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Offline COsusie

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Fulkerson Preparation?
« on: December 05, 2010, 04:43:13 PM »
1st post to the board.  I've been lurking since Thursday, when I found out I have to have a Fulkerson on R knee. UG!

So, what have you found to be helpful in preparing for this sx?  I want to go in strong.  Sounds like upper body strength will be important.  I'm sure having the house set up with supplies when I get home will help.  A list of supplies you kept on hand would be great! 

A little background.  In 2004 I took a tumble in a parking lot and had  to have 6 sx to repair damage to various body parts.  2 sx on L thumb to repair the lig that snapped off. 1 sx on L ankle to repair lig damage. A scope of R knee to clean up damage. A microfracture to stimulate cartilage growth. And finally, a carpal tunnel release on R wrist from overuse because my L hand was in a cast or brace for almost a yr.

Any suggestions from vets would be much appreciated!  Thanks!

Offline tink1976

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Re: Fulkerson Preparation?
« Reply #1 on: December 05, 2010, 06:32:34 PM »
Welcome to the board. I had the fulkerson done on my right knee Sept 24.  It was not planned. A LR was and when he went in my knee was too far gone and eneded up doing the fulkerson.

I can only speak for myself. But this is what helped me out. First of all I was not good on crutches at all. I fell when I tried to use them. So I got a walker and that helped alot. Also a backpack.. I would get my parents to get me a 12 pack of soda or juice and carry phone, drink, meds, snacks and everytihng in that back pack as you dont have use of your hands with a walker or crutches.  My dad did put a cup holder on my walker so I can get my own cup of coffee. Lol. Now I was bedridden as the pain was pretty bad for me. But I have low pain tolerance anyway. I used a bedside toliet for about a week until I was more comfortable with getting around. Plenty of magazines, books or anything else you are interested in as bordem really sinks in fast. Once I got out of the bed I used a little stool in the bath room to prop my leg up on when I had to use the bathroom. When my leg would hang down, it would get pretty painful when the blood rushed too it and the brace would push on the brusing.

I had to have help for the first 2 weeks. Bathing was the biggest problem so I did sponge baths at first and got a shower chair that made it eaiser to get in and out of shower. Good luck to you and Im sure you will do just fine. Keep us informed on how you are doing. It can be a long road but you come to the right place for support.

Tink
Dislocations from 93
Fulkerson TTT
LR
Cartledge repair
scrape of arthritis

Offline socogirl76

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Re: Fulkerson Preparation?
« Reply #2 on: January 17, 2011, 03:52:40 AM »
Well this is my first post, and Im thinking it might be good for me.  I  am having a fulkerson done on Febuary 28th.... This is after 3 months of PT shots up the cazoo and what ever else I can do to prolong my time.  Let me tell you i have gotten to the point that I CANNOT wait to get it done!!! I cant walk long periods of time without my kneecap dislocating, stand with out my knee going numb now(by the way that is something new ) kinda weird! I do have to say  i like the bookbag idea, to carry everything. I was wondering how long was everyone out of work after this surgery???? Did it all vary? How long were you in the brace for? Did you use a cpm machine? Any helpful ideas will be much appreicated!!!

Offline smillie

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Re: Fulkerson Preparation?
« Reply #3 on: January 17, 2011, 05:19:23 AM »
There is a pretty wide variety of post-op and rehab protocols. Check with your OS to see what he is going to require. Some will have you locked straight in a brace and NWB for a while. Others go with no brace and WBAT. Find out what yours does.

If you're going to be NWB for a period of time, it doesn't hurt to practice that beforehand to see where your challenges will be. If you're going to be locked straight in a brace, then see what that will be like to see what accommodations you will need. The stool for your foot to rest by the toilet is helpful. Figure out how you can safely bathe. Figure out how you will get food. You won't be able to drive for a while, so how will you get to dr. appointments and PT sessions? Is your house navigable by crutches? Do you need to move or secure any rugs? Do you need to clear any clutter or set up a place to sleep downstairs? Those are the types of things that are helpful to figure out beforehand. You'll likely need someone with you for the first little bit while you see how you handle the pain and get steady on your crutches. It's hard to know how you will tolerate the surgery and the meds.

Upper body strength is helpful. Strong quads are helpful too. The better condition you're in beforehand, the better start you will have on rehab.
patella pain began early teens
'94 TTT/LR/VMO adv.
'94 MUA
'10 tried PT again
1/11 scope/hardware removal
4/11 (Finally!) dx medial instability due to LR
5/9/11 LPFL reconstruction scheduled

cdubb

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Re: Fulkerson Preparation?
« Reply #4 on: January 19, 2011, 12:26:59 AM »
I'll be 11 weeks tomorrow from my TT (Fulkerson or AMZ as my doc calls it) with a patella ACI to repair damaged cartilage and I'm doing quite well at this point, but my recommendations for those early days would be to get a shower chair and a raised toilet seat with handles.  I only sponge bathed and washed my hair in the sink on day 2 post op. Day 3, I was showering braceless. I put a Tegederm patch over my incision to keep it dry and still allow me to shower relatively normally.  It was tricky getting in/out, but I was permitted heel/toe touch weight bearing, which actually helps to maneuver.  I would prop my leg up on the side of the tub. It was exhausting those early days, but it felt so much better to be clean and I found it worth it. 

