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Offline kathleenj

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back to work after oats
« on: September 08, 2004, 09:50:15 PM »
Today was a good day!!!  I am 12 weeks post my second Oats and I went back to work today!   I truly think the surgery was a success this time around.  
I have been having some problems with my plica but I had a cortisone shot on friday and it finally kicked in yesterday.  I hope that it lasts because it feels really nice to be able to walk across the room without pain and my OS said that if the shot doesnt work then he will need to take it out.  I really dont want to see the inside of an operating room for a long long time.  
Keep your fingers crossed for me.  
right knee oats 12/03 scope autograft
right knee revision oats 6/04 open autograft
loa, plica excision, chondroplasty 12/04
synvisc 5/05
patellofemoral OA
patella baja

Offline JG

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Re: back to work after oats
« Reply #1 on: September 10, 2004, 02:39:25 AM »
Hi Kathy,

That's great.  You're very smart.  I went back to work PT after week 2 and full time after another week.  I should have taken a minimum of 4 weeks.  Being on crutches at work was not good.  I had about 4 weeks of it (8 in total).  So how is everything feeling?  

My knee is still bothering me (medial joint, 5 grafts).  Although the grafts looked good during my last scope (April), the MRI showing the underlying bone didn't look so good.  My OS and PT have been really pushing me to be NWB for some time.  I've pushed back saying it's the summer, etc.  Well I was resigned that the best thing to do is go on crutches.  It really bothered me last week during PT as well as during my own workouts.  I was suppose to discuss this with my OS on Tuesday (9/7).  Well, last Saturday (9/4) I tripped, breaking a toe on my right foot (right is good leg, left is bad).  Turns out to be a really bad break.  My OS laughed until he realized it was my right foot.  He thought it was a clever way to get out of being NWB.   It looks like I might have to have my toe surgically fixed.  We are waiting a couple weeks to determine if it will heal correctly on it's own.  It has a oblique fracture, rotated, and displaced.

All I can do is shake my head.  My left knee is bad and I am having to rely on it since the toe is bad on my right side.

Let me know how you are doing...Janice

Sept-99 - L knee LR
Aug-02 - L knee LR/menisectomy
Apr-03 - L Knee Mosaicplasty Using Allograft (18 grafts)/LR/debridement/menisectomy; Right Knee menisectomy.
Apr-04 - L Scope - LR/Lysis Adhesions

Offline kathleenj

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Re: back to work after oats
« Reply #2 on: September 10, 2004, 08:50:18 PM »
Oh Janice,
What did you do to yourself?  I am so sorry about the toe.  Even more for the knee that needs to pick up the extra load.  How is it feeling with all the extra work it needs to do?  You really need to take it easy.  I know how hard it is to sit still but you really need to let things get better before going ahead and breaking something else ;)

I'm doing ok.  Its been 3 days of work now and the knee is holding up ok.  I am on my feet the entire time and I really cant complain.  A little soreness from muscles waking up but other than that, its going good.  I do have to say...if it wasnt for that cortisone shot last week, there would have been no way on earth that I could be back at work.  It has worked miracles and I am hoping it will last a very long time.  At least enough to get this plica inflamation under control.  
As far as the graft site...its GREAT!  No pain what so ever there so it leaves me to believe that it has healed ok.  My OS is pleased with that aspect of the knee and has given the ok to start doing what ever I want, just as long as I dont ever, ever, ever, run or take up tennis or any other twisting sports.  We dont want to make my tibial lesion any worse.   So basically I can do whatever I want as long as it is low impact. I can deal with that.

Again, I am really sorry to hear about your situation.  I hope your toe heals ok and you dont need to have surgery.  Try to take things easier and please keep me posted.  

Kathy
right knee oats 12/03 scope autograft
right knee revision oats 6/04 open autograft
loa, plica excision, chondroplasty 12/04
synvisc 5/05
patellofemoral OA
patella baja

jackpowell

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Re: back to work after oats
« Reply #3 on: September 11, 2004, 05:25:58 PM »
Hi Kathy,

Great to hear you are back to work and that the OATs appears to be a success.  I hope the scar tissue resolves itself and you don't need surgery.  I go under the knive on Monday!

Hi Janice,

Your poor toe!!!  My God, that must have hurt.  I got a small crack in my toe once and the pain was pretty strong.  Let's hope you don't need surgery on it.

