Finally...got some better news this week. After the last MRI, I had the chance to sit down with my doctor on Thursday. Immediately, he walked in and proclaimed, "I have good news."
The good news we heard is that the bone is now showing signs of vascularization...in other words, blood was beginning to flow back into the areas affected by the osteonecrosis. This is what we wanted to hear.
What does that mean? First, I no longer have to walk with a cane. Secondly, the overall process of healing will take around 6 months. Thus, we will have another MRI in 6 months to confirm the bone has healed completely. Until then, I have to continue to use my unloader brace for the next 6 months, but only when I know I am going to be on my feet for an extended amount of time. The great thing is I can begin introducing some activity back into my life. I was encouraged to walk around the block and to ride my bike. YEP, I can ride my bike again but I did have some specific guard rails...no hill climbing and no racing.
I am looking forward to spending time on the bike again.
I am still dealing with some pain in the knee. I am hoping that some of this is still a symptom of the osteonecrosis and the fact that my muscles and tendons are overloaded. I started to do some basic physical therapy to help rebuild the muscles and even ordered some orthotics to help with my overall alignement. Can't wait to see where things go.
I will continue to report any new progress and tell you how the therapy and the orthotics do for my overall progress.
Monday, May 20, 2013
Wednesday, April 3, 2013
I am Evolving
All of a sudden all the jokes of me being the missing link are beginning to make more sense.
Basically, my understanding is that the SONK is changing. It hasn't gotten progressively worse which is a good thing. However, before we start dancing through the streets naked...it is still there and by no means hasn't disappeared. Where do we go from here? Actually nowhere...yet. Doc said that he wants me to keep living life as we have for the past 30 days for another six weeks. At that point he wants to do another MRI to re-evaluate the knee. I think after the next MRI I will officially be glowing.
Waiting seems to be the word of the moment. If I am honest, my patience is beginning to wear thin. I am tired of sitting around, walking with a cane, and living in constant pain. We are now approaching the two year mark from when things went really bad with the knee. My wife and I are ready for answers and that seems to be our constant prayer right now. My doctor really acts like we need to outlast the SONK- so he can move forward with the osteochondral allograft procedure (Bone and Cartilage Transplant). Which I am not super excited about doing. I feel like we have looked at and tried the conservative approach and now we are ready to try some "not so conservative" approaches when it comes to the knee...which would be something artificial.
I guess we will know more in 6 weeks. At least that is what we are hoping for!
Friday, March 22, 2013
MRI #2
Yesterday, I finally made it in to have my second 3T-MRI of the year. I just wanted to update any progress in moving forward and this is one simple, and yet, big step forward. My follow-up appointment with the doctor will be in one week. At that point, I hope to have lots to share.
Friday, February 15, 2013
SONK
Today, I learned a new term related to the knee - SONK. Before I get to what SONK is and how it relates to me, let me briefly update what has taken place the last few weeks.
Over the past few weeks following the initial MRI results I have visited or have been in touch with five different orthopedic doctors concerning my case. Which led me to my sixth doctor that I visited yesterday. Why so many? It has been hard to get both a solid perspective of what the next step should be and to find someone that seemed ready to dive into my case (or had the expertise to dive in).
The first words that doc #6 had to say when he walked in the room was, "Lee, you have one challenging knee." After stating what I took as obvious...lol...he began to ask questions about the last year, we talked through the last few surgical reports, and then he did some pushing and moving of the knee. Coming out of that appointment we decided to schedule a scope of the knee to get eyes on what is really going on inside...with two possible plans of action based on what we found: 1) Osteochondral allograft or 2) Artificial fix.
Melissa and I left feeling like we had a plan of action that both of us were very comfortable in exploring. Then the phone rang. Dr. #6 was on the other end of the phone. He began to explain that he decided to dive into my MRI a little more and so he called his favorite radiologist to give an opinion on my films and together they came to a conclusion that I might have a SONK lesion. You can click on the link below to read into the detail of what a SONK lesion is.
SONK Lesion or (Spontaneous Osteonecrosis of the Knee)
What does this mean and where do we go from here? Basically our plan of action at this point is that my doc told me to put the unloader brace back on, walk with a cane, and to take it easy. There is a small chance that the damage to the knee (what seems to be a SONK lesion) could reverse itself if given to rest (if it is small). However, to do a scope of my knee could cause my SONK lesion to get worse if indeed that is what it is.
