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Knee update (post Dr. visit)...(30 posts)

Knee update (post Dr. visit)...jtferraro
Feb 4, 2003 4:58 AM
Well, as suspected, I really "did a number on it!". I fist saw my primary care physician (well, another doctor in the same office/medical group). She basically acknowledged that it is messed up, referred me to an orthopedic doctor, and prescribed x-rays and some x-strength Motrin. I was fortunate enough to get an appointment w/the orthopedic doc yesterday, too. I was kinda hoping, after speaking to him, that he was going to tell me that my knee issues were not as bad as I had thought. Well, contrary to that, I left his office really feeling upset. He said there is a 95% chance I'll need knee surgery and that he thinks I've not only torn the MCL, but also the ACL and maybe even the meniscus (medial, I think). Today I'm having an MRI done to see exactly what the damage is, although he said he is pretty certain about my knee. Upon feeling it and moving it around a bit he also commented that it is loose. I am now in a soft cast that goes from my thigh to just above my ankle. It has velcro closures and the only time I'm supposed to remove it is to shower. He said I can ocassionally remove it while watching TV, as long as I keep my leg straight/elevated. Another thing that really SUCKS is that I can't drive my standard shift car right now. If I really wanted to I probably could but the doctor recommended I only drive an automatic, if anything. Naturally, my snowboarding season is over this year. Guess I'll have to put some ski vouchers I have up on ebay. Like I said yesterday, I was just getting back into it w/spinning class, heart rate monitoring, treadmill running, watching what I eat, etc. After this lil' set-back I'm not sure how far behind/back I'll be! :( One thing that is kinda fortunate, I guess, is that although my snowboarding season is over the doc did say cycling is definitely a great way to regain strengh in that knee. I told him it doesn't kill me that my snowboarding season is over but I really want to put some miles on my new bike this spring. I wonder if the physical therapy I'll be going for will include cycling.

For those of you that didn't read my post from Sunday night - this injury was incurred snowboarding in the woods, where I had a lil' accident w/Mr. Tree. :( I wish snowboard bindings "popped your feet out" like ski bindings! Basically, I fell backwards just as I was heading for a tree and I hit the tree right on the left side of my left (lead) knee. This force tried to make my knee bend sideways. Actually, it DID bend sideways b/c when I first looked at it I thought, for sure, it was broken. It was so unnatural looking - scary. This caused my MCL, which is on the inner knee and connects your femur to your tibia or fibula, in your lower knee to stretch, then finally rip/tear. For any other snowboarders out there...take it easy in the woods and wear a helmet!

I'll give another "post-MRI" update...soon...

-Jeff
man, that sucks ...weiwentg
Feb 4, 2003 5:47 AM
hope you get better, and soon. at least you will be able to cycle after this.
remember what cancer did for Lance.
Thanks...I hope to snowboard/ski again, too...jtferraro
Feb 4, 2003 10:44 AM
just not in the trees anymore. Yeah, Lance is my inspiration...not that I'm comparing cancer to a knee injury, but if he could move on, so could I. I just hope I'm able to get back 100% functionality and power. Naturally, I know it won't be there in the beginning but I'm willing to work at it provided it is possible.

Thanks,

-Jeff
Best Wishes...PEDDLEFOOT
Feb 4, 2003 6:01 AM
...and good luck with the surgery.Keep us updated on how recovery goes.I hope your rehab includes riding.I just got a new bike this month and I know how I would feel if I couldn't ride this year.Take this as another challenge and try to channel your energy into the rehab.
Thanks - I'll keep you updated...jtferraro
Feb 4, 2003 10:46 AM
I hope my rehab included riding, too. I guess, from what Raven said, it won't be for a while, though. You're right -I'm going to take this as a challege and channel my energy into PT/rehab.

Thanks,

-Jeff
Sorry to hear that....lets hope for quick recovery! [nm]bent_spoke
Feb 4, 2003 6:06 AM
Appreciate it, b_s. (nm)jtferraro
Feb 4, 2003 10:47 AM
the good news is...Akirasho
Feb 4, 2003 6:11 AM
... given your description of the injuries, they are recoverable... and your longterm prognosis will probably be good.

While only your doc and PT can say for sure, It's a fair bet to say that some form of stationary cycling will be part of your rehab... and while involving the biggies of the knee, depending on when/if you have surgery, you may still get a bit of a season out of '03!

Good luck and keep us posted...

Also, when you go for your MRI, take a book (no metal staples in the bindings)... or have them give you a pillow and a blankey (in general, they MRI both knees (approximately one hour each) and they keep the room cool (they'll give you earplugs... and you'll be glad they did)) and take a nap.

Be the bike.
I really do hope to get some season out of '03!jtferraro
Feb 4, 2003 10:50 AM
Also, thanks for the advice on the MRI. My appointment is for 9:15 tomorrow morning. Are you saying that the MRI will take 2 hours?!?! I've heard it will only take a 1/2 hour. Hmm...either way, I'll make sure I'm prepared!

