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Wednesday, June 24, 2015

On the mend :)

Well, I said I'd be back in a month and it's turned into more than 6 now!
A lot has happened in the last 6 months so I'll try keep it as short as possible...
I got a specialist to build up my left work boot for me, and that has helped a lot.
I got really busy with work over the Xmas period, so I stopped gyming and didn't really find a lot of time for exercise outside of my daily work routine.
I drilled a ppull-up bar above the arch between my bedroom and kitchen so that i could still get some upper body workout done, and have been using this nearly every evening for the last 6 months.
Even with all the work i thought i was doing in the gym and in my daily routine, to strengthen my leg, I was finding that towards the end of the week my quad was really hurting me, some weeks, to the point where i would need to foam roll my muscles and would be in agony, some nights not even getting much sleep cos of the muscle pain.
Eventually I decided to seek professional advice, and went to see a biokineticist (something I'd been recommended to do since almost the beginning stages of my recovery).
Well, to tell you the truth, this woman has been a life saver!
If I can recommend to anyone out there who has suffered with muscle degeneration due to injury, or even misalignment or anything like that, do yourself a favour and go and see a biokineticist now!
She targets specific layers of muscles which i never even knew i had, and the exercises are so small in movemnet that i thought i was doing nothing.
Well i was wrong.
In the last 4 months she has taken me from being in pain on almost a weekly basis and battling to get round a 9 hole par 3 course once a week, to a pain free 3 months now, and regularly playing 18 holes on the full golf course and pulling my golf cart with all my clubs, etc along behind me!
Everything has gotten so much easier to do and my muscle strength has improved noticeably.
I still have another 2 months to go with her, and she has promised me that she will have my left leg as strong as my right before she is done with me.
I really could not be happier.
It comes with a price though.
1.5 hours of exercises every evening 6 days a week (ok, to be honest i get about 4 days a week done on average). That's an hour's exercises and 30min of stretches afterwards.
I see her once a week for a checkup and on that day she pushes me to my limits during that hour!
In the beginning i was sore the day after, but even when she really pushes me hard, the next morning i'm ready for more!
I'll drop back in and update soon.
If you're reading this because you want some sort of insight into how this kind of injury plays out with regards recovery, take my advice, see a biokineticist and you can thank me later...
Hugely positive about the future.
Hope this post helps you in your own struggles...
Peace
:)

Saturday, November 1, 2014

Summer's almost here

Sitting here at my kitchen counter with not a lot to do. The weathers windy and cold outside and i've done all the things i set out to do today, so i thought i'd update my blog a bit...
I finally joined the gym about a month ago, and threw sum leg training into the rest of my workout session.
The leg raises are still only with the minimum 5kg weight the machine allows, but i can almost lift it entirely with my left leg now. My right leg is for support just in case. 10 reps and 3 sets each trip to the gym, which at the moment is twice a week.
I'm also doing calf stretches and calf raises on the machine which is helping stretch out my achilles and making walking up hills a lot easier.
I've also started playing golf again, a love of mine since i was around 6 years old, which is a huge positive in my life!
I didn't think i would be able to swing a club again as your left knee needs to rotate out of the shot, and this would cause me a lot of discomfort.
But as i am getting stronger, my knee is able to withstand more of the rigours of everyday life and i am noticing it is slowly becoming a bit more flexible like it used to be before the accident.
I have just this week started back on the exercise bicycle again 20min a session 3 times a week to help build a bit more strength and also to get a bit of cardio into my gym routine, so i am sure that this will help as well with strength and flexibility.
Summer is fast approaching here in South Africa, and i am looking forward to getting back in the water again once the sea warms up a bit.
Both for my diving and also for a bit of bodyboarding.
I am going to go and see a specialist about building up my shoes, in the next month as well, because i want him to check my spine and see how much damage i am doing to it with the difference in leg length, and what his thoughts are on the long term prognosis of my situation with regards alignment.
I'll pop back and update everything in a month or so's time.
Until then, stay positive and appreciate every day.
Peace

Sunday, August 17, 2014

A sunny winters day

Its been quite a warm winter this year.
And today didn't disappoint either. 28C and not a breath of wind.
It was an afternoon made for fishing, with an incoming tide late in the afternoon.
The last time i went fishing off of Central Beach, i only made it half way to the river mouth. Its a fairly long walk of about 300m from the car park to the seaside across the sand, and then around another 1km to the river mouth along the beach. If you keep going, you double back on yourself on the river side of the beach, and thats another good 1-1.5km stretch again, back to the car park.
Last time had been about 3 months ago.
I'd made it over the sand and about another 150m down the beach and my leg had said no further unless i preferred to hop home!
I'd made it back to the car afterwards, but it really took it out of me.
Today was perfect for a fish from the river mouth and i decided i would make the mission, both for the enjoyment sake, and also to see where i was at with my strength and stamina.
I think its these little missions you make that are the away-from-the-daily-routine kind of exercise sessions that really enable you to see how far you've come.
I made it across the sand and all the way to the mouth. I fished there for an hour and then walked around the point to the river side of the beach. I fished there for another couple of hours, and made my way back as the sun was setting, all the way to the carpark.
I stopped twice, as much to soak up the last of the sun and to appreciate the beautiful river reflecting like glass in front of me, as to take a break.
I was very impressed with the trip. No fish were caught, but it was a great day out and i was very happy with how quickly my leg is getting stronger now that i am using it every day.
I am set to join the gym in the next week or so, and then i will take things up another notch.
Apart from the difference in length, i feel that i will make a close to full recovery in the coming months and years.
I will wait and see how my back and my knee hold up over time, but i am doing a lot of core strength work, which is very important in a strong body.
Just thought i'd share my little good news story.
Dont ever look back and regret. Look around you and appreciate. Look ahead of you and be excited.
Your future is yours to create.
Peace




Thursday, August 7, 2014

"Walking" the winding road of life...

