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Maine girl - revision

Discussion in 'Knee Replacement Pre-Op Area' started by maryo52, Oct 26, 2018.

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  1. Pumpkln

    Pumpkln FORUM ADVISOR Forum Advisor

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    Glad to hear there is no infection, at least the nickel allergy test gives you some answers why your knee has been so challenging.
    @lovetocookandsew had a mild allergy to nickel, she is doing much better with the "gold knee".
     
  2. Baxty

    Baxty new member

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    Good luck! If you need xrays post op and are running late or do not feel like going to the MGH radiology, the doc can give you an order for Maine such as at MMC Falmouth where there can be no wait. Some of the MGH docs also operate at New England Baptist Hospital.
     
  3. maryo52

    maryo52 FORUM ADVISOR Forum Advisor
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    I have a big decision to make, and it's my plan to just "sleep on it" a few days. I interviewed a surgeon at the Hospital for Special Surgery, Dr. Della Valle. He was diligent and fielded my questions. At HSS I would leave the hospital but stay in the area somewhere for two weeks and receive support services, and have a two week followup for staple removal and clearance to fly home. In Boston I would drive 5-6 hours home upon discharge from the hospital, receive services in my home, and return in 5 weeks. A home care nurse would remove staples. I liked the NYC doctor more but they are both excellent. I have a hard time envisioning spending two weeks in the New York area; I live in rural Maine (it's quiet). Anyhow, two excellent options.

    @Jamie Dr. Della Valle wanted to know where I heard about him, and I told him Bonesmart and your name. He had his nurse write down the information and said he would be in touch with you to thank you (!!)

    I certainly would welcome thoughts, suggestions, etc. from you all.
     
  4. Pumpkln

    Pumpkln FORUM ADVISOR Forum Advisor

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    I agree with sleeping on it, to allow your brain to process all this information.
    You might want to write down a list of the pros an cons of each location and surgeon.

    Happy you have two excellent surgeon to choose from.
     
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  5. Jamie

    Jamie ADMINISTRATOR Administrator

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    I spoke with Dr. Della Valle today and, honestly, Mary....my recommendation would be to go with him. He seemed very confident that he could help you. To me it's also preferable to have him nearby for a couple of weeks to monitor how you're doing. With the other doctor, you'd have to drive that 5-6 hours back to Boston if you needed to see him in person. After all you've been through with that knee you want to do everything you can to give it the best start in recovery that's possible.

    I know it will be an inconvenience and maybe even a bit uncomfortable to stay away from home for two weeks. But honestly, you'll be so early in your recovery, you'll be resting and sleeping a good bit of the time. I feel pretty certain HSS has this whole process down pat. I'm assuming nurses and others from their staff will be checking in on you wherever you stay once you leave the hospital. And....in the scheme of things....it's only a couple of weeks. You'll have the rest of your life with this new knee!

    Pumpkln had a good idea for you to write down the pros and cons for each choice. Maybe that will help you decide.
     
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  6. maryo52

    maryo52 FORUM ADVISOR Forum Advisor
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    I never realized that having two good options could be so difficult! I'm blown away he found your phone number and called! He was so great at answering questions. He treated me as a partner. I was also pleasantly surprised that my records from Boston appeared in my health record on the HSS system, so he was able to view my lab results. I think today I'm going to just enjoy knowing that I'm headed for a better surgery and experience either way, and have already been checking out airbnb in NYC. I found a place near Central Park, very close to where my mother lived for a while growing up. The one day we were in the city I noticed that the constant noise was challenging, but that airbnb claims to be quiet. You're right, I would be mostly sleeping and stuff like watching TV.
     
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  7. SusieShoes

    SusieShoes FORUM ADVISOR Forum Advisor

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    You do have a difficult choice. The comforts of home vs. being in less familiar surroundings for a couple weeks. HSS might be able to help set you up with a place they've worked with before. Just a thought. If you opt for Boston, the five to six hour drive, possibly in bad weather, would be difficult, even if you have a willing and able driver.

    In the long view, that two weeks would be a blip. I look back at my recovery now and it's a "well that was quick and well worth it!" Things that are difficult or annoying in the moment become mere bumps in our long road of life.
     
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  8. maryo52

    maryo52 FORUM ADVISOR Forum Advisor
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    You are so right Susie. It's just a blip, and as I think about it, 2 weeks of not looking at the woods out my window and hanging with my loyal dog is a reasonable investment for a great outcome. The fly in the ointment in my history of scarring. I think being in NYC I can be closely monitored for progress. I asked, would I have more than 90 degree bend by the time I go home, and he said yes.
     
