Fulkerson Osteotomy/MPFL reconstruct 4/30/2010

[naturegirl]

Hello all!

I've made it through the surgery and am finally alert enough to post! 

I had surgery on 4/30 to repair my MPFL ligament and do a Fulkerson Osteotomy.  I had to be at the hospital by 6am, which meant I woke up at 3 and had to leave the house by 4pm!  That was an adventure-I sure missed coffee that morning!

The doctors put in a nerve block before surgery, and actually finding the nerve for my quads was extremely painful.  I started crying because the nerve stimulation was sooo painful.  But they gave me something, I think a relaxing drug, and soon after that I found myself awaking in recovery!  Or so it seemed!  I was in quite a bit of pain when I awoke, on the underside of my leg where the block did not cover.  But the doctors quickly gave me more medicine, and it was much more manageable.  I was then taken to my room because I was staying the hospital that night.  Overall the pain was minimal.  I didn't often have to hit the button for morphine, which allowed me to be a bit more awake!  However, the block started the wear off that night, and they gave me a percocet around 5pm.

Things went downhill from there. I had a very bad reaction to percocet-I was extremely dizzy and couldn't focus my eyes.  I vomited a few times and came close to passing out.  And I had to endure these symptoms for 4-6 hours while it wore off.  Although I had ordered some nice soup for dinner, I never got around to eating it.

After that they ordered a new medicine, hydrocodone, which is a mix of vicoden and tylenol from what I understand.  I can only take 8 a day because of the amount of tylenol in it, but they've been working ok.  Overnight I had a grumpy male nurse, who apparenly couldn't hear well and wore hearing aids.  He didn't seem to be understanding a lot of what I said, and my Mom and I were ticked off because it felt like he was ignoring us!  It ended up that he just couldn't hear what I was saying.  I had really bad itching that first night, probably from the morphine, which they switched to another painkiller which still made me itch.  Eventually the nurse gave me Benadryl, which helped a lot!

I awoke the next morning in minimal pain again.  I hadn't had any drugs for 3 hours or so and was doing great.  Since I was having an allergic reaction to something that was making me scratch at the femoral catheter, they removed it early on.  I've had allergic reactions to the adhesives before, so that might have been it.  I was jut glad to have it out!  The pain began increasing then, but still it was ok.  I was able to get up and move to the bathroom, using my crutches, which was a relief.  I wanted to gain back some independence!

I will write more in a while or tomorrow about PT and getting home.  I hope all this was sensible!  I get very loopy with the hydrocodone.  I actually asked my Mom, while coming out of a drugged sleep, "How do they screw the weather balloons into the clouds."  I asked her many other odd things too...which I'm sure I'll hear about someday in the future!!


-Jen

[doublemom]

Jen - glad to hear your surgery went well, though sorry you had a bad reaction to the medications.  I was given Dilaudid 4 mg for the first week, which had me so high into orbit I don't remember very large chunks of time LOL... but it was great for pain control  

Sorry the femoral block was painful.  I don't remember getting mine at all.  I think they gave me something like Versed before doing the block, which didn't knock me out but I sure don't remember any of it.  I only vaguely recall a little bit of twitching in my thigh muscles, but nothing else until I woke up in recovery. 

As I just said to Lindsey... take it really easy the first week or two, and definitely keep up on your pain meds, even through the night.  It's very worth it to wake up and take them through the night so that you don't wake up in the morning in more pain.  Keep us posted on how you're doing, and be good to yourself!!!!

Andi

[naturegirl]

Day 2

After waking up with minimal pain in the hospital, getting some meds for the itching all over, and having the femoral nerve block removed, I started to feel a bit worse. I had been in a Continuous Passive Movement (CPM) machine all night, and the night before I had reached 90 degrees of motion while on the machine.  I was feeling pretty good and looking forward to going home. My doctor visited and said some stuff, which I was too loopy to remember (Mom does).  Then came the physical therapist.

The PT was very nice, but made me do a lot of painful things.  The first exercise was simply raising and lowering my foot, which I had been doing for a while because it felt good.  Then he had me do quad sets, those mad me cry they hurt so bad.  I also did SLRs with help.  I have to have my Mom help me lift the leg completely, so the SLR exercise seems silly.  But as long as hit helps me recover! They were pretty painful too.  My PT also had me crutch down the hallway to a PT room so I could try some stairs.  It was hard but I got really good at using the crutches quickly.

After PT was over, I was in a lot of pain.  And the nurse didn't want to give me more hydrocodone because I had had 2 already in the day, and can't exceed 8. However, it was about noon, and I needed something.  After kinda arguing with her, she did give me another, which eventually helped me to feel better. After a nice nap I headed home.  The car ride was 2 hours long, and I slept for nearly all of it.  That was nice!  Getting home and up stairs to the bedroom and bathroom was hard, but I managed.