I cant believe another 3 months has flown by so quickly!
It seems like just yesterday i was writing my last entry!
Well, the last 3 months has seen me move from every now and again relying on 1 crutch, to being totally crutch free!
I have visited the hospital for 1 final (hopefully) time, and they have basically said to me that i just need to exercise myself back to full fitness now. There is not much more that they can do for me.
They were very happy with my progress and have recommended that i get my shoes built up to help my back.
In the last 3 months i have had pretty bad DOMS in my left quad from overuse, but, unfortunately, this cannot be helped, as i need to lead a pretty energetic daily routine what with work and the rest.
I have not found any further problems related to my lower back, and have been in no pain at all, so this is only a good thing.
I have had my left shoes built up at the local shoe repair guy, which has added about 5cm in height to them.
This, i'm sure, has helped a lot.
I have not been able to get into the gym again as yet, but it is on the cards for the near future.
My daily life is not really affected at the moment, and long may this continue.
My knee has not given me a seconds pain either. The only pain that i have had is my quad, but i expect this to be intermittent as my muscle slowly gets stronger.
As of now, i can feel the muscle is stronger, but still no definition above the knee, as with my good leg. But this will come with time and exercise.
Overall, i am very happy with my progress, and take each and every day as a blessing, especially looking back over this whole ordeal.
I dont think that breaking a leg and damaging ligaments can ever be a good thing, but certainly it is even more difficult when you need to be active, like for work reasons, etc.
I have been to the driving range to hit some golf balls recently, as i am a keen golfer, and am optimistic i will be back on the golf course before the end of the year!
There's always something to be thankful for, and always something to smile about...sometimes you just have to look a little harder to find it...
Peace
Simon
:)

Sunday, April 20, 2014

Crutch Free!!!

Happy Easter everyone!
Its been a good few months since i last updated my blog.
I am now walking around crutch free most of the time! In the evenings and  first thing in the morning i stll use the 1 crutch so that i can give my leg a break (excuse the pun), but other than that i am pretty mobile.
At work i am up and down ladders, carrying scaffolding around, etc, and seem to be managing ok!
I had pretty severe DOMS (muscle pain) last weekend, after a particularly physical week at work, but luckily these only lasted for half a day and when i woke up the next morning i felt fine again.
I can feel that my knee is pretty strong, and the muscles are certainly helping as they get stronger.
My quad is still a fair way from being as strong as i would like it, but i can feel that every week there are strength improvements.
I would say that at the moment i am around 40% of where i would like to be to be back to as close a normal lifestyle as possible, but i am already walking, so this can only be a good thing right?
I dont think i will be having the rod removed when i go back for a check-up in June.
The pain i have felt in my knee for most of the last 3 years, is seldom a problem now, and only after a lot of physical exertion do i feel it anymore.
The only thing that i am noticing now, is a bit of lower back pain.
I suppose this is to be expected when 1 leg is almost 10cm shorter than the other!
Now that i am walking it is putting a lot more stress on my lower back, and this is a little worrying for the long term prognosis.
I have looked online and found that the human body can compensate for around 2cm of difference, and anything over 5cm, the specialists recommend surgery.
The options are not great though....
1. Lengthen the shorter leg, whcih involves removal of the nail, a bre-break, external fixation, and then every 34 days they pull the bone apart a cm so that it can regrow the space and lengthen the leg. This process for my difference in length, would take around 8-10 months, and then another 6-8 months after that to fully heal after the metal is removed!
2. Shorten the good leg! Basically, they surgically cut the femur, remove 8cm of bone, and then put you back together like they would a broken leg! Possibly a nail in the femur as well! At least this would balance me up though! The recovery is around 3 months on crutches again, and 8 months to fully recover.
Option 2 is certainly the preferred method for me, but i would need to be strong enough to walk and rest and stand on only my left leg for almost the entire period of my recovery, so that is still a fair way off!
I think that when the time is right, i will enquire about having this operation done.
It in't the most pleasant thing making the decision to cut a piece out of a perfectly good leg, but i think that this is certainly the better of the 2 options.
If i were to leave it, i would end up with serious back problems in the not too distant future.
But, for the moment, i am very happy with just walking, and enjoying not having to use the crutches all the time.
As soon as i can find the time, i think i would like to join the gym again and start doing sum serious strengthening exercises, as what i am capable of doing at home is very little compared to a gym with all its equipment.
Here's to the next 3 months being as rewarding as the last 3.
Til next time, chin up and keep positive...
8)

