Bee’s Knees: Pre-TKR, Setback

From the last post…1/24/2022

This post is officially done…for now. Next stop, Total Knee Replacement.

On 1/23/2023 I said:

“New, Approved-Dentist finished up everything he needed so I got Dental Clearance. This is the final piece of the clearance puzzles”

At the end of that appointment, Approved-Dentist gave me a prescription for an antibiotic, just in case.

Stupid me. I asked the intake nurse about that. She reported it to the surgeon who moved my surgery from 2/2/2023 to 3/9/2023. If someone else is rescheduled, I might be able to move mine back. Maybe.

Then, other test results came back – staph infection in my nose, maybe UTI.

Wednesday, 1/25/2023

So, I am still limping around, changing all the physical therapy appointments I’d set up for the 2/2 surgery. One of the positives is that I get more time in water aerobics building up my leg muscles.

A very positive:

1/27/23 was our 50-year anniversary. Amazing! We celebrated early with a cruise on the Wonder of the Seas. I’m still assembling those photos/posts but we went a little earlier in the month because it was cheaper 🙂 I chose this cruise because I thought it would be cool to be on the current world’s largest cruise ship. I have been on larger ships but DH has not.

We have another cruise scheduled for the Arctic Circle in July but I may not make it because of the new surgery date and recovery. I am very excited about that cruise because we tried to do something very similar and Covid changed those plans.

Someone pointed out that, since the new surgery is more than 30 days away, I may have to do all the clearances again.

Today, 1/28/23 is the 10th anniversary of the fall that started all this. My first post about my knee was really about Tom’s heart attack, and the reason for this blog in the first place. Who know that the knee thing would eclipse everything?

In that post I said:

Ice

Monday morning (for real!), I checked the weather and found that school was starting late because of icy conditions.  I put on boots and took the dog out.  It seemed to be raining – if it’s raining, it must be warm, right?  So I didn’t really pay attention (and I had other things on my mind!) and completely missed seeing the black ice.  Next thing I knew, I had fallen on one knee, my cellphone in my pocket bruised my other thigh and my left arm hurt where I’d reached out to catch myself.  Luckily, I hadn’t let go of the dog’s leash.

I ended up sitting in a puddle of icy water for a long time, figuring out how to get up.  I finally sort of crawled up the trash can that was sitting in the driveway.

The dog had an abbreviated walk, I changed my wet, cold clothes and headed to the hospital.  I was showing DH my knee and one of the staff bandaged it up for me.  I told him I hadn’t fallen at the hospital and wouldn’t sue but I guess he wanted to be sure.

(Today, Monday February 18 2013, my knee still has a huge lump under the skin and hurts when I touch it, although I’m no longer limping,  The bruise/pain from cellphone finally went away)

The very first of the Bee’s Knees series was February 28, 2016. I had no idea it would go on so very long. Like I said in the last post, I sure hope this is trus!

This post is (hopefully!) officially done…for now. Next stop, Total Knee Replacement.

Bee’s Knees: Pre-TKR, Part 2

From the last post…12/4/2022 And, there was good news and some surprising news. I got to the doctors office and right away they took x-rays. The results were “Evidence of end stage bilateral knee OA, L>R. Evidence of complete joint
space narrowing. Evidence of osteophyte formation. Evidence of cyst formation

I had no idea that my right knee was as bad. I guess I’ve been so focused on my left that it never occurred to me that I might have other issues.

