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Offline GemmaLeigh

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Operation date
« on: December 27, 2007, 10:28:03 PM »
So I finally got my date for my Realignment surgery and it's on the 30th January, however I am exhibiting in London with my clothing label on the 2nd, 3rd and 4th February. Now obviously it's not wise to go exhibiting 3 days after major surgery but if i say i can't make it am I going to have to wait another 6 months?

Both things are equally important, I have waited for this op since March this year on top of the 8 years that I have been having knee problems. On the other hand, my clothing label is my business and this is the biggest alternative fashion exhibition in the country and it starts of the spring/summer season. I could lose a lot og business by not being there.

So I don't know what to do, i was hoping someone might hae some advice. I'm really fretting.

thanks
1995 - first trip to the doctor with 'growing pains'
1998 - xrays show left patella is out of place
1999 - first dislocation
1999-2006 - Physio therapy every week
Jan2007 - Traumatic dislocation
feb 2007 - OS suggests surgery
Jan 2008 - date for surgery 30th jan

Offline Doc79316

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Re: Operation date
« Reply #1 on: December 30, 2007, 02:31:27 PM »
HI,

Maybe you could contact your OS or his secretary and ask what would be the waiting time if you had to postpone. If you explain the situation I'm sure they'll try to give you a different date. On the other hand, is there anyone you would trust to go to the exhibition in your place? You could always be ont he end of a phone in case you're needed.

You need to think about what is MOST important to you. Your health obviously is otherwise you wouldn't be having the surgery. I know your business is important too but your whole business isn't going to go under just because of one exhibition. Personally I feel it would be silly to put off your surgery after waiting so long with knee problems to finally get something done about it. I can understand your worry as I have also just set up a business of my own. But businesses go up and down all the time and what may be seen as a loss at this particular time, ould turn around and open up other opportunities for you elsewhere.

I can't really advise as it's a decision only you can make. I think though that you will need to weigh up the pros and cons of either postponing surgery (maybe for up to 6 months) or not attending the exhibition (or sending someone else?!).

Let us know what you decide an dhow you get on.

Take care,

Laura x
Left knee surgery
08/06/02-L/Release
13/08/03-Fulkerson TTT
05/06/05-Stabilisation & Medialisation/Tendon Transfer
13/01/06-Proximal Hamstring Superior Stabilisation
06/03/06-RSD/CRPS diagnosed
20/07/06 + 03/04/07-Excision of scar tissue
29/05/15-Arthroscopy
02/03/20-Left transfemoral amputation

Offline Clarkey

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Re: Operation date
« Reply #2 on: December 30, 2007, 05:06:45 PM »
If you can bare the knee pain for another few Months then you should prospone your knee Surgery till a lator date if the Exhibition is important to you and will make a lot of bussiness from it.

Its your choice maybe you should listen to Laura and get the Surgery done in January, if I was in your situation I would prospone the Surgery, but still go ahead with it if you think its the right thing to do.

Good luck if you do go ahead with the Surgery and let us know how its goes.

Nick :) {2007} :)
RK: PFPS, Arthrofibrosis, Tendinopathy, Five cortisone injections
16/01/18 Anterior interval release, distal patella excision, lateral meniscal repair
18/07/14 Anterior interval release  
16/11/09 Medial plica excision, fat pad trimming

Offline tanyap

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Re: Operation date
« Reply #3 on: January 02, 2008, 04:29:25 PM »
what did you decide to do Gemmaleigh?
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 GemmaLeigh

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Re: Operation date
« Reply #4 on: January 02, 2008, 05:33:47 PM »
I am going in for my pre op on monday 7th so I am going to talk to them then and see if there's any chance of getting it sooner, maybe if there is a cancellation from someone else. I really don't want to have to wait another year or even another 3 months really. I'm desperate to get back on my feet!!

I will let you know what they say on monday. Hopefully we can work something out that will suit both the hospital and myself and i'll still be able to go to the exhibition!! But there's probably more of a chance of seeing a pig fly through my window :)
1995 - first trip to the doctor with 'growing pains'
1998 - xrays show left patella is out of place
1999 - first dislocation
1999-2006 - Physio therapy every week
Jan2007 - Traumatic dislocation
feb 2007 - OS suggests surgery
Jan 2008 - date for surgery 30th jan

Offline tanyap

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Re: Operation date
« Reply #5 on: January 03, 2008, 09:00:00 AM »
Yes - see what happens. It all depends on whats most important for you - and how soon the surgery can be re-scheduled. The exhibition is only once a year, so its bad timing, but they might be able to delay surgery for a couple of weeks and not for endless months!!!

