Fulkerson

[Jellybean]

I loved reading people's stories so thought I'd share mine. I am scheduled for the Fulkerson's Osteotomy on Monday Aug 18th. I kept thinking it'd be cancelled. No particular reason to think that but I did.

I had a lateral release 17 months ago but my condition didn't improve at all. I struggle with constant dull pain in my knee and intense pain when attempting to do anything that involves weight bearing with the knee bent. Physio/physical therapy has been unsuccessful in building up my quad because my knee won't tolerate any of the exercises that focus on the quad. Three physiotherapist have referred back to the doctor saying they don't know how they can help me.

I am very nervous about Monday. I'm not worried I'll die anymore like I was for the lateral release but am terrified of ending up in worse condition. I can currently walk and bike and lead a fairly normal life so would hate to lose that. I am going ahead with the surgery though because the idea of never being able to walk up stairs normally, or run even a few steps, or lift something, etc seems unacceptable if there is a procedure that is likely to improve my condition. I will also lose my career very shortly if my knee doesn't improve. There is a fitness test that I need to pass within the next year or so to keep my profession. The surgeon believed I have an 80% chance of significant improvement, 17% chance of no improvement and 3% chance of being in worse condition. I know those stats can't be taken too seriously and its not an exact science. He spent a great deal of time with me though and I've spoken to many people who have worked with or had surgery performed by him on themselves or their children and have heard nothing but great things.

I think I have everything I need. I have a cyro cuff, shower chair, thing to keep my leg dry, prepared meals, a husband to be my nurse for a week, knee brace, prunes, low bed, and I think that's everything. I swear my tibia is hurting today just at the thought.

I am scheduled for 6am on Monday which is a relief. I can't imagine how people wait half the day to have the surgery.

[Jellybean]

Today is day 6. I didn't feel up to focusing on writing anything before today but I'll try to recap

Day 1 - checked in to hospital at 6 am. I undressed completely and my clothing was all put in a plastic bag marked personal belongings and I put on a hospital gown. My husband was brought back to wait with me until it was time. At about 8:45 I was given Valium and transferred to the operating room.

My next memory is being told to just breath while they asked me to rate the pain on a scale of 1-10. I remember this happening several times so I suspect they let me go back to sleep for a bit so the pain killers could kick in. Then I remember being told it took a lot of drugs to get my pain under control. We noticed my side was all wet and it was discovered the nerve block was partially ripped out and leaking. The nurse said the doctor would not reinsert it so if it didn't seem to be helping to remove it

I was feeling stomach sick and was asked if I wanted a prescription but said no for some crazy reason. About an hour after getting home I began throwing up and this continued along with the worst headache I've ever experienced for about 12 hours. It was the worst night of my life and I was pretty certain I would die. The on call doctor did call in a prescription for me at around 9 pm but it was too late I guess because it didn't help. I called emergency and was assured that this was a common reaction and I would survive.

Day 2 - so much better. I drank boost, stayed on top of anti nausea medication, rested and elevated my leg with a cyro cuff to keep it nice and cool. I couldn't believe how much better I felt. Getting up and moving however was extremely difficult and I needed help to remain on the toilet. I passed out once but luckily my husband caught me.

Day 3 - woke up with crazy pain in my calf after forgetting to take middle of the night painkiller.

[Jellybean]

Today is Day 11.

Most days since the surgery have not been fun. I can't believe how little I've been able to do on my own. I spent 2 days ago in the ER for extreme stomach pain and cramping. That problem seems to have been mostly resolved. I was also switched from Percocet to Vicodin which my body seems to like much more. I am down to a few pain killers a day. I find if I'm not standing up much I'm not in much pain. My leg is bruised from my knee to my toes. I am supposed to start physio in about a week so looking forward to that. I am so glad my husband has been around most of the time to help me. I can't imagine having gone through the last 10 days without daily help.

