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Knee Recovery

2016/08/02: Surgery by Dr. Delgado-Garcia at Holy Cross Orthopedic Institute with followup on 8/10, 8/17, 8/24.

2016/08/24: Knee brace has not worked at all well, especially in the last week & more. It gets sadly loose every day and often Nancy must fix it more than once in the same day. Today I went to the Orthopedic Clinic to see if we were doing it right and was told we have not been using the brace right. Chelsea (the brace person) told me lots but these truths seemed to dominate.

  1. The leg must always be straight, never bent, not even a little. After she tightened up the brace clearly it was keeping my leg straight.
  2. Two straps are below the knee and they are both meant to be very tight, tighter than we ever had them. They keep the brace from slipping down.
  3. Two straps above the knee will be comparatively loose, but she did not explain why.
  4. Whenever possible, the injured knee/leg should be both straight & elevated, meaning foot should higher than thigh.
Chelsea seemed bright and well informed, but she did not respond well to my questions. She simply repeated herself (with impatience). I told her that her main messages had not been clear to my wife and myself and that we had not known of their importance. Of course, we knew the leg should be straight whenever possible, but not with the very strong insistence of her manner. Chelsea did say we or I could come back if we need new instruction or adjustments to the brace. I did not know of her before this visit.

The Physical Therapist who had been coming to my home (Linda from RediNurse 561-389-7366) had given very little instruction and told me she had no booklet and papers to help me understand PT. Her only instruction was verbal (she only instructed me while I was lying on my back in bed) She said that I should perform four exercises, eventually with both legs but starting out with my healthy leg only. Only one excercise could be done with either leg and that was to bend toes up & down toward & away from my body repeatedly. The other three foot/leg exercises were not allowed because my knee injury would be hurt by them. HER STRONGEST MESSAGE WAS THAT I SHOULD BE AS NORMAL AS I CAN AND THAT MEANS SHE WANTS ME EATING MEALS & READING NEWSPAPER AT KITCHEN TABLE AND BACK WORKING ON MY COMPUTER BECAUSE THOSE WERE MY NORMAL ROUTINE. SHE SAID "GET OUT BED LOTS OF TIMES EVERY DAY" AND "BE AS NORMAL AS YOU CAN BE." This message was delivered very strongly by the PT person and was very memorable, unlike tedious monotone & paper instructions from Delgado & staff. The PT instructions were also inconsistent with the strong principles stated by Chelsea. It should also be noted that the PT had almost no bearing on my injured knee/leg. (Linda's exercises are: 1) ankle pumps, 2) knee to chest, 3) straight leg raise, 4) abduction out to side & return .) Linda, the PT person told me she had been brought onto my case by Dr. Delgado-Garcia.

Today (2016/08/24) I also talked with Holly (Dr.Delgado's secretary) saying Nancy and I had not been adequately instructed on how to maintain the brace. I said to both Chelsea and to Holly that there should have been a short (half page) instruction set with the most important instructions (Chelsea's above) because that little piece of paper could always be nearby and could keep us focussed on what is most important. Both Chelsea and Holly said the the brief instructions would be different for every patient so my idea would not work. My response is that the most important messages were included in long narrative and in lots of typed papers and they were not emphasized so they were not memorable.

2016/08/31 11:00 am is next appointment with Dr. Delgado-Garcia at Holy Cross Orthopedic Institute.

CONCLUSION I am very dismayed with the quality of instruction I have been given and with the non-communicative attitude of staff. When I tried to explain my dismay to Holly she simply dismissed me saying "this is not a hospital" (or something like that).

2016/08/25 2:00 pm: I called to talk with someone about the fact that I am walking lots & my sense that my knee is moving whenever I walk. I talked with Holly and we concluded that the sense of movement in my knee is normal and not violating my instructions since the movement is constrained within the limits of the brace settings. So I am now doing my best to be normal while doing what my life & rehab require and will learn more when I see Dr. Delgado on 2016/08/31 11:00 am.

2016/08/31 : Wonderful news. My orthopedic surgeon says I am healing very nicely. Today he adjusted the brace which had been set to allow zero degrees rotation of the knee from straight so that now the settings allow 40 degrees rotation. This, he says, should make it reasonable for me to drive an auto now. On Sept 14 he expects continued healing and reseting the allowable rotation to 90 degrees. That should allow me to sit in a seat on an airplane so I can visit my mother in Atlanta (visit plan is October 10). On Sept 28 he expects continued healing allowing for a reset of the brace to "fully open". Perhaps that will mean I can cease using it and hopefully it means I can resume (gentle) swimming. He urges we not restart physical therapy (PT) at this time, but soon and then we should take PT very seriously. Swimming is a very good element of PT. My weight today is 196 lbs meaning I lost 8 lbs in this ordeal.



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