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Author Topic: WonkeyDonkey's Open Wedge HTO Diary 07/12/2018  (Read 252 times)

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Offline WonkeyDonkey

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WonkeyDonkey's Open Wedge HTO Diary 07/12/2018
« on: December 13, 2018, 08:28:31 PM »
Here we go again!!   High Tibial Open Wedge Osteotomy Right Leg.

Background
•   have had 2 arthroscopies and an open wedge high tibial osteotomy on left leg
•   Have had pain in right knee and hip since Nov 2017, tried physio and steroid injection in hip
•   New Hospital
•   New consultant (another one featuring on KneeGuru)

Operation Day - Day 1 – Friday 07/12/2018

Arrived at hospital at 10.45am having had breakfast at 6.30am and water until 10.30am when I left home. I was shown to the ward and my bed. I had my obs taken, blood pressure upslightly! I wonder why!!! The physio fitted me with my crutches, showed me how to use them and I had a practice. I was visited by my anaesthetist and was talked through the anaesthetic, this time I was to have a spinal block and sedation. I was a little weary of having the spinal block but opted for it, with plan B being a GA. I also saw my consultant and discussed with him what was being done, he drew an arrow on the right leg. I was first on his list all being well.
I was wheeled down to the theatre and had the spinal block and sedation, I didn't know anymore until I woke up in the recovery room. The difference of the spinal block and a GA was that I didn't have that horrible sick feeling and grogginess. Knee was covered in a big bandage and padding so couldn’t see anything. Wheeled back to the ward and felt reasonably ok, even managed to eat some sandwiches. At this point I was being given paracetamol, and some liquid morphine. Had a visit from my consultant, to be told it had all gone well and that the correction was 6-7 degrees. He would see me again in 6 weeks.

Day 2 – Saturday 08/12/2018

I hardly had any sleep as my obs were being taken every 1 or 2 hours. Think I nodded off between 12am and 2am to be woken up. Struggled to sleep as I normally sleep on my side but had to lie on my back. Knee throbbed.
Today I started on my blood thinning medication this morning, 1 small tablet a day for 2 weeks. I also am taking paracetamol, liquid morphine and ibuprofen. I also started wearing socks to help reduce DVT, have to wear them for some weeks. Lovely!!
Should have been out of hospital today, but after breakfast and using a cryocuff during the morning, I had a visit from the physio, I was got up on my crutches which was a very painful experience and a simple walk along the ward was agony. I am on partial weight bearing for two weeks, then full weight bearing. I was not passed by the physio to go home and she didn’t even get me to do the stairs on my crutches. The pain got worse and I had a bit of a meltdown, cried on the shoulder of the nurse with another nurse drawing up more morphine. The amount of morphine was increased from this moment on.

Day 3 – Sunday 09/12/2018

Slept quite well last night, woke up once for the loo and a dose of morphine and went back to sleep until drug round at 6am.
Just after breakfast the physio came round and got me up and it was my turn to try the stairs today. Too say it hurt is an understatement, I was got up, sat in a wheelchair where she tried bending my leg as it seemed not to bend. I explained that I had had previous problems with the muscles tightening up and staying very tight. She released the muscle by pushing her fingers on it and gentle the pain eased. Unfortunately when it gets really tight it gives me terrible hip pain. Then I was  wheeled to the stairs. Back on crutches, went up 3 small stairs and 2 slightly deeper stairs. My pain levels where sky high. The physio signed me off on going up the stairs but not for the pain control. So back on the ward my meds were reviewed and the paracetamol was changed to Co-Dydramols, these are stronger than paracetamol, which I had been taking before I had my op! I was asked to note down hourly the amount of pain I was in so they could work out my pain relief. A bottle of liquid morphine was also got ready for me to take home, along with Co-Dydramols, Ibuprofen and the anticoagulants. I used the cryocuff on and off all day.

