Nick's FatPadTrim, Medial plica/Distal patella excision, AIR x2, LMR 3in1 Diary

[Clarkey]

05/09/14 Day 49 Post Op

The right knee not too bad pain wise unless I kneel or squat or try to increase my walking pace. I had a conformation letter to see Mr Snow on Wednesday 15th October 2014 at 10:40am. I am glad to see him 3 months earlier and did feel 5 months for the next check up was too long for AIR surgery when a watchful eye is needed in the earlier stages post op.

Doing 100 leg raises & two legged squats & patella mobilisation on a daily basis that improved the knee not giving out as much that's more flexible. Still hindered by pain and discomfort at the bottom of my knee. Just like it was pre op, as soon as I attempt to run or increase my walking pace feel pain and discomfort around the medial portal. 

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[Clarkey]

06/09/14 Day 50 Post Op

I will try and see how my right knee copes by walking longer distance now the knee is giving out less. I know it still early days as I am only 7 weeks post op and could be a while until I can run again. My concern is having the same pain and symptoms again as I did pre op that was excessive scar tissue that can easily come back again if you are more prone to scarring up after a scope.

It is annoying as I am still unable to do gardening work and when I start working towards my level 2 childcare and part of the course is hands on experience at a pre-school and hard for me to kneel and squat and cannot run quickly of a child runs into danger.

Hopefully the school community gardening project will not be too labour intensive during the autumn and can use my discretion and can sweep up the fallen leaves and get the pupils to pick up the leaves for me. Know doubt they will give me some stick saying making us do the harder work. Will tell them had knee surgery twice on right knee and my 2nd one was done during the summer holidays.

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[Clarkey]

07/09/14 Day 51 Post Op

Continuing as usual with squats, leg raises and patella mobilisation and will try and do a longer walk today that more hilly to see if my right knee gives out.

Portals are not looking too bad just have to keep an eye on my medial portal. If I try to kneel down straight away feeling pain and tightness around the bottom of my knee around the medial portal and have to get straight back up again to stop the pain from continuing.

The clicking around the medial portal is still there! Without the medial portal problem my recover would be going ok. I may have maybe been able to start light jogging without the medial portal pain!

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[Clarkey]

08/09/14 Day 52 Post Op

I managed without too many problems to walk about 1 mile to my local circlet club and back again home. The right knee only gives out slightly. I also attempted to do a light jog on a softer surface and would say the pain around the medial portal is worse pain then it was pre op.

I am walking at a slower pace then usual with a limp and cannot really increase the speed as the right knee then feels less stable and would rather walk at a steady pace.

I hope that the pain around the medial portal does ease down as I am into week 8 and was a fairly invasive surgery.

It is hard not to have at the back of my mind the pain around the medial portal could be scar tissue accumulation build up again!

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[kcknee]

Nick-

Please slow down. You have not been cleared to run.

After you saw the private physio in mid-August you wrote "He told me running is out of the equation for a couple of months still and not to rush into running again as my right knee has to be more stable before I attempt my 1st run."

Mr. Snow's office wrote at the beginning of this month "Mr Snow has seen him today and reassured him that he is making good progress at this early stage. Mr Snow has given him advice in terms of returning to his normal sporting activities, however he should hold off any high impact running for some time yet to allow his knee to fully settle." And  "he can straight leg raise but does have significant quadriceps weakness and wasting. He needs to focus on building his muscles strength and stability back again and should also concentrate on patella mobilisation. I have shown him how to do this today and although I offered to refer him to physio he was quite happy to do his exercises on his own."

I know you want to run again,but you are not just recovering from an initial surgery. You're recovering from a surgery for post-surgical complications and AF. If you do too much too quickly, you are in danger of having the scar tissue return. After your appt. with Mr. Snow you wrote "I asked him would scar tissue return and could not say yes or no. It could still happen I overdid it too soon and need to slowly build up to prevent any scar tissue from building up again. If it was to occur again would happen around now the early stages post op."

Concentrate now on patellar mobilizations, quads sets and other exercises to strengthen the muscles around  your knee. I actually used a PT more to slow me down and give me restrictions rather than to push me to do more.

Wishing you the best.

Kristin

[Clarkey]

09/09/14 Day 53 Post Op

I have to totally agree with you that at not a wise move to start running when I am only 8 weeks post op recovery. I just forgot what Mr Snow and my private PT told me not to do no high impact running for a few months post op.

