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Author Topic: Red.Lotus' Post op diary - multiple ACI, TTT *UPDATE - more surgery*  (Read 17371 times)

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Offline redlotus

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DAYS ONE - THREE

I arrived at the hospital for my procedure at 6am, and found that I was suprisingly calm.  I had some bloodwork, then was shown to the pre-op area.  I answered a lot of the same questions over and over again, then met with some resident anesthesiologists.  We discussed my options, and decided on concious sedation with an epidural.  I was promised that I would be nearly unconsious and would remember nothing from the actual procedure.  They started an IV, and not long after that they gave me some sedation and placed the epidural.  I was pretty relaxed because of the sedation, but I remember one of the residents saying "Are you okay?  You seemed really relaxed earlier, but now you sort of look like a deer in headlights!"  I assured her I was fine, and next thing I knew I was being wheeled into the OR.  Dr. Minas was there, and he patted me on the shoulder and said "We're finally doing this, huh?"  They gave me some oxygen, and I drifted off.  I do actually remember some of the procedure.  I remember that my nose itched and I kept trying to scratch it, only my arms were strapped down, so the nurse scratched it for me a few times. :)  I remember Dr. Minas talking to his resident about my patellar alignment.  Most disturbingly, I remember the sound of them breaking my tibial tubercle! 

I woke up in PACU feeling groggy but okay. I was still numb from the waist down, and was able to groggily inquire as to how things went.  I was told it went well.  I spent quite a bit of time in PACU, due to room issues.  I met with Dr. Minas' resident, who told me that the defect on my MFC was bigger than they thought (8 sq cm instead of 6 sq cm!), and that they had found two large kissing leisions on my patella which they had also done ACI's on.  They did the TTT as well.  After I could move my toes and the room was sorted out I was moved up to my hospital room and settled in.  It was a relief to see my mom (what can I say - at 26 the first thing I want when I feel crappy is still my mommy!) 

I felt okay for a while - no pain really - I was still numb.  Then sensation crept back and the bone pain set in.  It got pretty bad, and I will admit that I broke down and cried for a while.  The nurses and PCAs were very concerned about getting my pain under control and checked on me frequently.  I was given some oral meds, which did not seem to help, and every twenty minutes I hit the epidural button for a dose of meds as well.  Finally they put me on a PCA pump of Diloded.  I could hit that button every seven minutes, so with a button in each hand and doped up on oxycodone, I finally got some releif.  :)

Unfortunately I got very nauseous and itchy from the PCA pump.  Once my pain was under control with oral meds, they weaned me off the epiural and the PCA.  Soon after my dressing was changed and I got my first look at the incision.  8 inches long!  I had two drains in the knee, which were removed later (that was unpleasant.)

After three days, two nights in the hospital it was determined that I could leave.  I got perscriptions and discharge instructions, and was on my way.  That was the most uncomfortable car ride I've ever had.  I never realized how many bumps there were in 495 North!  I've read on here that some of you brave souls did outpatient for your ACIs and had to endure very long car rides home after - how you did that, I cannot imagine!

So after a few days of discomfort I'm feeling pretty good. Better than I thought I would!  I met with my PT today, and he was impressed with my progress so far.  I've been doing my exercises religiously, and I was able to sit on the couch and bend my leg to 75 degrees without intervention, which I was happy about. 

Still, can't wait until I'm back on my feet for real!

(This post was written and saved on my laptop when I had no internet, and posted after the fact - my surgery was on July 28th, this was written on August 1st  ;) )
« Last Edit: December 08, 2008, 02:30:53 AM by redlotus »

Offline redlotus

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Re: Red.Lotus' Post op diary - multiple ACI, TTT
« Reply #1 on: August 08, 2008, 12:52:50 AM »
It's been more than a week since my surgery, and I'm currently recovering at my parents' house in Maine.  I'm suprised at how good I feel overall!  I'm only allowed to go to 40 degrees on the CPM, which is frustrating because I feel like I could go a lot higher.  But I don't want to mess up my patellar ACIs.   ::)  There's still quite a bit of pain, but I've only taken 10 mg oxycodone today so that's good.  My incision looks good, although I'm still suprised at the size (I was told originally 4-6 inches, not 8!)  The bruising is fading and the swelling is going down, thanks in part to the Game Ready (love that thing, even if it is an ice hog!).  One of my drain sites continued to leak for several days, but that's stopped now as well.  Things are stiffening up for sure, and my ROM for extention has dropped to about 60 degrees when I dangle it off the bed/couch.  Still I think that's pretty good overall. 

