LAST MESSAGE...LAST MESSAGE....deanlebaronNOTstuckathome
2/22/03 tenth week post-op
I can continue to report good progress...no cane/crutches (but no foot
races either), stairs but slowly, flexibility about 2/3 rds of normal,
little strength in
the left leg but exercises have started in earnest.
Whereas the earlier dictum was "if it hurts, stop", now it
is "if it hurts, go a little more." The left leg is slightly
enflamed and swollen, especially after exercise but ice packs do wonders...and
feel so good. There are small delights like driving a car...albeit with
automatic transmission (my clutch leg is not ready for aggressive use
of
a manual yet).
Thanks to the expert, cheery team of medical and PT people, home people
and greetings from you this episode has not been too bad at all. I've
missed skiing this season but on the cold days when the snow looked so
good from my window, I would have spent more of the time having coffee
in the ski lodge than riding the high-speed quad (quad, ouch!, that's
the name for what I ripped).
But I can see the end and its a good one. Certainly will be ready for
summer fun and maybe some
before. I don't want to play on your sympathies
because its pretty good now. I'll continue my rantings
and ravings with
daily videos, articles and speeches on www.deanlebaron.com/ ...all trying
to be optimistic but usually failing.
And I'll ask John Sammons, Donna's brother and webmaster of this site,
to close it down in a week.
We'll keep it in archive on mine since the
record is too good to loose.
And when I make a bad forecast or slip on the other leg, I'll return to your messages and feel a lot better.
Gratefully, dean
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2/8/03 week eight post-op
Hard to believe that it is almost three months since I slid on the
Avenbuehl wanderweg with one leg downhill and the other up...rip. And
then crawl to where Donna could pick me up in the car. Since then
canes and crutches have taken over the weight bearing and although it
is a joy to move at all, it is difficult to imagine moving fast.
I shouldn't complain about progress which is still ahead of a normal
schedule. I have about 70 degree flex in the knee, have full mobility
around the house including stairs, only use a crutch/cane for the
stairs and than it is more for my head than for support and spend a
lot of time during the day out of the brace moving my leg around.
Soon, maybe a week or two, I'll use the machines to return some
strength to the leg. But the danger of a re-tear seems to be passed
so long as I'm braced against another fall or slip.
The end of this process is in sight...still far away with my one
eye...but in sight. The entire episode was lightened by the loving
care and supportive comments and good humor from family and
friends.......thanks, d
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1.29.03 week 7 post-op (just)
I'm informed that progress is good, way ahead of schedule. So the attempt,
mostly successful, is to curb my eagerness for the next events. Mostly
progress is measured by being able to do things bymyself: walking unaided
with a crutch or cane, stairs very carefully (with brace on, of course),
going in
a car for errands, flexing the muscles in a hot tub and doing strength training
on the good side.
But I have been very fortunate to have a top-notch medical team (Drs.
Peter Noordsij, Howard Jonas, Lou Kowalski and PT specialist, Chris Schmidt),
household group (Ellie, Francie, Roger, Tina), Virtualquest (Elaine and
Marilyn), computer gurus (Steve and Chris) and, of course, what makes
it
work is the head of the five star health spa with loving care, Donna.
On the Swiss side, before I came back to
NH was Dr Hans-Joerg Keel and
Astrid Baur plus the genial friendship
of Alfred Farha who worried more about
me than I did myself (still does).
I can't believe it takes all of them to sit on me
but apparently it does...and
it is working.
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2.23.03 week 5 post-op
Happy to be at the study desk - A
Video
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2.17.03 week 5 post-op
Dr Peter Noordsij and Chris Schmidt had conspired ahead of time by
email that I was misbehaving. The Dr. knew what I was doing in
pressure on the leg and flex without me having to confess. So I had a
lecture on how stretching the muscle now, which is possible, would
limit its ability to contract later. Seems logical to me.
However, he acquiesced in letting me try stairs with one leg, two arms
and a bottom, walk pegleg without the "elder" walker I've been using
(so long as I don't fall) and resume some steps toward normal life.
But real strength training is a couple weeks from now, not now as I hoped.
