Banner - Hide this banner





Author Topic: MPFL Reconstruction - November 18, 2010  (Read 7925 times)

0 Members and 1 Guest are viewing this topic.

Offline ParisBaby

  • MINIgeek (20-50 posts)
  • **
  • Posts: 46
  • Liked: 0
Re: MPFL Reconstruction - November 18, 2010
« Reply #15 on: December 08, 2010, 03:18:15 PM »
Day 20

I am the happiest person today.  I did a SLR by myself last night. Actually, I did 5.  I was having an awful night, my baby was crying cause he woke himself up and nothing I could do was soothing him, because normally I walk around with him in my arms and that works when nothing else will. Well with the brace on, I cant carry him and my walk is all stiff and unbalanced so I was so frusterated that I couldnt even help my son and nothing seemed like it was getting better. Not the bend, not the strength and I did this surgery for nothing... So I was sitting in bed and I am like this is the dumbest thing ever, I can control how much effort I put in and I WILL lift this  f-ing leg if it is the last thing I do.  So using the tips I found on naturgirl's post surgery blog (1. DO NOT tighten your glutes or your lower back. If you feel like you are, you need to poke yourself in those muscles to remind yourself to relax them. It helps, I swear.  2. Push the bottom of your heel out and flex your foot and raise from there.)  Using these tips, this is the first time I could actually FEEL my quad and knee cap engaging. I was so excited.  So I did some warm up quad sets and then I tightened my brace up and I lifted it.  It was AMAZING! I think I have subconciously been scared to lift it since I am terrified that I cant control the bend and that it will drop suddenly and hurt me. So I did 5 of the SLR's and my other leg lifts and I felt really good.
I have been really working on quad sets now that I know how to do them correctly, although I would say that 5 out of 10 of them are wrong and I have to start over, not tightening my glutes and lower back.

So I had PT again today and I had to do the SLR without my brace which is much harder for some reason, but this is the way my OS is going to make me do it on Monday, so I need to do whatever it is that he is going to make me try.  So I did the E-stim machine while doing quad sets and the SLR's. I am still having some trouble lifting my heel without the brace (I think it is my subconscious fear) but I am able to raise it once she starts me and I am able to hold it and lower slowly all by myself.  So I am going to practice a ton over the next 4 days and hopefully I can do it on Monday.  Also! I got to 75 degrees which is PAST my goal of 73. I hung my leg over the side of the table, we put a hot pack on it and I worked on it for about 5 minutes and at the end I was able to get to 75 degrees.  This is so great because when I first started this morning, I was only at 58 which was less that what I had on Monday and I was really downcast.  The heat felt amazing, it really took my mind off the pain of the tightness and helped me focus on controlling the bend. I raised and lowered my leg with my other leg several times trying to make sure that it is a nice and smooth controlled movement, just so that my knee can remember what it feels like to bend back and forth.  It helped work some of the pain out too when I was tired of pushing the stretch. 

So all in all, a wonderful day at PT and some more motivation to get to where I need to be on Monday. I think I might actually make my goals and that makes me so fricking happy that I can't even put it into words.  I am going to work really hard over the next several days to get the bend out and hopefully push it to 90 degrees and I will be using the time at work sitting at my desk to do several quad sets a day. Today has given me hope that my knee might be "normal" again someday and that it can happen. I haven't had that hope for 3 weeks now and I have to say it feels pretty darn good.

I am also going to get some Vitamin E. My scar is starting to scab and peel a little which for some reaon I find fascinating, but it isnt shaping up to be a nice scar so my PT said Vitamin E oil. Plus it is so dry and yucky cold out that I guess my skin could use a little extra moisture.

Oh and one more thing! I have done the last two PT sessions with NO pain meds whatsoever. No tylenol, no prescribed drugs, nothing. I havent done it on purpose, usually we are running late and I dont have time to find them before we have to get out the door but I have done it and it is fine. My knee is pretty tender right now, after the session, so I might get some tylenol so that I can work, but other than that, I feel like it is good to feel the pain. It reminds me that I hate wearing this brace and I hate having knee pain and the more I work on it, the less it will hurt tomorrow.  So it is my constant reminder to keep my head in the game and work on it. Plus I have lived with knee pain for about 12 years now so I guess I used to it. lol. But this time I actually can DO something about it, so it is good.