I also recommend a leg lifter strap. Found this useful to raise and lower my leg safely. It is just a strap with a loop on the end to hook your foot into.

Also purchased a great purse that crossed over my body. I didn't need a full backpack because getting around, I didn't need that much stuff, but I got a Vera Bradley hipster style purse and it worked great.  I also had a crutch bag that I could put bottles of water or my coffee mug in. 

You will see that doc protocols all differ from NWB, WBAT or something inbetween (like me- heel toe touch). I was heel/toe touch for 4 weeks, then 50% at 4 weeks, 75% at 5 weeks and allowed FWB at 6 weeks and to begin weaning off crutches then. I was also allowed to ditch my brace at 6 weeks, which I did. I had good quad control though, which is part of being able to ditch the brace.

I had a CPM, but that was more for my ACI part of my procedure instead of the TT.

Also second the sleeping downstairs if it is viable. I was lucky and we have a guest bedroom on the main floor and we also have a full bath and the kitchen is right there...it was perfect for recovery.  I actually didn't even move back to mine and my husband's bedroom until I was about 5 weeks post op. 

Have somebody with you for the first few days.  My surgery was Wednesday and my husband took off the rest of that week and returned to work on Monday, which was a good timeframe. He would leave before then for a couple hours to go to the gym/grocery/etc. , but only because I was okay alone and was able to get around fine by myself, but others report more difficult with mobility.

Also, stay on top of the pain meds. I never found my pain level beyond a 3-4 tops (except immediately waking up, but a morphine shot took care of that), but I consistently took the pain meds for about 3-4 days. After that, I could switch to prn and was completely off pain meds at 3 weeks post op.  At 10 weeks now, I managed to travel and walk through airports, sit on  planes and in work meetings all day and made it through without any difficulty.  So, it may seem like a lot in the first couple weeks, but if everything goes as planned, a couple months out, you'll be figuring out when to do the other knee!



Offline socogirl76

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Re: Fulkerson Preparation?
« Reply #5 on: January 19, 2011, 03:47:26 AM »
OH MY GOD !!! All this info is soo helpful! We are getting things in order as for people to be with  me and all that .  My husband is going to take a week off maybe 2 then the mother in law.... Im stocking up on shorts also.  How long were you all out of work? I work in retail???? did anyone wear a brace afterwards?

Offline smillie

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Re: Fulkerson Preparation?
« Reply #6 on: January 19, 2011, 07:27:44 AM »
I don't know when you could go back to retail. I went back to a desk job part time after a few weeks, but there is no way I could have stood up for long periods of time. Are you just having the Fulkerson or will there be a LR or medial reefing or anything with it? The more you have done, the longer it can take to recover. Read through a few post-op threads to see what they could do at various stages of recovery. Also ask your OS what he anticipates for your return to work. Just know that rarely to they over-estimate the time off work. It is much more common for them to under-estimate it. Unless there is a way to work sitting down, you need to think of it as a broken bone and you'll need that bone to be healed before you can stand on it all day. You also need to be careful about swelling. Standing brings on the swelling fast and swelling makes healing difficult. The more time you invest in your recovery, the better your outcome from the surgery will be. And whatever you do, set the expectation with your employer and family that all of these time frames are just an estimate and it will really depend on how YOUR knee tolerates the procedure and how your recovery goes. Cdubb's recovery is wonderful. Others have had much more difficult recoveries that have taken a lot longer. Patience is definitely requires. Don't rush it!
patella pain began early teens
'94 TTT/LR/VMO adv.
'94 MUA
'10 tried PT again
1/11 scope/hardware removal
4/11 (Finally!) dx medial instability due to LR
5/9/11 LPFL reconstruction scheduled

Offline socogirl76

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Re: Fulkerson Preparation?
« Reply #7 on: January 20, 2011, 04:17:40 AM »
Thank you so much for that info... As of right now they are doing the fulkerson, I know that there is alot of cleaning up they have to do.  I go to the OS in 2 weeks for x rays and everything else,(get my scripts for all the meds and what ever else).  As for the time off of work I have atleast 13 weeks right now for recovery, but like you just said I cannot rush it.  It all depends on how my body takes it.  I dont know how work is going to take it if Im out longer than that.   :P  How long were you in the brace after the surgery?  But again thank you for the info! Gave me some more questions to ask the OS... I will let you know what the OS is planning to do...

