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Author Topic: Distal Femoral Osteotomy - Pre & Post-Op Diary  (Read 115233 times)

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Offline jumpi5d

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Re: Distal Femoral Osteotomy - Pre & Post-Op Diary
« Reply #15 on: December 24, 2008, 06:09:32 AM »
I'm def. interested. I've been reading every night.  I'm having a Femoral Osteotomy in April to de-rotate and straighten my right femur. Then maybe 4-6 months later do the left leg. I was pretty excited to hear that you're doing so well!
-Paige

3/5/09 Right Distal Femoral Osteotomy for Patella Alignment 
11/19/09 Left DFO for Patella Alignment.

Offline aturpin

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Re: Distal Femoral Osteotomy - Pre & Post-Op Diary
« Reply #16 on: December 25, 2008, 10:32:03 PM »
Sorry for the gap in progress reports for those of you who are interested; the holidays get hectic.  And, thanks Cat.  I read a lot of your postings before my surgery and really appreciated the information you gave... just wanted to pay it forward.

Post-Op Day 17 (Dec. 22) - I had physical therapy today and we are progressing nicely.  I was able to get on the recumbent bike for fifteen minutes at level 4 and averaged about 70 RPMs.  I was able to get a good sweat going but really did notice the weakness in my surgery leg. I wasn't able to exert very much force.  That said, it felt like a good muscle building exercise. My range of motion continues to improve and I am at about 130 degrees. As I get more and more motion, the progress is a little slower.  In the beginning I could expect to make gains of 10-20 degrees in a week, now I am looking at 5-10 degrees each week. I am going to the gym regularly now and am able to get pretty good workouts.  I typically do the hand bike for 25 minutes, abs and upperbody. I don't have any pain hopping around anymore either. I am still trying to get off my nighttime pain med.  I tried again last night but wasn't able to get comfortable enough to sleep through the night. 

Post-Op Day 18 (Dec. 23) - I was able to go shopping yesterday and go the movies and out to dinner. I was happy that I could sit relatively comfortably through a movie and dinner and that I could stand long enough to go shopping.  I did have a scary incident though. I put my crutch on a sweater that had fallen off the rack by mistake. My crutch slipped out form under me and I put full weight on my leg.  It didn't hurt though, it just scared me. I shopped for about 2.5 hours and my leg tolerated it pretty well. However, my right leg was pretty tired from carrying all of my weight the whole time. I decided to take only half a pain pill before bed last night and it worked pretty well. I woke up once or twice but slept pretty well overall.


Post-Op Day 19 (Dec. 24) - As I approach my three week post-op anniversary I am going to post less as my progress is slower and restricted by my OS post-op guidelines.... basically, there is less to report. I had PT again today.  My insurance allows for 12 visits per calendar year so I am trying to get them all in. This is my 7th session, 5th outpatient session. The exercises remain the same from the beginning but I am adding 2-4 lb ankle weights to my short arc quad exercises and straight leg raises. I am also doing hip adduction and abduction.  I have seen a significant amount of atrophy in my left butt-cheek too so I am adding donkey kicks and leg lifts that will target my glute.  Today I was able to step up the resistance on the bike to level 5 and was able to get a good sweat going for 15 minutes.  Slept on half a pain pill last night but it didn't work as well as it did the night before last.

Offline aturpin

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Re: Distal Femoral Osteotomy - Pre & Post-Op Diary
« Reply #17 on: December 30, 2008, 06:57:56 AM »
Hi jumpi5d.  I am glad that my diary has been of use to you.  If there is anything you are especially interested in or anything I haven't mentioned please ask.  All in all, I have to say that the surgery itself is not bad.  The hardest part of this experience has probably been the first week post-op. The pain never got too intense but I definitely experienced a long ache for the entire week and I had a difficult time getting comfortable.  Also, the first steps in PT are tough.... breaking through the scar tissue and swelling brings on a lot of pain during the exercise and a lot of frustration at how far you have to go to get back to normal. After the first week, things definitely began improving. My best advice to prepare for this procedure is to be in as best shape as you possibly can, I truly believe this helped me come out of the surgery as well as I did, and to lay low for the first week.  By lay low I mean make as many arrangements as you can to be taken care of (i.e. meals prepared for you, having things brought to you, do all of your errands, cleaning, grocery shopping, etc. before surgery).  Lastly, stay on top of your PT no matter how painful at first, it definitely gets easier and the sooner you can get your flexion back, the easier and more comfortable life will be.


