45 replies to this topic

[Skywatcher]

Just a follow up.

I am grateful for the feedback from so many people here. As a result I have done some homework, and had my first visit with a knee specialist today. MRI tomorrow, but the doctor already can tell exactly what is going on from previous imagery and his exam.

I am pleased to find out that all the torn up material can be removed, and a substitute cushion replaced. No knee replacement, just a rebuild where I get to keep the original parts and get a new warranty. Healing time is short (6 weeks), but he has assured me I will be able to do all that I could before this began. I feel relieved and optimistic.

[AGAMA]

EXCELLENT!!

You deserve to catch a break.  

Now you just need an exit strategy for the meds...,

when the time comes.

 

That news HAS to have you feelin' better about the whole knee situation...

Edited by AGAMA, 01 May 2014 - 06:55 PM.

[BlackPeter17]

That's great news i must have missed this thread so I haven't been following but I'm glad there's hope! So are you getting a meniscal repair and debridement or is the dr replacing your meniscus I'm confused?

Edited by Direwolf13, 01 May 2014 - 08:19 PM.

[WilfredOwen]

That is great to hear! My advice to anyone looking at surgery is to research, research, research. There are 3 major parts that greatly affect the success of most orthopedic surgeries: Surgeon, Physical therapy and You.
Having a top notch Doc who specializes in what you need is a big deal. I've had 3 surgeries on my right knee. 2 ACL reconstructions and 1 scope to remove most of what was left of the meniscus.The first time I blew out my knee bull riding, so I asked around and went to see a top notch Ortho surgeon. He gave me the best advice I've ever gotten. It's so simple, yet over looked. He told me he didn't want to do it. He said to go to a Dr. that does that specific surgery(ACL) day in day out and he gave me a couple of names to check with. He would do it if I really wanted, but he did more knee replacements rather than reconstructions. I'm sure he would have done a great job but he had a point. If you have the ability to stack the deck a little more in your favor then why not?
I was lucky enough to have several family members in the medical field several accident pro friends who knew which direction to point me in. If you don't have that ask Dr.s, physical therapists and even pharmacists and the MRI "If you had to get ____ done, who would you go to?" And make sure you word it similar to that. Many places don't allow their staff to give recommendations or they can only recommend drs affiliated with their group. They can answer your hypothetical question and it's not considered a recommendation.
Good physical therapy can sometimes get overlooked. Good surgeons will almost always have good PT in place. Poor pt usually means poor end products and a good surgeon doesn't want that. Whether you go to pt or you do it at home, do exactly what they tell you to do. Don't slack off. My first ACL surgery went fantastic. I had full range of motion back in less than a month. I had full strength back in 3 months and when all my restrictions were lifted in 6 months, I was in the best shape of my life. I had a much harder time recovering from the 2nd and it took much, much longer. I was still limping 9 months later. That was due exclusively to the physical therapy and lack there of.
Surgeries are like plane flights, you normally only hear about the bad ones. There isn't a single person alive that can guarantee you will have perfect surgery and flawless recovery. If you do everything you can to get a good surgeon, follow their instructions and put the work into caring for yourself, your chances for success are pretty good.

[Skywatcher]

Thanks for the feedback my friends. Dire, I am not sure at this point exactly what this is called. It was explained to me that the surgeon removes the torn up meniscus material that will never heal. Until the MRI is reviewed, I do not know how much more material is torn up as I was shocked to learn it was 4 years agowhen the last MRI was done, and I have just been dealing with this for that long. I am making the assumption that a replacing material needs to go in, or there is no shock absorb-er, just bone to bone. I will have a full description of the process after the next visit.

 

Good advice Wilfred, and thank you. I already have every confidence in this doctor, both from recommendation and my own experience with him. I did the PT last time and it was excellent facility and therapists. I expect it will be the same facility this time. I tend to continue asking questions and getting opinion and recommendation until I have set my mind. Once that happens I feel confident to stay the course.

 

Agama, I have already whittled the opiates down to 0 for over a week. It took two weeks of reduction to get here.  Muscle relaxants are now down to maybe twice a week. (Edible indica) is helping with this. I want to get where I am able to sleep at night and pass on these except in dire need, because I know they will always be available, so the decision to take them or not has to come from me, not the availability.  I told the surgeon today about my subbing indica for vicoden. He was actually supportive of that course, but said that immediatly after the surgery I should keep the options open because they will be working to control both inflammation and pain levels. I know what he is saying, but do not need another mental free pass card handed to me to get where I want.

 

I also need to say I do not think I could be improving on all this without the extra work I have been doing with Chakra's alignment and balance. 

 

The hope of being able to spirit walk solo again is also a good motivator........

Edited by Skywatcher, 01 May 2014 - 11:32 PM.

[BlackPeter17]

ok I got confused for a second sounds like your going to get a repair and debridement.  These types of surgeries have varying levels of outcomes in which your activity the initial weeks will dictate how you feel a year from now.  Unfortunately unless your getting a hole new meniscus there is no way to partially repair it.  most likely he will go in there cut away the torn piece clean up the area and sew your meniscus back together.  6 weeks for return to function may be a little ambitious, but it is the best outcome.  

