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  • Cliffhanger,

    bummer re knee but shouldn't be another 6 month job...Michael's story is closer to normal, but great to hear your hammies are doing so well.

    Chris from SA,

    Told my husband the "helpful advice" I had given to you re consulting and he was horrified (he's an IT geek and doesn't get medical humour)....hope you are sitting a little more comfortably now.

    Laura (the tripper)

    Re your knee....here comes another curly answer....It may have something to do with your hammy but usually indirectly. With the early immobilisation and Non weightbearing phase comes a lot of weakness, especially in the hammy (dah) but also the glutes and quads. Your glute max and hammy control extension, but the glute med and min control rotation and side pelvic control. If this is down (which it almost certainly will be) it can cause increase rotational stress on the knee as you start to use it more. Also decreased quads and lack of range in hammy alter your gait pattern. So in short, lots of people will have this op and no knee pain, but if you have already a problem in your knee, it will be super easy to aggravate it more with all of the secondary weaknesses and lack of control going on. Hopefully this makes sense and is useful. A good PT will assess your control and give exercises to correct accordingly.

    All the runners out there ....

    Going ok with phase "return to run and decrease swimming" (yay because in brisbane terms it is cold....laugh all you like New Zealanders, southern ozzies and residents of the USA but we in QLD really suffer when the temp gets below 10 degrees Celcius!) Am doing my first week of 5 runs, with some gentle short accelerations (like really pathetic accelerations but better than nothing) and so far so good. Feeling stronger each day. Also slowly creeping the kms up....now about a whopping 50km per week! (over 1/3 of previous pre-injury status and stumbling towards 1/2). But MOST importantly, I am really enjoying running again. No other exercise compares. Hope everyone else who was part of the last running discussion is also progressing nicely.

    JaneC

    Comment


    • Working and sitting

      Originally posted by chris surf wa View Post

      Runagain could you really sit and work in week 2 or were you doing it lying down at first? I am a GP so I sit at my desk consulting when not doing minor surgery, hospital rounds and walking to an from the waiting room and treatment area. Going to try some short sessions in week 3

      .
      Hi Chris, in week 2 i was mostly sitting/reclining on the sofa with my laptop on my lap or sitting up in bed. I also sat in a normal chair at the kitchen table from time to time. The main thing was to frequently switch positions. You have to move before it starts to hurt--I found that if I let it go to long it was hard to get rid of the pain or get comfortable in any position again. Do you have multiple seating options at work? Even if you can occaisionally move to a more cushioned chair in the lobby or find a place to stand and work for awhile to break it up. You definitely cannot sit at a desk in one position for hours at a time.
      Today was my first full day at work and I was in an all day meeting. It actually went very well. The chair in the meeting room was sort of mesh in the seat so no cushion but no hard bottom either. Every so often I would stand or lean on my crutches for a few minutes and then sit back down. It wasn't until about 4pm that I started to feel sore and it was definitely manageable, not horrible pain. I never thought I would take such a keen interest in chairs and what they are made of!! We have some meeting rooms with very cushiony comfy chairs so I am having my assistant change as many meetings as possible to those rooms!!
      And every week will get better and better. Can you start back part time or is it all or nothing? Or can you do the 'office' work at home and just go in to see patients?

      Comment


      • Attending school events post op

        Someone a few weeks ago posted about going to their childs honors evening post op and wondered if it would be possible.
        On day 6 post op I went to my daughters ballet recital at her school. I was nervous about it but did not want to miss it. My husband told them in advance that I would be coming and they saved me a front row seat near the aisle so I had lots of space for my braced knee. It was in an auditorium with cushioned seats and only lasted about 40 minutes. I was totally fine and glad that I went.
        Last night, at 4.5 weeks post op I went to an awards ceremony at my older daughters school. I have been sitting without pain for a long time in different circumstances so I didn't anticipate any issues. Well, turns out we were sitting on metal folding chairs and I did not bring a cushion. And the ceremony went on and on... I was in so much pain and even sitting on my hands wasn't working. I ended up having to crutch across the entire gym (felt very clumsy with everyone watching) and stand at the back.
        So, based on my two experiences, here is my advice:
        1. If all is well and no complications you should go.
        2. Get someone to scope out the seats in advance
        3. Tell the school your situation and ask where you should best sit
        4. Bring a cushion
        5. Have an escape route!!

