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Fusion Long ride to a successful Fusion

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Quick question...why doesn't the circle turn green when I'm online (next to my picture)? It's gray now, and I'm here! :skp:
 
I don't know.....but I check it out once you are back online. I thought that was automatic....that it didn't require a check in a block on your user profile. Hmmmm.....
 
Hi Wanttoride

As a fellow horse lover and rider, I can certainly understand how you feel!
I put off knee replacements for many years, mostly because I was afraid that I would not be able to ride afterwards, even well broke horses
This past nov 30th I had bi-lateral knee replacements. My legs had become very bowed, to the point that the x-rays revealed i was wheel chair bound.
I rode right up to the time of surgery, and had shown and trail ridden all summer.
People were surprised, seeing me walk, and how I was still able to ride. I credit my riding with giving my quad muscles lots of strength that has helped in my recovery
I hope to be riding by spring and then showing again on my regular show circuit. I hope spring will find us both in the saddle again.
It has been hard having my husband look after the horses, but sometimes one has to trust and not try and do everything themselves!
My friend brought my show horse into the barn this past weekend, so I was able to see her up close for the first time in over a month. There was enough of a path to the barn through the deep snow , so that I could get there with crutches. Since I have a hoof stand, I don't need to support a horse;s leg while I trim their feet. I was thus able to trim her feet, which made me feel better. Smilie is IR , and I have been doing the natural high performance barefoot trim, getting her feet back to normal with very regular matenance. I was sore afterwards, but my mind was at rest, knowing her feet weren't going backwards!
Sorry, if I haven't really been able to give you any answers to the problems you posted about, but others with more experience have already done so,
I thought I would just send some thoughts of encouragement and some horsey news!
 

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Hi everyone! Well...I just finished an hour of "joint mobs" with my therapist and am now icing and have my foot up. I'm still not sure if icing is something I should be doing with the RSD, as I have also joined an RSD forum, and they say ice is a killer!
Guess that will have to be another question I need to ask: "Whereas ice reduces swelling, and allows more ROM, will it/does it aggravate the RSD issues"? I'll also be posting this on the RSD forum also.

Anyway.....my knee/leg is sore, but I took 1 oxycontin and 2 oxycodone an hour before therapy, so the pain will stay "hidden" for about 2 more hours. My therapist is VERY glad that I found "bonesmart" and noticed that I had a new "zest" for life the minute she walked through the door!

We talked a lot about my "history" and talked over the day I was in rehab (1 week post-op) and the PT person at the rehab center picked up my foot to raise my leg, then twisted it, and then dropped it. Whereas my knee is not cemented, would this/could this have caused a piece of the new knee to "move", causing my tibia to "rotate", thus making my left foot turn outward???

I remember the OS telling me how important it was that I begin bearing weight on the knee/leg a day after surgery because of the importance of getting that part to adhere/fuse to the bone. I wonder....:skp:.......what are your thoughts?

We also think it's strange that a simple xray taken at the OS office can tell him that the joint was put in correctly. How can 2 views (frontal and sideways) tell him if anything has rotated? The xrays are taken prior to me seeing the OS and then he looks at them quickly on the lightboard and says "everything looks good". He doesn't send them away for a radiologist to look at either. :sct:

Forgot to tell you this....I called the OS office today to get anti-b's for my upcoming dental appointment and his PA talked to me. I ran a few things by him and he said flat out that I was "very impatient, wanted immediate results, and that THIS is the reason why "they" don't like to do knee replacements on young people. They (young people) just want to "get on with their life"" too quickly and aren't willing to wait the year or two it takes to let the knee heal and get the ROM needed". :evil: I don't like this guy anyway, and we've already butted heads when I asked about the nerve damage, to which he replied, "well...you knew that could happen...you signed the waiver".

