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

[Clarkey]

06/06/18 Day 141 Four Months Post Op

At 20 weeks post-op recovery is slowly making progress walking with less of a stiff leg. My ROM is now 125 degrees that matches my left knee my good one. My physio is pleased with my progress. Been transferred to my local private hospital a mile down the road on NHS choice. I live within the hospital postcode and Prof Snow works at BMI Droitwich Spa Hospital. This is where my mum got her left knee and hip replaced 2 years ago through the NHS. Becoming more common taking on NHS patients at private hospitals, it helps reduce patient congestion in the large city hospitals. Think I am limited to 5 sessions that should be enough.

Will go swimming again after meeting the lady that runs the leisure centre café this morning in the street that happens a lot in  smaller towns. Said the changing rooms have been refurbished, last went in July 2017, was not impressed with the not very functional changing rooms. Will give it another go and see if it has improved.

Tempted to go back to gardening around the neighbourhood! Not sure if it wise and  should wait longer. I cannot do any digging, have to kneel on my left knee with all my weight straining the knee. Will end up aggravating the knee with some swelling showing up on the medial side, best to avoid kneeling on my left. Cannot kneel or squat with my right just as it was pre-op to scope #2 and #3. Feels like an elephant is sitting on my right knee if I try to kneel or squat on both knees.

My right hip consultation has been changed from Friday 15th June to Friday 27th July that often happens on the NHS. The right hip is behaving well at the moment, hope it stays this way.

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[Clarkey]

13/06/18 Day 148 Four Months Post Op

No changes with right knee remaining the same, can walk at leisurely stroll if I try to increase my leg becomes stiff with a more obvious limp. Can hide my limp if I stick to a slower comfortable pace. Does not matter if I lag behind others just have to add more time to my journey when walking.

Getting to the stage where I tempted to go back to do some gardening around my neighbourhood once again. My concern is that I will aggravate my knee causing another tear that might not be obvious straight away. Have now lost all my clients that have taken on other local gardeners.

I have not been able to earn any income this year relying on my deceased dad's army widow pension. It is a good amount ranked a Major. Just feel bad using my mum's husbands widow pension. My PIP that was previously DLA will be stopped on June 19th that was only £88 a month that I took out when I was still at work in 2010! Appealing against the decision. On the latest PIP assessment report they have left out important parts in my giving me 0 in communication when I am autistic and struggle with communication and socialising. Mental health, stress and anxiety is not classed as a medical condition so wont fund it. Many individuals are having their PIP's taken away, that is scandalous and corrupt that have daily high anxiety and stress condition, some cannot leave their front doorstep.

Still keen to help and support young people with disabilities that relate well with me, I can engage well with youngsters with LD and autism at a evening club I help out at every 2 weeks on a Monday evening. It is a natural gift coming across in a positive and friendly caring manner. Due to my previous conviction in 2005, causing minor cuts and bruises to hostel staff who tried to pin me down on the floor after shattering a glass fire exit door window due to frustration and anger. Was subjected to months of verbal, emotional and physical abuse by staff at all 3 hostels where I was forced to stay at in 2005. A one of incident is still hampering my life and career path caused by wrong meds and my dad's terminal cancer to cope with 13 plus years later. No lawyer in the UK is willing to take it to the Supreme Courts! This is so unfair and unjust not removing a minor criminal record.

Sorry for a rant, just want to get my life back to a normal again with a steady routine by earning an income, that is being hampered right now by unfair and unjustfied barriers and red tape.

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[Clarkey]

16/06/18 Day 151 Five Months Post Op

Five months post-op is still early days, not sure at this stage if surgery #3 has made any difference. My right knee does not give out, which is positive and feeling ok apart from around the portals still feels sore and delicate with swelling still around the bottom of the kneecap. Walking is fine as long as I stick to a slow pace can walk good distances, if I speed up then feel anterior knee pain. At least I am no worse off 3rd time round reaching the same stage prep-op with less sharp pinching pain that must have been the damaged cartilage. Hopefully as the quads build my walking pace will increase as well.

Can lift light to medium weight about 10 to 15kg can lift 25kg bags if it just a short lift into a trolley and boot of the car. Digging will stay away from and any other action that involves exerting pressure onto the kneecap. Driving feel good long distances are ok, would say at times the right hip and left knee can feel stiff and rubbery. Using the clutch in heavy traffic is what triggers the pain and discomfort.