        Comment


        • Originally posted by New Year's Tripper View Post
          runagain - Whenever you fall off the radar I figure all of your energy is being expended working, recovering and doing the mom thing.

          It sounds like your pre-surgical hamstring pain is gone - same here. I keep telling myself that my current discomfort is TEMPORARY and part of the healing process. I am walking easily with crutches and hope to be stick free later this week at 6 weeks post-surgery. My only recovery hiccup is a stiff and painful knee.

          I totally understand your risk adverse behavior given that a repeat procedure is to be avoided at all costs. I find myself avoiding crowds and high risk situations (e.g. out of control rug rats and the baggage carousel at the airport).

          Once I escaped the brace driving has been a snap. I was already weight bearing (standing) which made it easy to get in and out of the vehicle and manage my crutches solo. Of course, I use my cushion. I am also fortunate to have injured my left leg and own a car with an automatic transmission. A right leg injury or a stick shift would be more challenging.

          Hope you continue to make consistent progress. The PT will accelerate once you escape your brace. Continue to be good to yourself and come up for air and a rump break from time to time.

          All/JaneC (consult) - Is it typical to have knee issues around 6 weeks or is the discomfort more likely related to my pre-existing knee condition/arthritis ?

          Cliffhanger - sorry to hear about the new injury. I'm sure you will bounce back quickly based on your robust recovery from the much more serious hamstring procedure. Reassuring to know that a return to pre-injury activities is possible.

          New Year's Tripper (Laura)
          My bad leg is my right so maybe a bigger challenge for driving.

          Yes, pre op pain is definitely gone!! So much better than before. I had lived with that pain for so long it became almost normal.

          My knee is also very stiff. I have a history of problems and a previous surgery with my right knee which doesn't help. But I think it is just the immobilization that causes the soreness.
          And I think if you are prone to arthritis then the immobilization of the surgery will make it worse for now. I am sure it will feel better as you are able to do more stretches and exercises.
          Are you partial weight bearing with your crutches?

          Cliffhanger--that is such a big bummer about your knee. But as everyone else has already mentioned, meniscus repair is much less invasive than the hamstring repair. A woman I train with was back in the pool and on the bike within 2 weeks. A bit longer to run...

          Jane C--thank you for your running updates. I am dreaming of running again. How far off your normal pace are you?

          Comment


          • Originally posted by kp2020 View Post
            what are your symptoms??
            No pain...some mild muscle spasms if I overdo it..have to change position frequently from affected butt cheek.

            Comment


            • working and sitting part 2

              Originally posted by runagain View Post
              Hi Chris, in week 2 i was mostly sitting/reclining on the sofa with my laptop on my lap or sitting up in bed. I also sat in a normal chair at the kitchen table from time to time. The main thing was to frequently switch positions. You have to move before it starts to hurt--I found that if I let it go to long it was hard to get rid of the pain or get comfortable in any position again. Do you have multiple seating options at work? Even if you can occaisionally move to a more cushioned chair in the lobby or find a place to stand and work for awhile to break it up. You definitely cannot sit at a desk in one position for hours at a time.
              Today was my first full day at work and I was in an all day meeting. It actually went very well. The chair in the meeting room was sort of mesh in the seat so no cushion but no hard bottom either. Every so often I would stand or lean on my crutches for a few minutes and then sit back down. It wasn't until about 4pm that I started to feel sore and it was definitely manageable, not horrible pain. I never thought I would take such a keen interest in chairs and what they are made of!! We have some meeting rooms with very cushiony comfy chairs so I am having my assistant change as many meetings as possible to those rooms!!
              And every week will get better and better. Can you start back part time or is it all or nothing? Or can you do the 'office' work at home and just go in to see patients?
              Hi Chris

              Just realized I didn't read the last part of your question... If you are sitting in your office seeing patients that shouldn't be so bad because
              1. you can sit leaning back (not forward over a computer which hurts more)
              2. You won't be in the same position so long--not sure how long your consults are but cant imagine more than 20 min (that would be shockingly long here in the states for a GP consult)
              3. You will frequently get up to get the next patient
              4. You can always stand up while you are talking if you have to.
              5. You are bound to have good drugs on hand if it gets painful--haha totally kidding. I feel like I have an opioid arsenal on hand right now but I hate having to take anything.

