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Author Topic: Nick's 3in1 Diary FatPadTrim, Medial plica/Distal patella excision, AIR x2, LMR  (Read 275782 times)

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Offline Clarkey

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Re: Fluid around the Fat Pad!
« Reply #30 on: August 30, 2008, 02:32:41 PM »
I been thinking through what I should do to get the ultra sound done on the 15th September and think I know a way of doing it. I will ring up Alexander on monday and asked him if he could contact Paul who will decide if I need ultra sound, Alexander if you have read on my previouse postings, is the PT who suggested ultra sound and showed me the fluid and inflamation around the fat pad on the MRI scan.

Will explain to him I had 3 assesments already and want to do a 4th one on the 15th and the pain is increasing and if he could phone Paul to do the the ultra sound when I see him on the 15th September.

I need to get the ultra sound happening ASAP to see if it helps or not if after a few ultra sounds knee still the same would finallly see a OS for a cortisone injection and if that fails would have to have a scope. I may well not need surgery but its a possiblity if conservative methods fails.

If I could choose a time to take time of work it would be anytime from October till March as I said before we are far less busy at work if I was to take sick leave during the winter months, would be the best time, thats is why I want the Ultra sound soon just incase it fails.

My sister had a cyst in her knee and ultra sound fixed it so may well fix my problem but wont be upset if it fails. IF they did decide to scope would not be scarred anymore like I was a few months ago if it gets me running again but hopfully this wont happen.

Nick :) {2008} :)



« Last Edit: August 30, 2008, 02:34:17 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: Fluid around the Fat Pad!
« Reply #31 on: September 02, 2008, 04:18:13 PM »
Yesteday I left a message with Alexander's Secretary at the Hospital and this morning I got a phone call from him. He said they seemed to be some confusion about having ultra scan when I should be having Ultrasound therapy.

I just googled both terms and ultrasound therapy is as follows "uses high-frequency sound waves to produce heat that can reduce pain, It may be used to treat conditions such as musculoskeletal injuries"

Ultrasound scan "a painless test that uses sound waves to create images of organs and structures inside your body"

So as far as I am concerned still be using an ultrasound machine or is it another type of machine all togther. I did not want to ask him too many questions as he very busy but think the phone call has helped a little as he going to phone up Paul my PT at the Centre who saw me the 1st time.

Might not be a bad thing after all to have another assesment on the 15th September as I can know feel catching of the fat pad and is more easy to feel it catch then before so might say go for the cortisone injection. If you place your hand over the kneecap can feel a catching/crunching sensation around the fat pad are, before was not as bad but increased since going to the gym 3 times a week.

Alexander was great said if you have any other worries give him a call and fully trust what he reccomends.

Nick :) {2008} :)
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 suehaem

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Re: Fluid around the Fat Pad!
« Reply #32 on: September 02, 2008, 10:06:46 PM »
Hi Nick,

The machine you will be having is a little portable one on a trolley with a wand type instrument.  The will put jelly around the affected area and move this wand like instrument over the area that is sore.  It is very soothing, The machine hums whilst they are doing it.  They will do it for about 10 minutes or so.  when they do it you will wonder how that has helped but after a couple of goes you should notice some difference. 

Ultrasound scanning shows images of the internal structure to diagnose problems which is totally different from the therapy.  So it will be the above you will be having.

Hopefully not long now.

Good luck

Sue
 ;D
North Wales
Fall from horse 04/04
Arthroscopy 27/07/07 -Grade III debridement
Re-injured knee running 1/03/08
Arthroscopy 11/10/08 - Grade II debridement
09/03/16 Fracture fib sking damage to knees
31/05/16 Grade 4 Chondromalacia and patella tilt (R)
17/11/16 Need new knee cap (L)knee
Awaiting Arthroscopy 2018

Offline TwoBadKneesUSA

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Re: Fluid around the Fat Pad!
« Reply #33 on: September 03, 2008, 02:16:14 PM »
Hi Nick,

Wow what a difference a few words make!  Hopefully they can do the scan after the assessment.  The sessions are not that long like Sue said around 10 minutes.  If you end up needing a scope anyway, we are here for you.

