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 10

Sigh.  Today is the 9th anniversary of the fall on my knee.  There is not much change at all.  I keep a record everyday of how I’m doing in a variety of areas.  Every day I check off “knee pain” but I also have levels 1-10.  I don’t think it ever goes below 5.

Some nights I wake up with throbbing and move to the sofa.  I think maybe tossing and turning in bed makes my knee worse – I can’t do that on the sofa.

SalonPas is still my friend.  And braces and Tylenol.

This year, I hope to get that gel injection.  I’m a bit hesitant because it may make things even worse for a while and it takes 3 weeks to complete the series.  My schedule is already pretty tight and I don’t know how to work in 3 more appointments.

Our trip to Alaska (mentioned below) worked out well.  I travelled with the aforementioned SalonPas etc. and carried all in my backpack on various excursions.

Due to COVID we had to be tested before we went and show our vaccination cards several times before boarding.

I have the CovidWise app on my phone.  when we got home, I found that we had been exposed before the cruise while we were in Seattle.  I didn’t find this out until after the cruise because I had my phone turned off at sea.  It’s just as well that I didn’t know before/during.  I’m not sure what I would have done.

This year we have been to New York a few times to see our grandson.  We’ve started walking from the hotel to their home.  It hurts but it’s useful.  It’s also faster to walk than take an Uber, thanks to one-way streets in NYC.

Our Tattoo that was cancelled last year has been rescheduled for August.  I was surprised that we got a credit for this year.  I’d figured that it was a donation to the Tattoo fund.  So, we will get to walk around Scotland in August.

In September we have another cruise coming up – I will have to schedule that gel injection (hyaluronan (ORTHOVISC) 30 MG/2ML injection 30 mg), probably in July to make it work for August and September.

well-see


This is a continuation of an ongoing knee issue.  It started in 2013 with Icy Days and Mondays and Bee’s Knees I’m hoping to end my knee pain in the very near future.

Here is is July and we have a second trip to see our grandson this coming weekend and the rescheduled/rescheduled cruise in August.  That cruise started out as going to Norway a couple years ago.  That was canceled so we decided on Alaska with the train to Denali in June.  That was cancelled and Canada isn’t allowing people in, so we’re sailing out of Seattle, past Canada and on to Alaska.  We’ve seen some of the ports already but I just wanted to go somewhere, anywhere.

I’ve been having pain, bigger again and I hate to have that in NYC – or on a cruise.  It’s one thing to be kept awake with pain here at home and another entirely when you want to do things.

I had trusted that the doctor cleared that gel injection (hyaluronan (ORTHOVISC) 30 MG/2ML injection 30 mg) with my insurance company but it was a new doctor (the 5th one for my knee issues) today.  The last doctor had put the paperwork in but it never went anywhere.

Today was too soon for another cortisone shot.  I could have paid $380 for the gel and hoped that insurance would pay – but that was the first of 3 weekly injections and the doctor didn’t think it would start to help by this weekend, anyway.

He mentioned physical therapy again and/or possible surgery.  He did send me for another x-ray, which was promising.  By some fluke, his office takes my insurance but the attached radiology department doesn’t – so we went to the next-door hospital for that.

My results:

There is moderate to marked degenerative arthritis in the left
knee with joint space narrowing and osteophyte formation which is most
prominent in the medial compartment. A minimal joint effusion is
present. There is no evidence of a fracture.

After I left the doctor, a nurse called and said that I might be allergic to the Voltaren that a previous doctor had prescribed but I haven’t tried yet.  I’m supposed to try that and let them know.

I guess I’ll be taking my SalonPas, knee brace and lots of Tylenol to NYC.


“Quick kneecap recap” below from April 7, 2021:

First of all, came this article.  I’d already decided to get only one – max 2 – injections a year, with one of them being a week before a cruise.  Our cruise scheduled for June most likely will not happen – neither will our trip to see the Edinburgh Tattoo again in August.

I had been keeping up with water aerobics and the hot tub until both of those were canceled due to COVID-19.  So, my knee pain gradually started getting worse again.  Luckily, I’m not walking around so much and we don’t have stairs at home.  About 8 months or so ago, the pool opened up for water walking and lap swimming – with lots of rules, of course, but I manage to go about 3 times a week.  Often DH goes with me.  Unfortunately, the hot tub isn’t open

I’m still having lots of meetings on Zoom as well as piano teaching.  For those meetings, I’ve been using an iPad on a music stand. To be able to see well while sitting on the sofa, the stand and iPad need to be almost vertical.

My last steroid injection was in September 2019.  Thanks to COVID, I haven’t been hardly anywhere so no real (k)need.

However!, New York City has lifted it’s quarantine restrictions, so we’re going to go meet our new grandson…and I need an injection before we go.

good-news

Monday, April 5, I got that injection – and a lot of hope, finally.  For my fourth injection, I had a fourth different doctor.  This one had other options for me that no one else had every suggested.  A long-lasting gel injection, a saline/dextrose solution (I said it sounded like salty sugar water!)

On Monday, he actually used Ultrasound to guide the needle in.  He went about 2 inches above the knee from the outside to get the the inner part.  The others didn’t do that – they just went directly into the knee, just guessing where to send the steroids.

[COMPLETED] triamcinolone acetonide (KENALOG-40) 40 MG/ML injection 40 mg
40 mg
Other

It was so cool watching him do this.  I told him my last injections had lasted maybe a couple weeks and he said they should be much longer than that, which is why he wants to try the gel injection (hyaluronan (ORTHOVISC) 30 MG/2ML injection 30 mg) in the summer.  Apparently, it takes several months to get insurance approval – and he already started the paperwork!

I had the usual extra pain on Monday night (took 3 Tylenol), and normal pain on Tuesday,  Wednesday, I was feeling pretty good but had to skip the pool because you can’t go in for 48 hours after a knee injection.

I am just so happy to see other alternatives to steroids – or surgery.

Off to NYC tomorrow!



Read the rest of the Bee’s Knees Posts

Stay tuned for…

Bee’s Knees 9

This is a continuation of an ongoing knee issue.  It started in 2013 with Icy Days and Mondays and Bee’s Knees I’m hoping to end my knee pain in the very near future.

Here is is July and we have a second trip to see our grandson this coming weekend and the rescheduled/rescheduled cruise in August.  That cruise started out as going to Norway a couple years ago.  That was canceled so we decided on Alaska with the train to Denali in June.  That was cancelled and Canada isn’t allowing people in, so we’re sailing out of Seattle, past Canada and on to Alaska.  We’ve seen some of the ports already but I just wanted to go somewhere, anywhere.

I’ve been having pain, bigger again and I hate to have that in NYC – or on a cruise.  It’s one thing to be kept awake with pain here at home and another entirely when you want to do things.

I had trusted that the doctor cleared that gel injection (hyaluronan (ORTHOVISC) 30 MG/2ML injection 30 mg) with my insurance company but it was a new doctor (the 5th one for my knee issues) today.  The last doctor had put the paperwork in but it never went anywhere.

Today was too soon for another cortisone shot.  I could have paid $380 for the gel and hoped that insurance would pay – but that was the first of 3 weekly injections and the doctor didn’t think it would start to help by this weekend, anyway.

He mentioned physical therapy again and/or possible surgery.  He did send me for another x-ray, which was promising.  By some fluke, his office takes my insurance but the attached radiology department doesn’t – so we went to the next-door hospital for that.

My results:

There is moderate to marked degenerative arthritis in the left
knee with joint space narrowing and osteophyte formation which is most
prominent in the medial compartment. A minimal joint effusion is
present. There is no evidence of a fracture.

After I left the doctor, a nurse called and said that I might be allergic to the Voltaren that a previous doctor had prescribed but I haven’t tried yet.  I’m supposed to try that and let them know.

I guess I’ll be taking my SalonPas, knee brace and lots of Tylenol to NYC.


“Quick kneecap recap” below from April 7, 2021:

First of all, came this article.  I’d already decided to get only one – max 2 – injections a year, with one of them being a week before a cruise.  Our cruise scheduled for June most likely will not happen – neither will our trip to see the Edinburgh Tattoo again in August.

I had been keeping up with water aerobics and the hot tub until both of those were canceled due to COVID-19.  So, my knee pain gradually started getting worse again.  Luckily, I’m not walking around so much and we don’t have stairs at home.  About 8 months or so ago, the pool opened up for water walking and lap swimming – with lots of rules, of course, but I manage to go about 3 times a week.  Often DH goes with me.  Unfortunately, the hot tub isn’t open

I’m still having lots of meetings on Zoom as well as piano teaching.  For those meetings, I’ve been using an iPad on a music stand. To be able to see well while sitting on the sofa, the stand and iPad need to be almost vertical.

My last steroid injection was in September 2019.  Thanks to COVID, I haven’t been hardly anywhere so no real (k)need.

However!, New York City has lifted it’s quarantine restrictions, so we’re going to go meet our new grandson…and I need an injection before we go.

good-news

Monday, April 5, I got that injection – and a lot of hope, finally.  For my fourth injection, I had a fourth different doctor.  This one had other options for me that no one else had every suggested.  A long-lasting gel injection, a saline/dextrose solution (I said it sounded like salty sugar water!)