              And it sounds like you can start easy--schedule just a few patients and see how it goes and then just gradually increase.
              Just bring a cushion.

              Comment


              • Originally posted by Debbie d View Post
                Well, just got back from surgeon's office in Florida and he won't do the surgery...says that since I am 6 weeks out and 10 cm retracted and that I don't have any sciatic pain that I should get back to regular exercising, including Pilates and yoga. Said that the scar would be at least 12 inches long and he said that I may have nerve damage with the surgery so not worth the risk.
                I don't know what to think at this point.
                Hey Debbie D

                I would seek a second / third / fourth opinion. I am the freak here in this forum having 16 months between accident and surgery.

                My experience:

                Feb 2012 - Surgeon No. 1 said "we don't operate on old blokes like you unless you are an elite athlete" - I was 46 at the time and very active. Thought I could go to PT and defy the odds not realizing to run you need hamstrings connected.

                Nov 2012 - Surgeon No. 2 said "only done 2 of these and it is out of my skill set however I will refer you to a colleague"

                Feb 2013 - Surgeon No. 3 said "I've done 40 of these however the longest from accident to surgery has been 7 months and I am worried I will sever your sciatic nerve - it is too risky"

                Mar 2013 - Surgeon No 4 said "I've done 500 of these and a number over 12 months - you are too young to effectively give up - sciatic nerve is a concern however don't use that as an excuse for eliminating surgery"

                Apr 2013 - Surgery

                Week 7 now and am off crutches - started PT with JaneC (the torture queen - ha ha only joking Jane) - I do have sciatic pain through my foot however the pain is decreasing each day now that I am doing exercises.

                Best decision I have ever made (i.e. apart from conjuring up enough courage to approach the cute - out of my league - secretary who later turned out to be my wife).

                I also can't thank enough another forum contributor (SueR) who insisted that I travel to her surgeon in Sydney for a 4th opinion and subsequent surgery. Like you I had resided to the fact that nothing could be done.

                My advice is get another couple of opinions - seems like the surgeon who saw your results hasn't the skill set to fix you. Don't give up - I am sure other surgeons do have the necessary skills.

                Mr Yan (alias Michael)

                Comment


                • Debbie d: Doing okay?

                  Originally posted by Debbie d View Post
                  Well, just got back from surgeon's office in Florida and he won't do the surgery...says that since I am 6 weeks out and 10 cm retracted and that I don't have any sciatic pain that I should get back to regular exercising, including Pilates and yoga. Said that the scar would be at least 12 inches long and he said that I may have nerve damage with the surgery so not worth the risk.

                  I don't know what to think at this point.
                  I had a very strong reaction to your post. It was as if I received the news myself - gut check.

                  Hopefully you feel as if you received a balanced consultation catered to your circumstance. I'd feel horrible if you felt otherwise especially if you have any concern that the goal was to dissuade you from a beneficial procedure.

                  One element that jumps out at me is that Michael (Mr. Yan) had a 16 cm retraction and his vertical incision is only 5 inches. Why would your scar be 12 inches? Every patient's circumstance is different and every procedure has an element of risk; especially with the proximity of the hamstring to the sciatic nerve.

                  How do you feel about today's news? Are you considering obtaining a second opinion?

                  New Year's Tripper (Laura)

                  Comment


                  • So if you are going for surgery, do it as early as possible

                    Originally posted by Debbie d View Post
                    Well, just got back from surgeon's office in Florida and he won't do the surgery...says that since I am 6 weeks out and 10 cm retracted and that I don't have any sciatic pain that I should get back to regular exercising, including Pilates and yoga. Said that the scar would be at least 12 inches long and he said that I may have nerve damage with the surgery so not worth the risk.
                    I don't know what to think at this point.
                    Hi Debbie D

                    Sorry you are in a difficult position - having had negative advice from one surgeon is always going to decrease your confidence

                    You have nothing to lose in getting a second opinion.

                    Mr Yans's table shows you are not out on your own and you can take a copy of the table in to your next surgeon - I'm sure he would be interested

                    What you do need to do is act now.

