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Author Topic: How long can surgery wait without making it worse?  (Read 1369 times)

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Offline Kelly17

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How long can surgery wait without making it worse?
« on: February 23, 2012, 04:28:23 AM »
How long can I wait until I end up digging a bigger hole for myself?

I'm still a teenager July 2010 I injured my right knee playing soccer:
-nov 2010 microfracture on patella
-failed procedure
- pain again so another MRI/ showed a 5.6mm deep x 1.0cm wide x 15.0mm long, bad thing on my patella which I'm not really even sure  what that means and it also showed a bunch of cracks in the cartiledge of the patella.
-surgeon recomended OATS
Now I'm wondering how long I can really wait without damaging everything else in my knee. I'm young  and already my dreams of going into the military may be crushed because of my knee. It's getting worse and I'm being more limited on what I can do, I just really don't know anymore. (not that I ever really did) :)

Offline captainruss

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Re: How long can surgery wait without making it worse?
« Reply #1 on: February 24, 2012, 07:54:48 PM »
Mkelly,

If I may ask, why are you waiting?  I understand you have a failed procedure.  What was the procedure and have you lost confidence in the doctor who did it?

I am not saying you need surgery, but you do need to be treated.  Are you doing PT? 

Please find someone (OS) who can advise you.

Russ
80 Shattered patella 5 surg
09  TKR 
09  MUA
09  MUA
09  Knee infected??
10  TKR  Scar Tissue
10  2nd OS  Diagnosis Infection
10  TKR with antibiotic spacer, no joint
4/11  TKR
11  TKR PT
11  TKR
11  TKR  AF diagosis
12/11  HO diagnosed
2012  Intractable Pain
2012  OS split
amputation possible?

Offline Kelly17

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Re: How long can surgery wait without making it worse?
« Reply #2 on: February 25, 2012, 07:30:16 AM »
Russ,
I'm  still able to do most of the things I love and just suffering the consequences after, I'm now with a military surgeon who is fantastic and I have full trust in him... I just want to play until I can't anymore Then have the surgery but I don't want to risk more injury. I know this sounds likes bad plan but I have to get the surgery some time down the road anyways so why stop. I did PT and they did what they could for me but there's not much else to help me other then surgery.
 

Offline captainruss

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Re: How long can surgery wait without making it worse?
« Reply #3 on: February 25, 2012, 09:04:11 PM »
Mkelly,

I actually TOTALLY agree with your thinking for one specific reason.  I was initially injured at 17.  I underwent 5 surgeries over two years with two different OS.  The first wanted to fuse my leg straight at 17 years old.  I was outraged, first at losing my appointment to the Naval Academy, and second at 17 this doctor wanting to make me a permanent cripple.  My second OS did three subsequent surgeries and after a year of rehab with the Western Michigan University Sports Medicine Clinic (I still love you Jill) I was able to function pretty well.

I went 29 years owning and operating my own business and becoming a Captain.  I was in daily pain and my knee swelled every day.  I was able to do anything short of marathons....long runs...or achieving a 4.4 in the 40 yard dash.  I could kneel, I could work and carry heavy weight.  I did have patella tendon (no patella) dislocations from time to time, but other than pain I had no other problems.

I whined to my OS about the pain and was told over and over how a TKR would make me a new man in six weeks.  I would undergo this surgery that is being done by the thousands every day across this fantastic country by some of the best doctors in the civilized world.  My back and shoulder doctor was unable to do the revision because Florida Spine did not allow him to do people who needed revisions that did not originate with their clinic.

So, he recommended another OS who was younger than I am, but was missing his right patella just like I am and had a full TKR and was doing fantastic.  No need for a second or third opinion.  No worries....I had approximate 22 major surgeries after falling off a telephone pole in 1989 and I can do anything.  I should have consulted his OS.

Anyway....I have whined and posted about my trials and tribulations...long story short I should have waited until they had to carry me into the operating room.  I have not worked in 2 years...I am broke....I am definitely feeling outrage and frustration at three (3) different OS who diagnosed me as being infected including their attending Infectious Disease specialists who agreed and told me as recently as three months ago I am infected.  I am amazed that every single culture (test) came back negative, yet because my Ced Rate and C reactive protein levels were high (sign of inflammation...not infection) not one of these brilliant doctors have recognized AF. 

I am considered a bad person if I am angry at my loss of quality time, quality of life, loss of income because these OS treated me until they realized one at a time that they took out a perfectly healthy knee joint multiple times because they diagnosed incorrectly that I was infected.  The first two OS have told me there is nothing more they can do for me and the third, he says he will not revise the HO I have growing in my knee because he is "AFRAID I WILL BECOME INFECTED" if he rolls the dice and does surgery again.  He will fuse my knee straight to lessen the pain I have walking on it or he will amputate it if I want to try a prosthetic, but he can not treat me any longer if I insist that I not torture my fused back and arthritic hip by allowing him to fuse my knee or totally freak out my wife cutting my leg off above the knee.