Tuesday, January 14, 2014

A change of mind

Well, its now another month or more since i last posted.
Merry Xmas to all my readers, and a very happy 2014 to you all!
This is gonna be a wonderful year. Just believe it, and make it happen!!
On a personal note, i have noticed a marked improvement in my own mobility and strength over the last month and a bit.
I stopped going to the gym shortly after my last post, as work commitments took up most of my time, but have continued to do my straight leg raises every evening to help build strength.
I found that towards the end of December i was able to now stand with my full weight on my left leg fairly easily, although my balance is still really bad on just that leg!
My leg has continued to feel stronger and more stable day by day, and around Xmas time i went down to spend the day on the beach with a friend. I played bat and ball on the sand for about half an hour, and managed to even walk down into the water, have a swim for a good hour or so playing in the waves, and make it back up to where we were lying on the beach, all without the use of my crutches!
On New Years Eve i went to an outdoor party and danced for the first time in over 3 years on the dance floor without any walking aids! I can honestly say that nothing would have wiped the smile off my face!
About 3 days ago now i started walking with just 1 crutch in my right hand, and only to balance myself, as my left leg is a good 8cm shorter than my right leg.
My knee was sore after the beach trip, but only for about 1.5 days. Obviously the muscles in my leg got tired and decided to take a break and this left my knee susceptible to the rigors of moving around. This is what caused the pain.
After my NYE dancing session i was also a little sore, but this only lasted about 1 day and then i seemed back to normal again.
3 days ago, when i started walking with 1 crutch, my knee was sore, and i struggled a bit the following day to use just the 1 crutch, but the last 2 days have been pretty good, and i can feel that the use of just the 1 crutch is really helping me strengthen my leg a lot.
I am feeling very happy about my recovery now, and am pretty positive about the next few months, and losing the crutch altogether!
I have been doing a lot of thinking, and have decided that my best course of action would be to put off my op for another 6 months and wait and see how much more improvement there is, before "risking" the op.
I say "risking", as there is the possibility of the femur refracturing when they remove the IM nail, and also of infection. I have read stories of others on the net of having a bit of pain, and going for the rod removal, only for infection to set in, and they are now in a much worse state than before!
The pain that i have been feeling in the outer part of my knee for much of my recovery time over the last 2 years, is now very much subdued. I still feel it in certain movements, and my leg still has a long way to go yet, but i am sure that strengthening alone will see me right.
For anyone reading this blog and wondering if there will ever be a light at the end of the tunnel, believe that there will be, and believe the doctors when they tell you that muscle strength can fix most of your aches and pains.
I dont think that i will ever stop the strength training program i am working on, but this is a good thing, as i know that the stronger my leg muscles are, the more protection i am affording my knee.
I have a very lax ACL and according to the arthroscopy i need an ACL reconstruction, but i will continue to get stronger, and will prove my doctor right in that muscle strength alone can overcome even this severe knee injury.
Keep positive guys and gals.
Sometimes it is all you have to hold onto on a very dark and long road to recovery. But it is your most powerful weapon in the fight to get back to full health!
I'll continue to post how things are going. Hopefully soon i'll be free of my crutches altogether.
Peace and Love for the coming year...

Tuesday, November 26, 2013

Strength Training

Another month on, and i can happily say that i can finally feel my leg starting to feel like a leg again!
The strengthening exercises i am doing for my quad muscle are really beginning to pay off.
Although i can still not support all my weight through my left leg in a walking movement, i can now stand for short periods of time on my left leg stationary.
The support my quad is giving my knee is also something that i am noticing more every week.
My knee feels a lot more stable when i a moving around now.
Still a long way to go yet, but finally i am actually feeling some improvement!
I can feel when i lie on my left side that there is definitely something not right with my left hip, and i am sure that this has to do with the pin in my upper leg protruding out of the top of my hip joint.
Something that hopefully will be removed from the equation next February!
I have started doing calf raises at the gym and also added Adductor and Abductor exercises on the machines.
I've also started swimming again every other day in the gym pool for a bit of cardio exercise.
Its almost December now, so just 2 months remain til my op. I am hoping that by that time i am almost walking without my crutches.
Time will tell though. It's all about exercising and strengthening for now...

Wednesday, October 23, 2013

Xrays & operations...

Early up this morning, and the now all too familiar procedure of catching the hospital bus through to George and joining the queue system.
To make things a little more interesting this morning, when i eventually got to the front of the queue, they told me that i did not have an appointment, and had to first go to the xray dept and get my name on the list, then to go upstairs to the orthopaedic dept and get my name on the list there, and then to return to collect my file in order to go and get my xrays taken!
Muttering under my breath i headed off to complete the process.
45 minutes later, and with my name now on all the required lists, i was sitting in the xray queue waiting for my turn.
At 2pm i finally made it to the front of the queue, and went inside to get my xrays taken.
Then upstairs to wait for another 2 hours to get to to see the specialist.
He looked over the new xrays, which showed multiple angles of the head of my femur, the ball part that slots into the hip.
His thinking was that maybe the screws that went at a 45 degree angle through the nail in my femur, and into my hip, were protruding out of the side of the ball part, and scraping on something, causing the pain.
Unfortunately the xrays were inconclusive. They only showed that the 1 screw was broken off, and the 2nd screw that they used was screwed very close to the edge of the joint.
He suggested removal of the hardware in my upper leg to see whether this would fix the problems i was having.
He looked through his diary and made my appointment for the next available date, 11th February next year!
6 days before my birthday! Oh well, maybe a nice birthday present awaits me? One can only hope hey?!
He notified me of the complications that may arise from the op, namely infection, or the re-fracture of the femur, or that they cannot remove the screws!
I was willing to put up with the risks involved though, as we all seemed to think that the op is necessary to get me walking again.
He explained that after the op, even if everything went well, he would need me to still be on crutches for another 6 weeks in order to make sure the bone was strong enough to take my weight again.
I dont think that the op will fix me entirely though.
I know that there are a lot more problems with my leg and knee that will develop over time, and perhaps even in the near future, but if i can lose the crutches and get walking again without them, then this, for me, is a huge bonus!
I have done a lot of research on calcium supplements too, as he mentioned that the bone around my hip area looked very weak, as i have not been using my leg for weight bearing much over the last 2 years. He was afraid that the hip might fracture whilst removing the nail as the op is quite a forceful one.
I have some Calcium Carbonate/Glycine chewable tablets that i am taking, and research shows that vitamin D3 helps the body absorb the maximum amount of calcium for the bones, so i have bought some D3 as well.
1 tablet of vit D3 in the morning with 2 tabs of Calcium Carbonate and then another 2 tabs of Calcium with lunch.
I'll keep on with the quad exercises as well, and hopefully by Feb next year i'll be strong enough to walk once the crutches can get chucked away!
At the moment i am almost able to stand straight legged with all my weight on my left foot. I can put about 90% weight through it now.
I know that walking requires the knee to be a lot stronger than just being able to stand on the leg, but i'm sure that as the quad gets stronger, the knee will will get stronger too.
Thats my aim now anyway...to strengthen the quad muscle to the point where it supports the knee enough to limit the amount of damage that will be done to it when i am walking again.
So, thats the news up til now.
Back to the physio and supplements drawing board, and pray pray and pray some more that Feb next year i get some good news for my birthday!
I was really hoping to be walking by the end of this year, but that doesnt look like happening now.
At least i've got summer to look forward to.
Its almost here, and by all accounts its going to be a scorcher!
Much love to all my readers.
Peace

