I know it has been weeks since my last post but due to setbacks, I was unable to post. I have been through many changes in my recovery and will touch on a few. First, the complications I was having with the cpm and range of motion modalities, stemmed from what we initially thought was celluitis. Dr. Looney, immediately put me on Augmentin and did an aspiration of my knee. The procedure was less painful than I feared and the 25cc of blood removed looked normal. Next, I was sent for STAT labwork which thanks to hospitals farting around took about 4 days to get the results back. During, that time my knee had massive edema and near circumferential redness and heat.I was scheduled for a Lavage, in case infection was found. Thankfully, all labwork came back normal and no additional surgery was necessary. With a second opinion from Dr Calendine, the diagnosis was major trauma from the surgery caused the skin to become inflammed, irritated and heavily bruised.
In fact, I am now ten weeks out and the bruising and edema are still visible.
Range of Motion: I have slowly progressed and then degressed. In week eight my extension was 108 and flexion 119, weeks nine and ten, the flexion was 109 and 115 respectively. I am unsure of the change as my physical therapy practice has remained the same, two complete sessions a day with multiple quad sets and heel slides. We have now added low resistance stationary bike riding, which doesn't bring the relief I was hoping for. With my other surgeries, it would break up the scar tissue and take away most of the pressure, within the knee. But this isn't most surgeries! Dr Looney, is satisfied with my ROM and when I asked about the amount of pain that is still present, he reminded me that I'm only two months postop. I should expect this amount of pain until around the sixth month.
The osteotomy hurts just as bad as the knee does. Evenmore, now that I'm full weightbearing. I can feel the screws under the skin now and I must admit, it's freaky. I notice an increase in pain when the weather turns cool and when its raining. A myth? I don't think so.
I felt horrible until week six, that's when I became full weightbearing. Well technically, because I still had to use the walker, then progressed to the cane. I spent the better part of two months indoors, only going out for pt and Dr appointments. Trust me, you won't have any desire to go out and if you do, the pain and weakness isn't worth it.
At week ten, I feel much better. I can't say that I walk much better but I'm getting there. The fine staff at Top Rehab are doing their best to get me healed. Even, when I complain and pretend to do mini squats. Dr. Looney and Dr Calendine have given me their all and dedication. As I must say this surgery has been hard on not only me, but my family, friends, and medical team.
Wednesday, October 27, 2010
Friday, September 3, 2010
Emma's Dr Debut
Friday, I had an appointment with Dr Looney, to remove my stitches. The process hurt more than I remember other stitch removals hurting. The nurse who removed them, was very gentle, my wound is just very sensitive. She removed them quickly, while my three year old niece, Emma, looked on in amazement.
Emma, had her nitrile gloves on ready for her debut as a doctor. Standing on the table beside me she shouted at the nurse for not leaving her a stitch to remove.
Five minutes later, I had steri strips where twenty stitches once were. I am much relieved those damn things were itchy and uncomfortable. The incision is about ten inches long and goes under one of the straps on my brace causing friction between it and the wound.
Dr Looney is very happy with my healing and gives me a good report. He wants to see me back in a week.
Emma, had her nitrile gloves on ready for her debut as a doctor. Standing on the table beside me she shouted at the nurse for not leaving her a stitch to remove.
Five minutes later, I had steri strips where twenty stitches once were. I am much relieved those damn things were itchy and uncomfortable. The incision is about ten inches long and goes under one of the straps on my brace causing friction between it and the wound.
Dr Looney is very happy with my healing and gives me a good report. He wants to see me back in a week.
physical therapy day 2
Thursday, was my first physical therapy session at Top. I met with Andrea, for an evaluation, Monday. I was a medication withdrawing wreck with the shakes and nausea, she was kind enough to get me a cold pack for my hot flashes.
We did the usual measurements of edema and range of motion. She also, measured my burn, 1.5cm x 1cm just in case any of you care.
My range of motion was only 33 degrees flexion, doing a heel slide with 108 degrees extension.
My patella moved easily, as I had already been doing self mobility exercises at home.
Thursday's, session had greater success. My flexion had improved to 60 degrees with a sitting heel slide. I can't remember extension but it was improved too. I started the usual stretches, hamstring, gastronomic, soleus. Quad and Hamstring sets. And plenty of ankle and other isometric exercises. I'm still unable to do straight leg raises. The muscle control isn't there.
Andrea, has the great task of deciphering the orders between Dr Looney and the Carticel rehabilitation guidelines. There is separate procedures for different lesions etc. I have a combined rehabilitation using the Femoral Condyle, trochlea, and distal realignment guidelines.
I'm to follow the trochlear/patellar protocol combined with the distal realignment protocol. My flexion and ROM goals are 75 degrees by week 3. CPM 8-12 hours a day (0-40 degrees) for 2-3 weeks. Plus my daily routine of motion exercises.
Andrea, stretched my leg before putting me on a "low voltage" electrostim machine.
I did have increased pain after therapy during the night. I must admit my leg felt significantly better after pt.
We did the usual measurements of edema and range of motion. She also, measured my burn, 1.5cm x 1cm just in case any of you care.