I am having my OP notes and any other notes that were taken faxed to my therapist's office for them to see, and so that I can also have a copy. We are then going to fax them to a Dr. Kelly at Portland Orthopaedic Associates in Portland Maine and have him look at them. I called that office today, and in order to get a second opinion, he needs to see the notes beforehand. The office secretary told me that once he reviews the notes, I can get an appointment within 2-3 weeks. :wahey:

More good news! I called my short-term diabillity company, and I've got enough weeks to last me through mid April if I need it. Phew! Even though it's not what I'm used to each week for a paycheck, it's something and better than nothing! I was afraid at the end of 2009, STD would end. I'm sooo glad it doesn't! One less worry!

Let me know your thoughts on the above. Looking forward to responses! :fdbk:
 
Want's,
It sound like you are ready to move onward and see what can be done. Way to go!! You seem to have now decided to take the reins on how you will continue. It is going to get better now. As Jo and Jamie will tell you, only you can tell when something is not quite right. And you have to be the one to fight to get it fixed.
 
the PT person at the rehab center picked up my foot to raise my leg, then twisted it, and then dropped it. Whereas my knee is not cemented, would this/could this have caused a piece of the new knee to "move", causing my tibia to "rotate", thus making my left foot turn outward???

No, it wouldn't. It takes a lot more than that to shake those fellers loose! And it being loose wouldn't result in a rotation either. There isn't enough room for that.

We also think it's strange that a simple xray taken at the OS office can tell him that the joint was put in correctly. How can 2 views (frontal and sideways) tell him if anything has rotated? The xrays are taken prior to me seeing the OS and then he looks at them quickly on the lightboard and says "everything looks good". He doesn't send them away for a radiologist to look at either. :sct:

Well, surgeons can read xrays every bit as well as a radiologist and, for the purposes of things like joint replacements, better. They are accustomed to seeing them day in and day out. Heck I can read the xray of a TKR or THR better than a lot of radiologists! If the implant wasn't seated on the bone properly, believe me, we'd see. To the trained eye it stands out a mile.

(btw, who's 'we'?)

aren't willing to wait the year or two it takes to let the knee heal and get the ROM needed"
a year or two???? He's covering his butt!

he replied, "well...you knew that could happen...you signed the waiver".
And covering it again! How unfeeling and unprofessional to fob off a patient like that.
 
thanks! It's nice to know that what happened in rehab wouldn't cause the piece to shift on the tibia.

The "we" I referred to is my therapist and myself.

It's now 6:00 pm, the sun has gone down and I'm in a lot of pain....AND have a major headache! The pain meds wore off at 4:30 and "angel hubby" brought me another 2 oxycodone. I've got sharp, stabbing pains in my knee and alongside the top of my tibia about halfway down. The meds I took recently have taken the edge off, but that's about it. I've got leg elevated, pillow under my knee and one of my Pomeranians beside me standing guard over the "pain demons"!

Looks like a frozen pizza for me tonight. Boy, it sure was nice being mobile yesterday and this morning. I'll be in the recliner icing (still don't know if this is a good thing because of the RSD) for the better part of the evening......:sigh:
 
Jo...another question for you. If this OS is able to say that "everything looks good" on the xrays, and he sees these day in and day out, what would another OS see (or not see) on a second opinion?

If a second opinion OS looks at the same xrays and views the op notes, how can he come to a different conclusion? I hope I'm not sounding "dumb" here....:pzld:
 
Not at all. You asked how an OS could see that it was okay from an xray and I answered that. But that's not to say your chap isn't bluffing!

And from what I've thus far read of RSD, it could well be that your knees are fine. My sister had a lot of pain around her knees at the start - I mean in the first 12-18 months. Now she is very happy with her knees - and her hip. And they've all always 'looked fine' on the xray. And I saw those xrays so I knew they were. But we always knew the pain was from the soft tissues.

As for the notes, it's possible for surgeons to write notes in such a way as to gloss over any problems he had so another surgeon could choose to read them or read into them! Me, I always read into them!

