PKR JusticeRider’s rehab adventure

[JusticeRider]

Thank you @Layla When it rains, it pours! Hubby and I were able to get some Paxlovid antiviral and it seems to be helping. We both actually slept all night last night. Heaven!

Sis texted this am. Apparently the hospital discharged nephew last night, told him to just go home and take it easy. Just call if your breathing gets worse. They scheduled his echocardiogram and second CT scan (which were supposed to be this week) almost two weeks from now. MRI has yet to be scheduled.

Sis did not feel good just taking him home in his condition. A physician friend back in Montana told her to take him to the ER! So they took him there and they got him right in. Did the echocardiogram (heart looks good!), ran blood tests, did an MRI, and did ultrasound on his leg. The ultrasound showed a DVT clot in the back of his knee! They put him in compression stockings and had him doing ankle pumps (sound familiar?). Also gave him some Oxy for the pain. They’re waiting for results from blood tests and MRI.
I can’t believe they did in one night what the military hospital hasn’t been able to do in a week. But I’m so glad he’s finally getting some better treatment.

 

[sistersinhim]

Thank God your nephew is finally getting some treatment. The military should treat their members better than the treatment he got. I always thought they were way up there in their treatments. No so for your sis's son. What a shame. The good thing is he is in the best place now, and getting the help he needs. Now, you can rest better, too, knowing that.

 

[JusticeRider]

@sistersinhim , I agree! It makes me sad. Our soldiers deserve better! It’s really not right and I hope this isn’t common but it sounds like it is.

I just talked to my sister and they got the MRI results back. Uh oh. Looks like multiple contusions, strains, and sprains, which is not too terrible…no surgery needed for those. But also a torn medial patellofemoral ligament. And worst of all…full thickness cartilage tears and delamination on the patella.

He has an appointment with his PCP on Monday where he will get a referral to an orthopedist. I hope they can get him in soon…he’s really hurting.

BS staff, am I right that the only treatment for full thickness cartilage tears is grafting or replacement? Are there other viable options?

 

[djklaugh]

@JusticeRider "BS staff, am I right that the only treatment for full thickness cartilage tears is grafting or replacement? Are there other viable options?"

I think it would depend on where the tear is locate, whether the tear is jagged edged or fairly even, and maybe other aspects of which I am not aware. It might be possible to suture the tear .... but I am not a medical person. Hopefully the orthopedist will be able to come up with a good plan.

 

[mendogal]

I have done a survey of recent NIH research reports. It appears that grafting of chondrocytes, especially allograft, combined with medial patellofemoral ligament reconstruction if indicated, is the standard of care now.
I am familiar with sewing of cleanly torn meniscus cartilage; am not aware of it with patellar cartilage tears.

 

[Layla]

Thank goodness in her wisdom and maternal instinct your sister took her son to the ER. It is appalling that those willing to join the military to serve their country receive such sub par treatment when in need. I hope his appointment on Monday leads to speedy resolution and most of all eliminates the pain he is struggling with.

I am glad to read that you and hubs are feeling better. Wishing healing and good health for you all.
@JusticeRider

 

[JusticeRider]

Thank you so much to all for the advice and caring. I have passed these along to my sister and nephew. Yes, I am very glad they went to the ER. Crazy that they had to, but thank goodness they did. Sounds like my dear nephew might be needing his own BoneSmart thread before long. It really looks like he will need surgery of some sort regardless just a matter of what kind and when.

 

[sistersinhim]

Yes, it does sound like surgery is in his future. At least he is going to get better since he has a correct diagnosis.

 

[CatieViv]

I am so glad you and your DH are feeling better. Thank goodness your sister listened to her instinct. Now they have answers.

 

[JusticeRider]

Hello friends! After a difficult month or so, I am finally leaving a monthly update for 16 months post op. It seems crazy just typing that that it’s been so long! Maybe because there’s still so much change happening with my knee. The last several weeks are an aberration because between the bout of depression and the Covid, I was very inactive. This sadly caused me to lose some muscle tone and flexibility. But I am confident I will get it back quickly. Before all that, my knee was continuing to get stronger and my ROM was still creeping up bit by bit. I can now put my foot up into the stirrup from the ground! Yay! Although I can’t yet propel myself up to the saddle from that position. While still gaining strength and flexibility, my leg is not yet strong enough at full flexion to lift my body all the way up. But it is in sight! That will be a major milestone.

I had a fall last week that bent my knee as far as it currently goes and then some. I was carrying my little dog and going down my steps outside. Apparently they were a little slick from frost, because my non op (R) foot slipped and my op foot (L) stayed and I slid to the bottom (only a few steps, fortunately!) while my left knee bent up. Managed to partially catch myself with one hand behind me on the top step. Anyway, it hurt my knee, but not as bad as I thought it would. The pain mostly faded after just a few seconds and the worst I got was some stiffening for a few days. Man, I really hate falling since injuring my knee in 2020 and subsequent surgeries. Ugh! But glad it was not too bad. BTW, my dog was fine!

I’m still doing PT although we have switched the focus to my hip now, as I mentioned previously my knee graduated!! As we all know, the hip can affect the knee too so it’s important I address it for that reason too. But alas, at this point the hip continues to hold back my riding. I’m riding my own horse and enjoying it very much, but he knows me so well that he can forgive my uneven weight and cuing and he still understands what I’m asking for in spite of it. But I’m not currently riding at the level required for training. I have been pursuing freelance writing work and it’s mostly going well. I think I have resigned myself to the fact that my training career may be over. At least I can say without a doubt that my knee is NOT the problem! PKR success! But it’s bittersweet for sure.