The term “end stage” was a bit freaky. That sounds to me like I should be bedridden or something.

~~~

1/18/2023

Reject-Dentist still hasn’t sent the receipt, a treatment plan or called to discuss it yet. They did send me an email today asking me to set up an appointment.

Also on 1/18, I went to Reston Hospital for pre-op clearance. This was the third appointment this week, all because of my knee.

1/23/2023

New, Approved-Dentist finished up everything he needed so I got Dental Clearance. This is the final piece of the clearance puzzles

When I got home yesterday I had a new insurance card in the mail. I read all the information and it said I had dental insurance. Reject-Dentist had said that I didn’t so I assumed that I didn’t. Now I get to collect my papers from Approved-Dentist and submit those.

I was supposed to attend a class on knee replacement but the next one isn’t until next month so I got to watch a video instead. I also found this one very helpful:

This post is officially done…for now. Next stop, Total Knee Replacement.

Bee’s Knees: Pre-TKR

From the last post…12/4/2022 And, there was good news and some surprising news. I got to the doctors office and right away they took x-rays. The results were “Evidence of end stage bilateral knee OA, L>R. Evidence of complete joint
space narrowing. Evidence of osteophyte formation. Evidence of cyst formation

I had no idea that my right knee was as bad. I guess I’ve been so focused on my left that it never occurred to me that I might have other issues.

The term “end stage” was a bit freaky. That sounds to me like I should be bedridden or something.

~~~

12/17/2022

So, I’ve scheduled the surgery but i don’t have a specific time yet – I do have a date and a date for follow up and dates for physical therapy.

My dental clearance didn’t go well yesterday.

The new dentist never got my multi-page form and asked me for it in several emails and texts.  I had filled it out as soon as I made the appointment and emailed a copy which they never got. Fortunately, I printed it out.

The parking situation was bad, I hadn’t considered that it was a mall-type place and just before Christmas. After circling the buildings a few times, I had to park in a parking garage and walk. Remember, I’m doing this because of knee surgery.

I got to the building and…I was stuck in the elevator. I tried pushing any and all buttons but I never moved. Finally, I called the office and told them I was in the elevator and they sent someone out who pushed the button on the second floor and I started moving up.

The receptionist didn’t know who I was or why I was there but I had that 8-page printout of their form. I was surprised to see a bowl of candy canes on the main desk – really?

I finally went back and was (very slightly) calmed by the fact that the background music was Mannheim Steamroller.

I told the dental assistant what she would have known had they seen/read my form: I have been terrified of dentists since I was thrown out of one when I was a child (I’ll share more about this later), I have a very small mouth and a bad gag reflex.

She did the preliminary xrays and finally, the real dentist came in. She never looked at me but told my back that she wouldn’t approve me for surgery because there was a “lot of work she wanted to do first.”

I escaped to the front desk and the printer was broken. No receipt for my payment and no copy of a treatment plan. The person assured me that she would email them to me.

I was very leery of that elevator, so I took the stairs and walked back to my car.

Friday and Saturday and neither the treatment plan or the receipt for payment ever arrived.

I tried to log into their system to see if I could get the info that way and I’m not listed as a patient. It did ask me to fill out the forms…again.

Along about now, I decided that this wasn’t the dental practice for me so I found a new dentist, located way closer, on the first floor, in my old bank. I see him Monday. For a person terrified of the dentist seeing 2 in 2.5 days is amazing. I must really want to get my knee fixed!

On Saturday night, reject-dentist asked for a review. I’m waiting for new-dentist to be sure I’m not going back before I fill it out but I don’t think they’ll want to see what I have to say!

When getting dressed on Sunday morning, I found a small cut on my lip, possibly from Friday’s visit and then a filling fell out. Hmmm. Was she creating some of the work she wanted to do?

Monday, new dentist. I got to the new, closer dentist and they also had candy out in the waiting room. Also, they didn’t get my new patient forms and this is starting to look like a rerun.

They took me back and the receptionist was very kind and gentle and she listened to my bad dentist stories from long ago and last Friday.

More x-rays, the dentist came in and he talked to me, too. After the review and in-mouth checkup, he also wants to do a lot of work BUT he is working around my upcoming cruise and he thinks he can get this done so I can keep my surgery schedule. What a change from reject-dentist.

Unfortunately, that means I get a root canal and crown later today. But still. More after he actually does some work!

My TKR (total knee replacement) surgery is scheduled for 2/2, which is Groundhog Day. I’ve been telling people I hope it doesn’t mean I have to keep repeating my surgery! Now, it seems I keep repeating dental visits, too.