Have you got your xrays? If so, would you post them so I can take a look for you?
 
No...I don't have the xrays. They one that were taken at the OS office wer not taken digitally, so I doubt that I'd be able to get them on a CD. ?????? I don't know about any xrays that were taken during surgery. Do they take xrays during surgery?

I see what you are saying, for sure. The knee may very well be fine, and it just might be RSD issues that are stopping me from progressing any further. THAT'S what drives me CRAZY! I need to find out what I'm dealing with. One or the other...or both?

If it's the RSD and not any knee replacement issues, then I need to know what my prognosis is and how to deal with this so that I can incorporate "do's" and "don'ts" into my life. If it's an issue with the knee, then I want it fixed!

The big concern with my OS is the lack of ROM in both flexion and extension. After my UAM (done Nov. 22nd) I gained 20 degrees in flexion..now up to 78 degrees without much effort, and went from 25 degrees extension to 15 degrees, without much effort. Of course, with effort, I can get a little more.....maybe 85 and maybe 10. He keeps saying it's RSD and nerve damage issues and would have no problem doing another UAM since the last one gave me more ROM. That's what he says....do I believe him?

The Pain Management guy says the same thing....but of course, he wants to do nerve blocks 'cause that's what he does. And everybody now knows how I feel about those, so we won't go there.....

I need to have this second opinion to see if he agrees with the OS and Pain guy. If so, and there is nothing wrong with the knee, then do I have another UAM to get more degrees??? I try to run different scenarios in my head....."what if this" or...."what if that".

I should get my op notes in the mail within a couple of days. I'll take copies and send them to the OS in Portland. I want a copy for my own files, too!

I have another question for the group: "Does anybody else have memory issues with pain meds they are on?" I'm wondering because there are lots of times during the day that I just can't put a finger on what I want to say. I'll ask my husband to give me (the glass) and I can't come up with the words "the glass". It's VERY frustrating and it happens more now then before the surgery and the meds. My Mom says I've just got too much on my mind and I'm on overload....:pzld: ......what are your thoughts? Is Mom right? (Poor Mom...she's in Florida for the winter. She left a month after my surgery and it's very hard for her to be away while I'm going through this.)

:fdbk:

Hope all is well with everybody.....I'll check in often during the day. No PT today, so will work on strength and gait on my own.
 
Want,
Mom is right!! Mom's are always Right!!
And call up the OS office and tell them you need copys of your xrays thats all you have to do. Hope that you have good day.
 
I believe you have to call in and order them, and sign a waiver/release. That's what I was told with Dr. office #1. There was about a 10-day turnover. With my surgical x-rays, I took pictures with my iphone just for my personal use.The Dr. didn't care and turned the light off so I could get a better picture.
 
Sorry if I mislead. You call and they will get them copied and then when you pick them up you will sign them out. Or if you want them sent The OS office will fax you a release and you must sign it and fax it back. Sorry I did not think about all the angles. When you live in a very small town and have to go to the city for Doctors you are just use to doing all of this.
 
Do they take xrays during surgery?
Not as a rule
Does anybody else have memory issues with pain meds they are on?" I'm wondering because there are lots of times during the day that I just can't put a finger on what I want to say. My Mom says I've just got too much on my mind and I'm on overload
Very much so for the meds. But could also be because of all the stress you are under. Both, probably
If it's the RSD and not any knee replacement issues, then I need to know what my prognosis is and how to deal with this so that I can incorporate "do's" and "don'ts" into my life. If it's an issue with the knee, then I want it fixed!
Honestly, I hear what you are saying but you need to slow down a bit. Mentally/emotionally, I mean. It could take ages to get any answers and then they still might be vague.