Milly
'83 lt knee scope
'88 lt knee LR
'89 rt knee LR (6 mos. after left)
'05 rt knee scope (clean up)
7/5/07 - scope, LR left, right clean
3/19/08 - LR failed, Supartz failed
http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=47974.0
8/21/08 - new OS apt
8/5/09 - TTT, LR, PFJR sched.

Offline Clarkey

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Re: Fluid around the Fat Pad!
« Reply #34 on: September 04, 2008, 05:55:58 PM »
Thanks milly and sue for the replies from this posting seems never ending, I will remain positive about ultra sound therapy but will also not rule out having a scope if conservative treatments failed, if things go smoothly and get ultrasound treatment might last till around mid November but hope its sooner more like end of October. I would then go back to alexander and he would book me in to see a OS for an injection of cortiosone but if I did end up with an injection does it really fix my fat pad problem or should he rather look inside the knee and give it a good clean out.

I know its too early to ask and might not happen if ultrasound therapy fixes my problems but say it did not help and needed a scope how long would I have to wait to get it done maybe sue can advise me on that one. Lets say get put on a waiting list in december before Christmas would I have knee fixed before the end of March next year or would it be some time during the summer months.

I just need to know with my aspergers about what could happen fat pad problem contines after using conservative methods and is good for me to be prepared if it did happen, that way wont have so much stress and anxieties if it did happen.

I also know I would be supported in this forum if I did end up needing a scope which I hope wont happen but sometimes problems can only be be sorted in the operating theatre.

Nick :) {2008} :)

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 TwoBadKneesUSA

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Re: Fluid around the Fat Pad!
« Reply #35 on: September 04, 2008, 07:15:38 PM »
Hey Nick,

Have you dried out yet?  I don't know about time frames for schduling over there so can't help much there.  If the fat pad is still inflamed the cortizone should help that, it's a steroid.  Kind of a super anti-inflamitory.  I am one of the lucky ones where the cortizone crystalizes and is like grit in my knee.  Not nice at all, and it does not last long for me.  Lots of people have very good results with them though.  If it can calm the inflammation, then they probably would not need to look around inside.  If is still stays inflammed then the doc may want to have a look inside to see why.  Does that help some?

Milly
'83 lt knee scope
'88 lt knee LR
'89 rt knee LR (6 mos. after left)
'05 rt knee scope (clean up)
7/5/07 - scope, LR left, right clean
3/19/08 - LR failed, Supartz failed
http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=47974.0
8/21/08 - new OS apt
8/5/09 - TTT, LR, PFJR sched.

Offline suehaem

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Re: Fluid around the Fat Pad!
« Reply #36 on: September 05, 2008, 06:42:28 PM »
Hi Nick,

I think the longest wait you will have is seeing the OS first.  The first time I was referred in the November and saw him in the March and that was paying for a private consultation apparently it would have been December before I could get to see him.  I was put on the waiting list as an urgent case and was operated on in the July..  The second time I saw him within a month as I was still down as a review and I went on the routine list which was in June (because I was a chicken and did not want to go in two weeks time when he wanted to do it) and I have been listed for beginning of November.

Currently the waiting list has to be no more than 26 weeks in Wales.  I little different in England but not far off as they are the national guidlines (I work for NHS).  So if you go on the waiting list in October they will have to do you before the end of March.  If you go on your hospitals web site they will have the current waiting list lengths on thier site.  The other alternative is to say that you will take a cancellation to get it done quicker, so if they say at your consultation that they are putting you on the waiiting list say then that you will take a cancellation.

I think the wait to see the OS will be a while if you are referred as a routine.

Sue
 ;D
North Wales
Fall from horse 04/04
Arthroscopy 27/07/07 -Grade III debridement
Re-injured knee running 1/03/08
Arthroscopy 11/10/08 - Grade II debridement
09/03/16 Fracture fib sking damage to knees
31/05/16 Grade 4 Chondromalacia and patella tilt (R)
17/11/16 Need new knee cap (L)knee
Awaiting Arthroscopy 2018

Offline Clarkey

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Re: Fluid around the Fat Pad!
« Reply #37 on: September 06, 2008, 03:22:37 PM »
Thanks sue and milly for your repiles,

Its intresting to see how the waiting lists are on the NHS. My Sister a orthopaedic nurse in a hospital in Suffolk and she said the waiting list to have a scope is about 12 to 16 weeks but can get it done sooner but should not have to wait any more then 3 months.