On Monday, he actually used Ultrasound to guide the needle in.  He went about 2 inches above the knee from the outside to get the the inner part.  The others didn’t do that – they just went directly into the knee, just guessing where to send the steroids.

[COMPLETED] triamcinolone acetonide (KENALOG-40) 40 MG/ML injection 40 mg
40 mg
Other

It was so cool watching him do this.  I told him my last injections had lasted maybe a couple weeks and he said they should be much longer than that, which is why he wants to try the gel injection (hyaluronan (ORTHOVISC) 30 MG/2ML injection 30 mg) in the summer.  Apparently, it takes several months to get insurance approval – and he already started the paperwork!

I had the usual extra pain on Monday night (took 3 Tylenol), and normal pain on Tuesday,  Wednesday, I was feeling pretty good but had to skip the pool because you can’t go in for 48 hours after a knee injection.

I am just so happy to see other alternatives to steroids – or surgery.

Off to NYC tomorrow!



Read the rest of the Bee’s Knees Posts

Stay tuned for…

Bee’s Knees 8

This is a continuation of an ongoing knee issue.  It started in 2013 with Icy Days and Mondays and Bee’s Knees I’m hoping to end my knee pain in the very near future.

What’s happened since the “quick kneecap recap” below:

First of all, came this article.  I’d already decided to get only one – max 2 – injections a year, with one of them being a week before a cruise.  Our cruise scheduled for June most likely will not happen – neither will our trip to see the Edinburgh Tattoo again in August.

I had been keeping up with water aerobics and the hot tub until both of those were canceled due to COVID-19.  So, my knee pain gradually started getting worse again.  Luckily, I’m not walking around so much and we don’t have stairs at home.  About 8 months or so ago, the pool opened up for water walking and lap swimming – with lots of rules, of course, but I manage to go about 3 times a week.  Often DH goes with me.  Unfortunately, the hot tub isn’t open

I’m still having lots of meetings on Zoom as well as piano teaching.  For those meetings, I’ve been using an iPad on a music stand. To be able to see well while sitting on the sofa, the stand and iPad need to be almost vertical.

My last steroid injection was in September 2019.  Thanks to COVID, I haven’t been hardly anywhere so no real (k)need.

However!, New York City has lifted it’s quarantine restrictions, so we’re going to go meet our new grandson…and I need an injection before we go.

good-news

Monday, April 5, I got that injection – and a lot of hope, finally.  For my fourth injection, I had a fourth different doctor.  This one had other options for me that no one else had every suggested.  A long-lasting gel injection, a saline/dextrose solution (I said it sounded like salty sugar water!)

On Monday, he actually used Ultrasound to guide the needle in.  He went about 2 inches above the knee from the outside to get the the inner part.  The others didn’t do that – they just went directly into the knee, just guessing where to send the steroids.

[COMPLETED] triamcinolone acetonide (KENALOG-40) 40 MG/ML injection 40 mg
40 mg
Other

It was so cool watching him do this.  I told him my last injections had lasted maybe a couple weeks and he said they should be much longer than that, which is why he wants to try the gel injection (hyaluronan (ORTHOVISC) 30 MG/2ML injection 30 mg) in the summer.  Apparently, it takes several months to get insurance approval – and he already started the paperwork!

I had the usual extra pain on Monday night (took 3 Tylenol), and normal pain on Tuesday,  Wednesday, I was feeling pretty good but had to skip the pool because you can’t go in for 48 hours after a knee injection.

I am just so happy to see other alternatives to steroids – or surgery.

Off to NYC tomorrow!



A quick kneecap recap:

From https://maryomedical.com/2013/02/18/icy-days-and-mondays/ January 28, 2013:

 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.

From https://maryomedical.com/2016/02/28/bees-knees/

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, 2016, 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, 2016, I got very itchy, presumably from Vicodin so I stopped that and started taking Benadryl for the itchiness.

February 2, 2016, 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, 2016, I really needed the sleep so I took half a Vicodin.  No pain and no itching.  HOORAY!

February 8, 2016, I saw my regular doctor.   She thinks it’s a possible “lateral collateral ligament vs meniscus tear”.

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. As of this writing, I haven’t used that yet.

February 11, 2016, 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, 2016.  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 kneecap (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.

February 22, 2016, 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…” 

February 25, 2016,  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, 2016,  I went all day with no brace at all!!  A bit of pain but manageable.

February 28, 2016, 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.

March 8, 2016 at 9:48 am

Physical Therapy is sapping what little energy I had 

 I can tell it’s working but I am even more exhausted all the time. I’m taking extra Cortef but it’s not enough…

From https://maryomedical.com/2016/05/05/bees-knees-continued/

May 5, 2016

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


Fast forward to September 5, 2018

My knee has been bothering me off and on for a while.  I’ve been taking water aerobics and was careful not to do anything that would hurt my knee.  The hot tub afterward was a great place to aim hot water jets at my knee – that would numb any pain for a while.

I realized that the neoprene braces were making me itch so I actually found one with no neoprene – Hooray! “All BioSkin material is hypoallergenic. Latex-free and Neoprene free.”  Hooray again!

This last week or so, the pain has been getting worse again so I decided to try a new doctor.  This one seems like maybe – just maybe – he’ll fix things.

He said: “Your previous knee injuries made sense for pain but this spontaneous onset of medial knee pain is a bit strange.  I can only do a limited examination due to the pain and difficulty bending, but it seems to be over the distal insertion of the VMO (quadriceps muscle) with possible inclusion of some joint line tenderness on that same side.

I’d like for you to use ice packs in your knee brace at least three times a day with the goal of calming down the inflammation.

My goal with getting you to sports medicine next week is to re-evaluate it, hopefully with better ability to examine and flex. It may need ultrasound evaluation and/or steroid injection. Since you cannot take NSAIDS, I suggest trying the Ultram that your previous doctor gave you so you can sleep.”

So, next Wednesday, I have an appointment with sports medicine – I might be moving forward. Or not.

September 12, 2018, I got my first cortisone shot (Kenalog 40 mg/mL suspension for injection).  I did notice some sleep issues that first night, probably since I had the cortisone so late in the day

It was wonderful and got me through a cruise to Maine and Canada.  In Bar Harbor, I overheard some women talking about their knees.  One said that the cortisone didn’t work for her at all and she was going to have surgery <uhoh> and another said that they’d have to cut the nerves around her knee.  I’ve asked a couple doctors and Dr. Google.  No one seems familiar with that idea at all.

It also got me through our son’s wedding in October, including climbing stairs! 

It also produced one of my only smiling photos, ever!

December 5, 2018, I saw my endo, Dr. Roberto Salvatori, and “confessed” that I’d had this injection.  We’d talked about this before and how it might react with my daily Cortef and Omnitrope shots.  He hadn’t thought I should get this.  But, since it was a done deal, he said to monitor how I was feeling with the additional cortisone.

By then, the knee pain had returned, anyway, so no issues.

March 27, 2019, I found a new no-neoprene, no-latex brace on amazon. “Hinged Knee Brace: Shock Doctor Maximum Support Compression Knee Brace – For ACL/PCL Injuries, Patella Support, Sprains, Hypertension and More for Men and Women”
This is very good – much stronger than the one I mentioned below on September 8, 2018.  The only real issue I have with it is that it bent, so I have to bend my knee to put it on.  The other one is completely straight and just wraps around.

The older, wrap-around does have a tendency to slip sometimes so I make it tighter than I probably should.

I do love that they’re making products for people with latex and neoprene allergies,  though!

April 8, 2019, I was supposed to get my second cortisone shot in time for Easter but there were car issues at the last minute.

On the way to water aerobics, I was having trouble shifting my car. I’d have to actually turn the ignition off to do so.  Not fun!

When I got home, Tom was sure he could do it…but he couldn’t either.  He drove it into Advanced Automotive.

One of the Advanced Automotive mechanics test-drove the car and then found the bolts holding the brake master cylinder to the firewall had loosened.  

Could have been even more serious!

They fixed that for free since they were the last people to work on the car and maybe(???) didn’t tighten the bolts completely the first time.

Car runs like new now 🙂

So, I missed my first appointment but got a “new” car.

April 10, 2019, I broke down and bought this leg pillow.  I’d seen similar ones on TV but I got this on amazon (of course!). Aocome Knee Pillow for Side Sleepers Knee Pillow Ergonomically Designed for Back Pain, Sciatic Nerve Pain Relief, Leg Pain, Pregnancy, Hip and Joint Pain – Memory Foam Leg Pillow.

This is one of the better things I’ve gotten in my journey.  It’s very nice, soft – and blue!

I’m of 2 opinions about the little strap – it makes it easy to keep it “attached” to my knee but I have to bend my knee to put it on in the first place.

I think over time, the elastic may stretch out, making it harder to keep on.

The whole is covered with a washable velour-like fabric.  The price was reasonable enough that I could buy another one if/whey that strap expands too much.

I have a tendency to roll over in my sleep and found that I can use it as a little pillow to raise just my left leg instead of between both knees when sleeping on my side.