Offline JG

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Re: back to work after oats
« Reply #4 on: September 11, 2004, 07:43:51 PM »
Hi Kathy,

That's great.  It sounds like all is healing well.  I guess you know when you body feels right.  So does the graft site feel better after this surgery compared to your last surgery?  I didn't have problems until about 8 months.   So how bad is the tibia lesion?  I have a grade IV on my lateral tib plateau.   My biggest problem with this defect is bone pain.  BTW, what do you do for work?  I sit at a computer all day and I can work from home.  I would have been miserable on my feet all day at week 8 (when I got off crutches).

Jack, congratulations on the surgery.  So please give us the update.  Did you find a new surgeon?  Are you having OATS or ACI?  How was everything resolved with your insurance company?  Refresh my memory with the details.

As far as my toe goes, I think it will be okay.  It really didn't hurt, but it didn't look good.  It feels pretty good and seems to be healing well.  I'm going to try putting on a shoe today...we'll see.

Janice
Sept-99 - L knee LR
Aug-02 - L knee LR/menisectomy
Apr-03 - L Knee Mosaicplasty Using Allograft (18 grafts)/LR/debridement/menisectomy; Right Knee menisectomy.
Apr-04 - L Scope - LR/Lysis Adhesions

jackpowell

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Re: back to work after oats
« Reply #5 on: September 12, 2004, 06:06:57 PM »
I am going to have OATs surgery on Monday.  I had to find another doctor and he immediately scheduled.  There is no insurance issue.  Federal Blue Cross does not "exclude" OATs surgery so prior approval is not required and will not be granted.  You just have the surgery, submit the claim and they pay it.  The other doctor refused to do the surgery without prior approval so I was forced to get another doctor.

Offline kathleenj

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Re: back to work after oats
« Reply #6 on: September 13, 2004, 09:46:53 PM »
Hi Janice,
Hows the toe doing?  Were you able to get the shoe on it?  I'm glad that it is looking better.  Hopefully it will heal well.

It really is amazing how you just know when things are going ok.  Like you said...it just felt good.  The first graft felt like something wasnt right from the beginning.  It is really hard to explain, it just felt like it wasnt right.    This time around it felt different.  From day one I didnt have the clunking I had after the 1st graft. Everything was totally smooth when I moved the knee.  After the 1st graft I had some sort of clunk that was catching and rubbing deep in the joint as I bent and extended the knee.  I guess that is the only real difference that I noticed.  
As far as the tibial lesion goes...I'm not sure the grade or anything.  When I had my first surgery in Dec the cartilage was thinning.   By the time I had the second surgery in June it was crabmeat.  All shredded but not down to the bone yet.  So far I havent noticed any significant pain with it.  
It has been nice to get back to work.  I am a portrait photographer so I am on my feet for hours at a time and I just couldnt possibly had gone back to work any sooner than I did.  I just need to really watch how I move, I do alot of pivoting back and forth to the camera so I have to be careful.  My OS says pivoting movements are the worse thing for my knee...but hey, I love my job and there is no way of stopping me.

So have you decided to go NWB for a bit to help the knee?  I know its hard now with the toe issue but I was wondering what you have decided to do?  
Please keep me posted.  Take care
right knee oats 12/03 scope autograft
right knee revision oats 6/04 open autograft
loa, plica excision, chondroplasty 12/04
synvisc 5/05
patellofemoral OA
patella baja

Offline JG

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Re: back to work after oats
« Reply #7 on: September 20, 2004, 03:49:25 AM »
Hi Kathy,

The toe is okay.  I find out this week whether it is healing right.  I go for x-rays and my FU visit on Thursday.  I'm really noping I don't need surgery. That's another 6-8 weeks of laying low...just tired of that.  I've been laying low for 17 months (since my mosaicplasty).  I can't really wear a shoe except my cycling shoes (they have very stiff soles).  I started back to "rehabbing" my knee about a week ago.  I put my shoe on long enough to get through my hour rehab workout.  

That's a great job!  I'm jealous, I have not photography skill.  I'm sure it feels great to be living life again rather than sitting at home waiting to heal.  

In terms of NWB, it will have to wait.  My left knee is bad and my right foot.  I've got a double limp going sometimes...very funny.  I did go out for a 30 mile ride today, toe felt good, knee was a little painful.  

Once my toe heals, I'll go back to my OS.  I'm really thinking that I will hire a trainer (from my PT office) to work with 2x per month and pretty much going it alone.  If the OS says there really is a problem with the grafts and I should continue to PT, go NWB, etc. then I will.  Other than that I am ready to break free.  Although I'm in great cardiovascular shape, I could lose some weight, maybe 20 pounds...so that can be my next goal.