-Jeff
Hospital For Special SurgeryKeeponTrekkin
Feb 4, 2003 6:30 AM
Jeff:

I think you said you lived in Ct. You didn't say whereyour were being treated. I imagine Yale-New Haven has a good orthropedics department among others.

However, if you have any concerns, you should consider Hospital for Special Surgery in NYC (E. 70th St.). It is a world class facility with some of the best practitioners in the region and world. Russell Warren did very well by my knee (which had far less serious problems). I'm sure you could get a referral there from your local docs if you wanted to get a 2'nd opinion.

Best of luck. It's a long dark tunnel ahead but one which does have light at its end.

KoT
Yes, I live in CT...jtferraro
Feb 4, 2003 10:54 AM
The doctor whom I've seen is named Dr. Selden. He works out of Bloomfield, CT, which is near Hartford. Yeah, I'm considering a 2nd opinion...and I agree, YNH is a great place. I was born there. Thanks for the referral to the Hospital for Special Surgery in NYC. Hmm...I *DO* want a top notch orthropedic doc!!

I just hope this tunnel isn't TOO long and dark. If I know I can regain 100% functionality and power I'm willing to give it my all, though!

Thanks,

-Jeff
Hey, me tooKristin
Feb 4, 2003 11:18 AM
I was born at Yale in 1970. Later in 1987, as I was filling out college applications my parents said that since I'd already been to an Ivy League school, they weren't paying for me to go to another. :-)
One year later, I was born! Where are you now, Kristin? (nm)jtferraro
Feb 4, 2003 11:34 AM
Moved to the Chicago area in 1996.Kristin
Feb 4, 2003 12:31 PM
I never thought I'd stay out in the midwest, but I think it suits me well. New England (Connecticut especially) tends to be very reserved. I wouldn't say its unfriendly. But just friendly in a different way. People tend to keep to their own more and are less likely to invite strangers into their circles. Where Chicago is more relaxed and open relationally. That makes it seem friendlier--at least to a stranger.
Yeah, I know what you mean about CT...jtferraro
Feb 4, 2003 1:03 PM
So, how is the riding out there? What kind of riding do you participate in, group rides/centuries/racing/recreational, etc.? What kind of bike do you ride?

Also, where in CT did you live? I grew up in New Haven county and now live in Hartford county.

-Jeff
The riding out here kinda sucksKristin
Feb 4, 2003 3:30 PM
There are NO hills. This can alter ones perspective of hills and moutains over time. Also, it affects ones perseption of what straight is. For instance, after 6 years, I begin to look at Barrington Hills as hilly. Here is a picture of South Barrington topo for one of our routes. This is one of the hilliest areas around Chicago. Notice the mind staggaring elevation gains. The two spots I circled are what I would consider the worst climbs on the route. They get you out of the saddle at least.

Since my move south in October I am now in even flatter country. Farmland mostly with no hills at all. Hello headwinds. I mostly ride along (even on group rides) at a snails pace because...well, I'm slow. :)

My mother grew up on Forbes Place in New Haven and I was raised mostly in Groton. But I've lived all over New England and worked in Hartford for a while. Are you in insurance pray-tell?
Headwinds...yuck!jtferraro
Feb 4, 2003 4:16 PM
My parents both grew up in New Haven, too. On Lyon St., to be exact. It is not too far off of State Street. Although there are many insurance companies in Hartford, I don't work for any. I actually work for a large bank...FleetBoston Financial, although I'm a computer network engineer, not a financial guru!

-Jeff
Your rehab...Raven1911
Feb 4, 2003 6:39 AM
Jeff,

I work with post ACL's all the time as I am a physical therapist. What you might have is the terrible triad syndrome where all three structures are injured. It is typical in football type injuries where someone pivots on their knee and an external force is applied causing damage to all three structures. If that is the case then the surgeon will scope your knee for your meniscus and replace the ACL and possibly the MCL if needed via transplant. The rehab of such an injury takes 9-12 months. Don't get discouraged. The surgeon will offer you a choice of placement for the graft which will be hamstring, patellar tendon or cadaver graft. There are pro's and con's to all but if I were you I would choose the patellar graft as it seems to keep its tensile strength better than the rest. The surgeon will probably be more skilled at a couple more than other and will recommend a certain type. Choose carefully and research.

You will be walking and moving around with a brace on your leg right after surgery for up to 2-4 weeks. The guys I am working on right now, one just took his brace off at 3 weeks post op. Strengthening is vital around 6-8 weeks post op. For much of the time you will be trying to get back your range of motion. Typically we like to see 100 deg of flexion and 0 degrees of extension at the 2 week mark. Cycling will be apart of your rehab but not until you get around 110 of knee flexion which is required to pedal around a stationary bike.

