The Old Knees - Last Updated July 29, 2012

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1969 or 1970:  Playing for Lion's Club Playground in Kenner, LA, I slid to recover a fumble against Westgate Playground.  Scraped the front of my left knee pretty good but also did some internal damage.  No idea what kind of damage, though.  I never saw anyone about it.  Knee surgery then was not what it is now.  People who had it were never the same again.  The external scrape got infected and it took a long time to heal but it finally did.  The knee has had "loose bodies" and flareups periodically ever since.

Labor Day Weekend, 1998:  The left knee had flared up again and I finally saw someone about it.  X-Rays revealed "loose bodies" and arthritis.  Outpatient arthroscopic surgery was scheduled for the Thursday before Labor Day weekend.  Woke up during surgery to the sounds of the plink, plink, plink of the "loose bodies" being tossed into a pan but also to the surgical team talking about how much arthritis I had for such a young man.  At the time, I thought they knew I was awake.  Other than that, the surgery went well and I had no real problems for several years.  It has flared up a few times over the last few years due to injury or over-exertion but rest and a shot of cortisone usually makes the inflammation go away for a year or two until the next one.

Thanksgiving Weekend, 2011:  Both knees are starting to feel very heavy.  Some days, the pain in the left knee is excruciating.  I can't stand, I can't sit, I can't sleep.  Finally saw the orthopedist on January 31.  Comparative X-Rays reveal that the knees haven't deteriorated much in the last three years.  He recommended some wedges to relieve the pressure on the knees and a procedure called "joint fluid therapy".  That brings me to the reason for this page.

March 2012: I'll be undergoing joint fluid therapy.  I have not been able to find any patient who has talked about how or if it has benefited them.  Every source I find on the subject seems to have a vested interest in seeing it widely implemented.  I'm going to try to give the patient's perspective over the next few weeks/months.

March 3, 2012: Had some prescription orthotic heel wedges made for me yesterday.  In my case, they lean my knees inward toward each other and forward a little bit.  In the X-Ray below (That X-Ray is mine.  Right knee is on the left), you can see a small space between the thigh bone and shin bone.  As my orthopedist says, "Space is good".  My knees have less space than healthy knees and the bones are rubbing each other causing inflammation.  It's particularly bad in the left knee.  The wedges and the joint fluid therapy are intended to relieve that condition.  The wedges will try to even out the spaces between the bones and the fluid will lubricate and cushion.  Low impact exercise such as bicycling and swimming are also helpful and I intend to partake of the bicycling at the very least.  If all of this can relieve the pain for a few years until I can have the knee replacement surgery, I'll be a happy camper.  

March 13, 2012: See those spaces above that I was talking about?  Today, my doctor injected fluid into those spaces using the syringe with that very long, very large needle you see below.  The knees feel quite different tonight but the jury is still out over whether they feel better.  Also got some more news today.  Time to see a rheumatologist.  I have both forms of arthritis now.  Degenerative osteoarthritis in my left knee and rheumatoid arthritis in my right elbow.  The fun just never stops.

March 14, 2012: 24+ hours after first injections and there does not seem to be any noticeable improvement in mobility or pain relief.

March 17, 2012:OK, it's been a few days now and the first fluid injections have offered no improvement in my condition.  Both knees are as painful as ever.  I really think low impact exercise would help but I'm finding it hard to motivate myself.  Sitting high with my legs hanging down is just about the only comfortable position I can stay in for any length of time.  If my knees are bent, it is painful to straighten them.  If they are straight, it is painful to bend them.  My condition gradually improves as the day wears on up to a point but then levels off and starts to deteriorate.  When I get home from work, my knees aren't as sore as the hamstrings and other muscles in the back of my legs.  It takes a while for that inflammation to subside.  If it hasn't settled down by the time I go to bed, I'm not going to sleep well at all.  

March 21, 2012: Received my second injections yesterday.  The syringes felt like they were still embedded long into the day.  The knees feel better this morning than they have in a while.  I don't know if I can chalk this up to improvement or just a good day on the good day bad day roller coaster.  Still haven't talked to a rheumatologist.  The closest one to me that's also on our insurance plan is in Slidell, 30-35 miles from CrabAppleLane.  I'd like to find a closer alternative.  I figure to be seeing that person regularly.

March 28, 2012: Received my third and final injections yesterday.  As of this morning, I have not noticed much improvement but it did seem like I was better yesterday morning before the injections ... but only slightly.  Made an appointment with the Slidell rheumatologist yesterday.  They can't see new patients until June.  We'll see what the coming weeks bring.

April 3, 2012: One week since my final fluid therapy injection and it's hard to notice any improvement.  I still have a noticeable limp and it is still difficult to straighten my legs when they're bent or bend them when they're straight.  I think I'm sleeping better so there's that.

April 14, 2012: Not much change since last report but there have been a couple of good days.  Good is a relative term in my case.  Not as good as they were a year ago but not nearly as bad as they can be at times.  The wedges I'm using in my work shoes seem to be helping my neuroma.  The jury is still out on what they're doing for my knees.  On a side note, I'm not really happy that I have been getting maladies that women get much more than men.  Gallstones, neuromas, and rheumatoid arthritis are all much more common in women than men.

April 21, 2012: Not much change since last report.  Ibuprofen is hardly doing anything for me now.  Taking a few other supplements in hopes that one of them may eventually do something for me.  My knees seem to do better on work days.  Maybe the regimen is good for them.  Did a few things in the yard yesterday and today.  Will try to do more in the coming weeks ... mainly to see if there is anything to that.

May 5, 2012: Still not much change since last report.  There are days when I have hardly any pain once I straighten out my legs.  Straightening them still takes about 30 seconds.  Inconvenient when I need to get up and go quicker than that.  Yesterday, I had pain emanating from my right knee cap.  It hurt just to take a step.  Having that problem today, too, but not as bad.  Still think a cortisone shot in each knee would be beneficial.  I may have to seek that option even though it might mean going to an emergency room or another orthopedist.  Nothing I do is helping with the inflammation in those knees.

June 4, 2012: Saw a rheumatologist today.  We talked for a while.  He gave me an examination, had some blood drawn, and started a treatment plan.  Methotrexate for the rheumatoid arthritis, folic acid for the Methotrexate, and Prednisone for the inflammation.  The Prednisone is temporary.  The Methotrexate is being used because it's relatively cheap and the insurance companies dictate it.  Having read up on potential side effects, I am not particularly wild about this cocktail.  The next step is Enbrel, which seems to be much safer.  It's also more expensive.  Imagine that.  Drug companies want more for drugs that won't kill you as fast.  Who'd have thunk it?

July 10, 2012: Saw the rheumatologist today.  Not sure where this is going.  I think I'm doing quite a bit better but pain is not the only indicator.  I gave him a 70% improvement approximation but he thinks I can reach 99%.  Not really wild about overly optimistic doctors.

July 29, 2012:  Seem to be doing a little better every day.  If pain was the only concern, I'd be thrilled.  I'm worried about a lot of other things that have been happening lately and my concerns are heightened by the chances that they might be a side effect of the medicines I'm now taking.  General malaise, forgetfulness, lack of focus at times, and easy distraction are on my mind now.