Saturday, July 28, 2018

July 28 – “The Dreaded Monster Needle”


OK.  Time for today’s edition of the knee report, featuring this week’s star attraction, My Left Knee.

We headed into Texas for our visit with the orthopedic doctor yesterday.  Very nice clinic building.  I can see why they want to work out of a nice new facility instead of the renovated shopping mall in Galveston.  We barely had time to sit down before they were calling me back into a room.  All the preliminaries done – weight, vital signs and the like – they dropped us off in an exam room and told us to wait there.  Again, the door opened sooner than expected. 

Of course the one who next entered was not the doctor with whom I had an appointment.  How could I tell?  He was a guy.  My doc was supposed to be a lady named Kelly.  You don’t easily forget someone with such an elegant name.  This guy’s name was … I don’t remember.  Oh, he was a doctor all right, but UTMB is, after all, a teaching hospital, even at their Texas extensions.  So I told him all the gory details of my knee’s run-in with the collapsing chair.  He asked if we had actually seen the x-rays yet, and since we had not he pulled them up on the computer.  That’s when he got a somewhat adversarial look about him and asked, “So what do you know so far?”  I explained what I had been told up to that point, and he then responded, “Well, we just wanted to know what you have already been told before we tell you what we think it is.”  Hmm.  I’m not sure where he was going with that line of thinking, but it certainly didn’t inspire a load of confidence.  But he’s just the student …

Finally the doctor named Kelly arrived.  Now she did inspire confidence.  Chris and I both took to her right away.  She took her time with us, did a thorough inspection of my knee, and then gave us plenty of opportunity to ask questions.  So what was her analysis of the situation?  Well, on the one hand it was good news, but on the other …
So the good news.  In spite of the chair episode, no ligaments or tendons were damaged.  So right off the bat, surgery was pretty much off the table. 
On to the rest of the news.  There is obvious and pretty severe arthritis on the inside of the knee.  Bone on bone severe.  Apparently the chair event didn’t cause an injury, it just “woke up” what was already lurking.  The arthritis not as bad on the outside, but that matches up with the symptoms I have been having.  She said we could do an MRI, and it would probably also show a meniscus tear, but that would be the natural result of the severe arthritis, and there would be nothing that we could really do about it. 

I’m sure Chris wanted to hear all the gory details, but I was ready to jump ahead to “what can we do about it?”  Dr. Kelly (that’s her first name, by the way) very carefully laid out the course of action …
1. Anti-inflammatories – Done.
2. Physical Therapy and restriction of activity.  She also mentioned a particular brace that could be fitted to my knee that apparently worked well for her brother (except that he never wears it).  It is extremely expensive, however.  I voted that we wait until August to talk about that one.  That’s when Medicare kicks in. – So … Done.
3. Steroid injections directly into the knee (These can be done every 3 months).  Sometimes they work like a charm and you can be pain-free for months.  Other times it doesn’t work at all. 
4. Injection of some substance with the word “acid” in its name that recoats the bone heads like cartilage
5. Knee replacement.  She asked if we wanted to hear the details on this one.  Chris said, “Sure.  We don’t want to do that right away, but we want to hear the details.”  Sounded fascinating and even a bit encouraging, but … not today. 

We opted for the steroid injection.  Chris had already done her homework, so she knew what to expect.  I just knew what Dr. Kelly said as she left the room.  “The nurse will be in with a tray in just a moment, and I’ll be back.  Don’t look at the needle.”  Ah, the dreaded monster needle.  I’ve heard about that one.  “As thick as a pencil eraser and as long as your arm.  Hurts like crazy going in.  Gets even worse once they get in there and start moving it around to find the ‘sweet spot.’” 

It wasn’t nearly as bad as all that.  Oh, it was pretty long as needles go, but the doc sprayed some super-ice stuff on my knee first, so I didn’t feel it going in at all.  Now there was more of the steroid substance than I expected.  That seemed to take forever to make its way in.  And the subsequent pressure from it filling in space was definitely uncomfortable.  But she got it all in and told me to breathe again, so I guess I did OK.  She made an appointment for three months out just in case I needed another injection, and sent me on my way. 

We stopped for lunch and even made a jaunt around Hobby Lobby, and it didn’t really feel any different.  No instant magic, I supposed.  I crashed in my chair when we got home, exhausted and disappointed at the absence of instant gratification.  Things were some different as the evening progressed, however.  I really could tell a difference in the pain.  The weird rolling or clicking behind my kneecap was still there, but all the residual tightening and pain around it was … gone.  I went to bed guardedly optimistic. 

Psalms 86:16 says, “Turn to me and have mercy on me; grant your strength to your servant and save the son of your maidservant.”

Father, thank you for all the options for pain relief.  Thanks as well for all the prayers that have been offered up for me.  Hear them.  Amen.

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