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Author Topic: Nick's FatPadTrim, Medial plica/Distal patella excision, AIR x2, LMR 3in1 Diary  (Read 330548 times)

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Offline suehaem

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Re: Fluid around the Fat Pad!
« Reply #45 on: September 13, 2008, 09:26:25 PM »
Hi Nick,

Its the "system" that is slow.  My MRI also come back as normal but the pictures he took when he was in showed a lot of bits that the MRI could not see.  If you don't get any joy with being referred from the PT to the OS have you thought about trying your GP?

Unfortunately these things take time.  Try to find out from your local hospital the time from referral to your first OS appointment to give you some idea of the time scale and the waiting list time. 

I probably would not have the injection before your OS appointment as it will mask the pain during the examination.  I found mine lasted for six weeks and was due for another one before my OS appointment but decided not to have it so he could see what the knee was really like.  If you have an idea how long you will have to wait you could probably fit in an injection before he sees you.

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 #46 on: September 15, 2008, 01:51:47 PM »
Hi Nick,

Maybe your course manager can kick the system into high gear for you.  Even here in the states it can take a while to get an appointment with an OS.  Especially many of the sports medicine guys.  Like Sue says if the PT to OS route isn't working try your regular doc.  Hope the injection gives you some relief.  In the meantime try not to bash them on the ground again.  ;D  (Just teasing a bit here, I am always banging the knees into something solid like the desk, or the ground.)  Take care.

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 #47 on: September 15, 2008, 04:38:03 PM »
Hi Milly and Sue,

I been to see Paul my PT and was shocked when he said he will be doing ultrasound straight away, I sure he said he would assess my knee today and book me in for ultrasound. Maybe Alexander stepped in and said do ultrasound straight away. Its nice to be posting something positive for a change rather then negative things.

I thought I would feel vibrations from the ultrasound machine when he applied the jelly but felt nothing just the cool gel and the movement of the head from the machine. Paul did say it might or might not help and may feel the benefits after 3 sessions. I will now be booked weekly for the next few weeks and see if it reduces the swelling.

If it still the same after a few weeks will fax alexander and will adivise him that I need to see a OS for the injection. I also had it reconfirmed that I have a bone growth in my right knee as well as the swollen fat pad and did ask for another xray as last one was done in 2003 but alexander did not do what Paul asked for. Paul thinks the growth is also causing me problems and ultrasound wont really solve the problem. Paul advised me to ice me knee every evening in the hope that it will reduce the swelling and I started applying ibuprofen gel.

IF the bone growth has become larger and might be contributing to my right knee problems is a scope the only way to get it reduced. Would the OS file the bone done as this could also be the catching sensation I keep getting.

At least if ultrasound fails the OS will know its not working and will decide if I need an injection or a scope. Fingers crossed that ultrasound helps but if not will finally see a OS before March 2009.

Nick :) {2008}  ;D
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 #48 on: September 16, 2008, 09:29:41 PM »
Excellent news Nick at least the ball is rolling now.  Nothing worse than the wait and hopefully they will get you sorted but at least if things don't improve you will be on the right track now.

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 #49 on: September 17, 2008, 02:04:20 PM »
Hey Nick,

Glad they got the ultrasound going at least.  If nothing else, it should help the inflammation.  Now you've gotten things started anyway.  Keep up posted.

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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  • Neil TheElephant knee packed up carrying his trunk
Re: Fluid around the Fat Pad!
« Reply #50 on: September 18, 2008, 06:26:08 PM »
My next ultrasound appointment is this tuesday 23rd September at 9:30am. Paul did say he not sure if ultrasound will help but will give it a try and see if it helps. At the back of my mind I still think I should be seeing a OS by now as each time I try to run my right knee wont function properly as if I got a stiff leg and as I mentioned before pain is more regular and intense and when I do feel the catching inside the knee it hurts and feels unstable at times. I cant even sit down on the ride on mowers without my right knee acheing. It feels rubbery to touch when knee been at a certain angle for a long time as if there fluid inside the knee.

I tried to reduce the swelling with ice packs and ibuprofen gel and pills but does not reduce the swelling. You dont have to be a OS to work out that something wrong inside the knee as there something stopping me from running as if there something trapped inside the knee. I been doing PT and going to the gym and with no success. I did not know I was still limping that much untill a member at the golf course said how comes I am limping.

My Course Manger annoyed me again when he asked if I am paying private and when I said using the NHS said we have to pay for you in a sarcastic manner. Its all very well trying the conservative treatments 1st before bothering a OS but deep down feel there more to it then just doing ultrasound therapy.

If you can avoid a scope its a good thing but have a feeling it might happen as the best way to find what the problems really is and to take a good look inside the knee even if the MRI scan shows up just fat pad inflamation.

