Tuesday, June 22, 2010

My 18 year old fastpitch player has MPFL reconstructive surgery

Our 18 year old daughter was enjoying her senior year of high school and playing the sport she loves to play and is fortunate to get to play in college in the Spring of 2011. She was half way through her senior fastpitch season when the worst happened, she dislocated her left knee, this was the 2nd time this had happened. With four weeks of physical therapy we felt and she felt that she was ready to go back and finish up the season and hopefully help her team win a third state championship, but after 2 days back at practice it happened again. She had to hang up her high school cleats and call it a season. Following is Nat's journey, we are still hoping for a very happy ending:

May 19th, 2010
We see Dr. Eric Gordon, orthopaedic specialist. He suggests Natalie has an MRI that day and he will call us that afternoon. Later that afternoon we get the call from Dr. Gordon that she has a small tear in the bottom of her mpfl leading to her left knee. He suggests MPFL reconstructive surgery. Nat has 3 options: 1. Stop playing ball; 2. Continue physical therapy, brace her knees and have a 50/50 chance that it can and probably will happen again and cause further damage or 3. Have the surgery and reduce this injury from happening to only 5%. With college ball ahead in the Spring 2011, she chooses the surgery and will begin intense physical therapy back after surgery. Surgery is scheduled for June 18th, 2010. Dr. Gordon is going to attach a cadaver/donor hamstring to her kneecap in place of her mpfl. She will only have 1 plastic screw and this will eventually turn to bone-like substance. There will be no staples, the surger will be done arthoscopic.

Nat is not just having the surgery so she can continue to play sports. She is having the surgery for her quality of life and peace of mind. Each time the patella subluxes, cartilage damage occurs which eventually results in osteoarthritis. Cartilage cannot be replaced: knee replacement is used to correct the problem. We certainly don't want Natalie to be looking at a knee replacement surgery at age 40 or younger and there's also the fact that each time her patella subluxes, it is very painful and frightening for her. (I took this paragraph of information from A Country Mom's Blog because I liked it so much)

June 18 - Day of Surgery - Natalie's words before her surgery:
I'm a little nervous, my stomach feels week and I'm scared. I am nervous because I don't want them to think I'm completely under but I'm not and start the procedure...I don't want to know what they're doing and definitely don't want to feel it. I'm nervous about my recovery because I know it will be rough but I am also extremely excited because in a matter of time I will have a basically new life. I will be able to do what I love the most again and when I stop on the field for the first time I will feel so proud that I went through with this. This is so much more than me being able to play ball again, it's a whole new way I will do things. My entire teen years after I was injured I would always be really scared I would get hurt and now I wont have that constant fear of having this pain again. There's a lot of nerves that come along with this but I think there's a lot more happiness and excitement once you just sit and think of all the things you can do again. After this I will move on to a new chapter in my life that God has prepared for me and I couldn't be more excited. "His mercies are new very morning: Great is thy faithfulness". Now I'm going to go and get this shin dig on the road..... bye!

Friday, June 18th - afternoon after surgery
We left the outpatient surgery center around 1:30 p.m. and so far everything has gone really smooth. Nat is sleeping a lot. We have her leg elevated and icing it. With the Femoral Nerve Block she was given in her left leg, she probably will not have too much pain until it begins to wear off which will likely be during the night sometime. We will give her the pain meds every 6 hours even though she doesn't feel the pain now, catch it up front before it sets in.

Saturday, June 19th - day after surgery

Natalie is doing really good. She has had very minimal pain but the nerve block (I high recommend that anyone having this surgery receives this) has just worn off and we have been aggressively taking pain meds every 6 hours and ibuprofen in between to stay ahead of the pain. We will continue the medicine through today and then begin cutting back some tomorrow. She is moving around fine with her crutches and tomorrow will be a big day, she gets to take a shower!

Sunday, June 20th - 2 day post-op

Last night the pain began to set in with the nerve block wearing off but she handled it fine. Nat compared it to a menstrual cramps in her knee, lol. I think she has dealt with so much pain with her injuries that she has a higher tolerance to this pain than some may have. We removed the ace bandage and gauze for the first time and it really doesn't look too bad. Though there is swelling, it is not near what I thought it would be. She has put some weight on her leg with crutches and seems to handle it well. Nat was able to take a shower and that seemed to help her feel better.

Tuesday, June 22nd - 4 day post-op

Today we are 4 days post-op and I'm really pleased at how things are going. This is not easy be any means but Natalie is really pushing her way through this. We went out to eat last night and that was the first time to get her out since the surgery and even though it was difficult for her to get in and out of the truck, she wanted to get back out tonight. We went to Wal-mart and she drove a scooter and we shopped for crafts for her to do. We are still giving her the pain meds every 6 hours and ibuprofen in between just to stay ahead of the pain. On my previous post on June 19th I discussed cutting back but after talking with Dr. Gordon's nurse we decided to continue on with the pain management at least through the first week. We see Dr. Gordon again this Monday, June 28th and I feel positive that he will prescribe immediate physical therapy to begin next week. Keep your fingers crossed, this will really help Natalie see the road to recovery. So far with Natalie the worst part for her has been her emotions of wanting so bad for everything to just be normal again, at least that is how she puts it. That day will get her, I know it will.

