Thursday, May 28, 2009

Now what?


Our story so far: Several years ago, I went to Urgent Care with a sudden burst of knee pain and was diagnosed with arthritis via x-ray. Since then, that knee has remained cranky. A recent increase in pain sent me to my primary-care doc, who ordered more x-rays, and (in response to bloodwork) referred me to a rheumatologist, who was supposed to call me to make an appointment when the referral paperwork came through.

The rheumatologist never called and I never got the x-ray results, so today I called both offices, especially since my knee has been particularly sore these last few days, so much so that I was limping a bit in the ER last night (even on ibuprofen while wearing a knee brace). Turned out the rheumatologist had never gotten the paperwork; the primary's office said they'd refax it. A nurse told me that the x-rays were normal -- "they showed some bone spurs, but no sign of arthritis" -- and recommended physical therapy for my knee.

What the hay? Did the first doctor mistake bone spurs for arthritis? Can arthritis repair itself? Could the bone spurs be causing my current pain level, and if not, what could be, other than arthritis? And will the rheumatologist be able to answer any of this (if, of course, he ever gets the paperwork)?

I'm frustrated. Arthritis at least made sense of the pain, but now that simple explanation has been yanked away. I'll try PT when I get back from my trip, but I hope I get to see the rheumatologist next week (highly doubtful, given doctors' schedules and the high incidence of arthritis in a city with lots of retirees; the guy's probably booked out to 2011).

On the plus side, yesterday an unexpected consulting project fell into my lap, and I decided to use the proceeds to buy a Samsung N110 netbook. I love my VAIO, but it's very slow and the touchpad died about a year ago, which means I have to use an external mouse: decidedly annoying! The Samsung should be a lot faster than my current machine, and with any luck the touchpad will keep working for a while. And it costs one-quarter what the VAIO did, so what's not to like? Actually, I don't like the fact that it's slightly heavier than the VAIO, but on the plus side, it's also slightly smaller. I bought an external drive for loading software, since the one big drawback of the Samsung is no CD drive. I won't have to bring the drive with me when I travel, though; it will live at home.

So if everything arrives according to shipping estimates, I'll have a shiny new machine for my trip back East. Yippee!

And if my knee's behaving itself by then, I'll be even happier.

5 comments:

  1. I envy your Samsung! Are you getting Vista? Re: the knee, I dunno, but I thought arthritic changes could include spur formation? Hope the rheumatologist at least calls you.

    ReplyDelete
  2. Er -- "bone spurs" ARE a sign of arthritis. No one actually uses the term "arthritis" in x-ray reports. What's called "degenerative joint disease" (DJD) are the bony changes you see with long term joint inflmmation as well as wear-and-tear (narrowing of the joint spaces as well as "osteochondral spurring"). You cannot see actual inflammation, but it can be inferred from blood tests.

    I'm wondering what could be wrong with a single problematic joint in an older person (sorry; >50 I assume) that would prompt a rheumatology consult. Postive ANA? Frequently falsely positive, especially in women; not necessarily lupus or any actual rheumatologic disease. I wonder if you're going to wind up chasing your tail over test results. PT would certainly seem to be your best bet in th meantime.

    My $.02.

    ReplyDelete
  3. Anonymous9:04 AM

    Dear Susan,

    Knee pain ... a topic I think all too much about. Based on my experience, knee pain can often come from alignment issues, or should I say mis-alignment issues - times when the knee joint is taking too much stress because something is wrong in the relationship between the hip joint and the ankle joint. Physical therapy, which I just started myself last year, can be a huge help because it rebuilds the muscles that hold the upper and lower leg bones in the proper places to track without putting pressure on the knee. I hope it will work for you as well as it did for me!

    On a related note, there are also a few other things that I have used that you might like as well. I have found that regular network chiropractic visits help keep my body in better alignment, and Pete Egoscue's "pain free" exercise system gives me something to do when I go on the road. You can read more about network chiropractic, sometimes known as network spinal analysis, at www.associationfornetworkcare.com; more about the Egoscue method at www.egoscue.com.

    Wishing you a speedy recovery,

    Jean

    ReplyDelete
  4. OK, I was NOT losing my mind, which makes me feel slightly happier than I was last night. Your other posters have explained this much better than I could have even conceptualized it. Both my knees are misaligned owing to differences in length of my femurs, and occasionally my SI joint gets "stuck" which makes things temporarily more noticeable. My doc says the curve in my spine has now earned the title of "flexion deformity" (she likes to celebrate my little triumphs with me don't you know) and so I was googling for images and the first one I found looks like my RIGHT LEG!! I sure hope you can get some relief, and I think PT could be terrific.

    ReplyDelete
  5. Thanks, everybody! Terri: No, the Samsung comes preloaded with Windows XP, which by all accounts works better than Vista does.

    #1 Dino: I'm 48, just on the verge of being "older"! Yes, positive ANA, and also pain in other joints (the other knee, hip, elbows), although none of those are as bad as this one knee. I don't thing I have anything dire either, but I'm glad my PCP's being thorough.

    Jean: I'm so glad you've found treatments that work for you! Thanks for the info!

    ReplyDelete

Note: Only a member of this blog may post a comment.