Offline ParisBaby

  • MINIgeek (20-50 posts)
  • **
  • Posts: 46
  • Liked: 0
Re: MPFL Reconstruction - November 18, 2010
« Reply #16 on: December 13, 2010, 05:54:03 PM »
Day 25

OMG! I got clearance from my OS to drive and to unlock my brace to 70 degrees! I am the happiest person in the world right now, I even cried a little as I was able to sit in the front seat of the car and not feel like my back hurt and that my whole body was straining to accomodate the straight leg. It was fantastic and amazing what stupid things will make a person happy.

So I had PT today again... I have been really working on my bend, but I havent been able to get past 75 degrees at home. I sit in the shower until the water runs cold, I have a heat pack on it, I have been stretching every night, but still it hurts alot and I am not getting the bend. So today in PT she put me on the bike and had me rock forward and backward and I have to say WOWZA that hurt like a son of a gun.  I still wasnt getting it past 75 so at the end of PT, she basically had me sit at the end of the table and then she pushed on my leg and worked on my knee cap at the same time. It hurt, I am not going to lie, but I was happy to have some help pushing at my leg. We were able to get to 82 degrees which she wrote up for my OS to look at. I think we might want to add another day of PT to the schedule at least until I am at 130. She said that is fine, the perscription was for 2-3 times a week, so I am going to add some visits. I want to get this working and over with.  So my OS wants my bend to be at 110 in two weeks and then two weeks after that, he wants it to be 130. I am nervous, but I am willing to give it a shot. It is all for my benefit so I am not going to argue with him, specially now that I can drive myself to PT. yay! I am going to go get a rental car, since I am not sure that I can handle a standard quite yet so I have to rent one. It is worth the expense though if it means that I have more freedom. I am so stinkin' excited.

I was also able to do a SLR today in PT all by myself. The funny thing is that I can't do one without the PT at least touching my foot. She literally put her index finger on the bottom of my foot and then I was able to raise it. I think it is a confidence issue, something of a mental block. In my visit with the OS, I had told my fiance that if it looked like I couldnt do it, he needed to touch my foot with it finger and yep, as soon as he did, I raised my leg for the OS. So the OS seemed pleased with my progress and that my knee cap is moving around alot but seems secure. He comes in and immediately starts pushing it from side to side, pretty roughly. It still gives me the willies to feel that, I cant get past the fear it will pop out, but it is nice to see it in there, nice and tight.

So today was a really good day, even though it is snowing and really yucky outside.  I am still using my crutches because of the snow and the fact that I am un-used to the fact that my leg bends now so sometimes is sort of collapses on me, so while I am at work I will use the crutches, so I dont look stupid falling, but at home I havent been using them, in fact, I have been taking my brace OFF and walking for like 5 minutes around the house. I am very careful, but I feel like the brace was preventing me from using my quads and bending where I could.  I am thinking maybe a cane would work more, so that way I have a hand free but I still have some support while my leg is getting used to walking... I will have to check them out at the grocery store. :)

All in all, I am pleased with my progress, although I have to say... I was disappointed and upset before my OS visit. I find that my greatest successes usually follow my greatest low points, where I am doubting everything and all my reasons to have surgery seems stupid. Maybe this is a motivating factor for me? I dont know. I just know that every time I get upset and feel like this surgery was a big mistake, I end up pushing myself harder.  So for all those people that might be thinking that this was the worst decision you ever made, I get it, but try to use that as encouragement to push yourself a little harder. After all, we can live the way we are now, which kind of sucks, or we can hurt and go through pain, and it can get better. I just view it as, nothing is as worse as it is now, and if by me pushing on my leg and crying now makes the next time better, I will do it.

