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Author Topic: Sam's ACI  (Read 15256 times)

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dileigh

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Re: Sam's ACI
« Reply #30 on: September 04, 2008, 10:59:58 PM »
Yeah, I still get the buckle thing when it's tired.  Not enough to worry about falling down, just enough to be annoying.  Good luck next week

Diana

Offline SamB

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Re: Sam's ACI
« Reply #31 on: September 08, 2008, 03:00:44 PM »
I had drill this weekend. For anybody that's back to work in a job where you're on your feet, my hat's off to you.  I was on my feet for most of two days, and I was pretty sore by the end of each day.  I actually had to go back to the vicodin to get some sleep.   It's probably good to get reminded of my limitations sometimes, before I try to do something stupid that would actually hurt! :)  I'm still looking forward to my appointment this week, and moving on to "stage 3". It doesn't seem like it's been 12 weeks - it's like I was stuck in the CPM machine yesterday!

Sam
11/20/2007 - Removal of loose bodies, debridement, Left knee
4/15/2008 - Cartilage biopsy for ACI
6/17/2008 - Left knee ACI

Offline SamB

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Re: Sam's ACI
« Reply #32 on: September 11, 2008, 06:52:24 PM »
The doc said everything looked great - he was impressed with my flexion and extension, and I now get to start stage 3 exercises - biking, walking more aggressively, pretty much anything that's not running or twisting, turning, etc.  Not much else to say - it was a typical 4 hour drive each way for a 30 minute appointment.  It's nice to hear good news, though.  I find it's pretty easy to get into my own head and convince myself the whole surgery failed. :)  Now the challenge is to keep in mind that I'm not done, and I can't do anything I want.
Sam
11/20/2007 - Removal of loose bodies, debridement, Left knee
4/15/2008 - Cartilage biopsy for ACI
6/17/2008 - Left knee ACI

Offline SamB

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Re: Sam's ACI
« Reply #33 on: September 30, 2008, 06:23:31 PM »
I don't know if it's a mile stone or not, but this is my last week of PT.  I think my therapist has done a great job - my flexion is just as good as my good leg, and the strength is (very) slowly coming back.  I've been riding the exercise bike quite a bit, and it's sure nice to get my heart rate up.  It's also nice that riding the bike doesn't hurt at all!  Overall my knee feels pretty good - definitely not "as good as new", but I can see improvement, so that's encouraging.  It's already better than it was prior to the surgery, so that's a good sign too.  I guess I'll just keep plugging along.  My next appointment with the OS isn't until my 6 month checkup in December. 
11/20/2007 - Removal of loose bodies, debridement, Left knee
4/15/2008 - Cartilage biopsy for ACI
6/17/2008 - Left knee ACI

dileigh

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Re: Sam's ACI
« Reply #34 on: September 30, 2008, 11:17:45 PM »

I would call it a milestone.  I find out tomorrow if I get discharged from PT.   Congrats on beating me out  ;D


Diana

Offline SamB

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Re: Sam's ACI
« Reply #35 on: October 15, 2008, 07:54:46 PM »
Well, after being released from PT, I've kind of taken a step or two backwards, I think. They really loaded me up with exercises - my last appointment was by far the hardest I'd had.  After about a week of doing all the exercises, my knee said "enough".  It was getting pretty swollen and each exercise was more painful than it should be, so I'm on a week of rest, and then I cut the exercises in half for a few weeks.  I was so excited to be getting muscle definition back, too! It's a slow journey, I guess. :)

I added up the total cost of my knee since my injury.  Thank God for health insurance!  The total billed cost for the three surgeries and subsequent PT and everything is $119,342.44.  Obviously, the insurance company isn't really paying all that, but wow.  Amazing.  Makes me think twice about doing anything that could make the surgery fail! 

Sam
11/20/2007 - Removal of loose bodies, debridement, Left knee
4/15/2008 - Cartilage biopsy for ACI
6/17/2008 - Left knee ACI

Offline SamB

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Re: Sam's ACI
« Reply #36 on: November 02, 2008, 03:37:24 AM »
What a week! I had another setback last weekend, but not of the knee variety this time.  Apparently, 3 weeks of a stomach ache is a few too many, as my appendix had burst.  It did not make for a very pleasant couple of days.  I was pretty drugged up in the hospital as they tried to figure out what was wrong, though, so I have to admit, I don't remember much of it.  It actually took my mind off my knee for awhile, so that was good.  Plus, I've once again met the catastrophic cap for my health insurance within the first month (tore up my knee last year...), so that's something.   That makes 4 surgeries within a year...and way more time than I ever want to spend in the hospital! :)

I spent a good deal of time on my knees over the toilet, though, so I hope that didn't cause any harm. 

