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Author Topic: Nick's FatPadTrim, Medial plica/Distal patella excision, AIR x2, LMR 3in1 Diary  (Read 299045 times)

Offline Hiker girl

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Re: Nick's Medial Plica Excision & Fat Pad!
« Reply #1065 on: June 26, 2013, 09:03:12 PM »
Glad you finally have the appointment Nick.

I am 13 months post op same procedure.  This is the longest rehab process.  Two steps forward one back for no apparent reason.  Let us fat pad peeps know how things go or any advice for the rest of us :D


 Debbie
Rt. knee pain while hiking 08/10
Saw GP 04/11
PT 05/11  failed
MRI  clean 06/11
1st OS, nothing wrong, fired him.
2nd OS, cortisone shot 12/11 
Scope 05/12, fat pad impingement, cleaned and reshaped.
3rd and 4th OS think nerve problem
Nerve study June 2012, Femoral nerve damage

Offline Clarkey

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Re: Nick's Medial Plica Excision & Fat Pad!
« Reply #1066 on: July 02, 2013, 05:22:43 PM »
Hi All,

My appointment with Mr Snow was brought forward to 16:30 rather the original time of 19:00 and did not take Mr Snow long to come up with s possible solution. I have a very tight IT band in my right leg muscle that could well be contributing towards the anterior knee pain in my right knee.

I will have a botox injection due to having an tight IT band that should loosen some of the tightness followed by an intense PT session. I will see a radiologist to get the exact point to inject the botox and then go through some PT and see how it goes.

Mr Snow does not think it’s a mechanical problem with my right knee and does not think an exploratory scope is necessary and will carry on going down the conservative route for the time being. I also think it is just tightness that’s causing me all the knee pain as both hips are very tight and knotted.

This method and technique is still very new and on trial still and aimed specifically for athletes that do a lot of long distance running. The majority that have been using this method of botox and intense PT have benefited vastly.

I hope this method works for me, that will take at least 3 months from botox injection and followed by  some intense PT before I know if it benefits, cures, reduces my knee pain and swelling in my right knee.

Thanks for your message Debbie, plica syndrome can be hard to get right again as you well know.

[email protected]
« Last Edit: August 21, 2013, 05:43:48 PM by Clarkey »
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 Clarkey

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Re: Nick's Medial Plica Excision & Fat Pad!
« Reply #1067 on: July 12, 2013, 03:40:08 PM »
Hi All,

I would like some advice please as I am not sure how far I should push my right injured knee by running on it at a slow pace. I did try at a very slow pace jogging for about half a mile on a soft surface and as long as I do not go too quickly the right knee feels ok and not too painful. As soon as I increase the pace straight away feel pain and tightness at the bottom my knee that is very frustrating as I cannot push it any further.

Should I rejoin Droitwich Athletics Club again and start running with the beginners or wait till I had some treatment on my right knee using the botox injection method. My gut feelings is not to run right now as I could end up making my right knee even worse that's still swollen at the bottom since the fall on black ice in January 2013.

Mr Snow thinks my knee is not injured enough that it needs an exploratory scope that could still happen if all conservative treatments fail that’s always the last option and happy to see if the botox injection and PT benefits my right knee. Can then try another method of none invasive treatment if my right knee does not improve after the botox and intense PT programme.

Should I do a little bit of running or wait till my hospital appointment and forget about joining Droitwich AC this year as I am not happy with my running pace right now and rather join up again when I can run at a reasonable pace again.

[email protected]
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 Snowy

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Re: Nick's Medial Plica Excision & Fat Pad!
« Reply #1068 on: July 15, 2013, 04:53:50 PM »
I think you should let the pain be your guide on this. Pain doesn't happen for no reason - it's a warning sign that your body doesn't like something that you're doing. If gentle running doesn't cause a problem, then I would think it's okay to keep doing this. (Check with your PT first, though.) If strenuous running hurts, I would definitely avoid it.

