What Happened in Surgery

Going into surgery we knew there were three possible reconstructions that I would need, but my surgeon didn't know what he would do exactly until I was in surgery. He ended up doing all three reconstructions.

The first, which he was pretty sure he was going to do, MPFL replacement. My medial patella femoral ligament was replaced with a cadaver tendon.



The second, osteotomy of the tibia. The goal of this is to deepen the grove that the patella (kneecap) sits in. This can be done without using bone to build up the grove, in those cases a wedge is used to build up the grove instead. On my left knee (December 2009) my surgeon used a wedge, but for this knee he used my bone of my tibia to build up the grove.

The third, adjustment of the Q-Angle. The Q-Angle is the angle between the tibial tubercle (right under the kneecap on the tibia) to the middle of the patella and the middle of the patella to the ASIS (hip)

The Q-Angle:



The Surgical Fix:

No PT For Me

I was supposed to go to physical therapy today, but we decided it was just going to be a bad experience. Since just getting up to go to the bathroom is still such a task and painful, going all the way to PT was not going to be good. Plus, I still feel weak, like I'm on the verge of passing out when I get up, so being up for that long makes passing out for real a lot more likely situation.

My pain is still the same, and obviously moving is still just as difficult. I'm supposed to be backing down on the ice machine (I have a machine that circulates new cold water to my knee, it hooks up to a cooler type thing with a water/ice mixture) but when the ice is off my knee gets a very hot feeling inside. Overusing the ice can delay superficial healing, which means my incision. I had problems with that on my other knee last year, it really isn't a huge problem, I just had to keep my stitches in longer on one part of my incision. That can also give you a bigger scar, but because of EDS my scars are never perfect anyways. So, I'm working on backing off on the ice, but it's not a major priority, if I can get some pain relief from it then I'll use it. I've been turning it off at night, and saving it for the day which seems to be working.

Incision

Today we unwrapped my leg. My incision looks good. Unwrapping my leg was a little uncomfortable, but it felt good for it to get some air. We took off the extra gauze that was on my knee. Right now there is just one layer of padding, a small wrap and a large ace bandage which goes all the way down my leg covering my knee.

Same Old, Same Old

Unfortunately, I'm pretty much doing the same as I was last week. My mom moved my bed into the family room so that I can watch TV and be with everyone more. I'm still having significant pain, and it gets worse the more I move so I pretty much stay in bed all the time. I'm not ready to start decreasing my pain medicine yet, well see how I do the rest of the week. Apparently, I move my leg and jump in my sleep, so I often wake up in more pain.

The plan was to try to go back to school sometime next week, hopefully I start to turn the corner this week and can start going back to school next week.

Update

There's not much to update on. My pain is still the same and it's still quite uncomfortable to move. I haven't gotten out of bed at all today, which isn't such a bad thing. I keep my leg elevated, but after a while (a couple hours) it gets uncomfortable in the same position, so someone has to move it around for me. I've been able to drink more today, which is good to try avoiding passing out. I've been able to eat a little bit, some crackers and soup mainly but not "real food" yet. As long as I can keep on top of staying hydrated we don't have to be too concerned with the eating part.

I'm going to see my PT next Friday (I think) to mainly check in with the rest of my body and make sure I'm not loosing too much strength everywhere else.

Home!

I came home yesterday afternoon. Once I was in the car, the trip wasn't so bad but getting there was a little bit of another story.

We planed to leave right when it would be time for my medicine again so that I could just sleep the whole way home. My parents had started getting everything ready and were putting everything in the car. I got into my wheelchair by just lifting myself up and scooting into it while my dad held my leg up (my wheelchair was right against the bed, parallel). I've learned that that's the easiest was to transfer, rather than using the walker. I sat up in my wheelchair for a little bit because I often have problems with passing out post-op and that was the first time I got out of bed since my surgery. I was able to get into the bathroom with the walker and I was feeling tired, but still thought I could do it. I put some clean clothes on and then was going to try to stand up again and get back into the wheelchair. Then next thing I knew I was sitting down and just shaking. Luckily, my mom and dad were there. My dad was holding my leg up because it is very uncomfortable if it hangs down, and my mom was holding me up to make sure I wasn't going to tip over. Once I felt better I was able to get back into the wheelchair and then into the car and I pretty much slept the whole way home.

I'm still in quite a bit of pain and still really tired, so I'm pretty content with just laying in bed all day and moving as little as possible.

Surgery

Surgery went well. I ended up having pretty much the exact same things done as the other knee.

I'll give a more detailed update later on. Thanks for all the good wishes.

Getting Ready

I am pretty much ready to go for surgery. I have everything moved downstairs for surgery. My dad just moved my bed down this morning (I'll stay downstairs for 4-6 weeks). I finished getting all the little random things I needed. My bag is packed for Cleveland (that's where my surgery is going to be).

I'm looking forward to spending the rest of my day with my friends and having some fun before I leave (we're going up to Cleveland Sunday evening).

Right now the post-op plan is to go back to a hotel in Cleveland Monday night and stay there until Wednesday. My surgery is being done at an outpatient center so I can't be admitted, we'll see how that goes. If my pain can't be controlled and I'm having problems, then I'll be transported to main campus and admitted there. Hopefully I'll be comfortable enough to not need to be admitted.

Knee Surgery

I'm going to have right knee surgery this Monday (February 14th).

We know for sure that he will do the MPFL replacement (with cadaver tendon). We don't know exactly what else he will do, neither does he until he's in surgery. On my other knee I had an osteotomy done to deepen the grove that my knee cap sits in (bone work of my tibia). I also had my Q-angle adjusted (removing the insertion of the patella tendon on my tibia so that it becomes more aligned). Most likely, he will have to do at least one of those other things, but we won't know until I'm in surgery.

Right know we're developing a surgery plan, so I will update on that soon.

Knee Appointment

I'm going to Cleveland tomorrow to see my knee surgeon. Honestly, I would rather he just say I should have surgery now and get it over with, as opposed to making me wait until this summer. We'll see what happens. I'll update after my appointment tomorrow.

Physical Therapy

I ended up being able to go to PT on Tuesday and I'm going again this afternoon.

I'm slightly limited with my knee, but I'm able to do some exercises. It's obvious that my knee is going to hold me back as long as it is so unstable, but hopefully I can respect my knee and still gain some more strength for my hip.

Hip Appointment Update

I saw my hip surgeon yesterday, he is very impressed and happy with how my hips are doing. Honestly, I think we are all a little shocked at how well they are doing. They're like perfectly normal hips now, which I have to say is a lovely thing.

We talked about my knee and although he was bummed, he said that my hip can handle if I have to have surgery so soon. In the long run, that's good news for my knee and my hip as well.

I'm supposed to start back with PT (I haven't gone since I subluxed my knee) today, but the weather might be an issue with that. We got a huge ice storm over night and quite literally everything is closed. I'm hoping that things get better throughout the day so that I can get to PT, otherwise I'll hopefully get in another day this week.