Thursday, October 17, 2013

2 days and 1200km later...

The trip down to Cape Town was a long one. Luckily it was overcast so it wasn't a hot one in the car.
The specialist there saw me, and i did the usual climb up on the bed and he pushed and pulled on my knee and did the leg rotating thing i've become used to by know.
His findings were that my knee seems to be stable enough to facilitate walking!
He said that the pain in the lateral part of my knee was, in his professional opinion, and without having looked at any xrays or seen inside my knee, coming from the upper part of my leg.
It was pain transferal from my femur or hip.
He looked at the xrays i had brought with me, and said that he could not tell from them where exactly the pain was coming from, and that i needed better xrays or an MRI to make sure.
And that was my entire 20min meeting with him.
A 2 day round trip, and a pretty expensive fuel bill later and i was still none the wiser...but at least i had been pointed in a direction to look now.
I took a chance the following morning and called the hospital in George to see if i could possibly get a late appointment for the same day, and i could stop in there on the way past.
As luck would have it, they could fit me in.
5 hours later and i was once again sitting in the queue system waiting to see the specialist at the public hospital.
3 more hours later and it was my turn.
They were interested to hear of my visit to the specialist in Cape Town, and agreed that the knee might not be where the initial problem lay. Unfortunately it was too late in the day for xrays, so they scheduled me to return the following wednesday for xrays and a better look.
So, off i went again, with a date to return in a weeks time.
The plot thickens...

Sunday, October 13, 2013

Time for a specialist!

It's been 3 months since my last entry now, and i have been keeping on with the physio i am doing at home to try and strengthen my left quad.
I have noticed an improvement, but it is still very slow progress.
I have gone from straight leg raises, to straight leg raises with my work boot on my left foot, thus increasing the weight by about a half a kilo or so (they're steel toes caps).
My quad seems fine to take the exra weight, but my knee screams at me whilst grating and grinding under the kneecap!
But i'm still managing to get by every evening with a 50 set routine.
Luckily there hasn't been a return of the dreaded DOMS (delayed onset muscle soreness). I take Friday and Saturday off from this routine to give my quad a break from the workout, and this is seeming to give me enough of a rest to not have the muscle pain i've had in the past.
As these things usually go, i per chance, was speaking to someone and they mentioned a knee op they had had in the past and that there was an excellent specialist in the Cape Town area that i should get in contact with.
I found him online, and contacted him with my story.
He agreed to see me for free, waiving his usual consultation fee, and assess me and give me his diagnosis and also cost of getting fixed up privately.
I researched all about him, and am extremely confident that he is the right man for the job. He is 1 of the most highly qualified and experienced knee specialists in the country!
My appointment is finally (after 2 months trying to get a lift down to his practice) set for next week Wednesday afternoon.
I'm very excited to finally know exactly what is wrong with my knee.
One thing is for sure...there is nothing that i can bring to the table that he hasn't already seen and dealt with before!
So this is very encouraging.
Now just to hope that he has some sort of good news for me.
I'll be back online in the next 10 days or so to report back what he told me.
Peace

Wednesday, July 17, 2013

A change of thinking...