I am the last person who would want surgery but this might be the only way I can start to run again. I know so many people who had a knee scope for less knee problems ie could still be active by being able to run and play sports that I cant do anymore for almost a year.

So thats how I feel some might think I am jumping the gun by considering possible surgery at this stage, when I just started having ultrasound but feel its not drastic enough for my knee problem. At least try cortisone injection before a scope.

http://www.sportsinjuryclinic.net/cybertherapist/front/knee/fat-pad-impingement.htm 

(sounds very similar to my symptoms)

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 UK Girl !

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Re: Fluid around the Fat Pad!
« Reply #51 on: September 18, 2008, 08:42:01 PM »
Nick - just tell your course manager that you pay NI contributions and so are perfectly entitled to NHS treatment and say that its a shame he is healthy because he might actually be a bit more considerate towards you !
1978 - ruptured acl and all cartalidge removed.
several debridements over years
TKR 10TH JULY 2006 http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=28257.0  Aug 07 patellar maltracking - more physio! Still pain - but so much better !
BIOMET AGC  TKR  (with 10 yr warranty !)

Offline TwoBadKneesUSA

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Re: Fluid around the Fat Pad!
« Reply #52 on: September 19, 2008, 03:34:29 PM »
Hi Nick,

The ultra sound can't hurt and may help somewhat.  I don't think it's too early to think about seeing an OS and having a scope.  It's been long enough that someone should have a close look.  From what I understand if you are working and pay taxes you are paying into NHS, so why not use what you are paying for?  Some folks just don't get it.

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 #53 on: September 23, 2008, 04:56:29 PM »
Hi Milly and Sue and UK Girl,

I had my 2nd ultrasound appointment today at 9:30am this morning, I told my Course Manager that I have to leave at 9:20am to get to the PT Centre on time and said I never told him when I did last week. We have our 1st break at 9:30am after a 6am start and was having a moan at me for booking my apppointment during work time when its actually my 30 minute break. I only lost 10 minutes of work time and we mostly finish our jobs at around 9:20am so see what the fuss is all about.

I understand why he annoyed in a way as I had so many knee appointments but knee not getting any better and some of the appointments happened to be during work time. I was very peed of when my Manager laughed when I told him about my fat pad problem he seems to think its nothing and still thinks my knee problems is in my head.

I thought my work mates would support me but they also say I having too much time off work with my knee problems and still not making any progress. I returned to work after my mental breakdown in February 2006 and not had a single sick day off work even when knee pain been bad carried on working. Its ok for my course manager to play a round of golf during work time and not booked off as hoiliday. I been told by my manager would have to work overtime if I take anymore knee appointments, I think this is against the law as if you have a medical problem then its ok to take a few hours off work to have it looked at.

I saw Paul and he said he thinks the ultrasound wont help with my knee problems and thinks its this bone growth thats causing me the problems and should have another xray to see if its grown or not. I made him touch the side of my knee so he can feel the catching inside and said he can feel it as well. I also found out I have maltraking in the right knee as well said both knees caps are not aligned propery. I will have 2 more ultrasound appointments and if the right knee not improved will be reffered to see a OS. Wednesday 8th October will be the last appointment for ultrasound and if knee not improved within a week after last treatment Paul will fax Alexander to see Dr Brown for a cortisone injection into the fat pad.

I think I will be seeing a OS towards the end of this year and think its about time I did with 3 problems to the right knee, maltracking, fat pad infringement and bone growth inside the knee cap. I said my manager said its about time I saw a OS he did not say this just said its about time you had your knee sorted out properly.

I still get the impression people think my knee problems are in my head because I have aspergers and they think its a obsession and my brain telling my right knee that I cant run and feel knee pain when knee ok which I think its not. I hope they wrong that its in my head when 2 PTs have confirmed I do have problems with both knees.

Sorry again for the long post and moan but getting annoyed now with people attitude about my knee problems >:(

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 #54 on: September 23, 2008, 05:21:49 PM »
Hey Nick,

Some folks just don't get it no matter how you explain it.  If it wouldn't get you in trouble ask your manager if he knows any medical places that have appointments after 5pm.  I had to explain to one PT place that I had to get appointments after 5, then the secretary asks if I can come at 2pm.  Um, no - just told her needed after 5.  Unfortunately most places don't take the working person into consideration.  Your workmates may be upset, but they don't have the problem, you do.  I wonder sometimes what people think about.  If more than one medical professional has stated you have a problem, then for heaven's sake, you have a problem.  Sometimes you just want to smack folks you get so frustrated.  I hope you get your OS appointment soon.  Maybe once you've seen him/her, the office can send something to your boss?  Just a thought.  Take care.