Post-Op Days 22-23 (Dec. 27th & 28th) - I spent the weekend on my own again and it went very well. I am getting help carrying things from the car to my apartment but was able to prepare breakfast unassisted and run errands. Right now the only thing I really can't do very well, aside from walk of course, is carry things due to the crutches. I find myself doing a lot of one legged hopping as to free up my hands and I have definitely noticed my calf and quad on my good leg getting stronger and fatiguing. I have no problem driving especially since I had surgery on my left leg but I think if it was my right leg I would be good enough to drive as well. I have been continuing with half pain pills before bed and its going well. I was bad and did not do therapy over the weekend, however, I finally got fed up and removed my steri-strips (I think 3 weeks is enough time).  My scar is going to be a bit difficult as there is a significant amount of scar tissue underneath it and its fairly raised and swollen still. That said, I am positive about the outlook for my scar in the long term as the actual incision is fairly thin.  Once the redness, swelling and raised part goes away it shouldn't be so bad.... i hope :).


Post-Op Day 24 (Dec. 29th) -  I had PT today and was able to get to 143 degrees of flexion. I am no more than 10 degrees away from touching my heel to my butt... my next goal.  I am at 4 degrees hyper extension also... this is good for me but most people shouldnt strive for hyper extension. My exercises remain consistent although I have progressed to the 4-way hip machine (same as the one at the gym) instead of using ankle weights. I continue with Russian stem and I think this is probably the best exercise I do there.  It allows my quad to really fire, more than I can do on my own. I am able to do straight leg raises with a 4 lb weight now and am happy with my progress although I do wish I was able to build up my quad more.  It is still very squishy and small. I see my OS on the 8th of January and I would like to have a good amount of muscle when I see him... i think it will help my case for walking at six weeks. I have PT tomorrow and the following day and then not for a while so I am hoping to get some advice and exercises that will sustain me for a couple of weeks.

Offline aturpin

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Re: Distal Femoral Osteotomy - Pre & Post-Op Diary
« Reply #18 on: January 01, 2009, 05:42:36 AM »
Post-Op Day 26 (Dec. 31st) - Today was my last scheduled day of PT. I am going to be leaving my dad's house where I have been staying since surgery and heading back to Orange County where I live. I expect to come back to physical therapy but it will probably be a couple of weeks.  Today was a milestone day in that today I touched my heel to my butt.  Yes folks, I got 100% of my flexion back.  Its not quite that easy though.  It was pretty painful and takes a couple seconds of good stretching to get there.  BUT, I have gotten there and each time will get easier and easier. Also, I am officially off of drugs.  I have been for a few days but wanted to make sure it was for good before I announced it.  Up until this week I was having a hard time sleeping without a mild painkiller/anti-inflammatory.  Now, I am sleeping fine on my own. Today I road the bike for a total of 30 minutes and 7 miles (not all at once, one time at PT and once at the gym).  It is psychologically and physically uplifting for me to go to the gym and get a good sweat.  I am also doing upper body weights and I think in some way this has all been helping my progress.  Each day I continue to make good progress and am enjoying the challenge of recovery. I see my OS next Thursday and am really looking forward to showing him my progress and getting his opinion. I am starting to get antsy to walk now and am trying to be patient.... I am not a very patient person for the record. I have had a couple of slip-ups where I have accidentally put full weight on my leg.  It hasn't been painful but I can definitely feel the weakness in my leg.  I am eager to get walking and get stronger but I will continue to be compliant and patient...it definitely isn't worth stunting my progress.

Offline aturpin

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Re: Distal Femoral Osteotomy - Pre & Post-Op Diary
« Reply #19 on: January 03, 2009, 05:01:33 AM »
Post-Op Day 28 (Jan. 2) - Happy New Year and Happy Anniversary to me.  I am officially at one month post op with two more weeks until I can walk...I hope.  I have been able to sustain full flexion and got my heel to my butt both yesterday and today. Yesterday it was still tough to get to but today it was a little bit easier. I am hoping this trend will continue. My OS told me I was allowed to bear 30% of my body weight so I have progressed to the leg press.  I have been doing single leg calf raises and the leg press with a single leg with 25 lbs. It isn't much resistance but enough to get my quad and calf working. I have been sleeping with my brace on still but am contemplating taking it off during the night. I am going back to my apartment to live full time tomorrow.  I am a little apprehensive about this since I have established a strong routine at my dad's house and I will also be responsible for all of my meals, getting to the gym (which is further than my current gym), laundry, etc. without help. Fortunately, I will only be doing this for a couple of weeks until I can walk. I also feel up for it as I am getting around pretty well and have become pretty resourceful. Monday the 5th was supposed to be my first day back to work but I was laid off during my leave from work so I will be spending this time looking for a new job.  I look forward to being able to walk so I can go interview and be able to work full time. Unfortunately, I will not be able to speak to the difficulties of getting to and from work after this procedure though I suspect that the biggest problem would be that everything takes longer to do with respect to getting to work in the morning.  Also, sitting in a chair for 8 hours would become uncomfortable in not too short of a time.