I had my return appointment with the hospital last week wednesday, and, armed with a few questions, i was hopeful of a positive trip in this time.
Over the course of the last month, i have done a lot of research on the net, and have found that it is more than possible to live without an ACL. I also have been researching partial knee replacement technology, as this seems a better option to a full knee replacement.
These were the questions i wanted to put to the doctor on my visit.
The usual preliminaries out of the way with the queuing, and 4h later i was sitting in front of my doctor.
I asked him first about the ACL and whether or not he felt that it was necessary at this point in my recovery.
He told me that i was correct in that a person could lead a normal enough life without an ACL at all. It would mean that the knee would be less stable and prone to collapsing if too much sideways stresses were put on it, but in normal walking and such, it would hold up ok as long as the quad muscle was strong enough to support it.
He said that the stronger the quad muscle, the more support the knee would get, as the quad runs over the front of the knee.
I asked him about wear and tear, and he said that the meniscii would slowly get worn out if there was no ACL. Unless the quad muscle was super strong, in which case it could fully replace the function of the ACL. But we're talking body builder strength here!
My next question was about the knee resurfacing technique i had researched on the net. I only found instances of the op being performed in the USA and not in South Africa, and he told me that this is because SA did not think that it was a good idea to perform this op.
He told me that it was the same as the hip resurfacing op, and that issues had come to light that the grating of the metal used in the resurfacing, against the bone, was letting trace amounts of the metal into the blood stream, and this was causing cancer, anaemia, and other problems. He said he would not recommend it.
He agreed with my thinking that it would be best to keep strengthening my leg to the point of being able to walk on it, and then to take things from there. If there was pain we would deal with it then, and decide what to do.
I would think that the ACL would still need to be done at some point, but certainly this would be a better idea once i was already walking, as it is a best case scenario of 3 months to start walking again after the op if you were walking beforehand. And i am not even walking yet, so who knows how far this would set me back again!
He told me that up until now, all the tests that have been done on me; the sonar, MRI, x-rays, nerve tests, physical exams, etc, have all been static tests, and that it would not make sense to go from these tests straight to operating.
He recommended that i start walking first, and also to try and see a biokineticist, as he said that there was a very good chance that my alignment and also muscle imbalance was a major factor in the pain i was experiencing in the outside of my knee.
I was pretty happy with the chat that we had, and left feeling a lot more focused on what needed to be done now.
So now i'm back on a physio routine to keep strengthening the leg, and to try and get walking as soon as possible.
I have tried walking with just one crutch on my left arm, and i can manage it, which is encouraging. It is a lot of a limp and not much of a walk, but it forces me to put a lot more weight through my left leg, so this is a good thing.
I am trying to do this once every other day, as even with a short half the length of the car park outside (30m) walk, my quad and knee are screaming at me.
But it will get better and stronger in time. I am dead set on walking before the end of the year.
In October it will be 2 years since the accident and that is WAY too long to be off my legs!
So, here's to physio physio and more physio.....sound like a stuck record!! ;)

Sunday, June 9, 2013

Slow progress

Well, its been 2 months since my last post now.
I've been back to the physio a few times and the progress has been painfully slow.
I was hoping that after 2 months i would be noticing a marked improvement, but unfortunately, it is taking a lot longer than i hoped to strengthen my leg.
I have certainly noticed sum strength improvements, and mobility that wasn't there pain-free before, so this is encouraging.
I can now quite comfortably lie on my sides when i sleep, where as before i couldn't lie for long on my left side. Also, before when i used to fall asleep, i would have twitching of my quad muscle that would pull my leg straight, causing much pain. This seems to have lessened to the point of almost not happening anymore.
My physio exercises are getting a bit easier to get thru without any pain, and i have upped the length of time i am holding the contractions of the exercises for, from 7 to 10 seconds.
The straight leg raise is still giving me a lot of pain in my quad muscle 2 days after the exercises. Its just muscle pain, but most uncomfortable. I am alternating every other day with this exercise, to give my quad a rest in between.
The pain in the side of the knee is still there, but does seem to be recurrent a tiny bit less often now, although i can still not put my foot on the floor without pain.
My return to the hospital is in 1 months time, and my physio that i see every 2 weeks, reckons that i might be strong enough in a month for the doctors to let me go thru the next round of operations.
But a lot of hard work will need to be put in before then.
Its very difficult to stay positive knowing that i will still need another 2 major operations, with each one bringing its own 4-6 months recovery period!
I am busying myself with furthering my career with studies and courses in the meantime, and trying to line up some sort of business ventures in order to bring in some money, as i am still not working.
Unfortunately, its hard enough to find a job where i stay if you are able bodied, let alone on crutches!
Here's hoping that the next month goes well and that the doctors reckon i can get underway with the ACL reconstruction soon...

Thursday, April 11, 2013

EMG

The EMG test was a little daunting once i was sat on the bed.
I suppose being an electrician, you know all about electricity, and even though that should probably help the situation because it is only tiny amounts of voltage, I think it just means i am more aware of what is coming!
3 small electrodes were placed on the nerves in my feet, near my toes, and then something looking like a soldering iron with 2 prongs at the end, was held further up my leg, just above the knee area, and a dial on the machine was turned up, slowly increasing the voltage, until an electrical kick was felt in my toes.
This electrical impulse was measured by a pc system and recorded for analysis.
About 5 shocks were sent thru my leg from each location he put the prongs, starting at very mild, to sumtimes quite strong.
The entire set of tests took about 45min or so, and i was chatting to him during the sequence.
He said that my nerve respnse was perfect. As though i had brand new nerves! He said that my sensitivity of the nerves was above the norm, and the response times very fast.
I told him that i was kinda hoping that he would find sumthing wrong so that i could find the cause of the pain, but he said that nerve damage is the last thing that you want to find!
Nerve damage caused problems getting signals to the muscles, and in turn meant that muscles would not function correctly or be as strong as they were before.
He told me that certainly a positive result to his set of tests is what anyone would be hoping for.
After leaving him, it was back to the hospital, the queue system for my file, and the wait to see the ortho specialist.
After 4h sitting on a very uncomfortable hard plastic chair, i finally got to see one of the docs.
He wasn't too impressed to see me back again, and after looking thru my file (i had not seen this guy before), he wanted to know how on earth i could be expecting them to diagnose a pain in the knee problem after only 2 weeks post op!
I told him that i had been sent for this EMG test, and that i was asked to return to look over the results.
He went thru the results with me and told me what i already knew...the results were perfect.
Another thing ticked off the list of possible problems.
Then dr Cappaert walked in and said hello. He'd overheard me talking and came in to see how i was doing.
He told me that i wa trying to rebuild Rome in 2 weeks and that it wasn't going to happen.
He said that i had a lot of things wrong with my leg as a whole, and that the recovery procedure was going to take a long time yet and that i should be patient.
I asked him about the possible knee replacement that i would need to have in the future, and he told me that i should pray that it was not anytime soon, as the nail in the tibia would need to be removed in order to facilitate this op. And he said that the tibial nail was inserted in such a way that it would make removing it very difficult indeed. To the point he feared that they might shatter the tibia or knee in doing so!
This wasn't very comforting knowing that the procedure would need to be done at some point in the future!
He reiterated the fact that until i was strong enough in my muscles, they could not proceed with anything to help me diagnose further.
They booked me in for a return assessment in 3 months time, giving me enough time to get myself as strong as possible.
My physio return is on monday, so until then, its back to the drawing board as far as pain and exercises are concerned!
Another frustrating day in my life, but on the positive side of things, at least one more thing ticked off that could be causing problems...
Ps: i decided on removing the stitches myself as i was pretty certain they were nylon and were not going to dissolve by themselves. I got a pair of tweezers and untied the knots, and pulled them out. Painless. Now my knee can heal up nicely!