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[Clarkey]

20/06/18 Day 155 Five Months Post Op

Might need to slow down again at this stage post-op, becoming too over confident walking longer distances. Knee has given out a few times this week that should hopefully improve once the quads get stronger that are still small and feel like jelly. When I tighten my left leg my quads are solid with a large muscle mass My right quads are smaller when leg is tight.   

Sitting seems to increase stiffness and some pain and discomfort in both knees. Nothing major just nudging pain that must be PFPS. At my age reaching my 40 in December some wear and tear as well as the PFPS is normal. Driving seems to cause more pain and discomfort with my left knee when use the clutch a lot in city traffic and jams. Could have it examined next time I see Prof Snow to get an official diagnoses of what I expect could be runner knee. Will stay well clear from any cortisone injections and surgery. Would expect to be referred for for physiotherapy to help strengthen the muscles that could also be very tight that is contributing towards the anterior pain. 

No contact yet from my local NHS Choice referral to see an physio at my local hospital, might take a while to get through as a none private patient. Live within the postcode and taking pressure away from Birmingham ROH Physio Department for patients that live in the city of Birmingham makes more sense.

Sorry about last week moaning, sorted now with some support from the leader of the adult and young peoples group I help out at. PIP and hopefully employment support in areas that I want to pursue in to take away the negative labelling brick wall I am banging my head against for something that happened 13 years ago. Discretion of employer, from personal experiences many managers want to give me a breakthrough. The people above them are the one that lack empathy and understanding, still living in the 20th century with biased old fashioned opinions.

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[Clarkey]

27/06/18 Day 162 Five Months Post Op

One week to go before my 2nd post-op consultation with Prof Snow, would say at this point surgery success is 50/50. The right knee feels the same as it did pre-op walking at a the same pace that I am hoping improves once my quads have built up strong again. I have not yet had any confirmation for my new transfer to the local private hospital department, it might take while to get a place. Will call the hospital on Monday if I hear nothing this week.

Hard to tell at just 5 months post-op how successful the surgery has been? Could really do with regular physiotherapy sessions. Might have made the wrong decision to transfer from an NHS hospital to a private NHS choice hospital. Prof Snow works at the private hospital so has the right contacts. Otherwise will have to go for a few private PT sessions at the expense of my mum that not great but said she happy to pay for any health related appointments if it benefits my recovery in anyway.

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[Clarkey]

04/07/18 Day 169 Five Months Post Op

My 2nd post-op consultation went well this morning making good progress at nearly 6 months post-op. Prof Snow said he removed some of the tibia to give the patella tendon a better chance of recovery with less restrictions. A small labral tear repair and the knee was scarred up again which is why he carried out AIR as well a decompression if the patella tendon.

All I need now is more intense physio session up to now have been fairly light and easy. Prof Snow said it is a good thing that I did not push too hard at the early stages post-op as I scar up easily. He Will chase up physio appointment making sure it a slow a gradual process running again hopefully?

Think he me mentioned a low resistance  treadmill machine that puts minimal impact anti gravity machine? Think it’s the one where it inflates around your waist while running on treadmill but might be mistaken for another type of machine.

Can’t say yet if my 3rd scope was 3rd time lucky or unlucky until my quads are firmer and stronger, then will know. Six months until my next consultation in January when I am 1 year post-op and hoping maybe this time next year knee will feel normal again walking at a good pace with running being added bonus hopefully.

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[Clarkey]

12/07/18 Day 177 Five Months Post Op

One day later than my usual Wednesday after watching England losing against Croatia in the FIFA World Cup Semi Final. Football is not coming home, England dominated during the first half of the match, Croatia dominated the 2nd half with more attacking football and experience.

Already have got the my consultation letter, my next follow up review appointment is January 2nd 2019 @09:50. Will share the letter on Monday when I reach the 6 months post-op. Basically what I always had in the back of my mind saying had very aggressive physio, causing excessive fibrosis! Always knew the physiotherapist was to blame for the 2nd surgery failed surgery. Still have 2nd thoughts about medical negligence, its now in writing just hard to prove it, I paid private that happened nearly 4 years ago. Said in a few of my previous posts that the physiotherapist reputation is not great with previous misconduct and bullying of staff and leaving patients alone while seeing another patient! Maybe could sue it happened in the USA, in the UK it harder to prove and gather all the evidence. I cannot recall the date when I saw him so will not be on my medical records.

