Yet another knee injury question-- what would you do?

[crosscountry]

It sounds like some of you and/or your family members have not had a PCP who has earned or deserved your trust which is unfortunate.

I had, but he retired.

But even he missed one of my conditions. He did bunch of tests which all came back "normal". It took my own family experience to get myself a referral to the correct specialist, whom did a battery of more tests, one of which came back with the red flag.

I would not enjoy just doing routine physicals all day long and just referring any patient with a medical complaint to a specialist and can’t see how that would be satisfying to anyone. PCPs who are referral machines IMHO should reevaluate their career choice.

I quite doubt my current PCP felt the same way you do. Yes, the only time I see her are during annual physicals. She would discuss the result with me as to what each one means and how to keep them in good range. (if you're over a certain age, your physical won't be 100% perfect. She explains which matters more than others).

But if a patient is otherwise healthy, there's nothing to "build a relationship" on. Then, when something happens (cancer anyone?), can your PCP spot it quickly enough to send you to the right specialist? Can you trust your PCP to do so perfectly in every case? Even if he's 99%, won't help you if you're that 1 out of 100!

I like my current PCP in a certain way. She's more of my "health consultant" but she pretend that "I'm the expert and my advice should be taken as gospel". The kind of "trust" some doctors expect.

My Mom worked in a hospital as a patient rep/interpreter. All she saw day in and day out were patients who got delayed/misdiagnosed by their PCP! Occasionally, she saw a few who's sent in by their PCP at the earliest instance. But the ratios were pretty heavily skewed towards the bad side. So yeah, I'm definitely biased on the less trusting side.

Trust, but verify.

 

[neonorchid]

 

[James]

Had the exact scenario he talks about with not getting the acl diagnosed properly. Knee went out a few years later and tore the meniscus. When they went in to fix that, i.e., cut out the damaged part, they saw the acl completely torn.
I’d seen both a general doc and an ortho. Both declared the acl fine after the drawer pull test.
I’d love to see some objective data on the results of that test vs mri.

 

[Wendy]

I'm done for the season. I was very tentative at the Gathering and only skied 1/2 days when I did ski. My knee began collapsing on me while walking through the airport, so off to the ortho I go.

 

[neonorchid]

- knee began collapsing on me while walking through the airport, so off to the ortho I go.

Oh no! You looked so happy in the posted pix!
I hope it's nothing more than overuse tendonitis. What it has been with me when I've had similar, evaluation for PT, therapist would say, "change in activity level".
Basically no appreciable ski days to a full week is a lot and group dynamics make it too easy to overdo it, not to mention dream conditions!
Good that you stuck to 1/2 days. Still, our bodies need recovery time and lets be honest, who coming from a geographical snow drought winter has the self discipline to take days off in the midst of daily powder days!

Crystal ball is saying if the west remains strong thru April, you'll be skiing A-Bay Mothers day gathering - Best of luck

 

[AmyPJ]

I'm done for the season. I was very tentative at the Gathering and only skied 1/2 days when I did ski. My knee began collapsing on me while walking through the airport, so off to the ortho I go.

Oh no! I also hope it's just an "overuse" or "use and abuse of muscles that have not been used and abused" thing and not a soft tissue injury. Keep us posted, please!

 

[Wendy]

Oh no! I also hope it's just an "overuse" or "use and abuse of muscles that have not been used and abused" thing and not a soft tissue injury. Keep us posted, please!

Thanks. It was bothering me at Snowbasin; was hard to control my skis which is why I quit that day. I didn’t ski in all that powder at Sundance, which was sad, but probably wise. I had a great day at Brighton (love that place) but was skiing slow. I just haven’t been able to drive my skis this season so wonder if the knee is also partly to blame. Groomers feel worse than in snow though.

@neonorchid I did skip 2 ski days and took it easy when I did ski. I did feel as if something didn’t “feel” quite right. Hopefully I’ll have at least part of an answer after my appt on Wednesday.

 

[neonorchid]

 

[Wendy]

Oh no! You looked so happy in the posted pix!
I hope it's nothing more than overuse tendonitis. What it has been with me when I've had similar, evaluation for PT, therapist would say, "change in activity level".
Basically no appreciable ski days to a full week is a lot and group dynamics make it too easy to overdo it, not to mention dream conditions!
Good that you stuck to 1/2 days. Still, our bodies need recovery time and lets be honest, who coming from a geographical snow drought winter has the self discipline to take days off in the midst of daily powder days!

Crystal ball is saying if the west remains strong thru April, you'll be skiing A-Bay Mothers day gathering - Best of luck

I was happy! It's hard not to be when you're with great people in the mountains....no matter what you're doing or how badly you're skiing.

 

[Wendy]

Well, an x-ray and mobility test leans towards just arthritis, which I knew I had. Thank God.

I got a cortisone shot to help with inflammation. The ortho posited that the instability I was experiencing (knee collapsing) might have been due to my brain reacting to a signal that my knee was "catching" and reacting by allowing it to collapse. Interesting.

It's possible that I've torn my already-trimmed meniscus further. But doc said it's difficult to see this on an MRI of a surgical knee. So we both opted to go with the cortisone shot and follow up with a bit of PT.

Of course, it helped none that I rarely rode my bike this winter. For me, consistent bike-riding, even just riding my fat bike down to work (1 mile) and back is a good way to maintain knee strength. So after 2 days of taking it easy after the cortisone, I'm back on the bike. My knees are super important in doing other things I love: riding my bike, running my dogs, stand up paddle boarding. I'm not willing to give those up!