I have read some of your posts and see from your tag line that you had years of physiotherapy - tell me, were you dislocating during those years of physio?

Are you always on crutches now? What causes you to dislocate? Are you still doing physio or just waiting for the surgery?

Also - on the subject of anyone asking why you dont work - if they had to walk (or crutch!) a day in your shoes they would feel differently so just ignore that.

What are they going to do in your surgery? Is this your first surgery?

Sorry - Im asking loads of questions, I just find your situation interesting cos Im a frequent dislocator too.
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 GemmaLeigh

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Re: Operation date
« Reply #6 on: January 03, 2008, 11:57:41 AM »
I began physio after my first dislocation and for about a year they stopeed, but then i had a pretty serious one and it stopped helping. I carried on my physio incase it got worse if i stopped, I am now doing pre op excersises but have noo need to go to the physiotherapist as they can't do anymore until after the surgery.

I will try to explain the problem i have with my knee but to be honest I have absolutely no idea of any of the medical terms. lol.

It started as a severe growing pain at the age of about 11 or 12, then my knee bagan to click and grind when i bend it or went up hills or stairs. The doctor put it down to growing pains and said i'd grow out of it. I had my first dislocation at 15 and went to see an OS in hertfordshire where i as living at the time. I was not given crutches at the time and the recovery took a very long time. I had some x-rays and they found that my patella was so high up an too far to the left (towards the outside of my knee as it's my left knee) I was told that due to my age they were reluctant to operate so i was referred to a different physiotherapist and given diferent weighted excersises and a lot of taping.

The taping did nothing at all. It was just awkward to have to do morning and evening. When I was 16 I had my second dislocation and have been having them regularly since then. At the beginning of this year I had a really really bad dislocation and was NWB for 2 weeks and on crutches for 4 weeks. I was refered to an OS in Devon (i had moved house in this time) and had a lot of scans and tests.

I was put on the list for surgery in March 2007 and have been waiting since. I have had well over 20 dislocation in this time.

I have not had surgery before and i'm pretty scared. The sugery is to put the patella where it's supposed to be and bolt it down with 2 bolt just below the knee (i think!!) I will be in a brace that will let me bend my knee 30 degrees for 6 weeks and on crutches but should be able to put weight on it. Then i will have 5 months on intense physio. At some point I may have to have the bolts removed. Hopefully then i'll be fixed!!!

My dislocations don't sem to be caused by anything any more, originally it was when i twisted my leg or put pressure on my knee. Now it can just have a muscle spasm and come out. It's awful. I am on crutches most of the time, sometimes i can use just one and sometimes i can hobble around my flat on my own.

I think i answered all of your question tanya, maybe with all that information you can tell me what my surgry is? Have you had surgery or are you sticking with physio?


I got a call from the hospital this morning saying that if i cancelled my operation for the 30th i will have to wait another 5 months so i have said i'll take the date and will have to see how i feel on the 2nd feb. It seems unlikely that i will be going to the exhibiton though so i think my partner will be going alone and i will be looking after our 2 dogs on my own!!
1995 - first trip to the doctor with 'growing pains'
1998 - xrays show left patella is out of place
1999 - first dislocation
1999-2006 - Physio therapy every week
Jan2007 - Traumatic dislocation
feb 2007 - OS suggests surgery
Jan 2008 - date for surgery 30th jan

Offline tanyap

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Re: Operation date
« Reply #7 on: January 03, 2008, 12:17:14 PM »
Hi Gemmaleigh,
what a great post - full of info!!!

Ok - dont worry about not knowing any of the medical terms - that comes with time :)

Is it a TTT they are doing on you? They often do a Lateral Release at the same time, and VMO advancement too perhaps?
A TTT is a Tibial Tuberosity Transposition (phew - had to look that spelling up!!), where they move the 'bump' on the top of your shin bone (including the patella tendon) over a bit and screw it back down - this moves the patella tendon into a better alignment. After it heals you can get the screws (or bolts) removes - they are to hold the bone in place while it heals. It would make sense with the after care description you describe that itd be a TTT. They often do a Lateral Release at the same time, thats when they cut some of the tissues on the outside of your kneecap (in your case the extreme left for your left leg) that are connected to the kneecapto prevent too much of a 'pull' to the outside. A VMO advancement is when they move your VMO muscle (shaped like a teardrop on the lower inside of your thigh) forward a bit to try and better align it with the kneecap too.

They may only be doing one or other of the above. You may recognise some of those terms or descriptions from your OS visits.

Dont be scared. There is pain - of course theres is, its surgery!!! But they manage it with painkillers etc for the first while then you get to start on rehab and although that hurts it comes with the satisfaction of getting normal!!!

