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Author Topic: Derotational Osteotomy + TTT - 10/20/2009  (Read 120263 times)

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Offline doublemom

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Re: Derotational Osteotomy + TTT - 10/20/2009
« Reply #30 on: October 21, 2009, 05:11:40 PM »
Just stopping by to wish you a healthy and quick recovery!!  You're probably in la-la-land right now, but know that a bunch of us are here thinking of you and sending good thoughts your way :)

As for the pain pills and GI issues... ask your doc if you can take magnesium supplements, it'll help with constipation that always seems to happen from the pain pills. 

Andi
2000 R patella dislocation
2004 - Soccer injury - LK medial and lateral meniscectomies
2007 - Dx patellar tilt, lateral subluxation, grade III chondromalacia
5/13/08 - RK medial/lateral meniscectomies & patellar chondroplasty
4/6/2010 - RK TTT/LR scheduled

Offline crankerchick

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Re: Derotational Osteotomy + TTT - 10/20/2009
« Reply #31 on: October 21, 2009, 05:28:00 PM »
Well, it seems I was right. The pain is a bit more elevated today, probably a 7 out of 10 but I'm tolerating. I'm still doing the 2 percocet, but no IV meds. Its more of an ache and soreness, so its more annoying than anything. I truly hate having my leg elevated with nothing under the knee, it's the pits.

I pretty much slept about 20 minutes at a time all through the night, so i was able to do my stretching every hour except once when I slept through it. I was starving through the night though. I think I ate 2 fruit cups and applesauce!

After breakfast I had physical therapy which consisted of walking down the hall a bit on the crutches. I'm heel-toe touching on the crutches. Then some leg extensions and straight leg raises, neither of which I can do on my own so the therapist helps me lift the leg.

My doctor just called to check on me, so that was nice. Its funny, he's a bit of a hard ass when he posts online, and he claims he doesn't do the coddly, "you'll be alright" routine, but I think he did a fine job of being reassuring and comforting on the phone. I begged him to let me have 5 minutes every few hours of ditching the elevation at the heel so I don't go nuts and to my surprise, he said that would be fine. He stressed the importance of the hyperextension, but said i can take a 5 minute break every few hours. Thank goodness!

Because the surgery went longer than planned, everything is pushed behind because there are things I can't do until 24 hours post-op. I'm not allowed to shower and take the dressing off yet. They are still saying I will be able to be discharged today though.

They started me on the lovenox today. I didn't know it was going to be an injection that i have to give myself. It went ok the first time; it didn't hurt, just a pinch like giving blood. But it was unexpected and honestly not something i want to do, but oh well.

Well the computer tends to make me nauseous so I'm done with this post, LOL. I think I've typed enough anyway.

Thanks for all of the well wishes, I really appreciate them.

Latise
Mar '07 - plica excision
Oct '09 - femoral + tibial derotational osteotomy & TTT
Aug '10 - hardware removal
"You control your leg. Don't let it control you." -Smart trainer
"Get your a$$ in gear and go for it! Nothing will happen until you make it!" -Smart doctor

Offline nikkiluv

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Re: Derotational Osteotomy + TTT - 10/20/2009
« Reply #32 on: October 21, 2009, 06:51:01 PM »
Latise,

Glad to hear your surgery went well and that your pain and everything is pretty much under control. Yes, the day after surgery is pretty bad (although immediately post-op they had trouble getting my pain level down as my epidural kinked during my surgery), and then intense pain again the day after surgery when they were transitioning me from the IV and epidural meds to oral meds. Once they finally got the pain under control and the oral dosing down I was okay, but it when it was bad, it was bad.

I can't believe you're on the internet so much either! I could barely bring myself to come on the internet and update or do anything, as I thought it was just too much effort and not worth it...and for me to think that I must've been exhausted or in rough shape, since I'm literally on my laptop like every chance I get, haha!!!

I was on coumadin pills following my surgery. I would've done it if I had to, but I'm glad I didn't have to have the shots. Between that and the blood draws in the hospital and finger pricks from the home nurses to check my coumadin levels I'm sure I would have been an unpleasant person to deal with, haha. How often do you have to do them? Once a day? I only took my coumadin once a day and it had to be the same time, every day.