Offline spurs27

  • Regular Poster
  • ***
  • Posts: 88
  • Liked: 0
Re: MPFL Reconstruction - November 18, 2010
« Reply #17 on: December 14, 2010, 02:56:25 PM »
Paris,

First post for me on your page but I have been away from this blog for a while. 

I had an MPFLR just over 2 years ago and I think you are doing great!  It seems like your OS is like mine was in that he has you doing as much as tolerable in terms of activity.  Mine had me in a CPM machine the day of the surgery.  The CPM would bend my leg for me up to a set angle.  He had me increasing it by 5-10 degrees each day.  To this day I think that was the deciding factor in my recovery.  PT was hard, but that's where you make your money!  Today, I'm back to running 20 miles a week and doing everything else I used to love to do.

Have confidence in the judgement of your OS.  It sounds like he knows what he's doing.  Have confidence in your PT...they know it's hard for you but they also know that sweating a d few tears at PT will get you where you want to be a year from now.  Keep it moving and keep pushing yourself each session and it will pay off!

I'll check in on you from time to time and feel free to ask questions...

Brian
History:
1992:  L kneecap dislocation
1992:  L knee Arthroscopy & MCM repair
1998:  R kneecap dislocation
2002:  R kneecap dislocation
2004:  R kneecap dislocation
2007:  R kneecap dislocation
2008:  R kneecap dislocation
2009:  R MPFL recon

Offline naturegirl

  • Forum Faithful
  • ****
  • Posts: 410
  • Liked: 0
Re: MPFL Reconstruction - November 18, 2010
« Reply #18 on: December 15, 2010, 03:19:11 AM »
Hi ParisBaby!

Glad to hear that things are going well!  Isn't doing that first SLR exciting?!  That made my week when I was able to do it. :) 

It really sounds like you are turning a corner and hitting some major goals.  You bend will continue to improve....although it's frustrating that it takes soooo long!  It sounds like you have a great PT who is really supportive but knows when to push a bit.  And the fact that you are willing to push your limits and comfort zone will make your recovery easier. 

I look forward to hearing more good news about your knee, and I'm sure I will! :)  Good luck with your appointments in the coming week.  I'll be seeing my doctor for the first time in 4.5 months in a few weeks, and I'm hoping he will give me permission to serve in Peace Corps for the next few years (I've already been nominated, but the medical approval will make it or break it).  So hopefully he's pleased with me! 

-Jen
1999-ish: L knee hyperextension on trampoline
4/30/2010 Fulkerson Osteotomy and MPFL/LPFL reconstruction
Serving with Peace Corps July 2011-September 2013 in South Africa-knee is happy :)

Offline ParisBaby

  • MINIgeek (20-50 posts)
  • **
  • Posts: 46
  • Liked: 0
Re: MPFL Reconstruction - November 18, 2010
« Reply #19 on: December 15, 2010, 09:24:34 PM »
Day 27

I have been driving for two days now  ;D.  It is AWESOME to be back in control of my coming and going and not to have to schedule someone to take me to work and pick me up. I think that has motivated me more than anything. The driving has also forced me to bend more frequently and in different ways with my foot, since I have to reach the brake and the gas pedal. My knee hurts alot while driving but I think it is good, since it is forcing my ligament to accept the stretch and to hold it for at least 15 minutes.  This is really good therapy on my knee.

I had PT again today and I was able to get to 87 degrees after heat application, the PT pushing on it for like 10 minutes and some other stretching. So I am thisclose to 90 degrees. I have added an extra day of PT over the next 4 weeks as well since I feel that I need to really push myself and I find I work harder at PT than I do at home. So Mon, Wed and Fri I will be at PT for an hour working on my knee.  Hopefully I can meet the goals the OS gave me. 

I have also given up walking with the crutches. I ended up carrying them for the most part, I am not super stable on my knee but I figure the best way to become stable is to practice walking on it. So I have to concentrate when I walk, no distractions but this way I can work on walking normally and letting my knee feel the bend back and forth as I take steps.

