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Author Topic: Personal Knee Accountability  (Read 1015 times)

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Offline allyd

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Personal Knee Accountability
« on: January 11, 2013, 08:05:03 PM »
I post this not to accuse or point fingers or question anyone’s condition on here… but after a couple years of posting, and reading experiences. I’ve recently realized one thing. Rarely have I seen written: “I failed to do the rehab, I didn’t listen to my doctor, I tried doing this to soon and caused this to happened”. There are two sides to every story. Why is it we all as patients automatically assume our Doctor or PT has failed us in some way if things aren’t quite right with our knees? We as individuals have just as big of a responsibility/role in the success as they do, do we not? I know it’s not even close to the end-all answer to post/pre-op complications… but how much of a component is individual accountability?

Again truly, truly not posting this to question’s anyone’s condition. Just a general post for us all to stop and think about the big picture – and possibly inspire positive changes in our own lifestyle/attitude/recovery. Thoughts anyone? What comments have you received from doctor’s that seemingly are a bit brash but when you stop and think you realize “yeah, they are right” or “I wish I would have listened and done that differently” – I ask because I feel many doctor’s won’t tackle the elephants in the room, and instead give answers like – you’re fine, I can’t help you… but what they really mean is “I can’t help you until you’re ready to help yourself” (I personally got the “you’re fine I can’t help you” for 2 years from my first OS… but when my attitude/commitment changed, his diagnosis/treatment changed pretty quickly then too)

Looking back on my journey - I know I personally am accountable for some of the mishaps I faced along the road to even get TO surgery, let alone as I recovered from surgery. Post surgery, I’m thankful I have a doctor that is sometimes all too quick to point out MY shortcomings in order to get me back on track to success. In those moments, I have the choice to be offended or take the reality of the advice. Because what’s more offensive on the part of a professional really, saying the truth, or not saying anything at all?

In short. I think it would be great to post some personal stories of accountability. We should be just as willing to learn from our personal mistakes as we are from those of our doctors.
04/09 RK - Dislocated Patella & Grade III MCL Tear
06/10 RK - Re-Dislocation Patella
09/11 RK - MPFLr + Lateral Lengthening

Offline kimb

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Re: Personal Knee Accountability
« Reply #1 on: January 12, 2013, 12:23:05 AM »
I agree with your general sentiment. However, a doctor being the one that has gone through the years and years of training and education, are the ones we go to for answers. I think a good attitude and partnership with your doctor is of the utmost important. However, I don't think it's ok for a doctor to tell you "you are fine and I cannot help you" just because they don't like your attitude, and then change to "oh, something IS wrong and I CAN help you." People vary a lot on how they deal with various situations, and it's very frustrating as most people here know to be laid up and we hope for answers from a doctor. That said, if a doctor told me he could not help me, I would go to another doctor and not continue to see one that refused to help me find answers when I know something is wrong with my body.
 
Another part of the responsibility means being mindful and aware of our bodies. You can't just expect to see a general practitioner and say "my knee hurts" and get very far. You need to be exact and specific with the information you give them and what you hope for an outcome.
 
I was told by the first doctor I saw to wait for 3 weeks before coming back, and that I didn't need to stay off my knee unless I felt the need to. Turns out his advice could have caused my knee further damage, and the symptoms I had should have been a sign to refer me to someone who could help me much sooner than 3 weeks later. I knew better so I got a second opinion. You have to both be your own advocate, but know when you found a doctor you can trust. It's not always an easy balance to strike.
 
But in return, doctors owe patients honesty, and if they don't know what is wrong, they need to let go of their egos and be able to say "I'm sorry, but your problem is beyond my abilities but I can refer you to see this other person." In places where we don't have socialized medicine, we pay insanely high prices to see doctors. If I didn't have insurance, it would have cost me more then $400 for the doctor to tell me to come back in 3 weeks and to suck the blood from my knee. Most people cannot afford to throw that kind of money at a doctor and then be told they cannot be helped because the doctor doesn't like their attitude.