Milly might be right the cortisone might reduce the the swelling but I been told it temporary reduces the inflammation. Like you said might not need to go under the knife but if its still the same before my 30th Birthday on the 2nd December after conservative treatment would tell the OS to get it scoped as soon as there a cancellation like sue suggested as I could afford time off work up till March anytime after that would have to put surgery on hold till October 2009 as we very busy on the golf course from April till the end of September. This is just a maybe and hope it does not come to this.

Nick :) {2008} :)

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 suehaem

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Re: Fluid around the Fat Pad!
« Reply #38 on: September 06, 2008, 05:25:09 PM »
Hi Nick,

Worth giving everything a go first.  Hopefully the ultrasound will make things good for you and hopefully you won't need to go on to the others.  I found the injection brill, made a whole lot of difference with the pain and if all else fails then you know where you are heading.  Unfortunately the whole system is slow but you will get sorted eventually.

Sue
 ;D
North Wales
Fall from horse 04/04
Arthroscopy 27/07/07 -Grade III debridement
Re-injured knee running 1/03/08
Arthroscopy 11/10/08 - Grade II debridement
09/03/16 Fracture fib sking damage to knees
31/05/16 Grade 4 Chondromalacia and patella tilt (R)
17/11/16 Need new knee cap (L)knee
Awaiting Arthroscopy 2018

Offline TwoBadKneesUSA

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Re: Fluid around the Fat Pad!
« Reply #39 on: September 08, 2008, 02:17:59 PM »
Hey Nick,

If you have run out of conservative treatment and are still having issues, then you are right and they would need a look around inside.  I can understand the timing issue too.  I would love to get my knee "fixed" right away, but can't afford to take much time off without pay.  So I am waiting until I get enough leave time built and then have the surgery.

Milly
'83 lt knee scope
'88 lt knee LR
'89 rt knee LR (6 mos. after left)
'05 rt knee scope (clean up)
7/5/07 - scope, LR left, right clean
3/19/08 - LR failed, Supartz failed
http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=47974.0
8/21/08 - new OS apt
8/5/09 - TTT, LR, PFJR sched.

Offline Clarkey

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Re: Fluid around the Fat Pad!
« Reply #40 on: September 09, 2008, 04:14:58 PM »
Posting again sorry seems never ending, I am seeing my GP this Friday about a review of my AS meds if they can reduce the medication. I know others on this board have worse knee pain then me but the right knee pain increased a lot the last few days on the opposite side where I normally get pain. Also mentioned it before a lot more noticeable the catching inside the knee and can feel it if you place hand over the knee, if you listen in a silent room can hear the catching.

At the back of my mind I think there more going on inside the knee and will ask my GP if I could see a OS as I know how long it takes, during the time of waiting hope to have ultrasound and if it fixes my knee problem will cancel the OS appointment. I will also tell Paul about it next week Monday if he can get Alexander to get the cortosone injection on the way as it will take another few weeks and during that time can see if the ultrasound helps, if it fails will have the injection straight away, rather then waiting another few weeks to see a OS.

I need the knee sorted within the next 6 months so need to be a bit cheeky and ask to book me to see a OS. At the end of the day its my knees and know they not right and get annoyed with people saying why do you want to see a OS.

The knee pain becoming annoying now and more regular and think its the right time to see a OS even of others dont agree I worked now for 9 years so helped pay towards the NHS so about time I made proper use of it. There no harm in seeking a 2nd opinion as PTs are not a experienced as a OS and would make me feel better with my Aspergers to know I seeing the top person.

Nick :) {2008} :)
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 TwoBadKneesUSA

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Re: Fluid around the Fat Pad!
« Reply #41 on: September 10, 2008, 02:47:35 PM »
Hey Nick,

Post away, that's why we are here.  It helps when you know someone understands.  It would be a good idea to see an OS and see what he has to say.  Hopefully you won't need it, but good idea to try to get an appointment booked.

Hope you are better today.

