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Author Topic: Bilateral MPFL Reconstruction-7/25  (Read 19358 times)

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Offline franny

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Re: Bilateral MPFL Reconstruction-7/25
« Reply #30 on: September 07, 2012, 10:05:15 AM »
Hi Teach2Many,

Sorry to hear that you are in pain. I too have returned to work and am really struggling - I'm a few weeks further on from you (2 months post op) and I'm still struggling with swelling and pain.  I dont know about you but i just cna't make myself sit down much whilst im teaching! Sleeping is a nightmare for me too! At the moment I'm taking a combination of ibroprofen and codine which is hardly touching the pain.

The only suggestion I can make is that I am going to take an ice pack into work as we have a kitchen in one of the classrooms (with a freezer), I'm going to try to ice at lunchtimes. I dont think I will manage this all the time as I usually seem to be rushing around trying to sort one problem or another but I'm going to try and make a concerted effort to make time to ice! 
I'll let you know if it makes any difference to pain levels.

If I can think of anything else I'll pass it on.

Have a lovely weekend.

F
x
Bendy Childhood
1999 - Dislocation R Knee-cap
2002- dislocation L knee-cap & arthroscopy
Many subluxations & instability in both knees
2008- gave birth to daughter, PGP, subluxation and instability following birth
2010- dislocation L knee-cap
2011- EDS III diagnosis 
02/07/12- MPFL Reconstruction

Offline Xeplasma

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Re: Bilateral MPFL Reconstruction-7/25
« Reply #31 on: September 08, 2012, 03:57:52 PM »
Let's try this again. I wrote a lengthy reply yesterday only to realize that I had lost my Internet connection( and phone!!!) when came time to post.
I hope this finds you in less pain today Teacher and your hip starts behaving a little. :(
Standing in front of/ teaching to a full class is hard enough, having to do all the extra physical things you're faced with( lifting children) is unthinkable to me. Lots of hugs to you.

Offline Teacher2Many

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Re: Bilateral MPFL Reconstruction-7/25
« Reply #32 on: September 08, 2012, 07:34:50 PM »
Thanks for the virtual hugs!   ;D  This week has definitely been trying-increased amounts of pain, most likely due to being back at work full time which equates to increased amounts of tears and crying in PT!  ROM is increasing but very slowly:  L is at 88 hanging over the edge of the table and it should have been at 90 doing that 2 weeks ago.  R is a bit better with passive flexion measured at 102.  I'll be sending my OS an update at the end of next week with measurements, pain update, limitations, etc. just to give him a heads-up of concerns, issues, etc. prior to my appt.

If my left hip can talk, I can only imagine the nasty things it would be telling me every day!  Clearly, the cortisone didn't do anything, which I doubted it would, and since I am flexing my hip more to compensate for the limited flexion of the knee, it causes increased impingement on an already aggravated hip.  My hip OS will be getting an e-mail sometime this weekend requesting specific info on the surgical procedure, rehab, etc. so that I can start thinking about that decision while being more informed.

I am off to my niece's 3rd birthday 'fiesta' as she's having a Dora theme complete with a taco bar, flan, etc.  Wondering how I'm going to get there, as she lives on the second floor.   ???
6/07-L TTT & LR
6/08-R TTT & LR
6/09-Bilateral ACI
7/10-R derotational femoral & tibial osteotomies, LPFL reconstruction
6/11-L derotational femoral & tibial osteotomies, R hardware removal
1/12-L tibial hardware removed, R scapulectomy
4/12-L femoral hardware removed
7/12-L & R MPFL reconstruction

Offline Teacher2Many

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Re: Bilateral MPFL Reconstruction-7/25
« Reply #33 on: September 12, 2012, 03:15:59 AM »
Quick update:  7 weeks post-op tomorrow and it feels like it should be more than that!  Today ROM on the right measured at 105, the left is still about 88-92 with the same issues present on the left; severe pain, limitations, etc.  The knees have been buckling more which I know is due to weak quads and increased physical demands-the muscles just can't keep up as they tire so easily due to their atrophy and weakness.  Still unable to do a SLR on the left but the right is okay.  The left knee has been having this sense of 'impingement' ANYTIME going from flexion to extension.  Used to only be after long periods of sitting but now even just bending and then straightening out the leg causes this very sharp and intense pain on the medial side, weakness, inability to put weight through that leg, etc. but only for a few minutes and then it passes.  Very similar to the impingement in the hip and in the shoulder but not sure if you can get impingement in your knee.