Offline allyd

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Re: Personal Knee Accountability
« Reply #2 on: January 13, 2013, 05:13:29 PM »
kimb thanks for posting your story. You make some great points, and I agree we all need to advocate for ourselves and be aware of our bodies.

To clarify my story a bit - as a I think snippet quotes can make doctors sounds more cold than they are. My first OS, never was unhelpful, left his door open, and basically said... you SHOULD be fine, but if your not, come see me. Well, it was simply my choice/responsibility/willingness to put the effort and time in to utilizing those years of experience/knowledge. With a change in attitude, he also got more information, more details, etc. - which allowed him to properly diagnose.

Had he thrown out a quick easy fix early on, I really doubt the surgery would have been a success, as I wouldn't have put the effort into rehab, etc. - So, offering surgical options may have done me more harm than good at that point.

There is a lot of truth to the idea we all deal with situations differently. I guess looking back personally, I've seen my own short-comings - and see that not all statements by doctor's are as black and white as we see them.
04/09 RK - Dislocated Patella & Grade III MCL Tear
06/10 RK - Re-Dislocation Patella
09/11 RK - MPFLr + Lateral Lengthening

Offline Maverick

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Re: Personal Knee Accountability
« Reply #3 on: January 14, 2013, 03:12:36 AM »
Allyd, thank you for posting this journal.

Dealing with any surgery and pain is a challenge.  Since reading your post I have been wondering the best way to respond. 

I have had 4 knee surgeries as well as other surgeries.  For any situation in our life, surgery, injury, etc. we have to take control and be accountable.  There are great, good and bad surgeons and physical therapist.  It is up to each of us to find the right fit.  What works well for one person does not work for the other.

I am blessed to have a great OS AND PT.  I have worked with them since 2006 and we, together, have worked through a number of challenges.

I am sure that one reason they both have stuck by my side is that 1) we have had a very open communication and 2) I have put in 100% effort into my rehab.  I bring this up because I see some posts (not all), that note that they didn't or don't do their PT or listen to their OS.  I also have some friends that complain constantly about their knee and when I ask them about their rehab or PT program, the response is "oh, I didn't do that" or "it was too painful" or "I would rather watch TV".  I feel for these people but the surgery is the easy part.  You have to work through the rehab, do the work, do your part.  The OS can only do so much.  If you don't put in the time and effort, even through the pain, then your OS will likely say, "there is nothing else I can do." 

I spent a year rehabbing from microfracture surgery.  I have never had such a painful journey.  I spent more time and effort managing the pain than not.  But, I did the PT weekly, put my time into the gym and strengtheing and when we did not get results, I could honestly tell them that I did my part and they agreed. 

The long and short of it is that surgery is the easy part and rehab is the hard part.  If your not willing to put on the time then don't do the surgery.  You will be worse off.

This is not to judge or rant but a fact of anything that we do in life.  This forum has been great for me to understand my situation, know that I am not alone and get advice.  I hope that this opinion is respected.

Thank you!
1976 Arthoscopy, damaged cartilage
2007 Lateral release of the patella
2011 Meniscectomy and microfracture (grade 4)
2012 Debridement / Chondroplasty
2013 CRPS left knee

Thank you, Maverick

Offline allyd

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Re: Personal Knee Accountability
« Reply #4 on: January 14, 2013, 04:01:19 PM »
Maverick – I think you did a better job of conveying my message than I did. The simple concept of “you get out of it, what you put into it” – knee rehab is hard work. And my doctor is also very quick to point out that what she does in the OR is the easy part.