Day 4 – Monday 10/12/2018
 
Had another fairly good night sleep, only waking for the loo and some morphine.
Today I’m going home. I was helped to have a lovely hot shower today, Wow, it felt good!! All clean and dressed I was ready, packed and dosed up with meds, ready to go home. Drive was only about 20 minutes and then I retired to the sofa. My lovely husband waited on me, with drinks, food, cryocuff and anything else I needed. I have my own cryocuff container from previous knee ops and a new sleeve from the hospital. I had filled my freezer with pots of ice to start the process off ready for coming out of hospital. I was tired and kept nodding off during the afternoon. I wrote myself a list of all my medications and when I should take them. I have written down each time I take some as it’s easy to get muddled up and miss an important dose. I struggled up the stairs to go to bed. Why are the stairs you practice on so different to those at home?? I went up on my bottom using my arms to lift myself up. My husband came up with me to help. It was not an easy task.

Day 5 – Tuesday 11/12/2018

Had a fairly good night’s sleep, using the cryocuff and my meds, only woke to more morphine. Lazed in bed during the morning, when I got a phone call from the physio dept., saying I need to go in this week and an appointment had become available today. I explained I only came out of hospital yesterday, but apparently my file was marked urgent, so off to physio I went! Went through what had happened before my op and during my stay in hospital, think they were concerned about my pain and not being able to do the exercises. I managed to bend my leg about 70 degrees at the end of the session. So we went through some exercises and by the time I was home again my knee pain levels were high and I broke down into tears. I ended up taking more morphine and going to bed, with my cryocuff.

Day 6 – Wednesday 12/12/2018

Not a bad night’s sleep, only woke up once for the loo and morphine. Had a lazy day on the bed today, best mate came round so that cheered me up. Took the rest of the day easy and some of the swelling has gone down a little. Still trying to do the physio exercises regularly. Leg bends are better over the side of the bed or toilet than if I try to bend it myself. I close my eyes and breathe slowly and relax, the leg goes with the gravity. I am struggling to bend my knee when walking on my crutches.

Day 7 – Thursday 13/12/2018

Another fairly good night’s sleep. Woke only for morphine and went back to sleep. Changed the beautiful socks, thought it would be harder than it was, managed on my own. Came downstairs and stayed downstairs all day. Stayed awake too! Phoned my doctors surgery to arrange a telephone appointment with my GP for Monday afternoon, it’s mainly to sort out enough medication for the Christmas period and an appointment with the nurse next Friday to change the dressings. All sorted I thought I would phone to arrange Employment Support Allowance. Finally got through after hanging on for over 30 minutes, a few details taken then told my local JobSeekers would call to make an appointment. They did call to tell me I needed to go to their office for an appointment!! Joke, I said I had just had a major operation on my leg, was on crutches and couldn’t get there, so they are calling me back tomorrow. Maybe they will make a home visit. Have been making sure I have taken all my meds roughly on time. Pain is just about under control, but have the possibility to up the morphine dose if required.

Offline WonkeyDonkey

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Re: WonkeyDonkey's Open Wedge HTO Diary 07/12/2018
« Reply #1 on: December 27, 2018, 09:44:51 PM »
Day 8 to 13 Friday 14/12/2018 to Thursday 20/12/2018

Still taking all the pain meds I was given, added Lactalose to combat the side effects of all the tablets. I have had some good days and some not so good days, which I have slept through the day, not being able to keep my eyes open. I have not used my cryocuff quite so much over this week. Some days my calf muscle hurt a lot and felt it needed stretching, which I tried a bit only made my leg hurt more and I couldn’t put my foot flat on the floor. I seem to have got the pain under control now except on Tuesday when I had a session with the physio. I was walking better on my crutches, putting my whole foot down and bending my knee more. I still only got to 70 degrees to start with but got more during the session. The physio asked how I was going up and down the stairs at home, and I had to confess that I was still going up and down on my bottom. So she had me walk up the 4 steps, using one crutch and the hand rail, and down again with one crutch and the hand rail. Managed this ok, but their steps are completely different to mine at home. By the time I got home my leg was hurting big time. I dosed up on some more pain killers which didn’t really do their job as I would have hoped.