Thursday, April 4, 2013

Post op checkup

Today i was back to the hospital to have a 1 week checkup, and to get my stitches out.
After the usual long-winded queuing system to get my file and see the specialist, i was directed to dr Arnold, one of the operating surgeons with my op.
I spoke to him about the continued pain in the side of my knee, and he suggested that an EMG might be the answer to see if there were indeed any trapped nerves near the fibula head.
An ElectroMyoGram, is basically a nerve conductive test, where they check the condition of the nerves, and can tell you whether any damage has occurred or not.
He signed the necessary forms, and booked me in next wednesday for the test procedure at a clinic down the road from the hospital.
I asked about getting the stitches removed and he told me they were dissolving stitches and not to worry.
So, the knee pain saga continues...lets hope that the next set of tests reveals something...

Tuesday, April 2, 2013

Post op physio

I've started with the post op physio exercises that i have been assigned.
They may seem rather simple, but for a very atrophied leg, they are rather challenging. The same pain in the side of the knee continues to hinder me, and makes even the simplest movements such as sitting and standing a painful exercise!
But i'll try my best, as i need to get thru this...



The ticked exercises are the one's that i have been prescribed to start with so long. I have a return date in 2 weeks time to see the physio and she will access my progress and give me some more complicated one's if she sees fit.
The entire workout only takes around 20min to a half hour.
The pain i am feeling in my quads especially from these exercises is tremendous though.
I think they call it DOMS, Delayed Onset Muscle Soreness.
Its from overworking a particular muscle group.
Unfortunately, when your muscles are atrophied to almost nothing, even the easiest workout is going to cause soreness, so i have just been working thru the pain, which at times, has been rather difficult.
But i have no choice...soldier on and get it done...


Tuesday, March 26, 2013

Doctors notes...

Monday morning around 9am dr Cappaert and dr Arnold (the assisting surgeon) came into my room and Cappaert asked me if i wanted the good news or the bad news first...
"The good i suppose", was my answer.
He told me that the good news was that i had had the op and i didnt need to wait for that anymore!
This didnt bode well...
The bad news was that my knee was a bit of a mess to put it mildly!
I had significant cartilage damage to my kneecap where it glides over the femur.
I had an extremely lax anterior cruciate ligamennt, to the point that the dr thought that maybe it was completely torn.
And i had osteochondritis dissecans, a bone problem that can cause arthritis and osteoarthritis. Even if treated.
What the doc did was to scrape away all the rough bits of cartilage under the kneecap that were scraping on the femur, and try to create the natural groove for the kneecap to run in again. He told me that he hoped that new cartilage would form now that he had scraped away the diseased and dead cartilage and it would start to work in a normal fashion. Although this is hope. There is no certainty of this.
He told me that the cruciate ligament tear is a big op, and that he was not prepared to do any of the ops to fix me any further until i could get my quad muscle on my affected leg to the strength of my good leg!
He said this because any op that he did in the future, would need a recovery period, and that would weaken the quad through inactivity, and with a weak quad, any surgery he would do would be doomed to failure in the long run.
He also told me that i could thank dr Arnold very much, as he had fought my case to be operated on on the sunday, as the anaethetist did not want to do the op as it was not an emergency. This was policy.
But he won his argument and the op went ahead, making me officially the first and only elective surgery ever to be done in the George Provincial Hospital on a sunday!
So i thanked him, and asked where we go to next?
He said that i needed to go home and strengthen my leg muscles to the point that he was happy, so that further operations could be performed.
I was looking at 2, possibly 3 more operations, in order to get back to walking again.
Each op had a recovery period of around 6-10 weeks before the next could be performed, and the final op, the cruciate ligament reconstruction, has a recovery period of 6 months!
So, to cut a long story short, it looks as though i will be on crutches for at least another year, to year and a half!
Not exactly the news anyone would want to hear, but the facts remain...
I suppose i see it that at a worst case scenario, i am already more than half way to walking again from the start of this ordeal, 1.5 years ago, so every day from here on out is a day closer to walking!
I was booked in to see the physio the following day, but she was busy with other patients, so i only got to see her today (tuesday).
She has given me a complete set of physio exercises to be done 4 times a day, and 5 sets of each exercise. She has told me that if i am diligent and work hard, i may be strong enough for my next op in around 3 months time.
Its gonna be a lot of hard work to get me to that point, but i am up for the challenge!
I cant wait to get walking again, so i need to do this, and do it good!
So thats my lot really...i'll post pics of the exercises in my next update, and follow my progress as it happens throughout the rest of this adventure...
Peace & Positivity
Si

Post op assessment...