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  9. kneeper

    kneeper FORUM ADVISOR Forum Advisor

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    Hi maryo52 :wave: Wishing you the best.
     
  10. Teecup

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    Hi @maryo52. I was drawn to your thread by your comment on stillo's thread regarding straight leg raises with weight as a good quad strengther. Were you referring to those being done from a standing, seated, or supine position?

    Now for my two cents on your dilemma. Having read through this thread with all the great responses and the excellent referral, the right choice shines out effortlessly to me as an objective third party... NYC! What put NYC over the top were your own words...

    ... and SusieShoes's wise advice...
    Glancing at your original recoveries, I'd say you've had enough recovery challenges and surprises to last a lifetime! Why take chances you don't have to? :SUNsmile:
     
    Last edited: Nov 22, 2018
  11. maryo52

    maryo52 FORUM ADVISOR Forum Advisor
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    Hi Teecup, well I wouldn't use ankle weights early in TKA recovery but I use them to keep my quads strong. You can sit on the edge of a chair and do them, or lay on the floor.

    I'm doing the surgery in Boston. I could not work out all the logistics for NYC. They are comparable surgeons. I have to remind myself that I know my way through the arthrofibrosis maze.
     
  12. maryo52

    maryo52 FORUM ADVISOR Forum Advisor
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    I have a question. Because of my recurrent effusion that's never been explained, last year I asked my PCP to order a serum metal/cement allergy test with Orthopedic Analysis in Chicago. The results showed that I was highly reactive to nickel (but almost no reaction to other metals and cement). I showed the results to my surgeon, and he said the doctor who runs the lab questions the validity of nickel allergy -- my surgeon says he's friends with the lab doctor. My surgeon pointed at the bracelet and watch I was wearing, saying there was nickel in those. I have no skin reactions to nickel. My doctor says he can use components that have no nickel if I want but that the component options are more limited (for revision). I can see his points but then again, I've never had an explanation for my effusion. The decision apparently is up to me. @Jamie @Josephine
     
  13. Teecup

    Teecup member

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    Thank you!

    Congrats on the Boston decision! How wonderful to have two excellent choices to choose from. All the best, and hope to follow your recovery on the other side!
     
  14. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    Effusions are a reaction to a variety of situations. What it is not is a condition of its own, it's always a response to something else. Hence the fact why you would be unlikely to have a satisfactory explanation.

    Being more specific, these can include loose implants, soft tissue strains or tears (see this Tendinitis - an explanation) or infections. These more specific things can include bursitis (almost anywhere), synovitis (just soft tissues), tenosynovitis (inflammation at the junction of the tendon and muscle or bone), The fluid can accumulate in a joint or a pouch (like a bursa) or just around the affected area.

    In short, there often is no specific explanation for an effusion other than it is a clear sign that something is wrong - which you knew already, of course! So diagnosis can only be made on the basis of other visual symptoms such as swellings or loss of function or similar. Hope this helps.
     
  15. maryo52

    maryo52 FORUM ADVISOR Forum Advisor
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    Thanks @Josephine, that does help. I notice I have 6 of the 7 symptoms of nickel allergy listed in one source. By process of elimination, it's about the only possible explanation. I also found an article from an allergy professional publication saying that reactions to a substance may not occur cutaneously while wreaking havoc inside the body. I know my effusion is due to a hypertrophic synovium. Clearly my knee has never - NEVER - been happy with the implant. So I am certain in my decision to go with nickel-free components, and believe that my recovery will be much better than the first one for doing so.
     
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  16. Jockette

    Jockette FORUM ADVISOR Forum Advisor

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    What source was that? I’d like to check my symptoms with it.
     
  17. maryo52

    maryo52 FORUM ADVISOR Forum Advisor
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    @Jockette I'm attaching the document. It's pretty technical in places but there's lots in there that you'll follow with no problem.
     

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  18. Jockette

    Jockette FORUM ADVISOR Forum Advisor

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    Thanks!
     
  19. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    Thanks from me too, Mary. I'm always looking for good articles like this to add to the Library.

    BTW, I was just looking at your avatar and am thinking this must be a picture of you before your knee problems began because the flexion is about 160 degrees!
     
  20. maryo52

    maryo52 FORUM ADVISOR Forum Advisor
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    @Josephine This photo was taken in 1976 when I was 24. I had just moved 1000 miles away from where I grew up, sight unseen, and completely fell in love with this place (Maine). WHat's captured in this photo still stands out as a life highlight (plus I love remembering that I once had good knees!!)
     
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