I had all of the above done - worked good for a long time - unfortunately I had a number of mis managed dislocations after surgery that left me with my quads wasting away. A long time after - I got about 20 good years with only the odd dislocation.

I think youre absolutely right to take the surgery date. 5 more months is too long to wait.

If you have any questions about your surgery or rehab afterwards you can ask me and Ill do my best to answer.
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 GemmaLeigh

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Re: Operation date
« Reply #8 on: January 03, 2008, 12:52:49 PM »
Thank you so much,

What you've descirbed sounds about right and i will be checking with the OS on monday when i have my pre op as i feel a bit daft going in for surgery without really knowing what happening!! He has told me that there is still a chance of more dislocations in the future but if there's a chance that i will have fewer or none then it's definately worth it.

It feel strange that after all this waiting, this time next month i'll be out of hospital (hopefully) and doing my post op diary on here to kill the time :)

I'm so glad my GP gave me this website, it has given me so much information and made me feel a lot less isolated. For once i'm probably the person who knows the least about knees  :D

I have been taking glucosamine tablets the size of horse tranqilizers, as suggested by my gp (he has also got knee problems so he's handy for advice) I wondered if you knew if they actually do anything as i don't really feel a difference. I have been taking them for a few months but wondered if i should carry on taking them. Will they help my recovery?
1995 - first trip to the doctor with 'growing pains'
1998 - xrays show left patella is out of place
1999 - first dislocation
1999-2006 - Physio therapy every week
Jan2007 - Traumatic dislocation
feb 2007 - OS suggests surgery
Jan 2008 - date for surgery 30th jan

Offline tanyap

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Re: Operation date
« Reply #9 on: January 03, 2008, 01:52:50 PM »
I didnt have a clue what my surgery was at the time either - I only learned as I went along - the medical people talk to you as though you understand the terms they use and I always end up just looking blank!!!

They wont do a TTT unless they think there is going to be a good chance of success or partial success. Ive never fully dislocated since mine - as in kneecap right out of groove and off to the side somewhere - Ive only subluxed - which is a partial dislocation, its still more or less in place but sitting to the side a bit. The terms are often used interchangeably - I refer to my knee dislocating usually - but actually its subluxing. It was much much less frequent for me after the surgery and in fact for 20 years if it did sublux Id just pop it back into position and continue doing whatever I was doing with no real pain, just a bit achey for a couple of days afterwards.

I tried the glucosamine for a while too but I didnt really feel it did anything. Its a supplement thats supposed to help cartilage - its only a supplement, its not medicine so its not going to do any harm to take it - but I really dont know if it does much good? It may help with the healing process though - Id say carry on taking it as theres no harm in giving it a shot.

You are going to need to have your partner or a family member or friend around for the first while after your operation to help you at home. It will be difficult for you to do simple things like get on and off the loo etc...til you heal up a bit. See if you can organise a small stool in the bathroom to rest your leg on while youre using the loo. Also for fetching and carrying things for you cos you will be non weight bearing for the initial period too. If youre already used to crutches you probably have experience of some aspects of having limited mobility. Get an extra pillow for bed too so you can put it between your legs to sleep so youre not knocking off your bad leg with your good one and hurting yourself while you sleep. Theres a good amount of sore awkwardness for the first bit but I promise you the first few days are worst. You'll be fine, but dont try to do too much while the body is healing cos it needs rest and pushing things too early wont help you.

I assume that you, like me, have not been able to run for years? I had my first dislocation at 12 and Ive never been able to run since. My current OS says that i SHOULD have been able to after my surgery and that physiotherapy was stopped too soon - so do discuss with your OS what you are supposed to be able to do after you have recovered from the surgery and what are realistic expectations for you. Given your history its quite likely that your quads are weaker than an average persons and possibly prone to shut down also (mine are, each dislocation tells the brain to shut down the quads), speak to your OS/physio about e-stim (electric muscle stimulation) if you are having trouble getting them to fire (contract) after your surgery.

If it helps you - I was able to dance in high heels on drunken nights out for many years after my surgery - I just couldnt run for a bus :)
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 GemmaLeigh

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Re: Operation date
« Reply #10 on: January 03, 2008, 02:46:19 PM »
hahaa i haven't been able to wear heals for quite some time, more through fear that anything!! I have not been able to run either, but my most shocking discovery was that i couldn't jump!! Something so simple and my legs just won't do it.

I have been given lots of ideas of what i need to ask my OS on monday, its great because i would have just gone in and listened and then left just as in the dark as i was when i went in.