Keep me posted on your progress....Janice

Sept-99 - L knee LR
Aug-02 - L knee LR/menisectomy
Apr-03 - L Knee Mosaicplasty Using Allograft (18 grafts)/LR/debridement/menisectomy; Right Knee menisectomy.
Apr-04 - L Scope - LR/Lysis Adhesions

Offline JG

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Re: back to work after oats
« Reply #8 on: October 04, 2004, 11:14:55 PM »
Kathy,

How is it going?  Just wondering how the knee is feeling.  My toe is getting better, but slowly.  I go back to my knee doctor in a couple weeks.  I'm really just ready to to my own thing and when it gets bad, I can have another mosaicplasty either on the tender medial joint or my grade IV lateral fem chondyle.  

Let me know how you are doing.

Janice
Sept-99 - L knee LR
Aug-02 - L knee LR/menisectomy
Apr-03 - L Knee Mosaicplasty Using Allograft (18 grafts)/LR/debridement/menisectomy; Right Knee menisectomy.
Apr-04 - L Scope - LR/Lysis Adhesions

Offline kathleenj

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Re: back to work after oats
« Reply #9 on: October 05, 2004, 07:53:01 PM »
Hi Janice,

I'm glad to hear that the toe is healing ok.  I understand the feeling of wanting to just go ahead and do whatever you want and deal with things later.  I'm so sick of this knee hurting and just want to get things back to the way they were before all this knee stuff started.  I am more sick of not being able to do all the things I did before with my kids.  
Another mosaicplasty?  Yikes! Maybe they will come up with something else before that time comes for you.  I hope so anyway...you've had alot to deal with already.
As far as my knee goes......hmmm, it goes.  The cortisone shot I got helped alot but it didnt last as long as I wanted.  I wish my OS could do another one but he said he would only do that one for me and thats it!  If the shot wears off and I am still having problems then he will need to scope and remove adhesions and the plica.  I can actually feel the bands of tissue under the skin.  They hurt like heck when I touch it and they are messing up the way my kneecap moves.  I've also been having some medial joint pain, ut oh, thats the first time I actually admitted it.  I've been trying to ignore that, like maybe its my imagination, but its not. I'm hoping its just my tibial lesion and not the graft.  Its not bad 'ice pic' pain but its still there.
Looks like I will be having that scope soon. I just havent called him yet to tell him I'm still having problems.  (a little chicken I guess,  at least now I can work a bit so I'm not really looking forward to being laid up again.)
Anyway, let me know how things go at the OS.  And I hope that toe is healed up soon.
Kathy
right knee oats 12/03 scope autograft
right knee revision oats 6/04 open autograft
loa, plica excision, chondroplasty 12/04
synvisc 5/05
patellofemoral OA
patella baja

Offline JG

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Re: back to work after oats
« Reply #10 on: October 05, 2004, 11:19:24 PM »
Hi Kathy,

Interesting that you are having adhesion issues.  I had them as well, but really never exhibited symptoms other than my knee feeling full or "thick".  I had them cleaned out in April for my 1 post-op scope.  I guess they were really bad, but I didn't notice them for the most part.  I ended up having a LR, medial gutter release and an anterior interval release.  He actually had to use a scalple to cut thru the adhesions.  Based on feedback from the scar tissue posters, it was a big surgery.  My PT was surprised when she saw the scope picture because I had bad adhesions, but didn't show common symptoms.

I have tibia problems as well.  It's really hard to tell if it is tibia or femur sometimes.  My medial tibia is good, but my lateral tibia is grade IV to the bone.  The only good thing about the scar tissue was that it grew over my old lateral tib defect, just like having microfracture. I find my tibia pain to always been very deep bone pain and the front of my tibia will hurt.

Good luck and keep me posted....Janice

Sept-99 - L knee LR
Aug-02 - L knee LR/menisectomy
Apr-03 - L Knee Mosaicplasty Using Allograft (18 grafts)/LR/debridement/menisectomy; Right Knee menisectomy.
Apr-04 - L Scope - LR/Lysis Adhesions

Offline kathleenj

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Re: back to work after oats
« Reply #11 on: October 29, 2004, 09:39:19 PM »
Well the coritsone shot has officially worn off and the pain is back with a vengence.   Maybe working was a bit much for the knee but I really needed to get things back on track.  Fortunately I only have to make it thru November and then things will slow down with work. I was hoping that it would last longer than the 3-4 weeks because my os said he wont do another shot.  Only other option is a scope.  

My PT called my OS about 2 weeks ago and said that I should lay low with my activities and see if things calm down....like I'm running marathons  :-/  Honestly I couldnt take it any easier if I tried!  
Anyway, I called him and said nothing has changed and now he will see me on Tuesday.  Not that I'm in any rush for the scope, but....why do they always make you wait around?  What was he expecting to happen between the last call from my PT?   Regardless, I see him on Tuesday and I am certain he will want to schedule the scope.  I suppose its for the best.  I have been dealing with this for months and it just isnt getting any better, actually worse now.  