Day 14 Friday 21/12/2018

Today I had the dressing changed on my leg. It looked a bit of a mess by the time all the dressings, steri-strips and stitches had been removed. I have to say I was a little upset looking at the swelling, wound and redness. Still the length of wounds, were probably a little larger than I had thought they would be. I have to remember I must not compare with the left leg osteotomy, as they have used something different to my left leg. I had an iodine dressing put on the part that had not healed properly and then all covered with two dressings.

After this my son took me to see my father in the nursing home, I did not sit very comfortably so therefore came home with a sore leg again. Spend the afternoon resting it.

Day 15 to 16 Saturday 22/12/2018 to Sunday 23/12/2018

Had a lazy day Saturday, as my leg still hurt from the day before but eased off in the afternoon. Finished my blood thinning tablets this morning, so that’s one less to remember taking each day. Sunday my daughter picked me up and took me and my son to visit my dad again in his nursing home. We spent a lovely time there but again I paid for it not sitting comfortably when I was there as my leg hurt during the afternoon. I took extra pain relief to ease the pain.

Day 17 – 19 Monday 24/12/2018 –Wednesday 26/12/2018

Had a lovely day with my grandsons (age 2 and 4), opening all their presents, being careful not to get my leg knocked in their excitement. I kept on top of all my pain meds and have felt better in myself today. I feel that my leg and foot are walking better and touching the floor even upon getting up first thing in the morning. I have been doing my physio exercises regularly and trying to bend my knee more each time. I have even managed to do them at 3am in the night when I haven’t been able to sleep. I know and understand the importance of all the physio exercises in order to get the range of movement back in my leg. My husband has had to help me shower, and I had to change the dressing on my leg myself. I’m still wearing socks to reduce DVT’s.

Day 20 Thursday 27/12/2018

Today I had a day where I just could not keep my eyes open for long. I slept all morning on and off. I had taken my pain meds when needed and just nodded back off to sleep. I had tried to read but fell asleep with the book in my hands. I finally got up about 2.15pm. Had a lazy day, walked about a bit, and have not taken 2 of my doses of morphine lunchtime and teatime, pain is still manageable.

Tomorrow I have an appointment with the surgery nurse to change the dressings again. Hopefully they will have healed so that I do not need them dressed and they can dry up in the air. I will start to rub them with Bio Oil when the time comes.

Offline WonkeyDonkey

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Re: WonkeyDonkey's Open Wedge HTO Diary 07/12/2018
« Reply #2 on: January 03, 2019, 09:34:38 PM »
Day 21 Friday 28/12/2018

Today I had an appointment with the surgery nurse. She took the dressings off, cleaned up the wounds and redressed a small area with an iodine pad and dressing. I am to keep the dressing on until Sunday evening, and then it can come off and get the air to it. Can’t wait. Wounds feel tight and I feel the skin needs some moisturizing. Towards the end of the day the skin feels very tender where it has been poked and prodded. I am coming to terms with what the wounds look like and do not find them as shocking as I did. There is still some redness and bruising around the wound area but generally they are definitely improving.

Day 22 Saturday 29/12/2018
 
Today I went out and visited my Dad, but sat awkwardly and the leg got uncomfortable and by the time I got home it was hot and swollen. Rested it during the afternoon and ended up taking extra pain relief to help.

Day 23 Sunday 30/12/2018

Leg is still a bit swollen from yesterday so I took it very easy today, had a lovely shower with my husband’s help getting in and out on crutches. Luckily I have a stool to sit on in the shower so I can rest my leg. Dressing was taken off and it definitely is starting to look better underneath. I managed to come down the stairs on my crutches and not on my bottom so I must be a little more confident now.

Day 24 Monday 31/12/2018

I had a restful morning followed by a physio session in the afternoon. My Physio checked my wounds, and said they were healing nicely and to start massaging them with cream like E45 to break up the scar tissue. I managed to bend my knee 105 degrees, lifted my leg up with no problem, walked fairly well with both crutches but when one was taken away I was a little tentative about it and walked nervously. I was shown again how to go up and down the stairs, although I have been going up on my crutches for a few days now. After asking my physio, I was also shown how to hold both crutches when holding on to a rail coming down the stairs. I was told to carry on on both crutches when outside as I’m only 3 weeks out from a major op, but try using one when indoors. We are going to reassess this in about 3 weeks when I see the physio again. Knee hurt after the physio session so had to take extra pain relief.