Offline ParisBaby

  • MINIgeek (20-50 posts)
  • **
  • Posts: 46
  • Liked: 0
Re: MPFL Reconstruction - November 18, 2010
« Reply #20 on: December 15, 2010, 09:34:54 PM »
Hey Brian - It is great to hear that you are able to run again after the exact same type of surgery. How long did it take you to get that kind of mobility and strength back?  I would love to run again, I used to run very short distances, like a mile a day, but I liked it and I would like to be able to do it again.  My OS decided NOT to use the CPM on machine on me. I never knew why, but I did ask about getting one and he said no.  My PT thinks it is because he was trying to protect the bend in my knee right after surgery and that I wouldnt be able to feel if it was too painful because of the nerve block. Or he just wants me to work for it. lol. I dont know. I LOVE my OS. He laughs at my jokes and doesn't take me seriously when I complain about the long recovery. He also listens to me and my fiance when we have questions and will sit down and explain anything that I seem to freak out about. :) I would recommend him to anyone. I even checked his references with random OS and medical sales people, to see what they had to say about him. They gave him glowing references for this type of surgery, so for some reason that made me feel good.

Jen - I am so so so so so happy for you! Wow! The Peace Corps is an amazing adventure and I hope your OS gives you clearance. That is so exciting and a very inspirational thought. You are only 4.5 months out and you feel you are able to join the Peace Corps.  Is there any reason why you couldn't do it other than you had major surgery.. but I mean you are better now right?
The SLR situation was fantastic. I was so excited, but again I was coming from a major low too and I was able to channel that into motivation for my leg. Once I can bend past 90 I will be super stoked and then once I can sit in a chair without feeling any pain, or even noticing my knee bending, that will be a real turning point for me. I think this surgery is going well and I am fortunate not to have alot of the issues that some people are experiencing on this board. I am glad I read about them beforehand so I could set my expectations levels. Let me know what happens with the Peace Corps and good luck!
Lyndsie

Offline naturegirl

  • Forum Faithful
  • ****
  • Posts: 410
  • Liked: 0
Re: MPFL Reconstruction - November 18, 2010
« Reply #21 on: December 15, 2010, 11:22:45 PM »
Hi Lyndsie,

I'm actually 7.5 months out from surgery, but I haven't seen my doctor since August because I moved from the Midwest to Washington, DC.  Thus I couldn't quite travel the distance to see him! :) 

The Peace Corps requires a 1 year deferment for ligament replacements, and since I had my surgery April 30th, my start date of the end of June will be after that.  I suspect some questions from PC about my knee, but haven't heard any objections yet.  Of course, I also haven't received the full medical forms.  However, it is super exciting! 

Keep counting all the blessings...that's the best way to go.  I didn't have much trouble gaining back motion, however strength was harder for me to get back.  Each person is different.  I wasn't allowed to weight bear until 5 weeks out, which was horrible....so count yourself lucky you can do that!

-Jen
1999-ish: L knee hyperextension on trampoline
4/30/2010 Fulkerson Osteotomy and MPFL/LPFL reconstruction
Serving with Peace Corps July 2011-September 2013 in South Africa-knee is happy :)

Offline ParisBaby

  • MINIgeek (20-50 posts)
  • **
  • Posts: 46
  • Liked: 0
Re: MPFL Reconstruction - November 18, 2010
« Reply #22 on: December 16, 2010, 05:25:14 PM »
Day 28

Okay I am super grumpy today. It snowed another 2 inches last night, I forgot stuff upstairs and had to climb the stairs a ton and it seems like I am the slowest person around. I was really irriatable this morning, I am tired and I am sick of being in this brace and my knee hurting. Today is just a really pissy day for me. I was 30 minutes late to work because of snow and slow knee walking and I just dont like sitting at my desk. I am tired of wearing the same large black pants to work, but I cant wear anything else since they dont fit over my brace. I am tired of feeling fat and like a big loose blob. It seems that all the muscles in my body are gone.  Is that enough complaining? I am sure I can go on more but maybe I better stop, otherwise I will be even more pissy as this post goes on. I am even annoying myself.

