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Author Topic: Bill's MPFLr LPFLr Rehab  (Read 261 times)

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Offline frustrated101

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Bill's MPFLr LPFLr Rehab
« on: February 02, 2019, 02:12:07 PM »
After careful consideration, Iíve decided to do a diary.  Partly to vent, partly to help future surgical victims or those injured by life.  Long story short, I went in for AIR, LOA, and debridement surgery 1 year ago and a world-renowned idiot decided to stick a knife through my LFPL and MPFL ligaments after I was under the gas to improve pain and function.  Yes, you heard that right folks, he stuck a knife through ligaments to improve function but ended up crippling me athletically.  I ran a half marathon 1 month before seeing him and my passion is kiteboarding, I haven't done either since surgery and I can't even walk down stairs anymore.  I move like an old old man, I'm 33.  Iím pretty sure the dumbest pre-med student would have known not to do what he did, or at a minimum to ask the patient for their consent first.. He also bent by leg awkwardly during surgery (or at least Iím presume that) because I developed a painful snapping over my fibular head post op and it irritates the heck out of my peroneal nerve.

Anyhow, enough of my venting, Iím 10 sleeps post op and hereís where Iím at.

Pain-controlled with oxycontin, Percocet, ibuprofen and Tylenol.

ROM-about 90

Stairs- One at a time both up and down

Swelling-still swollen

Gait-Jacked up
 
Mental State- Not good

Gym
Elliptical-3 minutes-peroneal nerve aggravation
Treadmill-speed 1-uber slow-walking backwarsds with a focus on firing the quad-16 Minutes
Seated Leg press machine- 60lbs, 8 reps, 3 sets with a focus on the quad, super small ROM
Elliptical-3 minutes- no peroneal nerve aggravation second time around, better ROM as well
   
I know this may seem like a lot, but other LPFL MPFL posters (the late greyliston, smillie) were on the stationary bike at day 8.  I cannot do stationary bike because my ROM isnít enough yet, I think you need 110.  I also got the ok from my surgeon for everything. 

I attempted to attach some photos but file sizes too big.  Will fill in more back story as I go, I have plenty of time to fill
« Last Edit: February 02, 2019, 06:25:57 PM by frustrated101 »

Offline frustrated101

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Re: Bill's MPFLr LPFLr Rehab
« Reply #1 on: February 03, 2019, 01:06:17 PM »
11 sleeps post op

Exercises
Terminal knee extensions
   sitting bed, with pillows underneath knee and extend until almost straight
   8 reps
   pain-medial at terminal extension
Stationary bike
   starting at 270 and going back ward until 315
   3 minutes
   was able to do a full rotation backward at the end and knee didn't explode-wahoo.
Treadmill
   Super slow
   Walking backwards-3 minutes
   walking forwards-3 minutes


Meds-800mg ibuprofen


Pain-Lateral nerve pain.  It's not severe but it's like a constant prodding reminder from "the idiot" who did this to me and it says: "Hey bill, remember that time you and your insurance company paid $38,000 for me to grossly injure you.  Yes doc, I remember, like it was yesterday."

As a side note, the former OS billed $8,000 for left knee and $8000 for right knee.  He also told the insurance company that it was such a complex procedure that he needed a second orthopedic surgeon to do it, so the second surgeon was able to collect $8,000 for left knee and $8,000 for right knee as well, I think they are golf buddies.. I contacted the insurance company to tell them it that the billing couldn't possible be correct, I mean, $38,000 for a less than 5 minute consult and a 2 hour arthroscopic surgery?!?!?!  They told me the billing codes were correct.  It's greedy scumbags that contribute to rising medical costs. 