Offline aturpin

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Re: Distal Femoral Osteotomy - Pre & Post-Op Diary
« Reply #20 on: January 05, 2009, 07:55:42 PM »
Post-Op Day 31 (Jan. 5th) - No big news to report, everything seems to be moving along relatively slowly now. I am continuing physical therapy on my own and am still able to get full flexion and extension in the leg. I find my knee is pretty stiff these days and the area around my scar is a bit tender. These are proving to be annoying at the most.  I am looking forward to having a normal leg again where it moves freely and without stiffness. I am growing tired of the crutches as well.  At this point I find myself in a rut I suppose.  There isn't much more I can be doing on the physical therapy front and I have a week and a half until I can walk so I am just waiting now.

Offline jumpi5d

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Re: Distal Femoral Osteotomy - Pre & Post-Op Diary
« Reply #21 on: January 07, 2009, 06:19:54 AM »
I'm excited for you about how good you're doing. I've been reading, I don't really have any questions right now. I may later on though as mine gets closer. 

-Paige
-Paige

3/5/09 Right Distal Femoral Osteotomy for Patella Alignment 
11/19/09 Left DFO for Patella Alignment.

Offline aturpin

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Re: Distal Femoral Osteotomy - Pre & Post-Op Diary
« Reply #22 on: January 09, 2009, 02:19:06 AM »
Post-Op Day 34 (Jan. 8th) - Today was my first followup visit with my doctor in San Diego. We took some xrays and it was crazy to see all of the hardware in my knee; I have 2 screws from my ACL reconstruction and the plate and screws from this surgery.  My bone is  healing really nicely and I can barely see where the opening wedge is.  If the bone isnt healing, it will show up grey or black on the xray, I had some nice white areas with a little outline of the wedge visible particularly at the smallest part; it is as if it fills in from the outside in. My OS was very happy and surprised with my flexion and extension. He also was happy with the way my scar is healing and told me everything looked really good. 

Now for the catch:  I have to stay on crutches for 4 more weeks. I cannot believe I have to be on these things for another month. My doc initially said 6 more weeks on crutches but I talked him down to 4 weeks until my next visit and if I look good he will let me go.  It doesn't make a lot of sense to argue with a guy who knows what the appropriate procedure is but I wanted to make sure he wasn't being too conservative. I know this surgery takes a really long time to heal and it is so important that this heals properly (its the biggest bone in the body afterall) but this is taking forever. I knew that people typically spend 8-12 weeks on crutches after this procedure but I heard 6 weeks and held on to it. In reality, his recommendation will put me at 9 weeks on crutches, totally normal. However, as the person on crutches, thats a long time. The good news is that I can switch to just one crutch and I can bear 50% of my weight now... this is progress, I realize. I also get to ditch my brace which is cool too.

As far as therapy goes, I think my biggest obstacle right now is scar tissue. The next toughest thing is to build up my quad muscle... this is especially hard to do on only 30% - 50% weight bearing.  Cycling is the best way to go about this right now.  I remember when I first had the surgery I could wait for 2-3 weeks to go by knowing that things would be better and get easier.  I am kind of in the same mentality right now.... I cant wait for the next 4 weeks to go by so I can resume my normal life and get some more mobility. I also am looking forward to getting the next 2 weeks under my belt where I expect to have more strength, less achiness and to have worked through some of the scar tissue.

So far, if I have anything to say about this surgery is that it is a commitment.  A commitment to put your normal life on hold for a couple of months and take care of something that needs to be done.  And, a commitment to follow protocol and behave despite ones desire to push it. Don't worry about pain, dont worry about discomfort from crutches, rehab takes care of itself if you are diligent, the biggest thing about this surgery is the inconvenience and the commitment. I have little doubt that I will look back at this and say that it wasn't worth it but only time will tell.  Till then I will keep up the hard work and keep on keeping on.

Offline aturpin

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Re: Distal Femoral Osteotomy - Pre & Post-Op Diary
« Reply #23 on: January 09, 2009, 07:18:04 AM »
I think I mis-spoke, or rather mis-typed.... to be clear, I am confident that the inconvenience and struggle will be worth it in the long run and I can't wait to be recovered and back on the mountains.



