PKR I'm Here.... PKR left lateral complete!

[mcirish]

@mcirish Re my rant: No worries, I think we are good. I have been described as subtle as a truck, and certainly wasnt offended by that characterization.

Re your questions--here goes my straight shootin' replies, for what they are worth. Remember, you asked!

1.Ice more, ice all the time, ice some at night if you can sleep with the contraption on. Elevate as much as possible, with ice. Did I mention you need to ice that sucker? Ice will help the pain and swelling like nothing else. Josephine will jump on you like a duck on a June bug if you dont recognize the swelling as PAIN and medicate (and elevate and ICE) accordingly. I am approaching 8 weeks out and am still icing probably 6-8 hours a day,to which fact I attribute my "textbook perfect" recovery so far. (Pssst. @mcirish Dont tell ANYONE on Bonesmart that I still have over 80 Lortab left from the script for 100 that was supposed to only take me up to the 2 week follow up appointment, or that I'm riding horses and trimming their feet, because such is the stuff that urban legends of knee surgery recovery are based on, and probably therefore cant be true.) Embrace ice.

2. I havent had much in the way of scarey knee noises, but I have had some, mostly in the first few days post op. I am a bit concerned that you arent using a cane or a walker even in the house. I too was sneaking around with no visible means of support very early, but not quite as early as you are. The inside of your leg needs all the help it can get. The implant is probably fine, the soft tissues not so much.

3. I am the worst possible person to ask about the (allegedly) waterproof dressing since I made sure I changed mine the day after surgery since it was disgusting, not to mention no longer waterproof, since blood was running down my leg when I got home the day of surgery, and had been while I was still in the hospital. This is an area where I KNOW for a fact that the nurses couldve and shouldve done better, since they reinforced the dressing instead of changing it. (See, not always defending my sister and brother nurses. I've worked with more than a few who were sorry slobs.)

Since I was at PT that first postop day and since they had the wherewithal, dressing was changed, and NOBODY DIED. Your mileage may vary. I'd say if there's no drainage on the outside, meaning that the barrier hasnt been breached, you should be ok following orders, but since I am me and have never been able to stand gunky bandages on me or anyone else, I changed mine.

4.Hmm. How do you know it's 8-10" long unless you've been a baaaad boy and peeked under the waterproof dressing you're supposed to leave alone? Or are you extrapolating from how sore it feels and how big the bandage is? I had the standard foot long dressing (closely resembling the nasty thing between your steak and the styrofoam tray it came in) over an incision barely 2 1/2 inches long. I didnt have what amounts to a zipper there for the surgeon to go through, though. I just dont know.

@jeano Thank you for the info. I did peek at the knee, but I really got a good look at it when they changed the dressing the morning before I left the hospital. I was quite surprised (in a muted morphined way) at the size of the incision, but then I remember what the OS had told me and now it made sense. The existing ACL scar I had was just ugly. Did not heal well. Then I had the donor graft scar. So i was either going to have 3 large scars scribbled on my knee like a bunch of graffiti or a bigger artsy looking sucker. Plus he wanted to access the medial area to look at that and do any clean up that was needed. Will respond to the rest later, my knee is telling me that I need to lay down......NOW lol.

 

[mcirish]

@jeano

ice: The thing is, I am not really in any pain and the swelling isn't that bad anymore, so I don't need it that much. My whole non-expert opinion on ice is that it is used for pain relief and to prevent further tissue damage. After that, it doesn't really do much. I understand about getting ahead of the curve with ice and the pain meds, but I just don't need them that much. Also, after going through many, many prolotherapy sessions for my problem child knee, it was preached to me over and over again by the doctor that did the treatments that swelling, under the right conditions, is a good thing. It's the body's natural response and indicates that the body doing what is needs to to heal. I have also told by this same doc that some studies show that icing too much can reduce the body's healing response. Of course if I was in any real discomfort or if the limb was so swollen that my foot was starting to get tingly, purplish and numb, I would definitely ice, take anti-inflams, whatever. This is just what I have experienced and I am not advising anyone else to do what I do, it's just more weirdness from me. I have iced for about 2-3 hours today and will put the CTU on my leg tonight for about an hour before bed. I think today was a little heavy actually because of the load I put on my leg last night. Weird, I know, but like I said, works for me.

