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    Old 07-01-2012, 12:58 PM   #1
    mom477
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    Questions about knee

    So I posted couple months ago I think and am currently waiting a referral to a orthopedic surgeon and to get a MRI. Knee has been staying swollen and looked like there was fluid build up so went to get fluid taken out only to find out there was less than a cm of fluid and that has messed up my knee further from having it done. Got a steroid shot but it didn't help the pain at all.

    My question is why could it be staying swollen? I ice it and elevate it but it doesn't take the swelling away. Also I think it has been causing my shin to my toes to be swelling as well. Haven't been able to use the leg to drive (it's my left leg).

    So I am just curious as to what others think. I will be seeing specialist soon once my ins okays it.

     
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    Old 07-03-2012, 12:33 PM   #2
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    Re: Questions about knee

    Bump....anyone??

     
    Old 07-11-2012, 06:40 PM   #3
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    Re: Questions about knee

    Hi mom477!

    Sorry you're having so much pain in the knee and that the cortisone injection didn't help. (They "normally" are supposed to last about six MONTHS giving relief, but, if you have the fluid buildup and other possible issues going on with the knee, the injections will either last maybe six WEEKS or not help at all.) Last December, when my left knee started going bad again 8 months after my surgeon scoped it and repaired the meniscus and ACL, I got a cortisone shot at that visit that only lasted SIX WEEKS! Then, when he had to have his physician assistant give me another shot mid-January, that was when my surgeon and I KNEW it was time for him to do my left TKR ASAP! Had that March 23rd, and not a moment too soon! My surgeon stopped in to see me in Recovery that morning and told me that what he found was a LOT worse than he'd expected, and that he had to clean the knee out first completely and do a lot more cutting of the bones to fit the prosthetic knee than he originally anticipated. It all worked out in the end though because my left TKR healed very quickly and I'm finally walking NORMALLY on two prosthetic knees WITHOUT PAIN FOR THE FIRST TIME IN SEVEN YEARS!!!! So glad I had both done!!!

    To answer your question about why your knee would stay swollen even though you're icing it and elevating it as much as possible, every time you start walking on it again, you're putting pressure on the knee and that's why it keeps getting swollen. Until you see the Orthopedic Surgeon and get that MRI, you won't know WHAT exactly is wrong with the knee and whether you'll need a TKR or an arthroscopic repair to relieve your pain for good.

    In the meantime, the only other remedy I can suggest is to go to your primary doctor and have HIM fit you with a heavy duty adjustable knee brace to help take some pressure off the knee when you walk. It might cut down on the swelling too. Let me know if you do this and if it works for you.

    Regards,
    Carol (2012 carol)

    Last edited by ldy12; 07-11-2012 at 06:42 PM. Reason: grammar correction

     
    Old 07-27-2012, 09:04 PM   #4
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    Re: Questions about knee

    So mri showed scar tissue in my knee in the fat pocket and got a cortisone shot. Carol before it was a steroid shot. So far a little relief but not much. Doc said to give it a month and if it still bothers me we will see what else can be done. He mentioned scraping the scar tissue out. Never injured my knee so not sure how scar tissue formed but guess there doesnt have to be a cause. Im happy theres no tear anywhere and I know what's causing tons of pain

     
    Old 07-27-2012, 09:26 PM   #5
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    Re: Questions about knee

    Hi mom477,

    First, a little clarification for you - a "steroid" shot is the SAME thing as a cortisone shot - your surgeon just called it "steroid." (We are talking about corticosteroids that are artificial versions of cortisol which your adrenal glands make naturally - about 25 mg. a day., NOT the illegal and dangerous performance enhancing anabolic steroids that athletes use!)

    I have a feeling that maybe, and you can ask your surgeon this, you have the beginnings of osteoarthritis in the knee, even though the cartilage is not torn. From the sounds of what you're writing here as to the extent of your pain, he'll probably have to go in surgically, and clean out the scar tissue. How that might have formed, I have no clue, but, like I say, ask the surgeon if it IS an early indication of osteoarthritis.

    Continue to ice and elevate the knee, wear a very supportive brace, and do low impact exercise IF you can tolerate it, such as sort of brisk walking at your local HS track (which is ideal, just as a treadmill is, because they both have some "give" to them and you're not pounding hard pavement when you walk.) The other activity that is excellent for knee problems is swimming and water exercises.

    Keep me posted as to how much the second shot works, if at all. If it only lasts another few weeks, then your surgeon is probably going to have to go in and scope it.

    Good luck.

