Tuesday, September 17, 2013

Why They Call It Practicing Medicine Instead of Doing Medicine

Sometimes the internet is a scary place to be. I got the radiologist's report on the x-rays and ultrasounds I had done last week. At first I thought "AWESOME! My knee is taking me on vacation to Mexico!" Cuz, you know, what else do you think of when you see the word 'baja?' Mexico, right? Sun, surf, tequila! But not when it's preceded by the word patella. Who knew baja was a medical term? And a not so good one at that. And that's where the internet comes in. You know how as soon as you start getting some weird symptom and you go on the internet to self-diagnose? Yes, you do. You KNOW you do it! And whatever you think you have, the cure is ALWAYS worse than the 'disease.' Well, I haven't been to see the specialist yet. I see him on Thursday. The one who specializes in "complex knee reconstruction." But if everything, and I mean EVERYTHING, I've seen on the internet is true, then I can only believe that what the 'regular' orthopedic surgeon told me the other day is true. More surgery. That's the bad news. The good news is, Finally, an answer to the excruciating pain I've been having!

My previous surgeon kept telling me to "give it time. It could take a year or more for it to heal." A year later, "just give it some more time and keep working at it." Yeah, easy for HIM to say.

 Nearly two years now, and it's been getting worse, not better. To the point even I can't take it any more. And I think I've proven over the years that I can take boatloads of pain. So I finally went to see a different surgeon.  My old surgeon and the physical therapists kept telling me my quadriceps had healed and was working fine. "It's 'firing' when you flex it, so it's healed." I just needed to rehab more. (The surgeon had needed to cut through the quad to replace the knee joint [for the third time, after two infections].) All I knew was that I'd been working on it every day and still it hurt like hell. Even worse, sometimes. And I figured I had given it enough time to heal, and rehab was NOT getting me anywhere. No matter how hard I tried, I could not straighten my leg. I had NO extension ability. You know that exercise where you're sitting with your legs bent and you lift them up straight? Yeah, I can't do that with my left leg. According to the doctor who did the surgeries, it should have been happening. After each visit I'd leave even more dejected and depressed. And frustrated. Actually, frustrated doesn't even begin to cover it. Plus, sometimes I could barely walk.

The pain management doctor didn't want me taking pain meds. He thought I should go through the Chronic Pain Rehab Program again. I quit going to the psychologist because each week was just a repeat of the week before, and she agreed I should try Pain Rehab again. Personally, not only could I not see the point in it since I knew it doesn't get rid of the pain, just teaches you how to deal better while you lived with it, I knew how painful the program itself would be, the way the treatment areas were set up and all the walking and constant sitting involved. So that was not an option worth considering, as far as I was concerned. Thus when I went in for my physical last week and the doctor asked why I was in such a funk, and I told her, she gave me a referral to a different surgeon, and her scheduler was able to get me an appointment that week! After looking at my X-rays he ordered an ultrasound, which they were able to do same day. And that's how I got an answer to my prayers. Not the answer I'd hoped for, really. Not the optimal answer. But one I could live with, if it meant ending the pain and allowing me to walk around again like a real person! And one that didn't make me feel like a failure or that it was my own lack of effort that was causing the problem! I'm NOT a whiner! Or a weenie! There really IS a reason why my thigh was (is) killing me!  Apparently your quadriceps and patella tendons need to be intact in order for the leg to work right, and without what feels like a knife attack with every step. Or at least what I imagine a knife attack would feel like, never having actually been stabbed before.  But since stabbing is one of the descriptors they use on the pain chart, yeah, that's what it feels like. And speaking of those pain charts, sometimes a ten does n't cut it ( no pun intended.) And the chart with the faces? They need a face that looks like the shower scene in Psycho. That would perfectly describe the stabbing pain. Eeeee! Eeeee! Eeeee!

So, hey, back to the doctor's office. That lack of range of motion? NOT my fault! It's NOT a lack of effort! It is, literally, physically impossible for me to do leg extensions! Or to walk without pain! All this time I've been walking around on torn muscles. One of which is supposed to be one of the strongest muscles in your body. And not only that, apparently the knee replacement joint, the rod part that fits inside the femur, has loosened. Which adds to the pain. So, yeah. That's why I've missed so much and why I've been kinda cranky sometimes.
The surgeon I saw the other day has recommended that I go see the specialist surgeon. And once again, by having his office make the appointment, I was able to get in to be seen within a week. I LOVE the Cleveland Clinic! Well, as much as one can love a health care system. And okay, It may sound weird for somebody to be looking forward to surgery. But if surgery is what it takes to fix this, and according to what the surgeon told me and everything I've read about it, it's the ONLY way to fix it, bring it on! I'm just sorry I waited this long to switch surgeons. If I could do it without falling over, I'd be kicking myself! I could have saved myself a lot of aggravation and pain. And I could have been out living my life and enjoying myself instead of having daily pity parties. 
Unfortunately, my timing sucks, if my research is right. Of course I won't know for sure until everything is fixed, and I'll have a better idea after seeing the specialist, but it looks like surgical repair and 4-6 weeks of immobilization followed by 6-8 weeks of partial weight bearing, which means crutches. So figure a minimum of eight weeks on crutches. That pretty much rules out traveling to Maine in early November. Which means missing ANOTHER family get-together. Well, half the family, anyway, since it's women's weekend. But I was really, REALLY looking forward to the weekend, which is always a blast! So, once again I have to console myself with "There's always next year!" I think I can live with that.
UPDATE: Went to see the newest surgeon. So the spaces around the knee replacement implant (hardware) are too large for repair; there's not enough bone left. And those spaces are filled with infection. This specialist feels the problem is outside the scope of what he normally deals with and so has referred me to his partner, who is even more specialized. Still trying to get that appointment but have a follow-up this week to discuss plans for course of antibiotics after surgeon consults with infectious disease specialist. Here we go again!