Back to the exercises next week - I'm looking forward to starting up again, I think.

Sam
11/20/2007 - Removal of loose bodies, debridement, Left knee
4/15/2008 - Cartilage biopsy for ACI
6/17/2008 - Left knee ACI

Offline Gibbon35

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Re: Sam's ACI
« Reply #37 on: November 03, 2008, 12:49:54 PM »
Wow....Sam.....you dont do things by half do you  ;)

I hope your feeling better now .....

G

Offline SamB

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Re: Sam's ACI
« Reply #38 on: December 02, 2008, 07:00:08 PM »
I think I would like to try doing something by half - I'm thinking 2009 has got to be better.  My goal for next year is to keep myself out of the operating room! :)

Not much has changed in my knee in the past few weeks. Overall, I'd say it feels about the same as it did when I was done with PT.  I can walk fairly normally for quite a ways - 2 miles seems to be my max.  At that point, it's like I hit a wall - not so much painful, but just no strength left in my leg, which causes my knee to buckle a lot. I still have quite a bit of swelling below (toward my foot) my kneecap, and there's some concern that that is from being on my knees for two days when I had the appendicitis.  So, I'll have to see how that develops.  It's not really too painful, so I'm taking a "wait and see" approach.  I have my 6 month appointment in January (it'll actually be a 7 month appointment by that time) - I'm hoping to still hear good news.

I did get some good news on the insurance front - for awhile it had seemed that they weren't going to pay for my biopsy surgery.  Apparently, the hospital just had it coded wrong, so it went through. I'm convinced they still coded it wrong, and consequently are getting significantly less than they should, but since it's paid for, I'm not too worried about it.

Other than that, I just keep plodding along, waiting for that magical 12-18 month time frame when I can start to be myself again!
11/20/2007 - Removal of loose bodies, debridement, Left knee
4/15/2008 - Cartilage biopsy for ACI
6/17/2008 - Left knee ACI

Offline SamB

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Re: Sam's ACI
« Reply #39 on: December 09, 2008, 04:51:54 PM »
I found out this weekend I may not be promotable in the Guard until I'm able to be labeled as "deployable" (able to run or carry a 48 lb ruck for 2.5 miles).  It's a bummer - the step from 1st Lieutenant to Captain is pretty big.  I'm looking for ways to make it happen, whether loopholes or a modified PT test, so we'll see. I think I could maybe gut out the ruck march, but would be scared to death of causing damage.  I can handle the pain, but won't chance ruining the surgery.  At my 3 month appointment, the doc mentioned I may be able to start light jogging at six months (where I am now).  I have a hunch he was just trying to keep me happy, and will say something different at my appointment next month, but we'll see.  6 months seems extremely early compared to everyone else on here.

Otherwise, things are still going well.  Stairs are fairly easy, going down is much tougher than going up.  Fun stuff, this knee surgery... :)
11/20/2007 - Removal of loose bodies, debridement, Left knee
4/15/2008 - Cartilage biopsy for ACI
6/17/2008 - Left knee ACI

Offline casey2291

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Re: Sam's ACI
« Reply #40 on: December 09, 2008, 06:12:03 PM »
Hi Sam,
I don't know much about our armed forces, but my brother is in the army and he has knee problems.  He was recently promoted to major and he has been on modifed PT for awhile.  He also just had knee surgery (OATS) about a week ago and he is scheduled to go overseas in March and is part of a "deployable" unit.  Glad to hear that your knee is doing.  It took me forever to get back to doing stairs more normally...around the one year mark and even now I still have some trouble going down stairs but now I think that is due to my hardware from my osteotomy and not from muscle weakness.     
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 SamB

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Re: Sam's ACI
« Reply #41 on: December 17, 2008, 03:11:51 PM »
6 months today!  Things are still pretty good, I think.  I've still got a bit of swelling below (towards my foot) my patella that wraps around toward the inside of my knee.  It seems to appear anytime I do anything more aggressive than minimal PT, so I've got a call in to my OS about it.  I'm determined to think it's nothing to worry about until I hear otherwise.  As long as the graft is ok, it can't be too bad, right? :)