                    Some of the medical literature presents evidence that surgery after the 3 month mark does increase the risk of not having a great outcome

                    It is a difficult decision. Do you live without hamstrings and accept the loss of function, or do you try to get back to your pre-injury function with some scarring and face the significant, but small risk of sciatic nerve damage which would make you worse off

                    I suggest you find a surgeon who specialises in this, get his opinion, ask him to quantify the risk of sciatic nerve injury and its effects, then give yourself a few days to decide.

                    Hope this is a help
                    Only you can make a decision

                    Comment


                    • Day 13 progress

                      dressing removed - wound totally healed
                      feels much better without the dressing
                      posterior femoral cutaneous nerve neuropraxia (painfull hypersensitive skin posterior thigh - not sciatic nerve) continues but has at last started to improve
                      took my wife out for lunch for her birthday today - my first meal sitting down since the injury 18 days ago
                      sat on a foam wedge with an oval shaped hole I cut in it - worked fine along with arm rests to relieve pressure

                      I will do 2-3 hour consulting work tomorrow and will increase to 2 x 2 to 3 hour sessions daily next week.

                      Thanks everyone for your seating advice:

                      I am able to get up every 10 min or so to examine someone or get another patient. long meetings must be the worst (run again)

                      Mr Yan Thanks for IT advice. I wrote some stuff on word and tried to cut and paste - maybe it was too long -I will try again.

                      new years tripper - your knee problems may just be joint stiffness from lack of movement, sure your PT can sort it out, maybe try gentle passive knee bending and straightening exercises lying on your tummy if you cant get a pt soon.

                      Cliff Hanger - sorry to hear about your knee, I feel for you ... so early after your recovery. I checked out river surfing in Switzerland on youtube - looks pretty cool.

                      Comment


                      • Originally posted by Debbie d View Post
                        No pain...some mild muscle spasms if I overdo it..have to change position frequently from affected butt cheek.
                        It's a personal decision....you can always seek a second opinion. There are a few surgeons who repair chronic injuries but if your symptoms are minimal and you are able to do everything you want to do, surgery might not offer you much.

                        Comment


                        • Originally posted by Debbie d View Post
                          Well, just got back from surgeon's office in Florida and he won't do the surgery...says that since I am 6 weeks out and 10 cm retracted and that I don't have any sciatic pain that I should get back to regular exercising, including Pilates and yoga. Said that the scar would be at least 12 inches long and he said that I may have nerve damage with the surgery so not worth the risk.
                          I don't know what to think at this point.
                          Debbie, is this the surgeon that your doctor in Ohio described as the new hotshot? To be honest, it doesn't sound to me like he is all that familiar with this injury or surgery, based on that comment. Obviously it's a personal decision whether to get surgery or not. I have absolutely NO pain, and haven't since about a week or so after my injury. Yet I still can't imagine not having the surgery. There is zero chance of ever returning to completely normal without it. If I were you, I'd get another opinion. My doctor didn't even act like not getting the surgery was a logical option.
                          Last edited by BarbieKay; 30-05-2013, 10:48 PM. Reason: typo

                          Comment


                          • Just got off conference call with Dr Andrews in Birmingham and Dr Bradley in Pittsburgh. Dr Bradley said he is coming out with a paper showing those who have the surgery within 4 weeks vs those who wait longer and those with a greater than 5 cm retraction have a greater risk of sciatic nerve damage and the recovery is not as ideal. I am 6 weeks post injury and 10 cm retraction. Since i am not having pain the recomendation is intensive rehab. If i develop pain or problems with increased exercise Dr Bradley is the guy who deals wuth the more chronic cases of hamstring avulsion. It will be interesting to see this medical paper that Dr Bradley is writing. I am now totally confused as I was completely sold on the surgery. Michael, I'll have to look at you chart to see who fits my description and how they are doing.