    Carol

     
    Old 07-27-2012, 09:38 PM   #6
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    Re: Questions about knee

    Ok thanks . Last time the shot didn't work at all. Ive been tested for all arthritis and for now its negative. Will update as the weeks goes on.

     
    Old 07-27-2012, 11:24 PM   #7
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    Re: Questions about knee

    You're welcome! As I noted in my earlier lengthy post to you regarding what I went through with my left knee, starting last Dec., two cortisone shots in the space of six WEEKS apart failed to help me at ALL. But then, as I described, my surgeon and I determined that the osteoarthritis had progressed faster than we thought and the total knee replacement was really the ONLY OPTION for me at that point in late January. And, as I mentioned, when my surgeon opened the knee to prep it for the prosthetic knee, he found so much cartilage debris and left over pieces of what USED to be my ACL, that he had to clean all that out FIRST, BEFORE he could even start cutting the femur and tibia bones (above and below the knee itself) to make sure he could easily fit the prosthetic knee! When he came to see me in Recovery later that morning (mine was his first case of that day), he said the knee was in worse shape than he'd expected it to be, so it was a GOOD THING I had begged him, back in January, to do the TKR ASAP!!! I just KNEW that I had NOTHING LEFT in there to keep my knee from buckling on me all the time and it was getting more and more painful, because it was really just about bone on bone (like the right one already WAS in October of 2010 when I came back under my current surgeon's care.) THERE WAS LITERALLY NO CARTILAGE LEFT IN THE RIGHT KNEE, thanks to my previous Ortho surgeon who scoped it in 2005 and "supposedly" fixed a meniscal tear. I say "supposedly" because that moron of a "so-called" orthopedic surgeon only gave me a spinal for the scope procedure, but NO SEDATION, so I had to watch the ENTIRE surgery on a monitor he placed near my face! (I wasn't squeamish about watching, but it was just tortuous and more PAINFUL than it would have been, had he given me sedation!) Actually, looking back, I was kind of GLAD that I watched the entire scope surgery by this idiot! For TWENTY MINUTES, he was furiously "vacuuming out" the pieces of cartilage before allegedly repairing the tear. (I have to wonder now if he actually DID repair the tear itself back then!) Anyhow, this previous surgeon obviously took out MOST OF THE CARTILAGE in my right knee in '05. In June of 2010, when I went back to him because my right knee was starting to hurt again, and I wanted him to renew my handicap parking permit, he said he had to take x-rays to justify giving me the renewal permit. The jerk looked at the x-rays and told me the knee was STABLE!

    Unhappy with him, because I KNEW SOMETHING WAS WRONG WITH MY RIGHT KNEE, I switched back to my current Ortho surgeon in October of 2010. (He originally was in the same group as the one who messed the right knee up, but left in '95 to form his own practice. Why I didn't follow him at the time, I don't remember, but, hey, better later than never, that I switched back to him!) GOOD THING TOO! My current surgeon took ONE LOOK AT THE SAME X-RAYS the other guy had done four months earlier and told me my right knee was stable, and turned to me in absolute horror and said, "Carol, you need a TOTAL KNEE REPLACEMENT ASAP! You have NO CARTILAGE LEFT IN YOUR RIGHT KNEE - IT'S BONE ON BONE WHICH IS WHY YOU'RE IN SUCH PAIN!!"

    Since I could not take the liquid cartilage injections of Synvisc because I'm allergic to one component of it, the TKR was my only option on the right knee. (We didn't know until a month and a half before my April 2011 surgery that my left knee was going to develop a compensating meniscal tear and torn ACL.) Since I didn't want my surgeon doing BOTH knee replacements during the same hospital admission (would have done them 3 days apart), I consented to letting him scope the left knee during the same surgery as the right TKR. He did the scope at the very end, after he'd finished replacing the right knee. Months later, just out of curiosity, because I wanted to know how he did the left knee scope compared to the jerk who messed up my right knee, I asked my surgeon if he had "vacuumed" out the debris in the left knee. He responded that, no he had not. That he just cleaned it out, I guess by sterilely gloved hand, or small suction device, sewed up the meniscal tear and torn ACL and closed up the knee. THAT told me that the other jerk surgeon, when he had "vacuumed out" my right knee in '05, had totally damaged my right knee!!! My nurse friend and I were talking about this last September, and she said that IF I had NOT had the option of a total knee replacement for the right knee last year, I could have sued my former Ortho surgeon for malpractice and won, because I would have been able to prove that he'd PERMANENTLY DAMAGED MY RIGHT KNEE!!! Thankfully, though, I DID have the TKR option, and grabbed it! My current surgeon did a fantastic job on BOTH TKRs a year apart, so I consider myself very lucky for having made the informed decision of going back to him, when it was suggested to me by a nurse in my former primary care doctor's office!!