I guess I am just not feeling productive or good today. I go to PT tomorrow which is great since I always seem to feel better after PT.  Bad part is that it is at 6am, but it was the only time they had to fit me in. So early to bed tonight, and lots to do.  I am going to work on the bend today while sitting at my desk, the goal for tomorrow is to get past 90.  I was at 87 last time, I am thinking I should be at 95 at PT this time. a good bend gain will make me happy.  and that is one step closer to reaching my set target of 110. 

Offline ParisBaby

  • MINIgeek (20-50 posts)
  • **
  • Posts: 46
  • Liked: 0
Re: MPFL Reconstruction - November 18, 2010
« Reply #23 on: December 17, 2010, 03:12:58 PM »
Day 29

So I got to 90 degrees today in PT but no further than that. I have to say the earlier PT was brutal to get up for. My PT said that I seemed to be more sensitive to the aches and pains today than I normally am. I dont know if I am just going thru a phase this past couple days.  But I am glad to have reached 90. I feel that is a major milestone and the sooner I get past it and on to the next one, the better.
I feel sorry for my fiance. He is really bearing the brunt of my temper and my frusteration over my inability to do things for myself. I am so tired of asking people to help me, or explaining to people what happened. I just want to do things myself but I am afraid to take too many risks and have a possible setback. I have started showering without help again, and I am driving again too. Next step is to start being able to take care of my son. I am working on it, but walking is still a little scary so I get scared to carry him. oh well. Hopefully he still wants to marry me after all this is over.

Offline spurs27

  • Regular Poster
  • ***
  • Posts: 88
  • Liked: 0
Re: MPFL Reconstruction - November 18, 2010
« Reply #24 on: December 17, 2010, 06:28:07 PM »
Day 29

So I got to 90 degrees today in PT but no further than that. I have to say the earlier PT was brutal to get up for. My PT said that I seemed to be more sensitive to the aches and pains today than I normally am. I dont know if I am just going thru a phase this past couple days.  But I am glad to have reached 90. I feel that is a major milestone and the sooner I get past it and on to the next one, the better.
I feel sorry for my fiance. He is really bearing the brunt of my temper and my frusteration over my inability to do things for myself. I am so tired of asking people to help me, or explaining to people what happened. I just want to do things myself but I am afraid to take too many risks and have a possible setback. I have started showering without help again, and I am driving again too. Next step is to start being able to take care of my son. I am working on it, but walking is still a little scary so I get scared to carry him. oh well. Hopefully he still wants to marry me after all this is over.

Awesome on the ROM increase!  Getting to the point where you can go all the way around on a stationary bike is key.  Once you do that, all you have to do is keep lowering the seat on it (which causes your knee to flex to greater extents).  That really helped loosten it up for me.

I'm still married after having my surgery 3 months after the birth of our second child and saddling my wife with all that so you'll be fine :) 
History:
1992:  L kneecap dislocation
1992:  L knee Arthroscopy & MCM repair
1998:  R kneecap dislocation
2002:  R kneecap dislocation
2004:  R kneecap dislocation
2007:  R kneecap dislocation
2008:  R kneecap dislocation
2009:  R MPFL recon

Offline naturegirl

  • Forum Faithful
  • ****
  • Posts: 410
  • Liked: 0
Re: MPFL Reconstruction - November 18, 2010
« Reply #25 on: December 18, 2010, 12:06:23 AM »
Congrats on making it to 90! That is a step in the right direction.  And it just feels good to meet a "big" goal. :)  I definitely agree that the stationary bike helped me a lot with flexion, and it felt good to be using my leg again in a semi-normal way!

Bad days just suck, and they tend to come in groups.  Venting here helps a lot though! You'll make it through these few bad days and be on to feeling better soon enough.  And now that you've made it to 90, you can start setting other goals! 