My sister (other sister) often says things like that and "WHY don't they know?" to various things, and I have to tell her it's because doctors are only human and don't know everything. Then I get "WHY don't they know everything - they're doctors, they're supposed to!" Well, no - because they are human beings and fallible. It's part of our condition!
He keeps saying it's RSD and nerve damage issues and would have no problem doing another UAM since the last one gave me more ROM. That's what he says....do I believe him?
Well, this is another of those try-it-and-see things. In his considered opinion it is worth a try. No-one can give you any assurances that it will be better or not. If you don't trust him, don't let him do it. If you feel you can, despite everything, then do. No-one can make that decision for you. And an MUA is not a procedure fraught with hazards. There are potential hazards but I've never seen any of them actually happen. There are always potential hazards with any treatment.

And you can drive yourself insane with 'what-ifs' because, in the end, they are unanswerable and you know they are. Don't you? But it doesn't mean there is no hope of improvement.
 
It's a shame that even doctors don't recognize RSD/CRPS (Reflex Sympathetic Dystrophy/Complex Regional Pain Syndrome) sometimes. My OS was very aware of it. I'd told him that my daughter has it and I was so worried about it since it can be more prevalent in a family. Then when I was having all the typical nerve sensitivity and blotchiness of the skin, I was so scared. But I definitely didn't have it.

Wanttoride, you have the symptoms, the pain clinic confirmed it, you have no time to waste. If you can't get it stopped soon, you might not. Blocking the nerve with the epidural is one of very few things you can do to help. You've already had two professionals and the PTs tell you it's RSD. Now it's up to you to either take the risks or risk having RSD/CRPS long term. Even if something is wrong inside with your new knee, it's the RSD which needs to be seen about ASAP.

Sometimes the slightest injury can start RSD. My daughter was run into by a child on a bicycle when she was 10, tearing a ligament and piece of bone from her ankle. She was in a cast, later had surgery for scar tissue removal. Then she had chips of bone removed from the other leg's knee, then the knee bone was dying in the now affected leg and she had holes poked into it to promote new growth. Her ankle turned over and sprained often and after one of those, her RSD started.

Her foot swells every evening. The hair doesn't grow much on that leg. It can be cold. She can't stand wind blowing on her leg, but can't stand to wear tights. Socks have to be loose. Sometimes the sheets bother her leg. She has burning nerve-type pain. She weaned off pain medication when pregnant and now only uses 1/2 hydrocodone occassionally when I give her one at night from what I saved from my surgery.

I'm so sorry you have RSD/CRPS. I haven't heard anyone else on this list say they had it. I hope yours will go away.
 
you have no time to waste. If you can't get it stopped soon, you might not. Blocking the nerve with the epidural is one of very few things you can do to help. You've already had two professionals and the PTs tell you it's RSD. Now it's up to you to either take the risks or risk having RSD/CRPS long term. .

Ok..I'm really confused now. I've done a lot...and I mean a LOT...of research on nerve blocks in regards to RSD. 1. There is no guarantee that a nerve block is going to work. 2. If it does work, it can last from a minute to possibly 2 months at max....IF you are lucky. 3. Not once did I read or be told that by having a nerve block, my RSD would be "cured" or "go away". 4. I've joined an RSD support group/forum and there are MANY people that have had nerve blocks that have gone wrong, not worked and have gotten into a routine of blocks that work for maybe a day...so they continue to go back...hoping the next one will work longer.

I don't want to sound ungrateful here, as I do appreciate the information, but I think a lot of pressure is put onto people by Pain Specialists to have these done, and if they don't work, they are very convincing to have you have another one. This procedure is not cheap. I suppose if I were in so much pain that I thought I was dying, then I might consider it.

I'm also concerned that you say that it's "up to me to take the risks of RSD". There is no miracle cure for RSD. If one is lucky, it goes into remission. Everybody's body is different, and reacts differently. If one is not so lucky, it can escalate. THAT is what I'm trying to be careful of...not doing something that is going to aggravate the situation. THAT is why I want to be sure that PT isn't doing anthing that is aggravating the RSD...or something that I am doing. I've got it. Ok....I get it. Now...how do I deal with it?