I am probably going to get chastised for my passionate diatribe, but the simple point is in MY CASE, I could not do any more damage as I was bone on bone already if I had just kept living my fairly quality life.  I took the "easy" way out and I am going to suffer the remainder of my days without the mobility I had prior to having the TKR that was going to improve me for the next 10 years minimum!

Only you can make that decision, but please don't misunderstand.  I was asking why your are not getting treatment for pain or PT to strengthen muscles etc....or even surgery as a last resort....but my question of why are you not getting treatment is not why are you not getting surgery.  I apologize as I am very often misunderstood and I wanted to be clear about my feelings!  Good luck and I hope you will let us know how you are doing!

Russ
80 Shattered patella 5 surg
09  TKR 
09  MUA
09  MUA
09  Knee infected??
10  TKR  Scar Tissue
10  2nd OS  Diagnosis Infection
10  TKR with antibiotic spacer, no joint
4/11  TKR
11  TKR PT
11  TKR
11  TKR  AF diagosis
12/11  HO diagnosed
2012  Intractable Pain
2012  OS split
amputation possible?

Offline LindaM

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Re: How long can surgery wait without making it worse?
« Reply #4 on: February 26, 2012, 09:25:46 PM »
Hey there Kelly,
I am a high school teacher and I absolutely understand your feelings.  I work at a school where athletics are really important and I hear my kids say the same thing all the time.  In your first post you said something that made me wonder, you said that it was getting worse.  Apparently you can still stand the pain that playing gives you, but you are worried too if you are going to push to the point that you can't be fixed and that won't let you have the military career you were hoping for.

I am delighted that you have a doctor you trust.  Have you had a really adult conversation with him on your own, or has it been just quick visits?  You are not a little kid anymore and the conversation should be between the two of you with the parent who is paying as more of an observer.  Sometimes you need to plan ahead for a conversation like that- ask about alternative treatments that are available, consequences for delays, risks of surgery etc. 

As Russ has told you, you can't just ignore this and hope it goes away.  If your doctor has said there will definitely be worse outcomes if you delay surgery, it is time to suck it up and act like an adult about your own health.  You have another 70-80 years to wear that knee and a couple years of playing will seem like a pretty poor choice when you look back on it if it causes you to have a poor outcome when you finally give in and have surgery.

Most surgeries are very successful or they wouldn't be doing them.  This website is terrific for information, but because many people here are asking questions because they are having problems, it can be a little scary.  Do realize that only a few folks that have an ordinary recovery take the time to write about it.

Good luck on your decision making.

Linda 
>20 yrs. osteo and inflammatory arthritis, fibromyalgia
meniscus repair Sept. 2009
right PKR June 2010
left PKR Feb. 2012

Offline captainruss

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Re: How long can surgery wait without making it worse?
« Reply #5 on: February 26, 2012, 10:02:02 PM »
Kelly,

I try to keep a note pad handy.  I jot down all of the questions I think of in the weeks prior to my next appointment.  I keep a journal of sorts describing my pain level, where it hurts, what I did about it, what works and what doesn't work each time.  If I don't, I get nervous when I am in with the doc and think I am taking too much time or sound like a dummy.  I call that little pad my spare brain....as my original brain lets me down in drama filled situations.

As Linda advised, sooner not later....plus ice it every morning and night.  I know it is uncomfortable. 

Russ
80 Shattered patella 5 surg
09  TKR 
09  MUA
09  MUA
09  Knee infected??
10  TKR  Scar Tissue
10  2nd OS  Diagnosis Infection
10  TKR with antibiotic spacer, no joint
4/11  TKR
11  TKR PT
11  TKR
11  TKR  AF diagosis
12/11  HO diagnosed
2012  Intractable Pain
2012  OS split
amputation possible?

Offline Kelly17

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Re: How long can surgery wait without making it worse?
« Reply #6 on: February 27, 2012, 01:45:22 AM »
Linda and Russ,
Thanks so much for your replies, Linda I agree with you and an striving to also take into consideration my next 80 years but its difficult to fully comprehend getting so much older and dealing with some stupid soccer injury... I also agree with you Russ. I do always shut down at the doctors,I HATE telling peope how much somthing hurts because I'm to stubborn and a complete and total tomboy who is far from dainty and I don't tell my parents that somthing hurts but when I do they take my seriously and then I go in and shut down because I don't want to sound like I'm whinning like some other teenager with a injury. I guess after my first surgeon treated me like some annoyance to him I have just stopped really telling doctors my symptoms. My OS said the a MRI looked really bad but since my symptoms weren't really bad I had the option of waiting. I'm kinda stuck between a rock and a hard place because if I have the surgery a huge red flag goes up on my application for the military but if I wait and then need the surgery right before go in because it gets so bad then once basic starts I may not be 100% or anywhere near it.  The other major contributing factor is my parents and them not wanting the surgery until I
absolutely and completly need it.
Kelly

Offline captainruss

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Re: How long can surgery wait without making it worse?
« Reply #7 on: February 27, 2012, 04:37:42 AM »
Kelly,

I have the same problem with my daughter.  She wants to go to the Academy.  We have been trying PT and strengthening to get her into the Academy.  I have decide to improve her so she can pass the entrance exam or do we shoot her with cortisone and have her try to gut through it.  Well, she is getting worse and don't think she will pass.  I just don't want her to get disqualified by a military doctor.