[Jellybean]

Day 25

My knee brace is locked at 90 degrees now which is supposed to give me the ability to walk like a normal person so I am trying to do that. I find my knee no longer hurts when I'm sitting for short periods of time and I can walk enough to do normal household things without any real pain. I'm totally off painkillers. I still have some swelling and my lower leg is tender to touch but I'm wearing a compression sock to help with that and continuing to elevate frequently. My knee itself is very swollen and hard on the outer edge of the knee. I am doing physio/physical therapy 3x per week. My quad seems to be totally gone but I am able to flex the little bit of muscle that is left pretty easily.

I keep getting asked if the surgery was a success and I have no idea. It's way too early to tell. I think I'll be hopeful if I reach the point where I can lift my foot on my own from a seated position without intense pain but considering I have no quad I don't anticipate that being possible anytime soon.

[Jellybean]

Day 38

The swelling in my leg is way down thanks to using compression socks. The lower part of my leg is very tender and hurts to touch and I still have no feeling in a large portion of my leg to the right of the incision. I'm sure this is just normal nerve damage that will heal over time so not worried.

My quad is very small but I can flex what little muscle I have left without any difficulty. I still get quite a bit of pain in my shin so I hope that goes away soon. I haven't been cleared to drive yet but feel like I could. I sat in the car and tried moving between brake and gas and it seemed easy enough.

I notice my knee cap is catching to the outside of my leg and stays there until part way through bending my leg and then suddenly pops over to a medial position and remains there for the rest of the bend. It doesn't hurt but is a very unpleasant feeling. I hope this is just a normal part of the adjustment but it's hard not to be bothered by it. I see the surgeon in about 5 days so I'll ask him about it.

[Jellybean]

Day 39

I was thinking of some other things that are bothering me so thought I'd share. I am told to message the scar regularly with a lot of force but not enough to reopen the incision. That I should tolerate a fair bit of pain to do it. I've been doing that but I wish I knew where the screws were because I don't want to be applying a bunch of pressure to the screws. There are several hard spots that stick out where the incision is so they can't all be screws.

I also wonder what the point is of the brace. If I can bend my knee to 90 degrees and can put full weight on it what purpose does the leg brace serve? Is it just there to make sure that I don't accidentally bend it beyond 90 degrees in which case is it fine to not wear when I'm just wandering around the house and confident I won't accidentally bend it? I don't see any chance of accidentally bending it too far. It has been over a year since I've been able to bend my knee past 90 degrees so I'm not going to forget like someone might who recently had normal use of their knee. I wander around sometimes without it now but I do worry that I'm missing some other important purpose of it so I put it back on. I'll have to ask about this too.

[Jellybean]

Day 40,

I learned the hard way why the brace is so important. I thought there was no chance of accidentally bending it too far. I didn't realize that about a millimeter past the comfortable range of motion I have extreme pain and no control anymore so I bent it a tiny bit past where is comfortable and the knee gave out entirely. Extremely painful error I don't recommend. Luckily I was doing wall slides at the time so had no real weight on it and therefore it doesn't appear that I've done any damage but even with only the weight of my own lower leg it was shockingly painful and frightening. Once the knee went a little too far my foot just fell the rest of the way down and I had no control to stop it. Had I been keeping the other foot positioned like a brake below the bad foot this wouldn't have happened. I guess I got too confident. I'll be keeping the brace on now.

[Jellybean]

Day 44,

I had x-rays and the bone has healed properly so I am cleared to drive, go for walks, and start more aggressive physical therapy. The surgeon thought everything looks great but did notice that my kneecap is slipping out of alignment at one point during the bend of my knee. He feels that once my quad gains strength this should correct itself. It all looks good so far but I really won't know until we reach the point of me starting to run. He said he thinks I could start light running in 6 weeks. I wasn't expecting to be able to try it that soon but it would be nice. I have my next follow up with him in 4 weeks and was given a script for another 6 weeks of physical therapy 3 x per week.

[Jellybean]

Day 51,

I am having some sharp pain occasionally around the incision. I'm pretty sure it's where the screws are. It comes and goes suddenly and nothing seems to trigger it. It's sort of like every once in a while my bone realizes there is a screw there and then quickly forgets again. I'm not really worried about it but do hope it doesn't continue.

The weird knee cap moving is happening less often. I am loving physical therapy and doing very well. The only thing I'm really struggling with at this point is doing squats. It seems my butt has become lazy from my weird gait so I need to work at teaching it to do some of the work.