There has been a large 'pocket' of swelling on the right along the anterior tib-PT thought it was due to overuse of the anterior tib to compensate for walking, etc.  The last few days it's gotten a lot worse and is now on the left leg as well.  So I talked to PT today (not the one I usually see but have seen him quite a few times) and asked what he thought about it.  Nothing that I do seems to help-meds, icing, elevating, etc. and since it's getting worse, clearly it's something to address.  He thought it was lymphadema due to all the surgeries I've had and scar tissue being built up around my lymphatic system and he consulted with one of the other PTs there who works with patients with lymphadema and she agreed.  So they applied a 'spiderman like web' on both legs out of kinesiotape to help the draining of the swelling through the lymphatic system.  Need to keep an eye on it to ensure it's not compartment syndrome, as that was mentioned as well, but hopefully this will help.  It is tender with pressure but not necessarily to the touch.  The added in using the graston (sp?) tools today and also hooked up stim to the quads with it going on/off bilaterally while doing wall squats.  So not comfortable-told my PT there should be a reverse therapy day where patients treat the therapits and hook them up to all of these weird types of contraptions.   ;D

Sleeping is still difficult and painful; can't lay on my side at all-laying on the right kills the medial portion of the left leg and laying on the left kills the lateral portion of the left leg and the left hip so I'm stuck on my back but that still causes pain and issues.  Would love nothing more than a full night sleep, even if only 6 hrs.-one without pain and interruptions from the pain would be heaven!  Stopped taking pain meds since I couldn't find one that actually helped and figured why take them if they're not really doing much good.  I return to my OS on 9/24---hoping for a good report and one that doesn't include the need for a flexionator.
6/07-L TTT & LR
6/08-R TTT & LR
6/09-Bilateral ACI
7/10-R derotational femoral & tibial osteotomies, LPFL reconstruction
6/11-L derotational femoral & tibial osteotomies, R hardware removal
1/12-L tibial hardware removed, R scapulectomy
4/12-L femoral hardware removed
7/12-L & R MPFL reconstruction

Offline YogaGirl

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Re: Bilateral MPFL Reconstruction-7/25
« Reply #34 on: September 12, 2012, 07:40:15 PM »
Man, Teacher... You are just not catching a break on this at all are you?? That stinks.  :( I can't imagine the lack of good sleep, especially going on 7 weeks now. When I lay down tonight I will send good sleep vibes your way!

Its good to hear you're still cracking jokes in PT and going to 3 year-old's parties (did you get there, by the way?). Its so important to have those moments to just laugh and release that power that we can sometime let an injury hold over us.

You're doing great, it probably doesn't always feel like it, but you are. Keep thinking positive thoughts, and even find positives in the lows... You'll be feeling better soon  :)
www.peaceloveknees.com <---- check out my MPFLr blog
www.brightskyyoga.com

Offline Xeplasma

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Re: Bilateral MPFL Reconstruction-7/25
« Reply #35 on: September 13, 2012, 07:23:57 PM »
Hang in there Teacher!!
I'm hopeful for you that OS will not go 'flexionator' route, it seems that you're making good progress in spite of pain.
Sending you a new wave of virtual hugs. 130 ROM is getting closer everyday and hopefully all this taping is going to get rid of the lymphodema.

Offline Teacher2Many

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Re: Bilateral MPFL Reconstruction-7/25
« Reply #36 on: September 13, 2012, 11:13:15 PM »
Thanks for the wishes ladies!  I too am hoping that the 'spiderman' taping helps but yesterday the legs seemed more swollen than ever with increased pitting edema so we'll see.  Taking the tape off tonight when I shower to wash thoroughly (& shave) so that they can retape tomorrow.

Getting the 'flexionator' would not be my ideal choice but if that's what it takes to get those final 20-30 degrees of ROM than I'm game.  The limitations at work are killing me (as is the pain) and I think ROM needs to come first before strength can fully be addressed.  We'll see-1.5 more weeks until my OS appt.

YogaGirl-Yes, I did get to the party.  Slow & steady was the key with going up/down the stairs-had to lock the knees in extension when going up as it was too painful to bear weight with them in flexion but we managed, which is good, because I wouldn't have missed it for the world!
6/07-L TTT & LR
6/08-R TTT & LR
6/09-Bilateral ACI
7/10-R derotational femoral & tibial osteotomies, LPFL reconstruction
6/11-L derotational femoral & tibial osteotomies, R hardware removal
1/12-L tibial hardware removed, R scapulectomy
4/12-L femoral hardware removed
7/12-L & R MPFL reconstruction

Offline Xeplasma

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Re: Bilateral MPFL Reconstruction-7/25
« Reply #37 on: September 18, 2012, 10:25:29 PM »
How is it going Teacher? Is the taping working?