Wednesday morning arrived and i was about to head out the door to go book myself onto the bed waiting list, when my dad shouted to me that it might be a good idea to pack my bags just in case they have a bed for me. Rather safe than sorry.
So i headed back upstairs to throw some clothes and stuff into my backpack.
Then it was off to the hospital.
I picked up my file around 11am, and headed up to see the ortho guy i normally see. After about 30min wait, i was seen, and was told that the paperwork i supposedly needed to fill in, had been filled in the previous visit, just as i had suspected!
The nurse who helps with the admin said that they had not heard back from the wards yet, and that there may be a bed available.
I was told to wait, and took a seat, not knowing whether i would be heading home again, or booking in for the night?
At 3.30pm i got my answer --- "grab your bag, we've got a bed for you"!
I was over the moon. I called my mum and told her that she could now head home, and i followed the nurse into the orthopaedic ward.
I was shown to a room with 2 beds, and no one in it, so i ended up the first evening, having a room to myself, which was pretty sweet.
Thursday morning one of the ortho surgeons came in, as i came to realise they did every morning, and checked out my file at the foot of my bed and asked me why i was there?!
I told him i was in for a knee arthroscopy. He asked to see my knee, asked me a bunch of questions, and then told me that he thought that i needed a better assessment, and took me off the operating list, and sent me for a bunch more xrays!
He said that the head ortho guy, dr Cappaert, would see me the following morning to evaluate the latest xrays and decide what course of action needed to be taken.
So off i went for the xrays, and then returned to bed to while away the rest of the day, wondering whether i would be sent home now, and have to go to the back of the queue again!
Friday morning dr Cappaert arrived around 9am and spoke with me. After checking the xrays out, he said that the femur was healing really well and showing signs of new bone formation around the break site.
The tibia he was not so sure about, as it was difficult to ascertain from the xrays.
He said that, as he stated in December when he booked me in for the op, he thought that a diagnostic arthroscopy would be the best way to go. This way he could be sure what was happening inside the knee and take things from there.
I agreed with him, and he said that he would try and get the op done on the following monday or tuesday now, as they always had busy weekends, and sundays were reserved for emergency cases only.
So i settled in for a weekend in the hospital.
I was very impressed with the professionalism of the staff, the food was not bad at all, and the wards were spotlessly clean. A very good advert for the government run flagship hospital in SA, where they are trying to install a NHS type system.
On saturday night i was told that i should not eat anything after 10pm, as they were pushing to get me done on the sunday, as they had a busy day monday, and then Cappaert was not working, so a different doctor would have to operate on me on tuesday.
On sunday morning around 11am, a nurse arrived to prep me for surgery, and did some tests, gave me my hospital gown to wear, and i had to remove all jewellery and bracelets.
About half an hour later i was lying on my bed and being wheeled down to the operating theatre.
I waited about an hour in the waiting area outside the theatre as they finished up someone before me.
Then it was my turn.
First thing i noticed upon entering the theatre was the 40" LCD screen on the wall, which i commented on, and was told that that was where they watch movies when the op becomes a bit boring!
Haha! A surgeon with a sense of humour. Always a good thing.
I joked with the anaethetist and the surgeon while they put a drip in me and prepared to send me under.
I got the mask over my mouth and nose, and was told it was just pure oxygen, so took a couple of deep breaths, knowing how good it tasted from my scuba diving experiences with it.
The room spun slowly around and then i was gone...
I woke up in the recovery room outside the theatre, and the doc said that the op had gone well, and that he would see me the following morning to discuss the results with me.
I was taken back upstairs, and, feeling rather nauseous, i refused lunch when it was offered.
I was given a shot of morphine by the nurse, and was back to sleep for a couple of hours.
When i woke up, my parents were there for visiting hours.
After that i was starving and happpily ate the feta and mushroom quiche my mom had brought me for supper!
Then it was back to sleep again, dreaming of good news in the morning...

Monday, March 18, 2013

2 hops forward and 1 hop back...!

Well, i said last time that the next time i blogged would be post op...unfortunately, this is not the case!
Monday 4th when i went in to see the docs to book me in for my op, they told me that there were no free beds, and that i should return on the wednesday! I wish it were that simple, as the hospital is a full 2h drive away, and then the return trip if they cant see me!
I mentioned this to the doc, and he gave me a number to phone to check if beds were available so that i was not wasting my trip coming in each time.
I phoned them on the wednesday morning, and they told me that there were still no spare beds, and that i should try again the following monday!
Apparently mondays aren't very promising cos of the weekends events bringing, usually, more trauma victims into the hospital, and hence, the beds getting filled up!
After 2 frustrating weeks of phoning every monday and wednesday, i still have not been seen!
I phoned this morning, and the doctor who will be doing the surgery on me answered, and told me that in his honest opinion, i was wasting my time phoning every week.
He said that the best route to follow would be to come into the hospital on wednesday this week, and to give my name in to the reception that i needed a bed. They would put me on a waiting list for a bed, and when one freed up, i would get it. This would normally happen over the course of the weekend.
I would then stay in the hospital, thus laying claim to my bed, until they could do the operation!
Now, seeing as though they only do these arthroscopy's on a tuesday, wednesday and thursday, it might mean that i spent 4 or 5 days in the hospital without even getting seen to!
He also told me that although they try their best to see everyone who has a bed, as soon as possible, it might be another week before they saw to me!
So, even with a bed, there is no guarantee that i would get operated on within 4 or 5 days...it might be a week longer! Sitting in a hospital, eating hospital food, for up to 10 days or so before i even got the op!
Good grief!
But, not having many options left, i will have to follow these recommendations and go into the hospital on wednesday morning.
I'll know the same day when my admittance date will be. Then its to go stocked up with enough stuff to keep me busy to make it through to the op date, whenever that may be!
The happy days of a patient without medical aid... :(
Hopefully the next time i write will be with happier news...