Day 25 Tuesday 01/01/2019

Following the physio session yesterday I had a rather easy day today as my leg was still hurting a bit. I’ve kept up with all my pain relief.

Day 26 Wednesday 02/01/2019

Went to visit my Dad again and afterwards I went for a little walk to the local post box which is at the end of my road, and also pottered around the house, by the afternoon my leg was hurting and felt really stiff. It was lovely to be outside for a while. Must try to look at where I am going and not so much at my feet when walking. I got my cryo cuff out and iced it on and off during the evening. I kept on top of my pain relief.

Day 27 Thursday 03/01/2019

Didn’t sleep well last night so am a little tired today but I went out with a friend today for an hour, walking round a craft shop and then walked down to the post box again. Knee is feeling hot and stiff again, so rested it during afternoon and kept up with pain relief. I’m still wearing the socks to stop DVT, but take them off for breaks during the day. I am trying to keep up with the physio exercises, but on occasions I have not done them all, due to pain.

Offline WonkeyDonkey

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Re: WonkeyDonkey's Open Wedge HTO Diary 07/12/2018
« Reply #3 on: January 23, 2019, 04:46:51 PM »
Now 6 ½ weeks Wednesday 23/01/2019

When I look back on the last couple of weeks:
•   I’m sleeping better, and can actually sleep on my side for small amounts of time, then have to go on to my back, which is currently hurting upon turning and straightening the leg. I use a soft pillow between my knees to stop them rubbing together.
•   I have reduced the amount of pain relief I’m taking, no more morphine but still taking
Co-dydramol, although less and Ibuprofen
•   I have a small piece of one the wounds which still has a scab on it so not completely healed. I have 2 scars, the main one is approximately 8cm long and the smaller one is 4cm long. In general both scars are healing well and I rub the area around them with either E45 cream or Avon Tissue Oil twice a day.
•   I can bend my knee more, I can confidently walk around the house using one crutch, I use both crutches when outside or when my leg is getting tired, normally in the late afternoon/early evening.
•   I have been very positive through my recovery, only had a couple of meltdowns, when the pain has got too much but in general keeping the pain under control is my top priority.
•   I have walked to the post box on a number of occasions on my own, although it’s not far away.
•   I can get in and out of the shower on my own, not requiring help to get out, although thanks to my husband for all his help up to this point. I am using a shower stool whilst in the shower so as not to stand for too long or slip in the shower. I prop one crutch up by the shower door.
•   I have managed to walk around the supermarket with my husband on a couple of occasions, realizing that people are just plain ignorant about how hard it can be on crutches, I’ve had people walk out in front of me not looking where they are going, a child pushed a trolley into the arm part of my crutch, with no “Sorry” from either child or parent, and a pushchair pushed into the side of me!! Why aren’t the population more considerate? It puts me off going out, but then there are lovely people who offer you help, their seat, move out of your way, let you go first and generally the “good guys”
•   I find that when using crutches it is easy to look at where you are putting the crutches down and your feet, so will try to concentrate on looking up a little more.
•   I have watched a video on YouTube, about this operation using the Tomofix metal plate, made by my previous surgeon, and found it quite interesting (not if your squeamish) just to see how the operation is done and why bits of me hurt post op. It gives you a better understanding of what goes on.


