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Author Topic: Dr.'s appoinment...what to ask him?  (Read 2262 times)

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Offline newbie

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Dr.'s appoinment...what to ask him?
« on: October 16, 2002, 05:33:10 AM »
Well, I am going back to the OS on Fri. and am supposed to be scheduling my LR to be done in Dec. while I am there.  I was just wondering if any of you had any suggestions for things that I might want to check with him before "signing up" for the surgery.  He is a big time specialist in the city so I feel like if I want to talk to him I have to take my oppertunity now. Thanks for any advise you might have!

Offline Linds

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Re: Dr.'s appoinment...what to ask him?
« Reply #1 on: October 16, 2002, 06:10:43 AM »
Good luck with your appointment and the surgery I am currently 8 months post op from my LR.  ;) The number one question, infact the only one I could think of is..
Why does he think that the LR is the right surgery for you? The LR has a reputation for not working out as it should. But done for the right reasons and not because they just do it because it is the first step... is important
Take care and good luck
Hugs and Healing
Linds :)
1997 Scope RK
2002 LR RK
2002 Scope and hematoma evac RK
2004 LR LK
May 06 Fall from Horse, partial ACL tear and meniscus injury, Tibial plateau injury
2007 Scope, Plica Excision and Debride LK
2009/2010- Possibly Ankylosing Spondylitis?

Offline newbie

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Re: Dr.'s appoinment...what to ask him?
« Reply #2 on: October 16, 2002, 06:19:27 AM »
I know what you are saying.  That is a great question, but I asked it already at my first appointment.  He is doing it because I have an obviously tilted patella.  I already had an exploratory knee arthroscopy last year and they idn't find anything. (different surgeon did it)  But when the new doctor looked at my Xray he said that the patella was severely tilted so I need a LR to fix it.  I am hoping that he is right.  What do you think?

Offline Linds

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Re: Dr.'s appoinment...what to ask him?
« Reply #3 on: October 16, 2002, 04:20:49 PM »
Sounds good to me. Some Os's will use a LR surgery to  correct a lateral tracking patella..maybe sometimes it works, but it is designed to help a tilted patella. That is what I had. My LR has corrected my tilt, but I am still in a ton of pain. So I am actually off to get xrays today, and bone scan in two days. They think that it is the cartilage damage that is already there from years of maltracking...but these tests should shed some light.
Take care and good luck
hugs and healing
Linds ;D
1997 Scope RK
2002 LR RK
2002 Scope and hematoma evac RK
2004 LR LK
May 06 Fall from Horse, partial ACL tear and meniscus injury, Tibial plateau injury
2007 Scope, Plica Excision and Debride LK
2009/2010- Possibly Ankylosing Spondylitis?

Offline Janet

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Re: Dr.'s appoinment...what to ask him?
« Reply #4 on: October 16, 2002, 05:10:11 PM »
I would also ask exactly what he is going to do. Will he just be doing a lateral release? What about medial reefing? (Sometimes they loosen the lateral retinaculum, then tighten the ligaments on the medial side to keep the patella in place.) If he is planning a medial reefing, the rehab is different (i.e., non-weight bearing, brace, etc.).

Also, find out what to expect following surgery. Will you
be weight bearing? Will you be on crutches? For how long? How about stairs? Will you need help at home? Should someone stay with you for 24 hours or longer? If you are non-weight bearing, you will definitely need help!

Ask when you should start PT. I began PT three days following my LR, and had to make the appointment a month before the surgery.  Ask how long to expect the rehab to take. Ask how long you should expect to be off work.

Ask if he thinks the LR will solve all your problems. My LR was very successful in that my patella is now tracking in the groove. But we went in hoping for a 50% improvement in my condition, knowing it wouldn't solve everything. If I had thought it was the final answer, I would have considered it a failure. Know what to expect!

Good luck. Let us know how things go.

Janet
Torn quad tendon repair & VMO advancement 4/99, MUA with LOA 10/99, Patella baja and arthrofibrosis, LR & medial release & LOA 5/01, LOA & chondroplasty 6/03,TKR on 11/06, MUA 12/06. From perfect knees to a TKR in 7 years, all from a fall on a wet floor...and early undiagnosed scar tissue.