If you do decide to keep going with the slow running to keep in practice, I would hold off on joining the club. In a club environment with other runners there's going to be a lot more pressure to keep up with whatever pace the group sets, whereas on your own you can completely dictate how fast you go and ease off when your knee starts to hurt without worrying that you're impacting others in the group.

As you say, it's better to play it conservatively if in doubt - the last thing you want to do is injure your knee further.
Mar 11: R Biceps femoris tear (skiing)
Jul 10: ACLr (hamstring autograft)
Mar 10: L ACL rupture (skiing)
Feb 06: L partial ACL tear (kickboxing)
Dec 03: R bone edema (motorbike)
Jan 01: R patellar chip (motorbike)
May 93: R ACL sprain (hockey)
Ongoing: bilateral PFS and OA

Offline Clarkey

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Re: Nick's Medial Plica Excision & Fat Pad!
« Reply #1069 on: July 18, 2013, 05:30:05 PM »
Hi Snowy,

Good sensible advice and best not to joining Droitwich AC till my knee can increase in speed without feeling any pain. I did try once again to go for a slow run and do feel more pain each step on a hard surface and acceptable the pain on a soft surface and as you said maybe best to be cautious for the time being as pain and swelling is there for a reason as the knee is saying it is not happy please stop running and be daft if I did as I could end up causing permanent damage.

I know it will not take me long to get backing to my average running pace of 7 minutes a mile once my right knee gets the right treatment. 2013 can be a year for me to forget long distance running and look to spring 2014 to going running again for Droitwich AC.

[email protected]
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 Clarkey

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Re: Nick's Medial Plica Excision & Fat Pad!
« Reply #1070 on: July 30, 2013, 11:32:33 AM »
Hi All,

Been 4 weeks since I last saw Mr Snow who said he will refer me to the NHS Birmingham Royal Orthopaedic Hospital and have still not received a letter for an appointment to receive treatment on my right injured knee.

I have just been to the Receptionist at the Droitwich Spa Hospital and not putting the blame on them it is the job of Mr Snow’s Secretary to refer me to the ROH and made a cock-up of my last referral that was delayed then cancelled and never rescheduled the appointment for me. I hope to get a call from the Secretary later on today to arrange a date and time for an appointment at the ROH.

I have been waiting since March 2013 to receive some form of treatment and so far not getting any and could do without this added stress and anxiety as I have other more personal stuff to sort out right now in my life.

[email protected]
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 Clarkey

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Re: Nick's Medial Plica Excision & Fat Pad!
« Reply #1071 on: August 16, 2013, 03:24:36 PM »
Hi All,

I had no option left but to write a complaint letter to the Birmingham ROH for the time it is taking to get an appointment and did email the complaints department last week Wednesday 7th August and by Thursday afternoon was told Mr Snow has arranged to have an injection at the ROH and PT at my local physio centre.

I was expecting a letter by Wednesday the latest and still have had no letter for a date and appointment and if they not sent a letter by Monday will have to write a further complaint email as I have been patient and have had enough of the waiting and hope they can book me in soon.

Here the email I sent to the Hospital 07/08/13, fingers crossed will get the letter Saturday morning or Monday.


Dear Sir/madam,

I would like to complain about the services I have received from the ROH with regards to an on-going knee injury to right knee sustained in January 2013 when I slipped onto my right knee on black ice. I have had treatment previously at the ROH when I had an exploratory scope on my right knee under the care of Mr Green on 16th November 2009 as a day case procedure.

I decided to see Mr Snow at the Droitwich Spa Hospital for a private consultation on March 19th 2013 in order to speed up the waiting time to receive treatment on the NHS at the ROH. I waited for several weeks for an appointment till I finally was given a date that had to be postponed a few days before seeing Mr Snow and the lady that spoke to me over the phone said she will contact me to arrange a new appointment to see Mr Snow. I never received a phone call back again so had to arrange to see Mr Snow again at The Droitwich Spa Hospital under the NHS Choice Scheme as I got no response from the ROH.

