Bee’s Knees

bees-knees

 

No, I don’t think bees have knees but I do – and one of them was hurting a lot.  Mine started, I think, the day after DH’s heart attack – January 28, 2013.

Fast forward to January 2016.

I fell in the bathroom in the middle of the night and hit my left knee on the tub. I used a brace for a few days and it seemed better.

Around January 27-28, I was in Walmart and had to get a produce bag that was way over my head.  I had to stand on tiptoe…and my knee felt like something ripped.  Thankfully, I had a cart available to use as a temporary crutch.

Got home, used the brace, took Tylenol but the pain got worse.

Thursday, I drove home from choir at church.  My car is a manual so the act of using the clutch, extending my foot that way, made everything worse again.

Friday, we went to the Limp-In Clinic in Greenbriar.   That doctor was going to prescribe Cortef or NSAIDs but I couldn’t take either due to my history of Cushing’s (Cortef) and kidney cancer (NSAIDs).  He prescribed Vicodin and sent me for an x-ray.

January 31, I got very itchy, presumably from Vicodin so I stopped that and started taking Benadryl for the itchiness.

February 2, I went back to the clinic for the results of x-rays and  I mentioned the itchiness.  Since I have very limited meds available to me, he recommended an Orthopedist.  I called him when I got home and he didn’t take my insurance.  I tried another doctor who supposedly took my insurance but they didn’t.

February 7, I really needed the sleep so I took half a Vicodin.  No pain and no itching.  HOORAY!

LCL-tearFebruary 8, I saw my regular doctor.   She thinks it’s a possible “lateral collateral ligament vs meniscus tear”.  https://www.nlm.nih.gov/medlineplus/ency/article/001079.htm

I was surprised that she thought my knee was swollen but one of my therapists showed me later that it was.

She referred me to Physical Therapy (PT) and prescribed Ultram http://www.drugs.com/ultram.html.  As of this writing, I haven’t used that yet.

February 11, 8:30 am  My first appointment with PT.  Since my blood pressure was high, we mostly did assessments.  I had a main therapist and a student. They had to use 3 types of BP machine to do this.

I bent my knee and they took measurements with a caliper.  I lay on my front and they manipulated my knee to see what happened. They also concluded that it was a lateral collateral ligament.

A suggestion – to rest my foot on the walker without the brace and see if gravity helps my knee straighten out.

After this, there was more pain than before but I know this is the right thing to do.

February 13.  My leg feels a bit better.  I had the brace off last night and almost straightened my knee out.

Somewhere in this period, I learned how to manually move my knee cap (patella) around.  I saw my day 1 therapist again and he said my knee was angry.  Swollen, angry, whatever.  I just want a normal non-hurting knee!

One of the therapists had me doing a stretching exercise and my hip was out of kilter (everything is attached!) since I’ve been walking with my knee bent.  So she manipulated that back into alignment.

vastus-medFebruary 22, A new-to-me therapist had me do an exercise with a basketball under my knee, pointing my toe to the left.  I didn’t remember doing that before but she said I had.  Hmmm…

That hurt too much so we moved to a foam roll under my knee.  It was still uncomfortable but I did it, a bit too much, apparently.

Turns out this exercise hurt my “VMO”, which is short for Vastus Medialis Oblique.

“This is the most important quad muscle and arguably the most responsible muscle for knee stability. The VMO’s main function is to control knee extension…” Read more at  http://sportskneetherapy.com/the-best-vmo-exercises/

February 25,  My VMO pain still hurt.  I told my regular therapist about it and she worked on it some.  She concurred that my knee was swollen.

February 26,  I went all day with no brace at all!!  A bit of pain but manageable.

Today is February 28 and I haven’t worn the brace since the 27th. I still need assistance to get up from sitting but I can see huge improvement.

I still have 6 more PT sessions, finishing on March 16, but I’m really impressed with what they’ve done for me.  I still have twinges of pain and I don’t plan on stepping on tiptoe anytime soon but I can tell I’m on the right track.

If there are any significant changes (I sure hope not!), I’ll post an update.  When I’m done – and have approval – I intend to keep exercising, walking, climbing stairs, riding the bike.  I never, ever want to go through this kind of pain again.

I’ve learned a lot from PT – lots of new exercises, stretching, how to move manually my knee cap, all kinds of muscle names, that the lateral collateral ligament is attached to my ankle, that ice is better than heat for this kind of thing.

