Update. I saw my OS again Friday. I had x-rays of both knees before the appointment as my left knee is also causing some pain. We had a lot of discussion, the end result is as follows. First, he was going to a pain management symposium over the weekend, where there were to be pain management specialists from top places like Mayo, etc. Although a lot of the time was to be about addiction, he said he was going to speak to these guys about my problems with pain meds and see if they have any suggestions or new ideas, etc. He's also going to look into putting a pain medicine plan into my chart so any doctor who treats me will know exactly what to do and all my pain treatment will be consistent and proper for my body instead of generalized treatment. (I was recently hospitalized again for diverticulitis, the same pain management problems cropped up and I ended up with nothing for pain, which was a nightmare) He's the best one to do this as he's the one who has really seen firsthand what actually happens to me when I take narcotic pain relief. (He may have me see a pain management doctor also)
He also thinks it's time to pull out this implant and replace it with a gold knee. He says it'll be harder on me and more painful than the original surgery, so we will first need a plan in place for pain relief over the long term. He said there is way too much swelling at this point, and he also mentioned after moving my knee that my extension is still poor (we already know my flex sucks). There's no guarantee it'll take care of the problems, but I'm almost at the point where I'm willing to take the chance. I wasn't last time he and I talked, but I'm sick of the pain and restrictions this knee causes, so I am almost okay with taking the chance as long as we can figure out the pain problems. He was surprised since he had noted that I wasn't willing last time, but I told him I've reached my tolerance limit now. My left knee looks good, only has a tiny bit of softening which isn't a big deal, so the pain I'm having there is likely a result of the way I'm limping with my right knee and will hopefully resolve once my knee is repaired. The implant looks fine and shows no signs of loosening, so if I do have a revision he says it'll be more work to remove it than if it were loose. He also said it'll be more painful and a harder recovery than the TKR, which scares me to death.
We know I have an allergy to nickel; I think the issue in my OS's mind has been how much it actually affects me. He has mentioned that generally, allergies to the implants in knees should show irritation inside, and he saw none, or rashes outside, etc. I have disagreed with him in the past and we have talked about how if I only had a medium reaction to nickel in the test, then I might only have a medium reaction to the nickel, and maybe that has manifested itself as pain and swelling. I can't say what's in his mind, but I do think he has changed his opinion as to reactions, at least in regards to me. He really knows now that my body reacts totally differently than most people's. If 99.9% of people should respond a certain way, my body will be in the .01% and react in a totally unexpected and different way. So, if everyone who has an allergy should have certain symptoms, he now realizes I won't have those and will have other reactions. It took a while for him to personally see it, but he now has as he's spent more time with me. It was actually very helpful to have had him see what happens to my body on oral pain meds-it was like a light bulb went off in his head that day and all the backward reactions I've had finally came together for him. He mentions it every time I see him now, and he's still stunned over it. I think I'm the only person he's ever seen who has that reaction. He also mentioned that doctors now are so worried about addiction that they're over-reacting, and that's part of why they are so overly tight with me on the issue, even though I'm not one they need be worried about. That's why we need to do something in my chart so hospitalists and others know how to take care of me properly from now on.
Neither of us is certain that a revision with a gold knee will fix the problem, and that's why I've been so reluctant, besides the pain med part, but am almost at the point of willingness to take the chance. I think mostly what's holding me back now is the problem with pain meds, plus a little bit of worry about the result and the hell I'll have to go through again. I've already had something like seven surgeries just on this knee, two of them since the TKR. Nothing has helped to date, and I am frightened to go through all that again, let alone go through it for no gain.
This implant is well-cemented in there and isn't loosening at all, so he says it'll be harder to remove it. He showed me the newest x-ray and showed me how he'll have to very carefully chip around it to get it out and it'll take longer.
Anyway, he does seem to think I have too much pain and swelling at this point in time and a revision with the gold knee is worth trying, so we shall see.
Today I’ve been reading through my recovery thread-scared the daylights out of me just thinking about going through this again! Now I’m back at the point of saying no to a revision. Ugh.