Walking: the OS's instructions said "full weight bearing as tolerated". Aside from last night, I have never really pushed it. My weight bearing is usually trips to the bathroom and kitchen, then back to bed. (no more than 20 ft per trip) Once a day I gimp upstairs (one-legged drag with the rail as an assist), plop down on the floor with my little one and wifey, read stories, assist with managing Maya (daughter) maybe for 90 mins, then its' back down to quarantine, maybe a couple trips back and forth to the fridge, etc. Also, in the hospital, during my 2 PT sessions, the nurses were like "wow, you really don't even need the crutches/walker", just meaning that I looked strong, but please continue to use the crutches. I would still use the walker or crutches obviously, but I was heel toe from the beginning and was allowed to do as much as I could tolerate. And believe me, at home, I am very careful not to put myself into position to slip or trip. I don't stand on it for long periods of time (more than 2-3 mins). All I am really doing is "ambulating" for short distances and VERY carefully. Little short steps, no pivoting.

 

[mcirish]

I found this video when I was researching my PRK procedure earlier this year and kind of took this guys mentality when I thought about how my recovery was going to go, at least tried anyway. In no way am I saying I am like this guy or as tough as he is (nor would I want to be!), but his whole attitude and positivity just kind of inspired me.

 

[Ziggysmom]

I'm riding horses and trimming their feet

I felt I was ready for a walk to the main dumpsters where I live to toss out our trash about 10:00 last night (we live in a nice, funky rural area) I only had a small diaper bag to carry and our small wonder mutt Charlie on a leash. The Mrs. has the bigger bags. Total distance less than 1/8 mi round trip, slight incline....about halfway up I was spent. Had to use my 5'4" wife as a human crutch the last 100 yards home....

Poor Josephine is going to be banging her head against the wall when she reads this....she read me the riot act for folding a little laundry 6 days after surgery, LOL!!

 

[mcirish]

Poor Josephine is going to be banging her head against the wall when she reads this....she read me the riot act for folding a little laundry 6 days after surgery, LOL!!

lol...I didn't say it was the smart thing to do. I would not do it again if I could have a do over....probably would have only walked half the distance

 

[mcirish]

Just had to share some pics with everyone. First are a side by side of my legs/knees and the lovely waterproof bandage that was given to me (actually works quite well). The others are of my lil' nurse Maya who is constantly checking in on me and inspecting everything (what else do toddlers do?) She will actually hand me water bottles while I am lying down telling me to "drink....drink"....lol, just like her mom! I may change the bandage tomorrow so I could have a stitch shot to share. Thanks to everyone here who has been so helpful to me and patient with my various rants and self-absorbed posts. A Blessed New Year's to everyone.

Edit: I actually don't have gangrenous feet. This Sony camera exaggerates some of the colors quite a bit. Really.

 

[icep707]

I shouldnt say this cause im a niner fan but you were in "beastmode" last night. You were a baaaad boy! Ha! Ha! I think they call it odic! Remember this early on ,..... " less is more. " other than that and the early experience sounds like all is well. Congratulations !! 66 degrees today in santa rosa .

 

[mcirish]

I shouldnt say this cause im a niner fan but you were in "beastmode" last night. You were a baaaad boy! Ha! Ha! I think they call it odic! Remember this early on ,..... " less is more. " other than that and the early experience sounds like all is well. Congratulations !! 66 degrees today in santa rosa .

@incep707

haha I am still learning. I honestly do need to dial it back sometimes. I was wrecked this morning, but still needed to run to my office with the wife to pick up some checks and then to the bank.....by the afternoon I was tweaked. Needed to sleep for about 2 hours....then home PT, nice Ribeye (med. rare) with salad for dinner and then put the daughter to bed...been craving steak and red meat something fierce lately. Well, time to shut it down for the night...sounds like a nice day in SR...hit a high of 77 here in Santa Sue....#ridiculous

9ers got a tough one in GB....predicted high of ....-5F!!!! Scary cold.

When are you crossing over???

 

[jeano]

@mcirish: Ah, those first days of recovery when you think you have the world by the tail and then the world lets you know who has your tail in its iron grip! Just take it easy, and rest up after you overdo. Glad you are recognizing the need for rest and for extra protein, even if you are an ice apostate. Weather report from the Deep South--23 and windy. I can just stick my knee out a window.