I just read on the post op recovery notes my sister handed out from Ipswich Hospital that you can return to sporting activities within 6 to 8 week post op. As you clearly pointed out my knee surgery is different to a standard knee scope to repair a torn cartilage for examples.

How do professional sports men and women get back to full fitness again after just 6 week after surgery? Good PT and see the top world OS. I am not doubting at all Mr Snow surgical skills as if I paid through private medical cover I would have proper aftercare by his post op team at Droitwich BMI Hospital in Worcestershire.

I waited for surgery to try and get my right knee problem sorted so be stupid to be impatient and jeopardise my AIR surgery. I am just keen to get back into long distance running raising money for good causes like autism charities and leukemia charities that my Dad passed away from back in November 2005. I want to do a marathon one day to raise money for worthy charities.

You aso know what else is close to my heart that I PM you that should hopefully be sorted out later on this month!

Right knee is remaining the same not improving or worsening, I shall carry on doing my PT and patella mobilisation.

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[Clarkey]

10/09/14 Day 54 Post Op

Went swimming yesterday for 45 minutes solid doing breast strokes that a good workout for the whole body with minimal impact. It also relaxing and never really liked swimming and did it very seldom before my knee injury back in January 2013. I hope in time that running again long distance will happen again by spring 2015.

I am glad that I am walking ok again at a reasonable pace just annoying if I am overtaken by people twice my age as I have always walked at a fast pace before my latest knee problems started up again. Did not feel nice to feel restricted and realise how we take it for granted by being fully fit till health problem occurs. One can then feel for others that have even more limited physical needs in a wheelchair or walking with crutches with just one leg.

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[kcknee]

Nick- please call your surgeon's office to see if you should be doing the breast stroke. I obviously am not a doctor, but do know that is one of the toughest strokes on the knees especially when the muscles supporting the knees are not fully strengthened. Many times i have read that the breast stroke kick is not allowed so soon after knee surgery, never mind an AIR surgery.
Kristin

[Clarkey]

11/09/14 Day 55 Post Op

Thank one again Kristin for the pre warning, I always was under the impression that swimming is an ok thing to be doing after knee surgery. I always assumed that it is not putting any strain onto the joints!

I have found breast strokes put slight strain and pain around the medial portal but not as intense or painful as when I saw my PT who made me do a gym workout and stretches that did cause intense pain.

It annoying when sports men and women are back to full fitness again 8 week post op and I have to wait months to get back into running and yet others with more complex knee surgery can return back to running within 6 weeks post op.

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[Snowy]

yet others with more complex knee surgery can return back to running within 6 weeks post op

I think that what you need to remember is that the scar tissue, and the possibility of AF, means that you are dealing with a complex situation. Recovery from surgery is very different when you've had instances of recurrent scar tissue, and are trying to ensure that it doesn't return.

Kristin offers some really good advice. Frustrating though it is, you need to slow right down and not introduce new activities unless your surgeon's office or physio has specifically said it's okay to be doing them at this point. If you're tempted to introduce something, call or email and check first.

It might help to think of this as more like an ACL reconstruction recovery, where the first months of rehab are all about avoiding movements and activities that might damage the graft. It's very, very frustrating, particularly as the knee regains strength and you feel capable of more, but following the restrictions to the letter is the best way of ensuring a successful outcome in the long term. In your case, the same applies but you need to avoid early, undue stress to the knee that could cause the scar tissue to start forming again.

You will get there, but be patient and don't be tempted to rush into things. You don't want to find yourself in the same situation again, with more scar tissue and facing another surgery. Doing the right things now will help ensure a successful long-term outcome and return to running when your knee is ready.

[Clarkey]

12/09/14 Day 56 Post Op

Thanks for replying Snowy, yourself and Kristin are right that I cannot compare my knee surgery to a completely different type of knee surgery and now realise that AIR surgery is fairly invasive knee surgery to remove excess scar tissue. I did not think it was such a big knee problem dealing with AF compared to what I thought I was going to have a mircofracture that is a sign of cartilage deteriorating as it looked like it could be on my MRI scan pre op.

I admit need to slow down slightly as this morning when opening up the autism children’s charity shop with the Manager as I was getting items out to the front of the shop my right knee gave out again and was fairly painful! I thought I overcome the stage of my knee giving out now my knee is stronger doing daily PT at home.