Later Monday, December 19, 2022 – the afternoon wasn’t as bad as I remembered partly because somehow, my root canal had closed up. The dentist said that was “good news and bad news” because I had saved myself from the full treatment today AND saved a bit of money – like $1000. I guess the bad news is if i ever get decay under my new crown, I won’t have any pain to let me know. Sounds like good news to me.

Interestingly, the beginning of the crown the muted tv was showing the same program as the tv at reject-dentist. Maybe there’s a Dental TV station?

My next dentist thing is “just” a cleaning on December 28 and a tentative permanent crown on January 3.

Hopefully, no more knee related issues until then.

Meanwhile, it’s Wednesday night and Reject-Dentist still hasn’t sent a treatment plan or called to discuss it yet.

This post is officially done…for now

Bee’s Knees and (Rose) Hips

Original Bee’s Knees  I have been dealing with this *stuff* for almost 11 years now. I was finally approved for Orthovisic and my first injection of 3 was on March 2, 2022.

Since April 2, 2022 it seems like things have gotten worse again.

Fortunately, I got back into a water exercise class, not at my “favorite pool” but it’s still good.

My knee has been waking me up again, though and it’s hard to walk. Since Sunday, October 30, 2022, I’ve had sciatica too – at least it’s on the same leg. I have a message in to my doctor. This pain is driving me nuts. I can’t sleep, I can’t stand, I can’t walk. I haven’t been to the pool or the hot tub in over a week.

I finally have an appointment tomorrow (11/30/2022) with a new orthopedic doctor. Hopefully, there will be good, or better, news after the doctor appointment.

Hopefully soon…

Bee’s Knees – The New Chapter Drags On!

Original Bee’s Knees  I have been dealing with this *stuff* for 10 years now. I was finally approved for Orthovisic and my first injection of 3 was on March 2, 2022.

Since April 2, 2022 it seems like things have gotten worse again.

Fortunately, I got back into a water exercise class, not at my “favorite pool” but it’s still good.

My knee has been waking me up again, though and it’s hard to walk. Since last Sunday, I’ve had sciatica too – at least it’s on the same leg. I have a message in to my doctor. This pain is driving me nuts. I can’t sleep, I can’t stand, I can’t walk. I haven’t been to the pool or the hot tub in over a week.

Hopefully, there will be good, or better, news after the doctor appointment.

I found an article that said in part “Also of note, the data did suggest that hyaluronic acid injections are not totally benign. With 15 trials (6,462 participants) reporting adverse events in sufficient detail, da Costa and colleagues calculated that the shots came with significantly elevated risk for serious complications (relative risk 1.49, 95% CI 1.12-1.98). “Overall, 3.7% of patients receiving viscosupplementation and 2.5% receiving placebo experienced a serious adverse event,” the researchers found.”

I don’t know if what I’m going through is a “serious adverse event” but it’s certainly serious and adverse to me!

———————

How it went from Wednesday, March 2, 2022 when I got my first Orthovisc injection through March 30 with my GP-type doctor.  He watched how I walked and determined that my knee is swollen all around and performed Arthrocentesis (knee drain).

He said “Visibly swollen with protuberance in posterior fossa. Not warm to touch. Ballotable patella.

See aspiration note below: lateral subpatellar approach enabled withdrawal of 5cc straw colored clear fluid. 40mg kenelog + 4cc lidocaine injected easily. Substantial pain relief afterward and gait improved.

Read that post here.


March 30 after I got home from the doctor. First thing, I sent a note to my piano students cancelling lessons for today, then took a short nap and posted my blog post.  There was still pain so about 7, I had some wine.  It’s been a long time but I hoped it dulls the pain some.

9:45, put on an ice pack we had in the freezer already

midnight, bedtime – trouble running to the toilet.

March 31. I slept until 6:30. Not much pain when I woke up.

Thursday March 31 – woke up and was able to stand without a lot of pain.  Slept 5 hours, 16 minutes or 66% of needed sleep time.

went into work – about 2 something suddenly felt painful so I put on the brace again.  I am here until 9 pm tonight.

