Showing posts with label kneecap subluxation. Show all posts
Showing posts with label kneecap subluxation. Show all posts

Wednesday, July 18, 2018

My "Normal" with EDS

I often hear comments such as "get well soon," "that must be rough to have all of that in the summer," and "hope your recovery goes smoothly" from people when I am out somewhere. One time a lady even approached my mom to tell her she was thankful I survived whatever it was that happened to me.

I realize their intentions are good, but the funny thing is....the braces, the crutches/wheelchair, the mask, the port...that's part of my normal...everyday.


So what is my normal really like?


This is a difficult question (at least lately) because my “normal” or baseline changes weekly.

For me, my “normal” involves multiple joint dislocations everyday (most notably my kneecap, shoulder, ribs, and right hip--but this too can change on any given day), an average pain score of 6/10, daily headaches and neurological symptoms from craniocervical instability, allergic reactions to God only knows what, random POTS episodes with pre-syncope and/or syncope, difficulty tolerating food, weekly IV infusions for blood pressure and heart rate, and unrelenting fatigue/exhaustion.

Everyday I wear a knee brace to hopefully decrease the number of dislocations and subluxations I experience (it still doesn’t stay in place). I wear an ankle brace (or walking boot when I break my foot) to prevent my ankle from rolling out (inversion). I sometimes wear a hip brace to limit extension and hopefully prevent my hip from sliding out the front. With bad shoulder dislocations I often need to spend a few days in a pillow sling. When headaches and neuro symptoms (from neck instability) are really bad I use a cervical collar until my neck can be assessed by my physical therapist.

I use either crutches or a wheelchair everyday due to pain, fatigue, joint instability, and POTS.

My week consists of physical therapy 2-3x and multiple appointments. Unfortunately I am unable to work at this time but hope to contribute in a meaningful way one day.

Life with EDS is frustrating and unpredictable. But with every curveball I just try to keep swinging.

Monday, July 16, 2018

Update from Boston- Hip and Knee

I saw my primary surgeon in Boston on July 12th. We discussed my right hip and left knee in this visit. In my "Welcome Back" post I talked about what I thought the plan would be and it did not change all that much.


He presented my case to the hip team Thursday morning. They went over every option for my right hip and my PAO surgeon could not believe my hip is this unstable. Options for the right hip include another PAO for more anterior coverage, a femoral osteotomy to decrease anteversion, and re-doing the graft I had placed in December 2017. Everyone agreed that the graft should only be repaired/replaced if everything else is addressed too as it is likely to fail again if there are other factors contributing to my instability. That would be one massive hip surgery.

I explained that I feel like the kneecap is the worse of the two and that I think that we should focus on the knee and readdress the hip if/when something were to change. We talked about the risks of leaving the hip as is. Risks include dislocation that requires ER reduction (either closed or open), avascular necrosis, worsening pain, and arthritis from wear and tear from instability. 

He agrees that we can focus on knee and discuss the hip if the pain becomes unbearable or there are signs of avascular necrosis. We both believe it is possible that relying on the right hip during recovery for left knee could push it over the edge. 


The plan for the knee will be to replace the MPFL graft (original MPFL reconstruction was in 2010) which is completely ruptured, do a tibial tubercle transfer osteotomy, and provide lateral support as well to protect the kneecap from dislocating medially  His goal is to get the kneecap to sit in the center of my knee (it does not do that at the moment) while stabilizing it from both sides. He said it will require at least 3 surgeons so it will be a full house! The surgery will be in early December. 

While in Boston for the week I was able to spend some time with one of my friends that my surgeon introduced me to 2 years ago! We went mini golfing!


Friday, August 12, 2011

Peaks and Valleys

This week has been difficult for me physically and emotionally. Physically I have been in a lot of pain that seems to be getting worse. Therapy was difficult because of my hip and knees and I really didn't feel like I accomplished anything. My hip pain is likely my angry psoas...again. It's a difficult problem to manage (and it's very painful) but at least it's not joint pain. My knee pain is probably due to overcompensating and having a completely improper gait. My right kneecap subluxates when I don't wear the brace but thankfully, no subluxations or dislocations IN the brace. My left knee just hurts. It's getting very frustrating.

Emotionally I am exhausted. I am so overwhelmed and stressed with my compounding issues and I just desperately need a break. There's only so much that one person can handle before they explode. That's what happened this week. PT is a confusing/conflicting place for me. I love it because the people are great and very supportive--in a way an extended family because I have been in therapy (consistently) for 2 years. However, I hate it because it means more pain, frustration, and setbacks. With increased pain this week, came an increase in emotions. I cried more this week (at PT) than I have in a long time. I saw patients who I interacted with regularly (and became friendly with) being discharged and I wanted so badly for that to be me. Don't get me wrong, I am always happy for them when they "graduate", it just makes me think more about my pain, disability, and life. I just want to be able to wake up and go to bed (when I manage to fall asleep) without pain. I am tired.

During one of my breakdowns (and this was a major one at that), Cam left me with some words to think about. He has a way of knowing exactly what to say. He said that after every [mountain] peak is a valley. The peaks are my high points and progress and the valleys are my setbacks, pain and frustrations. So because I am in a valley right now, a peak must be right around the corner.

....But when do the valleys end? Will they ever end? Right now, I just don't know.