I saw Mr Snow again at Droitwich Spa Hospital on July 2nd 2013 and said I will receive treatment and physio at the ROH, I have not received a letter for an appointment at the ROH. I saw the Receptionist at the front desk at the Droitwich Spa Hospital last week Tuesday 30th July and she told me Mr Snow Secretary will call me back again for an appointment that’s now over a week ago and have not received a phone call from Mr Snow’s Secretary.

My knee injury has frozen my membership for Droitwich Athletics Club as I am unable to run right now as I have pain and swelling at the bottom of my right knee when I attempt to run and would like to get back to a competitive  level again as I was one of the top runner for the Club.

Please could you kindly arrange an appointment ASAP.

Regards,

Nick Clarke.


Hope they got a date set up and send me the letter soon.

[email protected]
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 Clarkey

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Re: Nick's Medial Plica Excision & Fat Pad!
« Reply #1072 on: August 20, 2013, 09:30:16 PM »
Hi All,

I went both to the Physio centre & Birmingham ROH asking when I am booked in for injection & PT & was told they have not yet received a referral from MR Snow & the lady I emailed 07/08/13 will call me today to arrange a date & time for PT & injection. This all happened yesterday morning & have not called or emailed me today & now reached boiling point as I complained several times to get treatment on my right knee & still no progress.

There no excuses now & may have to complain to the hierarchy of the Birmingham ROH as I am still getting swelling & pain in my right knee & hurts to run on it & really keen to get back I long distance running that I being denied right now due to poor management to get an appointment.

Having mild Autism known as Asperger syndrome it's not doing my anxiety & stress levels any good on top of some personal issues I am going through right now & had to resort to smoking to calm me down that I know is not doing my health any good.

[email protected]
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 Clarkey

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Re: Nick's Medial Plica Excision & Fat Pad!
« Reply #1073 on: August 21, 2013, 04:41:01 PM »
Hi All.

I have been yet again to Birmingham ROH this morning and spoke to the lady that deals with complaints and told me I am on the waiting list and may take time to get an appointment and have now written another email to her saying I want priority otherwise will complain to the Chairman of Birmingham ROH!


Dear ****,
 
Following on telephone conversation this morning you informed me that I am on the waiting list to see Dr James for an injection into my right knee as well as physio on my Right knee at the ROH. I originally paid to see Mr Snow at the Droitwich Spa Hospital hoping I would speed up the process on the waiting time on the NHS and had my 1st consultation appointment on Tuesday 19th March 2013 and was told I would see Mr Snow again on the NHS at the ROH.

I did finally get to see him at the ROH and two days before my follow up consultation received a phone call from a member of staff at the ROH that my appointment has been postponed and would get a phone call for to arrange another date and time to see Mr Snow and never received a phone call.
 
I then went for the NHS chose and book system at the BMI Droitwich Spa Hospital and saw Mr Snow for the follow up consultation on Tuesday 2nd July and was told I need physio and an injection for my right knee injury and would have it done at the ROH. I waited several weeks before contacting you on Wednesday 7th August 2013 and was under the impression I would be a priority case as I have been waiting a while now for my 1st treatment on my right knee.
 
I have a mild mental health condition known as Asperger syndrome that’s a mild form of Autism and with this condition we are more inclined to have higher anxiety and stress levels and the long wait is not doing my mental health any good and would asked you kindly to arrange to see Dr James and have physio ASAP. I know you have a long waiting list and may get cancellations and would be available for treatment at short notice as I am currently unemployed.
 
If this matter is not resolved soon I have no option left but to report the incident to the ROH Chairman Mr Bryan Jackson as I have been waiting long enough for some basic treatment. Long distance running is very important role as part of my Asperger syndrome and keen to get back to running again for Droitwich Athletics Club.