From here the plan is to rest the knee for a month, at that time we will do another 3T-MRI of my knee and compare the images to my January MRI. If the area they are concerned about doesn't change or worsens...it is a SONK lesion. We haven't talked in detail at this point what we will do if indeed this turns out to be a SONK lesion...but from my research the only options seem to be a unicompartmental knee replacement or a TKR.
It is hard to explain the emotions of the current journey. I feel more numb to it all at this point...probably because I feel I have moved into survival mode or I am just tired of facing the emotions of the problem. At least, at this point, it looks like we will have more answers in a month. In the meantime, I am rocking my new Walgreens cane.
Over the past few weeks following the initial MRI results I have visited or have been in touch with five different orthopedic doctors concerning my case. Which led me to my sixth doctor that I visited yesterday. Why so many? It has been hard to get both a solid perspective of what the next step should be and to find someone that seemed ready to dive into my case (or had the expertise to dive in).
The first words that doc #6 had to say when he walked in the room was, "Lee, you have one challenging knee." After stating what I took as obvious...lol...he began to ask questions about the last year, we talked through the last few surgical reports, and then he did some pushing and moving of the knee. Coming out of that appointment we decided to schedule a scope of the knee to get eyes on what is really going on inside...with two possible plans of action based on what we found: 1) Osteochondral allograft or 2) Artificial fix.
Melissa and I left feeling like we had a plan of action that both of us were very comfortable in exploring. Then the phone rang. Dr. #6 was on the other end of the phone. He began to explain that he decided to dive into my MRI a little more and so he called his favorite radiologist to give an opinion on my films and together they came to a conclusion that I might have a SONK lesion. You can click on the link below to read into the detail of what a SONK lesion is.
SONK Lesion or (Spontaneous Osteonecrosis of the Knee)
What does this mean and where do we go from here? Basically our plan of action at this point is that my doc told me to put the unloader brace back on, walk with a cane, and to take it easy. There is a small chance that the damage to the knee (what seems to be a SONK lesion) could reverse itself if given to rest (if it is small). However, to do a scope of my knee could cause my SONK lesion to get worse if indeed that is what it is.
From here the plan is to rest the knee for a month, at that time we will do another 3T-MRI of my knee and compare the images to my January MRI. If the area they are concerned about doesn't change or worsens...it is a SONK lesion. We haven't talked in detail at this point what we will do if indeed this turns out to be a SONK lesion...but from my research the only options seem to be a unicompartmental knee replacement or a TKR.
It is hard to explain the emotions of the current journey. I feel more numb to it all at this point...probably because I feel I have moved into survival mode or I am just tired of facing the emotions of the problem. At least, at this point, it looks like we will have more answers in a month. In the meantime, I am rocking my new Walgreens cane.
Thursday, January 17, 2013
MRI follow-up
Monday afternoon I had the privilege of sitting in the MRI machine for 45 minutes as I they did a cartilage map of my knee. Today we got the results.
The results were that the ACI procedure done a year ago, yesterday, didn't fully take. The lesion on the outside of my knee looks good but the other lesions (the larger ones) didn't work. Hearing that news was both good and bad. It was good in that it meant that I wasn't crazy. Bad...well I think you get the bad side of it. Hard to believe that we went through all the pain, craziness, time, money, etc. to be no closer to fixing the knee. Where do we go from here?
That is a good question. A question that we hoped would be answered today but what we found out...my knee is seriously jacked up and there aren't any real good alternatives. Here are the current three options on the table as discussed with my doctor today:
1) Do ACI surgery all-over hoping this time the odds fall in our favor
2) Try another procedure called: Osteochondral allografts. What is this? This procedure involves the transplantation of a piece of articular cartilage and attached subchondral bone to a damaged region of the articular surface of a joint. Basically transplanting cadaver material into my damaged knee parts with the hopes it works. (Probability of this working is around 50%)
3) or Knee resurfacing. A procedure in which a metal plate is placed in the damaged area of the knee. better alternative than a total knee replacement in that it allows me to keep all of my ligaments and tendons in tact.
*A total knee replacement is still not a good option due to my age.
At this point you might be wondering what our game plan is? We are not 100% sure if I am honest. We are going to seek an audience with a couple of specialist in the Osteochondral Allograft procedure to get their perspectives of my knee and whether or not this is a good option for me. One of those doctors is here in Phoenix and the other in San Diego.
There are still a lot of decision to be made and a lot of information to gather. More blogging to come...
The results were that the ACI procedure done a year ago, yesterday, didn't fully take. The lesion on the outside of my knee looks good but the other lesions (the larger ones) didn't work. Hearing that news was both good and bad. It was good in that it meant that I wasn't crazy. Bad...well I think you get the bad side of it. Hard to believe that we went through all the pain, craziness, time, money, etc. to be no closer to fixing the knee. Where do we go from here?