About 6, my knee started hurting more – I had rehearsals at 7 and 7:30.  During the second rehearsal, there were tornado and thunderstorm warnings and my knee got a lot worse.  I was able to put my leg up on a chair.  When I got home at 9:30, I iced it some more.

Friday, April 1, woke up and was able to stand without a lot of pain.  Slept 6 hours, 4 minutes or 76% of needed time.  Today is a “day off” so I hope to nap this afternoon.

As of 11:30 am, no brace yet.

about 5:40 or so, my knee started hurting under the patella.  The bandage came off and the area is looking a little reddish (to me) but it’s hard to tell.  I did get a nap, so I’ve now slept 6 hours, 38 minutes or 83%.  The new gel ring came and is in the freezer for a little later tonight.

I tried the new gel ring – said it “rolled on” which was great.  Unfortunately, it also rolled off when standing up.

Saturday, April 2

Hopefully soon…

Bee’s Knees – A New Chapter Continues!

Original Bee’s Knees  I have been dealing with this *stuff* for 9 years now. I was finally approved for Orthovisic and my first injection of 3 was on March 2, 2022.

How it went from Wednesday, March 2, 2022 when I got my first Orthovisc injection through March 30 with my GP-type doctor.  He watched how I walked and determined that my knee is swollen all around and performed Arthrocentesis (knee drain).

He said “Visibly swollen with protuberance in posterior fossa. Not warm to touch. Ballotable patella.

See aspiration note below: lateral subpatellar approach enabled withdrawal of 5cc straw colored clear fluid. 40mg kenelog + 4cc lidocaine injected easily. Substantial pain relief afterward and gait improved.

Read that post here.


March 30 after I got home from the doctor. First thing, I sent a note to my piano students cancelling lessons for today, then took a short nap and posted my blog post.  There was still pain so about 7, I had some wine.  It’s been a long time but I hoped it dulls the pain some.

9:45, put on an ice pack we had in the freezer already

midnight, bedtime – trouble running to the toilet.

March 31. I slept until 6:30. Not much pain when I woke up.

Thursday March 31 – woke up and was able to stand without a lot of pain.  Slept 5 hours, 16 minutes or 66% of needed sleep time.

went into work – about 2 something suddenly felt painful so I put on the brace again.  I am here until 9 pm tonight.

About 6, my knee started hurting more – I had rehearsals at 7 and 7:30.  During the second rehearsal, there were tornado and thunderstorm warnings and my knee got a lot worse.  I was able to put my leg up on a chair.  When I got home at 9:30, I iced it some more.

Friday, April 1, woke up and was able to stand without a lot of pain.  Slept 6 hours, 4 minutes or 76% of needed time.  Today is a “day off” so I hope to nap this afternoon.

As of 11:30 am, no brace yet.

about 5:40 or so, my knee started hurting under the patella.  The bandage came off and the area is looking a little reddish (to me) but it’s hard to tell.  I did get a nap, so I’ve now slept 6 hours, 38 minutes or 83%.  The new gel ring came and is in the freezer for a little later tonight.

I tried the new gel ring – said it “rolled on” which was great.  Unfortunately, it also rolled off when standing up.

Saturday, April 2

Hopefully soon…

Bee’s Knees – A New Chapter Begins!

Original Bee’s Knees  I have been dealing with this *stuff* for 9 years now.

I was finally approved for Orthovisic and my first injection of 3 was on March 2.

I was so excited when I started this post. Little did I know. Here’s how it’s been so far:

Wednesday, March 2, 2022 I got my first Orthovisc injection.

By Thursday, March 3 my knee was 90% better

On Wednesday March 9, I had injection 2

On the 10th, knee is still better

March 11 slept 91%, no knee pillow. good night’s sleep finally

March 12 woke up with sharp knee pain – screamed

March 13 – maybe that it was 21 degrees out affected things, maybe not.  Knee hurt a little all day.

