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Author Topic: Kathy's DPTT (TTT) Post-Op Diary  (Read 39547 times)

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Offline kathat

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Kathy's DPTT (TTT) Post-Op Diary
« on: June 19, 2008, 03:22:53 AM »
Howdy All,

Well, my surgery is all over, so I have moved to the post-op section. Here is a brief run down for those who haven't been following my saga.....

When I was in my teens I had sharp pain and buckling of my knee(s). Details are vague but I was diagnosed with patellar tracking/tilt issues and sent to physio. Pain eased and I thought nothing more of it. When I was in my twenties I noticed my knees had a tendency to ache at times, mostly with weather changes. I assumed that this was a result of my earlier knee problems and wasn't much to worry about. The aching got worse, though because it was only aching, not sharp pain, I still didn't believe it was anything major. I eventually mentioned it to my GP last year and I was referred to an OS. I had bilateral surgery - chondroplasty and lateral releases - in September 2007. About eight weeks later the aching was back with a vengance and physio became a battle to find exercises that would suit my super-irritable knees. When my OS reviewed me in May, he suggested a distal patellar tendon transfer (DPTT), which is also known as a TTT, TTO, Fulkerson's, and other names. This is what I had done yesterday, so I will now tell that story.......

My hubby and I arrived at the hospital at 9.30am with all my bits and pieces - crutches, bag of things to do, bag of toiletries and clothing. This is when I found out that I was being admitted through the Day Surgery Unit so all my stuff would have to be lugged around with me until I went to the wards after surgery!! So then everything had to be labelled (I am still peeling sticky labels off things  :P ). Then it was time to say goodbye to hubby and get myself all dolled up for theatre. Striped gaping hospital gown, towelling dressing gown, sexy blue "slippers", and a hat  8). Add tape around my rings, black texta drawing on my knee, and betadine halfway up my leg and I was ready for the show  ;D I sat down then in a nice, low, comfy sofa, only to be called for my surgery! I hauled myself up, handed over my belongings, walked to the theatre, and the show was underway.

Woke up! OUCH!! Thigh cramps and deep throbbing knee pain, and the shakes to boot. Morphine did nothing, so they went to town and gave me two Panadeine Forte (Paracetamol 500mg/Codeine 30mg per tablet) and some IV Fentanyl. Boy I wish I could take me home some of that stuff!! I loved the Fentanyl. Worked like a shot with no nausea. Beauty!! Then it was snuggle down under warm blankets and doze on and off between bouts of itchy nose scratching (stoopid air conditioning). Soon I was shipped off to my own room - I didn't even have to change beds as they had put me onto a bed while I was still out to it, rather than a barouche like last time. Tackled the water by the bed, as my mouth was dry and my throat sore. Add it to the IV fluids and I soon I was ready to explode  ::) The trip to the loo was interesting. I was told I was allowed to FWB, but I did make sure I had a crutch. The biggest thing I had to watch was that my outstretched foot didn't get shut in the door!! Walking was easier than I thought it would be, though the throbbing in my knee afterwards was hard to deal with.

I tried to stay awake all day, as I knew I would have trouble sleeping at night, even if I was tired. I came up to the room just after lunch time. Afternoon tea was bliss (a hot cuppa and lots of biscuits thanks to a kind nurse who realised I hadn't eaten since the night before). I returned some SMS messages and phoned hubby and the kids, did some "circular loom knitting" (like tomboy stitch/french knitting), read a book, watched TV and scoffed pain killers. The pain wasn't really sharp, just a throbbing ache, but it was hard to get the leg comfortable. Getting up to the loo made the throbbing worse, but I was so dry I went through 4L of water during my short stay! I made an awful lot of trips to the loo!!!

Sleeping was a non-event. I caught short bursts of sleep and that was about it. I could feel my knee starting to hurt behind my knee, which is the sign I get normally that tells me my knee is swelling, so I put my leg on a pillow (lengthwise under my leg) only to be told off because I was risking a clot!!! I don't know how she expected me to elevate! A pillow is fine as long as it isn't under the knee only - it should be under the whole leg. By morning I was feeling nauseous from the pain meds, lack of sleep, and because I needed food. Yuck!