I also found that it’s sometimes better to sleep on the sofa.  When I roll over, the pain from my knee often wakes me up again.  Lying on the sofa makes it harder to roll over.

During this time, my pain was so bad that I was considering surgery – later.

April 22, 2019, I got my second cortisone shot (Kenalog 40 mg/mL suspension for injection).  This time it was a new doctor (same practice), so I had to explain everything (knee history, Cushing’s history, kidney cancer history) to her.

I was unsure how often I could get his shot because I knew I’d want/need one before our cruise next September.  These look like places I will want to walk!

She said that the cortisone stayed mostly in the knee area so I could get one every 3-4 months!  I could have saved myself a lot of issues in early 2019 had I known that   So, I’ll go in the early part of September for #3 and maybe go on a 4-month schedule.

For reasons known only to her, she did the injection in my inner knee-cap.  Even with the lidocaine, it was a bit more painful there than I remember the other one – or maybe I just blacked that out.

She thought that the water aerobics I do 3 times a week (plus hot tub afterward) was a good thing.

Death Dreams.  I don’t think I’ve posted about these before but I used to have them quite often.  I hadn’t had any for a long time but I had 2 within 12 hours of getting the injection.  The first was about 6:00 PM.  I’d fallen asleep for a nap and DH was talking to me (in real life).  I kept trying to ask him which Easter service (that had been the day before) was coming up next because I needed some kind of medication to get through the service.  I know my words to him were confused and garbled but I was sure I was going to die if he didn’t help me.

The next was similar about 3:00am on 4/23/19.  I dropped my Kindle on the floor, which sort of woke me up but I wasn’t sure what the noise was.  I just knew I needed to take “something” to stay alive and wasn’t sure what that was.  I looked through my phone for ideas and checked the meds by my bedside.  Nothing.  Finally, I woke up more completely and realized it had been another dream.  I also picked up my Kindle and went back to sleep for another hour.

This morning (4/23) there’s still a bit of discomfort but I can deal with that.  I also had a bit of trying to run to the bathroom a little quicker than usual.  I also don’t remember that from before but I assume it will go away soon.

I hope this shot lasts nearly 3 months, too!  That would take me to mid-July. 🙂

I also hope that my sleep gets better than my March-April records with only one 8-hour sleep (counting naps!).:

Starting September 2, 2019, if I get 4 shots a year they would be: September, December,  March, June, September.

Starting September 2, 2019, if I get 3 shots a year they would be: September, January, May,  September


After my April 22, 2019 injection, things were mostly better for a while.

May 12, I went to a Celebration of Life service where the chairs were so incredibly uncomfortable.  They looked really nice but… I had trouble sitting.  I’d have to bend part way, put my arms on the armrest and fall the rest of the way.  While seated, it was a weird angle, so I didn’t like to sit but standing back up was very difficult.  My knees were stiff and painful through the next week.

Things were okish for a while.

June 7, we went to NYC and did a lot of walking/stairs which always makes things a little worse.  Around this time, my right leg started having an aching (bone?) pain.  I’m hoping that it’s “just” sciatica.

June 18, it was time for another stupid accident.  I got home from work, put my car in gear and the emergency brake on.  I stepped out of my car with my left foot planted on the driveway.  Somehow, the car rolled backward, twisting my knee.  Three Tylenol and a brace.  Of course, it was one of the braces I’m allergic to so I then had to take a Benadryl.  I’ll find one of my non-allergenic braces a little later.

June 22 – back to “normal” knee pain. Rest, keeping my knee up, a non-allergenic brace and Tylenol all helped.

In mid-August, 2019 my knee started getting really uncomfortable again.  The brace I’d bought for latex and neoprene allergies on March 27 was too hard to put on because I had to bend my knee to pull it up.  so I bought a wraparound one from the same company.

This one, which I hope is the last, is a mouthful of a name  “BIOSKIN Wrap Around Compression Supportive Knee Brace for Patellofemoral Pain and Patella Tracking Disorders – Q Brace“. That being said, it’s way easier to put on but I really don’t like wearing it all the time.

September 2. I was sitting on the sofa and went to straighten out my leg to put on a footstool.  Major owee.  On went the brace and three Tylenol.  I may be saving my one kidney by not taking other pain meds but I’m not sure what is going to happen to my liver  😊

September 4.  Hooray!  The next injection with yet another doctor.  This one, I know, though.  She’s my mother’s doctor and the reason I go to this practice in the first place.  When my mom was in the nursing home last year, this is the doctor they sent. She saved my mother’s life.  I had been complaining about my mom bleeding internally and the nursing home basically said “someone will check”.  I got Dr. Vo in there and my mom immediately left for the hospital where they took care of the bleeding.  Who knows, if I’d let her stay in the rehab/nursing.

I have no idea how she’ll do with knee injections, though

Actually, she did wonderfully well.  We started with the traditional PA, Jack,  who asked the traditional questions, did the weighing, blood pressure, temperature.  He asked if I could have a medical student come in and I said oh yes.  I’d definitely used to helping out with med students thanks to my many weeks at NIH.

David, the student, came in and asked similar traditional questions.  Then, Dr. Vo did the same.

Then, all 3 of them were there along with DH and my knee.  A little cramped but it worked.  She did a really good workup, Apparently, my patella isn’t moving as well as it should.  As always, they say my left knee is swollen but I can’t see that.  According to my pain when she pressed various places, she thinks I have a small tear (Patellar tendon rupture)  She was the first person to ever mention this possibility.  Years ago, another doctor thought it was a possible “lateral collateral ligament vs meniscus tear”.

Injury to the patellar tendon generally requires a significant force such as falling directly on the knee or jumping from a height. (I had most definitely fallen on my knee in 2013) – from https://maryomedical.com/2013/02/18/icy-days-and-mondays/

Ice

January 28, 2013, 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.

I had fallen on black ice and had been wearing flannel-lined jeans. Still got banged up a bit!

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.

(February 18, 2013, my knee still had 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)

~~

Back to 2019: Risk factors for Patellar tendon rupture include patellar tendinitis, kidney failure (DUH!), diabetes, and steroid or fluoroquinolone use (DUH, again – taking daily steroids, Growth Hormone and 2 previous Kanalog 40 shots). There are two main types of ruptures partial and complete. In most cases, the patellar tendon tears at the point where it attaches to the knee cap.

After all that, she showed the PA and med student how to find a good “line” for the needle to go into.  The injection includes lidocaine so it doesn’t hurt so much going in and kills pain fairly quickly in the knee.

She made a little circle with a marker (the others did this, too),  the PA really went to town with the spay antiseptic, including my sandaled feel.  She did quite well with the injection.  Tom said she hit the circle exactly.  There was a bit of discomfort when she hit/nudged something in there but it was fast.

As the first injection, this was on the lateral, outside, part of my kneecap.  The second was on the inner part.  I mentioned this to everyone, commenting that the second (medial) didn’t seem to work as well as the first.  I’d told the second doctor my pain was more on the inner side, so maybe she was going by that.  It’s my theory that the needle went right by the pain but what do I know?

More spray and a bandage.  They told me to move my knee around a lot before I could leave.  This was a first.  I used my time to go to the ladies room.  LOL

She gave me some exercises to do at home, some similar to what I do in Water Aerobics (Hooray!) which I have done for several years.  Both she and past doctors have said that’s one of the best things I can do for this.  However, I have to stay out of the water for a few days to be sure nothing gets into the injection site.

Dr. Vo also prescribed a tube of Voltaren 1 % topical gel to use as needed on our upcoming cruise.  This cruise is one reason I wanted to get the injection now.

She’s recommending 3 times a year group for this injection – the last doctor said 3 to 4 times a year.  I don’t want to get into the steroid-induced Cushing’s group so I’m trying for 3 (or less) times.  Starting September 4, 2019, if I get 3 shots a year the next Could be January, May,  September.

  • So far, the last 2 were September 12, 2018 (If it were not for the cruise, I could have held out a bit longer to make it more than a year since shot 1!)
  • Shot #2 was April 22, 2019.
  • Current #3 was September 5, 2019

The following list includes any diagnoses that were discussed at your visit.

1. Osteoarthritis
• arthritis: care instructions
• osteoarthritis: care instructions
• Voltaren 1 % topical gel
• Kenalog 40 mg/mL suspension for injection
• injection/aspiration large joint/bursa (PROC)
2. Tendonitis of left patellar tendon

Patient Instructions

Knee osteoarthritis – Discussed treatment with exercises. Continue water aerobics.
Knee injection done today.
Exercises given to strengthen patella tendon at home after pain improves.

Like 4/23/19, I also had an issue trying to run to the bathroom a little quicker than usual.  Actually, twice.

September 5, 2019.  I was sorry that I fell asleep quickly and didn’t get my watch off the charger but I know that I slept until 4:35am

Often, i’m tossing and turning to get my knee comfortable, even with the knee pillow from April 10, 2019.  I broke down and bought this leg pillow.  I’d seen similar ones on TV but I got this on amazon (of course!).

This is one of the better things I’ve gotten in my journey.  It’s very nice, soft – and blue!

I have a tendency to roll over in my sleep and found that I can use it as a little pillow to raise just my left leg instead of between both knees when sleeping on my side.