Looks like your retired military guy has him some longish scars, too, from what I could see in the video. Yesterday's big milestone for me was getting down on the floor (at the grocery store!) to retrieve the very last bag of decaf coffee beans on the very back of the bottom shelf. On the way down I was praying I'd be able to get back up, since this was my first grovel post-op.

I am getting ready for my first day back at work so will be prepared to do nothing at all tomorrow, which is what I was anticipating doing today--made the mistake of checking in with the agency I work for to put some feelers out about returning--thought the January schedule would be pretty settled but as it turned out she thought there were some holes to be filled next week--I said, OK, get back to me if you need me, THEN got the word at 5PM thursday that they need me 8AM to 4PM today. Oops. Guess I'll see if I can cut the umbilical cord to my Polar Care Cube. I was already wiped out from taking my ancient mother and myself to town to run various errands. Got very little icing and rest when I got home, then got less than very little sleep last night. The knee's not bad, but the rest of the body doesnt like this weather system.

I had planned to try a day without ice and a lot of sitting at a computer first, since that's mostly what I do at work when I'm not stamping out lives and saving disease. But we'll wing it! Wish me luck on remembering my work passwords and such--otherwise I wont get much charting done....

 

[RedRider]

This may be an odd question, and maybe a little too early to ask, but how is the "feel" of the implant? Is it a natural feeling or does it feel foreign?...like that feeling you get when you have a sliver in your finger.

Don't worry, you're not the only one feeling exhausted and in pain after New Years...

 

[kneeper]

Sounds like you did what most of us do, @mcirish --learning the hard way what our limits are. At least you had your wife-crutch on hand.

 

[kneewords]

Hi sorry to hear about your rough beginnings but sounds like you're doing good now. you're going back to work already? dang dude! you rock i was still a ball on the bed sobbing at your point. i wanted to let you know when i called our OS it was always "leave a message" the only way i could get thru is hit 0 and talk to the receptionist and BEG for someone to talk to. all my issues that were really bad at the time have just turned out to be the healing process and that takes time. Im at 5 months and still have some pain. Are you doing at home PT they sent someone to the house for about 3 weeks and then i had 6 weeks of outpatient. hang in you're doing great. the tiredness lasts while but your body has been thru a lot!

 

[mcirish]

@mcirish: Ah, those first days of recovery when you think you have the world by the tail and then the world lets you know who has your tail in its iron grip! Just take it easy, and rest up after you overdo. Glad you are recognizing the need for rest and for extra protein, even if you are an ice apostate. Weather report from the Deep South--23 and windy. I can just stick my knee out a window. So true jeano. I must recognize officially that this is the most intensive surgery I have had to date. My original ACL procedure came close only because 1982 techniques for knee surgery were almost primitive in comparison to what they do today. Although my left knee's messages are more muted now, she is still in charge that's for sure.

After I started to recover from the flu shot fiasco, my body would give me a quadruple whammy shutdown message when it had enough of me stressing it: sudden fatigue, nausea, dizzy, insta-cold sweat.....now I just get the fatigue and cold sweat mildly, but the message is still clear. Left knee is the boss, no question.

Looks like your retired military guy has him some longish scars, too, from what I could see in the video. Yesterday's big milestone for me was getting down on the floor (at the grocery store!) to retrieve the very last bag of decaf coffee beans on the very back of the bottom shelf. On the way down I was praying I'd be able to get back up, since this was my first grovel post-op.

Yes, I saw that. That procedure was back in 2010, maybe earlier, forgot what the video publish date was, but maybe that was the older technique???....I was forced to change my dressing this morning cause the membrane broke so the "ooze" started oozing out of the gauze barrier....yuck. (I will post a pic of it later) I was able to get a really good look as I cleaned the incision area....Dr. Sisto did a great job of using the existing scars and only added about 3-3.5" of scar and kept it all mid-line to medial. If he had gave me a fresh incision he would have had to somewhere lateral to mid-line which would have left me with 3 large scars. This one is large as well, but it is only a single continuous scar in appearance. Really happy with what he did.

Squatting to reach a bottom shelf.... I can only dream what that's like right now. How'd it go? How was it in comparison to the way your knee was before? If I squatted I would have to put all my weight on my right knee and just bend my left knee which was along for the ride. Could not put any pressure on the lateral compartment.

