Wednesday, October 7, 2009

Why I now wear a knee brace - A Cautionary Tale

I now have a knee brace, courtesy of my doctor. I am a size medium in knee braces, which will be useful to know in case someone decides to buy me medical accessories for Christmas. I don't know why they would, but anyhow.
When Kittyboy came home, he had to be held at a goofy angle for bottlefeeding, and so to keep him at the right angle, he got fed propped on my crossed legs, and I spent a lot of my day on the floor sitting crosslegged. Up and down and up and down. Not that great for knees. One day I bent down from the changing table, screamed, and thought I wasn't going to be able to get back up. My left knee was in agony. My first thought was "No, this is really bad, I just blew out my knee." I did get back up, and of course I kept going, because I had an infant and a husband at work and had no choice, and by the time Husband came home, I thought the worst was over. And my knee did slowly get better, though it was stiff while it healed. But when it still hurt a month later, I went to our public aid doctor, because we had only public aid for insurance, and explained that I'd damaged my knee a month before, and though it was moving well again, it still hurt along the sides like it wasn't healing up well. She said it was arthritis. I said no, it isn't, it felt as if I'd torn something, and Tylenol doesn't do jack squat. She said to try other over-the-counter stuff. I went to Walmart, bought one bottle of everything generic, tried them all one after the other, and went back later to say, "They don't work completely, and I still say it's not arthritis." She said again that it WAS arthritis, and prescribed me Tramadol. That is a very powerful don't-mess-with-it painkiller. It's an opiate. I took one - my knee didn't hurt, for the first time in over a month. I was happy, I was so happy. My gosh, I could sleep pain-free again. Then I started noticing some balance problems while taking it (at the minimum dose of one a day). Basically, I got more and more sensitive to it, until I bought a knee brace and decided I was only taking it if I really, really could not stand the pain. I told myself, I've got a high pain tolerance, this stuff is scary, I have to do this. Then one day I just had to, I couldn't even sit comfortably, and an hour after taking it, I had the feeling of bugs in my skin. I was shaking. I had the symptoms of a heroin addict. I couldn't sleep. It took 24 hours before the "bugs" went away, and that was scary enough to make me not take it ever again no matter what, because obviously it and I were not compatible. Mind you, my knee didn't just hurt when I was moving it, it hurt at night when it was still. Our friend Carel and his brother were over that night, so I asked THREE football players (Husband played in high school) what they thought of what had happened with my knee, and all three said yes, it's a sports injury, everything I described was consistent with that, the doctor was an idiot.
And then we got insurance (nine months after the injury), we changed doctors as fast as humanly possible, and Dr. B said I'd ruptured a bursa (yes! I was right!), and a week of anti-inflammatories made everything better. Problem solved.
Since then, every so often, I'll step wrong and put my knee out again - feels a little like the joint's going to bend in a way it shouldn't, hurts like the dickens, and then it continues to hurt for a couple days. After all that time that I kept using it until we got insurance, I figured there was no point in going back to the doctor, my knee is just as healed as it will ever get and I just have to put up with it.
So I put it out again Monday night, got up Tuesday morning, and thought it was better until I got out of bed and bent to pick up my jeans. THAT hurt. I went to our wonderful Dr. Hendricks at last, because I'm just tired of it and I can't keep up with a toddler this way. I was explaining the whole loooooong story to the nurse, said, "I went the first time, said I had a joint injury that didn't seem to be healing right, the doctor said it was arthritis and to try different OTC stuff, I went home and tried one of everything, went back and said nothing worked and 'by the way, I still say it's not arthritis,' and the doctor said, 'well I still think it is!' and gave me a prescription for Tramadol," and at that the nurse's eyebrows went up, and up, and up. I liked that expression. So writing a scrip for a powerful painkiller is indeed NOT typically the first thing you do when something hurts. I'm thinking you usually try to figure out WHY.
Dr. Hendricks' first question was whether ANYONE had thought to x-ray it, the answer to which is no. Dr. B diagnosed based on my description of what happened and the stiffness when it was healing, i.e. exactly what I told the first lady who swore it was arthritis, except the medicine he gave me worked, which is how we know he and I were right. But no, no one's x-rayed, so Dr. H ordered x-rays to see if there had been any skeletal damage. There hasn't been, which is really good to know - the knee's not growing any spurs or looking ground down, it really is JUST the bursa being re-aggravated.
And now we know that when this happens, I should wear a knee brace for a couple weeks, rest the joint as much as possible, elevate when possible, take anti-inflammatories, and let it heal again. With arthritis you do exactly the opposite, since there you want to keep the joint moving so it doesn't freeze up. This is why you should make very sure what the injury IS when a joint hurts, because if it's one and you treat for the other, you WILL make it worse, either way, guaranteed. Taking pain relievers to keep moving was the worst thing I could have done.
If I'd gone immediately and gotten treated for the right thing immediately, it could have healed completely and this wouldn't be an ongoing chronic thing. It also might not have - the initial damage felt pretty significant - but at least it would have had a chance. Yesterday I told Husband, who was REALLY upset with the first doctor, that it's truly both our faults, because I KNEW she was wrong, and I should have either kept harping until I got somewhere, OR said, "You know what, she may be clueless, but I do know what happened, I'll just ask around on my own and find out what to do for a sports-type injury." I didn't even do THAT, I just ignored it. I could also have tried to change doctors at the clinic. What I should NOT have done is sat down and shut up after the second appointment.
I now realize that telling myself "Well, as long as my knee doesn't hurt, whatever..." is the same thing as saying, "If I don't open the overdue bills, they'll just go away."
But my knee IS feeling better faster with the brace during the day and the Lodine, and a lesson has been learned!


Pres. Kathy said...

I am glad that you finally figured everything out. I can imagine how hard it was with your little guy. I was having issues with my hands when Niko was born and the doctors said it was common. I have had these pains before and after Niko. The doctor says that I have a caral tunnel (sp?) and if I wear a brace when it hurts it will go away. So when I do a lot of things with my hands, more than usual, I hurt more and wear my brace. I guess this is another things to learn patience!

Mimi said...

Prayers for you knee.

And, writing down - size medium in knee braces...