There are all sorts of invasive procedures that are available to RSD patients including implants in the spine to deaden the nerve. All with more than minimal risks. Right now, pain meds and Lyrica are keeping me comfortable and the RSD is manageable. Of course, I don't want it to get any worse....why would I? However, I know that nerve blocks are not a cure...only a bandaid. RSD never goes away.

If anybody can find me information that says that RSD goes away, I'd like to see it. I called my OS today AND my Pain Management Dr. and both said it doesn't go away. It can only be treated and managed in hopes of a remission. It's a lifestyle change in what you can and cannot do. That's what I'm told....and that's why I need to know asap so that IF there is something I or PT are doing that we should not, "it" needs to be stopped!

I have OS appt. on the 14th and Pain Management Dr. on the 22nd of this month. Hopefully, a second opinion in regards to my knee by the end of the month also. It is my hope that by February 1st, I will have a game plan as to what I need to do. I do know that an UAM can aggravate the RSD, and I found out today that my current OS and Pain Management Dr. are discussing this between themselves.

So...I am trying VERY hard to address the RSD issues NOW! Unfortunately, we have to try this new PT routine until I see the OS and see how my body has reacted to it. If the RSD is causing me NOT to get more ROM, then this is going to be a long, long, long road...........:thnk:for all the info. and support. Jo...you are right....patience is a verute...something I have very little of right now, so I need you guys to help me stay sane until I can get answers and appointments! :cnsl:
 
Awww sweetie! You'll get there. You just need time to become acclimatised to the facts that have become an unwanted part of your life. I'll let you know anything and everything I learn from chaps I take my sister to see. I can at least do that much.
It really, really is a tough call.
 
Want

If you don't want the nerve block don't have it.
You need to go to a new OS and see about that
knee and see if you really have RSD. I have
read all your post and you really need to be looking for a new OS one in another town and not connected with your OS in any way.

If you have RSD a really good surgeon will know what to do.

Good luck.
 
Jo....(and anybody else that can relate to this),
I'm baffled at something....I talked to my OS this morning. When I had my UAM, he told me that he got my knee to 130 degrees flexion and 3 degrees extension. He also said that IF there were a problem with the knee, it would not have bent that easily. Would this be so?

He's pretty sure that it's the RSD/nerve issues that are stopping the knee from flexing when I'm not under anesthesia. He said my body is just "protecting itself" from further pain, and "shuts down" at a certain degree to protect.

He said in time...if I'm patient and stop trying to rush things, that my knee will gradually gain degrees as it adjusts to different pain levels. This will happen slowly, and he said that I'm trying to get immediate results and comparing myself to people who have had knee replacements that have gone "as planned".

I'm in tears...and lots of them. I broke down this morning and just cried and cried.

My PT person isn't coming today, and frankly, I don't care. She has been doing joint mobs and trying to get "the fluid" out of my knee. She pulls and tugs on my knee and twists it left, right and up and down. Her view is that if there is "fluid", there won't be any more gain in extension. Is she trying to rush things? OS says "fluid" will disipate in time. When she is done with the joint mobs, my knee is purple. I have to elevate it for a couple of hours afterwards. As soon as I put my foot on the floor and start "crutching it" around....bang! The knee swells up, turns purple again and I'm popping another pain pill for "break-through" pain.

Is therapy doing my any good at this point? I'm thinking not...I can do everything other than joint mobs on my own, and I really don't think my OS is thinking this is working either. OS says slow down....be patient and therapy keeps trying to "go, go, go"! I want to pound my head on the floor!

I'm at a point where I just want SOMEBODY to make a decision and tell me what to do. I've got my op notes (received in mail today) and I am calling the OS in Portland to get the second opinion. IF that surgeon agrees that nothing is wrong with the knee, based on the UAM of 130 degrees and looking at the xrays, then I'm gonna FLIP OUT!!!! :hissy:
 
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