Morning came and the bandages got removed. I have Hypafix over my wounds (I had a scope done too), and the TTT wound has a long stitch through it too. I was allowed to shower with nothing covering my knee, so off I went. I only had a quick, warmish shower, but the wounds started weeping and my knee went boof - instant swelling. I could almost watch it swell. It's amazing what some thick cotton padding and a firm bandage can do to stop swelling, as my knee got much bigger once it was all removed. The pain also increased considerably and I could no longer do an SLR. At least I have some numb patches still  ;) I got some tubigrip and an ice pack to put on, and then the physio came. I got given exercises - basically range of motion exercises, ankle pumps, and quad contractions. I don't see a physio until 6 weeks post-op!! The PT then watched me walk with crutches. He wanted me to step onto my leg with my knee locked in extension and use the crutches for balance only. I did okay, so the final verdict is that I DON'T HAVE TO HAVE A SPLINT!!!!!!!!!!!!! Yippeee!!!!!  ;D ;D ;D ;D ;D

Then it was time to go home, so here I am. At home, in bed, knee up with ice packs. And some extra tubigrip for swelling, as the nurse was really skimpy with what she gave me and I had a huge bulge of swelling between the end of the tubigrip and the top of my sock. I think I am going to be black and blue soon!! When I change the dressings I will take a photo for you all. I wish I knew how to scan the arthroscope pics and then post them. I had some more shredded cartilage to clean up, even though it was only September last year when it was done previously. I got some piccies of it as souvenirs - I wanted pics of the TTT, but I didn't get any  :(

Anyway, I've written enough of a novel now. If you have got this far you are doing very well  ;) As you can see, I am very bored already!!

Bye for now, and take care. More of the saga later  ;)

Kathy xx

Offline KW

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Re: Kathy's DPTT (TTT) Post-Op Diary
« Reply #1 on: June 19, 2008, 03:36:30 AM »
Hi Kathy,  Glad you are home and all is well. I was able to be WBAT after my TTT's also and never had a issue.  Just remember to keep up on the pain meds for the first week or so. Get some rest!

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

Offline synlupri

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Re: Kathy's DPTT (TTT) Post-Op Diary
« Reply #2 on: June 19, 2008, 05:30:51 AM »
Hi Kathy,

It never ceases to amaze me at how different everyone's recovery is after the surgery.
I had a TTT/bone graft, LR, scope, meniscus repair done on my r knee, and am NWB for at least 8-10 wks.  I just had my first physical therapy appt today and I'm at 4 wk post op.

What are these drugs they gave you?  They sound wonderful.  The most I got was Percocet!  They also gave me a nerve block which was supposed to last for 24 hours.  That was nice, but hoo wee after that wore off I really felt the pain.  Horrible, just horrible.

Glad you are home.  Please rest and set an alarm to take your meds.  Nothing worse than waking up to gawd awful pain because the last pill wore off while you slept.  UGH!!!

Hey, what is a theater?  And why do you call the surgey a show?  Just curious.  I appreciate that they kept you overnight.  Me, I went in at 9:00am and was home by 1pm that same day.  It was awful.  No medical people to watch me and vitals.  It just blows my mind that such an intense major surgery such as ours could be an outpatient.

Take care, sleep well, my TTT sister.   

Hugs and happiness,
Syndi   :)
5-21-08 - TTT/Bone graft, scope, LR, meniscus repair, chrondoplasty
11-7-08 - Dual scopes and left LR.  Right knee hardware removal, manaual manipulation.

Offline WorkinWings

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Re: Kathy's DPTT (TTT) Post-Op Diary
« Reply #3 on: June 19, 2008, 05:44:22 AM »
Kathy,

I'm so amazed--and happy--at how clearly you are writing, for someone who's just been through major surgery, general anesthesia, is on big-time painkillers, and must be in quite a bit of pain!  Good job on the narrative!  Thanks for the interesting read  :D

Hope you are able to keep up the good job on the high spirits, and that this surgery does the trick for you for a long, long, long time!  A new and improved chapter begins in your life! 

Wishing you all the best in your recovery,

Angela
Feb'00: Twisting injury (w/"pop")
dx - bone bruise of lateral tibial plateau
Apr'00 to May'07: intermittent pain; NO instability
7/May/07: Lateral Release (which created instability)
17/Jan/08: dx - iatrogenic medial patellar subluxation s/p LR
16/Jan/09: Back to function!
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Offline kathat