My range of motion was only 33 degrees flexion, doing a heel slide with 108 degrees extension.
My patella moved easily, as I had already been doing self mobility exercises at home.
Thursday's, session had greater success. My flexion had improved to 60 degrees with a sitting heel slide. I can't remember extension but it was improved too. I started the usual stretches, hamstring, gastronomic, soleus. Quad and Hamstring sets. And plenty of ankle and other isometric exercises. I'm still unable to do straight leg raises. The muscle control isn't there.
Andrea, has the great task of deciphering the orders between Dr Looney and the Carticel rehabilitation guidelines. There is separate procedures for different lesions etc. I have a combined rehabilitation using the Femoral Condyle, trochlea, and distal realignment guidelines.
I'm to follow the trochlear/patellar protocol combined with the distal realignment protocol. My flexion and ROM goals are 75 degrees by week 3. CPM 8-12 hours a day (0-40 degrees) for 2-3 weeks. Plus my daily routine of motion exercises.
Andrea, stretched my leg before putting me on a "low voltage" electrostim machine.
I did have increased pain after therapy during the night. I must admit my leg felt significantly better after pt.
two weeks
Today, marks two weeks out from surgery. I must say I feel much better than last week. I have almost cut out the pain meds. My appetite is back, I'm still debating whether that's a good thing or not.
Yesterday, I finished the last dose of Lovenox. That's a subcutaneous blood thinning, injection to the love handles.i I was put on that instead of Aspirin, due to spending three days in the hospital after surgery.
I also finished up the worst tasting medicine in the world, Keflex! I had to enjoy that due to a defective bone saw that superheated and caused a burn next to my incision site. It is healing quite nicely, and should he completely healed in about a week.
I felt well enough this weekend to head out to a local Arts and Crafts fair. Big Mistake! Aside, from the lack of handicap access, immense pain occured from not having my leg properly elevated.
I have my third physical therapy session, today at Top Rehabilitation we should be doing measurements on my leg to check swelling and range of motion. I've been diligent with ice and elevation and kept edema to a minimum.
I go see Dr Looney, Friday as he is keeping a close watch on the burned area. I plan on discussing the many pains my leg has and its interference with my precious sleep. I understand that having your knee cut open and your shin cut and moved over, that pain is inevitable but its interupting my time in the CPM.
Its rather strange, I never had any pain caused by the CPM after microfracture. Its cramplike pain in my foot and calf and a tightness in my knee. I can only go to 40 degrees in the CPM for another week, so I'm really at a lose other than the pain is just normal.
I am still unable to do straight leg raises. I just don't have the muscle control to do them. I can move my leg from side to side but not up.
Final Musings: with two weeks down, I do feel better. Take one day at a time and don't think about the 6 weeks until weightbearing, if you do the walls will close in.
Yesterday, I finished the last dose of Lovenox. That's a subcutaneous blood thinning, injection to the love handles.i I was put on that instead of Aspirin, due to spending three days in the hospital after surgery.
I also finished up the worst tasting medicine in the world, Keflex! I had to enjoy that due to a defective bone saw that superheated and caused a burn next to my incision site. It is healing quite nicely, and should he completely healed in about a week.
I felt well enough this weekend to head out to a local Arts and Crafts fair. Big Mistake! Aside, from the lack of handicap access, immense pain occured from not having my leg properly elevated.
I have my third physical therapy session, today at Top Rehabilitation we should be doing measurements on my leg to check swelling and range of motion. I've been diligent with ice and elevation and kept edema to a minimum.
I go see Dr Looney, Friday as he is keeping a close watch on the burned area. I plan on discussing the many pains my leg has and its interference with my precious sleep. I understand that having your knee cut open and your shin cut and moved over, that pain is inevitable but its interupting my time in the CPM.
Its rather strange, I never had any pain caused by the CPM after microfracture. Its cramplike pain in my foot and calf and a tightness in my knee. I can only go to 40 degrees in the CPM for another week, so I'm really at a lose other than the pain is just normal.
I am still unable to do straight leg raises. I just don't have the muscle control to do them. I can move my leg from side to side but not up.
Final Musings: with two weeks down, I do feel better. Take one day at a time and don't think about the 6 weeks until weightbearing, if you do the walls will close in.
things to lose and gain
Prior to having aci with distal realignment it's best to gain and lose a few things.
First, lose all dignity, self respect, and pride. There is no possible way to make it through this surgery and recovery alone. For the first few days the only bath you will get is a spongebath. Your bathroom now becomes a bedside commode or bedpan, neither is enjoyable. Assistance is needed for basically everything, so finding a reliable friend, family, or spousal equivalent is best.
Invest in or find a bedside commode, shower chair, bedside eating tray. Many organizations loan out these items, check with your local Masonic lodge, Lions Club, etc.
Even if your bathroom is 3 feet away from your bed, that's too far to "hop" given the amount of pain you'll be in. Since you'll be non weightbearing for 6 weeks, standing on one leg in the shower is too risky. Get a shower chair, at a week out and you start smelling like a boar hog, you'll be happy to use it. Get a shower wand as well, no use drowning while taking a shower. And yes, I forgot to buy one.