I am getting ready for my first day back at work so will be prepared to do nothing at all tomorrow, which is what I was anticipating doing today--made the mistake of checking in with the agency I work for to put some feelers out about returning--thought the January schedule would be pretty settled but as it turned out she thought there were some holes to be filled next week--I said, OK, get back to me if you need me, THEN got the word at 5PM thursday that they need me 8AM to 4PM today. Oops. Guess I'll see if I can cut the umbilical cord to my Polar Care Cube. I was already wiped out from taking my ancient mother and myself to town to run various errands. Got very little icing and rest when I got home, then got less than very little sleep last night. The knee's not bad, but the rest of the body doesnt like this weather system.

I had planned to try a day without ice and a lot of sitting at a computer first, since that's mostly what I do at work when I'm not stamping out lives and saving disease. lol good one But we'll wing it! Wish me luck on remembering my work passwords and such--otherwise I wont get much charting done....LUCK! I know you will do fine, you are one of my knee "role models" here. Tough as they come....I don't know why, but I figured you might be from the South...didn't imagine the weather getting so cold there in the winter.

@jeano

All comment in above quoted text in bold.

 

[mcirish]

This may be an odd question, and maybe a little too early to ask, but how is the "feel" of the implant? Is it a natural feeling or does it feel foreign?...like that feeling you get when you have a sliver in your finger.

Don't worry, you're not the only one feeling exhausted and in pain after New Years...

@RedRider lol, yea, but surgery is a lot less fun than the debauchery you are speaking of....hmmmm so how does it feel??? Well, now that the swelling is receding and the painful areas have gone from basically MY WHOLE KNEE to just a few areas, it feels....mostly normal. Going through this recovery brought back memories of my previous surgeries, just more intense fatigue and recovery symptoms.

The implant: My implant is a lateral. The only reason I know it's there is because I can "feel" it's presence when the surfaces come into contact. Lateral compartments usually have more "float" and laxity to them, whereas medial compartments and surfaces usually don't because they are the primary weight bearing compartment..... on occasion, there is a very slight "clicking" or "knocking" sensation (not audible) when the implant surface come together sometimes, usually when my leg goes from a relaxed state to a tense state. And this is not every time I take a step. Usually just happens once every trip I make to the kitchen or other area from my little recovery cave (our multi-room). I was told this is normal with lateral PKRs as the swelling recedes and the muscle tone is still not up to par. Once the supporting muscles are strong again and most of the swelling has left, shouldn't really be an issue.

Other stuff: The joint already feels tighter and more stable. I know that some of this can be caused by swelling, but I can already tell by the way the joint tracks and the way it aligns fully extended that it is way better than it was before.....the pain right now, even a week post op is very similar to my post ACL+debridement experience last time out. There is a dull "toothache" type pain where the implants were mounted, mild to moderate. Has never really been that bad. I think I mentioned before that most of the pain was under and around the knee cap, kind of a grinding "sandpaper" sensation, moderate to severe, only when I tried to do a leg raise or heel slide. This was only the first 3-4 days, so I laid off the home PT and right now it is only mild when I do my PT.

Hope this helps you with your decision. It was not an easy one for me, took me a while to come to "getting metal" in my knee, but so far so good and I am happy I took the leap.

 

[mcirish]

Sounds like you did what most of us do, @mcirish --learning the hard way what our limits are. At least you had your wife-crutch on hand.

lol...Ignorance is not bliss, it's just ignorance! It is weird how when you start feeling normal physically, your body somehow convinces your mind to do dumb things ....takes time to overcome old habits even when self-preservation is at stake...

 

[mcirish]

Hi sorry to hear about your rough beginnings but sounds like you're doing good now. you're going back to work already? dang dude! you rock i was still a ball on the bed sobbing at your point. i wanted to let you know when i called our OS it was always "leave a message" the only way i could get thru is hit 0 and talk to the receptionist and BEG for someone to talk to. all my issues that were really bad at the time have just turned out to be the healing process and that takes time. Im at 5 months and still have some pain. Are you doing at home PT they sent someone to the house for about 3 weeks and then i had 6 weeks of outpatient. hang in you're doing great. the tiredness lasts while but your body has been thru a lot!

@kneewords thanks for posting! If a physician is good i am willing to put up with the delayed responses to a point. It's just part of dealing our medical system especially if the doctor is any good. And just to clarify, I was NOT back at work, noooooo-no-no just stopping by to pick up some checks that clients had left and I only did that because I had to. My wife acted as driver and toddler as....entertainment? lol I don't know, but I do know that I did not step foot in my actual office. I will return next Friday at the earliest.

