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Monday, September 16, 2013

Knee Problems

In my last post, I mentioned the sudden onset of a problem with my right knee for no reason at all.  So I had X-rays and an MRI done, and last week I got the results.  The good news was that all the ligaments are intact.  The bad news was that almost everything else sucks.
Knee X-ray showing severe arthritis

The findings were that I have maceration and tears in the medial (inner) miniscus that go from back to front, a possible tear in the lateral (outer) miniscus, joint effusion (aka water on the knee), Baker's cyst and a loose cartilage body behind the knee, and severe osteoarthritis in all 3 joints, with the most serious being chondromalacia (similar to runner's knee).  This latter condition is apparent in the attached X-ray picture, which shows that I have almost no cartilage between my knee cap and femur.  Normally, there should be about a centimeter of spacing there.  Now the bones are practically rubbing together.  Creak!

Looking at these findings, I was wondering how I could walk at all!  Shouldn't I be in a wheel chair?  Surprisingly, however, I've been pretty mobile.  I have some pain, mostly going up and down stairs, but especially after walking for a round of golf (I refuse to rent a cart!).  However, the pain has been tolerable, and I haven't bothered to take any pain relievers for it.

I was kind of disappointed that this happened, because I had been harboring secret thoughts about trying to get in shape to run in a 5K event some time next year in a cancer fund raiser for Multiple Myeloma or Dana Farber.  I had started combining walking with jogging on the treadmill at the gym early in the summer, but I kind of dropped out of the gym over the last couple of months.  I was planning to try to get back in shape again once fall rolled around, but ironically, this happened out of the blue, without my putting any stress at all on the knee.  Go figure.

Today I met with my osteopathic surgeon, Dr. Mattheos.  He was great at treating me after I fell off the ladder last year, although it hurt like hell when he yanked my dislocated finger back into place.  Grrrr!  But I have forgiven him for that.  He seemed a little surprised that I wasn't in more pain than I was.  My knee actually feels pretty good, with most of the pain on the inner side where the main meniscus tear is.  He explained that he could do arthroscopic surgery to repair the tear, but that could actually make things worse, which was his way of telling me that my knee is pretty fucked up.  The main problem is my arthritis, and cartilage repair surgery might actually exacerbate that.

The upshot is that he recommended a cortisone shot to reduce the swelling and let the cartilage try to heal naturally.  So that's what I got.  Who knows if that will work, but it feels pretty good right now.  I also got a prescription for some PT, which I may or may not use.  I have a follow-up visit in 4 weeks to see how it's progressing.  He thinks it is possible that I could get back to normal activity.  Who knows?  There might be a 5K run in my future yet.  But I don't think I will try running anytime soon.

Friday, September 6, 2013

One of Those Days

Today is one of those days.

Last week I suddenly had a pain in my right knee while just walking around the house, so I went to the doctor.  He sent me to have an x-ray and MRI, which I went to the local hospital for on Tuesday.  In the meantime, I have been hobbling around with a knee bandage for the last week.  I played 9 holes of golf yesterday walking (I'm too proud and cheap to take a cart), so the knee didn't feel so good today.  This morning,  my doctor's office called to report that I have a cartilage tear in my miniscus.  Great!  So I have scheduled an appointment with an orthopedic surgeon to see what happens next.  That started my day.

My meds had run out, so I checked with Express Scripts this morning and was told I couldn't get them until October.  So I called my doctor's office and had an emergency supply sent to the local pharmacy to last me for a while.  When I went to pick them up, I had a flat tire in the parking lot.  While trying to change the tire, the lock nut was on so tight that I broke it trying to get it off.  So I called AAA (not AA), who came about 45 minutes later, and he couldn't get it off either.  So he put enough air in the tire for me to get to the local Midas, where they had to force it off with an air hammer.  By then, I realized that I needed new tires, so they put on the spare and I drove to New Hampshire to buy new tires.  But in my brute strength (yeah right!) to try to force off the lock nut, I had also broken the key to the lock nut, so they had to also forcibly remove and destroy all the other lock nuts before installing my new tires.  No more lock nuts.  If anyone wants to steal my tires, just come and get them!  After about two hours and a thousand dollars later, I was finally back on the road.  That was fun.

When I finally got home about 6:30 after my odyssey adventure to pick up my emergency prescription, Gretchen informed me that they had actually been delivered by Express Scripts last week, but she had put them aside thinking that they were hers.  Oops.  Some days are like this.  Today is one of those days.  You just have to laugh about it.

I have been very lazy about updating this blog.  I should have updated this days ago, but I wasn't feeling very creative.  I went to the Farber on Monday for my monthly checkup, and things are still good.  I didn't want to put up a blog post just saying that everything was still fine.  Yawn.

Anyway, positive changes include my white blood cell count up significantly to 4.7, and my RBC, HCT, and Hgb have all increased, indicating that my anemia is alleviating somewhat.  The only negative number is my bilirubin, which jumped to 1.7 (normal is less than 1.2).  This can be indicative of potential liver problems.  Hmmm.  I wonder if that might have anything to do with the prodigious amount of wine that I consumed during our baccanalian Labor Day weekend bash.  I'm not sure I remember all of it, but we had a great time!  Oh yes, and don't tell Dr. R.