I haven't posted anything in awhile, I am sorry about that. Things have been kind of crazy. I had my appointment at the Medical College of Wisconsin with Dr. William Raasch last month.
The appointment pretty much went how I was expecting, the doctor things that Autologous Chondrocyte Implantation is my best shot at a somewhat normal knee. As I am sure most of you know, ACI actually consists of two surgeries. During the first surgery, the doctor will use a scope to take a look at the inside of my knee and assess the damage as well as harvest the cells to send to Carticel. Also, during this procedure, Dr. Raasch will take a look at my medial tibial patella (the site of my previous Microfracture). Depending on whether the Microfracture worked or not (which it probably did not) he would like to perform a Tibial Osteotomy during the actual implantation to take pressure off of that portion of my knee. I had come to terms with my needing the ACI, however, the mention of the Osteotomy kind of freaked me out. On one hand, it would be best to do both of the surgeries at once because both will leave me non weight bearing for 6-8 weeks so I might as well knock it out in one big swoop, however, the recovery will be huge. They will remove a wedge of my tibia in order to reallign my knee (he says I am slightly knock knee'd.... RUDE).
I have read soooo much research and information on all of these surgeries as well as all about the recoveries but I still have a lot to think about. First and foremost: my rehab. I need to figure out if my new surgeon expects me to go to his rehab clinic and if that is the case, I need to figure out my transportation situation. Milwaukee is about a 45 minute drive from where I live and I (obviously) will not be able to drive myself. Theoretically, I could continue at the Physical Therapy clinic I am at now (the Naval Hospital down here in North Chicago) but there is a reason why I was referred to a different hospital... because the surgeons at my current hospital do not usually perform ACI which means that the physical therapists are not familiar with the protocol. This fact scares me the most because this surgery will have a very strict and very delicate 3 phase rehab regime. I do not want to go through all of this and commit myself to an 18 month recovery only to discover a year down the road it didn't work because my physical therapist is not familiar with my unique situation.
Blehhhh... A lot to think about.
Tuesday, August 19, 2014
Saturday, July 19, 2014
7 weeks post-op
Not much has changed since my last post. I am still struggling with my range of motion and swelling. I now go to physical therapy three times a week and try to squeeze in the at-home exercises whenever I can. Whenever I do have some spare time at home I continue to spend it hooked up to my ice machine.
Wednesday I had a doctors appointment with my primary care physician before physical therapy. I had to walk around quite a bit so my knee suffered a lot. By the time I made it down to my PT my knee was huge. It was so unbelievably swollen. My physical therapist suggested I slow up on the at home exercises and give my knee some time to rest, and until the swelling goes down no active motion. For those of you who are unfamiliar with all of this "beat-around-the-bush" doctor talk, this means don't do any exercises on your own. This really hinders my rehab process because my husband is a Recruit Division Commander here at Naval Station Great Lakes so unless I am willing to wake up at 4am or bombard him for help as soon as he gets home, I cannot do my exercises at all. I managed to find a way to tie a dog leash loosely around my ankle to help support the weight of my leg but, geez, what a pain.
Luckily the swelling subsided by the time I had my next appointment so I was able to resume my regular routine (as swelling and pain allows). As of Thursday I was able to bend my leg 97 degrees with zero assistance. It's not much, and I am nowhere near where I want to be but I am trying to stay as positive as I possibly can. 😖
This picture was taken at my 7-week mark. As you can see, my knee is still pretty swollen and I am still struggling to regain all of the quad muscle that I have lost these past few weeks. I am hoping that this will be a little easier once I am able to walk brace-free.
I was hoping to be able to ditch my ROM brace this Wednesday or Thursday but unfortunately my doctor forgot to put a note in my record so I am stuck wearing it until my PT knows for sure I am allowed to. I am still getting used to trying to navigate and learn how the different offices and clinics within the Naval Hospital communicate so let me just say this: UGH!
I have my appointment up at the Medical College of Wisconsin with Dr. Raasch this Wednesday so I am hoping to get some suggestions on how to best tackle the annoyance that is my knee. Fingers crossed!
Friday, July 11, 2014
Breg T-Scope Premier Customer Service
I thought I already wrote a post about this but apparently I was mistaken.
