PKR My Drama Queen Patellofemoral Knee

[sistersinhim]

It is still an NSAID so if you use the maximum dose you cannot take any other NSAIDs such as aspirin, ibuprofen, or naproxen (Aleve). You can still take acetaminophen (Tylenol) though since that is not an NSAID.

It's true that it is an NSAID, but it is not oral and only a small amount of the gel actually enters the bloodstream, around 6%. This is something you should discuss with your doctor since at times you take ibuprofen.

 

[Cementless]

Finally, a wonderful surgeon decided to do an arthroscopy and look inside there.

I decided to ask my new Orthopedic dr. to scope my knee when he puts the plate in to reinforce my femur on April 20th. He is on vacation, so I don't know if he will. My left knee actually hurts more than my broken left hip and femur!!!

 

[EalingGran]

It’s such a conundrum. I don’t understand why they won’t do an MRI, or CT scan, or something, of my knee, but when 3 highly skilled revision surgeons, from 3 different locations, all come to the same non conclusion, and don’t offer further tests, I have to think that maybe they are right,

Can you not just get an MRI of the knee yourself or does it have to be a doctor referral?
In the UK there are reputable private hospitals that will do an MRI with reports for £250- £300 without a referral.

 

[Tino2You]

It’s such a conundrum. I don’t understand why they won’t do an MRI, or CT scan, or something, of my knee, but when 3 highly skilled revision surgeons, from 3 different locations, all come to the same non conclusion, and don’t offer further tests, I have to think that maybe they are right,

Can you not just get an MRI of the knee yourself or does it have to be a doctor referral?
In the UK there are reputable private hospitals that will do an MRI with reports for £250- £300 without a referral.

@EalingGran wish it would work that way in the US but sadly, if you pay it yourself it will cost about $1300 on average.

 

[EalingGran]

wish it would work that way in the US but sadly, if you pay it yourself it will cost about $1300 on average

Ouch! At that price it would pay to get cheap flights and have a holiday in London for a few days whilst getting an MRI!

 

[Jockette]

I don’t think we can just order an MRI ourselves, but if we could, I would not be willing to pay that much money for one.

Sometimes I wonder if they are actually listening to me. I posted the following in a reply to someone else, but I’ll repeat it here. I told this recent (third) second opinion that my knee often feels out of joint. He came back with, “can you describe that?” Seriously? I had thought it was self explanatory. So I replied, it feels like someone took my leg apart at the knee, and put it back together, wrong. And yet they see no reason, other than an MRI of my lumbar spine, to do any tests on the knee.

I have a fourth surgeon in mind, for when I’m ready to try again. But I don’t know how many times can I go through all the stress and anxiety of these second opinions only to be told there’s nothing to be done. And the PTSD I have from my entire PKR experience really does create a lot of stress and anxiety whenever I think of seeing another surgeon or the possibility of a revision. If it ever comes to a revision, I’m going to need God to do a mighty work, to get me through it.

 

[Jockette]

I decided to ask my new Orthopedic dr. to scope my knee when he puts the plate in to reinforce my femur on April 20th. He is on vacation, so I don't know if he will. My left knee actually hurts more than my broken left hip and femur!!!

Hopefully he’ll check it all out, once he’s inside your knee.

 

[WFD]

There are outfits in the US that advertise cheaper imaging - they even advertise on the radio.

One such outfit near me is Derry imaging in Derry, NH.

40%-70% off they say on their website.

I’m sure there are others in other parts of the country.

 

[Jamie]

There are outfits in the US that advertise cheaper imaging - they even advertise on the radio.

One such outfit near me is Derry imaging in Derry, NH.

40%-70% off they say on their website.

I’m sure there are others in other parts of the country.

I looked at their website and, while their costs may be less than a hospital imaging facility, you still need a doctor’s order for the imaging. Most insurance allows you to go anywhere for imaging when it’s needed. A facility like this would be attractive to someone who has insurance with a high deductible and copay payments.

 

[WFD]

you still need a doctor’s order for the imaging

You should be able to get your PCP to write the order. Most of us wouldn’t know how to specify what we wanted so we got the right scan, anyway.

 

[CricketHip]

@Jockette Glad to hear that the CBD cream is helping. I ordered that to have in my office and also keep some in my at home bathroom for the nights when I have an ache or pain. Currently it's my achilles tendon.
I find pulling on a wool sock after applying the CBD keeps the tendons and other soft tissues warm and seems to help even more. Maybe you could try something like that for your knee.
Your cataract surgery is fast approaching! Soon you'll have xray vision!