Thanks for listening and I'll post on Tuesday after my appointment.
right knee oats 12/03 scope autograft
right knee revision oats 6/04 open autograft
loa, plica excision, chondroplasty 12/04
synvisc 5/05
patellofemoral OA
patella baja

jackpowell

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Re: back to work after oats
« Reply #12 on: October 30, 2004, 10:58:02 PM »
Kathy,

   Best of luck on your appointment.  It it awful that he has to go back in there again.  Exactly what is the difference between plica and scar tissue?


Jack

Offline JG

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Re: back to work after oats
« Reply #13 on: November 03, 2004, 03:55:48 AM »
Kathy,

Sorry to hear you are still having problems.  Honestly, I think its a good thing that your OS want to take a peek.   It's good that he's not waiting 12 months or even 6 months.  It's best to catch things early.   This is a long post, so I apologize.

After my mosaicplasty 18 months ago, I only had a few visits with my OS.  I saw him at 7 days (unscheduled due to potential infection), 4 weeks, 3 months, 6 months and 12 months.   At the 1 month visit, my OS said that he "might" want to take a look at the joint at 3 months and then again at 12 months.  However, at the 3 month mark I had just come off crutches and he said that we "might" want to take a look at the joint at 6 months.  At 6 months, I was really just starting to feel stronger.  So at the 6 month visit he said that it was going to take time to heal so be patient.  I started to have problems at 8 months with the medial joint pain and lingering ROM problem (I'm still short 5 extention and maybe 20 flexion).  Since my OS said it would take a minimum of 1 year for the grafts to fully incorporate, my PT encouraged me to keep rehabbing (knowing my knee and mental state well), and my general belief that I don't have a knee problem (my best coping mechanism), I waited another 4 months to see my OS.  By that time, the medial joint pain was worse and ROM was still bad.  When I went to the OS at 12 months, he said, we really should have taken a look at the knee at 4 months and 8 months.  So by 12 months post-op, my knee was full of scar tissue and although the grafts looked good during the scope, the MRI showed that the grafts were cystic (that's can be good and bad).  Partially, it was my fault for not going back to him at 8 months and demanding a scope.  Partially it was that very very few OSs (if any) have any experience doing a mosaicplasty of this size, so my OS was "learning".  With the scope, my knee was full of adhesions/scar tissue, a new lat tib plateau defect and further damage to my lateral chondyle.

I've read most of your posts and understand that you are very frustrated.  Prior to the mosaicplasty, I would get very frustrated.  However, I really have learned to manage the knee given my lifestyle.  It's took about 4 years get to this point.   I do accept that I have a problem and can't do thing as I used to.  I'm always in rehab and management mode and this will NEVER change.  I've found activities that I CAN do and really have embrassed them.  Coming to some sort of "agreement" with yourself (and the knee) is so important.  

I took some time off to let me toe heal (about 4 weeks) during which I really didn't do much.  This helped out my medial joint pain.   I decided to go to PT 2x per week and really push through the minor problems for the remainder of the year.  Previously, my PT would really scale things down if I complained.  Each session takes about 3 hours.  I talked to my OS and said that I would like to "go it alone" for the next year or so...meaning no more surgeries.  He liked the idea and said he wasn't going anywhere.  My knee and legs feel great.  My medial joint pain has been very managable.  I do have lot of scar tissue in medical joint area from the patella tendon to the quad tendon.  Like you, I can feel the bands of scar tissue (the worst being the medial quad tendon).   I have my PT break up as much as he can each session.  It has really made my "traditional" medial joint pain feel much better.  You should discuss with PT or massage therapist.

Sorry for rambling and having another scope is a good thing...catch the problem quickly so you can get back to life.

Janice
Sept-99 - L knee LR
Aug-02 - L knee LR/menisectomy
Apr-03 - L Knee Mosaicplasty Using Allograft (18 grafts)/LR/debridement/menisectomy; Right Knee menisectomy.
Apr-04 - L Scope - LR/Lysis Adhesions

Offline JG

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Re: back to work after oats
« Reply #14 on: November 03, 2004, 03:57:23 AM »
Jack,

How are you?  Hope you are well.  Do you have an update on your knee for us?

Janice
Sept-99 - L knee LR
Aug-02 - L knee LR/menisectomy
Apr-03 - L Knee Mosaicplasty Using Allograft (18 grafts)/LR/debridement/menisectomy; Right Knee menisectomy.
Apr-04 - L Scope - LR/Lysis Adhesions