So about a week and a half ago I noticed this piece of grey plastic laying on the floor by my side of the bed. I picked it up, examined it, and then it hit me: it was from my brace.
It was this clip thing that controls the flexion adjustment and although I am not able to take advantage of this feature right now, I might need it after my next surgery. So I called the customer service number listed on Breg's website and someone literally answered on the second ring (WHOAH!).
She asked me a couple of questions (where and when I got the brace, blah, blah, blah) and before I knew it she was giving me a return authorization number and said that they were shipping me a replacement right away. The brand new brace arrived on my front porch in less than 24 hours along with instructions to simply throw my old piece of equipment in the same box and just leave it on the porch. A UPS man showed up the next morning, threw a label on it, and wah-lah!
As much as it seems like I am just rambling, I just wanted to share the most AMAZING customer experience I have ever had with all of you!
So about a week and a half ago I noticed this piece of grey plastic laying on the floor by my side of the bed. I picked it up, examined it, and then it hit me: it was from my brace.
It was this clip thing that controls the flexion adjustment and although I am not able to take advantage of this feature right now, I might need it after my next surgery. So I called the customer service number listed on Breg's website and someone literally answered on the second ring (WHOAH!).
She asked me a couple of questions (where and when I got the brace, blah, blah, blah) and before I knew it she was giving me a return authorization number and said that they were shipping me a replacement right away. The brand new brace arrived on my front porch in less than 24 hours along with instructions to simply throw my old piece of equipment in the same box and just leave it on the porch. A UPS man showed up the next morning, threw a label on it, and wah-lah!
As much as it seems like I am just rambling, I just wanted to share the most AMAZING customer experience I have ever had with all of you!
6 Week Follow-Up
It's been a little while since I have posted, sorry about that.
Things have been moving very very slowly. My physical therapy hasn't gone as well as I was hoping it would. My therapist had me focusing on strengthening my quad, meanwhile my ROM has consistently sucked. I should have asked more questions and done more ROM exercises on my own, however, I am not the specialist. I have been busting these exercises out as much as I can the last few days and I am seeing some progress. I can now flex over 90 degrees with minimal pain. It's not much (especially at 6 weeks post-op)--but it is better than nothing, right?
Today was my 6 week followup appointment with my Orthopedic Surgeon, Dr. O'Daniel. He examined my incisions (all 4) and they are all looking good. He also reminded me that they will be hypersensitive to sun for awhile so be careful when I am out in the sun. He has nothing to worry about because my legs remain consistently pale no matter how much time I spend in the sun.
Dr. O'Daniel was not at all pleased with my ROM and asked me what was going on in PT. After I explained how difficult of a time I have had with the office, he calmed down a little. He gave me a couple of additional exercises to start doing at home. He was also concerned with the amount of swelling that is still present (no matter how uncomfortable/painful it is, my PT keeps telling me it is normal). He prescribed some anti-inflammatory medication to hopefully provide me with some relief. I like to think I have a pretty high pain tolerance but I am hoping that as the swelling decreases, so will the discomfort.
I managed to get a little more information on what all he saw during the surgery. I have 2 holes in my cartilage (I cannot remember the exact measurements off of the top of my head). The one that was addressed was on my medial patella facet. At my very first ortho appt. I mentioned how the majority of my pain was on the inside of my knee, I guess this explains it. As I mentioned before, this defect was uncontained which means that the likelihood of the "superscab" staying in place (if it manages to form at all) is very low. The second (and larger) area of concern is on my lateral femoral condyle. This particular hole was too big to address with Microfracture so my surgeon left it alone.
Hence, my referral to the Sports Medicine Specialists at the Medical College of Wisconsin.
The next few weeks are going to be crazy busy. I have been upped to 3 PT sessions a week, thank goodness! I have begun to schedule these as far in advance as possible to ensure that I do not get overlooked again. Also, the week after next (Wednesday the 23rd) is my appt. at the Medical College of Wisconsin... Hooray! I am super anxious to get some answers. I need to start writing my questions down because I ALWAYS forget to ask the important ones.