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1.10.03 Week 5 post-op
Had the second session of PT with Chris Schmidt and he indicates that my progress
to date is ahead of a normal schedule. I'm exercising the leg regularly through
25 degrees and see little difference in aided
or unaided. And can easily flex
to about 45 degrees while the knee is supported by a pillow.
He is unhappy with the weight I tend to put on the stiff leg while using a walker
and reminds me of a
waltz instructor trying to teach me different dance steps
but this time Donna is not my partner, the
walker is and it is not the same thing.
But as long as I don't trip or stumble it seems alright and I'll try
to slow
down. Now putting the brace on and off by myself so this phase is re-humanizing
and an increase in self-reliance. Oh yes, Barb, a friend and hairdresser from
Sunapee, made a house call yesterday so I have a new haircut...seems breezy on
top.
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1.9.03 week 5 post operation
Have started PT under the firm guidance of Chris Schmidt of Schmidt PT.
He comes highly recommended, is clearly knowledgeable and sufficiently physically
imposing to add strength to his movements and instruction. Not surprisingly his
main message was to do less, not more. Thanks to the surgery skill of Peter Noordsij
and what recovery capability I have my stage
of flexibility is several weeks ahead of schedule (still not fast enough for
me). He gave several exercises which I am doing regularly and generally being
more cautious around places like showers. But I am getting rid of most of the
patient aids except the brace and ubiquitous walker (apparently I'm "carrying" the
walker not using it). Main thing is to not fall and tear out all the good work
that has been done for me so I remember the adage.."how do porcupines make
love?"....very carefully.....dean
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1.05.03 operation: week 4
No worthwhile progress for me to report except nostalgia for skiing as
I look out the window.
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1.4.02 operation +26 days
Studying a manual (slightly fictionalized) to see if I'd qualify as a
CIA operative. This branch of
government seems to have an unlimited, unknown, unmonitored budget and
needs computer
savvy peaceniks for exfiltration.
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"Coming Events" - Quadriceps Tendon Repair/
Rehab Protocol
Week 1-6:
• PWB with crutches in cylinder cast or brace
• Patellar mobilizations, scar massage when tenderness allows
• AAROM out of brace (with therapist only!) to limits outlined by
MD
• ROM allowance
Week 6-10:
• Begin isometric quadriceps strengthening
• Can WBAT with brace locked in extension (at therapist’s
discretion)
• AAROM to 45-60 degrees
• Continue patellar mobs, scar massage, desensitization
• Can begin straight leg raises
Week 10-16:
• AAROM,AROMto 115 degrees
• Stationary Bike when ROM allows
• Aquatic Therapy OK
• Can begin to push PROM at 12 weeks
• Theraband at 12 weeks OK
• Progress to PRE’s
Important Points:
• Early phases may require one visit per week only
• Brace should be locked in extension for ambulation for initial
six
weeks
• At week six, increase visits to 2-3/week based on patient need
for
guidance
• Emphasize that ROM gains expected for up to one year
MD flu Visits:
1. one week for cast/dressing change
2. four weeks
3. ten weeks
4. 4 months
5. 6 months
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1.1.03 New Year's Day Operation +23
Just about the time I get most of the standardized patient aids customized,
I hope to be out of it. Lots of electronics is at hand and video conferencing
with family by Beamer is within a foot. Now planning a temporary swimming
facility for water exercise. No pain and still no movement is allowed
in the knee. I'm moving the patella and incision to ensure no adhesion
from the operation.
For the medically curious, I'm including a picture of the brace
which shows it being worn without a bandage underneath...that is not customary
but was put on just to illustrate to a friend how it could have
been made waterproof by different material. It would have been a small
and inexpensive step for the manufacturer but the material may have
been dictated by insurance company practice.
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from Dean...12/28/02, operation + 16 days
Necessity is the mother of adventure (or was it "innovation"?).
I dropped the Tivo remote very early this morning when I wanted to watch,
at fast forward,
the ten or so new worldwide news broadcasts that are automatically recorded
each morning. I get a perceptive of the same stories from a number of
vantage points...and they are different. But this morning, disaster...I
dropped the remote on the floor and it slipped out of sight. Here I was
bed bound with no remote to control the news. The phone used for help
had not been put on its charger correctly. I was on my own.
