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We Are Flying Solo

November 20, 2012

WTF Just Happened? AKA The Surgeon's Update

So...I made this giant plan, right?  I pretty much gave up a year of my life to fix this stupid knee thing.  I had everything in place, all the characters lined up, & this massive, intricate web of steps ready to push into motion.

Anticlimax alert.

Then I woke up from anesthesia to be informed that all the tendons in my knee were, in fact, fine.  Big, chopping surgery with drills & such was not performed.  Arthroscopic exploration (which surgeon did say nothing was 100% till that) revealed that all of the issues stemmed from an intra-articular cartilage tear, just under the meniscus.  Which.....

Wait for it.

There is currently no available solution for.

I sat in my bed in puzzlement, looking from lifeshighway (BFF) to nurses to leg & back to lifeshighway.

What?

What happened instead was that the surgeon debrided (read:  power sanded & sucked out) all the loose cartilage edges & built up inflammatory tissue (a lot!), wrapped it up & sent me home, now neatly moved into the "oop, can't fix, no longer interesting surgical case" category.

It's not a bad thing that I now have a two-three month recovery instead of an eight month one.  But now I'm sitting here with this heap of plan in my lap going, Heh.  Now what?

After the nerve block wore off, I spent Saturday in a whole new world of pain I didn't even know existed (thank cod I requested the stronger drugs), was dragged to salvation by two amazing friends, had insane explosion of plan remnants yesterday in "you can't make this shit up" realm, & now on Tuesday am just resting till I go back to work & PT next Monday.

Long term prognosis:  I am now a horse.  We will try maintenance HA (hyaluronic acid; at least I'm a nice enough horse that I get the expensive stuff) injections & I will rebuild muscle around the joint.  I will then just manage flare-ups until someone invents a solution.

Lifeshighway & I remain scratching our heads from the abrupt departure from expected occurrences.  I've been putting this thing together since late summer, building up to it, building up to it, ready to get my solution, then WHAM-O!  Just kidding, you'll be fine by February, except not really.  Now you're just another person with a bum knee.

Have fun with that!

19 comments:

  1. Boo for bad news! At least it's a shortened healing time an you can ride the big shiny boys sooner rather than later.
    Just praying for a speedy recovery and that maybe one if these days, someone will invent something to fix all that.

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  2. Thanks, Jen -- I am glad that I will be able to ride this spring. Nothing wrong with that!

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  3. What the fuzz?!?! So now you're left with an "oh, sorry, we can't fix you but you're laid up for 2-3 months anyway..."
    It's a better healing time and nice that they did some patch work on it, but still... What the fuzz?!?! Hopefully with the work they did you won't need too much maintenance to keep riding :)

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  4. Yeah, that was my initial reaction, NSR! I think that's why I'm still kind of like, huh? Wait, huh?

    After some reading though, it looks like the cleanup was good, because apparently pieces often break off within the joint. Ow. And it is good to finally know the answer, but I don't even want to add up what I've spent since last May trying to solve that puzzle.

    I have now been reading about chondrocyte responses to different types of glucosamine and chondroitin. Hmmm, maybe I should write about that. Found some interesting things....

    Now that I do know, though, I can be more proactive about staving off arthritic changes so I don't end up crippled like I was with my back!

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  5. This post reminded me of the "Incurable Shi**y Ankle" joke: http://www.youtube.com/watch?v=ey4WSb-BVDQ

    Not that we're anywhere NEAR 40 yet. 'Cause we are NOT.

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  6. :( That sucks. I had no idea either rehab was so long. I think I still tell time lik ea two year old--everything takes "six weeks" but my definition of a week is variable.

    Maybe you should investigate magic? Sounds like as good a plan as anything.

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  7. That's a bummer! :(

    I hope you recover quickly and are able to manage the knee effectively and all that good stuff.

    I prescribe lots of horsey kisses!

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  8. Good news, bad news, too soon to tell...

    I hope that you got some kind of prognosis for what levels of pain you might expect until other options than "grin and bear it" are available to you.

    It's always good when you can avoid surgery, and maybe the physical therapy + HA will leave you feeling much better?! (Sprinkling magical optimism dust here!) What about cold hosing? ;D

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  9. Haha, thanks, I'm all about magic! I don't think I'll need much cold hosing though, since I work in plenty of cold rivers!

    I am hoping that after PT resets the balance, that I can manage the tear. I admit to totally neglecting it the last few months before surgery b/c I thought it was going to be fixed so oh well, I just quit. I'm not sure how I got so lucky as to get something that pointed to not one but TWO injuries that are invisible to imaging.