Just frustrating that he is still practicing, hope he retires soon before he ruins other patients knees that cannot be put right again. Once the knee has been pushed too hard in the early stages post-op the knee never really recovers fully. Today did slightly more heavy garden work lifting soil in a small bucket using my left hand to carry and heard my right knee crack so stopped, might improve once the quads are strong again. Could be scar tissue making a cracking sound which means I need to slow down again. If the knee feels ok you start to push it more not realising you could be causing damage. Swimming and cycling are safe options to go far that Prof Snow suggested doing, will start swimming again once a week increasing it gradually with guidance from a trusted and respected  physiotherapist .

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[Vickster]

Nick, UK law stipulates 3 years to start a claim for medical negligence so you'll need to let that one go and focus on the future for your knee and not the past and what might have been.

Precise time limits for starting medical negligence claims are laid out in legislation, albeit with a few exceptions being allowed. In simple terms, you have three years in which to make a claim, counted from the date upon which you first became aware that you had suffered injury as a result of medical negligence

Good luck for your ongoing recovery

[Clarkey]

16/07/18 Day 181 Six Months Post Op

Nick, UK law stipulates 3 years to start a claim for medical negligence so you'll need to let that one go and focus on the future for your knee and not the past and what might have been.

Precise time limits for starting medical negligence claims are laid out in legislation, albeit with a few exceptions being allowed. In simple terms, you have three years in which to make a claim, counted from the date upon which you first became aware that you had suffered injury as a result of medical negligence

Good luck for your ongoing recovery

Thanks for the clarification Vicky you are right best to forget about it. I have experienced far worse nightmares with my mental heath problems during my mid 20s. Will be on a website for miscarriages justice cases for autistic individuals and their families. It is still possible to fight towards an amnesty and pardon.

http://autisminjustice.org/Stories/nick's%20story.html

Why I have not been as much on KG lately, too busy freelancing and raising autism awareness within the police and courts as well as writing my own book, keeps me busy- 48000 words and counting so far.

My 6 months post consultation letter.


Dear Dr ****

Nicholas retuned to clinic. He has only had a few sessions of physio, he had difficulties getting here and he has transferred his care to Droitwich. Overall he has had a very quiet 6 months and I think actually this has been very good for him. The last time we did an interval release on him he had very aggressive physio and this flared things up and caused excessive fibrosis, I informed him that he really needs to now try and build up his core before he tries ant impact activity. He can swim cycle and maybe a little crosstraining but he is absolutely not to undertake any running. If he has been transferred to Droitwich they have the Alter-G machine there and this would be the best place to start.

I am going to see him in 6 months; time to see how is getting on.

Yours sincerely.

Professor M Snow


Hopefully the gamble for a 3rd scope has paid off and maybe can get back to light jogging again. Do not expect to be running long distances at a competitive level. Walking at a quicker pace would satisfy me, will wait and see how the physio goes over the next 6 months.

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[Clarkey]

25/07/18 Day 190 Six Months Post Op

Still waiting for an appointment for physiotherapy sessions locally rather than travelling on the M5 to Birmingham ROH. Nightmare during the summer holidays from 4 lanes on a smart motorway to one lane! Causing long traffic jams and tailbacks, making the hospital transfer has slowed down the PT sessions when I could start to push harder at over 6 months post-op.

Injury prone, went for a swim with my two nephews in the Lido pool out in the open to cool down in the never ending heatwave yesterday. 30 plus degrees tomorrow, hopefully will get a thunderstorm on Friday to cool down the high heat. Throbbing pain in right shoulder, was hard to get into a comfortable sleeping position last night. Took 2 paracetamols and 2 ibuprofen tablets to have a comfortable sleep. Feels like someone is digging into the shoulder, throbbing pain as if the muscles are twitching. Should improve with rest and must be an overuse problem. Becoming more injury prone as I reach my 40s in 5 months time.

Seeing my Hip OS on Friday afternoon, right hip is not too bad at the moment, just the odd stabbing pain that is manageable for now. The cortisone injection has helped numb the pain so can drive better pain free just more stiffness than pain and discomfort. My right side of my body joints seems to be weaker than my left side at the moment, might be a bad gait causing the injuries?

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[Clarkey]

01/08/18 Day 197 Six Months Post Op

Finally got my physiotherapy referral sorted after finding out the private hospital in Droitwich never received my referral! Even though I was told I was entitled to 5 free sessions of physio as I live within the postcode. Because I was under contract under the Birmingham ROH after my surgery they could not get the funds under NHS choice to pay at a private hospital that take on NHS choice patients. My mum had her left knee and hip replaced at the same hospital. Think you have to be at a retirement age to get free treatment. Would have had to go back to my GP practice, which I did straight away after talking to appointment manager in I her office. Had to wait a week to get a phone call from a GP that would have been tomorrow.