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Re: Kathy's DPTT (TTT) Post-Op Diary
« Reply #4 on: June 19, 2008, 06:55:46 AM »
Syndi - We call the operating room an operating theatre here, that's why I called the surgery a "show". Just a play on words! With different recoveries, there is also different protocols for each surgeon too. Also a bone graft probably means things take longer to heal, in your case. Fentanyl is an IV opioid pain killer. It also comes in a patch. It was certainly good. I only got the one dose however. Then I ended up with oxycodone (percocet), which was okay, and the Panadeine Forte, which didn't touch the sides. I could have had morphine, but I chose not to as I had low blood pressure and didn't want to risk falling when I got up to the loo. My surgeon infiltrates the surgery site with local anaesthetic, so it stays numb for 24 hours or so - very nice, but not once it wears off!! I have come home with Panadeine Forte for pain relief, as well as the Tramadol I was on prior to surgery, so I am going to be uncomfortable for a few days, as neither touches the pain much. They take the edge off a bit and that's all. So I am just reliant on ice and elevation to help keep things bearable. And laxatives to counteract the side effects of the useless pain killers  ;) Having things to do keeps my mind off the pain also, hence my long postings here!!  ;D

Angela - The big time pain killers only lasted until this morning, when I made sure I had a dose before leaving hospital  ;) So I am only on the small cookies now, and am trying to keep busy so time goes quick. I am surrounded by things I can do in bed. Just going to the loo is a major pain  :P Walking is okay, but the movements involved in getting in and out of bed, and on and off the loo are agonisingly painful. I am starting to wish I DID have a splint, so I could keep my leg straight while getting up/down!!

The only problem I will encounter if this surgery works will be going through it on the other knee!! Lefty's going to have a tough time being the "good leg" - it's been playing up lately, so even though my OS doesn't plan on doing the surgery on it, I might have to convince him to change his mind if it works well on the right knee. Anything for some relief - though I don't feel like it was such a good thing to try just at the moment!!  :P

My darling 11 year old son baked me a get well cake last night!! He wrote "get well mum" on it with lollies and icing - at least I think that's what it says  ;D It was waiting in the kitchen for me when I got home today. Gee, I love my kids!! The only problem will be trying to force myself to eat some - it's the last thing I feel like eating at the moment  :'(

I just had a thought - I have hardware!! A screw in my tibia! I have never had metal in my body before. I wonder if my OS will remove it at a later stage? What a souvenir to keep!

Anyway, the family are all out right now, so maybe I might catch some ZZZs. Catch you round.

Kathy

Offline Sore knee

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Re: Kathy's DPTT (TTT) Post-Op Diary
« Reply #5 on: June 19, 2008, 08:54:45 AM »
Kathy

Welcome to the other side and all things considered you sound as if you are doing great.
I hope the pain is bearable today and you also manage to rest. Great news  on the splint, thats promising start already.

Hope the swelling is ok today and I am so glad you are through it.
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: Kathy's DPTT (TTT) Post-Op Diary
« Reply #6 on: June 19, 2008, 10:54:30 AM »
Hi kathy,
Great story telling skills in your first post 'from the other side'.....

Cant BELIEVE you are able to weight bear already!! How cool is that!!! And no splint! You are surely superwoman!! I had a full pop cast after mine so weight bearing was out and i didnt have to worry about bending obviously - but the WEIGHT of the cast for the first few days was baaaaad.....also you get all kinds of aches and pains from being forces straight so better not to be.

Do the 'cushions round the leg' trick in bed to stop yourself bumping into your bad leg with your good leg. And elevate elevate elevate!!!!

Hardware eh? You get attached to it - quite literally in my case as my body has decided to grow bone over it so my leg looks a little defomed on the outside with this large lump of bone and my tibia looks slightly bowed in x-ray cos ive extra bone at the top - but heck, why not grow a little extra bone eh? You never know when you'll need it :)

We all want to see a piccy of your leg now!!!

Any problems other than general aches and pains after major op? This is the hardest part, even getting over anasthetic is hard, this time next week you'll be a different woman.
xx
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: Kathy's DPTT (TTT) Post-Op Diary
« Reply #7 on: June 19, 2008, 12:37:07 PM »
Hi Tanya,

I have no worries about my good leg knocking my bad one - my surgery leg is way, way, way up in the air on pillows, so my good leg isn't going anywhere near it unless it takes up rocket science and blasts off overnight!

I don't know if not having a splint is a good thing - it hurts to move, especially on the horizontal plane. I usually have to grab my trackpants and lift my leg that way, and even that is painful  :( I am just lying here doing nothing and I am quite uncomfortable as it is. Hopefully the swelling will subside with my RICE treatment and I will be more comfortable soon, as I think it's the swelling that accounts for most of the pain I have at rest. The pain on movement is centralised around the TTT site. I have quite a number of painful to touch areas also, which I hope start easing off - I always worry when an area that hasn't been operated on gets painful like that, though I know swelling and nerve irritation can account for some bizzare things.