Although having the towel roll underneath your heel and nothing under your knee is awful and annoying, you'll be thankful your doctor made you do it. I had to do that for 6 weeks (sleeping, etc.) and I hated it, but when I went to my doctor for my 6 week post-op it was worth it to have perfect extension. I was also grateful for it because it was one thing I didn't have to work on while at PT (since there was sooo much other stuff I had to work on!!!). ;)


ORNURSE,

You may think the dilaudid is overkill now, but after my surgery it was definitely a blessing! I had a DFO and ACI on May 18th, and was in the hospital for 3 days. I had an IV I coudl pump every 7 minutes, and an epidural I could pump every 20 minutes. One of them had dilaudid in it. I honestly could not have imagined being on just percoset for pain after my surgery, and I definitely have a high pain tolerance. This was my first major knee surgery, the other being scopes...I was on percoset for all of those, for just about a day or two max and then I didn't need them. I was on dilaudid for about 3-4 weeks. The first two weeks was definitely a constant dosing, and then I weaned myself down by increasing the time between doses, then decreasing the dose. I was on 8mg dilaudid for my pain. I'm out of state from my OS, and you have to call into their prescription line for refills. They told me the incorrect timing to call (2-3 days prior to running out, but didn't mention that's just the time for them to get the message and write the script...it takes another 1-2 days for it to be mailed!!!). I called the 2-3 days in advance, but ran out the day before the prescription. They called in percoset for me (that's the strongest thing they could do for me at the time), and when I ran out of dilaudid the first week and had to go on that for even just a few hours it was miserable!! Thank goodness my OS here wrote me a script for more dilaudid to get me through until I got the other script, otherwise I don't even want to imagine what I would've felt like, as we all know once the pain gets out of control it's so hard to get back under control!!

I wish you the best of luck with your upcoming surgery...I can't believe that you're going home the same day after your surgery!

Nicole
03/25/05 - RK debridement
12/22/05 - RK medial meniscal repair
10/31/08 - RK partial lateral menisectomy
03/13/09 - RK ACI biopsy
05/18/09 - RK ACI/DFVO
01/06/11 - ACI failure confirmed
*Currently awaiting call for fresh Osteoarticular Allograft Transplant cadaver match & removal of femoral hardware

Offline fraud_ninja

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Re: Derotational Osteotomy + TTT - 10/20/2009
« Reply #33 on: October 21, 2009, 06:52:02 PM »
Sounds like you are doing really well.  If you can keep the pain under control for the first few days then you should be in a good position.  Thats interesting about the elevating from the heel to help keep the knee in full extension.  It makes total sense, but I guess extension was never really an issue for me.  I always got full extension the first time I attempted without ever really trying.  

I am with you on wanting to see the Cowboys Stadium.  I have been to Dallas twice in the last year and still have not made it.  Does it count that I saw it from a distance from the top of one of the Roller Coasters in Six Flags Over Texas?  Ah, the next time I go to Dallas its going to happen for me.

So when do you fly to Atlanta?  Are you going to stay in a hotel for a few days before embarking on an airplane?  I cannot imagine flying the day after one of my surgeries.

Good luck with everything.  You should win an award for the most coherant posts by someone who just had surgery. lol

Brianne
12/26/02 LR R
10/26/06 TTT R
1/25/07 TTT L
12/17/07 TTT revision, MPFL recon R
2/7/08 TTT revision, MPFL recon L
3/24/08 screw removal R
4/30/08 screw removal L

Knees are fixed, training for a triathalon.

9/21/09- Right ankle reconstruction

Offline vl7007

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Re: Derotational Osteotomy + TTT - 10/20/2009
« Reply #34 on: October 24, 2009, 03:18:56 AM »
Hey Crankerchick;

Its great to see yor doing so well post op.  sorry I haven't been on line for a bit, my daughters first op was 5 weeks ago, and she is still only able to stand for about 30 seconds.  The pain does ease over time, Kat is down to 20 mg of oxycodin twice a day now and paracetamol when needed.  Her wounds are still healing so until that happens kat can't start hydrotherapy.  It's great that you were able to have your mum there, it really helps. When do you fly home? Will you be out of hospital quickly, as Kat was in for 3 weeks. Good luck with everything, you are in great hands.  Glad to hear you're moving. All the best.

