Derotational Osteotomy + TTT - 10/20/2009

[crankerchick]

I know what you mean about facebook. you should be able to say what you want. I've since stopped caring and post whatever i want regardless of what "friend" or family member might not like it. I just make sure not to bash coworkers or my job since i have coworkers as friends. FB is the land of "friends."

I can't imagine how frustrating and annoying it must be to hurt and no one knows why. Well then of course my knee hurt and was unstable for damn near 20 years with no real explanation, but somehow I don't think that is the same. They will figure it out, or will just resolve on its own, it has to.

I like face time because it never feels like explaining something over the internet or on the phone is sufficient for me. I suck with words and describing things. It's like a blind man trying to describe the weather to someone that is hearing impaired if you ask me. I want to be able to point to where it hurts. And like you said, body language is a big deal. I know i'm doing fine, I don't question that. But getting some reassurance and direction, especially since I am considering dropping formal pt, can only be a good thing.

Oh I definitely know the docs aren't God or psychics. It would help if they were, but *sigh* they are human. There's a lot of people that would do well to understand this simple concept.

So I'm sitting here in utter disgust because Duke is going to the National Championship and is probably going to win. Suckage. All is not right with the world. I need sleep now and hopefully wake up no longer disgusted.

Chocolate, ain't nothin wrong with that! Good call. Enjoy your Easter!

[sarbah77]

Well, we'll root for Butler.  I sure did, especially as they played (Michigan) State.  Or "little brothers".  Or "sore losers."  Depending on the score.

I had my six month post-op which turned into a "solve Sarah's medical mystery" this morning.  And I'm REALLY annoyed but I also think I'm far too harsh with my OS.  He's still not 100% sure what's wrong and I realize that I'm heaping all the blame on him anyway.

He's rotated back to the idea of "shin splints" which kind of seemed a given, especially since he sent me for an MRI to rule out a stress fracture.  Shin splints lead to... well, you know.

First, he said that there's no way the plate can come out now. That's how the conversation started and you (plural you!) and I know that to be true.  Next, he manhandled my poor leg around the plate.  Man, that hurt like HECk.  Of course, it hurts like heck a lot of times - when pressure is applied to it, when I try to sleep, etc - but having someone deliberately poking for a response was unfun!

We went around for a bit, before he said it sounds like shin splints (no foolin', man).  My husband had to press him a bit to get him to do anything about it.  Like the possibility of inserts?  My OS ran out of the room and tracked down the orthodics guru in the office and came back with a recommendation for some OTC insoles.  I guess I'll give that a chance and see how it goes.  Of course, those only fit in sneakers.  I don't always wear sneakers.  Ugh.

Then he suggested I use ice and take anti-inflammatories.  I emailed him, on March 19th, and asked him the same damned question.  Honest, I have the email where I asked "should I ice? Take Advil?" and he replied with "do what's most comfortable."  So I really feel like I've lost SO much time here.  Shin splints are not the end of the world, but if we'd able to work on "fixing" that weeks ago, I might be in so much better shape.  If he'd listened to me two weeks ago, well, who knows.  Ice/Advil are not, certainly, cure-alls, but even replying to my questions....

...especially as most of the email replies are about how I should talk only to him.  And then I got lectured about how I should stay in touch via email.  *head desk*  I try, I get nonsense for replies, and I'm not inclined to simply fill up his inbox because, as we've all established, our OS's are very busy people.

I guess the seriously positive upside to all of this is that I am REALLY feeling better, finally.  Finally!  I'm definitely not "OMG HEALED" but the pain is so much less.  Of course, we need to make sure my knee doesn't hurt, which would indicate I'm limping, so we shall see.  Tentatively optomistic, regardless.

[crankerchick]

I will definitely be rooting for Butler but *sigh* I don't like their chances. I am having friends over to watch, and one wants Duke to win. My mean side may have to come out if he cheers too loudly for Duke. I've never had to put someone out of my house before, but there's a first time for everything.

It's easy to be harsh with the OS when you are hurting and don't feel like you are getting answers. You aren't the first person he's probably had to deal with that has potentially misdirected and arguably irrational disgust for him, LOL. I don't think I could ever be annoyed with my doc, but I'm also not in your situation, so what can I say really. You know these guys are human and they do the best they can with what they've got. You wouldn't have let a dumbass chop on you in the first place, so you just have to try to be confident that he's doing the best he can to restore you to function once he actually listens to you and understands. You may have to push a little harder on the listening and understanding part. Remember, kneegeeks help other kneegeeks to remember to be their own advocate.