Offline chereb

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Re: Distal Femoral Osteotomy - Pre & Post-Op Diary
« Reply #24 on: January 09, 2009, 06:49:19 PM »
I have been reading through since you posted and you have given me a little hope. I am having my op on Thursday and not currently sleeping at night. The thought of the pain after is really scary. Im sure it will be nothing like I imagine but its the thought of the unknown if that makes sense. Any advice you would pass on for my last few days before I give up normality for a few months?

Offline aturpin

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Re: Distal Femoral Osteotomy - Pre & Post-Op Diary
« Reply #25 on: January 12, 2009, 10:51:51 PM »
Hi Chereb,

I completely know what you mean about not sleeping.  I was having trouble sleeping and having nightmares about a week before the operation.  And, the worst part was not knowing what exactly to expect... that made it so much worse....the nervousness and apprehension brought me to tears many a night.  That is why I decided to do this post.  Before the surgery I wanted all the information I could get my hands on hoping that it would help cure my anxiety.  For some reason though, it didn't really work. Every bad thing I read made me more nervous and even though I told myself that my case would be different, there was still that lingering idea that it might not be and not knowing was torture. After all was said and done and I was out of surgery I looked back and thought that all of the fear and anxiety was so disproportionate to the actual outcome. 

I can't say you shouldn't be nervous because 1) I think that's impossible, and 2) you are going to have a big operation and no one really wants to do that. And, I can't tell you that your case will be just like mine because nobody knows. So, my best advice is to be positive, work hard at rehab and do everything you can to make post-op life as easy as possible. 

-Do all your laundry before surgery.
-Cook a bunch of meals before surgery and freeze them for easy prep post-op.
-Do your grocery shopping and clean house before surgery.
-Let someone help you for at least the first two weeks....one week minimum but two weeks is better...any help after that is a great blessing
-One thing that is sooo helpful is having a wheelchair.  This doesn't have to be a wheelchair as much as just a chair w wheels. Something you can sit on and wheel yourself around in that will free up your hands for carrying things... even on carpet it will help but definitely for the kitchen and bathroom.
-I cannot tell you how much one legged hopping I am doing on my good leg (sometimes crutches are a hassle to just too slow). Get your good leg strong and ready to bear all of your weight for the next month.
-I have been taking a multi-vitamin everyday and am trying to eat a lot of protein, non-fat milk, and fruits and vegetables.... no useless carbs or sugars.  I really think this helps the body power up and helps the healing process.
-Be positive and be ready, willing and motivated to do rehab...its gonna suck in the beginning (1st week or so) but it will make everything easier and will help healing.
-Do rehab in an outpatient facility.  The camaraderie and opportunity to see people in your shoes is medicine for the mind. Even if they aren't as bad off it is therapeutic to see others struggling and working hard and it gets you out of the house.
-Lastly, go to the gym. Be as active (without risking your leg) as you can.  Do the hand bike, lift weights, whatever.  It gets the blood flowing and keeps your spirits and your health up. 

You said it best when you said you would be giving up normality for the next few months... that's exactly what it feels like.  I can do everything now that I could before surgery (except running, walking, etc...the obvious) but it takes longer and is twice the hassle. Just knowing this and being willing to be patient and accept it is half the battle. I'd say the last thing to worry about is the pain (provided you have decent nurses this will be under control). The hardest thing has been the rehab.  None of it is anything you can't get through.

I could go on and on (I think I have over the past 5 weeks :) ) but you will have your own unique experience and as long as you go into it with a tough mental attitude, a motivated spirit and a positive outlook you will be just fine.  Hundreds if not thousands of people go through this every week and we all make it out fine... and the majority of us are better for it. I won't sugarcoat it, it gets tough sometimes and frustrating and you may have a pity party or two but just be strong and this will pass.  Really, try not to be nervous.  If you are imagining anything like I was imagining, it won't be nearly as bad as you think. 

Good luck to you and if you have any questions or need any help please reach out, I am happy to help anyway I can.  Also, keep me/us posted on how you are doing. Don't worry, you are going to be great!

Offline aturpin

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Re: Distal Femoral Osteotomy - Pre & Post-Op Diary
« Reply #26 on: January 12, 2009, 11:05:56 PM »
Post-Op Day 38 (Jan. 12th) - I have been on 1 crutch for the past 4 days and I have to admit that scaling back to just one crutch makes life a lot easier.  I was disappointed with the news that I couldn't walk thinking how much it would suck to be on crutches for 4 more weeks.  But, one crutch for four more weeks is manageable.  Don't get me wrong, I would rather be walking but one crutch is a good compromise.