That is a good question. A question that we hoped would be answered today but what we found out...my knee is seriously jacked up and there aren't any real good alternatives. Here are the current three options on the table as discussed with my doctor today:
1) Do ACI surgery all-over hoping this time the odds fall in our favor
2) Try another procedure called: Osteochondral allografts. What is this? This procedure involves the transplantation of a piece of articular cartilage and attached subchondral bone to a damaged region of the articular surface of a joint. Basically transplanting cadaver material into my damaged knee parts with the hopes it works. (Probability of this working is around 50%)
3) or Knee resurfacing. A procedure in which a metal plate is placed in the damaged area of the knee. better alternative than a total knee replacement in that it allows me to keep all of my ligaments and tendons in tact.
*A total knee replacement is still not a good option due to my age.
At this point you might be wondering what our game plan is? We are not 100% sure if I am honest. We are going to seek an audience with a couple of specialist in the Osteochondral Allograft procedure to get their perspectives of my knee and whether or not this is a good option for me. One of those doctors is here in Phoenix and the other in San Diego.
There are still a lot of decision to be made and a lot of information to gather. More blogging to come...
Friday, January 4, 2013
ONE YEAR!!!
Yesterday I went in for my one year check-up. And yes, it was two weeks early, but who's counting. I was a little nervous going in not really sure where I stood and if the doctor would be happy with my overall progress.
As the Doc came in his first words to me were, "Was it worth it?"
That alone gives you a basic understanding of how difficult the surgery and the recovery are for this procedure.
After a brief five minute conversation it became clear that I haven't been progressing the way that I should. Some of the basic things that helped us reach that conclusion were:
- I was still having pain with any extended walking or standing
- I still have moments of swelling (specifically a real large knee this past weekend after working in the garage for a couple of hours)
- No real maneuverability while playing with the kids in the backyard. (Doc suggested I should be able to jog around and play soccer with the kids without any setbacks)
All of this to say... the last year and a half and two surgeries hasn't put me any closer to my goal of being semi-active again. At this point of the blog you might be wondering what the next step is from here.
The first step from here is to go and get a 3T MRI (an advanced MRI test) to see exactly what the status of my knee is. Based on the results of that MRI we will move forward. What does it mean to move forward? If I am honest I really don't know. What we discussed before the ACI surgery was that if this procedure didn't work the only real place to go would be a total knee replacement. I just cannot imagine having to go through a total knee replacement at my age. However, I also cannot imagine living with my current knee issues for an extended amount of time.
Emotionally the last few days have been a little difficult to digest. Knowing that the last surgery, pain, time, family and financial stresses didn't accomplish what we were hoping for is hard to swallow. I can liken it to running a marathon only to find out at 26.2 miles you ran the wrong direction and now you have to run back. I don't know exactly what the next year will bring. But what it seems is endurance will be the key to 2013 just as it was in 2012.
Obviously there is more to come.
As the Doc came in his first words to me were, "Was it worth it?"
That alone gives you a basic understanding of how difficult the surgery and the recovery are for this procedure.
After a brief five minute conversation it became clear that I haven't been progressing the way that I should. Some of the basic things that helped us reach that conclusion were:
- I was still having pain with any extended walking or standing
- I still have moments of swelling (specifically a real large knee this past weekend after working in the garage for a couple of hours)
- No real maneuverability while playing with the kids in the backyard. (Doc suggested I should be able to jog around and play soccer with the kids without any setbacks)
All of this to say... the last year and a half and two surgeries hasn't put me any closer to my goal of being semi-active again. At this point of the blog you might be wondering what the next step is from here.
The first step from here is to go and get a 3T MRI (an advanced MRI test) to see exactly what the status of my knee is. Based on the results of that MRI we will move forward. What does it mean to move forward? If I am honest I really don't know. What we discussed before the ACI surgery was that if this procedure didn't work the only real place to go would be a total knee replacement. I just cannot imagine having to go through a total knee replacement at my age. However, I also cannot imagine living with my current knee issues for an extended amount of time.
Emotionally the last few days have been a little difficult to digest. Knowing that the last surgery, pain, time, family and financial stresses didn't accomplish what we were hoping for is hard to swallow. I can liken it to running a marathon only to find out at 26.2 miles you ran the wrong direction and now you have to run back. I don't know exactly what the next year will bring. But what it seems is endurance will be the key to 2013 just as it was in 2012.
Obviously there is more to come.
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