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 #55 on: September 23, 2008, 07:45:09 PM »
Hi All,

Unfortunately there are a lot of people we come into contact with who can't, won't empathis with our problem.  Most of my friends and family have made comments like that and then eventually realise that you do actually have a problem.  I think they could do with a knee problem and they will then realise how bad things are for us.  We have good days and bad days but most of the time they can't see that.

Try to get something in writing to show to your employer that you needs to attend these appointments and like Milly said the chances of getting appointments out of hours is near on impossible (is impossible  ;D).  It is appauling the way he is treating you, everyone has the right to attend for medical appointments and just think how many more you will have to come  :(.  And remember knee pain is not in the head unfortunately its very real.

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 #56 on: September 25, 2008, 06:36:27 PM »
Hi Milly and Sue,

I not worked up today, must look like a Victor Meldrew always having a moan but think I have good reasons to have a winge. I worked out how many appointments I have attended so far, seen Alexander twice at the Hospital, Paul 4 times, 2 orthoctics 1 with a useless PT and 1 MRI scan. Six appointments was during work time, I took a day off work for 1st appointment with Alexander, picked up my insoles after work, had my MRI scan after work and had my 1st ultrasound appointment after work. My last 2 ultrasound appointments are after work. 7 appointments during work time and 5 after work so will have had 12 appointments in total so far. I worked out I would have missed only half a days work with the 6 appointments which I think is good as this is the only time I had away from work this year.

I will be getting a break next week from work will be going top my Sisters House in Suffolk with my mum from next Wednesday till Sunday. My Sister a nurse at a orthopaedic ward and she asked her OS can a meniscus tear not show up in a MRI scan and he said 95% of the time a tear shows up. I dont think its a torn meniscus. A combination of maltracking, bone growth and a imflammed fat pad must be causing the right knee problems.

I also worked out IF I did need a scope and it was done in the Spring and Summer rather then the Autumn or Winter would not matter with work. We had one less greenkeeper all summer and will be having a new greenkeeper in December. At the moment there are 5 of us working but normally should have 6 green staff. I am sure the course manager can be without me as he will be back to 5 staff during the busy months, once the new guy starts in December.

My right hip is starting to hurt a lot more, is this typical if you have a knee injury that I forgot to tell Paul but will when I see him on Monday.

I told my Mum and Sister about my manager and they think I might not know when my boss is joking about my knees. I know when he joking when he said its best to chop your leg off. I know he was being an ass when he was funny about my appointments and should not be using the NHS as he has to pay towards just like I been doing during the last 9 years. Aspergers people sometimes cant tell if people are joking or not but I know when he is and isnt.

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 #57 on: September 25, 2008, 09:51:24 PM »
Hey Nick,

It doesn't sound to me like you've missed that much time.  If you are short a person though, it may make it seem like more to the others.  Not that anyone should make nasty comments about it.  Hope you have a good time visiting your sister. 

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 #58 on: September 30, 2008, 10:30:47 PM »
I now had my 3rd ultrasound appointment yesterday afternoon and Paul said I should feel some difference by now and so far the knee still the same. Regular knee pain and still get the catching sensation and cant run, I will have my 4th and final ultrasound on the 8th October and will wait another week to see if knee has improved or not. The 15th October will be the day that Paul will fax Alexander to see a OS for a cotisone injection into the fat pad and if that does not help suppose will have a scope.

I think there a high possibilty of having a scope as when I last saw an OS back in 2003/2004 they said they would scope the knee but thankfully the right knee got better. I saw 3 OS's 1 mentioned removing the plica, 2nd wanted to scope the knee and the 3rd OS I never saw for 2nd assesment as I could run again suddenly and knee pain was not so bad anymore.

I dont know why Paul cant refer me to an OS now as the ultrasound not helping at all. I have to go and see Alexander again who will then book me in to see Dr Brown who good with Injections. It would make more sense for Paul to refer me to see Dr Brown as I would have to wait too long if I see Alexander 1st and would then wait a further few weeks to see Dr Brown.

Knee got worse rather then better and feel pain while sitting and driving that did not happen before so hope to see a OS before my 30th Birthday on the 2nd December.

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 #59 on: October 08, 2008, 01:41:56 PM »
Hey Nick,

Too bad the ultrasound isn't helping very much.  It may still be working on some of the inflammation.  You may not be able to get the OS referral until all the ultrasound appointments are finished.  Not sure what the rules there are.  Looks like a scope may be on the calendar for you.  If so, I hope they can find out what's up and do something for it. 

Sorry I missed you in chat the other day, our work blocks those kinds of things and I have a hard time getting to the computer at home with two teenagers in the house.

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.