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My turn for a change! ;-)

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Josephine

NURSE DIRECTOR EMERITA
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I saw my knee surgeon today. Changed from the guy I was seeing before because this one has taken over as THE knee expert! Well, once we got past his telling me about the two additions to his family (his now has three little ones all under 5!) and how stressed out he was on account of it, we got down to the big issue - my knee!

He checked out the arthroscopy photos taken by the other surgeon and had me walk up and down and then crouch - which I found, much to my surprise, I could do reasonably well. He looked as surprised as I was!

The he pummeled and pulled at the knee in the accustomed fashion. I think the OS Hippocratic Oath must have a section added to find 'the spot' and then ask you in such a casual manner "Does that hurt" while you're clenching your fists to your mouth to stop emitting that howl of anguish! It's definitely a skill!

He was about to send me for an xray when I handed him the cd-rom with the films from Stanmore last August. He was content to look at those and went through all the pointers in them and in the photographs.

So the conclusion is that whilst I have exposed bone in some areas on the medial side, oddly they are not in the significant weight bearing areas! He said he would have been inclined to a uni except there is early evidence of disease in the lateral compartment which therefore rules it out. A TKR is the best option which I already knew,

When I mentioned about going to Stanmore to see if I was suitable for MIS, he told me it was all but phased out in the UK now owing to the unacceptably high rate of failures.

However, all things considered, he was of the opinion that functionally, all evidence to the contrary, my knee was in better shape than he (or I) had a right to expect and the best treatment at the moment it to leave well alone, that my episodes of pain were so infrequent and short lived an arthroscopic wash-out was not indicated either. I was told I could contact him for a further appointment whenever I felt the need.

I departed in good spirits but with a slight limp which a period of retail therapy soon sorted out! I'm greatly encouraged!



Whilst I was there I took the opportunity to ask him about knees that underwent an exacerbation of condition after an arthroscopy and he agreed it could happen but usually in cases where the surgeon had been over-enthusiastic and trimmed and snipped at the rough areas in an attempt to make them look more tidy.


 
You mean like glucosamine? Tried those but I have a dodgy gut and they played it up no end. They did have a good effect on the joint though which was just as well considering the amount I had to keep racing upstairs to the loo!
 
Josephine, I bet you give any OS you have a run for their money! Congratulations in being deemed not bad enough. I'm trying to decifer if you liked your doc or not. Retail therapy has allways been one of my preferred lines of treatment.Glad it helped. Have you had the synvisc/mylan shots? Or cortisone?
 
Josephine, Glad to hear you have dodged the bullet for now. While I am extemely grateful to have had the surgery and would not wish the pain I had prior to surgery on anyone, this is as you know a hard surgery to go through. I just hope you don't put it off like I did until you make more problems for yourself, i.e., the hair-line fracture of my left tibie and all the debris inside that needed to be cleaned up. We need you and want the very best for you. God bless you. Rowdy
 
Well, ALL the surgeons (ortho) are the best! Never met a nicer or more competent gang outside of the Royal National Orthopaedic Hosp. But the ones there were very prima donna-ish whilst the guys at the local squat are very much the 'lads' and about as friendly and sociable a group as you could find, hence the long chat about his kids. When I left in Sept 06 he had one babe and another on the way. Now he's had a third (and I didn't even ask him what sex it was!). He's a really lovely young feller, professional but down to earth, business like but VERY approachable. He joined staff shortly after I'd had my scope and wasn't long after that he was saying he happily take me over if I wanted as the other surgeon had almost stopped doing knees in favour of hips, thus allowing him and a new chap to set up a definitive knee service. So that was why I went to him.

Oh, and he's a good laugh too! Regularly had the staff sitting room in uproar with his jokes and kidding around.
 
No one else with two cents to share?
[Bonesmart.org] My turn for a change! ;-)

 
Poor Jo, she's lookin' for some love...
did you get synvisc shots?
 
Josephine! Sounds like a great OS. My guy is a bit older and been around a few times but I really like him. Can't say that he would break up the waiting area with a joke, but he is kind, understanding and will always answer your questions. (although I have heard him talking with his nurses while waiting and they all seem happy and even heard a few laughs!) He was super when he told me the TKR was the next step. He worked with me to weigh options (there really weren't many). He is honest. He does crack a few light hearted comments about my old teaching postition (emotionally disturbed kiddos) and what triggers my visits to his office.(can't carry the laundry up the stairs without crying - his response - just go shopping - who needs laundry) I have been with this guy since 2003 and am comfortable - It sounds like the gentleman your are with also provides you with that needed relationship. Trust is soooooooo important.

Hope all continues to be well!
Marianne
 
It's great your knee is not as bad as they had first thought but keep in mind that only you know this Jo. All the tests in the world can tell you one thing but only you know the pain level. That was interesting that the UK is shying away from the MIS because of the high failure rate. I'd rather go through the worse, initial pain and get it right the first time.
 