 The former OS also had me do MRI's to both knees a few hours before surgery  (despite the fact that I showed him a right knee MRI that was approximately 6 months old the day before at our appointment).  Another couple thousand.  And lastly, the surgical room billed a few thousand ( I signed a form, or remember signing something where the nurse had said the the some of the surgeon's share ownership in the surgical center--->another few thousand for "the idiot".  Maybe I should call him "the genius" however, he's brilliant at maximizing the bill.  Enough of venting for the day.  Let's all hope for a patriots loss tonight.
« Last Edit: February 03, 2019, 01:13:51 PM by frustrated101 »

Offline frustrated101

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Re: Bill's MPFLr LPFLr Rehab
« Reply #2 on: February 04, 2019, 08:07:55 AM »
12 sleeps post op

Gym
   Leg press-lifted toes off to isolate quads more
   Treadmill-9 minutes-backwards, sideways, forward
   Elliptical-1 min-ROM not good enough
   TKE leg weights-bothers lateral nerve, still not good**
               **there was once a time the TKE felt so good to do, kept me out of pain for years.  It
                  hasn't felt good to do this exercise in over a year. 


Pain-yes

Medication-Out of opioids, f** it, don't feel like asking for more and will just deal with it.  Maybe pick up some Carlsberg or Tuborg's, dry January is over and done with.

Mental state-men sana incorpore sano.  Translation-knee not good, mental health not good


Daily Vent-Part 2 of my nightmare involves cancelling my insurance in February of 2018-3 weeks after my surgery.  I had no idea that ďthe idiotĒ was quite possibly the dumbest surgeon on the planet and definitely only 1 of 5 surgeons in the U.S. who could have possibly done to me what he did. 2 knees, 4 ligaments cut in less than 2 hours, genius.  Oh how I rue my decision to his question "Wanna do them both at the same time??"  Didn't realize he was such a money loving scumbag.  Anyhow, 3-4 months after my surgery I realize that I had been crippled, but also had no way to pay a doctor to get better, because if you do have healthcare, you will get raped financially (My expenses for the surgeries exceed $10,000).  Without insurance, you cannot afford to be raped.  I visited a Texas doctor some months after surgery and paid cash for the visit.
He said my LPFL and MPFL needed to be rebuilt and quoted me $30,000 for my left knee, his personal fee was $10,000 he said and he also want to an osteotomy on me and not a TTT, some sort of tibial one.  No thanks I thought, Iíll Wait for the 2019 insurance cycle and hopefully recover then.
« Last Edit: February 04, 2019, 04:48:18 PM by frustrated101 »

Offline Brandon123

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Re: Bill's MPFLr LPFLr Rehab
« Reply #3 on: February 04, 2019, 03:31:36 PM »
frustrated,

I understand if you're frustrated...quite a crazy story!
RK sharp pain while running, diagnosis chondromalacia patellae 6/09
RK arthroscopic chondroplasty 9/09
RK rehab, recovery, 90% normal, started running again -> back to square one 5/15
RK diagnosis patellofemoral arthritis + LK diagnosis chondromalacia patellae 8/15 -> conservative treatment

Offline frustrated101

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Re: Bill's MPFLr LPFLr Rehab
« Reply #4 on: February 04, 2019, 04:19:35 PM »
Thanks Brandon.

Offline frustrated101

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Re: Bill's MPFLr LPFLr Rehab
« Reply #5 on: February 05, 2019, 08:17:20 AM »
13 sleeps post op

Post-op apt
     stitches come out
     Doc says no restrictions
     Doc says knee will be stuck at approx 90 for 6 weeks and then it will be much easier gaining ROM after       
         that
     Doc says that it's going to take a while to get better

Gait-Due to limited ROM, I literally lurch step to step.  It's very cumbersome just walking a couple hundred meters.  But it's good to have a timeline now no when my ROM should get better.