I will have to ask a close friend to come and stay with me then i guess, as my partner will be going to the exhibition. I won't have time to worry about my knee because i'll be worrying about Paul keeping the business going! He's not the most out going, confident person, it's usually me that does all the talking :/

Thanks for all of your advice Tanya, I defnately would have just let paul go away while i sat here unable to feed the dogs or get myself to the toilet!!
1995 - first trip to the doctor with 'growing pains'
1998 - xrays show left patella is out of place
1999 - first dislocation
1999-2006 - Physio therapy every week
Jan2007 - Traumatic dislocation
feb 2007 - OS suggests surgery
Jan 2008 - date for surgery 30th jan

Offline tanyap

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Re: Operation date
« Reply #11 on: January 03, 2008, 03:45:28 PM »
hahaha - i remember thinking when i was going in for the surger that id be grand when i woke up - then i woke up and i couldnt do anything!!! mind you i was only 15 so i didnt have to do much!! and id a full plaster of paris leg cast that was drying out and weighed a ton!!!! must have been before immobiliser braces!!

It is shocking when you discover you cant jump!! If youre like me you'll probably find a squat very difficult too. Do you have a noticable difference in the size of your quads between the good and bad side? Especially the VMO as thats the main kneecap stabiliser - to find it sit on a chair with both feet on the ground and push your heels into the ground - feel your thighs above your kneecap and towards the inside of your thigh - I reckon you will feel much more 'meat' on the good side when you do that.

I would advise you to make a written list of questions for your OS - otherwise you'll forget bits.
Its very important to ask about what you should be expected to do after recovery, and also ask about what you'll be capable of in the days and weeks immediately after surgery too - he may let you do more than I was allowed do as my procedure was so many years ago and practices change etc...

Definitely have someone stay with you - even after an anasthetic you might be groggy for a day or two - its not worth being left alone in case you do get into difficulties.



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 GemmaLeigh

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Re: Operation date
« Reply #12 on: January 11, 2008, 02:54:01 PM »
So the update to this is that I have taken the date and had my pre op. I have tld them that i have no choice but to go to london 2days after surgery. They didn't seem to bothered. I didn't even get to see my surgeon as he wasn't there that day so i can't ask my questions until the day of surgery.

I had to go and order my wheelchair today!! Really hit home that it's actually happening. But i was impressed that it only cost £7 a day to hire with a leg elevation thing.

Will i still be out of it 2 days after my op? Does anybody know if i'm allowed to take my brace off to shower or anything?
1995 - first trip to the doctor with 'growing pains'
1998 - xrays show left patella is out of place
1999 - first dislocation
1999-2006 - Physio therapy every week
Jan2007 - Traumatic dislocation
feb 2007 - OS suggests surgery
Jan 2008 - date for surgery 30th jan

Offline tanyap

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Re: Operation date
« Reply #13 on: January 11, 2008, 03:00:48 PM »
hi gemmaleigh,
whats the wheelchair for? 

i can only comment on my own experiences and that was that i was on morphine and pretty much out of it for 2 full days after surgery and then kept in hospital another 3. But that was 20 years ago - techniques and pain management may be wayyyy different now.

If youre being put in an immobiliser brace I would imagine NO removal until the doc says so. I had a full leg cast (as I say 20 years ago things were different) so there was no question of me taking it off :) I got used to showering by standing on a towel in front of a sink full of water and basically washing and rinsing bit by bit!!! mind you that was so i wouldnt damage the cast more so than damage myself!!!

ring your surgeons office and tell them you are going to fax over your questions as you didnt have a chance to see him at the pre-op - his secretary will probably tell you to go ahead and she will see that he gets them.
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 KW

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Re: Operation date
« Reply #14 on: January 11, 2008, 03:03:15 PM »
Gemma,  Yes I was allowed to take off my brace to shower and when sitting around the house.  If I remember correctly I was allowed to cover the incision with plastic wrap (or something to keep it dry) after 3 or 4 days and once the stitches were removed I was showering with out the incision covered.  

As for being "out of it" 2 days PO...That is probably going to depend on how much pain med you are taking.  With my 2nd TTT (April 2007) I started working form home the day after I was released from the hospital (i spent 1 night in the hospital).

Best of luck,
Karen
Right Knee
2000 - 2002 - Scope,LR,TTT,Unscrewed
01-10-12 - PFJR

Left Knee
04/07 TTT/LR
08/07 Bone Grth Stim
10/07 Loose/Bent Screw
1/08 Unscrewed/MRI~NON-UNION
02/19/08 Lt  TTT Revision W/Graft
12/09/08 Scope
05/15/09 Scope
09/04/09 PFJR/Unscrewed