I also found that it’s sometimes better to sleep on the sofa.  When I roll over, the pain from my knee often wakes me up again.  Lying on the sofa makes it harder to roll over.

When I woke up at 4:35, I did have to get to the bathroom quickly but it was ok. Later, about 6:00 it wasn’t so good 😊

Later in the day, I was still limping a bit, perhaps more from habit than anything else.

A bit of pain on the inside of my knee but nothing that required a brace OR Tylenol.

I ordered a new travel container for my growth hormone.  The last “system” was kind of clunky.  It worked fine but required too many components.  This one looks like it will fit in the water bottle compartment of my backpack.  I definitely don’t want another failure.

I’ll be posting a review of the Dison Care Insulin Cooler Travel Case Medication Cooling Bag when we get back  I find it amazing that I ordered the black for $59.00 with a 10% coupon.  The same thing in white is $65.00 with no coupon.

I fell asleep almost immediately, but woke up about 12:30 and never really got back to sleep.  I think I’m obsessing about what to pack for the trip and getting all my work done that should be done before I go.  Also, an ear work of a handbell piece we’re working on.

September 8

I got 6 hours sleep last night!  7. 37 with a nap.  WooHoo!

September 9

The big pains are mostly gone.  Every now and then will be a little twinge.  Yesterday, I felt a little unstable on my knee but nothing major.

I think I’m ready knee-wise for this cruise.

September 12

I had a new type Death Dream last night but I doubt that it’s related to the injection. In this one someone was coming at me with a knife.  Hopefully, this was a one and done!

So, I’ll post this just before the cruise, then, the next update will be…later.

April 14, 2020

First of all, came this article.  I’d already decided to get only one – max 2 – injections a year, with one of them being a week before a cruise.  We currently have a cruise scheduled for August, but that may not happen.

I’d been keeping up with water aerobics and the hot tub until both of those were canceled due to COVID-19.  So, my knee pain gradually started getting worse again.  Luckily, I’m not walking around so much and we don’t have stairs at home.

I’m having lots of meetings on Zoom as well as piano teaching.  For those meetings, I’ve been using an iPad on a music stand. To be able to see well while sitting on the sofa, the stand and iPad need to be almost verticle.

After one meeting a week ago, I moved the unit out of the way, the iPad slipped off the stand and the edge whacked the top of my kneecap.  Major owee and a few bad words, Tylenol and a knee brace.

Stay tuned for…

Bee’s Knees 7

This is a continuation of an ongoing knee issue.  It started in 2013 with Icy Days and Mondays and Bee’s Knees I’m hoping to end my knee pain in the very near future.

What’s happened since the “quick kneecap recap” below:

First of all, came this article.  I’d already decided to get only one – max 2 – injections a year, with one of them being a week before a cruise.  We currently have a cruise scheduled for August, but that may not happen.

I’d been keeping up with water aerobics and the hot tub until both of those were canceled due to COVID-19.  So, my knee pain gradually started getting worse again.  Luckily, I’m not walking around so much and we don’t have stairs at home.

I’m having lots of meetings on Zoom as well as piano teaching.  For those meetings, I’ve been using an iPad on a music stand. To be able to see well while sitting on the sofa, the stand and iPad need to be almost verticle.

After one meeting a week ago, I moved the unit out of the way, the iPad slipped off the stand and the edge whacked the top of my kneecap.  Major owee and a few bad words, Tylenol and a knee brace.

A quick kneecap recap:

From https://maryomedical.com/2013/02/18/icy-days-and-mondays/ January 28, 2013:

 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.

From https://maryomedical.com/2016/02/28/bees-knees/

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, 2016, 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, 2016, I got very itchy, presumably from Vicodin so I stopped that and started taking Benadryl for the itchiness.

February 2, 2016, 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, 2016, I really needed the sleep so I took half a Vicodin.  No pain and no itching.  HOORAY!

February 8, 2016, I saw my regular doctor.   She thinks it’s a possible “lateral collateral ligament vs meniscus tear”.

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. As of this writing, I haven’t used that yet.

February 11, 2016, 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, 2016.  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 kneecap (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.

February 22, 2016, 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…” 

February 25, 2016,  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, 2016,  I went all day with no brace at all!!  A bit of pain but manageable.

February 28, 2016, 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.

March 8, 2016 at 9:48 am

Physical Therapy is sapping what little energy I had 

 I can tell it’s working but I am even more exhausted all the time. I’m taking extra Cortef but it’s not enough…

From https://maryomedical.com/2016/05/05/bees-knees-continued/

May 5, 2016

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


Fast forward to September 5, 2018

My knee has been bothering me off and on for a while.  I’ve been taking water aerobics and was careful not to do anything that would hurt my knee.  The hot tub afterward was a great place to aim hot water jets at my knee – that would numb any pain for a while.

I realized that the neoprene braces were making me itch so I actually found one with no neoprene – Hooray! “All BioSkin material is hypoallergenic. Latex-free and Neoprene free.”  Hooray again!

This last week or so, the pain has been getting worse again so I decided to try a new doctor.  This one seems like maybe – just maybe – he’ll fix things.

He said: “Your previous knee injuries made sense for pain but this spontaneous onset of medial knee pain is a bit strange.  I can only do a limited examination due to the pain and difficulty bending, but it seems to be over the distal insertion of the VMO (quadriceps muscle) with possible inclusion of some joint line tenderness on that same side.

I’d like for you to use ice packs in your knee brace at least three times a day with the goal of calming down the inflammation.

My goal with getting you to sports medicine next week is to re-evaluate it, hopefully with better ability to examine and flex. It may need ultrasound evaluation and/or steroid injection. Since you cannot take NSAIDS, I suggest trying the Ultram that your previous doctor gave you so you can sleep.”

So, next Wednesday, I have an appointment with sports medicine – I might be moving forward. Or not.

 

 

September 12, 2018, I got my first cortisone shot (Kenalog 40 mg/mL suspension for injection).  I did notice some sleep issues that first night, probably since I had the cortisone so late in the day

It was wonderful and got me through a cruise to Maine and Canada.  In Bar Harbor, I overheard some women talking about their knees.  One said that the cortisone didn’t work for her at all and she was going to have surgery <uhoh> and another said that they’d have to cut the nerves around her knee.  I’ve asked a couple doctors and Dr. Google.  No one seems familiar with that idea at all.

It also got me through our son’s wedding in October, including climbing stairs! 

It also produced one of my only smiling photos, ever!

December 5, 2018, I saw my endo, Dr. Roberto Salvatori, and “confessed” that I’d had this injection.  We’d talked about this before and how it might react with my daily Cortef and Omnitrope shots.  He hadn’t thought I should get this.  But, since it was a done deal, he said to monitor how I was feeling with the additional cortisone.

By then, the knee pain had returned, anyway, so no issues.

March 27, 2019, I found a new no-neoprene, no-latex brace on amazon. “Hinged Knee Brace: Shock Doctor Maximum Support Compression Knee Brace – For ACL/PCL Injuries, Patella Support, Sprains, Hypertension and More for Men and Women”
This is very good – much stronger than the one I mentioned below on September 8, 2018.  The only real issue I have with it is that it bent, so I have to bend my knee to put it on.  The other one is completely straight and just wraps around.

The older, wrap-around does have a tendency to slip sometimes so I make it tighter than I probably should.

I do love that they’re making products for people with latex and neoprene allergies,  though!

 

April 8, 2019, I was supposed to get my second cortisone shot in time for Easter but there were car issues at the last minute.

On the way to water aerobics, I was having trouble shifting my car. I’d have to actually turn the ignition off to do so.  Not fun!

When I got home, Tom was sure he could do it…but he couldn’t either.  He drove it into Advanced Automotive.

One of the Advanced Automotive mechanics test-drove the car and then found the bolts holding the brake master cylinder to the firewall had loosened.  

Could have been even more serious!

They fixed that for free since they were the last people to work on the car and maybe(???) didn’t tighten the bolts completely the first time.

Car runs like new now 🙂

So, I missed my first appointment but got a “new” car.

April 10, 2019, I broke down and bought this leg pillow.  I’d seen similar ones on TV but I got this on amazon (of course!). Aocome Knee Pillow for Side Sleepers Knee Pillow Ergonomically Designed for Back Pain, Sciatic Nerve Pain Relief, Leg Pain, Pregnancy, Hip and Joint Pain – Memory Foam Leg Pillow.

This is one of the better things I’ve gotten in my journey.  It’s very nice, soft – and blue!

I’m of 2 opinions about the little strap – it makes it easy to keep it “attached” to my knee but I have to bend my knee to put it on in the first place.

I think over time, the elastic may stretch out, making it harder to keep on.

The whole is covered with a washable velour-like fabric.  The price was reasonable enough that I could buy another one if/whey that strap expands too much.

I have a tendency to roll over in my sleep and found that I can use it as a little pillow to raise just my left leg instead of between both knees when sleeping on my side.

I also found that it’s sometimes better to sleep on the sofa.  When I roll over, the pain from my knee often wakes me up again.  Lying on the sofa makes it harder to roll over.

During this time, my pain was so bad that I was considering surgery – later.