Med-400mg ibuprofen


Mental-realization that this is going to take a while, I'm thinking 6 to 12 months for recovery


Daily Vent-So about 3-4 months after the surgeries I realize screwed I post a review for "the idiot" on google maps, not realizing it would alert him to the post.  I was really depressed and wrote something like "I could run before surgery with him and now I can't walk down stairs, I do not recommend him".  And then I get an email to him the next day saying something along the lines that "he is a world renowned expert and that him and his team were hurt by comments and that I wasn't recovering because I hadn't go to my post-op appointments or go to his personal physical therapist and that it takes a team for a good recovery and that surgery always brings the possibility for making things worse"

My response was something like "yes surgery can make you much worse and I realize that now.  But I never came there asking for both knees at once, it was you who offered it, and I was naive/dumb enough to accept" (I hadn't at the time realized that he cut my LPFL and MPFL otherwise I would have lambasted him for that- that was a later email I sent to him) and also that it was his greed as the reason he offered both at once and that in the future it should only ever be 1 joint at a time.  He never responded to the email and quickly took down public viewership for his google reviews.

As far never do a 2-weekpost op appointment-no I wasn't going to drive 20 hours round trip, stay in a super expensive hotel, and have my insurance give another 300 dollars to him just to take some stitches out

As far as never doing a 1 month appointment-Same reasons as above (20 hours, hotel cost, apt cost)plus if he hadn't cut my LPFL and MPFL, I never would have needed to go to another surgeon for decades.  And do I really need to travel 20 hours to have some idiot tell me that my quadricep is wasted and my left knee isn't worked properly, thanks idiot, I can realize that myself, not all patients are the idiots you think them to be (although we all kinda were, in a way, for choosing him)

As far as not going to his PT- I stayed in town for 7 days afterward and went to PT twice daily for 7 days.  I knew the routine down pat, there was no reason to continue staying there and staying at an expensive hotel.  I did the exercises on the worksheet to a T.  I returned to where I was staying and went to the gym EVERY SINGLE DAY until 2 months post op where my patella had decayed to a point where it hurt just to look at the stationary bike.  I remember taking one of those city bikes out one day and after attempting to power up a hill the pain was bad enough where I had to get off the bike and limp home-a broken man.
« Last Edit: February 05, 2019, 02:05:16 PM by frustrated101 »

Offline frustrated101

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Re: Bill's MPFLr LPFLr Rehab
« Reply #6 on: February 06, 2019, 08:41:36 AM »
14 sleeps post op

Gym
TKE
Leg press
Ellpitcal-3 minutes

Mental state-frustrated, left quad about half the size as right for over a year, if and when it comes back, it will mean the surgery was a success.  Dr. Teitge told me through email that when ROM returns it should be easier to build the quad.  So that means maybe late March or April??

Daily Vent-The INFAMOUS lateral release

The lateral release is an antiquated procedure that involves cutting of the lateral retinaculum and the structure it houses (LPFL).  It is seen as the panacea for patellar issues.  Patella pain?  Cut the retinaculum.  Torn MPFL? Cut the other side-"problem solved".  Disclocating patella- what should we do??? lateral release they say!!   If a house with 4 support structure has one damaged in a storm, the solution
A-rebuild the damaged beam
B-destroy another structure
   A is the correct answer for intellectually challenged surgeons like the idiot I had.
 I really don't understand the stupidity but as my friend Lisa likes to tell me, lobotomies were more common 50 years ago-->stick a knife into the brain to improve function.  Yea, Genius. 


Unfortunately the LPFL is an evolutionary structure, the procedure is completely guess and check, and more cases than not the patient ends up worse.  Unfortunately there are unethical doctors out there, like the one I had, who just say to the patient (victim) afterwards: "surgery can make you worse, you knew that, you should have known better.  I'm you sorry your knee is still a problem for you.".Me- No jerk off, my knee isn't still a problem, it's exponentially worse because you did a bunch of experimental s**t I didn't consent to.And it's quite a simple procedure, poke a hole in the knee, insert cutting instrument, cut the retinaculum as much as you won't, and then check you bank statement in 2 weeks to ensure that the insurance company did indeed deposit the $8,000 for 15 minutes of "work".  I'm pretty sure half the people on this site could learn how to do it with 15 minutes of training, and it's not like there are any consequences for making the patient worse, so cut away!