OH! And I also have permission to ditch my locked brace starting next week (the 7 week mark). I am so excited to get that thing off and start walking normal, I can hardly think about it without getting all giddy. It's the little things. :)
Things have been moving very very slowly. My physical therapy hasn't gone as well as I was hoping it would. My therapist had me focusing on strengthening my quad, meanwhile my ROM has consistently sucked. I should have asked more questions and done more ROM exercises on my own, however, I am not the specialist. I have been busting these exercises out as much as I can the last few days and I am seeing some progress. I can now flex over 90 degrees with minimal pain. It's not much (especially at 6 weeks post-op)--but it is better than nothing, right?
Today was my 6 week followup appointment with my Orthopedic Surgeon, Dr. O'Daniel. He examined my incisions (all 4) and they are all looking good. He also reminded me that they will be hypersensitive to sun for awhile so be careful when I am out in the sun. He has nothing to worry about because my legs remain consistently pale no matter how much time I spend in the sun.
Dr. O'Daniel was not at all pleased with my ROM and asked me what was going on in PT. After I explained how difficult of a time I have had with the office, he calmed down a little. He gave me a couple of additional exercises to start doing at home. He was also concerned with the amount of swelling that is still present (no matter how uncomfortable/painful it is, my PT keeps telling me it is normal). He prescribed some anti-inflammatory medication to hopefully provide me with some relief. I like to think I have a pretty high pain tolerance but I am hoping that as the swelling decreases, so will the discomfort.
I managed to get a little more information on what all he saw during the surgery. I have 2 holes in my cartilage (I cannot remember the exact measurements off of the top of my head). The one that was addressed was on my medial patella facet. At my very first ortho appt. I mentioned how the majority of my pain was on the inside of my knee, I guess this explains it. As I mentioned before, this defect was uncontained which means that the likelihood of the "superscab" staying in place (if it manages to form at all) is very low. The second (and larger) area of concern is on my lateral femoral condyle. This particular hole was too big to address with Microfracture so my surgeon left it alone.
Hence, my referral to the Sports Medicine Specialists at the Medical College of Wisconsin.
The next few weeks are going to be crazy busy. I have been upped to 3 PT sessions a week, thank goodness! I have begun to schedule these as far in advance as possible to ensure that I do not get overlooked again. Also, the week after next (Wednesday the 23rd) is my appt. at the Medical College of Wisconsin... Hooray! I am super anxious to get some answers. I need to start writing my questions down because I ALWAYS forget to ask the important ones.
OH! And I also have permission to ditch my locked brace starting next week (the 7 week mark). I am so excited to get that thing off and start walking normal, I can hardly think about it without getting all giddy. It's the little things. :)
Thursday, July 3, 2014
The Medical College of Wisconsin
About a week ago I got a letter stating that Tricare (my health insurance company) had approved a referral request. Hooray!
The referral is to the Medical College of Wisconsin to see to see Dr. William Raasch. I've done my research and I must admit, Dr. Raasch has an impressive resume. "He is the head team physician for the Milwaukee Brewers, Milwaukee Mustangs, Wisconsin Lutheran College and Wisconsin Lutheran High School. He is also the company physician for the Milwaukee Ballet Company."
I got in contact with several people who got me enrolled in their system and told me what information I needed to gather for them on my end (radiology reports, discs with X-Rays and MRIs, operative report, etc. ).
Well I got all of that done and... drumroll please... I have an appointment scheduled for July 23rd, hooray!
Well I got all of that done and... drumroll please... I have an appointment scheduled for July 23rd, hooray!
Has anyone had any experience with this particular hospital or doctor? If so... do share!!
At Home PT
Last night was a rough night. I decided to sleep with my IceMan on for the first time in a few weeks because my knee was extremely swollen and was bothering me all day. I thought that it would provide me some relief but for some reason, it provided just the opposite. I could not get comfortable. It was so bad that I was actually relieved when it was time to get up in the morning.
After I got home from work I decided to look up some additional at home PT exercises to try and work out this stiffness and increase my crappy ROM. I do not recommend doing this, however, it seems that no therapist at the hospital I go to is familiar with the rehab protocol for Microfracture patients (nor do they seem to even know what a Microfracture is; awesome, right?).