April 22, 2019, I got my second cortisone shot (Kenalog 40 mg/mL suspension for injection).  This time it was a new doctor (same practice), so I had to explain everything (knee history, Cushing’s history, kidney cancer history) to her.

I was unsure how often I could get his shot because I knew I’d want/need one before our cruise next September.  These look like places I will want to walk!

She said that the cortisone stayed mostly in the knee area so I could get one every 3-4 months!  I could have saved myself a lot of issues in early 2019 had I known that   So, I’ll go in the early part of September for #3 and maybe go on a 4-month schedule.

For reasons known only to her, she did the injection in my inner knee-cap.  Even with the lidocaine, it was a bit more painful there than I remember the other one – or maybe I just blacked that out.

She thought that the water aerobics I do 3 times a week (plus hot tub afterward) was a good thing.

Death Dreams.  I don’t think I’ve posted about these before but I used to have them quite often.  I hadn’t had any for a long time but I had 2 within 12 hours of getting the injection.  The first was about 6:00 PM.  I’d fallen asleep for a nap and DH was talking to me (in real life).  I kept trying to ask him which Easter service (that had been the day before) was coming up next because I needed some kind of medication to get through the service.  I know my words to him were confused and garbled but I was sure I was going to die if he didn’t help me.

The next was similar about 3:00am on 4/23/19.  I dropped my Kindle on the floor, which sort of woke me up but I wasn’t sure what the noise was.  I just knew I needed to take “something” to stay alive and wasn’t sure what that was.  I looked through my phone for ideas and checked the meds by my bedside.  Nothing.  Finally, I woke up more completely and realized it had been another dream.  I also picked up my Kindle and went back to sleep for another hour.

This morning (4/23) there’s still a bit of discomfort but I can deal with that.  I also had a bit of trying to run to the bathroom a little quicker than usual.  I also don’t remember that from before but I assume it will go away soon.

I hope this shot lasts nearly 3 months, too!  That would take me to mid-July. 🙂

I also hope that my sleep gets better than my March-April records with only one 8-hour sleep (counting naps!).:

 

Starting September 2, 2019, if I get 4 shots a year they would be: September, December,  March, June, September.

Starting September 2, 2019, if I get 3 shots a year they would be: September, January, May,  September


After my April 22, 2019 injection, things were mostly better for a while.

May 12, I went to a Celebration of Life service where the chairs were so incredibly uncomfortable.  They looked really nice but… I had trouble sitting.  I’d have to bend part way, put my arms on the armrest and fall the rest of the way.  While seated, it was a weird angle, so I didn’t like to sit but standing back up was very difficult.  My knees were stiff and painful through the next week.

Things were okish for a while.

June 7, we went to NYC and did a lot of walking/stairs which always makes things a little worse.  Around this time, my right leg started having an aching (bone?) pain.  I’m hoping that it’s “just” sciatica.

June 18, it was time for another stupid accident.  I got home from work, put my car in gear and the emergency brake on.  I stepped out of my car with my left foot planted on the driveway.  Somehow, the car rolled backward, twisting my knee.  Three Tylenol and a brace.  Of course, it was one of the braces I’m allergic to so I then had to take a Benadryl.  I’ll find one of my non-allergenic braces a little later.

June 22 – back to “normal” knee pain. Rest, keeping my knee up, a non-allergenic brace and Tylenol all helped.

In mid-August, 2019 my knee started getting really uncomfortable again.  The brace I’d bought for latex and neoprene allergies on March 27 was too hard to put on because I had to bend my knee to pull it up.  so I bought a wraparound one from the same company.

This one, which I hope is the last, is a mouthful of a name  “BIOSKIN Wrap Around Compression Supportive Knee Brace for Patellofemoral Pain and Patella Tracking Disorders – Q Brace“. That being said, it’s way easier to put on but I really don’t like wearing it all the time.

September 2. I was sitting on the sofa and went to straighten out my leg to put on a footstool.  Major owee.  On went the brace and three Tylenol.  I may be saving my one kidney by not taking other pain meds but I’m not sure what is going to happen to my liver  😊

September 4.  Hooray!  The next injection with yet another doctor.  This one, I know, though.  She’s my mother’s doctor and the reason I go to this practice in the first place.  When my mom was in the nursing home last year, this is the doctor they sent. She saved my mother’s life.  I had been complaining about my mom bleeding internally and the nursing home basically said “someone will check”.  I got Dr. Vo in there and my mom immediately left for the hospital where they took care of the bleeding.  Who knows, if I’d let her stay in the rehab/nursing.

I have no idea how she’ll do with knee injections, though

Actually, she did wonderfully well.  We started with the traditional PA, Jack,  who asked the traditional questions, did the weighing, blood pressure, temperature.  He asked if I could have a medical student come in and I said oh yes.  I’d definitely used to helping out with med students thanks to my many weeks at NIH.

David, the student, came in and asked similar traditional questions.  Then, Dr. Vo did the same.

Then, all 3 of them were there along with DH and my knee.  A little cramped but it worked.  She did a really good workup, Apparently, my patella isn’t moving as well as it should.  As always, they say my left knee is swollen but I can’t see that.  According to my pain when she pressed various places, she thinks I have a small tear (Patellar tendon rupture)  She was the first person to ever mention this possibility.  Years ago, another doctor thought it was a possible “lateral collateral ligament vs meniscus tear”.

Injury to the patellar tendon generally requires a significant force such as falling directly on the knee or jumping from a height. (I had most definitely fallen on my knee in 2013) – from https://maryomedical.com/2013/02/18/icy-days-and-mondays/

Ice

January 28, 2013, 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.

I had fallen on black ice and had been wearing flannel-lined jeans. Still got banged up a bit!

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.

(February 18, 2013, my knee still had 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)

~~

Back to 2019: Risk factors for Patellar tendon rupture include patellar tendinitis, kidney failure (DUH!), diabetes, and steroid or fluoroquinolone use (DUH, again – taking daily steroids, Growth Hormone and 2 previous Kanalog 40 shots). There are two main types of ruptures partial and complete. In most cases, the patellar tendon tears at the point where it attaches to the knee cap.

After all that, she showed the PA and med student how to find a good “line” for the needle to go into.  The injection includes lidocaine so it doesn’t hurt so much going in and kills pain fairly quickly in the knee.

She made a little circle with a marker (the others did this, too),  the PA really went to town with the spay antiseptic, including my sandaled feel.  She did quite well with the injection.  Tom said she hit the circle exactly.  There was a bit of discomfort when she hit/nudged something in there but it was fast.

As the first injection, this was on the lateral, outside, part of my kneecap.  The second was on the inner part.  I mentioned this to everyone, commenting that the second (medial) didn’t seem to work as well as the first.  I’d told the second doctor my pain was more on the inner side, so maybe she was going by that.  It’s my theory that the needle went right by the pain but what do I know?

More spray and a bandage.  They told me to move my knee around a lot before I could leave.  This was a first.  I used my time to go to the ladies room.  LOL

She gave me some exercises to do at home, some similar to what I do in Water Aerobics (Hooray!) which I have done for several years.  Both she and past doctors have said that’s one of the best things I can do for this.  However, I have to stay out of the water for a few days to be sure nothing gets into the injection site.

Dr. Vo also prescribed a tube of Voltaren 1 % topical gel to use as needed on our upcoming cruise.  This cruise is one reason I wanted to get the injection now.

She’s recommending 3 times a year group for this injection – the last doctor said 3 to 4 times a year.  I don’t want to get into the steroid-induced Cushing’s group so I’m trying for 3 (or less) times.  Starting September 4, 2019, if I get 3 shots a year the next Could be January, May,  September.

  • So far, the last 2 were September 12, 2018 (If it were not for the cruise, I could have held out a bit longer to make it more than a year since shot 1!)
  • Shot #2 was April 22, 2019.
  • Current #3 was September 5, 2019

The following list includes any diagnoses that were discussed at your visit.

1. Osteoarthritis
• arthritis: care instructions
• osteoarthritis: care instructions
• Voltaren 1 % topical gel
• Kenalog 40 mg/mL suspension for injection
• injection/aspiration large joint/bursa (PROC)
2. Tendonitis of left patellar tendon

 

Patient Instructions

Knee osteoarthritis – Discussed treatment with exercises. Continue water aerobics.
Knee injection done today.
Exercises given to strengthen patella tendon at home after pain improves.

 

Like 4/23/19, I also had an issue trying to run to the bathroom a little quicker than usual.  Actually, twice.

September 5, 2019.  I was sorry that I fell asleep quickly and didn’t get my watch off the charger but I know that I slept until 4:35am

Often, i’m tossing and turning to get my knee comfortable, even with the knee pillow from April 10, 2019.  I broke down and bought this leg pillow.  I’d seen similar ones on TV but I got this on amazon (of course!).

This is one of the better things I’ve gotten in my journey.  It’s very nice, soft – and blue!

I have a tendency to roll over in my sleep and found that I can use it as a little pillow to raise just my left leg instead of between both knees when sleeping on my side.

I also found that it’s sometimes better to sleep on the sofa.  When I roll over, the pain from my knee often wakes me up again.  Lying on the sofa makes it harder to roll over.