For now you say you are in a soft brace. Try to keep your strength as high as you can for now as it will speed up your recovery. I would recommend you flexing your muscles (quads and hamstrings and calves) as much as possible to keep them strong. Do not be afraid of taking that brace off. The doctor just doesn't want you running around or falling as a result of the injuries you might have suffered. Your muscles will atrophy really bad if you keep that brace on. You are not going to hurt anything by taking the brace off and maintaining your range of motion and flexing the muscles of your leg in your own house. Also post-op it is vital that you control your swelling. Keep your leg elevated and ice it often. You will be put in a CPM machine that will constantly move your knee too. Try to push the range of motion on the knee as much as possible. If you have any questions about anything email me, ty6897@yahoo.com. Good luck and keep that leg strong!

Raven
Raven....thanks!!jtferraro
Feb 4, 2003 11:32 AM
Man...this just SUCKS!! What do you mean when you say: "If that is the case then the surgeon will scope your knee for your meniscus" Sheet, I might be down for a year, eh? :::SIGH::: Where is this patellar tendon? At what week mark do you usually see 110 of knee flexion?

Thanks for the advice in flexing my quads, hams, and calves! I will do that. Also, I've now removed the brace and am icing my knee again. I'm not sure how important icing it still is but I've been doing it on and off. Are you suggesting I bend my leg, too??

Thanks,

-Jeff
re: Knee update (post Dr. visit)...JimP
Feb 4, 2003 6:40 AM
Jeff,
Good luck on the surgery and rehab. I had to have both knees done about 9 years ago - roto-rooter job to clean out the meniscus on one knee and trim the meniscus on the other. My therapy did include riding and I was able to be back on the road in 6 weeks. The out-of-saddle and climbing can still be challenging but I am still riding.
Jim
Thanks. Questions...jtferraro
Feb 4, 2003 11:39 AM
Why did you need the surgery? You never got 100% functionality/power back?

-Jeff
Thanks. Questions...JimP
Feb 5, 2003 5:58 AM
Jeff,

I tore up the meniscus in the left knee so bad that it had to be totally removed when I was 49 (I am now 60). I also had some tears in the meniscus of the right knee that the doc cleaned up. In addition to that, there was also calcification of arthritis that was removed. My father has had total knee replacement on both sides so I have blamed him for my genetic predisposition to these kind of problems.
Since the bones of the left leg are now bone-on-bone, there isn't any shock absorbtion so I can't run at all. I am able to ride but some times there is a pain in the left knee when I am out of the saddle. I was always a spinner so now I rely on 90-100 rpm to keep from overloading the knee joint. I suppose I am lucky to be able to ride as much as I do without any other problems.
Jim
Dag. Sorry to hear that.Kristin
Feb 4, 2003 6:47 AM
That really sucks. Hang in there, and follow the doctors orders to a T. If you do then, in the end, you'll be sure you've not derailed yourself along the way. But if you don't you'll always wonder if doing this thing, or going on that ride added to your recovery time.
Yeah, I hear ya' re: following Dr's oders, but I think Raven...jtferraro
Feb 4, 2003 11:43 AM
has some good points since he is a PT. Flexing the muscles and removing that soft cast ocassionally do make sense. I'm not sure if I should be bending my knee, though. Raven?

-Jeff
Sorry to hear, best wishes on a speedy recovery. nmnoveread
Feb 4, 2003 6:50 AM
Thank you. (nm)jtferraro
Feb 4, 2003 11:43 AM
Jeff, some thoughts....eyebob
Feb 4, 2003 7:30 AM
Many of us have had knee surgery around these parts. I had my right ACL done in 1997 (10 years after it's last blow out in college hoops). That's when and why I started cycling. Here's the deal. Look at this as an opportunity to build the strength and focus that you want to become a better cyclist. It'll come slow at first, but you only get one shot to rehab, so do it correctly. Kind of like investing in the future, yes? I'd find a good PT, or strength and conditioning coach to guide you through it. It'll probably be a good 4 months until you're outside on your bike so get used to the indoor trainers. This may also be a good time to bone up on nutritional components to healing as well as some of the alternative stuff that's got a good track record. Don't lose hope. It'll probably take a good 2 years until you feel really back to normal.

Be well. Keep us posted.

BT
Some questions...jtferraro
Feb 4, 2003 11:51 AM
What caused your ACL injury in 1997? Did you have surgery in 1987, too? Thanks for the advice on the rehab about doing it RIGHT. What kind of nutrional components are you referring to? DAMN, you really think it will be 2 years before I feel 100% again?!

-Jeff
re: Knee update (post Dr. visit)...mainframe
Feb 4, 2003 7:45 AM
Jeff, very sorry to hear of your mishap. Just keep in mind that positive thinking can accomplish many things! Tell your body what it needs to do. Refrain from thinking in the negative. Separately, what kind of manual shift car do you drive?
Thanks. For whatever reason you ask, I drive an Audi. (nm)jtferraro
Feb 4, 2003 11:52 AM