Here is what Lisa said in her comment:

“My doctor says the clot, based on ultraound/doppler tests, began behind my knee. Apparently, the lower in the leg the clot, the less serious/smaller it is and the more likely it is to either be absorbed by the veins or become a DTV (deep vein thrombosis) instead of a Pulmonary Embolism. Above the calf is considered dangerous. Normally the act of getting up to pee throughout the day during immobilization is enough to prevent a clot. I must have had the perfect storm of injury location and severity. The scary thing is that it was 4 months after the injury when the clot broke free and traveled to my lungs. Please encourage everyone on this blog to discuss DVT and PE with their orthopedist. Leg cramps and shortness of breath might not seem serious, but they can be signs of something deadly. I would even encourage folks who have a dislocation to carry a card in their wallet stating that fact. If I had lost consciousness and an ambulance had been called, it might have taken longer to get to the root of the problem without my being able to provide a history.”

There you have it. If you are fairly new in your recovery of a dislocated knee, please be aware of the complications that could arise. Watch out for the signs and symptoms and talk to your doctor.

I would also like to thank Lisa who took the time to share her story so that others could learn from it.

Cheers,
Jonesy

Related posts:

1. Tips on making sure you’ve found the right physiotherapist for your knee injury.

1. It is essential that you feel comfortable with the environment, the staff and, most important of all, the physiotherapist. If you don’t feel comfortable with any of those I would say move on until you do.
2. Try and find a physiotherapist that has worked with an injury like yours, this helps to ensure that he/she knows how to treat your specific injury.
3. Make sure the equipment looks well maintained and up to date. If there are machines that look like something Houdini escaped from I would say get out as fast as you can.
4. The physiotherapy clinic needs to be convenient and easy for you to travel to. The reason for this is that there will we days when you are finished your physio session and you are going to be exhausted and in some serious discomfort. The last thing you want is a drastically long trek back home.

I realize the list is quite small, but to me those were the key elements for my recovery. If you have any other tips you would like to add please let me know.

No related posts.

The first week of physio was really tough. My quadriceps had completely disappeared. I had no muscle, it was weird to look at and depressing to see how quickly muscle can deteriorate (the doctor and physiotherapist both said that after 3 days of inactivity your muscles will start to deteriorate, your body determines that it isn’t essential so it breaks it down ). But my quad wasn’t the focus; it was my knee, and getting its full range of motion back. At the beginning of the week I could barely bend my knee at all, but after a grueling week of physio my range started improving. Aside from the exercises, I also had the electrodes hooked up to the knee; this would work the muscle around the knee. I also had an ultrasound type thing that was rubbed around the knee and surrounding area to break up the scar tissue that had formed on the tendons. What happened in my situation was that I had stretched my tendon to the point of just about breaking it apart, and because of that trauma there was a lot of micro fibrous tears throughout the tendon; and that is what the physiotherapist needed to repair as well.

This aspect of my recovery stayed consistent throughout. The other areas came once he felt my range of motion was good, as well as my balance and step.

From there I moved into doing the bicycle as well as the leg press, and the kick-back/kick-forward machine. The leg press wasn’t too bad, it was low weight with increasing repetitions (over time the weight was increased as well). Once again it is amazing how weak my leg had become because of this whole situation. However, my progress was good and I kept on trucking. The kick forwards were really really bad though, and painful too.

The bicycle, well, at the beginning it was DEADLY! At first I couldn’t do a complete rotation, it hurt way too much. Being the guy that I am though, I thought “let’s just give er a bit more shall we?” and by accident I made a full rotation; dear sweet-lord did I pay for it, it hurt something awful and the physiotherapist gave me some harsh words as well. It was a stupid move on my part and I never tried to be a rock-star in my recovery from that point forward. I did what I was told and went at my physiotherapists pace.

As I had mentioned in the previous post, after the first week I switched the crutches for a cane, which wasn’t too bad since he taught me how to use it properly (parallel with your bad leg as you walk and not out in front of it like a lot of people do), and after a week of the cane it was no aids whatsoever. It was a bit tricky at first but I eventually got the hang of it, although stairs were still quite hard and I had to concentrate and take it easy.

Another great recommendation by my physiotherapist was water therapy. All I needed was a swimming pool that had a shallow area that got progressively deeper. The reason for this was that in the beginning I was simply to just walk around in water that was up to my waist, what this allowed for was my body to get that sense of balance and the walking movement/motion yet still having the benefit of the water to help take the strain of weight and gravity off my leg. After doing this for a while I also added in periods of doing the bicycle motion under water as well. I really felt that this additional component of my physiotherapy really helped the progress of my recovery.