Somehow, the pain feels different than before the injections. It feels like it could be the back of my leg – maybe I tore my muscle after I felt so good after Shot#!.

March 15, Stepped out of bed sharp pain

March 16, Injection 3, final.  It felt like needle moved in my knee

And from there things go

I started having pain standing/walking again and using a pillow between my knees at night.  Many nights I took 3 Tylenol just to see if I could get some sleep

March 26, I stood up from bed, fell backwards back down. Luckily, the bed was there.

March 29, The pain was excruciating so I 3 tylenol before bed and ordered a gel band from amazon. It freezes so I can ice my knee all around. I also did some reading about pain after OrthoVisc and some sites mentioned fluid on the knee or fluid behind the knee (Baker’s Cyst). I tried to look at my knees in the mirror without much success but my DH looked and he thought my left knee, the one in question, looked bigger than the right.

March 30 – today! – I got up this morning and I could barely walk. I went on amazon again and ordered a 3-wheel walker. I tried to make an appointment with the doctor who did the OrthoVisc but he wasn’t available until April 28.

Luckily, I was able to make an appointment for today with my GP-type doctor.  He watched how I walked and determined that my knee is swollen all around.

He said “Visibly swollen with protuberance in posterior fossa. Not warm to touch. Ballotable patella.

See aspiration note below: lateral subpatellar approach enabled withdrawal of 5cc straw colored clear fluid. 40mg kenelog + 4cc lidocaine injected easily. Substantial pain relief afterward and gait improved

He drained my knee (Arthrocentesis) some but couldn’t get a lot of the fluid out. Actually, looking at the numbers, he took out about equal numbers with the lidocaine and cortisone he injected  I suggested he install a faucet to help me keep this draining. He was hoping that it might continue to drain into the thick bandage he put on.

In his after-care notes he said “I hope that this injection and ice allow the swelling in you knee to go down. If the pain resumes along with swelling, I suggest taking the oral prednisone. Regardless, please get in touch with Dr. X (Orthovisc injector). Let me know if you have increased pain, redness, warmth, or fever.

Oh joy!

I came home and was able to take a nap, at least. Unfortunately, I had to cancel piano students to do so. My knee is still uncomfortable and I’m having trouble walking but I think the injection and the Arthrocentesis help in the coming days.

I really don’t want to do this knee draining thing often. Even with the lidocaine, it was painful. Not the worst pain I have ever had but nothing I’d sign up for fun. My worst-ever pain day was April 28, 2006. That day was the day I learned I had Kidney Cancer, which became the reason I can only take Tylenol for my pain. My endo will be unhappy if I take that Prednisone and he is always unhappy when I get cortisone in my knee.

Hopefully soon…

Bee’s Knees – Bad Knews

And here, I’ve been worried about a Cushing’s recurrence instead of knee pain relief.

 

Joint Injections: Are They Worth the Risk?

Adverse outcomes hastening joint replacement have raised concerns

  • by Nancy Walsh, Senior Staff Writer, MedPage Today

Intra-articular injections of corticosteroids for relief of the pain of hip or knee osteoarthritis (OA) may have adverse long-term consequences, researchers suggested.

These injections are commonly performed and have been “conditionally” recommended by the American College of Rheumatology and “should be considered,” according to the Osteoarthritis Research Society International. The American Academy of Orthopedic Surgeons, however, has advised clinicians to be on the lookout for emerging evidence for or against the use of intra-articular injections in the knee, explained Ali Guermazi, MD, PhD, of Boston University School of Medicine, and colleagues.

However, a review of the outcomes following 459 injection procedures performed during 2018 in a single center now has identified four potential adverse events that should raise concerns, particularly for certain patients:

  • Accelerated OA progression, reported in 6% of patients
  • Subchondral insufficiency fractures, seen in 0.9%
  • Complications of osteonecrosis, in 0.7%
  • Rapid joint destruction including bone loss, also in 0.7% of patients

These findings were published in Radiology.