Offline Teacher2Many

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Re: Bilateral MPFL Reconstruction-7/25
« Reply #38 on: September 19, 2012, 03:05:35 AM »
Thanks for checking in...things are going.   ???  Work doesn't seem to be getting any easier with all my little ones and am getting a new little one on Monday of this upcoming week (which of course I won't be there for as I'm taking off that afternoon for my post-op visit).  My AM class is a handful with a lot of aggressive behaviors and my PM class has a few runners so I'm never sitting/resting for more than 5-10 minutes at a time.  The knees hurt all day every day and seem to be getting more irritable at bedtime probably because of all the activity during the day.  The kinesiotaping does seem to be help with the lymphedema when it's on.  However, when it's off (ie I take it off when it starts to peel/come off and it then gets reapplied the next day at PT), the swelling returns right away but at least it helps when it's on.

There has been some clicking/popping in the knees a few times which I always attributed it to swelling and/or muscle weakness.  This past Friday, PT was pushing the R knee to bend to measure ROM and it very loudly 'cracked'-he heard and felt it, as did I.  Since then, the R knee has been popping/clicking like crazy (countless times/day) and I've had to realign it a few times.  Really hoping it's due to swelling, etc. and has nothing to do with a failed MPFLr.   :-\

But I go back to the doc on Monday and am excited to get some answers.  I sent him an extremely long e-mail this past Friday, as I had a question on the ice machine (the company called and said they had new orders to deliver it-thought maybe PT requested it due to swelling but ended up being a paperwork mix up) and sent a very detailed and lengthy update for his info, not expecting a response.  He said to bring a copy with on Monday and we'll go over all of it and he'll have answers to all my questions.  Biggest concerns are the limited ROM, continued pockets of swelling, immense pain in the left knee, and overall pain interferring with sleep, daily activities, etc.

Hopefully some answers...and something to help with the pain!
6/07-L TTT & LR
6/08-R TTT & LR
6/09-Bilateral ACI
7/10-R derotational femoral & tibial osteotomies, LPFL reconstruction
6/11-L derotational femoral & tibial osteotomies, R hardware removal
1/12-L tibial hardware removed, R scapulectomy
4/12-L femoral hardware removed
7/12-L & R MPFL reconstruction

Offline Teacher2Many

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Re: Bilateral MPFL Reconstruction-7/25
« Reply #39 on: September 20, 2012, 03:38:24 AM »
Feeling defeated...8 weeks post-op today and with passive ROM, the R measured at 100 and the L at 99.  Neither are making much progress and the R has been around 100-102 for the last 2-3 weeks. 

Hoping for answers on Monday!
6/07-L TTT & LR
6/08-R TTT & LR
6/09-Bilateral ACI
7/10-R derotational femoral & tibial osteotomies, LPFL reconstruction
6/11-L derotational femoral & tibial osteotomies, R hardware removal
1/12-L tibial hardware removed, R scapulectomy
4/12-L femoral hardware removed
7/12-L & R MPFL reconstruction

Offline Teacher2Many

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Re: Bilateral MPFL Reconstruction-7/25
« Reply #40 on: September 25, 2012, 12:44:34 AM »
You know it's never good when your OS uses the 'f' word during an office visit!

8 weeks, 5 days post-op and after 30 direct minutes with my OS, we are all definitely perplexed as to what's going on.  No definitive answers at today's appointment but a cortisone shot was done in the left knee in an attempt to see if the pain is coming from within the joint (if it is alleviated with the shot, then the answer would be yes), a script for a Medrol dose pack given to see if that helps with the pain (he was quite upset to hear about the significant high pain levels and the meds that should work that aren't...his reaction and comments when I told him that the oxycontin doesn't even touch the pain were a bit humorous), and am scheduled for bilateral knee MRI on Saturday with a return visit to go over the results and figure out a plan of action next week Monday.  He's not sure if the pain is coming from inside the joint or from the area of the graft, if the screws are contributing to the pain, if there's an issue with the actual graft, etc.  Fingers, toes, and eyes crossed that the MRI shows something (not that I want anything to be wrong but I would like to have the answers as to why things are the way they are).

