know that I've done all that I can.

Casey, hang in there and remember that each day gets a little bit better. I remember trying to get away from Jason on that table a few times, too! haha  Yesterday, I just wanted to kick him, but knew that would only hurt me more!!!!  Sorry to hear about the sleep problems, but that is pretty common after surgery.  Try lying on your right side and putting a pillow under your left leg for support.  I found this to be a pretty good way to get off of my sore back.  Good Luck, tonight and sweet dreams!

Peg Leg
10/06  Miicrofracture Rt knee on mfc
defect was 1.3x2, small defect under patella
04/07 Arthroscopy/Cell harvest for Carticel
06/28/07 Carticel surgery ,Rt. Knee
12/27/07  Scope to debride Patella lesion,Rt. Knee
4/17/08  Fulkerson AMZ, Rt. Knee
6/25/09 ConforMis BiCompartmental Knee Replacement

Offline kathat

  • SuperKNEEgeek
  • *****
  • *
  • Posts: 1520
  • Liked: 1
  • Aussie, Aussie, Aussie
Re: ACI and HTO on 10/22/07-It's going to turn out great!!
« Reply #43 on: November 22, 2007, 10:50:01 AM »
Peg Leg - feel free to join in!! I am happy to have some stronger pain relief, but it comes at a price. I feel really fuzzy headed at the moment and I am still aware of the aching, though it's settled a bit. I am not going to be able to take more than what I have been on previously when it comes to working or driving, so the new pills certainly have their limitations. I'll reserve further judgement until I've fiddled a bit more though. I might be able to come up with a workable combination. Even if I can stop the pain from keeping me awake it'll help.

Casey - Peg Leg has the right idea. I found after my surgery that I slept better if I piled up pillows around myself. I have a long pillow that I put under my back and one leg, then I had a pillow under the opposite knee, one between my knees, and one to cuddle. When I wanted to tilt the other direction I would use the cuddle pillow and the knee pillow to prop one side of me up, and the long pillow would take the place of the knee and cuddle pillows. The one between my knees stayed put. I still find I sleep like that when I can, as I get pain in my lower back and kneecaps when I sleep on my stomach, and shoulder pain if I sleep right on my side. I just can't seem to be able to sleep flat on my back. Try fiddling around with pillows. I have noticed at work that many people can only sleep on their backs if they have a "cuddle pillow", so try that to start with. Good luck!!

Kathy

Offline casey2291

  • SuperKNEEgeek
  • *****
  • *
  • Posts: 1011
  • Liked: 0
  • User's Text
Re: ACI and HTO on 10/22/07-It's going to turn out great!!
« Reply #44 on: November 22, 2007, 12:19:45 PM »
If we are having an "official" pity party count me in too!!  I had a pity party last night because I was just so frustrated with the knee and this whole recovery...a true pity party with tears and all.   :'(  This surgery keeps teaching me that I am not as tough as what I thought I was....maybe when it is all done and over with I will be tough.   8)   I feel much better today.  Sometimes, I think the emotions just build up and I need to let them out and then afterwards I am ready to move forward again with a positive attitude.  I guess that is just the woman in me coming out...emotional and all.  It drives me crazy sometimes. 

Thanks for the suggestions for sleeping.  Unfortuntely, I have tried using pillows and have tried using them in multiple ways.  Using pillows after my previous surgeries always seemed to work.  I think I just need to wait for a little more healing before I can roll around in bed.  I did sleep on my side somewhat last night for a little while which was nice.  I think the more I am in the cpm machine and as the flexion increases, I find myself accomodating for the tightness that I feel by lifting my butt off the bed which ends up putting a lot of stress on my back causing a sore back.  This doesn't help when it comes to sleeping either.  The good thing is that I am not working now which means that I can take naps during the daytime (in between all those PT exercies I have to do  ::) )

Kathy...Glad to hear that you got some pain meds.  It sounds like you have a lot of pain.  I still don't understand why your OS doesn't want to move forward with ACI if you are in so much pain all the time.  I hope that you have some pain free days ahead of you.

Peg Leg...Hang in there!  Let's hope that your OS has some idea of what is going on and can figure out what to do to help you.  How many days a week do you still go to therapy
« Last Edit: November 22, 2007, 12:23:13 PM by casey2291 »
LOA #2 and hardware removal 12/15/08-new cartilage from ACI looks "GOOD"
LOA on left knee 3/18/07
ACI and HTO on left knee 10/22/07
scope of right knee on 6/21/07
microfracture left knee 3/18/05