I've been trying to keep on top of the pain pills, because everything does just get worse if you don't.  Other than that just sleeping and trying to eat and be hungry has been my goals!    Pretty easy overall, although the pain can creep up on you if you don't keep track of meds.

-Jen

[lindseym27]

JEN!!! so glad to hear that you made it through okay! I had to laugh at the itching part of your post! I was doing the same exact thing! I thought the first day I was going to itch my face off! My mom said that is a normal reaction to these pain killers and eventually the itching will stop...which it has for me! But the first two days I was itching ALL OVER! it was crazy! I'm with ya...on keeping up with the pain medications! This morning was rough, because I didn't wake up to take my meds... and I was in A LOT of pain this morning.

I also started a diary! So this should be interesting following each other through this! I also haven't been too hungry, but trying to eat a lot of calcium enriched foods, and protein to heal

Happy Healing!

[naturegirl]

Jen - glad to hear your surgery went well, though sorry you had a bad reaction to the medications.  I was given Dilaudid 4 mg for the first week, which had me so high into orbit I don't remember very large chunks of time LOL... but it was great for pain control  

As I just said to Lindsey... take it really easy the first week or two, and definitely keep up on your pain meds, even through the night.  It's very worth it to wake up and take them through the night so that you don't wake up in the morning in more pain.  Keep us posted on how you're doing, and be good to yourself!!!!

Andi

I had to convince my Mom that taking the drugs on time, even if I wasn't awake or in too much pain, was important.  She finally agreed today and keeping on schedule has been better.  I think after seeing how much pain the PT exercises were she realized I needed the meds.  I know she was afraid that I wouldn't be coherent enough to remember when I could take them or how many to take, but I proved to her that I won't take them early, etc. 

And you aren't kidding about Diladid!  They put me on that through the IV at the hospital after I was itching so bad from the morphine.  It really put me to sleep!  For hours at a time!  It was nice to sleep for long periods of time though.  The hydrocodone they sent me home with also knocks me out.  I slept from about 10:30pm to 3:30am dead like a rock last night.  So nice!

[naturegirl]

JEN!!! so glad to hear that you made it through okay! I had to laugh at the itching part of your post! I was doing the same exact thing! I thought the first day I was going to itch my face off! My mom said that is a normal reaction to these pain killers and eventually the itching will stop...which it has for me! But the first two days I was itching ALL OVER! it was crazy! I'm with ya...on keeping up with the pain medications! This morning was rough, because I didn't wake up to take my meds... and I was in A LOT of pain this morning.

I also started a diary! So this should be interesting following each other through this! I also haven't been too hungry, but trying to eat a lot of calcium enriched foods, and protein to heal

Happy Healing!

Man all I can remember that first night was the itching!  Horrible!  I had the choice of being in pain or itchy.  So glad that's over with!

Mom's making me mac 'n cheese for lunch.  Not so healthy but it sounds good!  That's a plus.  Glad to be getting my appetite back!

Good luck with everything!  Sounds like your recovery is going great!

[Jennifer34]

Hi

It is really important to stay on top of the pain.  Get on a schedule.  If you take it when you feel it, it can sometimes be too late and then you are playing a catch up game.  I learned the hard way after my MPFL reconstruction on March 31st.  I let the pain get out of control and I paid for it.  I literally paged the surgeon and begged him for another femoral nerve block.  He didn't go for it and told me to increase my Dilaudid.  I ended up taking about 12 mg in a 9 hour period, per dr's order.  The next day, they checked on me and I was actually lectured by my OS assistant to write down what meds I take and when.  Once I did that, it was easier to deal with the pain.   I took Dilaudid after this surgery and it worked great as long as I took it with Benedryl.  I was told that pain meds do cause the itching, so I just loaded up with Benedryl and never had a problem.  I did always get tired and take a long nap after I took it but at least I wasn't in pain.

Take the recovery slow and do not go too fast.  Your body needs time to heal.

Take care
Jennifer

[crankerchick]

Jen, glad to catch up on your diary and see you are doing pretty good. Just keep resting/relaxing for these days and you will see marked improvement in your strength and pain levels.

Sound like things are going well for you so far so just keep up the good work and stay in front of that pain!

[naturegirl]

Jen, glad to catch up on your diary and see you are doing pretty good. Just keep resting/relaxing for these days and you will see marked improvement in your strength and pain levels.

It's gotten so much better since I've been on a pain med schedule and spent most of the part 18 hrs or so sleeping.  I feel a bit lazy, but I have so much more strength today!  Yesterday I was wondering why in the world I had done the surgery, and today I'm looking forward to a normal life again! 

Thanks for the support and advice-everyone!