Tuesday, February 26, 2013

Almost there...

Well, its been a long 2 months or so since i went for my bone isotope scan, and i am happy to say it is now only 1 week til i get my op on my knee.
All things going well, i should have already had my op by this time next week!
To say that i'm looking forward to having the arthroscopy may be a bit strange, but i am certainly looking forward to putting all this behind me as soon as possible.
I have a lot of faith that after this op i will start to finally return to a somewhat normal life again.
There have been moments over the last 2 months where i have been in a lot of pain, and even phoned the hospital mid January, to see if there wasn't a chance i could get a place sooner if a place opened up?
I can see that over the last year my knee has slowly degraded to the point i am now, where even taking it from a bent relaxed position over the edge of the bed, to a straight out position, is painful, and a lot of clicking and grating can be heard under the kneecap.
Sleeping has been a bit of a battle for the first 6 weeks or so since the scan. As i am drifting off to sleep the muscles in my quad seem to have a nervous tic and contract, pulling my knee tight and causing a lot of discomfort. This would happen regularly during the night, making sleeping thru impossible.
Luckily as i have strengthened my quad muscle, that seems to have stopped, for the most part anyway.
Although i have been doing a fair bit of strengthening exercises, my quad still remains at around 15-20% of normal strength. This is not great, but at least i have managed to get some strength back into it.
Straight leg raises don't present such a problem anymore, and i can relatively easily do 5 sets of 20.
My op is on the 5th, but i will be admitted on Monday next week, the 4th.
I'll need to get my file and go up and see the ortho specialist, who will admit me to my ward, and i suppose, give me some advice on what the procedure will be and what to expect afterwards.
I have done a fair bit of research on the op though, so i have a good idea of what is to be expected.
I even found a pretty cool video on the net that explains the entire pre, during, and post op procedure...
Knee Arthroscopy Procedure
My brother has also had 2 arthroscopic knee surgeries to repair a torn meniscus, which i know that i have too, so i have spoken at length about it to him.
I dont think anyone can say for sure that they are enjoying going into hospital, but like i said, this is a necessary op, and i know it will certainly help me on the way to walking again.
All thats left now is to mentally prepare myself for surgery, and next time you hear from me will be post op!
"Break a leg"
8)

Wednesday, December 12, 2012

Bone Isotope scan!

Well, today was the day of my bone isotope scan.
I was a little nervous, but grateful that after this scan i would know for sure what needed to be done to me!
The bus dropped me at the private clinic where i was to have my scan and i headed up to the doctor...sorry, correction...nuclear physician's office, for my scan.
I was asked to lie down and they injected me with the substance in my right arm. It was luckily only a needle full and didnt hurt too much.
I was asked to return in a couple of hours, so i headed off for sum breakfast down the road.
When i returned, i lay down in a machine not dissimilar to an MRI machine.
I lay still while the machine slowly spun around me and took images of my lower body.
The whole procedure took about an hour, and then i was on my way.
Or so i thought.
I had the bus drivers number to call when i was done, so i gave him a call and he said that he was on the road back to where i had come from, 2h away, and that he would get another bus or ambulance to pick me up.
After 3 more phone calls over the next couple of hours, he eventually returned back to pick me up 3h after my original call!
Then i was off to the provincial hospital to get my file. They had to phone up to the orthopaedic section to let them know i was coming as it was already so late in the day.
When i got upstairs, i sat and waited another 2 hours before the specialist i had been seeing all along came walking up to me with another man. He introduced us, and he turned out to be the head of the orthopaedic department.
We went into the consultation area and he pulled out my scan results and put them up on the xray viewing machine.
The scan showed up that there was still action around the fracture sites, which meant that the bones were still healing. He told me that bones can continue to heal for up to 2 years, so based on the scan, he would not recommend another op before that period is up. This would only be in October next year. And obviously only if the bones still weren't grown back together by then.
The other area of the scan which was just a big blotch of activity was the knee!
He said that this indicated that the knee was extremely unhappy, which is why i am experiencing a lot of pain in that area.
He said that until they go in and see what is the matter they would not be able to do anything about it.
So, with my knee scope already booked in for March (thank God, as the new date had it not already been booked earlier, due to demand, was only in May!), all that was left to do was strengthen the quad muscles as much as possible before the op.
He told me that normally he would want the affected legs quad muscle to be 120% of the good leg's strength. At the moment i can just about lift my leg straight form a bent position, but i am sure i could lift more were it not for the pain in my knee.
He said that it was a bit of a catch 22 i was in as i needed to exercise the quad muscle even though the exercise meant hurting my knee!
We also checked my blood tests and they were perfect. He said that he had never seen an infection reading as low as mine. Everything was great.
So, basically what needs to happen is that over the next 3 months up to the 5th March, i need to work on my atrophied quad muscle as much as possible in order to get it ready for the op which will immobilize it again for possibly another month or more.
I have done a bit of research online and have found that an electric muscle stimulator might be very helpful for my quad muscle as it could exercise the muscle without the need for me bending my knee.
I have found one online and am in the process of ordering it.
So, another visit to the hospital and another different diagnosis!
At least this one is based on the scan, and not some doctors hearsay.
Apparently the recovery period after the scan is 3-4 months, so this would mean that all things going well, i will be walking by June/July 2013...
But i wont know for sure what the outcome will be before the scope in March. I am still very optimistic that the scope will rectify the problems with my knee, and that come the middle of next year i will finally take my first steps!