Today I have been to see the physio, we talked about how I was getting on, and she commented that my walking was much better than when I last saw her. She measured the flex in my knee and it was at 130 degrees with no help. I am very pleased with this; I started at 135 degrees before the operation so not much more to go. Today at physio I tried walking without crutches but it was a little painful, so for the time being I am back on one crutch indoors. I also tried to go up the stairs just holding on to the rails each side and no crutches. I currently use one crutch on the stairs at home. I managed but could feel pain starting to build in my leg, so was told to continue with one crutch. I have lots of lovely exercises to continue with and a couple of new ones to try. I am to try using the bottom stair leading with my operated leg and to do step ups. I can also start to use my exercise bike for about 5 minutes at a time with no resistance.
I have worked hard on my physio exercises and now need to concentrate on strengthening the muscles. This should then help to get me off the crutches and back walking on my own.
I was also told that just because I was doing well, better than my previous osteotomy, I must not overdo it as this can cause strained muscles etc. and more problems, so to take my time with my recovery. Seeing the physio again in 3 weeks.

I can feel that already this operation has worked as the arthritic pain has gone and I only have post-op pain which I am keeping under control. I know it is a long recovery, having done it before, but hopefully it will all be worth it. In about 12 to 18 months the Tomofix plate will come out.

I have an appointment with my Consultant in 2 days’ time, so will up-date after that.

Offline WonkeyDonkey

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Re: WonkeyDonkey's Open Wedge HTO Diary 07/12/2018
« Reply #4 on: February 04, 2019, 07:51:01 PM »
7 – 8½ Weeks 29th Jan 2019

I went to see my consultant last Friday, had x-rays and was told that “at 6-7 weeks patients don’t normally come in smiling” I was having a good day and feeling good about my progress. We discussed how I was doing, looked at the x-rays where we could see the bone starting to fill in the gap and he checked my wound which still has a small scab on. All looking good. I asked a few questions that I was curious about and was given the answers. I am allowed to go swimming but not breaststroke legs. I was also reminded not to overdo it on a good day. I’m seeing my consultant again in May.

Yesterday I went for a walk to the doctor’s surgery and the chemist, a round trip of approximately one mile. I started off fine, concentrated on walking upright and not looking at my feet. I got to the surgery and was starting to feel tired. In hindsight I should have stopped and had a sit down, but didn’t. I then walked a little further to the chemist, texting my husband that I was on my way back. I then started the walk back, feeling a little tired at this point. The further I walked the slower I got, about half way back my knees were hurting, my hands were feeling sore and my self-esteem was dropping. If there had been a seat maybe I would have been okay. I carried on plodding very slowly, steps getting smaller and very uncomfortable back home. Why do I think I am super invincible?? By the time I got home both knees hurt, my hands hurt, I felt tearful and fed up. My recovery just took a nose dive downwards. It took my one and a half hours from the time I left home to the time I got back, a trip I have always taken for granted. Not doing that again in a hurry! I will take to doing smaller distances and building up before I try that again. All dosed up on pain relief, I had an uncomfortable night’s sleep and awoke at 4.20am and struggled to get back to sleep. I’m taking it easy today.

I must learn not to overdo it. Took a few days to get back to the way I was before my stupid walk!!
 
Moving on, I have tried to walk a little each day, although my knee feels quite stiff and tight. The skin feels like it hasn’t any extra to give, even though I massage it every day with either moisturiser or oil. With the snow I haven’t been out for a couple of days but went for a little walk today.

Over the past 10-14 days my knee has been super sensitive and I cannot stand anything resting on it in bed, having to put my leg outside the covers, and even the soft trousers I have been wearing have made it feel strange. I can’t really describe how it feels!

Offline Vickster

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Re: WonkeyDonkey's Open Wedge HTO Diary 07/12/2018
« Reply #5 on: February 04, 2019, 07:58:56 PM »
Did you mention the sensations in your leg to the Consultant? If it doesn't improve, you should in case you're developing a complication like CRPS (rather than it being cut nerves starting to come back to life)

Good luck for your ongoing recovery :)
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up

Offline WonkeyDonkey

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Re: WonkeyDonkey's Open Wedge HTO Diary 07/12/2018
« Reply #6 on: February 04, 2019, 08:20:45 PM »
Thanks Vickster for your suggestion.

I didn't mention it to my consultant as it had only started a couple of days previous to seeing him, and I just thought it was the nerves getting back together. If it carries on I will phone his secretary and get an appointment to see him.