Vicki ;)

Offline crankerchick

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Re: Derotational Osteotomy + TTT - 10/20/2009
« Reply #35 on: October 24, 2009, 06:36:43 PM »
10/24/2009
Post-op day 4

Thanks for the posts everyone :-) It's great to sign in and see the well wishes.

So Wednesday was a little worse than Tuesday. I figured out the computer was contributing to my nausea, so that is what I haven't come back for a while. After I signed off on Wednesday, I felt sick to my stomach again and ended up vomiting. At least I felt better afterwards. Then they came in to give me a shower and change the dressing. I got overheated in the shower and fainted :-( but thankfully I was sitting in a chair in the shower and I didn't slump or anything. I gave the nurses and my mom a scare. Evidently they yelled for the PT (the only man) and he rushed in to help in case I fell over. I came too and was still a bit dazed but feeling like I had been sleep for a while and felt better, LOL.

After that, people were concerned of course, so back to the bed and only doing the exercises every hour, after a nap. My blood was low, but my doctor said that was to be expected and he didn't feel it was low enough to do any kind of transfusion or anything. He called Wednesday evening to check on me, so that was nice. He wanted me to stay the night, so I did.

Wednesday night I slept more through the night, about 2 hours at a time. That's havoc on your leg, not to stretch for 2 hours and to be in that uncomfortable position for so long, but the sleep was needed too so I guess it's just a balance.

Thursday morning I got started with PT after breakfast. He took it easy at first because he was worried about me fainting, but after lunch and talking with Doc, he decided I needed to try to walk a bit farther. I was up for the challenge. I walked about 50 yards, to which earned me a gift from my PT - a set of Texas longhorn Coasters! He planned for me to ride back in a chair, but I only rode half the way and then felt up to walk the rest. We did some more exercises and then I was pooped! Nap time. Then more stretches, medicines, and relaxing and they let me go at 10 after my last dose of meds.

I'm doing the Lovenox every 12 hours, so twice a day. Sub-cutaneous injection. It's actually not too bad, but I'm still not a fan of doing it.

Getting into the hotel room was a bit of a chore, as our room is at the end of a hallway. I was a bit worried, but I made it. I couldn't get fcomfortable in the bed at all and for a moment, thought I should have stayed in the hospital.

But we eventually got more comfortable and I slep 2-3 hours each time, stretching and medicating in between.

Friday was just me and my mom hanging out in the room. We went out only for dinner: a 5 minute ride to Sonic. I've never been to one before, and I really enjoyed my food, but it was a bit bittersweet because I didn't want to order anything to greasy and risky nausea. I got a chicken club sandwhich, and it was excellent.

Sorry for the grotesque, but I finally got some results from the stool softener and the mild laxative my mom gave me at my 6 oclock med time. I've felt better of course after finally going.

Today we've just been doing the same, relaxing around the room. Right now, I'm sitting up on the couch with my leg elevated on a foot stool. I can look out the window and I'm successfully using the computer without feeling sick.

The important important important thing so far is and remains moving every hour or so. Sometimes, between the bathroom, resting, stretching, getting back into bed, it can take 20-30 minutes for all of that and I get down and settled and its time to do it again! I really wish I could measure my ROM because I really need that confirmation that I'm keeping my 125 degrees that I had in the hospital.

I'll go for PT on monday, then a visit with the doctor, and then leave for ATL that evening after the hour ride south to DFW. That will be a long day, I hope I can make it through.