When I woke up at 4:35, I did have to get to the bathroom quickly but it was ok. Later, about 6:00 it wasn’t so good 😊

Later in the day, I was still limping a bit, perhaps more from habit than anything else.

A bit of pain on the inside of my knee but nothing that required a brace OR Tylenol.

I ordered a new travel container for my growth hormone.  The last “system” was kind of clunky.  It worked fine but required too many components.  This one looks like it will fit in the water bottle compartment of my backpack.  I definitely don’t want another failure.

I’ll be posting a review of the Dison Care Insulin Cooler Travel Case Medication Cooling Bag when we get back  I find it amazing that I ordered the black for $59.00 with a 10% coupon.  The same thing in white is $65.00 with no coupon.

I fell asleep almost immediately, but woke up about 12:30 and never really got back to sleep.  I think I’m obsessing about what to pack for the trip and getting all my work done that should be done before I go.  Also, an ear work of a handbell piece we’re working on.

September 8

I got 6 hours sleep last night!  7. 37 with a nap.  WooHoo!

September 9

The big pains are mostly gone.  Every now and then will be a little twinge.  Yesterday, I felt a little unstable on my knee but nothing major.

I think I’m ready knee-wise for this cruise.

September 12

I had a new type Death Dream last night but I doubt that it’s related to the injection. In this one someone was coming at me with a knife.  Hopefully, this was a one and done!

So, I’ll post this just before the cruise, then, the next update will be…later.

Stay tuned for…

Bee’s Knees 6

This is a continuation of an ongoing knee issue.  It started in 2013 with Icy Days and Mondays and Bee’s Knees I’m hoping to end my knee pain in the very near future.

What’s happened since the “quick kneecap recap” below:

In mid-August, 2019 my knee started getting really uncomfortable again.  The brace I’d bought for latex and neoprene allergies on March 27 was too hard to put on because I had to bend my knee to pull it up.  so I bought a wraparound one from the same company.

This one, which I hope is the last, is a mouthful of a name  “BIOSKIN Wrap Around Compression Supportive Knee Brace for Patellofemoral Pain and Patella Tracking Disorders – Q Brace“. That being said, it’s way easier to put on but I really don’t like wearing it all the time.

September 2. I was sitting on the sofa and went to straighten out my leg to put on a footstool.  Major owee.  On went the brace and three Tylenol.  I may be saving my one kidney by not taking other pain meds but I’m not sure what is going to happen to my liver  😊

September 4.  Hooray!  The next injection with yet another doctor.  This one, I know, though.  She’s my mother’s doctor and the reason I go to this practice in the first place.  When my mom was in the nursing home last year, this is the doctor they sent. She saved my mother’s life.  I had been complaining about my mom bleeding internally and the nursing home basically said “someone will check”.  I got Dr. Vo in there and my mom immediately left for the hospital where they took care of the bleeding.  Who knows, if I’d let her stay in the rehab/nursing.

I have no idea how she’ll do with knee injections, though

Actually, she did wonderfully well.  We started with the traditional PA, Jack,  who asked the traditional questions, did the weighing, blood pressure, temperature.  He asked if I could have a medical student come in and I said oh yes.  I’d definitely used to helping out with med students thanks to my many weeks at NIH.

David, the student, came in and asked similar traditional questions.  Then, Dr. Vo did the same.

Then, all 3 of them were there along with DH and my knee.  A little cramped but it worked.  She did a really good workup, Apparently, my patella isn’t moving as well as it should.  As always, they say my left knee is swollen but I can’t see that.  According to my pain when she pressed various places, she thinks I have a small tear (Patellar tendon rupture)  She was the first person to ever mention this possibility.  Years ago, another doctor thought it was a possible “lateral collateral ligament vs meniscus tear”.

Injury to the patellar tendon generally requires a significant force such as falling directly on the knee or jumping from a height. (I had most definitely fallen on my knee in 2013) – from https://maryomedical.com/2013/02/18/icy-days-and-mondays/

Ice

January 28, 2013, 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.

I had fallen on black ice and had been wearing flannel-lined jeans. Still got banged up a bit!

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.

(February 18, 2013, my knee still had 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)

~~

Back to 2019: Risk factors for Patellar tendon rupture include patellar tendinitis, kidney failure (DUH!), diabetes, and steroid or fluoroquinolone use (DUH, again – taking daily steroids, Growth Hormone and 2 previous Kanalog 40 shots). There are two main types of ruptures partial and complete. In most cases, the patellar tendon tears at the point where it attaches to the knee cap.

After all that, she showed the PA and med student how to find a good “line” for the needle to go into.  The injection includes lidocaine so it doesn’t hurt so much going in and kills pain fairly quickly in the knee.

She made a little circle with a marker (the others did this, too),  the PA really went to town with the spay antiseptic, including my sandaled feel.  She did quite well with the injection.  Tom said she hit the circle exactly.  There was a bit of discomfort when she hit/nudged something in there but it was fast.

As the first injection, this was on the lateral, outside, part of my kneecap.  The second was on the inner part.  I mentioned this to everyone, commenting that the second (medial) didn’t seem to work as well as the first.  I’d told the second doctor my pain was more on the inner side, so maybe she was going by that.  It’s my theory that the needle went right by the pain but what do I know?

More spray and a bandage.  They told me to move my knee around a lot before I could leave.  This was a first.  I used my time to go to the ladies room.  LOL

She gave me some exercises to do at home, some similar to what I do in Water Aerobics (Hooray!) which I have done for several years.  Both she and past doctors have said that’s one of the best things I can do for this.  However, I have to stay out of the water for a few days to be sure nothing gets into the injection site.

Dr. Vo also prescribed a tube of Voltaren 1 % topical gel to use as needed on our upcoming cruise.  This cruise is one reason I wanted to get the injection now.

She’s recommending 3 times a year group for this injection – the last doctor said 3 to 4 times a year.  I don’t want to get into the steroid-induced Cushing’s group so I’m trying for 3 (or less) times.  Starting September 4, 2019, if I get 3 shots a year the next Could be January, May,  September.

  • So far, the last 2 were September 12, 2018 (If it were not for the cruise, I could have held out a bit longer to make it more than a year since shot 1!)
  • Shot #2 was April 22, 2019.
  • Current #3 was September 5, 2019

The following list includes any diagnoses that were discussed at your visit.

1. Osteoarthritis
• arthritis: care instructions
• osteoarthritis: care instructions
• Voltaren 1 % topical gel
• Kenalog 40 mg/mL suspension for injection
• injection/aspiration large joint/bursa (PROC)
2. Tendonitis of left patellar tendon

 

Patient Instructions

Knee osteoarthritis – Discussed treatment with exercises. Continue water aerobics.
Knee injection done today.
Exercises given to strengthen patella tendon at home after pain improves.

 

Like 4/23/19, I also had an issue trying to run to the bathroom a little quicker than usual.  Actually, twice.

September 5, 2019.  I was sorry that I fell asleep quickly and didn’t get my watch off the charger but I know that I slept until 4:35am

Often, i’m tossing and turning to get my knee comfortable, even with the knee pillow from April 10, 2019.  I broke down and bought this leg pillow.  I’d seen similar ones on TV but I got this on amazon (of course!).

This is one of the better things I’ve gotten in my journey.  It’s very nice, soft – and blue!

I have a tendency to roll over in my sleep and found that I can use it as a little pillow to raise just my left leg instead of between both knees when sleeping on my side.

I also found that it’s sometimes better to sleep on the sofa.  When I roll over, the pain from my knee often wakes me up again.  Lying on the sofa makes it harder to roll over.

When I woke up at 4:35, I did have to get to the bathroom quickly but it was ok. Later, about 6:00 it wasn’t so good 😊

Later in the day, I was still limping a bit, perhaps more from habit than anything else.

A bit of pain on the inside of my knee but nothing that required a brace OR Tylenol.

I ordered a new travel container for my growth hormone.  The last “system” was kind of clunky.  It worked fine but required too many components.  This one looks like it will fit in the water bottle compartment of my backpack.  I definitely don’t want another failure.

I’ll be posting a review of the Dison Care Insulin Cooler Travel Case Medication Cooling Bag when we get back  I find it amazing that I ordered the black for $59.00 with a 10% coupon.  The same thing in white is $65.00 with no coupon.

I fell asleep almost immediately, but woke up about 12:30 and never really got back to sleep.  I think I’m obsessing about what to pack for the trip and getting all my work done that should be done before I go.  Also, an ear work of a handbell piece we’re working on.

September 8

I got 6 hours sleep last night!  7. 37 with a nap.  WooHoo!

September 9

The big pains are mostly gone.  Every now and then will be a little twinge.  Yesterday, I felt a little unstable on my knee but nothing major.

I think I’m ready knee-wise for this cruise.

September 12

I had a new type Death Dream last night but I doubt that it’s related to the injection. In this one someone was coming at me with a knife.  Hopefully, this was a one and done!

So, I’ll post this just before the cruise, then, the next update will be…later.

A quick kneecap recap:

From https://maryomedical.com/2013/02/18/icy-days-and-mondays/ January 28, 2013:

 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.