I for one LOVE the sense of accomplishment I have in successfully rehabbing my knee. And I think that’s what’s great about realizing how much of a role the patient plays in the process. I don’t just say “I have an amazing OS/PT that fixed my knee” – I say “yeah, I have a great OS/PT, but I worked my butt off to reach my goals, and they were my goals, not her goals – I did that part of it.” So, while it’s great to be personally accountable for some of the ‘failures’ of our knees, we also get to be accountable for the ‘success’ as well! And I for one am proud of all the work I put into my knee. 
04/09 RK - Dislocated Patella & Grade III MCL Tear
06/10 RK - Re-Dislocation Patella
09/11 RK - MPFLr + Lateral Lengthening

Offline JTB

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Re: Personal Knee Accountability
« Reply #5 on: January 14, 2013, 05:02:25 PM »
ALLYD, Mav and all the usual suspects,

I agree it is as important to have patient accountability with respect to rehabilitation from medical procedures, just as it is crucial to have MD accountability. Of course surgical competency has, for better of for worse, a profound influence on patient outcomes, but that said and all things being equal (if that is possible), so does patient competency in their role as active participants in their recovery/rehab. There are other variables that factor into and that influence outcomes: competent physical therapists, physician assistants, etc. It is a long list and there is no room nor need to be comprehensive here.

I have had several major injuries/procedures over the years and have always had successful recoveries and outcomes and they required extensive rehab and I was always a very active participant in my recovery and rehabilitation. Why wouldn't I be, with such a vested interest? I still do extensive PT 6 days a week for my back and shoulders, above and beyond the PT that I have been doing to address my current knee problems. I have my TENS unit on right now as I type this. It feels nice  :D   

I do appreciate the flow of ideas here. I know a lot of us here feel as if our backs are against the wall, well because when you're battling to just walk and get your life back, it is! And that sense can sometimes force our thinking to be defensive and one-sided, making us overly sensitive to what we perceive as criticism. Sometimes though, in order to create and possess a more comprehensive protocol to assess our own situations, a certain amount of healthy contention is necessary to move down the  road to recovery and improvement, along with the support, kindness and understanding that is in abundance here and usually a given at KneeGeeks
« Last Edit: January 15, 2013, 12:15:36 AM by JTB »
Bike racer electing sport-med scope Jan 2011 for patella catch: shave patella, MFC and trochlea (with sneaky lateral release) Grade 3 findings. @ 1 year, CRPS, pain inhibition, muscle atrophy, osteopenia, sudden bilateral chondromalacia. in free-fall 2 1/2 years.
Today on Strava riding well.

Offline allyd

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Re: Personal Knee Accountability
« Reply #6 on: January 14, 2013, 06:30:59 PM »
JTB, thanks for weighing in. I definitely agree with all you have to say… and want to stress to all reading the intent with my initial post isn’t to give PT’s or OS’s a free pass, or to minimize their impact of all involved on a successful outcome – but simply to look at the specific component of what WE can do and what role WE play in the success/failure. I just felt it doesn’t get discussed enough, and like you say, at some point, our backs are all up against the wall – and could use a little encouragement/reminder to push forward and do our part to make it a success.
04/09 RK - Dislocated Patella & Grade III MCL Tear
06/10 RK - Re-Dislocation Patella
09/11 RK - MPFLr + Lateral Lengthening

Offline jt801

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Re: Personal Knee Accountability
« Reply #7 on: January 15, 2013, 10:20:09 PM »
This is an interesting thread. I had microfracture surgery in 2009 but my O/S did not prescribe any kind of rehab other than the CPM and said i could ride a stationary bike (but only after i asked about it).  The literature available says that proper rehab is critical for the mfx surgery to be a success so i question why my doctor didn't prescribe any. Also, the majority of articles i've read suggest that returning to sports is a bad idea after microfracture for situations like mine (full thickness defect in weight bearing area). However, the O/S said it would be fine and i should get back to full activities if that's what i wanted to do. As of today i've been on a full schedule of work, sports, and anything else i've wanted to do for 3 years with minimal problems. My question is what's a person to do in the face of such a bunch of conflicting information?
12/99 left knee lateral release and plica removal
1/09 right knee chondroplasty and microfracture LFC















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