All in all everything was slow and took time but I kept progressing well. The only problem was that work was pushing to have me return to work, and before I knew it they asked my physiotherapist for his recommendation. Being the ethical gentleman that he is (which is important to me) he let them know that although I still required therapy I wasn’t in a position where I couldn’t travel to work and do my job. And that was the end of that. I was back to work and my life returned to its normal state and physiotherapy fell by the way side. It is completely my fault for letting that happen. I could have found some way to balance a strong continued recovery regimen but I didn’t. And I know that I am not 100% recovered because of it. My leg gained some muscle back but not close to what I had before. My knee still hurts from time to time depending on my level of activity, and the weather tends to affect it also, especially when it is a damp and rainy day. It makes crunchy noises too at times, which has me worried that scar tissue may have built back up. That being said, I need to fit my recovery back into my schedule or else things will never get better. I don’t want to be the person that says “well, I guess that is the way things are and I am just going to have to live with it.” I don’t want to live with this discomfort and pain, I don’t want to think that way, and I agree that right now this is the way things are but they don’t have to stay this way. I can do something to change it. And I will.

If anyone else has a knee injury recovery story I would love to hear it.

All the best,
Jonesy

Related posts:

1. My lateral dislocation of the patella – Part Two
2. A Little Lateral Dislocation of the Patella Anyone?

So, where did I leave off? Right, the three weeks before seeing the doctor for the second visit. This was a pretty difficult time at first. It took awhile to get accustomed to living on the couch, you feel so boxed in and restricted, and your whole body starts to play games with differing comfort levels (i.e. when your legs are comfortable your back decides not to be, when you back is comfortable your neck decides not to be, etc.), eventually a happy medium is reached and all is right in the universe. The key is keeping yourself busy. I did a lot of reading, caught up on my Japanese animation shows (Naruto and Bleach), watched movies, and put together the two articles on web design and Canadian tax laws. When my mind was focused on other things besides my knee it makes it a lot easier to deal with.

One thing that was hard to deal with was getting up off the couch to move around, which took a few painful attempts to perfect because getting off the couch required the synchronized use of the crutches and upper body strength to be able to push yourself up off the couch and ensuring you keep your bad leg from doing anything other than staying off the ground. Getting back onto the couch was also just as fun, but a bit easier in my opinion.

Since I had everything I needed on the main floor of the house moving around with the crutches wasn’t too bad. It was when I had to go for my doctor’s visit that I realized just how death defyingly difficult it was to get down stairs with crutches and a splinted leg. Scary scary scary.

My visit with the Doctor went fairly well I guess. He looked at my knee, looked at my X-rays from before, felt the knee and the surrounding area, and indicated that he was confident that I wouldn’t need surgery. Whew, that was a relief. I am not a huge fan of being cut open if I don’t really have to be. The Doctor advised me that I would be okay to get started on my physiotherapy and that I should come back and see him in two weeks time. He then directed me to go and speak with the physiotherapist that is in the clinic.

The physiotherapist at the clinic was quite nice and personable, and she was simply there to explain to me what I needed to do at home to promote my recovery (stretching and flexing exercises for my knee and leg muscles). She also taught me how to go up and down stairs with my crutches. Wow, no wonder I nearly killed myself when I left my house to go to the doctor’s, I was going down the stairs completely wrong! The way she showed me made a world of difference. It consists of utilizing both the handrail of the stairs (if there is one) and the crutches. With the crutches you double them up in the arm that isn’t using the handrail, and whether you are going up or down determines which leg you use. If you are going UP stairs you will lead off with your good leg, and when it comes time to use the bad leg you ensure that you have the crutch do the work (you can’t have your leg touch the stair or apply any pressure to it. When you have to go DOWN stairs you lead off with your bad leg, although you aren’t technically using your leg because you are having the crutches do the work. She told me to remember it this way: “Good people go to heaven and bad people go to hell.” Which means, since Heaven is UP you use your good leg to lead when you are going up the stairs. And since Hell is down you use your bad leg to lead when going down the stairs.