The Background

Cochrane meta-analysis evaluated 27 trials that included more than 1,767 patients found moderate improvements in pain and slight benefits for physical function following intra-articular corticosteroid injections for knee OA. However, the review noted that the quality of evidence was low, concluding that the results were inconclusive.

“Whether there are clinically important benefits of intra-articular corticosteroids after 1 to 6 weeks remains unclear in view of the overall quality of the evidence, considerable heterogeneity between trials, and evidence of small-study effects,” the Cochrane reviewers wrote.

In an editorial accompanying the Boston University report, Richard Kijowski, MD, of the University of Wisconsin in Madison, wrote, “The use of intra-articular corticosteroid injection to treat OA remains commonplace in clinical practice despite the lack of strong evidence supporting its efficacy.”

In vitro and animal research has revealed that corticosteroids actually can have negative effects on cartilage. “The action by which corticosteroids are chondrotoxic is complex, but it seems to affect cartilage proteins (especially aggrecan, type II collagen, and proteoglycan) by mediating protein production and breakdown,” Guermazi and colleagues explained.

Moreover, the local anesthetics often combined with the steroids also have been linked with chondrolysis.

And a recent retrospective study of 70 patients with hip OA found that 44% of patients who were given injections of triamcinolone with ropivacaine had radiographic progression and 17% experienced collapse of the articular surface.

“Thus, there is a growing body of evidence to suggest that intra-articular corticosteroid injection can accelerate the progression of joint degeneration,” Kijowski observed.

The Events

The injection protocol used at Boston University involved 40 mg triamcinolone, 2 mL of 1% lidocaine, and 2 mL of 0.25% bupivacaine.

Accelerated OA progression, characterized by rapid loss of radiographic joint space, was first observed in trials of nerve growth inhibitors, wherein some patients required joint replacement earlier than had been expected. Some experts have suggested that a loss of joint space exceeding 2 mm within a year can be considered accelerated progression, which can be accompanied by effusions, synovitis, and local soft tissue changes.

This accelerated OA progression was seen in 26 patients, following hip injections in 21 patients and knee injections in five.

Subchondral insufficiency fractures were the second type of adverse outcome observed, and were seen in four patients undergoing intra-articular hip injections. This event was previously thought to occur in elderly patients with osteopenia, but has now been reported in younger, active patients who present with acute pain but no apparent trauma.

The affected area often is weight-bearing and may involve loss of cartilage and meniscal tearing. Radiographic findings can be normal or subtle, while on magnetic resonance imaging (MRI) subchondral hypointensity may be detected. If the condition is identified early, before articular collapse has occurred, healing can occur, but once the articular surface has collapsed, the joint must be replaced.

Early identification of subchondral insufficiency fractures also is crucial before intra-articular injections, because the steroid may interfere with resolution of the fracture. Moreover, if an injection is performed and results in pain alleviation, the patient may increase weight-bearing and worsen the insufficiency fracture, hastening collapse.

The third type of event the researchers identified involved complications of osteonecrosis, which typically present with insidious onset of pain or can be asymptomatic. MRI is required for the diagnosis, and can help predict collapse by the extent of osteonecrosis and bone marrow edema. Once collapse has occurred, the only option is joint replacement.

The fourth adverse outcome, rapid joint destruction including bone loss (also referred to as rapidly progressive OA type 2), occurred in two patients with hip injections and one following a knee injection. Some previous authors likened this event to accelerated osteonecrosis, and others have hypothesized that the joint destruction results from undiagnosed subchondral insufficiency fractures.

The Advice

There are currently no recommendations regarding imaging before performing an intra-articular corticosteroid injection, and in some cases, findings may be subtle. “However, given the relative ease of performance and the low cost of radiography, there should be a low threshold to obtain radiographs before performing an intra-articular corticosteroid injection, as the intervention may affect the disease course (i.e., it may result in accelerated progression),” Guermazi and colleagues wrote.

Of particular concern are patients who have no apparent OA or very mild changes on radiographs who have been referred for injections because of pain. In these cases, the indication for injection should be “closely scrutinized,” as destructive or rapidly progressive joint space loss tends to develop in patients with severe pain but minimal structural change on radiographs.

