Post op

I had a complete patellectomy (removal of my knee cap and realignment of the knee) due to the knee cap not tracking correctly and extensive arthritis damage. At my first post op appointment we found that my quad muscle isn't firing. I can't move it at all. The Dr still has me in the immobilizer and wants no range of motion in my knee.

From the day of surgery I have been in lots of pain. The surgeon said it was because I had poor pain thresholds but my pain management Dr disagrees. After the first week the surgeon said he will only prescribe tramadol now. Throughout the day I use lots of ice packs. I've also noticed that it hurts less when I'm up moving around. At night, I have horrible pain in both knees! My other knee has the same issues and isn't doing well taking so much stress. I haven't slept more than an hour at a time since I got home. I'm very frustrated with the whole thing.

Are there other pain management methods I could try? I use ice, rest, and elevation right now. Any other suggestions would be so helpful.

You can do yourself a favor and look for another knee ortho to find out what would cause the muscle to not perform as it should have post op and if that awesome surgeon who is leaving a patient hung out to dry by following a post op protocol for meds on a patient with a complication had anything to do with that muscle not functioning.

Then work on finding out why a PM Dr doesn't do what's required for him,treat pain?

I've had way more knee surgeries then I would have in hindsight simply because 50% of them never delivered the results I were assured they would and I ended up with more issues than gain but I have found heat works better than ice,my surgeon who was the best of the best never ever allowed a immobolizer no matter what you have had done and was adamant they should only be used for a day or two for a strain or sprain since post op any procedure the object was to quickly retrain that knee to function properly and I am not saying remove yours against drs orders but showing you differentiated opinions of surgeons thinking. My knees always did better healing with the contours of a recliner versus propping pillows in bed,gels and creams that contain mentholated ingredients are awesome for the deep achy pain of a joint just don't get it in the suture lines if they're still open.

Wishing you luck and hoping your not left with a failed operation syndrome and this is all temporary.

Are you in the states? Don't know exactly what laws they're talking about but all of us here as CPers have remained under the care of our PM Dr and the surgeons, its apples and oranges one has no bearing on the other. Surgical pain is categorized as acute and fibro is chronic, apples and oranges and unless you are not in the states a little bs from them.

Moist heats better than dry and warm is better than hot.

I think the problem comes because my pm was treating my arthritis pain which is what caused the need for surgery. My pm said he's more than happy to treat me again. I go back to the surgeons office on next Thursday so I'll be requesting again that my pm be allowed to resume treatment at this point.

I actually haven't tried moist heat and I have a hearing pad that is designed to apply moist heat. I Feel dumb! I'll try that immediately.

I've reached out to the surgeon who handled my shoulder surgery to get his opinion. He was great and my shoulder is so much better than before surgery. I'll let you know what he says about this muscle not firing and what protocol he thinks I should be following. Then I can present it next week.

I was without any pain meds for about a month prior to surgery. I made a decision to do so because I wanted to get through surgery with the minimal of meds. That sure helped me /sarcasm. I just would love to be able to sleep. The pain precludes so many things.

I tend to think its the surgeon. I think he's complicating things because I've been seeing my pm for a while and have a good relationship with him. He actually hugged me and said he'd be more than happy to help me again when I was ready. I had to have surgery out of town and my pm sent a card. I just don't think he's blocking my care.

I'm using a moist towel right now. It feels like heaven! I'm staying with my ex and didn't bring my heating pad. Thanks for pushing me to use it.

I'm very concerned that this muscle isn't working. I can not lift my own leg at all. I'm going to demand to know why he won't let me do any PT. I dont want it getting weaker. The problem will be that I won't even see the surgeon at my next appointment. He won't be in the clinic at all.

I'm very frustrated with my care. He's a top rated surgeon. I have felt largely ignored until I'm actually there. Then he brings in lots of residents, interns, and med students to look at the results of my connective tissue disorder. I definitely leave feeling like a freak of nature and without being cared for.

It's about 2 weeks now. I have called the surgeon who did my shoulder to get his opinion. I'm waiting on him because I do trust him. It seems wrong to me, too. In fact, I'm very worried about it.

I'm going to suggest something I rarely do and since the surgeons top of the line may be a bust but some especially those who carry around a "God complex" have been honest thinking no one would dare challenge them. Get a copy of the surgical procedure transcript and this can be gotten from the surgeons office or the hospital, surgery center. The entire procedure is transcribed start to finish of any surgery. Once you have that you can do one of two things, take it the consulting Dr or you can take it to a injury lawyer and they will have people look it over for anything that might have gone wrong or contributed to the issues your having, they have folks who look at every step of the surgery.

It just seems odd to me the protocol he's following even though each surgeons different I would want to have the peace of mind that knowing he's doing it for my well being versus his knowing something I don't but should.

In the event the drs office says they don't have the op report from the facility where your surgery was done, I would go ahead now & call the facility & ask for medical records dept & request to pick up a copy of your op records. Let them know you will be there on Thursday & this gives them plenty of time to make it available.

Your going to have some instability in the knee just due to the missing anatomy since joints are built to function as a whole and removing any part of the whole leaves your body to rethink the way it moves, it can be retrained to cover the loss, great thing about human anatomy and its complex physiology! However the muscle is what we would expect to jump in and pick up the slack and for whatever reason yours isn't and your going to need it to step up and do that but first finding out why its not is essential to the success of the procedure.

Definitely!! Without the knee cap to protect the underlying anatomy of the knee a fall onto it could cause you some greater complications not to mention what a broken hip or anything else could do. If you have already fallen several times I would suggest staying with someone or at least having someone stay with you. What if you got up during the night to go to bathroom and fell and couldn't get up or hit your head? It could be a really dangerous situation for you and until you at least get a idea of what is happening and why I strongly suggest that idea. If you just can't go somewhere or have someone stay I would avoid stairs, use a walker, keep the phone on you at all times and set something up that someone checks on you very routinely.

Wondering how many mg of Tramadol they have you on. I'm on 50mg, every 4-6 hrs as needed. I have the ok to take 2 tablets if needed but I tend to get nauseous if I do and sometimes vomit. I always start with one tablet and if, after an hour have no relief or insufficient relief, I take the second. I usually don't get the nausea that way.

Hope you get back to the doc that helps the most!

By all means stay with the walker. At least by using it if you do start to fall you have something to hold onto. It is going to be interesting to see what your prior surgeon has to say.

I saw my surgeons PA yesterday. She was very happy with my incision, degree of swelling, and degree of mobility of the knee. After numerous exercises, its been decided to let me start PT. The pt will be focused on electric stimulation of my quad that still is not firing. The Dr still is insisting on no range of motion in my knee.

They did give me a paper for my pm saying that my last script from them was for tramadol and that they won't be giving me anymore meds. I also got the surgical report. I delivered both to their respective drs. The other orthos nurse assured me that he would look it over as soon he can. My pms receptionist said she doesn't think he will see me at all while I'm still seeing the surgeon, even with the paper!!I had her write him a note and I will be calling Monday morning.

My knee is not my only source of pain. I've had arthritis in all of my joints for over 20 years. My back is in terrible shape. I can't sleep because my pain is unmanaged. I'm losing weight because the pain keeps me nauseated. I'm miserable. If my pm won't see me, I don't know what I'll do.