 

[Flashlight]

When I first injured my knee my PCP ordered an xray. The xray was done with me laying down on the table. I found out that is the incorrect way for a knee injury it has to be standing. I continued to have severe pain and increased swelling, so PT was ordered. I didn't go to PT but scheduled an appt with ortho. It took weeks before they would order an MRI. That is when the damage was seen. It's all about insurance. They want the doctor to try the less expensive things first. A few years went by, and I ended up in an Ortho urgent care. An xray was taken it was ok and right away a MRI was ordered. Maybe that is the way to go? I wouldn't say anything about revision I would say you had a fall nothing showed up on the xray and you have lingering pain/discomfort. I would bring a copy of the last xray done.

 

[Jockette]

A few years went by, and I ended up in an Ortho urgent care. An xray was taken it was ok and right away a MRI was ordered. Maybe that is the way to go? I wouldn't say anything about revision I would say you had a fall nothing showed up on the xray and you have lingering pain/discomfort.

I did fall the day after Christmas, I went to an Ortho urgent care on January 5 and they took X-rays, which didn’t show any problem. That’s always where it ends. Saw an Ortho surgeon on January 18. He doesn’t see any reason to look further for a problem.

 

[Flashlight]

I forgot that you went to Rothman Urgent Care after your fall. I'm sorry this is happening to you, and that you can't find the answers you need. I know it must be very frustrating.

 

[JusticeRider]

I wonder if you need to escalate? Women get gaslit a lot by doctors. We’re not always taken seriously. You seem like a very sensible, strong, matter of fact kind of person. Maybe they assume that, as a woman, if it were really bothering you, you’d be making more of a fuss?

I hear people talking about walking around in pain ‘at a level 10’. The way I understand it, level 10 is supposed to be the worst pain you can imagine. The worst pain I can imagine is the kind of pain that has you screaming, throwing up and blacking out from the intensity. Nobody at that level of pain would be walking around. But I’ve had ovarian cysts burst and migraines that literally blinded me. I guess my point is, the pain scale is so loosey goosey. Same with people’s reaction to pain. Maybe you just have to kick up a bigger fuss than you would normally?

I was complaining about that stupid pain scale to my dad one time. He gave me some advice that I laughed about initially, but it actually kind of makes sense. He said “when they ask you what your pain level is always say seven.” When I asked him why he said, “if it’s too low, they won’t take you seriously and if it’s too high, they’ll think you’re being too dramatic. Just always say seven.” I was saying 4 because compared to ovarian cysts and migraines, that seemed accurate. But my 4 could easily be another person’s 8. And unfortunately, I think sometimes dr’s expect women to be dramatic.

Oh! One more thing I just remembered. One of the things that finally got the docs to take my pain seriously was when I mentioned that it was keeping me from being (ahem) ‘intimate’ with my husband. Sorry for the TMI but that really seemed to get their attention! It was right after that that I was finally able to get the arthroscopic surgery done that found the problem. I remember thinking how funny it was that that really caused some concern.

Anyway. Food for thought!

 

[Jockette]

@JusticeRider I agree with everything you said above!

I don’t like the 1-10 pain scale at all! What is wrong with descriptive words that say so much more? And, I feel the same way about the 10 that you do. Back in 2010 I was sent to a pain management for my back issues. He told me that a 10 was like having a car on you. Seriously? I can’t even imagine that! I do like your dad’s advice about the 7, I will remember that!

I am actually thinking about second opinion #4. First I want to get through my upcoming cataract surgery, which I hope will be successful (my PKR was supposed to be successful, so I’m a bit gun shy.)

 

[JusticeRider]

Jockette, I hope your cataract surgery goes so well! Smooth, fast, painless, and above all, successful!! Then if you decide to get 2nd opinion #4 on your knee, you’ll be feeling good, seeing clearly, and empowered! You know we’re all rooting for you

 

[EalingGran]

He said “when they ask you what your pain level is always say seven.” When I asked him why he said, “if it’s too low, they won’t take you seriously and if it’s too high, they’ll think you’re being too dramatic. Just always say seven.”

That is so clever! Will remember that advice.
Good luck @Jockette with the cataract surgery. Totally understand why you want to get that sorted before facing another orthopaedic opinion.

 

[Rain Dancer]

I hope that you do seek a fourth opinion and seriously consider a TKR. After the success of my surgery to release the popliteus, I now know what a normal TKR can feel like, and it is amazing. You deserve that experience too after all of the pain you have been through. Good luck with the cataract surgery!

 

[Jockette]

I hope that you do seek a fourth opinion and seriously consider a TKR.

I would do a TKR, but I have never been offered one. No one seems to think it’s necessary, ( except those of us here on Bonesmart. ) My knee works well (enough) mechanically so they won’t even offer me any tests. I asked for an MRI of the knee with this last surgeon, but he won’t do it.

And if all my problems actually come down to a permanent nerve issue, a conversion to a TKR will not help that, and I would think that with all the disruption the surgery causes, it could make things even worse for me. So, maybe they do know what they are talking about.