Morning PT does suck.  I had to do mine at 7:30 in the morning so my Mom could drive me there before work and pick me up on her morning break. I had to wake up extra early so I could massage and stretch well before PT, which made it hurt less.  But after lying all night my knee always hurt more for morning PT.  Ugh!

Jen
1999-ish: L knee hyperextension on trampoline
4/30/2010 Fulkerson Osteotomy and MPFL/LPFL reconstruction
Serving with Peace Corps July 2011-September 2013 in South Africa-knee is happy :)

Offline ParisBaby

  • MINIgeek (20-50 posts)
  • **
  • Posts: 46
  • Liked: 0
Re: MPFL Reconstruction - November 18, 2010
« Reply #26 on: December 20, 2010, 04:23:02 PM »
Day 32

I got to 95 degrees today! I'm getting closer and closer to being able to go around on the stationary bike too.  Today is a good day, although the PT was probably the most painful I have ever had. She had me lay on my stomach and then she bent my knee back toward my butt. ow. that is all I can say. I had to pull out my deep breathing exercises from birthing class and I even got a little teary eyed, but I got through it and I got another 5 degrees, which I am super excited about.  I did another new exercise today too, where I laid on a weight machine and I started doing calf raises and lowering. Basically if I were standing, I would be raising and lowering on my toes, but this gets a good stretch in my calf too since I am letting my weight push my heel lower than my toes. So a semi-normal work out move. lol.  I was up and moving around more this morning too, so that I would try to be looser for PT. (Thanks for the suggestion Jen.) I think it helped.  My son has pink eye and a cough so it wasnt like I was sleeping much anyway. So I figured I might as well get up and get stretched out. :)

The snow has let up a little too so it isnt as scary to walk around. I am taking every opportunity that I have to bend my knee and flex my foot up and down. I find that if I bend it to the max that my brace will allow right now (70 degrees) and then I flex my foot up and down, it gets a better more painful stretch.  Hopefully this is helping with the flex and extension even while I am trapped in meeting with the brace on.

I was also able to do my SLR sets pretty easily today. I didnt even need the finger touch to my foot to get me started. I just started doing them and my PT was helping someone else and came back to me doing them. She was happy about that. I joked that I was ready for the ankle weights now. lol.  I have to wait until I am able to raise it without even the slightest bend and no twinges of straining.  Which I have to admit, I do strain a little and my knee cap hurts when I do them. So I am okay with still practicing and holding on the weights. I am able to balance pretty easily on my leg and the slight resistance band work we have done has been super easy too. 

What a difference a weekend makes! I feel like my attitude has improved so much and I am ready to try more. :) Hopefully I can keep it up and continue to meet my other big goal of 130. After that, a new brace and more freedom!


Offline ParisBaby

  • MINIgeek (20-50 posts)
  • **
  • Posts: 46
  • Liked: 0
Re: MPFL Reconstruction - November 18, 2010
« Reply #27 on: December 22, 2010, 08:24:24 PM »
Day 34

Another day at PT... It was again pretty painful as she is bending my knee more aggressively now, with me lying on my stomach and she is pushing it toward my butt. The good news is that I gained another 3 degrees on the bend so I am officially at 98 degrees before Christmas. This is great news to me, since I couldn't have imagined it before when it hurt so much to bend to 90. I would really like to get past 110 before the start of the new year. Who knows, but I think I can really work on it over the holiday weekend.  She is having me do more exercises involving moving and lifting, seems to be engaging more of all my thigh muscles rather than just my quad. I dont really understand why I am doing them, but I trust that it leads to the overall health of my leg and knee.  It was hilarious to watch my legs as I was squatting. I have my normal leg which has a normal sized thigh, not too much muscle, and then I have my right leg. It is so skinny and little looking. It looks so abnormal compared to my other leg, I burst out laughing when I saw them next to each other. I have looked before and noticed that it was smaller but when I saw them both contracting, doing the same things, it was too much. I think my laughter was slightly horrified too, but also I felt sad. I am not really sure why I was sad, I just was sorry for my poor little leg.  :-\

I gave my PT a Christmas gift today too, and I hope that isnt too weird... The way I see it is that I see her more than I see alot of my friends and I am very vested in how much effort she puts into my therapy. I would like her to know that I appreciate her time and efforts and that I hope we have a successful relationship in the new year. lol.  I should have written that on the card, but I was running late (as usual) and I forgot the card.

