Post Tibial Osteotomy and returning to work as well as starting Physiotherapy

Recovery in weeks 3 and 4 (Feb 2018)
In the weeks surrounding returning to work, I did find it tiring in the afternoon. I was able to work from home for a reasonable period; it helps the sense of things returning to normal.

Trying to balance a laptop, having a bag of frozen peas (to reduce swelling) and laying flat as much as possible does get uncomfortable – be aware. The swelling is getting less and some mobility was returning. I am going out more for a walk around also.

Starting Physiotherapy (at last!!)

Physio day (at the One Hatfield hospital) was something I was really looking forward to. In the same week, the UK was being braced to abnormally cold weather. Very challenging journey indeed to the hospital!

Loiza was worried on the day to drive. The outside temperature was around -1 to -3 centigrade on the day but snow was very light. In my mind I was completely set on going and would have driven myself to get there. I say this because I had set my mind to get to this milestone-  its where the expert can tell me if my recovery is going well and what i need to do to get better. Having stopped work at 2pm, we set off.

I have to say that just sitting in the car and going for a drive is something i really enjoyed.

We waited for the physio to arrive and sat with a coffee.

We met with the resident physio, Craig. He started by testing my strength, assessed flexibility. He then went over additional exercises. Examples for strength exercises are :

  • Lying on the floor and lifting the leg up 6 inches and lowering slowly
  • Tensing the Quads and pushing the knee down
  • Bring the knee to your body
  • Roll up a towel, rest under the knee and straighten the leg
  • Stand up and hold a ball behind the knee and push the leg back

Craig said he was happy that I had been exercising- he could tell.

The final task was to walk and alternate the walking sticks – aiming to move me off 2 crutches and onto 1.

Having concluded the session, the task was to continue at home on a regular basis and get some core strength back.

Living with the Osteotomy – venturing out of the house!

After my Tibial Osteotomy, its times to get moving again. Read my blog for my diary entry

The next 4 days

Hello there! I took a few days off from blogging as the weather in the UK is just amazing.

Shoreditch, London. Keeping the rich out of our common places

Forcing a routine of getting up and resting is just something that has to be done. As Loiza and others tell me when I become impatient, the importance is for a full recovery of :

(1) the soft tissue beneath the skin

(2) the bone that is missing coupled with the metal work

(3) tendons and muscles that are affected by the surgery

It is so important to recover well in order to have the right level of mobility, otherwise the surgery will not be as effective.

The overarching pain at the moment is the joint pain. My knee is still stiff and swollen. Slowly movement is coming back but I am conscious of keeping my muscle mass however it will be noticeable that I am losing muscle. My ankle now is the most painful. The swelling (and blackness of the bruising) is more painful and keeping my knee above the rest of my body is easier said than done.

I am now negotiating the stairs and taken showers by sitting on the stool – the stair climb is painful as pain is felt on the outside of the knee (as the alignment takes effect).

On the 12th February Loiza took me out for a walk and I covered the longest distance (ok it was about 20 metres there and back). Compared to the last time I went for a walk, I have trebled the distance. The issue is the continued pain in the knee.

Get some loose clothing and get some exercise.

The pain in the evenings is interesting, I get shots of pain from the top of the tibia to half way down. A throbbing pain as well as the area around the stitches. If this is the healing process then great but they are heavy bursts of contracting pain. I really cannot wait for the clips to be removed, I won’t miss the protruding metal clips i can feel within the bandage.

Day of the Tibial Osteotomy Surgery

January 31st (Day of op)

I didn’t have a good sleep the night before so got up early. No food or drink as prescribed by the hospital so getting ready was quick. Priya was awake and gave me a hug before she went off to get her breakfast. Aroon was asleep so i gave him a shove. Time of arrival to the hospital is 7am. I remembered for the last 4 or so weeks repeating to myself “this is the last time i do….in a while”…well that the end of the line now.

We arrived at the hospital on time and taken to my room. All sparse but the TV was good. Not sure how many people have used the room as its all very new.

Mr Minhal Chatoo (Surgeon and specialist ) came in and spoke about the operation and highlighted the risks. This is expected as he covered risks in tibia under/over correction, risk of cutting a nerve and rehab time. The good news from what he said was movement on the Knee will be possible as the cuts will be below the knee. He was very reassuring as he drew an arrow on my leg

He left by saying that i am the second person on his list and that the anaesthetist will be round later. We sat until 10:20am and then was taken down to the operating theatre.

I remember an Australian lady and Joan Washington (Sister) taking me down on the lift; i made a comment about the disco lights in the lift (nervous energy!).

I was led into the operating theater and laid on the table. At this point another chap who was administering the drugs noted my DOB was incorrect – born in 1953? That was corrected quickly.

Once the anesthetist came back, he mentioned the drugs and an additional injection in my right thigh to aid the operation. We chatted and had a giggle for 10-15 minutes as their actions were completed. I noted the time was about 11:40am.

The operation was to cut below the shin on the right leg. A wedge 11mm wide would be cut out. A bone graft applied. The gap create in the leg will have metal strips screwed in to support the bone growth to correct my leg.

The drugs took action and i passed out

Coming round after surgery

I came around at about 1:30 and i was in agony – a sawed leg, 2 metal pins and bunch of screws added to my leg. 2 nurses were near by. They talked and administered drugs once they spoke to the anesthetist. I was left downstairs for a while. Once the pain was tolerable, they wheeled me back upstairs. I was glad to see Loiza in the room.I held her hand. I cannot remember if i fell asleep again but i guess it was on and off. They gave me oxygen and connected me to saline and heart rate monitor.