    I'm dealing right now with some lower back pain issues that MAY have kicked up once both knees were done. Now that I'm walking correctly and balanced, the long brewing back issues have not gotten used to the idea. My surgeon, and pain management doctor, both said that the back issues had probably been brewing for a long time. But because I was constantly shifting my weight from one bad knee to the other, my brain was most likely sending signals to my back that this was "normal" walking for me. Now that my knees are "in balance", the doctors say, my back needs to start receiving new signals from the brain so that I won't get the pain that I'm having right now. My knee surgeon started also sending me to his group partner who is the spinal expert for him to figure out why I'm still having issues in a different part of my back, now that the pain management doctor finished giving me lumbar spinal nerve block cortisone injections. (the second set of which I received this past Monday.) Now, the sacroiliac nerves (just below the hips) on BOTH SIDES, have been getting more painful and I also have a shooting pain UP the middle of my spine! I was supposed to see the spinal doc Thursday afternoon, but, when I got back from physical therapy at lunchtime, there was a message for me from their office. I called and was told I had to re-schedule because he had to cancel his entire office hours appointments due to an emergency surgery he had to do that was apparently going to take most of the day. By Thurs. evening, I was in such pain that I called my knee surgeon via the practice's service and asked him what I should do. He told me I had to go back to the Pain Management doctor, AND see his spinal expert partner, because he only focuses on joint replacements. So, Friday morning, I called my pain management doc and asked if he could see me for like 15 to 20 minutes in the afternoon. They squeezed me in and I went to him. I showed him where it was hurting and he MAY have to give me nerve block cortisone injections in both sacroiliac nerves, but he wants me to see the spinal Ortho doc next Thursday first, to see if that is actually where the pain is coming from. (He's pretty sure it is, but wants confirmation from the spinal doc.) In the meantime, for the pain, he changed me over to oxycodone with acetaminophen at the lowest dose so I don't have a nausea problem, like I did in the hospital in March with my left TKR surgery. I had been taking Tylenol/Codeine which was easier on my stomach, but obviously NOT strong enough to combat this back pain. (Acetaminophen and Tylenol are the same drug. Tylenol is the BRAND name.) So far, I've taken two Oxy tablets and they're starting to help a bit more.

    So, that's MY situation right now. I had thought that when I got both knees replaced and they were all healed up, that it would take pressure off my hips and back! Not quite yet, but my doctors, physical therapist and chiropractor all say that when they're done treating my back with the cortisone nerve block injections, I SHOULD eventually be a lot better. I SURE HOPE SO 'cause I'm tired of being in pain all the time! It sucks!

    Anyhow, it's after 2 AM here in NY, and even though I don't have to get up early for anything, it being a Saturday, I do want to read for a little before going to sleep. (IF I can keep my eyes open, that is!) The oxy tablet I took at 11 PM, is starting to make me drowsy, which is one side effect I'm not crazy about. That's why I'll only take it if I know I am going to be home all day. I don't exactly want to be caught driving erratically because I'm drowsy and then have all kinds of legal issues because of it! Look what happened to Kerry Kennedy a week or so ago when she took Ambien the night before heading to work and rammed into a tractor-trailer on one of our main interstates! NOW, she's in all kinds of trouble over what she claims was the cause! (But then, those Kennedys are ALWAYS GETTING IN TROUBLE with the law and ending up with slaps on the wrist!)

    I'm rambling here. I'll let you go.

    Keep me posted on your knee progress. Just keep doing the things I told you in my earlier post, until your surgeon decides to operate to relieve your pain.

    Best regards,
    Carol

    Last edited by ldy12; 07-27-2012 at 11:35 PM. Reason: punctuation correction

     
    Old 07-28-2012, 06:34 AM   #8
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    Re: Questions about knee

    I am so sorry you had to deal with all of that due to the previous surgeon. Obviously that guy shouldnt be practicing. Thankfully you have a awesome doc(s) now. Hopefully your back gets better.

    So from what I am understanding is that the scar tissue COULD be the start of osteoarthritis but that it isn't a given.