I suppose an extra few months not running is a wise move, I just feel I am being too cautious and paranoid. I feel that the running club that I frozen my membership are giving me the cold shoulder blanking me when I know a few of the members for being to fussy with my knee injury when passing them at leisure centre when going for a swim.

I love to run, it's funny how people attitude change when I was one of the top runners for the club and now cannot run at all! I am missing the social side as well competing at different running clubs in organised races so not only about running.

Also still trying to sort some legal issues as well as having to deal with a nightmare former tenant not paying his rent at my flat as I cannot afford the mortgage and the rent covers it till I find a job that I am passionate about. Adults with aspergers can be very fixed on one career and will not consider any other. Some members of KG will know what I am talking about as I will be very good doing the career that I am passionate about.

My flat when it was up for rent was in immaculate condition when the tenants moved in August 2012 that did not look after my flat by not ventilating the flat with the blinds down all the time that caused damp along the walls, ceilings, windows frames and had to remove furniture ruined by mildew eating into the woodwork.

I have had rent indemnity thankfully that no longer being covered as it has been over 6 months and thankfully moved out September 1st 2014. Flat needs to be rejuvenated again as the electrics and water are faulty, damaged electrical items and furniture that something I could do without right now!

I am use to set backs in life and become very strong with my knee problems, Aspergers and my breakdown period and bullying that has caused me to put on hold my dream job. I am in the process of writing a book about the highs and lows of being autistic. I have been told my book will be a big success if it was to be published one day that I aiming for to help novices and those that know already about autism.

My story will benefit many people that know someone that has autism or on the spectrum themselves that is often know as a hidden disability that a life long condition of daily anxiety and stress so what I been through has made me a much stronger individual.

I do not want members feeling sorry for what I have gone through I can cope and manage it ok as I will achieve what I aiming for in the end. I am over the worse part now, things can only getting better from now onwards.

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[Clarkey]

13/09/14 Day 57 post Op

I think it due to my right knee AIR surgery only 8 weeks ago yesterday that now my left knee is also showing signs of pain as it compensating for the right knee while it healing. My right hip is also causing some pain that usually the case when recovering from any type of knee surgery.

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[Clarkey]

14/09/14 Day 58 Post Op

Is kneeling too soon after AIR surgery going into week 9 post op! When I do try to kneel or squat feel pain and tightness around the medial portal that is restricting when I am doing gardening and kneeling down during a Sunday church service that then looks disrespectful.

I could force myself to kneel and squat by putting up with the pain level but concerned it might be bad for scar tissue formation! If AF has returned it would be here by now after 6 weeks post op so kneeling and squatting will not make my right knee pain worse!

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[kcknee]

Nick- right now you have to keep your knee calm and not inflamed. Massage knee with vitamin e deeply over portal several times a day also doing patella mobilizations. Plan times in your day for the deep tissue massage, patellar mobilizations and gentle strengthening of the muscles around your knee. Keep reminding yourself to slow down now, do the physical therapy to keep knee moving and strengthen muscles, and listen to your surgeon.

Scar tissue bleeds a lot, so tearing it forcibly by kneeling or squatting when your knee is protesting that it is feeling restricted, will cause bleeding that inflames tissues and causes more scar tissue to form. Your helpers will have to do any squatting work during your gardening, and it is no more disrespectful for you not to kneel and cause injury to your knee than it is for those in a wheelchair to not kneel or rise during services. You have a serious knee condition and you have a temporary disability for now.

[Clarkey]

15/09/14 Day 59 Post Op

Thanks once again Kristin for you sound and sensible advice. I did not realise that AF is serious knee condition to manage with that seems to be on the increase. Surely there must be a way to cure excessive amounts scar tissue forming after knee surgery and AIR surgery. With modern day medical science would think there are methods to eradicate arthrofibrosis!

It true not to feel bad not being as functional as I would like to be into week 9 post op just annoying as I like running, swimming and gardening for leisure that hard to put on hold if you could once do them all without any problems.

I had to pull out of the Childcare Level 2 due to personal obstacles at this present time and my right knee AIR surgery recovery that I hope will soon be solved. I am doing an online Diploma in Child Care as well as doing my GCSE English and Functional Skills Math’s at level 2 after passing my level 1 exam in July.

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