Russ
80 Shattered patella 5 surg
09  TKR 
09  MUA
09  MUA
09  Knee infected??
10  TKR  Scar Tissue
10  2nd OS  Diagnosis Infection
10  TKR with antibiotic spacer, no joint
4/11  TKR
11  TKR PT
11  TKR
11  TKR  AF diagosis
12/11  HO diagnosed
2012  Intractable Pain
2012  OS split
amputation possible?

Offline LindaM

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Re: How long can surgery wait without making it worse?
« Reply #8 on: February 27, 2012, 03:47:52 PM »
Hey there Kelly,

The concept of getting older isn't just tough for high-schoolers, I sometimes wonder what I am doing with such old children.

 When you talk next with your doctor, do follow Russ's advice and have a list.  Saying it hurts is a statement of fact, not whining.  Your doctor can't advise you properly if you don't tell him the whole truth.  Be sure to ask about a timeline for your surgery- when you finally get it, how long is expected recovery time, how much PT, then add about 5-6 additional months to get back to full strength.  This will help you plan the time frame that will allow you to be ready if you still plan on the military.  And think about what branch you want to apply for.  Probably the Navy wouldn't be as concerned about a knee as if you were Army and expected to do more marching, and the field you want to go into would make a difference too.

Take care.

Linda
>20 yrs. osteo and inflammatory arthritis, fibromyalgia
meniscus repair Sept. 2009
right PKR June 2010
left PKR Feb. 2012

Offline captainruss

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Re: How long can surgery wait without making it worse?
« Reply #9 on: February 27, 2012, 07:48:46 PM »
Kelly,

The toughest part is to have the courage to question anything you have a question about.  If you get a funny feeling something doesn't sound correct, I will bet you dollars to donuts in is not correct.  Having the courage to say, "Hey doc, you said Russ' knee was infected yet every single culture and indium 3 phase bone scan can back negative?"  How is it infected yet not growing cultures that show it is infected?  Doc: Well his Ced Rate and C Reactive Protein levels are very high!"  "Okay doc, I went on KG and found out that Ced Rate and C reactive protein are not indicators of infection, but they are measures of inflammation.  Inflammation can often be mistaken for infection as they both cause the same swollen, hot, red, stiff, and lack of ROM conditions as Inflammation can."  Doc:  "We have used Ced Rate and C reactive protein for years to measure infection..."  "Yes sir, but don't you think there is at least the possibility after dozens of tests with negative cultures that the underlying problem might be something else"  Doc:  "My 25 years of experience tells me that despite the negative cultures, if I take out the knee joint and collect samples from inside the fibula and tibia I will have the cultures back in two weeks telling me the specific nature of the infection and will adjust the antibiotics for that specific infection.  We need to schedule surgery for Tuesday."  "Okay doc, you are the expert"  Three weeks post op and I am calling and calling....but no more conversations.  I am laying next to my perfectly healthy knee joint which was removed.  An antibiotic spacer is inserted between my two leg bones.  It is not attached as every time I lift my leg non weight bearing the bones separate sliding on the spacer.  When I put my foot down weight bearing I feel extraordinary pain.  Six months later I still have a spacer....no infection diagnosed.  Yet the surgeon states he can no longer revise my TKR because of the slow recovery,

I understand this is a crazy example, but it is exactly how I ended up with my second of many revisions.  The doctor was well known and very confident.  I was intimidated to the point I could not question him regarding scar tissue.  I had just learned of AF, but the doctor would not discuss this issue or any other issue wit.
80 Shattered patella 5 surg
09  TKR 
09  MUA
09  MUA
09  Knee infected??
10  TKR  Scar Tissue
10  2nd OS  Diagnosis Infection
10  TKR with antibiotic spacer, no joint
4/11  TKR
11  TKR PT
11  TKR
11  TKR  AF diagosis
12/11  HO diagnosed
2012  Intractable Pain
2012  OS split
amputation possible?

Offline Kelly17

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Re: How long can surgery wait without making it worse?
« Reply #10 on: February 28, 2012, 02:19:40 AM »
Russ- I absolutely agree with you about the courage to ask the doctor questions. Next appointment I wil ask away :)
Linda- the recovery before I would be able to do much of anything would be more then a year, and for the military I want to go Airforce or coastgaurd both into the medical field. I just have to figure out what to do next, I don't really have much of a say because m parents so I will just have to ask my doc strait forward what i should do.

Offline captainruss

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Re: How long can surgery wait without making it worse?
« Reply #11 on: February 28, 2012, 03:11:44 AM »
Kelly,

Keep us posted....let us know how you are doing!
80 Shattered patella 5 surg
09  TKR 
09  MUA
09  MUA
09  Knee infected??
10  TKR  Scar Tissue
10  2nd OS  Diagnosis Infection
10  TKR with antibiotic spacer, no joint
4/11  TKR
11  TKR PT
11  TKR
11  TKR  AF diagosis
12/11  HO diagnosed
2012  Intractable Pain
2012  OS split
amputation possible?















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