    I have never had knee issues before but my whole right side of my body has always been affected with all of my health issues. I am now wondering if the constant numbing from the bottom of bad knee to toes is either linked or due to my neuropathy. I will have to set an appt with my PCP to address that issue. Goodness been seeing so many doctors lately. I am only 35 but have had to deal with constant pain my whole entire life.

     
    Old 07-28-2012, 08:42 AM   #9
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    Re: Questions about knee

    Hi there!

    Yeah, it made things tougher, but I believe that if I HAD followed my current Ortho surgeon to his new practice, I STILL would have ended up having to have the total knee replacements due to the "end-stage" osteoarthritis in BOTH knees. But because of the other jerk surgeon's incompetence, I had to have them at LEAST a decade sooner than if I had been under my current surgeon's care! ("Maybe"?) And you're right, the other guy DEFINITELY SHOULD NOT BE PRACTICING MEDICINE, LET ALONE SURGERY!! (You should see the horror stories people told on one of the doctor rating sites about this incompetent idiot! They left his office WORSE OFF, like me, than when they went to him!!) And would you believe that this jerk was named to the Top Doctors in the U.S. New York Metro Region in a publication put out by Castle Connelley this year!!? They publish this directory of Top Doctors in the U.S. every year and sort it by medical specialty. Not every doctor makes the list every year. They try and get a mix in different regions of the country. So one doctor might make the list one year, than get booted the next. Skip a year and then get picked again. But, the REALLY EXCELLENT doctors like my current Orthopedic Surgeon make the list EVERY YEAR! My current Ortho surgeon has been named a Top Doctor in the U.S. TWELVE YEARS RUNNING, INCLUDING THIS YEAR!!!! My pulmonary doctor has been named a Top Doctor at LEAST 7 or 8 times in a row, also including this year. (But, just because your doctors are not picked, does NOT mean they are not good doctors.) The hand surgeon in my knee surgeon's practice, who did both my endoscopic carpal tunnel release surgeries last October didn't make the list, but SHOULD HAVE! He did an AMAZING JOB on my hands and gave me back 100% functionality WITHOUT PAIN IMMEDIATELY FOLLOWING BOTH PROCEDURES! (Which reminds me - I saw that YOU have bilateral carpal tunnel syndrome. You should find a hand Ortho surgeon to do the same procedure I had on my CTS in both hands!)

    I'm guessing that the trouble with your knee MIGHT signal early osteoarthritis in there, but you'd really have to check with your primary care doctor, and/or neurologist, given all your other conditions that are "connected" to osteoarthritis. No, it's NOT a given, but from the sounds of what kind of pain you're having in the knee from the scar tissue, that'd be my best guess.

    Let me know what you find out about this. Keep me posted! And yes, it's a shame that you are having these chronic problems,usually associated with MIDDLE AGE, at the age of 35! I feel bad for you to have to endure these conditions so early in life!

    Regards,
    Carol

     
    Old 07-28-2012, 03:07 PM   #10
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    Re: Questions about knee

    I have yet to find someone that will do the release for CP in my right wrist. My left hand rarely bothers me. Since the emg comes back as no nerve permanent damage they wont do the surgery but yet I cant use my right hand most of the time??? And I have now 5 bulging discs in my neck which makes it hard for me to function alot and use my arms. And having disc degenerative disease my back causes me tons of issues and Ive lost close to 2 inches of height within the last 2 yrs. Ahhhhh the joys of getting older and being stuck with health issues LOL.

    Yes the pain from my knees and other stuff is hard ost days but try to stay positive. Took my many years of crappy doctors to find the great doctors I have now. Well except for my neurologist as he continues to prescribe me meds I cant take and I dont think he really "hears" me as he has MS and think because he can function that others like me should be able to too. He is also one of the top MS researchers in the US.

     
    Old 07-28-2012, 08:56 PM   #11
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    Re: Questions about knee

    Hi again,

    Regarding your left carpal tunnel nerve, just because there's no permanent damage does NOT mean that the nerve isn't trapped. Same goes for your right hand CTS. The carpal nerve in both hands are obviously collapsed and "trapped" under the "tunnel" and need to be released. There's got to be SOME Orthopedic hand surgeon willing to do the release surgery for you out there in Colorado! If you are near Denver, call the University of Colorado Medical Center and ask for a hand surgeon experienced in endoscopic carpal tunnel release surgery.

    What are they going to do about the bulging discs in your neck? Are you a candidate for neck fusion surgery?