On Monday my family is heading to New England for a busy week. Shane moves into college on Tuesday. This is going to be a rough day! He's my best friend and I can't believe I have to spend the next several months at home without him. I am definitely going to miss him. At least I know I will see him every 6-8 weeks (when I have appointments).

On Tuesday and Thursday I have appointments with my surgeons. I will be seeing all of my surgeons for post-ops and evaluations. I will also be seeing a back specialist to discuss my chronic back pain and instability. I am really in need of some answers.

Friday, August 5, 2011

Humpty Dumpty

I've been feeling a lot more like Humpty Dumpty these days---well really for the last 2 years but more so lately. Somedays I feel like I will never be "put back together"---and the reality is I won't ever be "healed." I have surgery to correct one joint/problem and then something else dislocates. Even the joints I have already "fixed" will need more "fixing" in the future. It's a never ending cycle of surgeries and recoveries. It's frustrating because there are so many things I want to do but find I am unable to or I just end up injuring something else.

I fell down the stairs last week. My knee buckled, gave out and I slipped. This happened 6 days after I stepped in a hole. I am becoming more and more concerned with my left knee and it's inability to function and support me. It hurts all the time and gives out whenever it feels like it. I imagine this is in part due to lack of muscle strength and control--but it's getting very frustrating. Thankfully (and surprisingly) no complete dislocations with the fall--I just subluxated my right kneecap. However, I did hear a "pop" in my right hip and definitely over extended it (not to mention landed on it). My groin pain has been horrible ever since. I am hoping it is just my iliopsoas, which is an annoying problem to deal with...but something that IS manageable. I am, however, concerned that I aggravated the labral tear in my right hip. I will discuss my concerns with my hip surgeons at my post-op appointments in 2 weeks and see what they think.

Recap: I have a labral tear and FAI in my right hip that was noted on an MRI last year. Due to my EDS, my PAO surgeon decided it was best to keep my hip capsule closed (if possible) and not repair the tear--less is more with my body. Re-positioning the socket with the PAO surgery takes the uneven load off of the labrum and typically prevents the need for a scope. (In order to repair the labrum and FAI, the surgeon needs to open the hip capsule. This creates instability--something I can seriously do without).

I have been very frustrated and over-whelmed lately. I have been in therapy for 2 consistent years--the only breaks I have had are for surgery. I feel like I have made zero progress because everything (except my shoulder) hurts all the time. Joints I have been working on for 2 years are still painful. It's just very stressful.


I have so many overlapping problems that it's hard to see the light at the end of the tunnel. I just want so badly to not have this body. I want to go back to my "glory" days of gymnastics, when my body was "unbreakable"---I had the strongest muscles and was so physically fit that my joints just stayed in place. I was able to experience being an athlete (and a talented one at that). I  trained everyday for hours. I want to feel that accomplished again. I miss the intense training, and learning new skills. I miss competing. It was my life, it defined me...and slowly EDS took that away. 

US National TOPs Team
1999

US National TOPs Team
2000
Now I don't even know what it's like to live without pain. Unfortunately I can't change my body and how it has altered my life, so I just have to accept it and make the best of it. I ask you God to give me strength...

God grant me the serenity
to accept the things I cannot change;
courage to change the things I can;
and wisdom to know the difference.

Living one day at a time,
Enjoying one moment at a time,
Accepting hardships as the pathway to peace,
Taking, as He did, this sinful world
as it is, not as I would have it,
Trusting that He will make all things right
if I surrender to His will;
That I may be reasonably happy in this life,
and supremely happy with Him;
Forever in the next.
Amen


My left (operative) shoulder is doing well. I have almost no pain with everyday activities and have a functioning ROM.  My surgeon's orders are to take PT very slowly and progress only as noted in the script. My exercises in PT seem very easy to me but I guess that's my sign of some progress.

We head to Boston in 2 weeks to move Shane into college and see all of my surgeons. I am hoping to schedule my right ankle surgery and discuss the procedure with my surgeon. I also need to address my right knee subluxations and instability. Hopefully I haven't reached the surgery stage yet. I will also be meeting with a spine specialist at Mass General. We have a lot to discuss in regards to my spine and SI instability, and chronic back pain. I have been in a tremendous amount of pain in my back and would really like some answers and relief.

I haven't reported on my CRPS nerve pain in awhile. This is because it hasn't been a problem for several months now. Occasionally I have a flare and hypersensitivity, but it's short lived. I can touch my leg without pain and have not had any swelling or discoloration. I am still taking 1800mg of Neurontin a day. I do not feel comfortable weening off just yet because I still experience the occasional flare. CRPS also has a mind of it's own and sometimes all it takes is an injury or trauma to the leg for it to start back up again. I will meet with my pain doctor sometime this fall/winter to discuss the next steps.

I am currently taking heart rate medication (Verapamil) to control arrhythmias. The medication seems to be helping as I am no longer waking up in the middle of the night to my heart pounding out of my chest. I had an echo last week to see if I have any structural problems with my heart. I will discuss the results with my Cardiologist at the end of August and post an update at that time.

On Wednesday I had a BBQ with two of my (newly engaged) best friends--Jamie and Andy! It's always great to spend time with them. We talked for hours, listened to country music, and went in the hot tub. It was an awesome night.

BBQ night
(yes I went dark...I am now a brunette)