[Jellybean]

2 months post op

I am trying to walk without a limp now but finding it very difficult. I can't even feel what I'm doing wrong but can just tell that its not a smooth walk. The physical therapist watched me and said its that my bad leg is landing in a bent position and not straight. He checked and I am capable of completely straightening my leg. It's so odd because it feels to me like it is totally straight when it isn't. I don't seem to be able to straighten it anymore than I am when I'm walking although when still I am able to straighten it. PT said that with more quad strengthening it should improve. Even if I try to hyper extend it when walking (realizing it only feels hyper-extended and is actually only straight) I still can't. I noticed that I always stand with the bad leg bent to keep the weight off it and this seems to be purely habit at this point so I am working on not doing that anymore which I think will help.

I have full range of motion now in my bad knee which is great. It's still not as good as my good knee but my good knee has more range of motion that what is considered normal. If I remember correctly my good knee bends to 154 and my bad knee to 140. PT said that my bad knee may never be able to bend as far as my good knee and that isn't something I should worry about.

I am very happy with my progress so far.

[Jellybean]

9 Weeks post op

I saw my surgeon again and he feels I'm doing great. He says he's rarely seen a case go as smoothly as mine but that I should be prepared for some bumps in the road ahead and not to get discouraged if this happens because it's normal. I no longer need to wear the brace which is fantastic. I can also start using an elliptical. I was given a script for another 10 weeks of physical therapy 3 x per week.

I am doing great in physical therapy. Everyday I'm better then the day before. They no longer ice me or use e-stim after my sessions. I am working now on trying to get the correct muscles to work. My brain has become so accustomed to avoiding using those muscles due to pain that it's really difficult to convince them to work. It is slowly working though and I'm feeling very good about things.

[Jellybean]

3 months post op

I am working on real strength building now of the quad. It's great to be starting to see muscle return. I am doing squats, deadlifts, various forms of bridges and planks, and lots of other stuff. I woke up both mornings this weekend hardly able to walk from the muscle soreness but no knee pain which feels amazing. I've been trying to eat lots of lean protein as recommended by the physical therapist to assist with muscle growth. I am so excited and happy with my progress. I am told I am still limping a little but that my walk is at about 95% of a normal walk so I'm sure that will continue to improve as my quad strength returns. My walk feels normal to me so its hard to fix. I still go down stairs one at a time but have very little difficulty going up them like a normal person.

[Jellybean]

5 1/2 Months Post Op

I am done with structured physio and am just working on my own now. I have been cleared to run starting slow. I have gone for 2 runs which were a combo of run/walk but went well. It was slightly painful and very awkward at first but got easier as I went. My limp actually seems to have disappeared mostly now that I'm running. I'm not sure why but it's great. I've been trying to walk without a limp for months with no success and wouldn't have guessed going for a run was going to be the cure. My bad leg still has much smaller quads but it's still getting better every day. I am also going up and down stairs normally now although I do have a bit of limp going down. It's hard to keep up with the physio on my own because it is so boring and I feel like I've been doing it daily for years now but I keep telling myself it will be worth it.

[Jellybean]

I am now over a year post op. I just competed in a 5k and did great with no pain and no swelling. I think I could have done a half marathon but am trying to not push my luck. I am still aware of the weaker leg but the more I ran the less aware I was. I have also easily passed the fitness test to remain in the military. So glad I had this surgery. For me it has greatly improved my life!! I still need to do some work to get the bad leg as strong as the good one and plan to keep doing extra work to keep it strong and lower the risk of injury. I am already stronger than I thought was possible 6 months ago though. It was a lot of work. Much more than I anticipated but so worth it. Next year at this time I hope to have completed my first half marathon since the surgery.

[runfar]

Congrats to you!! I hope you will be able to run your 1/2 marathon soon! I am looking at a repair surgery also -- and am glad to hear it has helped you!! I have run 25 marathons and can barely walk 4 blocks 9 months after my lateral release surgery. I would love to be able to run agin!!! It is my life and I have no life without running or being able to even walk now. I am glad to hear there is hope that a repair can help!