So I determined to get out of bed by swinging the dead leg over the good
one and letting it down to
the floor very slowly while supporting my arm on the trapeze. Success,
now I'm standing or rather
leaning upright, against the bed. I then used an extension grabber to
reach the walker that was
within about five feet and stood up, turned the bedroom lights on and
looked under the bed. There
it was, the remote, about under the middle of the bed. With the trusty
grabber, I grabbed.
Success. And returned to bed by reverse process to conduct, with the
Tivo remote more firmly in
my grasp, the daily search of news sources.
Yes, one small step for man and a major step for his access to news sources.
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Christmas Day - 12/25/02
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My daily status report, 12/23/02, operation plus 13:
Embarrassingly little to report each day. Tiny improvements like my
adjustable bed is 6" lower which allows me to get in and out more
easily,
still with pretzel-like twists on the parts of my body that move. And
my
upper body is getting a workout on the walker and bed trapeze. I remember
a friend who had two useless legs but the upper body of a bantam wrestler.
Bantam I'm not but I can feel the muscles from the waist up taking over
from the little use the legs are getting...one none. Michael Crichton's
Prey
is great; stayed up a good part of last night reading it. And will report
it as
a book review for www.comdig.org/ since it is an excellent explanation
of the
science that interests me.
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Sunday: 12/22/02 operation +12
Some things next change, the Sunday New York Times on paper. In Switzerland
we read the
online edition with is posted by 0800 CET or 2 AM EST. Always makes you
feel a little ahead
of things getting it that early but still, in case anything is missing,
I check www.google.com/ and
click on news to get my now favorite no-human editor aggregated world
news source (replacing paperboy). But when you have the time, don't want
to archive anything and don't want to use
Copernic Summarizer to read faster, the crinkle of the paper and dirty
hands from the ink is pleasurable.
What do I read most thoroughly: front page, op-ed (Krugman, Friedman,
Rich and occasional Dowd), Book Review now that I can take the reading
time...latest is Prey by Crichton, a good application of complexity to
a thriller, and the front page of the Business section hoping I'll see
Floyd
Norris. And the rest after these.
dean
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Saturday, December 21, operation plus 11 days
First shower in almost two weeks with the good leg in and dead one out.
A few
splashes on the floor but felt great. Every day I try to do something
new and the
accomplishments are almost baby-like.
As in yesterday was the first day to get into and out of bed unaided although
it does
require strange contortions. And each day I take the brace and Ace bandage
off to
manipulate the patella and sewn-together quad. Attaching a pic here that
was just
taken showing a happy guy with these small steps
and great care.
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12/19/02
Dean, Dr. Howard Jonas, Nancy Jonas, and Donna (the photograher)
celebrate a major milestone -- the removal of Dean's "staples"
(ouch)!
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Seventy two hours from the operation performed by Dr Peter Noordsij,
Concord Orthopedics at New London Hospital. Was taken to the hospital
and returned by Dr Howard Jonas who was allowed to
scrub and attend in the operating room by Dr Noordsij. Howard was very
impressed by the job including some unique aspects that will make the
result better (I had a spinal, felt nothing, and dreamed of a conversation
with Jack Kennedy). Spinal was handled by "David", prep and
recovery by "Deb" who did their work competently and pleasantly.
Marcia and another David were the nurses handling my room overnight and
the next morning. Dr Kowalski looking in during the morning...he was the
referring
physician that put me in touch with Dr. Noordsij.
Although sometimes people return home after this procedure (I suspect
dominance of the insurance market) I stayed over night and was well pleased
to do so. I was not ready to be released without
training on walkers and crutches the next day. And I had, and still have
a circulating cooler for the knee and a blood drain (this has gone). And
have cut back on the narcotic pain pills although after taking two before
going to sleep at night, I think of old Chinese guys smoking opium pipes.
Not a fun process but a necessary one and I'd recommend this combination of orthopedic surgeon and hospital to anyone with the same problem. And I'm in for several months or more recovery.
Now I am reminded why it is a good idea to stretch the muscles before
exercise.
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Quad Reconstruction
Wanderweg Injury and Surgery[RealVideo Clip]
Explanation of Rupture of the Quadriceps
Pictures of the excellent operation done by Dr Peter Noordsij
CAUTION! NOT FOR THE QUEASY.
 |
Picture of the surgical team in action (funny).
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