Dedicated_Dad
junior member
If you've been reading my novels at https://bonesmart.org/forum/showthread.php?t=1546 then you'll appreciate this.
Miracles still happen, people. I'm proof that your prayers work.
I managed to get through to this "big dog" Doc's secretary today at ~1 PM. She said he'd be away for the next 6 weeks, after today...
Could I be there by 3:30?
I'm 2.5 hours away.
Read all that again, please -- I want you to see the miracle.
I was getting dressed while she took my info on speaker phone. I hung up and ran out the door.
I hit ZERO traffic, and actually got there ~1/2 hour early.
It gets better!!
After examining me and talking a bit, he told me what's wrong. After some Q&A I am 100% sure he's right. Not only do I have an answer, I have a plan to fix it!!
Important facts: My joint (MCL/LCL) is loose. Further, my quads are also loose due to lack of full extension for years. I still have some extension lag. Further, when he asked me to "snap flex" my quads, I can't. They still jiggle a little before locking in.
Here's what's happening: When I lift my leg to walk, gravity pulls the joint apart before the quads tighten. The fat pad behind my patella, which we all have, gets caught between my patella and the metal on the femoral component. As the quads tighten, it's pulled out, making the "snap" I hear and feel. The same thing happens when I straighten it, thus my double-pop. The straighten-pop is more painful, as it would be expected to be.
It's getting worse because the more it gets pinched, the worse it swells, and the more inflamed it becomes, the more it gets pinched. He explained using the tongue as an example. It's always between our teeth, but we usually don't bite it. If we DO bite it, it gets swollen/inflamed and we end up biting it again, which makes it more swollen.... Only when we stop biting it does it get better.
This is why it never popped on close-chain exercises: only when gravity can separate the joint, and my quads are slack, is the fat pad able to get caught. If I am horizontal, the joint doesn't separate even if my quads are slack. If my quads are tight -- as when I'm squatting -- it doesn't get stuck, thus no pop!!
Here's the solution: He gave me a big honking cortisone/lidocaine shot. This settled down the pain (I LOVE lidocaine!!) so I can walk, except he doesn't want me to walk if I can avoid it. I am to walk with my knee bent if I must walk, to avoid the pinching and popping.
Further, I am to take a huge dose of Celebrex every day for a month, to see if the anti-inflammatory and not walking can solve the problem, let the fat-pad shrink enough to get out of the way.
If not, I am to call in a month and they'll do an arthroscopy to remove ("excise") the fat pad.
IF this doesn't give me a 100% cure, I may need a thicker spacer, but that's a last resort.
He said in no uncertain terms that he thought my surgeon did a great job given all the challenges with this leg. He too said the knee was loose, but given all the problems I had, if he'd made it tighter and I couldn't straighten it, or couldn't bend it, I'd be complaining it was too tight. With my quads in the horrible shape they were in -- my wife used to call it my "concentration-camp leg" -- it was impossible to judge and set all soft-tissue balance perfectly. Now that I am stronger, we can see where it will end up and thus **IF** they need to change the spacer it will be a quick and relatively minor fix.
He told me he'd advised other people to sue their surgeon, wouldn't hesitate to tell me if he thought mine had messed up, but he believed my loyalty to the man was well-placed. He did a good job, given all my problems it's a GREAT job. Add in the way he was there for me, and I am right to have nothing but gratitude!
The fat-pad thing doesn't usually happen to little old ladies with arthritis, it's only likely to happen in cases like mine with a history of trauma and etc... My OS is a relatively small-town guy -- trauma cases go to the big city 2.5 hours away via helicopter, as I did. He's probably never seen a mess like mine before, thus didn't know about the fat-pad thing.
So, I am about the happiest man on the planet right now.
A top-tier Doc has told me what's wrong, and how we're going to go about fixing it. I am 100% sure he's right.
Like I said, there's a G*d and he takes care of me!!
Thanks again, guys. I can't believe this has happened, but I am so grateful to all of you for being there. I was not in a good place yesterday...