I found a couple of great exercises and saw immediate results. My physical therapist has had me do all of my previously mentioned exercises while sitting up with my arms behind me; however, I decided to give those same exercises (with a couple of changes) a try while laying on my back. It is insane how much of a difference this made. First, being able to place my hands on my stomach helped me to control my breathing which helped me to relax which made a WORLD of difference! After doing my "floor routine" I climbed onto the ottoman to do my heel slides. Right away I was able to successfully bend my leg a little more than 90 degrees with no pain and very little discomfort. That is over a 20 degree difference in less than two days!
Also, I was able to do 25 leg lifts all on my own! Before now it would take me a few tries to even get my leg off of the floor and even then I could only do a couple unassisted before I felt intense pain and pressure on the inside of my knee (is that normal?). I still felt that pressure and some popping/grinding today, but nowhere near as bad as before.
I really needed today, I have begun to get really frustrated with how little progress I have made lately.
There were two exercises that gave me a little trouble. One was when I was bending my leg/sliding my heel while on my back. Somewhere between 20 and 30 degrees I kept feeling this really painful popping/shifting on the inside of my knee. After I realized that it would not subside, I stopped immediately. The other one that gave me an issue was putting a rolled up towel underneath my knee and trying to lift my lower leg while keeping contact with the towel. I did this at PT the other day and it was unbearable, however, I thought it was perhaps because their foam roller is freaking gigantic. I got the same popping, however it was a lot less painful and eventually it became more uncomfortable than anything. I made a note of both of these concerns and will be sure to bring them up to my PT on Monday.
Now I'm off to spoil myself with a couple hours of uninterrupted icing. It's the little things...
After I got home from work I decided to look up some additional at home PT exercises to try and work out this stiffness and increase my crappy ROM. I do not recommend doing this, however, it seems that no therapist at the hospital I go to is familiar with the rehab protocol for Microfracture patients (nor do they seem to even know what a Microfracture is; awesome, right?).
I found a couple of great exercises and saw immediate results. My physical therapist has had me do all of my previously mentioned exercises while sitting up with my arms behind me; however, I decided to give those same exercises (with a couple of changes) a try while laying on my back. It is insane how much of a difference this made. First, being able to place my hands on my stomach helped me to control my breathing which helped me to relax which made a WORLD of difference! After doing my "floor routine" I climbed onto the ottoman to do my heel slides. Right away I was able to successfully bend my leg a little more than 90 degrees with no pain and very little discomfort. That is over a 20 degree difference in less than two days!
Also, I was able to do 25 leg lifts all on my own! Before now it would take me a few tries to even get my leg off of the floor and even then I could only do a couple unassisted before I felt intense pain and pressure on the inside of my knee (is that normal?). I still felt that pressure and some popping/grinding today, but nowhere near as bad as before.
I really needed today, I have begun to get really frustrated with how little progress I have made lately.
There were two exercises that gave me a little trouble. One was when I was bending my leg/sliding my heel while on my back. Somewhere between 20 and 30 degrees I kept feeling this really painful popping/shifting on the inside of my knee. After I realized that it would not subside, I stopped immediately. The other one that gave me an issue was putting a rolled up towel underneath my knee and trying to lift my lower leg while keeping contact with the towel. I did this at PT the other day and it was unbearable, however, I thought it was perhaps because their foam roller is freaking gigantic. I got the same popping, however it was a lot less painful and eventually it became more uncomfortable than anything. I made a note of both of these concerns and will be sure to bring them up to my PT on Monday.
Now I'm off to spoil myself with a couple hours of uninterrupted icing. It's the little things...
Wednesday, July 2, 2014
PT Session #3
So today was my third physical therapy appointment. I have noticed somewhat of a difference since I have started but my progress has been nothing to write home about (not worth the stamp). I have increased my ROM to about 80 degrees and I am able to do leg lifts on my own for the most part (I still need some help to initially get my leg up off of the table).
The biggest frustration I am facing right now deals more with the therapists than my knee. I am no stranger to this physical therapy clinic, however, when I was there before, it was more for strengthening and whatnot post my spill on the ice. What I am noticing now is that no one seems to know what a Microfracture Surgery is. They keep assuming I just broke my leg or something which is (obviously) not the case.
Because physical therapy is
I have been doing what I am told but I really and truly hope that their lack of knowledge and understanding do not hinder my post-op recovery or make my condition worse.
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