    Sounds like it's time to get a new neurologist too! If this guy is not really paying attention and you keep having to remind him NOT to prescribe meds you can't take, I don't think this doctor really cares about your well being. If he did, you wouldn't have to keep telling him the same thing visit after visit. What's the matter, doesn't he check your chart WHILE you're sitting there in front of him? As with the hand specialist you need, when you call the Univ. of Colorado Med Ctr., also ask for a new neurologist! (So WHAT if your current guy is a top MS researcher - he obviously is more suited as a research doctor than a clinician who sees patients! He doesn't sound like he relates to you at all! I know I wouldn't stay with a doctor like that!)

    Let me know if and when you find a hand specialist, and a new neurologist who will REALLY LISTEN TO YOU!!

    Regards,
    Carol

    Last edited by ldy12; 07-28-2012 at 08:57 PM. Reason: information correction

     
    Old 07-29-2012, 07:58 AM   #12
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    Re: Questions about knee

    I know that and it's frustrating to not find a doc to do the release surgery. I won't give up. And yes time to find a new neurologist. As far as my neck The MRI shows that the bulges arent "that" bad even though it causes me tons of issues. With the degeneration of discs the surgery isnt possible right now.

    I doubt I will wait a full month as my knee is killing me but in the middle of moving so it has to be put on hold for now anyways.

     
    Old 07-30-2012, 02:05 PM   #13
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    Re: Questions about knee

    Keep me posted and let me know when you go for any treatment or surgery on the knee and the hands.

    Best regards,
    Carol

     
    Old 08-09-2012, 03:56 PM   #14
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    Re: Questions about knee

    So I do have arthritis in my knee. Having nerve blocks done in my neck in a week and a half to see if it helps my pain from herniated discs and doc did say it could help my hands some. After that I will make an appt for my knee and after all of that I will look into my hands if needed. Just thought Id let you know. And the steroid shot has not helped at all.

     
    Old 08-09-2012, 05:58 PM   #15
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    Re: Questions about knee

    Hi mom477,

    Glad you are getting the nerve blocks done for your neck. I had lumbar region nerve block injections last month on both sides and they've really helped. Now, though, I have to go for nerve blocks to both sacroiliac nerves on August 22nd. Once I get that done my lower back should feel a lot better, according to my Ortho surgeon and pain management doctor (who does the procedures.) I also have two bulging discs in the middle of my spine and may need an epidural nerve block injection for those. But will have to wait at least a month before I can get that done.

    As for your knee, I'm not surprised the cortisone shot didn't help. I had two within a six week period in my left knee this past December and January and neither one worked. But then, I had severe end-stage osteoarthritis so I had no choice but to have the TKR surgery. Once I get my back treatments squared away, I should be just about pain free most of the time because my brain will be sending the correct new signals that my body mechanics changed after the knee replacements and my back should quiet down.

    Now, though, I have osteoarthritis in both shoulders! Just went to my Ortho surgeon on Monday for that. I thought I had torn ligaments in my rotator cuffs in both shoulders, but he did x-rays and said there are no tears in either one, so far, that is. However, he did diagnose the osteoarthritis and bursitis in both and said my left shoulder is worse and weaker than the right. He told me he won't mind doing surgery at some point if and when I need it, but for right now, he wants to treat this conservatively by sending me for PT and then maybe trying cortisone injections in the shoulders. Unlike the knees which were totally shot and I had to have the TKRs ASAP, he said I have more time with the shoulders before he would need to do any kind of surgery. (Either a scope or total replacement.) He didn't say so, but I think he's going the conservative treatment route to give me a breather for a couple of years after my two major knee replacements! (Which I am grateful to him for - that he's not one of those surgeons who is just looking to make money off the surgery route. He really cares about doing the right thing by me and that's why I have such an excellent rapport with him. He respects my decisions and participation in my own care. He actually is one of those rare Ortho surgeons who "expects" full partnership by his patients in their treatment! He went into medicine and Orthopedic surgery specifically because he really cares about getting his patients back to full functionality by whatever treatment method is determined to be the best for each patient. A lot of Ortho surgeons (and I previously went to a really bad one) are the "my way or the highway" type of surgeons. Not my Ortho doc - you can "really" sense that he's not in this for the money only. He just really cares about his patients' well-being.

    Let me know when you are going for the knee surgery, and if you have any pre-surgery questions I can answer so you'll know what to expect both during your hospital stay and through rehab!

    And, I agree, the carpal tunnel situation can wait. See how you do with the nerve blocks. Maybe you'll be pleasantly surprised and your surgeon might end up being right about the blocks helping your CTS issue!

    Best regards,
    Carol

     
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