Well, I think that covers everything. Sorry for the length, just wanted to give a day by day since I wasn't able to post the other days. It wasn't that I really felt that terrible, although it was worse Wednesday then it was immediately post op, but more that I suspected the computer was contributing to my nausea so I just avoided it altogether.
Mar '07 - plica excision
Oct '09 - femoral + tibial derotational osteotomy & TTT
Aug '10 - hardware removal
"You control your leg. Don't let it control you." -Smart trainer
"Get your a$$ in gear and go for it! Nothing will happen until you make it!" -Smart doctor

Offline sarbah77

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Re: Derotational Osteotomy + TTT - 10/20/2009
« Reply #36 on: October 25, 2009, 11:57:48 PM »
Hey Latise!

I've been so focused on my own recovery that I haven't made it out of "my" thread to see if you'd posted elsewhere, until today.  I have, however, been wondering how you've been doing and I'm really glad to see that you're okay!

It's amazing how different our hospital stays were - even though I had a less significant surgery, I was coddled much MUCH more and it was terrible!

Keep up the good work!
-Sarah

11/16/10 - plate removal, FINALLY
4/5/10 - no, really, crutch-free
2/1/10 - crutch-free!?
10/13/09 - HTO opening wedge
6/26/09 - arthroscopic plica removal
4/06 - Synvisc/cortisone injections
7/5/05 - arthroscopic plica removal & surprise microfracture

Offline crankerchick

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Re: Derotational Osteotomy + TTT - 10/20/2009
« Reply #37 on: October 27, 2009, 09:00:21 PM »
10/25/2007
Post-op day 5

Uneventful. conquered the shower. ate some authentic mexican that was very good and very cheap. my kind of meal!

The big news is yesterday and today.
Mar '07 - plica excision
Oct '09 - femoral + tibial derotational osteotomy & TTT
Aug '10 - hardware removal
"You control your leg. Don't let it control you." -Smart trainer
"Get your a$$ in gear and go for it! Nothing will happen until you make it!" -Smart doctor

Offline crankerchick

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Re: Derotational Osteotomy + TTT - 10/20/2009
« Reply #38 on: October 27, 2009, 09:00:54 PM »
10/26/2009
Post op day 6

I had physical therapy. We did quad sets, straight leg raises, and leg extensions. Or should I say, I did quat sets and then for the SLRs and LEs I clenched my quad and my therapist lifted my leg, LOL. Evidently I was supposed to be doing the leg raises and extensions all along, but I didn't know that. I felt horrible and worried, but my therapist calmed me down and told me not to worry, its not like I could do them really anyway. When we did them in the hotel, I couldn't lift my leg off the bed.

After that, I rode the stationary bike. First the recumbent for about 20 minutes and then an upright just to practice getting up on it, as I wasn't sure which type I would have access to at my in laws. It was REALLY scary doing the bike at first. I was afraid I couldn't get it around, but I could. When my operative leg is at the bottom of the range of motion, it feels very wobbly and my knee feels like its going to twist. That is extremely scary because twisting is a definite no for pain. But a few revolutions and I was rolling. It felt so good.

Then it was a visit with the doctor and xrays. Everything looked good so a handshake and a few funny anectodes later we were making the 1hour drive south to DFW for the 615 flight out to Atlanta. We stopped halfway for lunch and a rest.

The flight was what you can expect. I can bend my knee. I can only imagine how bad it would have been otherwise. It was just extremely uncomfortable to sit in one position for that long. Our wait in the airport was about 1.5 hours, then about 30 minutes on the plane since I boarded first, and then 145 minute flight and hten another probably 15-20 minutes waiting for everyone to get off and the wheelchairs to show up. It was loooong. I was so happy get off. But thankfully, I was able to will myself to sleep through the flight, and I guess my leg realized no matter how much it protested, the situation wasn't changing, so it finally just went numb and gave me relief.