    I'm totally going to go watch the ankle thing. I don't know what that is, but nooooo, 40 is nowhere near, erm... >.>

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  10. Yikes. I can feel your frustration, because while mine never got to the point of requiring surgery, when my bum knee blew out a few years ago I got a lot of "Huh. Well it SHOULDN'T do that, but we don't really know why." Oh, thanks, super.

    I'd love to hear what you found about chondroitin & glucosamine. I've been taking a human joint supplement since my injury, and I definitely find it helpful -- and popping pain meds does NOT produce the same results. But I'm always intrigued by the science behind things.

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  11. Hey, I have some Glycoflex III I can send you. It's made for dogs, but I'm sure it could work its wonders on human knees, too. And
    I think Pentosan, Surpass, ice boots, and Back on Track products are all in your future. ;-) (I have no shame--I have allergy pills that I got from my small animal vet, no joke. :-) We non-health-insurance-having people have to get our drugs somewhere!)

    In all seriousness, though, best of luck to ya. I'm sure it will all work out just fine and you will be healed up good as new in no time. I also have a bum knee; it was never diagnosed because I never had it looked at, which is probably for the best. It bothers me sometimes, but doesn't hold me back from doing anything (except running long distances, so that's a great excuse for not jogging!).

    In the meantime, drugs and chocolate are your friend! Chocolate has cartilage-healing properties, as evidenced by many peer-reviewed scientific papers.

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  12. Ugh that sucks. Hopefully someone finds a solution!

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  13. I will see if I can write up what I found! Frizz, I think I am going to put myself on the human version of what I gave my old dog. That stuff extended her life I swear by a year and a half, I saw it work when no other variables changed, amazing shit.

    My doctor specified only two prohibitions: don't take up running and don't get fat. Erm, thanks, ok, I hate running and I have a chinchilla metabolism, so... Seems like everything else was up to me. Cliff ski jumping? Guess he's lucky I hate snow.

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  14. It is the femoral condyles or the tib that is effected - because if it's the injury that I'm thinking of, (as in the cartilage at the end of the bone) you need a more honest doc! there are a couple of option for that - microfracture and stem cells.

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  15. Deered -- microfracture and stem cell use have both been used in an experimental fashion (aka a not covered by BCBS fashion, LOL) to regenerate cartilage and results have not been exceedingly strong. In fact, the recovery from stem cell implantation is over a year and the data I looked at did not make it look to be a worthwhile year. I'm glad I'm not the only science nerd though! :D

    My tear is directly under the meniscus on the top side of the big cartilage pad between the femur and tibia. He gave me the scope pics. It's a very small tear that just lifts the edges of the top cartilage layers. So there is no bone there that is even directly against it, just the tendonds.

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  16. Because I am a medical geek, I had to go find a nice illustration of the human knee and try to figure just exactly what is the matter with yours. This was fairly helpful:
    http://www.patient.co.uk/health/knee-injury-meniscus-cartilage-tear.htm

    I mostly turned up info on meniscal tears (must be more common). I just think it STINKS that you have something they "can't" fix!!! Grrrr.

    For what it's worth, I just had a dog expert-type person inform me that studies have proved only fish oil is truly effective at joint lubrication; glucosamine/chondroitin et al. don't work as well. I don't know about you but I'm adding fish oil to my regimen...

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  17. Hmmm, your friend may want to dig deeper into the literature. A significant body of work is out there and it has demonstrated that the effectiveness of joint supplement materials has a lot to do with their source. The closer the species are, the better it works. For example, a cow's tissue would work better for you than a fish's tissue or a turtle's tissue. Dang, I need to just go ahead and write my post on joints and such...

    But the website you posted refers to a tear of the meniscus, whereas I tore the articular cartilage, if that's what you meant. Good diagram though!

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  18. Hi! Firstly, I love your blog and your writing style.

    Secondly, you may want to check into acupuncture. Check around/ try out a few, find someone with some experience, and give it a whirl. Give it a go of, say, 10 treatments, twice weekly and see if you notice an improvement.

    Yes, I'm an acupuncturist, and yes it works :-) Like any service, it is really important to hook up with a practitioner who you feel really hears you, and that you feel comfortable with.

    Best of luck! There is always a way...

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  19. Thank you, thank you, Karen!

    And that is a great suggestion -- I actually do plan on looking into that when I am farther along in PT. It's difficult because I live in a small town so visit costs and gas mileage add up quickly and I have to prioritize carefully. I've tried to get my vet to give me a go, LOL. But there is ONE clinic here in town, just opened last year, so I will give them a try in a bit. I really hope they don't suck, because if they do, then I will be out luck on that front, but I definitely want to try!

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