Estimated Time of Recovery PVNS

Journal Of My Recovery From Open Synovectomy, Radiation, Manipulation, Recurrance of PVNS

November 7th MRI Diagnosis PVNS

November 15 Researching pvns, treatment options, finding surgeon. What will pvns mean to my lifestyle? Making a list of questions for surgeon.

Dec 3 met Dr DeComas, xray taken,  discussed if biopsy confirmed pvns she would switch from arthroscopic to open synovectomy.

Dec 14, 2011, Open front synovectomy left knee, 23rd surgery from other stuff

1 day post op in hospital, worked with PT department on crutch use.  36 hrs post op femoral block wore off. I was taking Tylenol, 10 mg Oxycontin ER every 12 hrs, Oxycodone 5 mg for break thorough pain, and injectable morphine every half hour and I was still crying like a baby. In the middle of the night switched to Dilaudid which controlled the pain but made me nauseated, Reglan & Zofran to control vomiting. pain 6-8. Drain still expelling much fluid.

2 day post op, Johnson Pratt drain pulled in late afternoon.2-3 seconds of intense pain.

3 day post op, discharged from hospital, medication, ice, many pillows useful to secure leg in drive home. Large zip lock bag for nausea. good leg and hip are hurting due to the extra stress.

Day 4 post op, feeling better, pain 4-,5, narcotics, lymph massage, ice, elevate. washed hair in kitchen sink and sponge bath 

Day 6 post op, pain 3-4, take meds prior to getting out of bed in a.m., tempted to use only 1 crutch at home but knee gives out without warning. need to get out of house.

1 wk post op, pain 2-3, 1st regular shower, reduced breakthrough narcotics, bruising is showing now, prefer to use 2 crutches in order to focus on correct strides. Good knee is aching due to the additional stress of compensating for pvns knee.

2 wk post op, pain 2-3,  stabbing pain begins, staples removed, unable to drive, use crutches only on outings. narcotics evening only to sleep. crutches in storage, resumed sex 

3 wk post op began physical therapy, beginning to drive short distance

4 wk post op ROM 56 degrees, frustrated with being gimpy, mentally anxious to return to my desk job but physically not ready. 

6 wk post op ROM 70 degrees, pain 2-3, stabbing pain intermittent, family stresses, financial stresses as bills start rolling in. Driving normal distances. Will make decreased monthly payment arrangements until return to work. 

7 wk post op, Radiation Treatment begins, 18 treatments at 200 greys per. 

8 wk post op 2/13/2012, Ready to return to work if not for RT, ROM 84 degrees, pain spiked  3-4 with increasing activity, good knee continues to hurt due to extra stress. 4 Radiation Treatments done, increasing fatigue, swelling. Rarely take narcotics.

9 wk, 9th RT session, feeling the cumulative effects, pain 3-5, slight burning sensation, vice grip feeling, heat at site, darkening of skin, swelling, fatigue is overwhelming. I had to back off on physical therapy. Compression, elevate, Ice, meds. ROM is still at 84%.

10 wk post op, At this point it's a mental game of keeping your attitude in check and not having too many pity parties.

12 wk post op radiation therapy finished. Physical therapist says one more month of pt. focusing on range of motion.

14 wk post op. My best range of motion prior to radiation therapy was 84 degrees. During radiation I lost 10 degrees, 2 weeks after rt stopped I’m at 81degrees. 

16 wk post op, 4 wks post radiation therapy ROM has been stuck at 81 degrees for 2 wks. Prior to RT ROM 84 degrees, lost 10 degrees during RT= 74 degrees, regained 7 degrees the 1st 2 wks post RT. 

18 wk post op, 04/18/2012, Knee manipulation under anesthesia followed up by aggressive physical therapy 4 times a week. Obtained 110° in surgery, had a reaction to morphine requiring iv benedryl. PT following day rom 110° with help 118°. Healing wise put me nearly back to week 2 post op, pain 5-6.

19 wk post op, 1 wk post manipulation, ROM 113° with help, pain level 4 with nerve pain feeling like a knife jabbing into my knee, with swelling, 10-12 hrs daily in cpm machine for 4 weeks.

20 wk post op, 2 wk 4 days post manipulation. ROM 113°, pain level 3. The nerve pain has stopped and my knee quickly stiffens up if I have it immobile for an hour. It is a very fine line between working it too much or too little. I continue to have problems with swelling. 

25 wk post op, 7 wks post manipulation 6/6/12. Surgeon is pleased with rom @ 113° which means I haven't really lost any rom since manipulation. She is hoping that the rom will continue to increase as the residual pain and swelling decreases  in the next six months, which will make it a year from surgery date. Pain level is 2-3 but decreases with moderate movement. It is a fine line between doing too much vs too little.  I finished physical therapy a couple of weeks ago since I have the motivation to do pt on my own, I  know all of the exercises that I need to do and I have easy access to a gym. My good knee has been hurting for nearly three months but is now constant and hurts nearly as much as pvns knee. Surgeon has ordered mri on pvns knee for  follow up and on the good knee to rule out pvns.

6 month post op follow up MRI 6/14/12. 9 week post manipulation 6/21/12. Per mri new diffuse thickening and rare intratendinous of pvns post surgical. Joint effusion and synovitis noted with additional hypointense focus superior margin which is new, decreased popliteal cyst however multiple foci of hypointensity present diffusely. Residual or recurrent pvns. My good knee continues to be swollen and painful awaiting mri results.  Constant dull pain level 5-7, diffuse swelling in pvns knee, minor swelling in non pvns knee, continuing exercises 3 time wk, ice, elevate. Range of motion at best 110° due to swelling. Pain may be much increased due to pain pump being reduced by 15%. 

06/03/2012, UTI treated with 4 days of Cipro, very very ill

06/28/2012 Bilateral steroid injections in the knees due to swelling and constant pain. Experienced a Cortisone flare increasing the pain for 2-3 days. Had a mild systemic reaction to the steroids causing severe anxiety, moodiness,  flushing of the face, slight difficulty breathing and increased heart rate, necessitating Valium to avoid asthma attack and tachycardia... this lasted  about 4 days. . The symptoms are slowly abating and my knees are feeling much better with very little swelling. Do your research prior to having steroid injections, systemic reactions are rare but can be quite severe and far outweigh the benefits of the shots. I'm unable to have the Cortisone shots again due to the reaction. 

07/08/2012,  2nd  UTI treated with 10 days Cipro, flank pain, very very ill

07/23/2012,  3rd UTI treated with Cipro, bad flank, abdominal pain, appointment with urologist 08/01/2012. Wondering if the subsequent infects have anything to do with the steroid injections.

07/30/2012, 1 month post steroid injection, pain level prior to steroid injections 5-7 nearly a month later it is now a 2-3, swelling is very much reduced. ROM estimate 120+. Knee continues to stiffen after being sedentary. Felt comfortable going down an escalator for the first time since surgery. The posterior knee cyst continues to enlarge causing minor discomfort. Knee constantly aches but actual pain is finally dissipating. My body feels very worn out probably due to all of the procedures and recurrent UTIs this past year. I had a dream last night that I had returned to work and I was so happy. Someday :-) The last 8 months has been more then challenging and I see it wearing on everyone around me. The battle becomes most fierst at the end.

08/01/2012, I saw the urologist appt, flow, nuclear study and cystoscopy scheduled. Been very ill and with less movement I'm not able to exercise my knee so it is stiffening more, heat is still coming off of it but from what I hear it is normal. Difficult to deal with pvns issues and other illness.