-Jen

[naturegirl]

Day 3

After my first night at home, I had hoped things were going to get better.  Well, Mom and I made a mistake in how we were elevating my knee, which caused significant pain and movement issues.  We had stuck 2-3 pillows directly under the knee so that it was bent, not realizing it needed to be straight in order to maintain extension.  Once we realized this, we spent the rest of the day trying to keep it extended.  Man, it hurt!  But I kept right on schedule with the pain meds, which helped.  I also took the max dosage most of the time because the pain was high and my knee was swollen.  So I don't remember much of the 3rd day!   

When I attempted to do PT, which is 4 exercises 3 times a day, I had less mobility than the previous day.  This scared me and Mom quite a bit, but everything's working out now.  Pushing through the pain to do the exercises was hard, but I'm glad I did. I gained back the mobility and now my pain is significantly lower.    Yay!

All the advice about keeping up with the meds is dead on.  I wish I had done this the first few days!  My biggest problem now is feeling hungry then actually wanting to eat more than a few bites.  I've lost my hunger!  Has anyone seen it?     I almost have to force myself to eat, and I've been feeling weak and a bit lightheaded, so getting food down is really important at this point. 

Thanks to everyone for the advice and encouragement!  Now that my mind is a bit more clear today, it's keeping my spirits up!   

-Jen

[crankerchick]

OoO good ole elevation with nothing but air under the knee. I know it well. My doctor is one that was insistent on that, and yes it is annoying and uncomfortable, but worth it in my opinion.

I only did it religiously for about 10 days or so and then I got my doctor to say it was fine to change it up. I never lost extension, so in that respect it was worth it to me. I just moved around a lot, like every hour or so, which was fine because I was usually dying to move and bend anyway. Sitting in one static position for a long time has never been my thing.

Glad to hear you regained the mobility/range of motion you had lost. That's the key, just keep pressing on and pressing through. Things will calm down in the next few days :-)

[Jennifer34]

Hi Jen,

It does get better.  Exercises are going to hurt for a while.  I would take pain meds, wait until they kick in and then do it.  It may be more tolerable.  Either way, it will hurt but maybe less.  I still do that now occasionally because I still get alot of pain a month out when I do PT exercises.  Sometimes, I will take pain meds before PT to help deal with it.  The most important thing is to stay on schedule with the pain meds.  It sounds like you are now doing that.  Sleeping and trying to keep your leg straight is a balancing act.  I put two pillows on top of each other, another pillow halfway off the above pillows.  It seemed to work well.  I had to keep my leg straight w/brace on for the first 2 weeks.  If the bed is not cutting it, I would move to a couch/sofa and sleep there.  I got more hours of sleep in on the couch versus my own bed since surgery.  Even a month out, I still sleep on the couch when the pain is bad.  It prevents me rolling around.

When I had my MPFL on March 30th, I did not want to eat afterwards at all.  I would get hungry, fix it and then only take a bite or two.  I ended up eating more chicken-n-bisket crackers and sprite the first two weeks.  Sometimes, my friends/neighbors would pick up stuff and bring it over.  I was recovering alone.  With the amount of pain meds you are taking, you need to eat alot of fruit and foods high in fiber.  Try eating small meals several times a day.  You need to keep up your energy to help you heal.  Those pain meds will do a number on your digestive system and that can affect your appetite. 

Mobility is going to come and go the first couple weeks.  Some days will be better than others.  Just work through it.  The one thing that you mentioned is that your knee is swollen.  Are you icing it at all?  The swelling can and usually will make the pain worse.  I had the Cyro Cuff on my knee 24 hrs a day for the first 5-6 days and was surprised at how well it did to control the swelling.  Make sure you are icing it.

Take care, glad you hear you made it through the worst.  It should only get better from now on.  Just relax and let it heal.

Jennifer

[doublemom]

Yep... I remember needing to eat so the pain meds wouldn't make my tummy feel gross, but having absolutely no desire to eat anything at all.  For the first 2-3 weeks or so, I had to force myself to eat.

You'll have good days and bad days, but just keep elevating and icing and doing those exercises.  As for sleeping, I usually sleep in a recliner any way (nasty sinus problems), and it's been fairly comfortable with my leg propped up that way versus being in a bed.  Not sure what it is, but the recliner is fairly comfy with the leg elevated.

It keeps getting a bit better every day, so hang in there!!!

Andi

[missfefela]

hi am your doing ok and have come out  the other side
Keep going I look forward to reading about you getting better and seeing what ive got to look forward to.
Kisses
xx

[lindseym27]

Hello Jen!

Glad to hear you're doing well! The pain meds are terrible for the digestive system! I've been trying to pump up the fiber!!! To keep things regular Are you back to school yet? I have A LOT of bruising starting behind my knee and wrapping around the outside ( where the LR was done) do you have any bruising? It's very very sore! I have terrible pain in the morning...when I get out of bed. Are you experiencing that?