Other than that, I can do stairs pretty well - like everyone else, I think going down is harder than up.  I can climb stairs almost normally, so that's nice.  I bike a little, but if I do anything over 15 or 20 minutes, that spot swells up, so I don't do too much.  The same goes for most of my other PT, so I'm mostly just doing stairs, walking as much as possible, and holding my leg up when I'm sitting at work.  It seems that 2 miles is about my limit for walking - much more than that, and it gets pretty achy and starts giving out.  I think most of that is just muscle weakness - there isn't much pain in the graft area at all.  I've got my next OS appointment in about 3 weeks, so hopefully he'll agree that it's going well.

Sam
11/20/2007 - Removal of loose bodies, debridement, Left knee
4/15/2008 - Cartilage biopsy for ACI
6/17/2008 - Left knee ACI

Offline SamB

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Re: Sam's ACI
« Reply #42 on: January 05, 2009, 04:13:19 PM »
I've got a question about pain meds.  I still am forced to use a vicodin about once every week or two, typically after I'm on my feet for awhile (like drill weekends) or if I accidentally bump my knee or something along those lines.  Is it unusual to still have to use the "hard stuff" more than six months after surgery?  Is/was anybody else in the same boat?  Directly after each surgery, I typically used less medication than prescribed because I was concerned with developing an addiction. I've been told that using it in such small amounts (5-10 mg / week) isn't a concern for addiction, but I would sure rather not use it at all.  Unfortunately, when my knee starts to hurt, Tylenol doesn't seem to even touch the pain, and I have to revert to the vicodin.  Is that normal?

Along the same lines, I lost a lot of confidence in my OS's on call docs this last week.  I was visiting family in another state, and had forgotten my pain meds. After getting ran in to, bumped, and all sorts of other unpleasantness by the dogs and little kids, I called in to my OS to see if I could get a rx somewhere close to where I was.  The on call doc said he couldn't, and that I should just take a couple Aleve.  After I told him I wasn't supposed to take any NSAIDs, he asked what type of surgery I had had.  It kind of seems like that's something you should know prior to handing out instructions.

Thanks for any replies/advice/anecdotes!

Sam

11/20/2007 - Removal of loose bodies, debridement, Left knee
4/15/2008 - Cartilage biopsy for ACI
6/17/2008 - Left knee ACI

jonhark

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Re: Sam's ACI
« Reply #43 on: January 05, 2009, 07:23:14 PM »
Sam--

Completely normal to get pain after over-doing activity at six months out. Your graft won't be firm until 18-24 months depending upon size and location.

You shouldn't have anything to worry about as long as pain subsides after 2-3 days. I personally didn't get any pain relief from Vicodin or Tylenol. The only thing that has ever reduced pain in the knees was 800mg ibuprofen that i ate like skittles when in the armed forces. As you know, nsaid's are contra-indicated for the first 12 months after surgery.

I can't imagine life in the Army after having carticel (now knee #2 for myself). Every day activities would be fine. But 20 mile ruck marches and 4 mile runs just wouldn't be feasible.

Keep your head up. Once 18 months rolls around you will be thinking about your knee a lot less.

Oh yeah, my doc's PA recommended Advil after the surgery for pain control.....and my doc is one of the top 5 Carticel surgeons in the country. I think there is a reasonable debate going on about whether nsaid's inhibit cell growth. Personally, I wouldn't take them because 1) Dr. Minas has done more of these procedures than anyone and he's against them and 2) why risk the outcome for temporary pain relief?.

Jon




Offline mareek

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Re: Sam's ACI
« Reply #44 on: January 06, 2009, 02:59:37 AM »
Hi

I've been ready Sam's experiences with interest.  I had an ACI at the end out July.  Everything was going fantastically (surgeon couldn't believe where I was at) until the beginning of December.  One night I was walking and I felt a sharp pain in my knee.  It was OK then, but next day the knee was stiff.  From then on things seem to have gone downhill.  The whole leg seems to ache and the knee hurts if I stand still for too long.  I haven't been back to see the surgeon yet, but fear the worst with the graft.  Have done no running or high impact exercise, only walking, some standing (cooking is unavoidable) and rehab exercises.  Any idea?

Maree