                            QUOTE=BarbieKay;62487]Debbie, is this the surgeon that your doctor in Ohio described as the new hotshot? To be honest, it doesn't sound to me like he is all that familiar with this injury or surgery, based on that comment. Obviously it's a personal decision whether to get surgery or not. I have absolutely NO pain, and haven't since about a week or so after my injury. Yet I still can't imagine not having the surgery. There is zero chance of ever returning to completely normal without it. If I were you, I'd get another opinion. My doctor didn't even act like not getting the surgery was a logical option.[/QUOTE]

                            Comment


                            • Originally posted by Debbie d View Post
                              Just got off conference call with Dr Andrews in Birmingham and Dr Bradley in Pittsburgh. Dr Bradley said he is coming out with a paper showing those who have the surgery within 4 weeks vs those who wait longer and those with a greater than 5 cm retraction have a greater risk of sciatic nerve damage and the recovery is not as ideal. I am 6 weeks post injury and 10 cm retraction. Since i am not having pain the recomendation is intensive rehab. If i develop pain or problems with increased exercise Dr Bradley is the guy who deals wuth the more chronic cases of hamstring avulsion. It will be interesting to see this medical paper that Dr Bradley is writing. I am now totally confused as I was completely sold on the surgery. Michael, I'll have to look at you chart to see who fits my description and how they are doing.

                              QUOTE=BarbieKay;62487]Debbie, is this the surgeon that your doctor in Ohio described as the new hotshot? To be honest, it doesn't sound to me like he is all that familiar with this injury or surgery, based on that comment. Obviously it's a personal decision whether to get surgery or not. I have absolutely NO pain, and haven't since about a week or so after my injury. Yet I still can't imagine not having the surgery. There is zero chance of ever returning to completely normal without it. If I were you, I'd get another opinion. My doctor didn't even act like not getting the surgery was a logical option.
                              [/QUOTE]

                              Dr. Bradley did my surgery.....my injury was "chronic" - around 3 months out, but the retraction was small and I was extremely symptomatic. I couldn't sit for more than 5 minutes. I was completely unable to run or even jog. The small retraction (3cm) and the severe symptoms made him think I would get good results, and I couldn't be more pleased. He has written several papers on the topic, a book chapter on the topic, and has been the team physician for the Pittsburgh Stealers for over a decade. I trust him completely.....he did my surgery when others would not. The fact is, most surgeons would be hesitant to operate if you aren't very symptomatic. I feel sure about this as I am an ophthalmic surgeon (not orthopedic) myself. Surgeons are trained to "weigh the risks and benefits" before operating, and if we have a patient who is doing very well without surgery, we don't generally operate.
                              There is another physician here in the states, Steven B. Cohen who does more of the chronic cases. He and Bradley have authored some papers together on the topic, but Cohen has authored some individually as well. If you are seeking another surgical opinion, I believe he has done more chronic cases.
                              Last edited by kp2020; 31-05-2013, 08:57 AM. Reason: additional info

                              Comment


                              • Originally posted by Debbie d View Post
                                Just got off conference call with Dr Andrews in Birmingham and Dr Bradley in Pittsburgh. Dr Bradley said he is coming out with a paper showing those who have the surgery within 4 weeks vs those who wait longer and those with a greater than 5 cm retraction have a greater risk of sciatic nerve damage and the recovery is not as ideal. I am 6 weeks post injury and 10 cm retraction. Since i am not having pain the recomendation is intensive rehab. If i develop pain or problems with increased exercise Dr Bradley is the guy who deals wuth the more chronic cases of hamstring avulsion. It will be interesting to see this medical paper that Dr Bradley is writing. I am now totally confused as I was completely sold on the surgery. Michael, I'll have to look at you chart to see who fits my description and how they are doing.

                                QUOTE=BarbieKay;62487]Debbie, is this the surgeon that your doctor in Ohio described as the new hotshot? To be honest, it doesn't sound to me like he is all that familiar with this injury or surgery, based on that comment. Obviously it's a personal decision whether to get surgery or not. I have absolutely NO pain, and haven't since about a week or so after my injury. Yet I still can't imagine not having the surgery. There is zero chance of ever returning to completely normal without it. If I were you, I'd get another opinion. My doctor didn't even act like not getting the surgery was a logical option.
                                [/QUOTE]

                                I was very happy with Dr Bradley. Still early days for me but I feel better already and anticipate getting back to full activities eventually. I was very chronic (over a year) but no retraction. Some threads hanging on and lots of bad tendon underneath.
                                It is a very personal decision but for me was a no brainer. I was not ready to hang up my riunning shoes or live my life with physical limitations.

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