News:  Not a lot.  I am still hitting the gym and doing the therapy.  I can't help but feel a little stagnant as the leg can't heal fast enough  and I want to be doing more. I am just being patient, that is a key word in this whole thing, and doing the most I can for it. I don't think I have mentioned this so far, probably cuz it isn't that big of a deal, but maybe its worth bringing up.  So where my quad has atrophied has become quite tender...both the skin and the muscle.  I have been calling it veal for lack of a better explanation.  It just feels fragile and tender and unused and when I rub it too hard or scratch it, it hurts pretty quickly. Also, my hip flexors and quad is also very tight and sore.  It feels so good to stretch it, very much like a sore muscle from working out too hard or something.  The doctor thought this was pretty normal considering what was done to the hip and leg but it sure has been lingering for a while.

I went grocery shopping the other day which was nice because it was a step back into some normalcy... granted I did it on one crutch with the support of the grocery cart also.  But still, progress. I also have done laundry and cleaned the apartment a little... oh, and I can also vacuum and cook.  There really isn't anything I can't do now that I was doing in my pre-op life, it just takes longer and is a bigger hassle.

I am up to 45 minutes on the bicycle and felt my quad burning the other day... what a nice feeling after it has been dormant for so long. I am also doing the leg press but am keeping the weight to 30 lbs... frankly, Im not sure if I could do much more anyway. I can definitely feel the quad getting strong and being more alive and active. I have been working my calf also and it is improving but I have to say that my calf is tiny.... long way to go on that guy. My work is cut out for me but I am up for the challenge and can't wait to get back to my pre-op form.

Offline chereb

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Re: Distal Femoral Osteotomy - Pre & Post-Op Diary
« Reply #27 on: January 13, 2009, 03:16:54 PM »
Thank you for the reply. Cant beleive its only 2 days away now. My left knee is shot too so dont know how it will go with being the main support. I have got a grocery shop sorted and DH is having 2 weeks off from work to help. Good idea on the wheelchair. My MIL has one which im sure i could borrow. I am trying to arrange the physio locally as the hospital is about 30 miles from me! I have spoken to my GP who said its not a problem so just have to get the hospital to make my referral there. You sound like you are doing really well and im sure it wont be long until you can finally walk. Once DH returns to work I have the 9 and 4 year old to take to school/nursery every day. Its only 5 minutes walk away but im sure it will be a challenge. Still having trouble sleeping....gets worse and im sure Wednesday night will be a sleepless one. At least I get a sleep on Thursday,lol. Trying to be positive and optimistic and its hard because you dont know for some time how successful its going to be! Once sufficiently recovered I will be having the left knee done too. Im sure I will wish I was still ignorant to knowing what the op is like for that one,lol

Take care of yourself...4 weeks will go past and you can dich the crutches hopefully! Good luck.

Offline aturpin

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Re: Distal Femoral Osteotomy - Pre & Post-Op Diary
« Reply #28 on: January 16, 2009, 12:48:44 AM »
Post-Op Day 41 (Jan. 15) - Over the last few days I have continued therapy and experienced a little push back from my leg.  On Monday I spent 30 minutes on the bike, did the leg press and 4 way hip machine and felt a little sore afterward and into the next day.  My knee was tight and achy.  I didn't feel like I really had done that much so I ignored the symptoms and did the same therapy on Tuesday.  I continued to feel tight and achy afterward and the following morning my knee was very swollen and my quad got a little sleepy.  I iced the whole day and did not do any rehab.  That seemed to help and I got back on the bike on Wednesday and Thursday without problems.  I know now what the symptoms of "overdoing" it are and will listen better next time.

On a side note, my knee is starting to look more and more like a knee each day.  This might not make sense but up until this point my leg looked puffy and disproportionate.  It now has definition where the knee joint is and appears to be settling into its new angle.

Also, today I forgot that I cannot walk and tried to take a walk to my bathroom from the bed. I put full weight on the leg as a normal step and the leg gave out.  I dont know what to think of this. I have been curious what it would be like to try and walk but didnt have the guts or willingness to disobey. But, now that it has accidentally happen I am glad to have found out.  However, I am dissapointed that the leg is still not ready to walk on.  It felt like it lacked the strength to support my body weight so I will continue to work hard to get my strength back and I will be patient over the next 3 weeks on one crutch.

Offline aturpin

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Re: Distal Femoral Osteotomy - Pre & Post-Op Diary
« Reply #29 on: January 16, 2009, 12:55:03 AM »
Hi Chereb,

Today was your surgery and I hope everything went really well.  Now you can relax and all of the anxiety and nervousness can stop....you did it!  And now it is time for healing.  I hope you are excited that you have the surgery over with and you are on the path to recovery. After the next 7 or so days you should be feeling a lot better so just hang in there, be patient and take it easy.  Take care of yourself!















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