I asked my surgeon about lateral release the at the appointment before surgery, I say to him "what about this procedure called lateral release." His exact words were "I don't like to do too much, then you get instability.".  So it was a complete shock to me that when the orthopedic fellow (who also was able to collect $16,000 just for holding my knees during surgery) tells me afterwards that not only did they do a lateral release but they did medial releases as well to both of my knees.  And he said it with a big smile on his face, insinuating that my knees where going to be stronger than those of superman because I had these magical lateral and medial releases.  I wonder how many people he will injure as the result of being taught my my moronic surgeon. 

The 2nd email I sent to my surgeon basically reiterated the pre-op visit.  I told him that I was diagnosed with iatrogenic (surgeon caused) instability because he cut my MPFL and LFPFL.  I repeated what he had told me (doing too much causes instability) and then told him that he couldn't have DONE MORE.  I have many theories on why he did what he did and one of them is he was just showing off to his orthopedic fellow "hey Connor, look how many things I'm destroying on Bill's knee--->I'm and orthopedic god, I can do anything!!" POS.

His response to the email was that I should come in, to be re-evaluated, (and of course give him more money)  Only with a full examination would be able to tell me what's wrong.  He did 4 things during my surgeries with him
1-Anterior Interval release (cutting of scar tissue between fat pad, patellar tendon, and tibia)
**my main symptom was my knee cap being pulled downward, it was EXTREMELY uncomfortable, and it was the reason I went to him.  The release solved my problem.
2-debridement (just removal of some scar tissue)
3-plica removal (plica is non-functional embroyonic fold that serves no purpose but is just a remnant fetal period)
4-Lateral and medial release (cutting of the evolutionary lateral and medial retinaculum including the LPFL and MPFL).  The 2 ligaments that hold your kneecap against your thigh bone

**It was quite obvious to me why my patellas had gotten worse and why I could no longer walk down stairs. 
So in my mind, I'm thinking this guy is so f*cking stupid he still doesn't know what he did wrong.  And by that point I had educated myself with material from kneeguru and knew that there was a high liklihood he had never done and MPFL or LPFL reconstruction so, that along with his intellectual stupidity made it a complete no-brainer to never want to see or associate with that man again.**

Anyhow, mine is one story of many on this site.  Some have just had lateral releases and gotten worse.  Some have had lateral releases, gotten worse, the doctor says that I didn't release enough, and get more of it cut and end up even worse.  Some have undiagnosed MPFL tears and the doctor cuts the LPFL and they get exponentially worse.  I had both my MPFL and LFPL cut so I empathize with anyone who has gone through this or will go through it. 
« Last Edit: February 06, 2019, 11:20:38 AM by frustrated101 »

Offline frustrated101

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Re: Bill's MPFLr LPFLr Rehab
« Reply #7 on: February 08, 2019, 05:09:58 AM »
16 sleeps post op. 

Today is my 34th birthday, I lost a year of my life and counting because of that idiot.  Hopefully this year will be better but I have my doubts.  I need to slow down, take a long-term perspective because this is going to take a long time.  6 weeks of healing, 6+ weeks of rehab at least.  How do you forgive someone who has taken so much from you? I don't know.

In Denmark the first floor is counted as Floor 0 so I am changing the outlook on my recovery. My 0 week was days 1 to 7; 1st week day 8 to 14; 2nd week day 15 to 21; etc etc.  So I am officially on week 2. Many rehab protocols are very conservative for the first 6 weeks, and as Dr. Blond told me, I'm going to be stuck at about 90 for that time anyway.

Pain-almost fell when I got up, should dissipate.  Am I 34 or 80???  Thank you to "the idiot" you are a true innovator in the field of medicine, lateral releases are bad enough, but a medial release too???  Pure genius, I guess you thought lateral releases were so good you'd decide to knife the other side as well.

Daily Vent
Greedy Doctors.