Mr Chatoo then called us to talk about the operation. He said the procedure was on plan and that he was satisfied. This was a relief. Loiza and I reflected and after  a while and then she left for home. I fell asleep again. I remember waking up as Joan was taking my Heart Rate when i complained that i wanted to vomit. I felt that i was losing consciousness and could feel my self sweating and my heart pounding. The Doctor lay me down and i could hear them telling me to keep my eyes open. I was struggling but they pulled me through. After laying flat, i felt much better. My blood pressure dropped due to a reaction of the drugs. At least that gave me something else to worry about rather than my leg.

The pain in my leg is prevalent but didn’t feel like it was sawed, had metal strips and screws put in. the air pumps/ cushion on both legs is helping my blood circulation. Dinner arrived and it was seabass with potatoes. It tasted dry but i finished it so quickly.

Loiza, Aroon and Priya arrived at 7:30ish..if felt like they had been gone for a long time. The  kids made me a card for “Brotato”.

Priya read her “grand designs” magazine with me and Aroon talked about his Physics lecture at school. He mentioned the speaker was very enthusiastic about her subject matter. We sat chatted and i just watched everyone -i was just happy to see them and didnt want them to leave.

Joan came by with her shift replacement and went over my case notes. A shame to see her go as she really looked after me as i came round. She was calm, direct and very precise,

Loiza and the kids left and i fell asleep again. Another nurse came in and administered pain killers. They kept the oxygen running. I was a little impatient on waiting for things but the nurses must be busy. Anyway things went as per plan anyway. Every 2 hours they came in and checked my vitals. The pain was bearable and was able to move my toes. I didnt want to risk moving any more than that.

The day before the Tibial Osteotomy

30th January 2018 (Day -1)

On 30th January 2018, I went into hospital (https://www.onehealthcare.co.uk/hatfield/) for my surgery.

Initially the Osteotomy surgery date was meant to be on 17th January but the surgeon had to push the time back as there was a risk of overrunning on a more complex surgery that was planned earlier in the day. For me, I had programmed my mind (at home and work) that surgery would be on a specific date so felt prepared. With that moving, it was tough trying to adjust and refocus on work but it had to be done.

Work for me this month was very manic; recruitment, interviews, dealing with sales staff in the corporate world is stressful. Also, with my manager being unable to take my workload, this didn’t help the stress levels. This actually helped me avoid thinking about the surgery.

So now i am sat at 6:30pm on Tuesday feeling a little numb. I’m not sure how to react other than to ‘go with the flow’ tomorrow.

In terms of the ‘what will i do after the surgery’ quandary, not too sure what that would entail. The thought of the surgeon drilling through my tibia, taking a 1.1cm width of bone out, drilling holes and adding metal plates is daunting. What will the pain be like after a few days? How will i go to the toilet, shower and dress myself. Also being stuck in the house with a wounded legs for a week or so is not riding well.

I’m not sure what Aroon or Priya are thinking. Aroon is wrapped up in his own things and Priya is busy being a girl. As long as they support Loiza, thats all goodness.

I’m going to go early to watch Priya at football practice and see how the day ends, Its NIL BY MOUTH 12 hours before the surgery and need to get to the Hospital by 7am.

A Quick note about me

Hello There!

I am Jayesh (“Jay”) Lad, married to Loiza Lad and we have 2 children, Aroon and Priya.

We live in a suburb just outside London, UK where we have joys of being very close to the countryside and 20 minutes away from London, one of the greatest cities in the world. We live an active lifestyle and enjoy spending time together as a family and with extended families.

Life is about staying healthy, bringing up the kids, paying the mortgage and going on holidays.

In 2018 I underwent a surgery called a Tibial Osteomety at the One Hatfield Hospital on my right leg. After a year of recovery I decided to blog on my recovery process with the aim of helping others who may be thinking of taking their journey, or like me, on their journey right now,

My background

I have always been active.  When I was young, I was a regular in the schools football and basketball teams from U11’s to U18’s. I also played for clubs outside of school. Training, playing and winning was the poison growing up. I also took on Kick Boxing and other martial arts outside of school and was very good at it. 

During University I kept up with Basketball but other sporting activities may have been replaced by going to pubs and clubs.

As I started work and changed jobs (from teacher to Trainer to IT consultant) my job entailed a lot of travelling by car and by air. 

post

I guess I was in my mid twenties when I noticed pain in my knees. If was was sat driving for over 2 hours (such as commuting to work), I would experience stiffness and then going for a jog after was something I did not do too often. I just lived with it.

In my 40’s I decided to take up Sprint Triathlons, Mini Marathons. I had to shift my weight (109kg when i am 1.82m) – this certainly takes its toll on recovery and ability. I know this did not help. In my mid 40’s i just had to stop as the pain from running was very specific and very painful. I had to make a change

 

Is the remedy an Athroscopic Debridement

I visited a local Physiotherapist in 2016/107 as  I found that running on a treadmill and even jogging was becoming painful and recovery was taking much longer. My plan to train for the summers Sprint Triathlons was on the balance.

I was refered to a private hospital in Enfield where the specialist reviewed my x-rays. He noted the rhumetism in my righht knee for my age (47 at the time) was severe and that I would need a knee replacement in a few years.

As an interim, he would carry out an Arthroscopic debridement procedure. In my own words, its a day case where the surgeon washed the debridement from within my knee and cavity and provide some resolution to the pain I was getting.

They say the recovery is quick…well not for me. I could’nt walk for weeks and underwent Physiotherapy for over 6 months to recover