I have seen people get meniscal repairs and do stupid stuff weeks 3-5 like go to concerts, or go back to work immediately working construction, or negotiating flights of stairs daily.  the issue here is that the meniscus is avascular and unable to repair it self.  when the work is fresh you can easily screw it up by bearing weight on it.  now if its a straight forward repair you will be allowed to put weight on it when walking but Id keep the activity down to a minimum and just perform circulation exercises while resting the initial recovery.  giving yourself optimal time to recover is essential in this surgery more so then others due to the inability to heal and repair itself.  I would avoid stairs for the next 4-6 weeks as you will notice that your swelling will increase with activities that involve compression and grinding of you meniscus.  don't be afraid that your not going to get better if you don't push it initially. usually around 6 weeks if there is no swelling and no pain then I initiate squats and stairs reciprocally.  

some docs don't recommend PT with this surgery.  Ive seen people have no PT and be fine.  Ive seen people who have gotten 4 scopes and then a knee replacement and had PT every time.  the moral of the story is that what you do after will impact the integrity of the repair and even though you may have no precautions I would limit activity to minimum for a few weeks.  just keep it elevated and relax.  

like you said you would imagine that there needs to be something in place of what taken out, and thats the problem with meniscal tears.  when you damage the shock absorber in your knee you will be more prone to further arthritis.  just remember take it easy, keep it elevated, and just think about how much fun your going to have this summer :)

peace, good luck!

[torn2bits]

Skywatcher,
Im glad ya stepped outside the comfort zone and saw a doctor .
I hope you get better fast.... TORN

[dial8]

My knee does the same thing. I can perform really strenuous activities with no problem but the smallest miss step with the up swing of my leg and it will dislocate slightly and swell for about 3 days and then it is good again. It has happened more times than I can count. I don't think it is as bad as yours cause even though it is swollen and tight I can still get around and put weight on it. It hurts too but not bad enough for medication. I had surgery on my other one to address torn cartilage. It was arthroscopic surgery and took me about a month to recover. That was over 20 years ago though. My Step father recently had a knee replacement and after about 2 weeks he was out and about even mowing his own yard (riding mower). He is still really sore and stiff but he recovered rather quickly. New technology I reckon.

Edited by dial8, 02 May 2014 - 10:34 AM.

[gatekeeper]

I used to go hunting with a friend who had to have his knee replaced from college football back in the day caching up to him. From what I can remember the surgery went well and he never complained. It still plays up from time to time and he won't hike up the hills with us, preferring to take a truck as close o the deer stand as possible. Bu he's able to get over at least some of the rough terrain out where we hunt fine enough. The surgery worked fine for him overall. You'll be alright man, if anything you just have to worry about catching something new while you're still in the hospital

[BlackPeter17]

outcomes for TKE are specific to the condition of the knee prior to the patient.  if a person is healthy and active a successful knee replacement will allow them to do more then they were able to prior to the surgery, and at return to prior level activity before injury is expected unless something did not go well with the surgery and or with the recovery.

 

a knee scope is minimally invasive and done in most areas as an outpatient procedure or day clinic.  if you catch something getting a scope then the conditions have to be pretty bad and equipment pretty dirty.  

[BlackPeter17]

My knee does the same thing. I can perform really strenuous activities with no problem but the smallest miss step with the up swing of my leg and it will dislocate slightly and swell for about 3 days and then it is good again. It has happened more times than I can count. I don't think it is as bad as yours cause even though it is swollen and tight I can still get around and put weight on it. It hurts too but not bad enough for medication. I had surgery on my other one to address torn cartilage. It was arthroscopic surgery and took me about a month to recover. That was over 20 years ago though. My Step father recently had a knee replacement and after about 2 weeks he was out and about even mowing his own yard (riding mower). He is still really sore and stiff but he recovered rather quickly. New technology I reckon.

Please describe the dislocation a little more for me.  is your knee cap dislocating (if so which direction) or is your knee locking, or is your knee giving out on you?  where is it swollen after this process occurs?

[BlackPeter17]

Here you go sky!

[Skywatcher]

Here you go sky!

 

Thanks Dire, I want to read all this, but your images are too large. I will need to copy and save on my PC to view them. I really appreciate the info.

[BlackPeter17]

Let me see what I can do. I could email the photos to my self and shrink them then re-post them. I'm not very computer orientated so I tend to complicate things like photo/file sharing. If I shrink it will you be able to view them on a full screen? The images are marvoulus. The text is very informative. The place that put the book out, HSS is pretty prestigious as far as I'm concerned.

I have lots of other books and literature, you just gotta figure out what kind of tear you have. Posterior horn, bucket handle, what ever and I can see what I can dig up. I also got some frank netter books with really neat illustrations.

Edited by Direwolf13, 02 May 2014 - 05:44 PM.

[Skywatcher]

I can edit any photo on my laptop. I use Adobe Photoshop myself, and can resize to any size I want. For the site here, 72 res, and about 600-800 seems to fit on the page. I have already started reading. The image from the MRI today will be specific, for the new damage since the last was taken, and I know more now about what I am looking at.

[BlackPeter17]

If you have the report it will show a summery at the end. The disc is fun to look at and there may be other stuff showing that's not in the report, your dr will most likely look it over if he's concerned however it's pointless because he's going to be looking directly in there whenever your getting surgery.

If they give you the whole report just skip over the initial procedure unless your looking to take a nap!

[BlackPeter17]

heres some cool pics

http://www.netterima...0/45.1-27_1.htm

 

http://www.netterima.../image/7684.htm

[BlackPeter17]

so whats the news with your knee?  I found a great book in my collection going over various procedures for the different tears and the outcomes with evidence based practice approach if your interested.

[Skywatcher]

so whats the news with your knee?  

As usual, I seem to be the only one in any kind of hurry. I have an appointment to review the MRI and decide the course of action for next week. I know nothing new yet.

[BlackPeter17]

Ok well keep us posted and let me know if you want some more reasorces!