I'm already sick of the lack of mobility/ability to care for myself.  I've gotten used to living in "civilization" (aka urban Massachusetts) and now I'm back to living on an island off the coast of Maine, so that's a bit of culture shock as well.  I love "home," but it's tough to go from where I was to a place where the stores (all two) close at 5pm, and there are no banks, restaurants, theaters, take-out food, or even STOPLIGHTS!  On the bright side I get to hang out with most of my graduating class from highschool - there were eight of us total!  ;D  Good times....

Well, I'm off to read the op notes my surgeon's RN emailed me!  Light reading before bed!

Offline djs60

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Re: Red.Lotus' Post op diary - multiple ACI, TTT
« Reply #2 on: August 08, 2008, 03:19:25 AM »
Hi Redlotus,

Reading your posts brought back some memories (my ACI/TTT was 4/07 with Dr. Minas).

I recall being surprised at how long my scar was (I think mine is about 10 inches), but it's now so faded it's barely visible.  Hope yours turns out the same way.

I remember being temped to increase my ROM beyond 40 degrees, but didn't.  Remember, this is a very long recovery, and you really can't speed it up, but you could probably mess it up by being impatient. 

Good luck, and keep us posted.

djs60
3/06 left knee arthroscopy - grade IV lateral trochlea defect
chondroplasy & removal of loose bodies
1/07 left knee arthroscopy/cartilage biopsy
4/27/07 left knee trochlea & patella ACI with TTO

Offline madrvr757

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Re: Red.Lotus' Post op diary - multiple ACI, TTT
« Reply #3 on: August 08, 2008, 08:28:46 PM »
Hey Redlotus

Glad to hear everything went okay.  If I remember right I'm 3 days ahead of you.  Although I think you had a bit more done than I did. I had a lesion on my trochlea and also the TTT.  Although when I had my 1 week follow up, Dr. Gomoll was concerned with a lot of redness, which he prescribed an antibiotic.  My therapist today was concerned that it's gotten bigger, so after a call to the office.  Im headed back down to Boston on Tuesday.  There's nothing like a 4 hour drive for a 10 min appointment :-)

 I hit 78 degrees today at therapy.  But like you am stuck doing the 0-40 on the CPM.  I spend the day in it, I haven't been brave enough to try and use it at night while I sleep. 

I'm with you on the game ready system.  Works awesome, but needs a design change for the ice box.  I probably reload it several times a day.  And the worst is when I wake up around 3:30 and have to refill.  It's pretty bad when the temp gauge reads in the high 70's :-)  I looked it up on Amazon.com and it's a $2,100 dollar system.  For that money you would think they could make it refrigerated and keep the water a constant 35-40 degrees.  That would be perfect. 

The Netflix is really paying off and so isn't the PS 3 :-) 

Matt

P.S.  Here's a hint, watch out for water on the floor.  I hit a wet spot the other day and the crutch went sliding out from under me and I jammed the bad leg into the ground.  That wasn't a good night. :-)

Offline MegTX

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Re: Red.Lotus' Post op diary - multiple ACI, TTT
« Reply #4 on: August 08, 2008, 09:48:41 PM »
glad things are going well.  My patellar ACI & TTT was 9-1/2" of incision.  :-D  I get comments on my "pretty scar".  At least it's straight.  I've seen pics of some pretty zig-zaggy things.  My doc did a nice straight job even if it is a monster.

I haven't seen the "game ready" systems, I just had an iceman, but that was running constantly for about 2 months postop, and I was doing about 2 bags of ice a day.  Luckily we have a chest freezer and my hubby would just go get 8-10 bags of ice at a run.  Even if we had an ice maker, I don't think it would have kept up with me!