Regards,
 
Nick Clarke.


I am normally a patient and easy going but had no option but to become a Victor Meldew to get it sorted out finally & sure she will act now in making my appointment a priority.
 
[email protected]
« Last Edit: August 21, 2013, 05:01:25 PM by Clarkey »
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 Clarkey

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Re: Nick's Medial Plica Excision & Fat Pad!
« Reply #1074 on: August 21, 2013, 05:00:37 PM »
Hi All,

Already had a email back and just shows sometimes you have to be pushy as they made a mistake.


Dear Mr Clarke
 
Please be assured that I do understand how difficult this wait is for you. 

I am currently trying to arrange your physiotherapy and I will be speaking to Dr James secretary tomorrow regarding a date for your injection.
 
I understand that waiting is a very anxious time and I will do my upmost to minimise this wait for you.
 
I will be telephoning you tomorrow with an update and hopefully I will be able to provide a date for your injection.
 
With kind regards.

*****


Dear *****,
 
I am sure you trying you best to fit me in the best you can it just taken longer than expected after paying privately in March 2013 for 1st treatment that as you well know I would have got an follow up consultation if the lady at the ROH called me back again after the cancelled appointment with Mr Snow which is why I asked for priority.

Regard,
 
Nick.


The Birmingham ROH have always been good to me with regards to my last knee injury and surgery just ashame I had to make a complaint that’s always my last option as I do not like falling out with people.

[email protected]
« Last Edit: August 21, 2013, 05:02:22 PM by Clarkey »
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 Clarkey

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Re: Nick's Medial Plica Excision & Fat Pad!
« Reply #1075 on: August 28, 2013, 02:46:57 PM »
Hi All,

Finally some good news to share will be having a botox injection into my right knee on Thursday 5th September 2013 and have to be there nice and early for 7:30am. Usually asked to come in that early for day surgery and would think that they would give the injection without the need for a general anesthetic unless they manipulating!

I sure it just a straight forward injection with no spinal or GA just been booked in for an early appointment. I also pre booked for physio and waiting for a date to be confirmed, can finally say I making some progress getting my right knee treated. 

[email protected]
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 Clarkey

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Re: Nick's Medial Plica Excision & Fat Pad!
« Reply #1076 on: August 30, 2013, 04:16:28 PM »
Hi All,

I have received the confirmation letter from The Royal Orthopaedic Hospital and as I was expecting mentions no food after midnight onwards and mentions the word surgery. It may be just a standard letter that they send to all patients attending the Day Case Unit and hopefully it's a standard covering letter to covers themselves.

I can cope with pain ok as I have a high pain tolerance level and have had 2 cortisone injections before on my right knee as well as IMS sessions that all cause some pain and discomfort and feel that going under a general anaesthetic for such a minor procedure is a bit extreme and that a local anaesthetic would be the better option.

I do not mind having a general anaesthetic for a surgical procedure and only having a CT guided botox injection into my right knee that just a sharp prick at worst nothing more and feel being knocked out is not necessary.

Has anyone had other injections into your knee and had to go under a general anaesthetic that I know they may do for manipulation mine just a tight IT band and very tight muscles that IMS can sort out dry needling a procedure that's safer and less risky as I think I am one of the 1st patients at the ROH to have a botox injection into the knee that is still very new in the UK. I hope I do not end up worse off as they do not yet know the long term side effects of botox into the knee.

http://www.livestrong.com/article/79800-botox-knee/

The above article says no form anaesthetic is required for a botox injection so why is the hospital telling me not to eat after midnight as I have to be there at 7:30am in the morning and feel it not required just for a CT guided botox injection!

[email protected]
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 Clarkey

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Re: Nick's Medial Plica Excision & Fat Pad!
« Reply #1077 on: September 02, 2013, 04:36:38 PM »
Hi All,

I did asked the lady that arranged my appointment for Thursday’s CT guided Botox Injection if I will have to be put under sedation as it says no eating after midnight and do not mind that she has not got back in touch with me as she done what I asked her to do and arranged the injection date.