Milly
'83 lt knee scope
'88 lt knee LR
'89 rt knee LR (6 mos. after left)
'05 rt knee scope (clean up)
7/5/07 - scope, LR left, right clean
3/19/08 - LR failed, Supartz failed
http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=47974.0
8/21/08 - new OS apt
8/5/09 - TTT, LR, PFJR sched.

Offline Clarkey

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Re: Fluid around the Fat Pad!
« Reply #42 on: September 11, 2008, 07:01:03 PM »
I been doing some research on fat pad problems and certain I may well have Hoffa's disease and will paste a link that shows a MRI scan of fat pad or Hoffa's fat pad.

http://www.mypacs.net/cases/ANTERIOR-KNEE-PAIN-HOFFAS-DISEASE-884405.html

My 2 heavy falls onto the pavment have agitated my fat pad and would like to have the cortisone injection rather then ultra sound as it cant make my knee any worse and is worth a try (faster). As I said before will see my GP and will get him to feel the catching inside the knee which is easy to feel more then it was a few weeks ago. Will ask him if its a good idea to ask Paul to book me in to see a OS.

Nick :) {2008} :)
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 suehaem

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Re: Fluid around the Fat Pad!
« Reply #43 on: September 11, 2008, 08:50:22 PM »
Hi Nick,

One thing I can definately say if nothing is fast when it comes to getting knees sorted  :(. I know time is not on your side but definately give the ultrasound a try at least then if things are not settling they are more likely to listen to you and move through the treatment options a bit quicker.

I found that it took a long while for them to agree that things were not working with me last time round but if you end up heading for any surgery the injection is a welcome relief.  It is frustrating waiting to get those wheels in motion when people are taking their time deciding the best plan of action.  You will get there eventually.

Sue
 ;D
North Wales
Fall from horse 04/04
Arthroscopy 27/07/07 -Grade III debridement
Re-injured knee running 1/03/08
Arthroscopy 11/10/08 - Grade II debridement
09/03/16 Fracture fib sking damage to knees
31/05/16 Grade 4 Chondromalacia and patella tilt (R)
17/11/16 Need new knee cap (L)knee
Awaiting Arthroscopy 2018

Offline Clarkey

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Re: Fluid around the Fat Pad!
« Reply #44 on: September 13, 2008, 03:12:06 PM »
Hi Sue I am sure you are right about giving ultrasound a go but remain sceptical about it as the knee pain becoming more intense now. Was mowing on a sit on mower and got very intense pain on and off and never been so bad before. I always ask advise from my Sister who a nurse at a orthopaedic ward and she said when you see Paul the PT on Monday say you want to see a OS as the Patient has the rights to see a OS even if the PT does not agree.

MRI scans are not 100% reliable and sometimes miss things out and my sister and I think I may have torn some menicus. My brother in law 1st scan came up normal and a few weeks lator second scan showed he torn his menicus and will be under the knife soon. The last time I saw the PT the symtoms where not so bad and will at least ask for a cortisone injection into the fat pad as its a quicker method of reducing the swelling and it cant make my knee any worse then it is now.

(Heavy fall twice onto pavement cant do good to the knee structure)

If it was June I would try the ulltrasound 1st before injection but I am limited in time as I mentioned before and cant afford to see if ultrasound works or not. IF it fails and I did need to see a OS it might be February next year and if the only option was to scope the knee would be done in the Spring and Summer months which I cant afford to do in my job as a greenkeeper with golf tournaments daily from mid march till mid october.

Paul said if they did decide ultrasound would have to wait 6 weeks from the 15th September which would bring it to the 27th October and would not be till the new year that I would see a OS for an injection.

The OS who would give the injection has his own website and looks good so looking foward being treated by him as he very good with injections.

http://www.drgrahamebrown.co.uk/treatments.asp

My course manager says he wants my knee back to normal before march and said is about time you see a OS. If a scope was the only option left in the end, even though it scares the hell out of me you have to do things in life you dont want to do and if it solved the knee problem would be worth it.

I know people who have less knee pain and can run and walk ok who seen a OS so dont feel bad asking to see one as it will soon be my 1st anniversary since my fall and as you know stopped me doing a favourite hobby of mine jogging which I am now starting to miss.

Sorry if you think I am jumping the gun by not waiting for ultrasound but time is limited now so have to go for the injection instead.

Nick :) {2008} :)





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















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