So some progress, some holiday time and hopefully a good begininng to the new year.

Offline ParisBaby

  • MINIgeek (20-50 posts)
  • **
  • Posts: 46
  • Liked: 0
Re: MPFL Reconstruction - November 18, 2010
« Reply #28 on: December 27, 2010, 03:14:09 PM »
Day 40

Whooooohoooo! Today in PT I got to 110 degrees and I am so close to being able to go all the way around on the bike. I was so excited when she measured me, I am still a little in shock, like are you sure? Do you want to measure again just to make sure it is right?  ;D  This is fantasic news since that means I have met the goal of the OS for my visit on Wednesday so the pressure is off a little bit, although I am still going to push it since I would like to make sure I am meeting my next goal on time too. So this is a good day, I don't have to go to work today, which makes it a BETTER day.  I am really happy with my progress. I would like to get a little more stability and strength in my leg for when we take the brace off. I feel like I am really shaky with walking and stuff so I will mention that to my PT, since we have bend where it needs to be, lets start working on getting my leg muscles back and use back.
I am happy today!
 

Offline ParisBaby

  • MINIgeek (20-50 posts)
  • **
  • Posts: 46
  • Liked: 0
Re: MPFL Reconstruction - November 18, 2010
« Reply #29 on: December 30, 2010, 02:27:01 PM »
Day 43.

It is officially 6 weeks since I had my surgery. I have to say, I am doing okay, but I wish I were in less pain.  I had my OS visit yesterday and I didnt see my regular OS since he is on vacation. I saw a PA, which I think means Physician Assistant.  He was really nice and positive but he wants to change my brace to the patellar support one.  It is smaller, and a LOT tighter, which makes me really uncomfortable. Plus I dont feel like I am at all stable in walking and whatnot. So I am a little upset and I refuse to wear it. It cut of my circulation so bad that I had the mark from the brace 2 hours after I took it off. I am going to PT today, I am taking my brace and I am going to ask them if this is normal. If not, I am going to call in after the first of the year to see if maybe I need to get a larger one. It is just too uncomfortable for me to wear. So I am wearing my old one for now, I unlocked it to 90 degrees to I am still getting the bend. I am really concerned with my leg muscle support. I feel like it isnt built up enough for me to feel comfortable on it yet everyone wants me to walk around on it like normal. I feel like saying, yeah right are you all crazy? I know I wont do it, my body is already compensating for the weakness and I feel like that is a path I dont want to go down.  I have gotten lazy in my SLR's and I am turning my leg ever so slightly in and that means I am using my hip flexor instead of my quad. I have noticed myself doing it, I am working on stopping but I am lazy sometimes and I just want to move my damn leg.  I am going to talk to my PT aout exercises I can do at home to work on it.   
I also did a new exercise in PT that has me freaking out. He put me on a box about 1 inch off the ground, made me stand on it with my bad knee, and then try to bend my knee and touch my other heel to the ground. I simply couldnt do it. I did like 7 and it was a struggle for each one, with my leg shaking and me saying that I was too scared to do it. I feel like my knee is going to collapse.  I have no support and I have no control over it. I know this is probably mental but I mean, isnt there some way to trick me into thinking I have some support? So needless to say, follow that PT up with the OS taking my support away, really kind of ticked me off. They arent the ones that have to deal with the pain when I do fall or the worry that I will fall in front of a bunch of people and humilate myself. I mean, I had that problem before surgery with my knee dislocating, so why the hell did I go through surgery if the result is the same?
I need to talk to my real OS and talk to the PT and see what I can do. I just feel like a failure because I am too scared to do what they now want me to do.