Tuesday, June 29th
11 days post-op, Natalie started physical therapy today and did great. She is sore but not in any intense pain. We saw Dr. Gordon yesterday and he prescribed PT and will see her again in 4 weeks on July 26th. The brace will stay on and locked until then but she is free to discard her crutches when she is comfortable without them. Her incisions have healed and she has minimal swelling. Her physical therapist thinks that by next week Natalie will be walking without the crutches since she works really hard in PT. Natalie will have physical therapy 3 times a week. On her first day today she was doing leg lifts and leg slides. Her physical therapist, Bo Crenshaw, has worked with her through her knee dislocations and he will push her through this. There is a special place in our hearts for Bo, he has always been there to help her through her injuries and now through this recovery, we have all the confidence in the world in him.

July 4th, 2010
Natalie is now 16 days post-op and doing well. She is still on crutches but has only had 1 week (3 days of physical therapy). Today is the first day she is attempting to not take any pain pills. She is ready to start driving again and will have to be off the pain meds in order to do this. Her quad muscles are "waking up" quite nicely. Though they are no way near what they were she is already seeing some definition of her muscles. I think her new goal for next week of therapy will be to go down to using only 1 crutch.

July 8th, 2010
3 Weeks post-op and I continue to be amazed how just another day of therapy can make a difference. Natalie gained some confidence from somewhere today and she is really walking on her on. She is keeping her crutches loose but not under her arms and she is placing weight on the leg while walking. At therapy they even let her stand on her leg without a brace and she was able to do it though it was very odd feeling she said. She is at Physical Therapy 3 times a week and on the other 2 days she is doing upper body weight work on her arms and abs. I'm excited to see where she will be by the end of next week.

July 16, 2010
4 weeks post-op today. Natalie ditched her crutches the first of this week and has not used them again. She does still have her brace on fully locked though. At therapy she has walked without her brace and balance herself on her leg without her brace on. Bo said that she will have to be able to do a leg lift with her leg kept straight before Dr. Gordon would allow her to walk without the support of her brace. She is close but has not succeeded with this yet. She has one more week of therapy before she sees Dr. Gordon again on July 26 and I feel confidant that she will accomplish this before then. She is working hard in therapy and this task has been the hardest so far. He quad is strengthening and showing more muscle definition, still a ways to go on that though. She leaves for college in 4 weeks so she has a lot of work to do before then.

July 26, 2010
5 weeks post-op now. Today we saw Dr. Gordon and he took the brace off. Natalie is now working towards a 120 degree bend and when she gets there she will be able to start running. After her appointment with Dr. Gordon she went straight to therapy and was able to go from her 90 degree bend to a 105 degree bend. That was great! Now she begins the tedious task of working hard to rebuild her quad muscle. This will take time, probaly at least 8 more weeks. We are hoping she may be ready to hit the field by October but know that she has to have really great muscle tone before she does that. She leaves for college in 3 weeks, August 14th. Dr. Gordon wants to see her before she leaves so we see him again on August 13th.

August 2, 2010
6 weeks post-op now and Natalie got her bend to a 120 degree bend today at physical therapy! She will begin working her way into running now and she is so excited about this accomplishment.

August 20, 2010
9 weeks post-op now and Natalie is doing really good. She saw Dr. Gordon on August 13th before we took her to college in Mississippi on August 14th. Dr. Gordon prescribed 4 more weeks of therapy in Ripley, Mississippi and then wants Natalie to begin rehabbing on her on. Natalie is still working on building the quad back up on her leg but it is getting better. She is not running yet but hopefully will be running within the next 2 weeks. Dr. Gordon will see Natalie again on September 27th and if everything looks good he thinks he may release her to gradually go back on the field.

September 11, 2010
Natalie was 12 week post op yesterday. She is now running on the treadmill and jogging on pavement. She is working hard in therapy to regain her muscles. She has significant improvement in her muscle tone. She sees Dr. Gordon in 2 weeks and we will know more after that regarding when she can return to the field.

February 17, 2011
Wow, I'm so sorry I have been so long giving an update on Natalie. She is doing great! Natalie is now 8 months post op and has already played in a college game! She is still needing to gain complete muscle definition but is very close to having it fully returned. She now considers her surgery knee her good leg, lol! This has been a long and at times very difficult road to recovery but all in all it so far seems to be a very good outcome. Natalie returned to the softball feel at 16 weeks post op. Her coach was very good at slowly working her back in and didn't let her jump in too quick, which is her nature. She will see Dr. Gordon again in April and I think at that time they are going to discuss removing the metal button that was used to attach the ligament. It seems to cause some discomfort but Dr. Gordon wanted to leave it in place for at least 1 year.