Anyway, I took some pics. I will post this first, and then post the pics, as last time I tried to post the reply with pics included, I managed to erase my whole post  :P

You will see how the bruising shadows the skin on my shin, and you may be able to notice that the same area is quite swollen (though it is swelling up towards the camera, rather than out sideways from my leg, so it's hard to see). I will try to post some more pics as things progress and change.

Enjoy!

Kathy

Offline kathat

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Re: Kathy's DPTT (TTT) Post-Op Diary
« Reply #8 on: June 19, 2008, 12:39:15 PM »
Here is the first picture....


Offline kathat

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Re: Kathy's DPTT (TTT) Post-Op Diary
« Reply #9 on: June 19, 2008, 12:41:04 PM »
And now another one...


Offline arkitect06

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Re: Kathy's DPTT (TTT) Post-Op Diary
« Reply #10 on: June 19, 2008, 01:27:39 PM »
Kathy, doesn't look too bad!  Congrats for getting it all over with.  I hope your recovery goes smoothly!  Are you allowed to bend it?  If so, do you get to work on ROM?  Sorry you don't have a brace!  I couldn't imagine not having one after my TTT. After my surgery, I thought I could be fine without it while getting around the house....no way!  My leg flopped around!  So I took it off only while sitting and put it on every time I got up. I hope your pain is manageable!  Thinking about you!

Farrah
11/16/10 Fulkerson TTT, chondroplasty, LR (Left Knee)
11/17/09 SCS re-implant
7/29/09 I&D
5/7/09 SCS removal b/c of MRSA
12/15/08 & 2/6/09 SCS Revision
10/30/08 Spinal Cord Stimulator Implantation
6/27/08 diagnosed with RSD
1/8/08 Fulkerson TTT, chondroplasty, LR (Right Knee)

Offline tanyap

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Re: Kathy's DPTT (TTT) Post-Op Diary
« Reply #11 on: June 19, 2008, 01:38:56 PM »
wow! It looks great! Did you really have a TTT?????? I thought itd be way more misshapen and swollen looking!

Youre not too badly bruised - yet, but it will probably still come up for a bit, I still had bruising coming out for around 10 days after my scope. When the main swelling went down the bruises came up.

It actually looks quite 'normal'!!
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: Kathy's DPTT (TTT) Post-Op Diary
« Reply #12 on: June 19, 2008, 03:46:56 PM »
Wow it looks neat and clean. Looks like a good job !!!!

hope the pain will be ok and just keep resting.

You are doing great :-*
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 KW

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Re: Kathy's DPTT (TTT) Post-Op Diary
« Reply #13 on: June 19, 2008, 03:55:11 PM »
Kathy,  Sounds like you are doing great.  That looks like all 3 of mine. It looks really good..little swelling keep up with the ice! I hope you have little pain like I did....Sure the first week is no walk in the park but it will get better. 

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

Offline kathat

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Re: Kathy's DPTT (TTT) Post-Op Diary
« Reply #14 on: June 19, 2008, 04:22:00 PM »
I am certainly lucky in that I don't really swell much. The small amount that I do have is uncomfortable enough. I really work hard at keeping the swelling down early - I have hardly left the bed, and I always have a tubigrip on, elevate above my heart, do my ankle pumps, and I ice pretty much around the clock with the 20 min on, 5 min off regime suggested by my PT paperwork. It has improved quite a bit since I got home. It is more obvious in the earlier photos that I took, but they are too big to post, so I can't show you here. I will try to upload them on Facebook and give you the link instead. I have to work on flexion and that is inhibited a bit by the swelling, but more by pain. I am to flex passively to the edge of pain only, which isn't far at the moment. It starts to stab in the TTT site. My exercises consist of working on flexion, quad contractions (pushing the back of my knee into the bed with a small roll under my ankle), and ankle pumps. I am not managing much with the exercises at the moment, due to pain, but that should ease with time. I figure any flexion and quad contraction is better than none and puts me ahead of where I'd be if I had a brace/splint.

It is nearly 1am here, and I have managed a couple of hours sleep so far tonight. I got up to get a fresh ice pack, and I was disappointed to see all the lights were still on and hubby was still up - it wasn't nearly as late as I had hoped it was!! I am due more pain relief at 1.30am, so if I can stay awake until then I can top up on pain killers and it might see me through the night.

I am off to try and get some photos on Facebook.....

Bye for now,

Kathy















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