Thankfully I managed to get my hip OS to make a double referral, he was fantastic with good autism awareness knowledge. Said to me straight away sorry for the delay of over 40 minutes hope you did not get too anxious. Explained things short and simple with a delay between for different information to progress and take in. Even dictated in front of me which has never happened in all my previous consultations over the years with various OS's.   

What he has done is a referral for both my right knee and hip for physio at a smaller NHS hospital in North Worcester with various clinics that had a minor injuries unit. Smaller premises and less crowded more autism friendly. Have to wait now for a date that should be within the next 4 weeks. Have been discharged under his care as my right hip is feeling ok at the moment. What he did mention is if my right hip becomes more of a problem again when I see Prof Snow in January. Can ask him make a referral back again, hopefully right hip will not get worse and will not need to do this.

Just as I am making progress my right shoulder pain is still the same! Pain is from the right shoulder down the back of my arm up to the elbow that is making the right side of my neck stiff and sore. The pain eases when I wake up in the morning at its minimal stage. As the day progresses pain increases to throbbing stabbing pain! Sitting and typing on laptop aggravates it and washed the car yesterday that made the pain intense towards the evening. Every night take 2 200mg ibuprofen tablets and 2 paracetamol tablets in the daytime. Have to wait until Monday to see the private physio that worked at the former Droitwich Knee Clinic so very experienced and trustworthy. Just took 2 paracetamol tablets feels like the back of my right shoulder and neck feels heavier in weight with throbbing pain!

Rotator cuff tendonitis is just a guess from my symptoms, sore and knotted slight crunching sensation when touching side of shoulder and moving arm! Doubt it a trapped nerve in spine that has similar symptoms as pain increases during the day not constant. Why I booked to see a psychotherapist. Anyone else had similar symptoms? Did feel pain in the past in neck and shoulder on and off! Maybe swimming in the cold water has inflamed the tendon even though I did not swim very much too busy in a small swimming pool with kids on summer holidays and only felt then pain once I got back home again. Cant sleep on my right side that not as bad as it could be. I have got use to sleeping on my left after my knee surgery in January for 8 weeks.

25/07/18 Day 190 Six Months Post Op

Injury prone, went for a swim with my two nephews in the Lido pool out in the open to cool down in the never ending heatwave yesterday. 30 plus degrees tomorrow, hopefully will get a thunderstorm on Friday to cool down the high heat. Throbbing pain in right shoulder, was hard to get into a comfortable sleeping position last night. Took 2 paracetamols and 2 ibuprofen tablets to have a comfortable sleep. Feels like someone is digging into the shoulder, throbbing pain as if the muscles are twitching. Should improve with rest and must be an overuse problem. Becoming more injury prone as I reach my 40s in 5 months time.

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[Clarkey]

08/08/18 Day 204 Six Months Post Op

Had my physio appointment on Monday, have a pinched tendon in my right shoulder. Was given ultrasound and massage manipulation on top of my right shoulder. Been given some stretching exercises to do with elastic bandage for resistance. To ice the shoulder a couple of times during the day is better than taking painkillers. Have very tight knotted muscles that's contributing to the pain and discomfort. Pain has eased now at the start felt like as if I had torn the Rotator Cuff Tendon! The pain I was getting was very high, took 2 paracetamols and 2 ibuprofen tablets at the peak! Now just take one ibuprofen tablet before going to bed.

Pain is still there but less intense and can manage ok during the day without pills. Was lucky to have my niece visiting from South Africa with her boyfriend a personal trainer. He found 2 sore knotted area around the shoulder blade. Skin went all red and showed me how to stretch using a broom handle against my arm. He said dry needling would be really helpful. Had IMS done a few years ago for my right knee after scope #1. It actually helped me get back to running again for a brief time period. The Musculoskeletal Physician in Sports and Exercise Medicine that did the IMS sessions still works for the NHS. Have reservations as he can come across rude and has upset female patient with sexist remarks! He old school should be retiring soon. Been in practice since the early 80s, the Boris Johnson of Sports Medicine. Not everyone can take his dry sense of humour very well.  