Offline newbie

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Re: Dr.'s appoinment...what to ask him?
« Reply #5 on: October 17, 2002, 02:30:14 AM »
Thanks for your ideas.  I was also wondering if you had any good recommendations for a knee brace.  The one I wear now is just a soft sleeve and it is constantly falling down (especially when I wear tights under it).Plus it doesn't feel tight enough.  The doctor told me to wear it all the time (except for bathing and sleeping) and I do feel SOME difference with it on because when I take it off my knee kills!  But I really think I need a different one.  ANy suggestions that I might talk to the doc about?

Offline Ross

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Re: Dr.'s appoinment...what to ask him?
« Reply #6 on: October 20, 2002, 03:58:44 AM »
Newbie, if the soft support keeps slipping down it sounds to have lost its elasticity or perhaps your leg has wasted down a bit and you really need to get a new one fitted.  It is not meant to constrict blood flow to your foot, just provide some support for your knee ;)

I'd be inclined to ask your OS for a referral for a new appliance.
I'm a grumpy old bear with a busted knee.  The growling you hear is my tummy rumbling!

Offline Leentje

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Re: Dr.'s appoinment...what to ask him?
« Reply #7 on: October 20, 2002, 06:23:54 PM »
Hey Newbie,

Make a list of questions and write them down on a piece of paper. That way you can look at your list, otherwise you'll forget some questions.

I would ask :
1. Why a LR?
2. Will he do a medial reefing also, some cartilage cleanup or just a LR?
3. Does your OS think it can take away all your pain or can he give you a % of pain that will still be present after surgery? (my OS said you will have a 50% pain post-LR of what you have now)
4. Rehab? Weightbearing? With or without crutches? How long? So you can organise yourself. PT?
5. Ask him some pré-op quad exercices! Good advice : do SLR, hundreds a day!
6. How long will you be out of work/school?
7. ...

Every OS works with different procedures, follow up what your OS says and keep the advice of others in mind. My LR was a failure (50% eh?) because my maltracking was extremely bad!

Ask your OS to be honest with you. That way you know what to expect. Good luck on friday

Helena
Bilat patellar malalignment/PFdysplasia
00/06/83 L wrist #
11/12/00 L knee LR + chondroplasty
21/08/02 L knee TTT
02/03/04 L knee stretched PCL
11/09/07 L ankle dislocation/medial avulsion #
25/05/09 L ankle medial avulsion # AGAIN!
05/06/13 R ankle dislocation

Offline newbie

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Re: Dr.'s appoinment...what to ask him?
« Reply #8 on: October 20, 2002, 09:19:48 PM »
Hi Helena!
Thanks for the advise.  I went to the Dr. on Fri. and we have officially scheduled the surgery for Dec. 24th (don't worry, I don't celebrate Christmas so it is not interfering with the holidays for me) ;)  But even though I got to this post after I went to the doc I think I did a pretty good job of asking questions.

You said to ask:
1. Why a LR? He said because of the tilt of the patella, he thinks this will straightne it out.
2. Will he do a medial reefing also, some cartilage cleanup or just a LR? He said that he will look around wile he is in there and will clean up anything that needs to be done but he doesn't think I will need medial reefing (thank goodness!)
3. Does your OS think it can take away all your pain or can he give you a % of pain that will still be present after surgery? (my OS said you will have a 50% pain post-LR of what you have now): He said this should hopefuly take away most of my pain...but no promises  :-/
4. Rehab? Weightbearing? With or without crutches? How long? So you can organise yourself. PT?  He said that rehab will be for a while but I can be weightbaring after two days (as tolerated)  and that I shouldn't need the crutches for more than 2 weeks.
5. Ask him some pré-op quad exercices! Good advice : do SLR, hundreds a day!:  My OS is great, he has already had me working on my quads for 2 months!
6. How long will you be out of work/school? I am a preschool teacher so I am doing the surgery over vacation.  I will hopefully end up missing only 4 days of school at the most. (But I am not trying to lie to myself, I know that going back to those little ones with my knee all sore after surgery will be no picnic)

The only thing that really suprised me about my visit was that my OS insisted on explaining the surgery one more time before we "signed on the dotted line" and when he showed me where the insicion will be (inside of my knee) I almost freaked out.  It is going to be between 4 and 5 inches long!!! YIKES!  I said to him..."that's gunna hurt" and he most certainly agreed.
Oh well, this is hopefully all for the best.