Offline smillie

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Re: Fulkerson Preparation?
« Reply #8 on: January 20, 2011, 03:46:22 PM »
Mine was done 16 years ago, so I don't know that my protocol is a good example. Plus I had more done than you are having. I was in the hospital 5 days, was non-weight bearing for a while (weeks?) and was in the brace for a good long while. I also ended up with a lot of scar tissue and ROM problems. Look for a post-op diary from "Doublemom". I think hers is probably a lot more typical for what you will see these days. There are probably others, but I haven't read a lot of the Fulkerson diaries.
patella pain began early teens
'94 TTT/LR/VMO adv.
'94 MUA
'10 tried PT again
1/11 scope/hardware removal
4/11 (Finally!) dx medial instability due to LR
5/9/11 LPFL reconstruction scheduled

Offline tink1976

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Re: Fulkerson Preparation?
« Reply #9 on: January 20, 2011, 04:52:44 PM »
I had my Fulkerson done 9/24/10. I was in a brace for about 8-9 weeks ( untill the bone was healed) It was a locking brace that kept my leg straight for a few weeks.. Then i was allowed to unlock it and walk and the brace moved with my knee. I could take the brace off at night, when I was resting or showered but had to have it on anytime I was up moving around. Best thing to do is talk to your OS. Some people have had a full cast and others had a brace like mine. I was non weight bearing for 1 week then it was as tolerated. I was on crutches for 3 weeks as my leg was weak and I needed extra stablity.

Everybodys exp with this procedure is different. As for me. I am now almost 4 months post op and I still go to PT 3 times a week. It has taken me a while to get 125-129 ROM. Mainly from my muscles being so tight. I have had problems with my shin hurting and retaing fluid but I will say that it gets better every day. Take your pain meds as perscribed. I agree with the person about a shoulder bag and shower chair. I sponged bathed for a while as I have a low tolerance to pain. When you are home alone, make sure u have lots of snacks and bottle drinks that u can throw in a bag. I had a small backpack that I kept pain meds, phone, snacks and drinks in and took it where ever i went. Also when you use the bathroom.. it may not be a bad idea to get a stool or a few books to put ur heal on as sometimes gravity can be pretty painful. Start PT asap. I waited and did in home therapy as it was my right leg and I couldnt drive and didnt have a driver and with the PT starting so late I got pretty far behind in my recovery. Once I got in outpaitent PT I went from 76 ROM to 125-129 in less then 2 months and my knee feels alot better and the swelling is down alot. Good luck to you and let us know what your OS says.

TInk
Dislocations from 93
Fulkerson TTT
LR
Cartledge repair
scrape of arthritis

cdubb

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Re: Fulkerson Preparation?
« Reply #10 on: January 21, 2011, 02:36:12 AM »
I think you'll find that you don't need as much help as you think you will and one week is probably more than sufficient for your husband to take off.  If he has extra vacation time though, it's nice to have the company!  It gets lonely and bored being home alone all day....daytime TV sucks...I was on knee geeks a lot though!  If you read my diary, I had postings several times/day in those first weeks.  Now, I'm lucky if I get one once or twice a week! I was up and around the morning after surgery in the kitchen preparing myself breakfast.  Moving the food from kitchen to eating location is what is tricky on crutches.  Using a bag to put food in really help.  This sounds funny, but the best bag I found is a bag from Caribou Coffee. It's the bag that they put the coffee beans in when you buy bags of beans.  It has a solid bottom and good handles and isn't too bag.  Works better than a grocery story plastic bag.  After my husband returned to work, he was still wonderful in making my coffee, putting it in my thermos and setting it by my "station" on the couch and leaving me a bowl of grapes and crackers to minimize my having to get up when he wasn't there.

Agree with starting pt right away.  I started on day 12 post op with formal pt.  My range was also more restricted because of the patella ACI. I could dangle to 90 degrees a couple times/day, but other than that the CPM couldn't go beyond 45 until after week 4.  After 6 weeks, I could begin to progress more and it just came back.  Surgery was 11/3/10 (I'm now 11 weeks, 1 day) and on Monday I measured 133, which is only 10 degrees off from my right knee (which incidentally was also scoped the same day as my patella ACI and TT).  I just recently dropped to twice per week because three times was getting too crazy with  working full time, rushing to PT and it was putting a lot on my husband for picking up our 4 year old from daycare/preschool, as well as my stepkids on some nights.  2 is enough for me now and I am pretty independent in exercises and we also purchased a stationary bike.

As for work...working in retail will make it trickier to return because you need to be on your feet a lot of the day.  I have a sedentary job and initially was approved for 6 weeks.  I returned earlier though because I felt I could.  I started working from home at 4 weeks and then I went into the office at 5 1/2 weeks.  Even sitting at a desk all day with my foot propped up on a box of paper under my desk, my knee/foot/ankle swelling increased in those first couple weeks.  Major cankle!! Returning earlier than I did would have been difficult because I couldn't drive until my brace was unlocked to 60 degrees because I didn't fit in my car any earlier to drive until I had enough motion.  When I do my right knee, I may need to take the full 6 just for driving purposes...although, I could maybe just stay working from home.

Remember though...everybody is different in their doctor protocols and recovery.  So, while this board is very helpful in getting ranges of what is normal/expected and getting ideas on dealing with some of the logistical things post operatively, try not to compare your recovery to others too much.















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