 

no-pain

 

 

 

 

 

New ibuprofen patch delivers drug without risks posed by oral dose

ibuprofen
Some people, such as me!, can’t take Ibuprofen or NSAIDs.  This might be a good solution…
Ibuprofen is used by many people to relieve pain, lessen swelling and to reduce fever. Though there are many worrying side effects linked to overuse of the drug, a new ibuprofen patch has been developed that can deliver the drug at a consistent dose rate without the side effects linked to the oral form.

The patch was developed by researchers at the University of Warwick in the UK, led by research chemist Prof. David Haddleton.

The Food and Drug Administration (FDA) have recently strengthened the warning labels that accompany nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen.

New labels warn that such drugs increase the risk of heart attack or stroke, and these events happen without warning, potentially causing death. Furthermore, such risks are higher for people who take NSAIDs for a long time.

Ibuprofen can also cause ulcers, bleeding or holes in the stomach or intestine.

With these risks in mind, finding an alternative way to relieve pain without the risks is a worthwhile endeavor. Though there are commercial patches on the market designed to soothe pain, this is the first patch that delivers ibuprofen through the skin.

“Many commercial patches surprisingly don’t contain any pain relief agents at all,” says Prof. Haddleton, “they simply soothe the body by a warming effect.”

Patch drug load 5-10 times that of current patches

Working with a Warwick spinout company called Medherant, the researchers were able to put significant amounts of ibuprofen into a polymer matrix that adheres the patch to the patient’s skin, enabling the drug to be delivered at a steady rate over a 12-hour period.

The researchers say their patch paves the way for other novel long-acting pain relief products that can be used to treat common conditions – such as back pain, neuralgia and arthritis – without taking potentially damaging oral doses of the drug.

Prof. Haddleton explains that, for the first time, they can “produce patches that contain effective doses of active ingredients such as ibuprofen for which no patches currently exist.”

He adds that they are able to “improve the drug loading and stickiness of patches containing other active ingredients to improve patient comfort and outcome.”

The team notes that the drug load made possible by their new technology is 5-10 times that of current medical patches and gels. Furthermore, because the patch adheres well to skin, it stays put even when the drug load reaches levels as high as 30% of the weight or volume of the patch.

Other potential uses for the patch

There are currently a number of ibuprofen gels available, but the researchers say it is difficult to control dosage with these gels, and they are not convenient to apply.

“There are only a limited number of existing polymers that have the right characteristics to be used for this type of transdermal patches – that will stick to the skin and not leave residues when being easily removed,” says Prof. Haddleton, who adds:

“Our success in developing this breakthrough patch design isn’t limited to ibuprofen; we have also had great results testing the patch with methyl salicylate (used in liniments, gels and some leading commercial patches).

We believe that many other over-the-counter and prescription drugs can exploit our technology, and we are seeking opportunities to test a much wider range of drugs and treatments within our patch.”

Medherant CEO Nigel Davis says they anticipate their new patch will be on the market in around 2 years. He adds that they “can see considerable opportunities in working with pharmaceutical companies to develop innovative products using our next-generation transdermal drug-delivery platform.”

Despite the risks associated with long-term use of NSAIDs, Medical News Today recently reported on a study that suggested use of the drugs could reduce risk of colorectal cancer.

Consumer Updates > FDA Strengthens Warning of Heart Attack and Stroke Risk for Non-Steroidal Anti-Inflammatory Drugs

Next time you reach into the medicine cabinet seeking relief for a headache, backache or arthritis, be aware of important safety information for non-steroidal anti-inflammatory drugs.

FDA is strengthening an existing warning in prescription drug labels and over-the-counter (OTC) Drug Facts labels to indicate that nonsteroidal anti-inflammatory drugs (NSAIDs) can increase the chance of a heart attack or stroke, either of which can lead to death. Those serious side effects can occur as early as the first few weeks of using an NSAID, and the risk might rise the longer people take NSAIDs. (Although aspirin is also an NSAID, this revised warning doesn’t apply to aspirin.)

The OTC drugs in this group are used for the temporary relief of pain and fever. The prescription drugs in this group are used to treat several kinds of arthritis and other painful conditions. Because many prescription and OTC medicines contain NSAIDs, consumers should avoid taking multiple remedies with the same active ingredient.

via Consumer Updates > FDA Strengthens Warning of Heart Attack and Stroke Risk for Non-Steroidal Anti-Inflammatory Drugs.