So around July 2018 (5 months after my surgical crippling-I was desperate to get better but of course I didnít have insurance so there wasnít much I could do) I visit the doctor from Texas.  The consult was 250 dollars cash.  At the time, I didnít realize how easy it was to transfer medical data (xrays, MRIs) from one clinic to another so I went there without them.  At the appointment he tells me, we need to reconstruct the things that were cut (LPFL and MPFL) and that he might want to do an osteotomy to fix some varus issues. I stopped listening to him when he mentioned the osteotomy.  One man scammed me, one man did an illegal experiment on me, no way I going to let a third man to saw into my bones. 

Anyhow, in December of 2018 I finally do a skype consult for $180 with another surgeon.  I send him my Xrays, MRIís, entire life history ahead of time.  At the consult, he tells me that my LFPL needs recon using IT band, my MPFL needs recon using gracilis autograft and suture anchors.  This basically matched the conclusion I had already come to so I was happy with the consult.  But after going through my experience, and the fact the the Texas doctor had many good outcomes with people on the site, I wanted to get a definitive yes or no on the osteotomy he had mentioned.

So I send him in email, along with the MRIs and XRays that I didnít have with me the first appointment.  Iím thinking to myself, hopefully he can just do this with no charge, as I had already paid an initial consult fee and if I had them at the appointment it would have been included as part of it.  But just in case, I say that ďif I have to pay another consult fee for the answer, then so be it, but that I will need a DEFINITIVE answer on the osteotomyĒ

His secretary sends back in an email response ďIn order to continue the conversation, you will have to make a payment of $350 ďwith no mention of a DEFINITIVE answer.  So not only was he not willing to include the XRay/MRI review as part of the the initial appointment, but he wanted  $350, 100 dollars more than I paid the first time I saw him.  If the secretary had just sent back, Dr. XXX is a busy man we would have to charge you for an additional consult fee for the review and after that we will give you a DEFINITIVE answer regarding the osteotomy.Ē  I would have thought that to be reasonable and respectful.  But to ask for an additional 100 dollars, to try and shake down a person who had been injured by an idiot, it just seemed petty.  He was extremely arrogant too and as I know from personal experience, arrogance and overconfidence leads to medical errors or just plain medical battery.So I never responded but I do have an email I hope to send him in the future and here it is:

Thank you so much Dr. XXX.. I ended up getting the LPFL and MPFL reconstructions.. It costs me and arm and a leg to do it and I will be making payments on it for months if not years.  It was totally worth it though.  Thank you again. 

I know these stories are getting long, but thereís some valuable information within them that will hopefully help future victims reduce the window b/w injury and recovery.


« Last Edit: February 08, 2019, 05:22:11 AM by frustrated101 »

Offline Brandon123

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Re: Bill's MPFLr LPFLr Rehab
« Reply #8 on: February 08, 2019, 09:25:16 AM »
Today is my 34th birthday, I lost a year of my life and counting because of that idiot.  Hopefully this year will be better but I have my doubts. 

Happy birthday :) Fingers crossed your upcoming year will be a much better one!
RK sharp pain while running, diagnosis chondromalacia patellae 6/09
RK arthroscopic chondroplasty 9/09
RK rehab, recovery, 90% normal, started running again -> back to square one 5/15
RK diagnosis patellofemoral arthritis + LK diagnosis chondromalacia patellae 8/15 -> conservative treatment

Offline frustrated101

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Re: Bill's MPFLr LPFLr Rehab
« Reply #9 on: February 09, 2019, 05:35:52 AM »
Thanks Brandon!