Lots of netflix were had.  I had my laptop and just streamed stuff, so I didn't even have to get up and change the DVD's.  :-D
Lateral Release, Medial "Reef" - '91
{16 years of grinding, pain, swelling and lots of ice}
'scope 7/07 - .7cm2 tibial plateau microfracture, 2.5cm2 grade4 patellar CP debridement
ACI & Fulkerson TTT 2/08 (patella lesion then 4.5cmx3cm)

Offline redlotus

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Re: Red.Lotus' Post op diary - multiple ACI, TTT
« Reply #5 on: August 08, 2008, 10:50:22 PM »
Thanks for the replies.  :)
Having a bit of a rough day.  I was up all night with bad muscle spasms in my knee, around the patella.  Those seemed to abate during the day, but I was exhausted.  Now they're back.  :-\  I've been trying to do my PT exercises, but I can barely bend the leg without setting off spasms and the patellar mob hurts like heck.  The swelling is still down, though, and no redness or signs of a problem.  Just a buttload of pain.  And to make matters worse, there was a delay in sending me my oxycodone refill perscription, so I'm dangerously low on meds and not due to get more until next week.  Benefit of living on an island - no pharmacy!  I have to mail it, then wait for the meds to be mailed back.  I've been taking tylenol, but it's like trying to stop a freight train with a fly-swatter.  I was feeling so good about my progress, and now I feel like I'm back-sliding.  But I'm still hanging in there. 

Matt - sorry about your difficulties, and the four hour car ride!  I did that a week post -op to get from Mass to Maine and it sucked.  And yeah, a four hour ride for a ten minute appointment sucks!  Netflix does rule, and I have tons of TV shows and movies saved on my external HD to watch as well.  I hear you on the "water on the floor" issue.  Did that myself already.  Boy, my Nana would be appalled to hear the language that came out of my mouth!  ;D  Not fun, indeed!  Keep us posted on how you're doing!

Meg - I think you win in the scar dept!  Mine actually looks like it won't be too bad, since Dr. Minas uses the cosmetic sutures.  And it is nice and straight.  Someone loaned us an ice machine, and that thing is running all day!  Between the CPM, Game Ready, and ice machine, this place is humming! :)

dileigh

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Re: Red.Lotus' Post op diary - multiple ACI, TTT
« Reply #6 on: August 09, 2008, 12:38:38 AM »

I remember the spasms, they do go away after a while, I just don't remember when.  Is there anyone that could go pick up a prespscription for you instead of just waiting for it to be mailed? 

The first few week or so is the worst.  I promise it does get better


Diana

Offline MegTX

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Re: Red.Lotus' Post op diary - multiple ACI, TTT
« Reply #7 on: August 09, 2008, 01:31:12 AM »
Wow.  Hope you get your meds in time.  I only had vicodin for mine, and did it outpatient, which made for some really rough days.  I made certain I overlapped my scripts, since my OS is only in the office 2 days a week for refills (surgery the other days) and they only gave me enough for about 10 days at a time.  Damned DEA and their regs about pain meds!!!

I had the spasm thing too... it sucks.  It does abate after a while... try doing your patella mobs when it starts up, it kinda helps get things to calm down, or at least it did for me.

My OS did staples, which makes for some interesting scars.  I'm about to start experimenting with some henna to camouflage it.  :-D  I think others have had longer scars, but I know mine was certainly longer than I expected!  Somewhere on my hard drive I have a pic with the measuring tape by it... I swore it was a foot long and my hubby told me I was overestimating it, so we put it to the test.  :-D
Lateral Release, Medial "Reef" - '91
{16 years of grinding, pain, swelling and lots of ice}
'scope 7/07 - .7cm2 tibial plateau microfracture, 2.5cm2 grade4 patellar CP debridement
ACI & Fulkerson TTT 2/08 (patella lesion then 4.5cmx3cm)

Offline redlotus

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Re: Red.Lotus' Post op diary - multiple ACI, TTT
« Reply #8 on: August 09, 2008, 07:07:50 PM »
Still having muscle spasm issues, but otherwise okay.  My cousin is coming up from Mass to hang out for the weekend, so that's exciting!  I got my packet in the mail from Dr. Minas, and included was the CD-ROM of pics from the surgery.  Yay!  Check it out - my knee is MESSED UP!  :o

WARNING - GRAPHIC PICS!
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*
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My patella, after they prepared the defects for implantation...

...and the MFC defect, ready for implantation.

The whole shebang


After they did the patches...

Ta da!