That said, I feel you on the responses that he has shared. Its not so hard to say "Yes use ice and advil" or "No, just duke it out." But men aren't best communicators either, and couple that with being super busy and it is a bad recipe.

I can't really advise on how to handle the situation because I have never been it before. This is my first experience with even communicating with a doctor so freely in the first place. I've never had a doctor I could email or call directly, so I'm still starry eyed about that. I do know that I'm a bit of a b1tch when I need to be, and I make no apologies. In the end, what matters is results and sometimes the dark side has to come out for that to happen. So perhaps your passive aggressive emails could be replaced with a little more forceful responses. Something along the lines of "Hey, yes or no, ice and advil?" I think it's ok to be blunt and straight-forward, and even perturbed, on a phone call or email, as long as it remains professional and respectful. But that's just me. I am 3rd generation of women that say whatever they feel, I've just learned from my predecessors and abandoned the rudeness that usually accompanies their statements and behaviors.

I'm glad you are least feeling better. Hopefully the orthotics, ice, and advil will help this to resolve. Just remember not to overdo it since you are feeling a bit better. If this really is an overuse injury, it's best to take it slow.

[crankerchick]

On a different note, I called my doctor's office and it looks like I will be able to meet with the physical therapist and the doctor the week I'm trying to go out. I'm waiting for them to call back and confirm for sure that the PT will be able to work with me the whole week, then I'll book my travel. I really hope they call back today because I don't want to miss out on the travel deals that are available today. The schedule is to meet with the PT first, on a monday, and then the doctor on wed (he's not in the office on mon or tues). Kinda wondering if I should be seeing him first, and then the PT, so i guess that is a question i need to ask.

I'm feeling good about this trip. Some of my family yesterday gave me the whole, "aren't you being a bit foolish and dramatic, going all the way out there for a follow-up?" comments and what is wrong with my therapist here. They don't want me to even think about dropping formal PT. It's funny how I've handled this whole thing on my own, yet the peanut gallery still has input on how I should do things. I've wasted my life away in pt for 20 years, so forgive me if I don't have a lot of faith in them and want some reassurance that everything is kosher.

My mother-in-law went with me on the preliminary trip to Houston and she thinks its a good idea for me to go. Better safe than sorry.

Good thing even though I care what other people think, I don't let what they think stop me from what I think I need to do for myself. If it turns out to be a unneeded trip, well so be it, better safe than sorry. If i lived in TX, it would be a no brainer that I would go back for follow-ups. Just because I'm 1500 miles away means I shouldn't? $$$ is a dumb reason not to do something when the means are there to do it.

[sarbah77]

Oh, definitely, my perception is colored because of my frustration.  Stepping back, I realized that, and it helps.

But I saw one PA twice. I had regular PT.  None of them went "gosh, maybe we should treat this like shin splints"? Or "oh, hey, these symptoms are similar to..."? And then, the MRI to test for a stress fracture.  I think that they all might have gone "OMG KNEE!" when I've been saying "leg."  I'm 33; I know the difference in my body parts and I'd hope they'd know that.  If I say leg, I mean leg.  If I tell them my knee is fine but my leg hurts...

...I hopefully won't overdo it.  My "no walking!" doctor's note is good through the 18th. I leave on vacation a few days before that.  That should give me time to heal at my own pace and not at my boss's, who was trying to push me into walking across campus for a meeting on Wednesday.  That's what got me into this mess, so, no, not while there's a note on file saying so.  And, ideally, the shoe inserts will help.  I always wear athletic shoes when I walk further than a block so if I'm wearing dress shoes at work, I'm probably not going far.  (Did I mention I actually keep an old pair in my office, anyway? HA!!)

My husband had much the same opinion you do.  He figures my surgeon replies to my email because it's in front of him.  But since I'm not in front of him, he fires off a reply and moves on to the next thing... that he's not always looking at the person behind the email but the words in the email.  But I'll do what the surgeon wants - if he wants to be kept updated, fine.

I don't usually send him passive-aggressive emails.  They infuriate me and I won't do it to others.  But when i asked him directly about ice and pain killers, and got a reply of "do what makes you comfortable", I followed up with a back-handed P-A email, which got the exact same response.  I was frustrated and just trying to see if an indirect approach would have better success than direct.  it didn't.  I'm sticking to direct.