Quick nephew update…he has gotten the referral to see an orthopedic surgeon but no appointment yet. The way things have gone with the system so far, I fear it could be months before that happens. It may well require the ‘squeaky wheel’ treatment to get one at all. I told him to just keep calling and bugging them until he gets an appointment. Ask to be put on the cancellation list, call and ‘check in’, ask if anything has opened up. Sometimes you have to make a nuisance of yourself. I hope he will be assertive enough to do what needs to be done so he is not waiting until spring and beyond. His knee is badly injured! Anyway, prayers for him.

I’m still popping in to read some threads here on BoneSmart from time to time and really enjoy reading about everyone’s recoveries! Keep posting! The support and kindness on this forum restores my faith in humankind. Happy healing and holiday blessings to all!

 

[sistersinhim]

Falling is always a fear for all of us. Thank God your knee did fine, oh yes, and that sweet puppy dog, too!

I'm sorry your hip is still acting up. Do you think you'll be facing a THR? At least your new knee and hip are allowing you to ride some. Hopefully, you will soon be back to normal.

I wish your nephew could get into surgery sooner rather than later. Be sure and send him here!

 

[mendogal]

You're on the horse!?!?! On the horse?!?!.YES!!!!

So glad that fall was minor. I hope your mood is improving along with your strength, flexion, and stamina. Best to you and yours for the holidays and 2024.

 

[JusticeRider]

I'm sorry your hip is still acting up. Do you think you'll be facing a THR? At least your new knee and hip are allowing you to ride some. Hopefully, you will soon be back to normal.

Thanks for the kind reply, @sistersinhim
I fear someday in the future there will be a THR, but hope not! Having had two surgeries on it, my left is at risk of developing arthritis. My other hip clunks, and I know the hypermobility is a factor in all my joint challenges. But maybe I can limit the replacements to my knees?? That would be nice.

Right now the issue with my left hip is most likely caused by my inability to rehab it or even do many basic things after it’s surgery, because of my knee. Because my knee could hardly bend and made me limp and restricted so many movements, my hip never got a chance to do normal things. By the time my knee was functional thanks to my PKR, it had been 2 yrs since my hip surgery. So the main symptom is tightness. It just doesn’t have normal movement yet. It’s actually pretty functional in most ways, but for riding you need a lot of hip flexibility, coordination, and strength.

Edit to add: the hip is extremely flexible on flexion and extension but abduction is where it is very tight. I think it can be rehabbed, but it may take a while.

 

[JusticeRider]

You're on the horse!?!?! On the horse?!?!.YES!!!!

Yes @mendogal and I am so grateful for that! I just went for a wild ride today in fact, ended up on a very scary trail where my horse partly fell and I ended up having to get off and lead him on foot up extremely steep and tough terrain. Thank goodness my knee is strong! We made it up and the rest of the trails I rode were lovely and fun.

 

[CricketHip]

I am very impressed about getting your foot into the stirrup, from the ground, that’s a really big deal!
Congrats to meeting that milestone.
I’m sorry about your hip slowing things down, and totally get the issue with cuing and balance.
It’s always so good to see your updates, but am sad about that hip part! Bittersweet, indeed.
Glad you have the freelancing abilities, good for you.

 

[EalingGran]

Really good to hear your update, even if the news is a bit of a mixed bag.
Also really glad you are recovering from covid and the fall- that is an ever present terror for us surgical survivors.
I hope your hip holds up. Like you I definitely don't want further surgery for a good while. It's great you are riding, but sorry it's not to your old standard for training.
You are right to push your nephew to keep bugging his medical team- it definitely is the creaking door that gets oiled.....

 

[CatieViv]

So glad to read your update. Riding must have been wonderful! It sounds like you and Justice have a really good relationship. Sorry to hear about your fall. My first thought was I hope she's ok. Second thought was the little dog!

Hopefully your hip starts to cooperate. I too want to avoid further surgery for a long time. My left knee has been giving out on me and complaining. Let's not talk about hips!

 

[Layla]

I am sorry to read of your fall, it had to be frightening! Thankfully you and your pup are doing ok.
Say it isn't so, with your hip! Ugh...nothing worse than getting one thing under control and now this. Hopefully PT helps.

Your poor nephew. I'll lift a prayer for him.

Enjoy the rides on your horse. Happy Holidays, JR!

@JusticeRider

 

[dotski]

I’m guessing your hip needs just needs time for flexibility and strengthening. But I’m sorry it is hurting you now though. I was convinced for a while after a meniscus injury my hip had arthritis as it often hurt. But what I didn’t realize is that I didn’t squat on the leg for well over a year and that resulted in very weak hamstrings and glutes. Once I found a really good you tube channel for yoga (Yoga with Kassandra), I did some of her hip routines and over time noticed a tremendous difference. Also found many trigger points that needed releasing so muscles could release and fire properly. I found it took a long time recover hip strength and flexibility - and I didn’t go through half of what you went through! And now I’m going to be doing it all over again with this TKR recovery.

 

[JusticeRider]

It sounds like you and Justice have a really good relationship.

@CatieViv this is so true. Words can’t even describe our bond. We have been together for 27 years and have experienced so much together…growing up with each other, learning together, moving states, moving homes, competing in 100 mile endurance rides as a team and overcoming so many crazy challenges and adventures together. Aging together. He’s been with me longer than my husband of 23 years! I trust him with my life and he does the same.