“Clinicians should consider obtaining a repeat radiograph before each subsequent intra-articular injection to evaluate for progressive narrowing of the joint space and any interval changes in the articular surface that can indicate subchondral insufficiency fracture or type 1 or 2 rapidly progressive OA,” the authors advised.

“We believe that certain patient characteristics, including but not limited to acute change in pain not explained by using radiography and no or only mild OA at radiography, should lead to careful reconsideration of a planned intra-articular corticosteroid injection,” the authors concluded, adding that MRI may be helpful in these circumstances.

“Patients might be more than willing to take the small risk of an adverse joint event requiring eventual joint replacement for the possibility of at least some degree of pain relief after intra-articular corticosteroid injection,” wrote Kijowski.

“However, patients have the right to make this decision for themselves,” he stated.

From https://www.medpagetoday.com/rheumatology/arthritis/82753

Issues of Aging

Once again, I’ve changed the focus of this blog.  This time to the issues and problems that come with aging.

In January 2018, I managed to do something painful to my thumb.  I finally couldn’t take it anymore and went to the ER on February 1.  They did x-rays and sent me away with a spica splint (I thought they were calling it a thumb spike), a diagnosis of deteriorating thumb joint plus tendonitis, and a referral to an orthopedic doctor.

Here it is the end of March and I still haven’t been able to get to that new doctor.  Maybe soon?


February 6, 2018 we were still living at the Residence Inn due to water damage at our home on November 6, 2017 (more on that in another blog, someday).  My mom and I were coming back from WalMart and she fell in the parking lot.  Luckily, DH was still in our apartment and he came right down.  He couldn’t get her to stand up, so I drove the car over to her.  Although she didn’t want to go, we took her to the emergency room.

They did lots of scans there.  The first determined that she’d broken her pelvis in 2 places.  Thankfully, they don’t do surgery for a broken pelvis.  They thought that they would send her to Mount Vernon Hospital for intensive rehab.

Her white blood count was high, so they assumed infection and started 2 IV meds for that.  Her blood pressure dropped very low several times, causing her to pass out.

A chest x-ray was clear, so no infection there.  Because of the passing out episodes, they sent her for a head scan in case there had been a stroke.  Nope.

About 1 am on the 7th, a hospitalist came in to admit her.  He asked if she had abdominal pain and she said yes.  So, he started palpating various areas and found a tender spot.  He called for an abdominal scan, which showed internal bleeding.  So, the WBC wasn’t from infection but massive blood loss.

They called an ambulance and sent her to Fairfax Hospital for emergency surgery to stop the bleeding.

At Fairfax, they did a new scan with contrast – missed that she was allergic to that – and found that the bleeding was stopping all by itself.  Then, they gave her Benadryl.

She stayed there for 3 nights because Medicare required 3 midnights before going to rehab.  <Sheesh!>

From there, she went to Manor Care for rehab.  She no longer qualified for Mount Vernon.

She was doing really well…until she started having internal bleeding.  Back to Fair Oaks.  Same room.  AARRGGHH!  She was admitted for a few days to stop the bleeding and turned out to have an ulcer.  Then, edema.

Finally, she came home and is doing really well with a walker.  The pelvis is supposed to heal itself in a couple months.


 

 

 

Bee’s Knees, Continued

bees-knees

 

My left knee is still bothering me, even after doing Physical Therapy since January. <sigh>
It seems to get better, then something happens and it’s back to pain again.  When we were on a trip to New York a month ago, we walked a lot and climbed so many stairs, I had to buy a new brace.
Today is supposed to be my final PT but I don’t think I’m ready.
When this clinical trial came to my email, I just went through the whole survey for this but there was no doctor nearby:
 
Osteoarthritis Research Studies. Knee and hip arthritis studies enrolling now. No-cost medication. http://curec.lk/1VL5hu9
 
We’ll see what the next step is (so to speak!)
Someday…
no-pain