Oh true, true! And no - I didn't get any shots. It hardly hurts at all these days and can't remember when I last had to take a pill for it.

And Sean's a great chap. I knew him as a registrar so we go back a little way. Nice thing about all these guys is they know my history and I have a lot of respect from them for it which feels good - though sometimes makes me feel like one of those Egyptian mummies being respected for being so old!

I once spoke to a new junior doc (Mid Eastern) about wearing gold chains round his neck when he was scrubbed up (BIG no-no - changes rub off skins scales that end up floating up on the body heat 'umbrella' from the top of the gown and floating gently down onto the surgical area!). Well, he was a bit indignant about being told (and by a woman!) and showed it whereupon the surgeon tapped his hand with an instrument handle and told him sternly "You listen to Sister Fox, she's been around in this business forever and what she doesn't know about things like that isn't worth knowing!"

Not so sure about the 'forever' crack but appreciated his support!
 
Hey Jo, Is knee replacement physically demanding for the surgeon? Mine is a great big football player and I was second on his agenda Monday. When he came over to see me pre-surgery, he had looked like he had run a marathon or something.
 
love the "forever" story Jo! It was truly a great compliment---- with an unintended (I am sure) twist! LOL!

I'm glad to hear you don't need anything drastic at this time!
 
Hi Jo, I'm back at last, though will be AWAL for the weekend again. I am so pleased you don't need the TKR just yet. It certainly makes a difference to be able to talk to your OS as a friend I bet. We used to have a lot of laughs with some of the Housemen and Registrars when I worked in thaetre. One houseman said he like to grow African Violets and had a drip set up to feed it. We one went into the mens bathroom in theatre and put clingwrap over the bowls and urinals, worked really well!!!

Well, keep looking after that knee, hope it doesn't let you down anytime in the near future. Take care. Have really missed you all. (((((((((((HUGS))))))))))) Sue
 
Hey Jo, Is knee replacement physically demanding for the surgeon? Mine is a great big football player and I was second on his agenda Monday. When he came over to see me pre-surgery, he had looked like he had run a marathon or something.

Yes, it is physically demanding as are hip replacements. Which is one reason why some won't even consider doing bilats. Consider this as well, for 2-3 hours, they cannot drop their concentration, sit down, have a drink scratch an itch or wipe their own sweating brow.THAT takes some self-discipline. You have to get your mask on just right (well, it comes naturally very quickly) for if it's a tad uncomfortable there's nowt you can do about it for 2-3 hours! Plus you are wearing a gown, gloves and mask over your scrub suit and standing under a hot operating lamp with other machinery kicking out heat at the rate of at least ½kw per hour. In other words - it's HOT!

You got back ache, head ache, stuffy nose, are too hot, need a pee? Forget it! Everything about you and your personal comfort or needs, gets put on hold when you scrub up. And it's not just the surgeon - it's also his assistants (usually two) and the scrub nurse. They all have the same goal - there's only one focus, one priority and that's the patient!


Story time .....
When I first became aware of my knee problem, I was on call one night. We had a patient come in with both arms badly injured. By the time he came up to theatre it was around 11pm. The surgeon and I, having already put in a full and very busy day's work, had been waiting since about 8pm for him to be fit enough to come to theatre. Well we finally got started with the surgery around midnight and did the first arm but when we got to the second it was so badly broken the surgeon was really stuck for what to do. By the time he had sorted it and we'd got the patient off the table and into recovery it was 4.30 am and I still had to sort out my instruments and make sure they were all correct as the nurses working with me were from another theatre and unfamiliar with the kit I had used.

When I finally left it was 5.30 am. I had been on duty for 17 hrs and standing for a full 6 hrs! It took me almost 40 mins to get down to the car park - a walk that usually took me about 10! It was the next day my knee started to hurt. And in my pay packet the next month I received a wondrous £150 for my labours! ($300)
 
And I bet the exchange rate wasn't 2 for 1 back then so it might have been even worse for the pound! It is a trying job, I can see. I know I couldn't do it! It seems that most ortho surgeons are men and maybe this is why; you know, the need for a lot of muscle power. Have they ever used one person in the room that does nothing but wipe the brow of the surgeon and attendants?

My doctor doesnt wear the big plastic mask. He says it fogs up and he can't see.
 
Have they ever used one person in the room that does nothing but wipe the brow of the surgeon and attendants?


Has been done! Usually the most junior nurse so, if the surgeon is one of those dashing young Brad Pitt look-alikes, we can all laugh when she gets a hot flush at mopping his fevered brow! Florence would turn in her grave!
 
My OS is named Christopher Blake. I had a mental picture of him before I met him. Maybe a Brad Pitt look-alike/football player/Superman type guy....

NOT.

He is about 5/9"and wiry, probably my age or a few years older, and looks more like a weasel than movie star!

But what a glorious, heroic name!
 
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