But I am also glad I brought my husband along.  He's also my advocate, which is good because when I get frustrated I just shut down.  I know this, he knows this, he comes with me.  (I have a coworker who reacts similarly but doesn't bring along an advocate, and prefers to gather sympathy rather than FIX)  He was the one who forced the idea of shoe inserts with the surgeon.  Of course, he'd also admitted he didn't know knowledge of shin splints, so my husband (the marathoner, who does) suggested it, and my surgeon who also had admitted he wasn't 100% ran out to get advice on it.  (Let's face it, that's also AWESOME - he went and got the answer to a question he didn't have an answer for!)

My PT also wanted an update on my appointment.  He actually wanted me to stop by and let him know what was up, but the appointment ran late and my husband had a meeting blah blah blah.  So I sent HIM an email, too, and, GUYS!  The only thing HE wanted to know was if I'd gotten a sense of when "soon" really was for the plate removal.

BAH!

My OS asked me to keep a pain journal.  Now that I'm more rational and not venting at you - thanks for listening, by the way! - I think I'll look in to that and get marching forward.

We're actually going to miss the game tonight.  We have tickets to Avenue Q, which is here in town.  My husband is SO excited.  (If you knew my husband - he looks like a stereotypical midwestern farm boy - you'd also be as amused as I am)  You should make your Duke loving fan a cone of shame.  It would be fun.

[sarbah77]

Good luck with the trip! I hope they get back to you today, but you know how Mondays can go.

I haven't said it, but I totally agree with you for going.  There's no price for peace of mind, period!

And if you can afford it- like, you're not missing a mortgage payment - then do it.  I'm lucky that I live in the same TOWN as my hospital system (and my surgeon, of course, but hooray for large college towns), but I'd probably be flying out a lot more often than you have.

Plus, anything the Houston PT says or suggests can only help out your current PT.  If your current PT gets his knickers in a twist about it, then fie on him!

[crankerchick]

:-) I totally feel you on the whole, "maybe we should treat this like shin splints" thing. But you know, hindsight is 20/20 too. It's easy to think that now. You definitely feel like weeks went by without any real "targeted" treatment plan. But realistically, what is different now from the other weeks, except having the orthotics for what they are worth, and now being instructed to ice and take the anti-inflammatory. If it really is shin splints and overuse, isn't the best treatment just to rest, stretch, light exercise, etc? So in that case, time has not really been lost in the shuffle.

I feel you on being infuriated by passive aggressiveness. My mom is so passive aggressive and it drives me absolutely insane. It's sweet too that you have your husband there to advocate for you. I love my husband, he's awesome, but he doesn't know how to do the support thing in the way some women (like me) need it. I just have to accept his way of supporting and get the rest from friends and kneegeeks. He's not unsupportive, he's just not supportive in the way that I need sometimes. But such is life.

I think the pain journal is a good idea. I've never done it myself, but I can see how it would help. Sometimes time starts running together, and when a certain places started hurting gets lost. And it helps when you look back and can remember just how awful something felt before compared to now. It just helps with perspective.

A cone of shame? Thats awesome, too bad I have pt tonight and won't have much time on my hand!

Honestly, I can't believe this is my first trip for follow up too. My doctor said from the beginning, there was no need to come if everything was fine, but I'm the kind of paranoid person that I just can't believe I was ok with that. Part of the reason I started thinking about this trip was simply, he only knows what I bring to his attention. I'm more less the one in charge here of whether something is "bad" or not. But I'm no doctor, how the he11 do I know if something is "off" or not to even bring to his attention? I made it 6 months without wiggin out, I think I'm doing good to only just start losing my confidence.

[crankerchick]

Haha so I just requested my surgery report for sh1tz&giggles. Received it by fax afew hours later.

Nothing surprising in it, it just says that exactly what I was told would happen actually happened. But still it s creepy reading about my leg getting sawed on. And I learned some new words like "fluoroscopy" and "fasciotomy" and "diaphysis." Lookout world, I've got my pseudo medical degree now.

It's amazing that how they rotate the bone is so simple, just using a pin for reference and then rotate the bone basically using a protractor. How primitive. I also have some kind of wire in for the tibia, FIBERWIRE. Gotta look that one up.

Just thought I'd share. I read about how it is done before, in some material passed on to me by some awesome kneegeeks, but still, reading in the surgery report makes it more real, like this is what was done to me holy crikees!

[crankerchick]

did i just type "holy crikees" on the internet?

'tis been a long day

[sarbah77]

did i just type "holy crikees" on the internet?

'tis been a long day

I figured it was a self-censoring move on the internets.  Or on a board where I'm not sure of the cussing policy.