At this point I now had a referral slip for a physiotherapist, so it was up to me to find a physiotherapist in my neighbourhood and get started on my recovery. My wife was a real help in this department because she went to the physiotherapists in my surrounding area to get a feel for the Doctors and to see what the facilities were like. Out of about 7 of them she felt one was the best choice. She felt really good about the doctor and the place itself wasn’t too busy or overcrowded. The exercise equipment looked in good shape and up to date. All of these helped her decision but in the end she also told me it was the vibe that she got from the place; it felt right and the doctor felt like a good person.

She was right. The doctor was a really great guy who was very knowledgeable. Right from the very beginning when he first saw me hobbling in my crutches he said to me “Well, first, we’ll be getting rid of those in a week” (meaning the crutches). His philosophy was that they inhibit recovery because you become too dependent on them, which doesn’t provide your body the ability to reteach itself how to walk properly and to redevelop the proper walking motion. After the week we would then go to a cane for two more weeks and then after that nothing; just me and my appendages. And sure enough that was how it worked out, not magically of course, there was a lot of work and pain involved in the journey; but that, as they say, is another story. =)

Related posts:

1. A Little Lateral Dislocation of the Patella Anyone?
2. My dislocation of the patella – physiotherpay and beyond

Aside from never experiencing pain like that, I have never heard the human body make a sound like that either. It was a very loud crunching and popping. I thought I only heard the sound inside my body since I could feel it travel up my leg and into my head, but the people I was playing with said they heard the noise as well. I don’t think I’ve ever sworn as much in my life either. I’m pretty sure I exhausted a years supply of expletives from the moment it happened to the first few minutes while I was lying on the ground. The ambulance came fairly quickly and it was my first ambulance ride to the emergency room as well. (A lot of first emanated from this sordid event).

The emergency room visit was long and drawn out, par for the course here in Toronto, but at least the emerg doctor had a very friendly gurney side manner. She discharged me with Tylenol 3s, a leg splint, and the standard RICE method for recovery (Rest, Ice, Compression, and Elevation), and told me to book an appointment with the Orthopedic Surgeon in three days.

Three days of lying/sleeping on the couch in my living room doing jacksqaut, taking painkillers, and cursing the gods whenever I had to reapply the splint after icing my knee (6 times a day no less) before I had a chance to visit the orthopedic surgeon. He confirmed the emerg docs diagnosis about the patella dislocation, and then nonchalantly told me about the fact that the dislocation indeed tore the knee cap off from where it normally dwells, and that there are minor fragments of bone floating around the knee area. He said he wasn’t too concerned about those as they are quite small, he would look again on my next visit, which he informed would be in three weeks time. As for treatment, he didn’t want to go the surgery route (thank god) and feels the best way for my knee to heal is to continue doing what I’m doing (RICE) and in three weeks time he’ll see how things are progressing. If all is well I will be downgraded from a leg splint to a knee brace that will allow for bending of the leg along with a device that will keep the knee cap in place so that it can continue to heal.

And so, that leaves me back where I was a week ago. Lying/sleeping on my couch, taking painkillers, and being mildly annoyed with the gods whenever I have to reapply the splint after icing my knee (6 times a day). The pain has gone done considerably since this first happened, but there is still swelling, and a constant pain/discomfort. It really hurts during the night when I sleep the most, I think this is because I tend to move and flex my leg a lot when I sleep. So when I wake up it hurts like a sonuvabitch.

The down side of all this is the fact that I am in constant pain/discomfort, I can’t really move around to much, the couch in my living room is now my permanent place of residence, and my wife has to take care of not only our 6 month old daughter but me as well now. That’s a lot for anyone to have to deal with. =(

The plus side is that I am getting to spend a lot more time at home with my wife and daughter, I’m reading more, and sharpening my web design skills as well. The first stop on my “web design skill sharpening journey” is giving this blog a redesign. Hopefully the changes are noticeable and appealing. I liked the first version, but as it is for any web site design, there is always room for redesign. I wasn’t going for anything drastic though, just some aesthetic changes that perk things up a bit. I’m happy with where I’ve taken things so far. I’m sure during my recovery I’ll come up with other things to add or change as well. Besides, there’s no sense just lying here bitching and moaning about my situation and not doing anything productive with my time. As they say, “when life hands you lemons, just make lemon aid”.

cheers,
Jonesy

This is part one of a three part series of posts regarding my knee dislocation and recovery. You can find Part Two HERE and Part Three HERE, and I have also written a post about tips on making sure you’ve found the right physiotherapist. That post can be found HERE

Related posts:

1. My lateral dislocation of the patella – Part Two
2. My dislocation of the patella – physiotherpay and beyond