a Taj MuttHall Dog Diary: Knee Surgery Will Occur

Tuesday, November 21, 2006

Knee Surgery Will Occur

SUMMARY: Surgery's a go but it might not solve all my problems.

I'm discouraged. Met with the surgeon today.

The problem is that my knee issues aren't all consistent with meniscal damage. In part, the most-currently-aggravated pain moves around; sometimes it seems to on the upper side of the kneecap, sometimes to the right, sometimes below--very occasionally, to the left. That's not consistent with meniscus damage, apparently, which usually stays very unambiguously put.

Probably the most-commonly aggravated is the right side, which also happens to be where I've been experiencing the very painful catch/pop syndrome for the last week. That IS consistent with meniscus damage...but it's only been doing that for a week; where has it been for the last year while the pain has gradually grown?

When the doc held my knee in such a way as to try to isolate the problem, the greatest pain was when he pressed straight on the kneecap--jumping out of my seat pain--which is also not consistent with meniscal damage. And there was some pressure-related pain on the top/right side of the kneecap and the below side of the kneecap, ALSO not meniscal related.

But some of my symptoms ARE consistent with meniscal damage, and the MRI report is very clear that there are notable tears.

So I have at least three issues with my knee, he says:
  • Cartilage "abnormality" behind the kneecap (chondromalacia). Nothing can be done about that (well, maybe full knee replacement, but I'm nowhere near there yet.)
  • Some arthritis/calcium buildup, aka degenerative joint disease (DJD), aka arthritis (despite the other orthopedist saying there's really not enough there to call it arthritis yet); also can't do anything about that.
  • Meniscal tears and possibly folding and pieces floating around--can definitely do something about that.

    He feels that there's a very good chance that he can fix most or maybe even all of my pain. But not a complete guarantee because of the other known issues from the MRI and my various symptoms. In fact, maybe he's just being conservative, but it seems that the odds are worse than normal that he will, in fact, be able to make all the pain go away. So I don't know what I'll be dealing with until we do the surgery and see whether the pain goes away. That sucks.

    On the other hand, with Kaiser, it's an outpatient procedure and (they told me) should cost me only $5. I hope they're right.

    This doctor won't do arthroscopy with local anaesthesia, but either spinal (where I stay conscious) or general anaesthesia (where I don't) are OK. He defers to the anaesthesiogist for that, whom I won't see until the day of the surgery.

    I'm really tired of being in pain all the time and in being so limited in what I can physically do at the moment, I just want to do it and hope that things are much better then.

    On the other hand, he says that (depending on many factors, including what he actually does when he goes in), I could be up and running in anywhere from 2 weeks to--well--4 months, but on average, he says about 4 weeks. That's promising. It sounds a bit ambitious, but we'll see.
  • 2 comments:

    1. Wow El. Good luck with the surgery. I guess he really can't tell what is up until he gets in there and can look at it. I hope it isn't as serious as it all sounds and that you are up and around quickly. Might as well get it over with. Been there.

      /amy

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    2. Yes, I remember your concerns and also how much better you felt afterwards, even though it wasn't your knee but something much more difficult! I've talked to bunches of people in agility who've had their knees done and not one has been unhappy with the results.

      Thanks for the note.

      -ellen

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