Here, first, is the very short version:
I fucked up my knee dancing. A PT misdiagnosed it and so I continued dancing. The knee locked and the pain became unbearable. An MRI showed a shredded meniscus on both sides of the knee and a bunch of unanticipated arthritis. Everyone predicted surgery, perhaps a knee replacement. My chiropractors sent me to a non-surgical orthopod with whom I’ve agreed to try a non-surgical strategy.
Here, now, is the story with emotions and characters and sham surgeries:
A few weeks ago I was dancing, as is my wont, at my favorite venue’s monthly Saturday night dance when I felt something pop and my right leg locked. I apologized to the woman I was dancing with and limped home.
The next day I went to Vermont, as scheduled, but still couldn’t unlock my leg and could barely walk. Valerie and Mark’s 4-year-old had to carry my cosmetic bag up to the bathroom so that I could basically hop up the stairs. Susan had to give me her arm when we went to the hotdog restaurant to hear Patty Carpenter make fine music.
I went to a loud Trumpy PT who insisted my problem was a tight IT Band, so I returned to my favorite dance class, after which I was in excruciating trouble. My great chiropractors identified a problem with my meniscus and gave me the name of a non-surgical orthopod at the clinic I belong to.
I had an MRI on Monday. The terrifying results arrived on Tuesday: shredded meniscus on both sides; “diffuse bone marrow edema;” fissuring of cartilage; massive swelling; very advanced arthritis – and much more. A friend who works in rehab read the report and talked of knee replacement. I live alone. I have a book coming out and a conference to attend. It’s more than bad enough I can’t dance.
Meanwhile, I had to cancel anything that involved standing or moving, including my work teaching fitness and dance to elders. My doctor suggested a cane. The nurse brought me one along with a copious sheaf of paperwork in which I had to promise to pay for it if my insurance didn’t. “But I have Medicare. Don’t they pay for canes?” She wasn’t supposed to say, but she thought not. “How much does this cane cost?” No one knows until the bill goes to insurance and is rejected and falls into my lap. “No thanks.”
Instead I bought one from Goodwill for $3.00. That evening my friend Bambi, a medical person, adjusted the cane for me and I watched YouTube videos to learn how to walk with it.
Today I met with the young, sweet non-surgical orthopod. He fulfilled my primary wish and gave me a cortisone shot (elder friends of mine call us Steroid Nation), as well as this big ole knee brace with metal hinges. He recommended a certain PT in the same building, with whom I made an appointment for next Friday.
He told me of a study in 2002 described at this link in comprehensible and fascinating language outlining the reasons many are skeptical about arthroscopic knee surgery. I’ll include a quote at the end of this blog for those who are interested.
The orthopod doctor said I should aim for 50% improvement in a month. I’ll take it! I could live with half the pain and twice the mobility, not to mention fewer pain pills. I asked him what I could or could not do and he said that obviously I cannot dance, but that otherwise to listen to my body. Right now my body is asking for yet another pain pill. Right now – besides dreaming of waking up and finding out that Bernie is president – I’m hoping that the cortisone shot is going to click in and do its job.
Thanks to everyone who has proven to really give a shit about me and my wounded knee.
THE END
http://robertclaremd.com/im-skeptical-about-arthroscopic-knee-surgery/
“But it wasn’t until 2002 that we first had any real evidence about whether the procedure actually worked, when a novel study appeared in the New England Journal of Medicine. Somehow doctors convinced 180 veterans from the Houston VAMC to enter a trial wherein patients were randomized into 1 of 3 groups: arthroscopic lavage (washing the knee with at least 10 liters of fluid), lavage with arthroscopic debridement (trimming and shaving the joint), or sham surgery wherein patients were given an anesthetic and surgical incisions made through the skin without actually operating on the joint. In the latter group, surgeons called for instruments as if performing the procedure and even mimicked the lavage by splashing fluid onto the knee and floor. God bless the vets who volunteered for the trial, the doctors who enrolled them, and the hospital’s Internal Review Board that had the intellectual honesty, curiosity, and cajones to approve the study. Neither the patients nor the providers who examined them afterward knew which had received the sham or the real surgery. Patients were examined at multiple intervals for up to 2 years afterward and compared with regard to pain, mobility, and function.
“And guess what? There were no differences between the groups at any time during the follow up. The sham surgery worked just as well as the real surgery.”
And if you want an additional article, here’s another:
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