From https://maryomedical.com/2016/02/28/bees-knees/

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, 2016, 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, 2016, I got very itchy, presumably from Vicodin so I stopped that and started taking Benadryl for the itchiness.

February 2, 2016, 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, 2016, I really needed the sleep so I took half a Vicodin.  No pain and no itching.  HOORAY!

February 8, 2016, I saw my regular doctor.   She thinks it’s a possible “lateral collateral ligament vs meniscus tear”.

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. As of this writing, I haven’t used that yet.

February 11, 2016, 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, 2016.  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 kneecap (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.

February 22, 2016, 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…” 

February 25, 2016,  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, 2016,  I went all day with no brace at all!!  A bit of pain but manageable.

February 28, 2016, 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.

March 8, 2016 at 9:48 am

Physical Therapy is sapping what little energy I had 

 I can tell it’s working but I am even more exhausted all the time. I’m taking extra Cortef but it’s not enough…

From https://maryomedical.com/2016/05/05/bees-knees-continued/

May 5, 2016

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


Fast forward to September 5, 2018

My knee has been bothering me off and on for a while.  I’ve been taking water aerobics and was careful not to do anything that would hurt my knee.  The hot tub afterward was a great place to aim hot water jets at my knee – that would numb any pain for a while.

I realized that the neoprene braces were making me itch so I actually found one with no neoprene – Hooray! “All BioSkin material is hypoallergenic. Latex-free and Neoprene free.”  Hooray again!

This last week or so, the pain has been getting worse again so I decided to try a new doctor.  This one seems like maybe – just maybe – he’ll fix things.

He said: “Your previous knee injuries made sense for pain but this spontaneous onset of medial knee pain is a bit strange.  I can only do a limited examination due to the pain and difficulty bending, but it seems to be over the distal insertion of the VMO (quadriceps muscle) with possible inclusion of some joint line tenderness on that same side.

I’d like for you to use ice packs in your knee brace at least three times a day with the goal of calming down the inflammation.

My goal with getting you to sports medicine next week is to re-evaluate it, hopefully with better ability to examine and flex. It may need ultrasound evaluation and/or steroid injection. Since you cannot take NSAIDS, I suggest trying the Ultram that your previous doctor gave you so you can sleep.”

So, next Wednesday, I have an appointment with sports medicine – I might be moving forward. Or not.

 

 

September 12, 2018, I got my first cortisone shot (Kenalog 40 mg/mL suspension for injection).  I did notice some sleep issues that first night, probably since I had the cortisone so late in the day

It was wonderful and got me through a cruise to Maine and Canada.  In Bar Harbor, I overheard some women talking about their knees.  One said that the cortisone didn’t work for her at all and she was going to have surgery <uhoh> and another said that they’d have to cut the nerves around her knee.  I’ve asked a couple doctors and Dr. Google.  No one seems familiar with that idea at all.

It also got me through our son’s wedding in October, including climbing stairs! 

It also produced one of my only smiling photos, ever!

December 5, 2018, I saw my endo, Dr. Roberto Salvatori, and “confessed” that I’d had this injection.  We’d talked about this before and how it might react with my daily Cortef and Omnitrope shots.  He hadn’t thought I should get this.  But, since it was a done deal, he said to monitor how I was feeling with the additional cortisone.

By then, the knee pain had returned, anyway, so no issues.

March 27, 2019, I found a new no-neoprene, no-latex brace on amazon. “Hinged Knee Brace: Shock Doctor Maximum Support Compression Knee Brace – For ACL/PCL Injuries, Patella Support, Sprains, Hypertension and More for Men and Women”
This is very good – much stronger than the one I mentioned below on September 8, 2018.  The only real issue I have with it is that it bent, so I have to bend my knee to put it on.  The other one is completely straight and just wraps around.

The older, wrap-around does have a tendency to slip sometimes so I make it tighter than I probably should.

I do love that they’re making products for people with latex and neoprene allergies,  though!

 

April 8, 2019, I was supposed to get my second cortisone shot in time for Easter but there were car issues at the last minute.

On the way to water aerobics, I was having trouble shifting my car. I’d have to actually turn the ignition off to do so.  Not fun!

When I got home, Tom was sure he could do it…but he couldn’t either.  He drove it into Advanced Automotive.

One of the Advanced Automotive mechanics test-drove the car and then found the bolts holding the brake master cylinder to the firewall had loosened.  

Could have been even more serious!

They fixed that for free since they were the last people to work on the car and maybe(???) didn’t tighten the bolts completely the first time.

Car runs like new now 🙂

So, I missed my first appointment but got a “new” car.

April 10, 2019, I broke down and bought this leg pillow.  I’d seen similar ones on TV but I got this on amazon (of course!). Aocome Knee Pillow for Side Sleepers Knee Pillow Ergonomically Designed for Back Pain, Sciatic Nerve Pain Relief, Leg Pain, Pregnancy, Hip and Joint Pain – Memory Foam Leg Pillow.

This is one of the better things I’ve gotten in my journey.  It’s very nice, soft – and blue!

I’m of 2 opinions about the little strap – it makes it easy to keep it “attached” to my knee but I have to bend my knee to put it on in the first place.

I think over time, the elastic may stretch out, making it harder to keep on.

The whole is covered with a washable velour-like fabric.  The price was reasonable enough that I could buy another one if/whey that strap expands too much.

I have a tendency to roll over in my sleep and found that I can use it as a little pillow to raise just my left leg instead of between both knees when sleeping on my side.

I also found that it’s sometimes better to sleep on the sofa.  When I roll over, the pain from my knee often wakes me up again.  Lying on the sofa makes it harder to roll over.

During this time, my pain was so bad that I was considering surgery – later.

April 22, 2019, I got my second cortisone shot (Kenalog 40 mg/mL suspension for injection).  This time it was a new doctor (same practice), so I had to explain everything (knee history, Cushing’s history, kidney cancer history) to her.

I was unsure how often I could get his shot because I knew I’d want/need one before our cruise next September.  These look like places I will want to walk!

She said that the cortisone stayed mostly in the knee area so I could get one every 3-4 months!  I could have saved myself a lot of issues in early 2019 had I known that   So, I’ll go in the early part of September for #3 and maybe go on a 4-month schedule.

For reasons known only to her, she did the injection in my inner knee-cap.  Even with the lidocaine, it was a bit more painful there than I remember the other one – or maybe I just blacked that out.

She thought that the water aerobics I do 3 times a week (plus hot tub afterward) was a good thing.

Death Dreams.  I don’t think I’ve posted about these before but I used to have them quite often.  I hadn’t had any for a long time but I had 2 within 12 hours of getting the injection.  The first was about 6:00 PM.  I’d fallen asleep for a nap and DH was talking to me (in real life).  I kept trying to ask him which Easter service (that had been the day before) was coming up next because I needed some kind of medication to get through the service.  I know my words to him were confused and garbled but I was sure I was going to die if he didn’t help me.

The next was similar about 3:00am on 4/23/19.  I dropped my Kindle on the floor, which sort of woke me up but I wasn’t sure what the noise was.  I just knew I needed to take “something” to stay alive and wasn’t sure what that was.  I looked through my phone for ideas and checked the meds by my bedside.  Nothing.  Finally, I woke up more completely and realized it had been another dream.  I also picked up my Kindle and went back to sleep for another hour.

This morning (4/23) there’s still a bit of discomfort but I can deal with that.  I also had a bit of trying to run to the bathroom a little quicker than usual.  I also don’t remember that from before but I assume it will go away soon.

I hope this shot lasts nearly 3 months, too!  That would take me to mid-July. 🙂

I also hope that my sleep gets better than my March-April records with only one 8-hour sleep (counting naps!).:

 

Starting September 2, 2019, if I get 4 shots a year they would be: September, December,  March, June, September.

Starting September 2, 2019, if I get 3 shots a year they would be: September, January, May,  September


After my April 22, 2019 injection, things were mostly better for a while.

May 12, I went to a Celebration of Life service where the chairs were so incredibly uncomfortable.  They looked really nice but… I had trouble sitting.  I’d have to bend part way, put my arms on the armrest and fall the rest of the way.  While seated, it was a weird angle, so I didn’t like to sit but standing back up was very difficult.  My knees were stiff and painful through the next week.

Things were okish for a while.

June 7, we went to NYC and did a lot of walking/stairs which always makes things a little worse.  Around this time, my right leg started having an aching (bone?) pain.  I’m hoping that it’s “just” sciatica.

June 18, it was time for another stupid accident.  I got home from work, put my car in gear and the emergency brake on.  I stepped out of my car with my left foot planted on the driveway.  Somehow, the car rolled backward, twisting my knee.  Three Tylenol and a brace.  Of course, it was one of the braces I’m allergic to so I then had to take a Benadryl.  I’ll find one of my non-allergenic braces a little later.

June 22 – back to “normal” knee pain. Rest, keeping my knee up, a non-allergenic brace and Tylenol all helped.

 

Stay tuned for…

Bee’s Knees 5

This is a continuation of an ongoing knee issue.  It started in 2013 with Icy Days and Mondays and Bee’s Knees I’m hoping to end my knee pain in the very near future.

