Nice To Knee-t You

I was early for my appointment, so I got in pretty quick. Well. If you don't count the time it took me to hobble down the hall to the exam room. Farmer H insisted on accompanying me. I don't really like that. But in retrospect, he probably would have thought I was lying if he hadn't heard it all for himself.

A tall tattooed gal took my vitals. She had a full sleeve on her left arm. She was friendly and efficient. When she left the room, Farmer H had to voice his opinion. 

"I don't know why young gals ruin their appearance with tattoos!"

"She was just fine. It's none of your business. Don't be so judgmental." (As I told The Pony later on the phone: "Dad has no idea what else she might do in her off time. Maybe she has a side job as a dominatrix! Her life and her skin are not his business".)

Farmer H also spent time looking at the charts on the wall. Diagrams of various bone-related maladies. "See there? That's what I have wrong with my hand. It's all bent out of shape by the arthritis."

"This is NOT all about you! Make your own appointment."

Dr. Ortho knocked, and entered the exam room. He was probably early 40s. He reached out to shake my hand. I introduced Farmer H. Dr. Ortho sat down on a rolly stool, and rolled over to sit right in front of my chair. I was relieved that he didn't ask me to get up on the exam table. I don't know if I could have made it, despite the stepstool with a tall handle on it.

Dr. Ortho asked me to pull up the leg of my sweatpants, which I had chosen to wear for just that reason. It's hard enough stepping in and out of pants at home with my usual leaning supports. He felt around my kneecap. Picked up my foot behind the heel, and stretched out my right leg.

"How far can you extend?"

"Ouch."

"You're missing the last 30 degrees." He set my foot down. "Now pull your foot back, and bend it as far as you can."

"That's it."

"About 80 degrees. Here are your x-rays." Dr. Ortho stood up and turned on the screen. "Here's the right knee. And the left. You can see how they're bent. The right one bends in, and the left one bends out. You have degenerative arthritis. The cartilage is gone. So you have bone on bone."

"It really hurts when I stand more than about 10 minutes."

"I don't doubt it."

"It's hard for me to even get up from a chair like this. With no arms to push up from. I can't get my knees bent far enough back to get them under me and stand up."

Dr. Ortho sat down on his rolly stool. Ran his hand around my kneecap, pressing.

"That's where it hurts. On the inside. And down below the kneecap."

"Yes. The cartilage is gone. The tibia hurts where the femur is pressing on it." He ran his hands down my lower leg. "I see you have some redness here. You need to get that checked out. I won't be doing a knee replacement on you. This operation will mess up circulation for a while. I'm concerned that this redness could develop into cellulitis, and spread up the leg, and get into the joint. I'd like you to see your regular practitioner again, and get a referral to a cardiologist, or a lymphatic doctor, to see if this can be cleared up."

"I have an appointment in June."

"It needs to be before that. I'd LOVE to do a knee replacement on you. Maybe you can come back in six months, and we'll see where we're at. It will change the quality of your life. In the meantime, I could offer you a steroid injection to help with the pain."

"Yes. I think I'd like to try that."

Of course Farmer H was chiming in that HE'D had a steroid injection in his knee, and it worked for about six months.

"Well, you were very lucky if it lasted that long. This is good for about three months. I could give it again in four months if it's helping. I'll go get it ready."

Dr. Ortho left. The tattooed gal came back with a tray holding a syringe and a vial. "I'll just get his injection ready."

"There's not any lidocaine in there, is there? Because I have a sensitivity to that, and it raises my blood pressure and speeds up my heart."

"No. This is just Kenalog, and some saline." She left, and Dr. Ortho came back about five minutes later.

Dr. Ortho took out his inkpen. "I'm just marking my landmarks." He didn't seem to be writing on my skin. Just poking the pen at the side of my kneecap, and above. Then he got up to get the syringe.

"I'm going to try not to look."

"That's what I always do!" said Dr. Ortho. Heh, heh. Doctor humor. I HOPE!

He stuck the needle in the side of my knee. It wasn't painful. Just pressure inside as the fluid went into my knee cavity. Dr. Ortho said he was going to send a note to my NP about his concerns. I made the appointment on Friday, and see the NP on Monday (lucky that they had a cancellation).

I've gotta say, I really like Dr. Ortho. I don't know if I'll ever "be able" to get a knee replacement. The injection of Kenalog seems to be helping already. At least at home, I don't have to grab onto things to get around the house now.