My right hip consultation letter came through the post with my referral letter for PT on my right knee and hip at the same time. Hospital for PT is more local to me on the NHS. My Private Physiotherapist gave me a discount for 1st session. If the shoulder pain persist is it better to see her or my GP for a referral for dry needling sessions? It should help ease my knotted and tight muscles.

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[Snowy]

I am glad to hear someone mentioned dry needling - while it can feel very unpleasant it really is the best thing for knotted muscles. A couple of IMS sessions and it will be much easier for you to keep the tension out of the shoulder with foam rolling or another rolling technique at home. I would see if there's anyone else in your area who does IMS, if not it might be worth just sucking it up and dealing with the unpleasant physician to get it done. He sounds pretty awful but if he has the skills to do the job it's better for you in the long run than not getting the treatment you need.

[Clarkey]

16/08/18 Day 212 Seven Months Post Op

Snowy, nice to see you around again posting on my 7 months post-op day. The right shoulder pain has improved where I do not need to take any painkillers. Still cannot sleep on my right hand side with shoulder/neck pain building up! When you are asleep it is normal to toss and turn. Woke up this morning with a headache after waking up on my right hand side. Dry needling would be of a benefit? You might know already seeing a GP in the UK is a long winded process. Have to call at 8am in the morning to talk to receptionist then have to wait for a call from the GP who decides if he/she needs to see you are not. With cut backs and people living longer have to wait 2 weeks to see a GP. Made to feel a guilty and a burden! End up putting up with the pain and discomfort or pay privately. Why I paid to see a physiotherapist instead of seeing my GP, who would say take pain killers when pain gets bad and to come back if it does not improve instead a referral for physiotherapy sessions straight away.

With regular shoulder, neck and headache think I should be able to get referral for some dry needling sessions even if it is with the physician that is not that great with patient satisfaction. As long as he finds the trigger points and can help reduce the pain and tightness in the knotted muscles, worth enduring the physical and mental pain.

Back to focusing on my right knee after 7 months post-op. Frustrating that there been delay in having physio on my knee and hip due to changing of the hospital locally that went all wrong! No referral came through and was lucky to have an consultation with my Hip OS to make a referral for both joints 4 weeks ago. Might only be halfway there as the standard waiting time can be up to 8 weeks. The hospital I am going to is only a minor injury hospital in North Worcester with various clinics. Bigger hospital in Birmingham like the Queen Elizabeth is like walking into a town the size to cope and manage with a larger population of residents in the city. Worcestershire NHS hospitals are one of the worst performing hospitals in the UK along with Staffordshire under funded and underperforming, a postcode lottery! Birmingham hospitals get high praise and patient satisfaction at the Birmingham QE and ROH. 

Until I have regular PT sessions and good advice cannot say if the right knee is the same, worse or improved. Quads are still small and squishy and do not want to give myself my own exercise programme at the gym concerned I end up overdoing if I had AIR surgery done twice have to be cautious about excessive scar tissue building up. Hopefully get an appointment soon with a physiotherapist, Can ask her/him to give PT on my right shoulder or do I have to see my GP first that is a long and complicated process. Gone are the days when you could call and book an appointment on the same day or the following day. Stressed out patients are taking their anger and frustration our with the GP receptionist is on the increase! A job no one likes right now.

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[Clarkey]

22/08/18 Day 218 Seven Months Post Op

Still waiting for a physiotherapy appointment for my right knee and hip, If I do not hear back by letter or mobile from the hospital by Friday will give the hospital a call on Monday morning. Would be really useful to build up my quads with the right PT programme. Right knee tends to give out at times that happened today in the supermarket! It does not cause any pain or discomfort, just be nice to get the quads firmed up once again.

Swelling is minimal with some slight swelling around the bottom of the knee and around the three bottom portals that is some scar tissue that certain after having then opened up 9 times in total including top portal to drain away the blood and fluid during the surgery. Can feel a hard lump on the top portal that scar tissue that not any bother up there.

Walking is good over longer distances just have to be careful not to walk up and down hilly slopes and too many steps. Hip is doing ok just the odd shooting pain if I have been walking for a while or doing light to moderate gardening duties. Shoulder feels ok at the moment, pain comes and goes. The pain to begin with was very intense taking 2 paracetamols and 2 ibuprofen tablets during the first 5 days. Now feels fine just some mild pain and discomfort on the top of my arm from the shoulder to the elbow while driving the car and typing on keyboard.

With not much to share and report will do a monthly post-op review on the 16th day of each month.

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