[crankerchick]

Nah I would just cuss and let the filter blank it out. Unfortunately, this time it's just good old fashioned nerdbomber.

So I'm all booked! I called the office back before I left work, confirmed the appt dates with my doctor, and just finished booking my travel. I let my pt here know that I'm going out for a follow up and he offered to write up a status report. I also told him if he has any questions for the doctor, that he should include them. If I do get the ok to rehab on my own, I think I will still follow up occasionally with the PT here, so either way, he should still have any questions answered.

Today I asked for more some proprioception type exercises so I can start to get some of my agility back. He gave me 3 new exercises to do on 1 leg, 2 which included bending the knee with the weight on the leg. So i went from feeling high on owning my exercises to low on trying to bend with weight on one leg and failing miserable. It hurts a ton now, but so be it. It's good for me, it will get easier. I can handle the hard work, I can't handle sitting around doing nothing.

[crankerchick]

So it definitely hurts more today after the 2 new exercises. I decided to follow my PTs advice (just for today though) and not do back to back days of strength training considering my pain level after yesterday's session. So today I just did a warm up on the treadmill and then the stationary bike.

On top of that, my right leg is hurting. I noticed the other day a spot below my kneecap, sort of right where the inner part of the patella tendon connects with the patella. It was a bit tender to the touch and was definintely noticeably painful doing something like going down the steps. It's quite a bit more painful over the last few days so that I feel it just when I walk. My guess is tendonitis, but what do i know.

I know my not perfect gate is not good for my "good" (but twisted) knee, but I also think the activity is getting it too. As I've increased my exercising intensity as my surgery leg has grown stronger, the "good" leg just starts to hurt/ache more and more. The same thing was happening before the surgery, although I was limping then too, so I can't relaly say if it is the activity or limping or both. I will say my limp now is definitely better than before the surgery. Before the surgery I locked my "bad" leg straight and walked that way for 10 months. At least now I walk normal and bend both knees, albeit with a slight limp from weakness and lateral tightness in the surgery leg.

The pain isn't bad, but more unsettling than anything. I have PT again tomorrow night, but hopefully after taking it a little easier today my thigh/hip will feel good as new (old?) so I can terrorize it again tomorrow. I look forward to doing the challenging exercises, I can't wait to do the 2 that I struggled with yesterday again. I just want for it not to hurt tomorrow because if the pt asks and I say I hurt, he'll probably not have me do them. I rather work through the pain unless the pain is really awful, which it isn't, but I also can't lie and say it doesn't hurt cause well, i'm not a liar, its just not my thing.

As for the "good" leg, well I'm going to start popping 4 advil every 4 hours and ice it and see if that helps. I think at this point I should be allowed to take anti-inflammatory pills, but maybe i should clear that with my doctor, since he said no anti-inflammatory medicines after surgery.

So I'm a little down today, just cause my right leg aches and my left hip/thigh is hurting. My gait is kinda bad today. Sure do hate to pull the cane out, so hopefully it is better tomorrow.

Oh yeah, 24 weeks post-op today. Still making progress. The lateral tightness is still present, but is either a little better or I've just managed to finally stop thinking about it. As a result, my gate has improved even more. I still have a bit of trunk rotation that I think I'm missing. I can tell because some steps I guess my muscle memory kicks in and I go to rotate when stepping with the surgery leg and it hurts in my thigh and I have to catch myself.

[crankerchick]

So I just finished pt. I didn't tell him how the 2 new torture exercises messed me up, and he didn't ask so I got to do them again today. LOL. Now I can barely walk so home to the cryocuff LOL. The 2 really engage the VL and the hip abductors so that is good. It will get easier. We also worked on trunk rotation while walking for what that was worth.

So I'm getting a little anxious about the upcoming pt with my doctor's therapist in TX. I'm going out on the 19th and will meet with him before meeting with my doctor. I'm juzt anxious cause it'll be just my luck he'll take one look at what I can do and be like "damn girl you suck for 6 months post-op!" Then I'll be all pissed off with myself because im an over achiever and dont handle failure too well. But that is the point of the trip right? To assess where I am and get me on a plan to where I want to be if the current one needs adjusting? LOL I can't believe I'm nervous about something so dumb. Oh well.

[sarbah77]

Piffle.

For starters, you know he won't.  you know that your surgeon knows where you're at and isn't terribly concerned.  You know the real reason is to make sure that you're not missing anything in your recovery.

Of course, I wouldn't be thinking annnnny differently than you, so take my words with a grain of salt.

[crankerchick]

LOL. At least we are on the same page.