Ortho is an avid skier. An Alta addict! He did not tell me to stop skiing, said what I do regarding that is my choice, but advised PT and strengthening for a few weeks first, and avoiding hard icy moguls (I do), steep moguls where I may land harder than desired (I do because I suck;-), and....wide skis on groomers.

Of course, skiing here in PA sucks so I'm bagging out of that now. Ortho ALSO said he had a LOT of ski injuries this year due to poor snow conditions and people just powering through it.

 

[Wendy]

Had the exact scenario he talks about with not getting the acl diagnosed properly. Knee went out a few years later and tore the meniscus. When they went in to fix that, i.e., cut out the damaged part, they saw the acl completely torn.
I’d seen both a general doc and an ortho. Both declared the acl fine after the drawer pull test.
I’d love to see some objective data on the results of that test vs mri.

Good point about seeing test data.
My ortho told me MRI's are difficult to assess some injuries of previously injured knees. I don't quite know why that is, but I believed him.

I was really concerned I had a similar situation due to my collapsing knee, and only a bit of pain on the lateral side of my knee. I passed the drawer pull test with flying colors.

 

[neonorchid]

Well, an x-ray and mobility test leans towards just arthritis, which I knew I had. Thank God.

I got a cortisone shot

going forward and hoping you won't need this info: https://sportdoctorlondon.com/cortisone-vs-hyaluronic-acid/

 

[dan ross]

I love my orthopedic surgeon. Two hips replaced by this guy. I even waited an extra six months( Covid backup) so he could do the second one The quality of life has improved tremendously- I’m almost able to run again where last summer going up stairs took forever. Just wanted to throw some gratitude to these docs. A good Ortho is worth their weight in gold- life changing in my case.

 

[skiki]

Just chilling.
Finally had the surgery on Friday. When my PCP saw the MRI she contacted a friend of hers who had ACL reconstruction a year or two ago after a ski injury to ask who did hers for my referral. So far so good.

 

[Tony S]

View attachment 204149
Just chilling.
Finally had the surgery on Friday. When my PCP saw the MRI she contacted a friend of hers who had ACL reconstruction a year or two ago after a ski injury to ask who did hers for my referral. So far so good.

Good luck!

 

[Tom Inca]

Hope you have an uneventful recovery. Thank you for sharing your journey.

My ACL reconstruction surgery was last week too. It was on Monday, so I am a few days ahead of you. So far, so good. I was able to ditch the crutches on the second day and my doctor said I could remove the ace bandage on the third day. I’m still in a removable splint, which I wear most of the day. I took one Percocet the first night thinking I might need it to sleep. Haven’t needed pain meds since, not even Tylenol. The ice machine really helps. I see you have one too. It’s a good thing.

This is my second reconstruction. My first graft lasted 33 years. It tore off, I think, when I was skiing this season, but I cannot pinpoint when it actually happened.

I first had the surgery in the late 1980’s, and it was a much different experience. I was hospitalized for 2 nights. It was a very painful experience. I wore a contraption called a Bledsoe brace, and I was on crutches, not able to put weight on my foot, for 4 months. My leg atrophied. It took a really long time, like over a year, to get my strength back. We did not have cold compress ice machines back then either. Oh my, have times changed!

 

[skiki]

Wow, crutchless at day 2 already? Impressive. I don't think the nerve block was even fully worn off until the end of day 2. Between the other current ACL reconstruction thread, what I'm finding online, and my own doctor's instructions, I'm struck by differences in post surgery protocol. I'm partial weight bearing with crutches, annoying stockings on both legs, full brace, high dose of aspirin daily, Tylenol 3 times a day, CPM machine to get me up to 90 degrees by the end of the first week, first PT 3-5 days after surgery (today is the day) and my first post-op appointment isn't until June 2. I didn't bother with the Breg ice thingy until after I took the surgical dressing off on day 2. My knee was so padded and insulated that I was icing my thigh instead. But I'm glad I bought it, so much better than ice packs (and a big thanks to Bunny F. in NYC for selling it so cheaply on FB marketplace.)

So far the only thing I'm willing to go outside of dr's instructions on is the annoying stockings. I admit that I don't always wear it on the good leg. My poor feet aren't used to being encased in nylon.

 

[Mike King]

Those stockings are really important to avoid getting blood clots. If you get blood clots, it is a life threatening situation -- they can break free and cause a stroke. Even if you don't get a stroke, getting blood clots means months on an anticoagulant and likely no skiing, biking, or anything where there is a risk of a fall. So just suck the discomfort up...

 

[Jwrags]

Those stockings are really important to avoid getting blood clots. If you get blood clots, it is a life threatening situation -- they can break free and cause a stroke. Even if you don't get a stroke, getting blood clots means months on an anticoagulant and likely no skiing, biking, or anything where there is a risk of a fall. So just suck the discomfort up...

Actually, unless you have a hole between the two sides of your heart the blood clots will go to your lungs causing a pulmonary embolism. Try hard to avoid blood clots forming in your legs!

 

[skiki]

I'm starting to get used to having my legs encased. Eventhough the paperwork says to wear them for one week, my PT said he recommends to wear them until my first post-op appointment which is at 2 weeks, and then see what the PA says. Sigh. But I'll do it. I know my getting my knee back up to snuff and cleared for this next season is already a longshot. I don't want to do anything that might make those chances even slimmer. The delays from being away from home and then scheduling around my youngest's college graduation have already put things back a bit.