To be honest, if I absolutely had to, I could probably make it back early next week, but it would not be pretty.......and is not happening anyway. I think a full 2 weeks will be good for me. Sure, I would love to take off 1-2 months, but I am not one of the lucky few who qualify for such a luxury.

 

[jeano]

@mcirish--re the descent to the floor--what I did was basically a very deep genuflection (lots better than I do in church, bad me) full kneel on the right knee, left was bent about as deep as it could go but foot was flat on the floor. Then I had to skootch around and reach the right arm in to the depths of the shelf, grab the coffee, twist back out and decide how to get up. At home I wouldve gone into the classic yoga pose Downward Facing Dog, which involves hands and feet flat on the floor, legs and arms straight, butt sticking up, but thought perhaps that might frighten the other shoppers. So I pushed down on the second shelf up from the bottom one, and took a chance that the new knee could do all the thrusting required to get my carcass up. It hurt a very little around the knee cap. Didnt knee that scar tissue there anyway.

Re work. Probably I have been pampering myself too much, because the knee was the VERY least of my worries at work. We were busy and I was up and down, wasnt chained to the computer for terribly long intervals (and I did have to get IT to reset my username so I could get into the darn thing) and I had no opportunities to ice or elevate other than propping my left leg up on a wastebasket for about 30 seconds. I was just fine. More fuzzy in my thinking than compromised in my mobility or comfort. Now I'll have to stop being a slug at home. Lest anyone reading this think I am superwoman-- I work in a teeny tiny crisis unit, do little to no actual patient care that involves lifting, and typically work no more than a couple of 8 hour shifts a week. And I can always say no thanks. So most definitely NOT working full time, other than the full time job called being the stay at home dog, cat, horse and poultry mother and housewife.

mcirish PLEASE rest up as much as you can, now and when you go back to work. You will be soooo tired for a least a couple more weeks if your experience is anything like mine.

 

[kneewords]

i agree with you re the aftercare after all the critical part was the surgery and he is outstanding. I'm just so happy to have someone on the forum with the same OS!

 

[mcirish]

i agree with you re the aftercare after all the critical part was the surgery and he is outstanding. I'm just so happy to have someone on the forum with the same OS!

Me too, especially a good OS! lol. I will kept updating the thread ad nauseum wit any updates including any dealings with Sisto.

 

[mcirish]

@mcirish--re the descent to the floor--what I did was basically a very deep genuflection (lots better than I do in church, bad me) full kneel on the right knee, left was bent about as deep as it could go but foot was flat on the floor. Then I had to skootch around and reach the right arm in to the depths of the shelf, grab the coffee, twist back out and decide how to get up. At home I wouldve gone into the classic yoga pose Downward Facing Dog, which involves hands and feet flat on the floor, legs and arms straight, butt sticking up, but thought perhaps that might frighten the other shoppers. So I pushed down on the second shelf up from the bottom one, and took a chance that the new knee could do all the thrusting required to get my carcass up. It hurt a very little around the knee cap. Didnt knee that scar tissue there anyway.

Re work. Probably I have been pampering myself too much, because the knee was the VERY least of my worries at work. We were busy and I was up and down, wasnt chained to the computer for terribly long intervals (and I did have to get IT to reset my username so I could get into the darn thing) and I had no opportunities to ice or elevate other than propping my left leg up on a wastebasket for about 30 seconds. I was just fine. More fuzzy in my thinking than compromised in my mobility or comfort. Now I'll have to stop being a slug at home. Lest anyone reading this think I am superwoman-- I work in a teeny tiny crisis unit, do little to no actual patient care that involves lifting, and typically work no more than a couple of 8 hour shifts a week. And I can always say no thanks. So most definitely NOT working full time, other than the full time job called being the stay at home dog, cat, horse and poultry mother and housewife.

mcirish PLEASE rest up as much as you can, now and when you go back to work. You will be soooo tired for a least a couple more weeks if your experience is anything like mine.

Thanks jeano, I will. Like many of us, I am one of those individuals who tries to handle too much stuff at one time. In a way, this surgery and down time has been a good way for me to shut things down and clear my head. It has actually afforded me a break from my crazy, hectic life. Still have about another week off here, although I might need to check in on some pending deals and new prospects next week from the home office. In any case my progress and recovery is going well with no real setbacks to speak of other than the flu shot thing.