So there you have it.  I have some pics of the incision that I'll post later if anyone is interested.  I thought they were interesting shots, and it was sort of validating.  I've gotten attitude from some people about how my knee "isn't really as bad as you think it is,"  ::) and I think that because the injury isn't visable people tend to dismiss it as "whining."  Well, I guess now I can whip out photographic (emphasis on the GRAPHIC) evidence!  ;D

Offline madrvr757

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Re: Red.Lotus' Post op diary - multiple ACI, TTT *Now with surgical pics!*
« Reply #9 on: August 10, 2008, 12:48:59 AM »
WOW!!!  Now that's impressive.  :o 

I was wondering why you had to spend 3 days in the hospital, and thats some pretty good photographic evidence as to why :)

Offline djs60

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Re: Red.Lotus' Post op diary - multiple ACI, TTT *Now with surgical pics!*
« Reply #10 on: August 10, 2008, 07:05:15 PM »
wow - those are big defects.  Do you know the measurements?

djs60
3/06 left knee arthroscopy - grade IV lateral trochlea defect
chondroplasy & removal of loose bodies
1/07 left knee arthroscopy/cartilage biopsy
4/27/07 left knee trochlea & patella ACI with TTO

Offline SamB

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Re: Red.Lotus' Post op diary - multiple ACI, TTT *Now with surgical pics!*
« Reply #11 on: August 10, 2008, 07:10:04 PM »
Those are some great pics.  And I thought my one kneecap hole was bad. :)  I've gotten the whole "oh, your knee really isn't that bad" thing too.  I think people just don't really understand - to them, if you didn't tear your ACL, then it's not that bad, regardless of what you actually did. :) 

Keep your head up - things will get better, although slowly. 

Sam
11/20/2007 - Removal of loose bodies, debridement, Left knee
4/15/2008 - Cartilage biopsy for ACI
6/17/2008 - Left knee ACI

Offline redlotus

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Re: Red.Lotus' Post op diary - multiple ACI, TTT *Now with surgical pics!*
« Reply #12 on: August 10, 2008, 09:34:16 PM »
Hi folks  :)

Matt - yes, they are sort of impressive, aren't they?  ;D

djs60 - Here is a quote from my op notes with measurements:

Quote
The areas of damaged tissue were then radically excised with a#15 blade elevator ring curet. Because of thinned out cartilage in the medial femoral condyle, a high-speed bur was used to deepen the medial femoral condyle further. It was then sterilely templated and all three lesions were then measured. The femoral condyle measured 35 mm long and 15 mm wide, lateral patellar facet 15 x 15 mm, and the medial patellar facet 20 mm x10 mm

I was pretty astounded myself when I saw those pics andread those measurements!

SamB - Thanks for the encouragement!  I'm keeping my head up  :)  Everyone who really matters to me knows what an ordeal this knee thing has been, and has been really supportive and understanding, so to heck with the rest of them, right?  :P

Had a pretty good day today - no spasms.  Didn't sleep well, but what's new?  ::)  My cousin made it up from Mass, and we went to a charity tag sale/auction, got some ice cream, and sat at a picnic table at the beach for a while.  It was great to get out of the house!  My ankle is bothering me for some reason - I have a big swollen bruise on my inner right ankle (the operated leg) that really hurts.  I have NO IDEA how I did it!  Darn Coumadin!  I probably poked my ankle with my pinkie toe or something in my sleep, and voila! Contusion!   ::)

But otherwise ok.  My ROM is going up again despite that little setback (yay!), and overall I feel pretty good.  I haven't taken anything other than Tylenol during the day since day before yesterday!

Thanks for all the support!  ;D
« Last Edit: August 10, 2008, 09:36:05 PM by redlotus »

Offline redlotus

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Re: Red.Lotus' Post op diary - multiple ACI, TTT *Now with surgical pics!*
« Reply #13 on: August 10, 2008, 09:51:11 PM »
Just for the heck of it, here's the incision about four days post-op!


dileigh

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Re: Red.Lotus' Post op diary - multiple ACI, TTT *Now with surgical pics!*
« Reply #14 on: August 10, 2008, 10:02:26 PM »

The ankle could just be blood pooling from the op.  I had that, if that's the cause, it will go away in a week or so.  I didn't have to do the Coumadin, so I don't know if that has something to do with it or not.

Those are some big defects! 


Diana















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