Being at my in-laws, I can do more for myself. I'm in a smaller bed so I can reach things better and the bathroom is right there, I can even go by myself. I can go through the house as I like. I slept decent last night when I said I'm tired enough so to heck with the mound of elevation, I'm gonna get comfortable and get some sleep. Maybe that wasn't the smartest thing to do, but it was after 12 when we finally got to bed and I had been going non-stop since 9am, it was time for a real rest, not a restless 30 minute nap with leg locked straight and can't go back to sleep without getting up and moving around. At least without the mound, I can wake up and fall back to sleep after a little movement.
Mar '07 - plica excision
Oct '09 - femoral + tibial derotational osteotomy & TTT
Aug '10 - hardware removal
"You control your leg. Don't let it control you." -Smart trainer
"Get your a$$ in gear and go for it! Nothing will happen until you make it!" -Smart doctor

Offline cat

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Re: Derotational Osteotomy + TTT - 10/20/2009
« Reply #39 on: October 27, 2009, 09:09:24 PM »
Yay, the dreaded plane trip is over! Keep up the good work and positive attitude,
 ;D ;D

"Miserable malalignment"
 Lateral release, medial reefing, VMO advancement, and TTT-  3/2/04
Screw removal- 5/24/05
Cortisone injection to pes anserine- 7/27/05
Femoral derotation osteotomy, TTT revision- 10/18/07

Offline crankerchick

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Re: Derotational Osteotomy + TTT - 10/20/2009
« Reply #40 on: October 27, 2009, 09:26:50 PM »
10/27/2009
Post-op day 7

Today I did therapy here in Atlanta. The therapist is really good; good enough to make me consider staying here for the duration of the rehab. I've seen my share of therapists and this guy seems to be the most knowledgeable about what he's doing. And he has a great personality to match, so all around good experience. I went through the whole history with him (at his request, I warned him I was long-winded) and showed him my pictures I have showing my "not patella alta" and the osteotomies and plates in my femur and tibia. He was actually familiar with the procedure and has treated someone who has had this done.

He noted how extremely not normal it is to do what i had done, more common to do either the tibia or femur but not both, and said he has also had patients that have had just the tibia or the femur. In just one visit, I'm very satisfied with him. He looked at my prescribed therapy plan and blessed it and said it was good. Sometimes, people show up with exercies from their doctor or ER or even an ortho and he feels like half of them need to go out the window.

I was happy to hear that he was on board with following my protocol given to me by my therapist in TX. I wasn't about to deal with someone that I would have to constantly battle over what should or should not be done. He just can see that my strength isn't what it needs to be to do 3 sets of 15 leg raises and what not, so we did some muscle stimulation and just focused on getting my heel off the table. He told me not to kill my self trying to raise my leg 6 inches and the like, when it's clear I can't do that. Push myself to the point of pain, but don't over do it. I'll go 2x per week since my entire plan can be done at home. I'll just go there for the massage/tens/guidance/etc.

So far the patella tendon of course is the limiting factor. I can only clench my quad so much and for so long before it feels like its going to burst off. Any kind of twisting is of course pain, and there is a certain way I can have my leg angled when I'm cructhing or attempting to sit or stand that makes a very peircing 11/10 owieee pain. Beyond that, the pain is ok. I'm just taking tylenol extra strentgth every 4 hours, and working in a hydrocodone if i need one (or think I need one). I took one yesterday before PT and today before PT but that is it. I'm considering ditching the tylenol completely.

So, overall things seem to be going very well, even though as the patient it just seems like it takes forever. I can't sit in any way and be comfortable and it's just so frustrating. The femur I can't tell sometimes if how i'm sitting or laying is making it worse or not. THings could defeinitely be worse, I know. I'm very thankful that at-rest the pain is very tolerable, but man, what I wouldn't give to just find a comfortable way to exist without my hip feeling so tight.
Mar '07 - plica excision
Oct '09 - femoral + tibial derotational osteotomy & TTT
Aug '10 - hardware removal
"You control your leg. Don't let it control you." -Smart trainer
"Get your a$$ in gear and go for it! Nothing will happen until you make it!" -Smart doctor

Offline mhsflute07

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Re: Derotational Osteotomy + TTT - 10/20/2009
« Reply #41 on: October 28, 2009, 02:03:57 AM »
Hi Latise,

I'm glad everything seems to be going well and you're not in too much pain. I live in Atlanta and was just curious as to where you're going to PT if you don't mind sharing.

I hope you have a good night!