If you must be alone for any length of time, make sure all snacks and meals are close by. There's nothing better than being bedbound and hungry. Don't worry, the first week you'll go through a period of anorexia.
That's just week one. In week two keep your laptop handy. Have plenty of movies & books available.
Any important business needs to be taken care of before surgery. You won't be able to get out and you won't feel like it anyway. Also, bad idea to move the weekend before surgery. This I know from experience, I can't find anything, like my Razor!
Make a schedule of people who can help and when they can and try to make appointments during that time. Until you stop taking painkillers, driving is out and that varies from person to person.
These are just a few suggestions to make life easier after ACI but the best may be, keep your pain pills close.
First, lose all dignity, self respect, and pride. There is no possible way to make it through this surgery and recovery alone. For the first few days the only bath you will get is a spongebath. Your bathroom now becomes a bedside commode or bedpan, neither is enjoyable. Assistance is needed for basically everything, so finding a reliable friend, family, or spousal equivalent is best.
Invest in or find a bedside commode, shower chair, bedside eating tray. Many organizations loan out these items, check with your local Masonic lodge, Lions Club, etc.
Even if your bathroom is 3 feet away from your bed, that's too far to "hop" given the amount of pain you'll be in. Since you'll be non weightbearing for 6 weeks, standing on one leg in the shower is too risky. Get a shower chair, at a week out and you start smelling like a boar hog, you'll be happy to use it. Get a shower wand as well, no use drowning while taking a shower. And yes, I forgot to buy one.
If you must be alone for any length of time, make sure all snacks and meals are close by. There's nothing better than being bedbound and hungry. Don't worry, the first week you'll go through a period of anorexia.
That's just week one. In week two keep your laptop handy. Have plenty of movies & books available.
Any important business needs to be taken care of before surgery. You won't be able to get out and you won't feel like it anyway. Also, bad idea to move the weekend before surgery. This I know from experience, I can't find anything, like my Razor!
Make a schedule of people who can help and when they can and try to make appointments during that time. Until you stop taking painkillers, driving is out and that varies from person to person.
These are just a few suggestions to make life easier after ACI but the best may be, keep your pain pills close.
Monday, August 23, 2010
Worse than Microfracture
0630 I was awake and happy with how my knee felt considering the brutality of the surgery. My ROM brace is locked out straight, swelling is incredible but somewhat masked by the Ted stocking and dressings. My toes are a familiar betadine orange.
Around 0430, the nerve block began to wear off, no increase of pain just tingling from the nerves waking up. By 0830 a new pain began not the constant ache around the osteotomy but a burning stabbing pain around the medial condyle. Soon it became unbearable and I became a slobbering, crying mess. No position of comfort could be found, so I had a phone call made to Dr Looney, within two minutes his office had returned the call and arrangements made for the hospital.
I was begging for relief, the knee felt like someone was hammering a hot poker in it. I took my alloted dose of pain medicine, then I took more. Thankfully, the ambulance came quickly, yes an ambulance! My sister was working that day and who better to come get me? Anyway, I new morphine was in my near future, what I didn't know was that 8 mg, later I would still be in agony.
Nearly, two hours later I was in Williamson medical center emergency department. Dr Looney was in surgery, so Dr Calendine met me in the ED. He is a colleague of Dr Looney and extremely nice to me.
The staff quickly unwrap my leg and check for compartment syndrome, as I was having tingling and numbness but that wasn't the cause. Soon, I received dilaudid and phenergan for my troubles and a quiet peace came over me. Except for my snoring.
I ended up staying 3 days in the hospital with high doses of potent painkillers coursing my veins.
The moral of this story: ACI with osteotomy is worse than Microfracture, its not an outpatient surgery, and make sure you get a prescription for something stronger than Percocet.
Around 0430, the nerve block began to wear off, no increase of pain just tingling from the nerves waking up. By 0830 a new pain began not the constant ache around the osteotomy but a burning stabbing pain around the medial condyle. Soon it became unbearable and I became a slobbering, crying mess. No position of comfort could be found, so I had a phone call made to Dr Looney, within two minutes his office had returned the call and arrangements made for the hospital.
I was begging for relief, the knee felt like someone was hammering a hot poker in it. I took my alloted dose of pain medicine, then I took more. Thankfully, the ambulance came quickly, yes an ambulance! My sister was working that day and who better to come get me? Anyway, I new morphine was in my near future, what I didn't know was that 8 mg, later I would still be in agony.
Nearly, two hours later I was in Williamson medical center emergency department. Dr Looney was in surgery, so Dr Calendine met me in the ED. He is a colleague of Dr Looney and extremely nice to me.
The staff quickly unwrap my leg and check for compartment syndrome, as I was having tingling and numbness but that wasn't the cause. Soon, I received dilaudid and phenergan for my troubles and a quiet peace came over me. Except for my snoring.
I ended up staying 3 days in the hospital with high doses of potent painkillers coursing my veins.
The moral of this story: ACI with osteotomy is worse than Microfracture, its not an outpatient surgery, and make sure you get a prescription for something stronger than Percocet.
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