What’s happened since the “quick kneecap recap” below:

After my April 22 injection, things were mostly better for a while.

May 12, I went to a Celebration of Life service where the chairs were so incredibly uncomfortable.  They looked really nice but… I had trouble sitting.  I’d have to bend part way, put my arms on the armrest and fall the rest of the way.  While seated, it was a weird angle, so I didn’t like to sit but standing back up was very difficult.  My knees were stiff and a pain through the next week.

Things were okish for a while.  June 7, we went to NYC and did a lot of walking/stairs which always makes things a little worse.  Around this time, my right leg started having an aching (bone?) pain.  I’m hoping that it’s “just” sciatica.

June 18, it was time for another stupid accident.  I got home from work, put my car in gear and the emergency brake on.  I stepped out of my car with my left foot planted on the driveway.  Somehow, the car rolled backward, twisting my knee.  Three Tylenol and a brace.  Of course, it was one of the braces I’m allergic to so I then had to take a Benadryl.  I’ll find one of my non-allergenic braces a little later.

June 22 – back to “normal” knee pain. Rest, keeping my knee up, a non-allergenic brace and Tylenol all helped.

 

A quick kneecap recap:

From https://maryomedical.com/2013/02/18/icy-days-and-mondays/ January 28, 2013:

 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.

From https://maryomedical.com/2016/02/28/bees-knees/

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, 2016, 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, 2016, I got very itchy, presumably from Vicodin so I stopped that and started taking Benadryl for the itchiness.

February 2, 2016, 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, 2016, I really needed the sleep so I took half a Vicodin.  No pain and no itching.  HOORAY!

February 8, 2016, I saw my regular doctor.   She thinks it’s a possible “lateral collateral ligament vs meniscus tear”.

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. As of this writing, I haven’t used that yet.

February 11, 2016, 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, 2016.  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 kneecap (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.

February 22, 2016, 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…” 

February 25, 2016,  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, 2016,  I went all day with no brace at all!!  A bit of pain but manageable.

February 28, 2016, 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.

March 8, 2016 at 9:48 am

Physical Therapy is sapping what little energy I had 

 I can tell it’s working but I am even more exhausted all the time. I’m taking extra Cortef but it’s not enough…

From https://maryomedical.com/2016/05/05/bees-knees-continued/

May 5, 2016

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


Fast forward to September 5, 2018

My knee has been bothering me off and on for a while.  I’ve been taking water aerobics and was careful not to do anything that would hurt my knee.  The hot tub afterward was a great place to aim hot water jets at my knee – that would numb any pain for a while.

I realized that the neoprene braces were making me itch so I actually found one with no neoprene – Hooray! “All BioSkin material is hypoallergenic. Latex-free and Neoprene free.”  Hooray again!

This last week or so, the pain has been getting worse again so I decided to try a new doctor.  This one seems like maybe – just maybe – he’ll fix things.

He said: “Your previous knee injuries made sense for pain but this spontaneous onset of medial knee pain is a bit strange.  I can only do a limited examination due to the pain and difficulty bending, but it seems to be over the distal insertion of the VMO (quadriceps muscle) with possible inclusion of some joint line tenderness on that same side.

I’d like for you to use ice packs in your knee brace at least three times a day with the goal of calming down the inflammation.

My goal with getting you to sports medicine next week is to re-evaluate it, hopefully with better ability to examine and flex. It may need ultrasound evaluation and/or steroid injection. Since you cannot take NSAIDS, I suggest trying the Ultram that your previous doctor gave you so you can sleep.”

So, next Wednesday, I have an appointment with sports medicine – I might be moving forward. Or not.

 

 

September 12, 2018, I got my first cortisone shot (Kenalog 40 mg/mL suspension for injection).  I did notice some sleep issues that first night, probably since I had the cortisone so late in the day

It was wonderful and got me through a cruise to Maine and Canada.  In Bar Harbor, I overheard some women talking about their knees.  One said that the cortisone didn’t work for her at all and she was going to have surgery <uhoh> and another said that they’d have to cut the nerves around her knee.  I’ve asked a couple doctors and Dr. Google.  No one seems familiar with that idea at all.

It also got me through our son’s wedding in October, including climbing stairs! 

It also produced one of my only smiling photos, ever!

December 5, 2018, I saw my endo, Dr. Roberto Salvatori, and “confessed” that I’d had this injection.  We’d talked about this before and how it might react with my daily Cortef and Omnitrope shots.  He hadn’t thought I should get this.  But, since it was a done deal, he said to monitor how I was feeling with the additional cortisone.

By then, the knee pain had returned, anyway, so no issues

March 27, 2019, I found a new no-neoprene, no-latex brace on amazon. “Hinged Knee Brace: Shock Doctor Maximum Support Compression Knee Brace – For ACL/PCL Injuries, Patella Support, Sprains, Hypertension and More for Men and Women”
This is very good – much stronger than the one I mentioned below on September 8, 2018.  The only real issue I have with it is that it bent, so I have to bend my knee to put it on.  The other one is completely straight and just wraps around.

The older, wrap-around does have a tendency to slip sometimes so I make it tighter than I probably should.

I do love that they’re making products for people with latex and neoprene allergies,  though!

 

April 8, 2019, I was supposed to get my second cortisone shot in time for Easter but there were car issues at the last minute.

On the way to water aerobics, I was having trouble shifting my car. I’d have to actually turn the ignition off to do so.  Not fun!

When I got home, Tom was sure he could do it…but he couldn’t either.  He drove it in to Advanced Automotive.

One of the Advanced Automotive mechanics test-drove the car and then found the bolts holding the brake master cylinder to the firewall had loosened.  

Could have been even more serious!

They fixed that for free since they were the last people to work on the car and maybe(???) didn’t tighten the bolts completely the first time.

Car runs like new now 🙂

So, I missed my first appointment but got a “new” car.

April 10, 2019, I broke down and bought this leg pillow.  I’d seen similar ones on TV but I got this on amazon (of course!). Aocome Knee Pillow for Side Sleepers Knee Pillow Ergonomically Designed for Back Pain, Sciatic Nerve Pain Relief, Leg Pain, Pregnancy, Hip and Joint Pain – Memory Foam Leg Pillow.

This is one of the better things I’ve gotten in my journey.  It’s very nice, soft – and blue!

I’m of 2 opinions about the little strap – it makes it easy to keep it “attached” to my knee but I have to bend my knee to put it on in the first place.

I think over time, the elastic may stretch out, making it harder to keep on.

The whole is covered with a washable velour-like fabric.  The price was reasonable enough that I could buy another one if/whey that strap expands too much.

I have a tendency to roll over in my sleep and found that I can use it as a little pillow to raise just my left leg instead of between both knees when sleeping on my side.

I also found that it’s sometimes better to sleep on the sofa.  When I roll over, the pain from my knee often wakes me up again.  Lying on the sofa makes it harder to roll over.

During this time, my pain was so bad that I was considering surgery – later. April 22, 2019, I got my second cortisone shot (Kenalog 40 mg/mL suspension for injection).  This time it was a new doctor (same practice), so I had to explain everything (knee history, Cushing’s history, kidney cancer history) to her.

I was unsure how often I could get his shot because I knew I’d want/need one before our cruise next September.  These look like places I will want to walk!

She said that the cortisone stayed mostly in the knee area so I could get one every 3-4 months!  I could have saved myself a lot of issues in early 2019 had I known that   So, I’ll go in the early part of September for #3 and maybe go on a 4-month schedule.

For reasons known only to her, she did the injection in my inner knee-cap.  Even with the lidocaine, it was a bit more painful there than I remember the other one – or maybe I just blacked that out.

She thought that the water aerobics I do 3 times a week (plus hot tub afterward) was a good thing.

Death Dreams.  I don’t think I’ve posted about these before but I used to have them quite often.  I hadn’t had any for a long time but I had 2 within 12 hours of getting the injection.  The first was about 6:00 PM.  I’d fallen asleep for a nap and DH was talking to me (in real life).  I kept trying to ask him which Easter service (that had been the day before) was coming up next because I needed some kind of medication to get through the service.  I know my words to him were confused and garbled but I was sure I was going to die if he didn’t help me.

The next was similar about 3:00am on 4/23/19.  I dropped my Kindle on the floor, which sort of woke me up but I wasn’t sure what the noise was.  I just knew I needed to take “something” to stay alive and wasn’t sure what that was.  I looked through my phone for ideas and checked the meds by my bedside.  Nothing.  Finally, I woke up more completely and realized it had been another dream.  I also picked up my Kindle and went back to sleep for another hour.

This morning (4/23) there’s still a bit of discomfort but I can deal with that.  I also had a bit of trying to run to the bathroom a little quicker than usual.  I also don’t remember that from before but I assume it will go away soon.

I hope this shot lasts nearly 3 months, too!  That would take me to mid-July. 🙂

I also hope that my sleep gets better than my March-April records with only one 8-hour sleep (counting naps!).:

 

Starting September 2, 2019, if I get 4 shots a year they would be: September, December,  March, June, September.

Starting September 2, 2019, if I get 3 shots a year they would be: September, January, May,  September

 

Stay tuned for…