I just like to put my mind at ease and like to know what will happen on Thursday as some websites relating to Botox injection into the knee says local anaesthetic and other are saying general. I am happy to accept either if it gets me running again it just a little daunting knowing you be put under a GA or mild sedation just for an injection.

I saw my GP this morning regarding another health matter and he told me that for some injections at a Hospital they may have to sedate me. If anyone that posts on my thread from time to time please let me know if you or know of anyone that had to be sedated for an injection into the knee or just around it.

I feel I am in very safe hands under the care of Radiologist Dr James who was a member of the Medical team for the London 2012 Olympics as they do have the top UK Consultants at the ROH in Birmingham that work private as well as NHS so are highly trained and experienced.

Dr James does diagnosis of orthopaedic, spinal and sports related injuries. Dr James also undertakes a wide variety of musculoskeletal and spinal interventional procedures including percutaneous biopsy and vertebroplasty. Dr James spotted my inflamed fat pad when I last saw him and was trimmed during an exploratory scope as well as removal of my medial pica nearly 4 years ago.

http://www.spirehealthcare.com/littleaston/our-facilities-treatments-and-consultants/our-consultants/dr-steven-james/

This is the closest I could get regarding botox injection that for treatment of children and the procedure sounds similar to what I will have done on Thursday. A PDF version from Royal County Surrey Hospital, NHS. 

Botox® has an effect on the nerves where they meet the muscles. There is
a chemical ‘messenger’ called acetylcholine that is released from the nerve
endings to make the muscle contract; Botox® stops this release happening.
Botox® helps to reduce some of the excessive muscle contraction and so
the muscle becomes less stiff.

Sounds very much to what I am experiencing right now that is tight and knotted contributing to a painful IT Band.

Where is the Botox® injected?
Botox® is injected into the affected muscle or muscles whilst your child is 
under a mild general anaesthetic.

So might as expected have a GA just for an injection, why not just numb the region sing  an local anaesthetic. or epidural as GA are usually only for surgical procedures not injections.

http://www.royalsurrey.nhs.uk/Patients/Information-Leaflets/DownloadPDF?DocID=1262%2C1139%2C5%2C1%2CDocuments&MediaID=d087d4cd-89e8-459c-a849-c2448a35496e&Filename=Botulinum+Toxin+12020732_456w.pdf

[email protected]
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 Nettan

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Re: Nick's Medial Plica Excision & Fat Pad!
« Reply #1078 on: September 03, 2013, 11:17:13 AM »
Hey Nick!

I have never Heard of sedation for one injection. The information you have is about Children that get lots of injections like if they have celebral pares. So take it easy.
All best/Nettan
Surgery 6 times left knee torn meniscus, RSDS,chondromalacia, nervdamage cause constant nervpain,chronic inflamm.
Spinaldamage wheeler 100%.
Right knee damaged aug-06, use brace surgery 4/9-07.LCL tear.

Offline Clarkey

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Re: Nick's Medial Plica Excision & Fat Pad!
« Reply #1079 on: September 03, 2013, 05:22:04 PM »
Thanks Nettan,

I always thought the same way you are thinking and usually sedate children like when they have their teeth extracted as they may not be able to keep still, or as you pointed out at the link for children with cerebral palsy.

I just like to know why they say no eating and drinking just water after midnight this coming Thursday. As I said before if it helps me get back into running again then do not mind what they chose to do on day of my botox injection into my right knee.

Maybe will get some sort of guidance for certain types of injections not just botox were they give a mild sedative not a full on GA just something to make you feel dozy by posting on the main section of KG as I like to know what will happen before hand as this puts my mind more at ease and surprised no one knows a yes or no answer and maybe the regular team of posters are on Holiday as I not seen my regular posters online during the last week.

[email protected]
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