Thanks again!!
DD
Miracles still happen, people. I'm proof that your prayers work.
I managed to get through to this "big dog" Doc's secretary today at ~1 PM. She said he'd be away for the next 6 weeks, after today...
Could I be there by 3:30?
I'm 2.5 hours away.
Read all that again, please -- I want you to see the miracle.
I was getting dressed while she took my info on speaker phone. I hung up and ran out the door.
I hit ZERO traffic, and actually got there ~1/2 hour early.
It gets better!!
After examining me and talking a bit, he told me what's wrong. After some Q&A I am 100% sure he's right. Not only do I have an answer, I have a plan to fix it!!
Important facts: My joint (MCL/LCL) is loose. Further, my quads are also loose due to lack of full extension for years. I still have some extension lag. Further, when he asked me to "snap flex" my quads, I can't. They still jiggle a little before locking in.
Here's what's happening: When I lift my leg to walk, gravity pulls the joint apart before the quads tighten. The fat pad behind my patella, which we all have, gets caught between my patella and the metal on the femoral component. As the quads tighten, it's pulled out, making the "snap" I hear and feel. The same thing happens when I straighten it, thus my double-pop. The straighten-pop is more painful, as it would be expected to be.
It's getting worse because the more it gets pinched, the worse it swells, and the more inflamed it becomes, the more it gets pinched. He explained using the tongue as an example. It's always between our teeth, but we usually don't bite it. If we DO bite it, it gets swollen/inflamed and we end up biting it again, which makes it more swollen.... Only when we stop biting it does it get better.
This is why it never popped on close-chain exercises: only when gravity can separate the joint, and my quads are slack, is the fat pad able to get caught. If I am horizontal, the joint doesn't separate even if my quads are slack. If my quads are tight -- as when I'm squatting -- it doesn't get stuck, thus no pop!!
Here's the solution: He gave me a big honking cortisone/lidocaine shot. This settled down the pain (I LOVE lidocaine!!) so I can walk, except he doesn't want me to walk if I can avoid it. I am to walk with my knee bent if I must walk, to avoid the pinching and popping.
Further, I am to take a huge dose of Celebrex every day for a month, to see if the anti-inflammatory and not walking can solve the problem, let the fat-pad shrink enough to get out of the way.
If not, I am to call in a month and they'll do an arthroscopy to remove ("excise") the fat pad.
IF this doesn't give me a 100% cure, I may need a thicker spacer, but that's a last resort.
He said in no uncertain terms that he thought my surgeon did a great job given all the challenges with this leg. He too said the knee was loose, but given all the problems I had, if he'd made it tighter and I couldn't straighten it, or couldn't bend it, I'd be complaining it was too tight. With my quads in the horrible shape they were in -- my wife used to call it my "concentration-camp leg" -- it was impossible to judge and set all soft-tissue balance perfectly. Now that I am stronger, we can see where it will end up and thus **IF** they need to change the spacer it will be a quick and relatively minor fix.
He told me he'd advised other people to sue their surgeon, wouldn't hesitate to tell me if he thought mine had messed up, but he believed my loyalty to the man was well-placed. He did a good job, given all my problems it's a GREAT job. Add in the way he was there for me, and I am right to have nothing but gratitude!
The fat-pad thing doesn't usually happen to little old ladies with arthritis, it's only likely to happen in cases like mine with a history of trauma and etc... My OS is a relatively small-town guy -- trauma cases go to the big city 2.5 hours away via helicopter, as I did. He's probably never seen a mess like mine before, thus didn't know about the fat-pad thing.
So, I am about the happiest man on the planet right now.
A top-tier Doc has told me what's wrong, and how we're going to go about fixing it. I am 100% sure he's right.
Like I said, there's a G*d and he takes care of me!!
Thanks again, guys. I can't believe this has happened, but I am so grateful to all of you for being there. I was not in a good place yesterday...
Thanks again!!
DD