Erin
June 2, 2005 TTT/LR  R.
July 26, 2005 TTT/LR  L.
June 6, 2006 Microfracture R.
June 5, 2007 Microfracture & Screw Removal R.
March 12, 2009 Scope and ACI Biopsy R.
May 12, 2009 TTT, Trochleoplasty R.
December 15, 2009 ACI (patella) & bilateral hardware removal
December 21, 2010 LOA and LR

Offline CHILLYdogs

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Re: Derotational Osteotomy + TTT - 10/20/2009
« Reply #42 on: October 28, 2009, 02:19:44 AM »
Latise!

Two dozen CHILLYdogs are wagging their tails and howling their heads off over here for ya!

Proud,

Kyle



[email protected]

contralateral BPTB ACLr: Nov'08
back to sports, no restrictions: Feb'09
( yep!! that's @ 12 weeks post-op :-)

Thank you, thank you, thank you, Doc Sanders!!!!!!
(http://www.sandersclinic.net/)

Offline crankerchick

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Re: Derotational Osteotomy + TTT - 10/20/2009
« Reply #43 on: October 28, 2009, 05:50:58 PM »
I believe the name of the physical therapy place is Genesis Physical Therapy. It is in Camp Creek if that helps at all. I'm not very familiar with the area, that's about all I can provide.

Mmm chilly dogs, sounds tasty! Except you are talking about dogs of the chilly type, so in that case, cool! Maybe they could pull me along for a ride, to relieve this boredom.

10/28/2009
Post-op day 8
So far the day is going good medically. I had a scare in the night, doing my cannonball stretch when I woke up to go to the bathroom. For some reason, I had ridiculous piercing pain when my mom raised my leg off the bed to bring my knee to my chest. We tried three times and got to the same place each time. It scared the crap out of me, so we gave up and I went back to sleep. This morning I was petrified to try again, but I tried again and it was much better. I hit the point where the pain came, but it wasn't as bad and I just tried to relax and go a little at a time but stop if it was like it was during the night. Well, thankfully it wasn't. When I went a little further the pain subsided a lot and I felt confident to push through. A little more and it was gone completely and I was able to go ahead and bend my knee to my chest the rest of the way and finish the stretch. I did it 2 more times along with the rest of my exercises, pain free too, and just iced afterwards and all was fine.

My mom left today to go back home, so that was rough. She has been with me since I left for TX last week. I know it was hard for her to leave me. I'm already a little homesick and a lot bored, but I know this is the best place for me to be. I wonder if my longings for home are just coinciding with my mom leaving. I hope the feelings pass, because for the last few hours I've been finding it hard to fight the tears.

I brought lots of stuff to do, but I just don't feel like doing any of it, I don't know why. So i'm just sitting on the bed watching tv. It's coming on about the time do the exercises again so perhaps that will distract me some.
Mar '07 - plica excision
Oct '09 - femoral + tibial derotational osteotomy & TTT
Aug '10 - hardware removal
"You control your leg. Don't let it control you." -Smart trainer
"Get your a$$ in gear and go for it! Nothing will happen until you make it!" -Smart doctor

Offline slmac

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Re: Derotational Osteotomy + TTT - 10/20/2009
« Reply #44 on: October 28, 2009, 09:36:52 PM »
Latise, What you are feeling is totally normal. You've been through a lot, and feeling homesick and missing the help of your mom is par for the course now. The important thing is not to get frustrated and don't get too down, but if you need a day where you are in a funk a little bit you do what you need to feel better. I know it's easier said than done. I was alone trying to take care of my daughter by myself if the mornings at 10 or 11 days post op and that's when I got bummed out and started missing my mom like crazy because she had been visiting and helping us out. It sounds like you are doing great!!! I use a similar techniqe of relaxing and pushing a little further each time I relaxed on days when the pain gets really bad. Some days that's the only way I can bend. Hang in there lady! You are going to do great. It sounds like your therapist and the facility are top notch! Sandra
Knee pain and issues during HS...played tennis
7/30/09 dislocations began
9/18/09 TTT (Fulkerson Osteotomy), MPFL Repair, and arthroscopic debridement
12/29/10 hardware removal
8/12 dislocations started
9/11/12 MPFL recon with allograft