Per OS orders, PT is canceled for the rest of the week and we will see what Monday's appointment holds before canceling any more.  Wasn't too happy about that, as I know how hard it is to get back flexion after a long weekend without PT and the thought of going 1.5 weeks without PT isn't great, but I think there is a fear of making things worse with therapy since we aren't really sure what's going on.
6/07-L TTT & LR
6/08-R TTT & LR
6/09-Bilateral ACI
7/10-R derotational femoral & tibial osteotomies, LPFL reconstruction
6/11-L derotational femoral & tibial osteotomies, R hardware removal
1/12-L tibial hardware removed, R scapulectomy
4/12-L femoral hardware removed
7/12-L & R MPFL reconstruction

Offline Xeplasma

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Re: Bilateral MPFL Reconstruction-7/25
« Reply #41 on: September 26, 2012, 08:00:58 PM »
Oh man, crossing fingers and everything for you here. :(
I really hope he(/you/they/someone!!!!) figures it out very quickly for you. Sending you tons of virtual hugs!

Offline Teacher2Many

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Re: Bilateral MPFL Reconstruction-7/25
« Reply #42 on: September 28, 2012, 12:07:21 AM »
Thanks for the hugs!  MRI was today...never shed tears before during an MRI but having to keep those legs that still and in that position for 1.5 hrs. killed! 

Got the CD with images and the only thing I could definitely make out was the screw from the MPFL, all of the screw holes from the multiple other surgeries, the tibia fracture line from the past surgeries, what appears to be some fluid within the joint (or at least that's what I'm thinking from past images), and a big black blob on each knee.   ;D  The rest I can only speculate on what I'm seeing based on what I know from past imaging, surgeries, etc.  Radiologist in training I am not!  I should get the radiologist's report sometime tomorrow so that will give me time to review it over the weekend before my appt. first thing at 7:45 am on Monday morning.  Keeping fingers & toes crossed that although I don't want there to be anything majorly wrong, would be nice if something showed up to explain all of the issues, symptoms, etc.

Should have some answers in less than 24 hrs....   ???
6/07-L TTT & LR
6/08-R TTT & LR
6/09-Bilateral ACI
7/10-R derotational femoral & tibial osteotomies, LPFL reconstruction
6/11-L derotational femoral & tibial osteotomies, R hardware removal
1/12-L tibial hardware removed, R scapulectomy
4/12-L femoral hardware removed
7/12-L & R MPFL reconstruction

Offline YogaGirl

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Re: Bilateral MPFL Reconstruction-7/25
« Reply #43 on: October 02, 2012, 02:36:31 PM »
Hey Teach- Its Tuesday... so what'd you hear??
www.peaceloveknees.com <---- check out my MPFLr blog
www.brightskyyoga.com

Offline Teacher2Many

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Re: Bilateral MPFL Reconstruction-7/25
« Reply #44 on: October 03, 2012, 01:45:39 AM »
So yesterday I met with my OS to go over things after the MRI.  Summary of the visit:  "I don't know."  The things he was looking for on the MRI were okay-the graft is good (no tears, etc.) and the screws are still in place (possibility of them pulling out).  So who knows!  The MRI report stated there was swelling within the joint (worse on the right than the left) and some femoral condyle cartilage damage (worse on the right than the left) but neither of these findings were mentioned yesterday.

I guess it's a good thing-wasn't really wanting there to be anything wrong but at the same time, an answer would be nice.  We did talk about flexion as I'm only about 95-105 depending on the day/knee at 10 weeks post-op.  He said that full flexion isn't typically gained until 4-6 months...my response "oye"!  Seriously, why did that never come up in any other prior visits or in any pre-op discussions?  He won't consider doing any other type of manipulation, clean-up of scar tissue, etc. until I hit the 4 week mark so I'm just to keep on trucking, continue with PT 3 days/week (tried to push for 5 but he didn't think that was best due to the swelling), and just push harder with the pain, etc.  He gave me a new prescription to take nightly-one for percocet.  Never had this one before but had to try something.  Took one last night and it did seem to help slightly; at least I slept a little bit more.

The downside to this all is that I'm back to popping those knees back into place 10-20 times/day.  Granted, much better than the 50 times/day it was prior to surgery but didn't think I'd be doing it at all.  Still hoping that part of it is due to fluid within the joint and surrounding tissues so we'll see if this improves over time or not.

I go back in 6 weeks for another visit so we'll see what is said then (and the cartilage issue will be addressed then as well, especially if the patella pain symptoms persist).  Until then...more tears will be shed trying to get these darn knees to bend which is fine...dealing with the pain is nothing if it means limitless mobility in a few months! 

Sometimes you just got to suck it up and keep on trucking...
6/07-L TTT & LR
6/08-R TTT & LR
6/09-Bilateral ACI
7/10-R derotational femoral & tibial osteotomies, LPFL reconstruction
6/11-L derotational femoral & tibial osteotomies, R hardware removal
1/12-L tibial hardware removed, R scapulectomy
4/12-L femoral hardware removed
7/12-L & R MPFL reconstruction