2 weeks post op

Here's the routine I've settled on
https://www.uwhealth.org/files/uwhealth/docs/sportsmed/SM-28670_MPFL_Protocol.pdf

I'll summarize

For 42 days....
ROM at 0 to 90
Exercises- quad sets and 4 way leg raises
**basically sit around and wait for ligaments to heal



Todayís Rant
$10,000 credit card bill coming due, time to liquidate some retirement savings, Thanks PM, you are my hero.  Letís do a side by side comparison of pricing for the surgery I had 31Jan2018 and the surgery I had 23Jan2019

31Jan2018 with PM-Left Knee
1 hour duration
2 ligaments DESTROYED
2 surgeons needed (per PM request)
$8,000 to lead surgeon PM
$2,000 to surgical center (possibly partly owned by PM and his fellow surgeons)
$8,000 to orthopedic fellow CZ (b/c PM said he was needed to hold my leg)
Total cost-$20,000

31Jan2018 with PM-Right Knee
1 hour duration
2 ligaments DESTROYED
2 surgeons needed (per PM request)
$8,000 to lead surgeon PM
$2,000 to surgical center (possibly partly owned by PM and his fellow surgeons)
$8,000 to orthopedic fellow CZ (b/c PM said he was needed to hold my leg)
Total cost-$20,000

23Jan2019 with LB Left Knee
2 hour surgery
2 ligaments RECONSTRUCTED
Total Cost- $7,500

2019 Right Knee (assuming I get it done)
2 hour surgery
2 ligaments RECONSTRUCTED
Total Cost- $7,500


Total Cost PM- $36,000 in billing for a 2 hour procedure that cripples me involving simple tasks that including sticking a knife through structures
Total Cost LB- $15,000 for a 4 hour procedure that puts me back together involving complex tasks such as ligament harvesting, drilling, and proper tensioning.

The state of healthcare in the U.S. isnít the fault of PM, but he can be faulted for telling BCBS that CZ needs to get paid $16,000 for holding my legs during surgery.  There was a PA there for my surgery with PM, Iím sure he could have passed the scalpel to you just as easily for less.  Iím still out $25,000 plus expenses and a lost year plus of work so I reserve the right to say this, again and again, F**k you PM.
« Last Edit: February 09, 2019, 06:56:38 AM by frustrated101 »

Offline frustrated101

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Re: Bill's MPFLr LPFLr Rehab
« Reply #10 on: February 10, 2019, 07:29:20 AM »
Still Week 2...

Pretty bored, filling time with the series Vikings, HIMYM, reading internet, Tetris, etc etc.  One more week in Denmark then a 10 hour flight.  I'm so bored, I'm actually looking forward to the 10 hours on the plane..

Offline Brandon123

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Re: Bill's MPFLr LPFLr Rehab
« Reply #11 on: February 10, 2019, 10:24:24 AM »
I'm just curious, how will you deal in practice with such a long flight trip? I assume you will not be able to sit normally with the leg bent 90 degrees? At least not for 10 hours straight?
RK sharp pain while running, diagnosis chondromalacia patellae 6/09
RK arthroscopic chondroplasty 9/09
RK rehab, recovery, 90% normal, started running again -> back to square one 5/15
RK diagnosis patellofemoral arthritis + LK diagnosis chondromalacia patellae 8/15 -> conservative treatment

Offline frustrated101

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Re: Bill's MPFLr LPFLr Rehab
« Reply #12 on: February 10, 2019, 11:04:38 AM »
Yea, ROM pretty bad, not quite 90 maybe 80-85, so I reserved an aisle seat that allows for left knee extension and of course will walk around every 1 to 2 hours

Offline Brandon123

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Re: Bill's MPFLr LPFLr Rehab
« Reply #13 on: February 10, 2019, 11:40:01 AM »
Yea, ROM pretty bad, not quite 90 maybe 80-85, so I reserved an aisle seat that allows for left knee extension and of course will walk around every 1 to 2 hours

Ok sounds good!
RK sharp pain while running, diagnosis chondromalacia patellae 6/09
RK arthroscopic chondroplasty 9/09
RK rehab, recovery, 90% normal, started running again -> back to square one 5/15
RK diagnosis patellofemoral arthritis + LK diagnosis chondromalacia patellae 8/15 -> conservative treatment

Offline frustrated101

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Re: Bill's MPFLr LPFLr Rehab
« Reply #14 on: February 11, 2019, 03:39:18 AM »
Still week 2....

quad sets
4 way leg raises
clamshells