By the way, any ideas on a brace I can wear.  
Ross was correct, I talked to my OS about my brace and he said it doesn't fit properly because my quads have wasted a bunch.  So he told me to wait until I have my surgery and they will fit me for a new brace.  BUt I wondering if you had any good braces that I could suggest to him that are better than others?
Thanks again!

Offline Leentje

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Re: Dr.'s appoinment...what to ask him?
« Reply #9 on: October 20, 2002, 09:52:20 PM »
Hey Newbie,

Where will the "scar" be? On the inside of your knee? I had a LR and it was a scope, only 2 little (now invisible) scars! Is your OS doing an open LR? And why is the scar on the inside? Sorry, it's not clear to me... Helena
PS my OS opted for a Genutrain brace (Bauerfeind) but I think lots of people here have a PTO brace by BREGG
Bilat patellar malalignment/PFdysplasia
00/06/83 L wrist #
11/12/00 L knee LR + chondroplasty
21/08/02 L knee TTT
02/03/04 L knee stretched PCL
11/09/07 L ankle dislocation/medial avulsion #
25/05/09 L ankle medial avulsion # AGAIN!
05/06/13 R ankle dislocation

Offline Heather M.

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Re: Dr.'s appoinment...what to ask him?
« Reply #10 on: October 21, 2002, 12:11:37 AM »
I also had my LR done arthroscopically.  LR started out as an open procedure, but it seems to be more common to do everything witha  scope these days.  Maybe because scarring is always a concern with LR and an open incision leads to more scarring?  Perhaps that's why the incision is on the inside, away from the LR site?  Just a thought.

I did meet one person in PT who had an open LR, and she said her doctor had always done them that way....
Be warned, though, that an open surgery takes longer to recover from.  

I never had a brace and can't wear the PTO on my knee now because it puts too much pressure on the site of the lateral release.  Just ask your doctor what kind of things you can be doing at home (quad sets, bending, etc.) after the surgery and before PT so you get a jump start on recovery.

Heather
Scope #1: LR, part. menisectomy w/cyst, chondroplasty
#2-#5: Lysis of adhesions/scar tissue, AIR, patellar tendon debridement, infections, MUA, insufflation
#6: IT band release / Z-Plasty, synovectomy, LOA/AIR, chondroplasty
2006 Arthrofibrosis, patella baja
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Offline chica_2626

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Re: Dr.'s appoinment...what to ask him?
« Reply #11 on: October 21, 2002, 03:18:34 AM »
I have a BREG brace and it seems like a good enough brace but only if I'm going to be walking around a lot...I'm not quite sure what type of brace it is but it is designed to stop my patella from moving off to the lateral side.  I did notice though that it caused me discomfort if I was sitting down or driving...so I don't wear it too often...only if I'm going to the mall or those rare occassions I try to go walking with friends when my knee feels like cooperating with me!!
Lateral Release Right Knee 6-21-02
Peroneal Brevis Tendon Repair Right Ankle 6-29-05

Offline Leentje

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Re: Dr.'s appoinment...what to ask him?
« Reply #12 on: October 21, 2002, 09:43:06 PM »
Hey

I just wanted to add something, I found the open LR less painfull than the scope LR. After my scope I had stabbing pain for MONTHS at the LRsite, after the open procedure I only felt some nagging pain for a few days.


Helena
Bilat patellar malalignment/PFdysplasia
00/06/83 L wrist #
11/12/00 L knee LR + chondroplasty
21/08/02 L knee TTT
02/03/04 L knee stretched PCL
11/09/07 L ankle dislocation/medial avulsion #
25/05/09 L ankle medial avulsion # AGAIN!
05/06/13 R ankle dislocation