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Patella issues
Last year I started seeing a physiotherapist regarding my knee problems. After several visits with somewhat limited improvement, she referred me back to my doctor. I saw my gp, who referred me to an orthopedic surgeon and I first met him last month. After some examination and discussion of issues, he surmised there are actually two problems occurring. Firstly, I seem to have some sort of cartilage tear behind my patella and that’s causing the pain on one side. That is relatively easy to repair using a keyhole procedure called a knee arthroscopy. The second problem is my patella tracks well off to the side of my knee instead of up and down like it should. He sent me for a CT scan which confirms this and also shows it’s a bilateral problem. Correcting this problem requires something called a tibial tubercle transfer, which essentially moves bits around so that my patella tracks up and down again. It requires open surgery and an overnight stay in the hospital. I agreed to have the surgery but did have some concerns as to whether I was being rushed into it.
The Scientist suggested I go back to the physiotherapist to discuss from that perspective so I went to see her last week. She read the report of the CT scan and was of the opinion that I should go ahead with the surgery. She even asked if anything was said about my right knee, which rather surprised me as I don’t have nearly the same problems there. The physio seems to think having this surgery may prevent me ending up with a total knee replacement twenty years down the road. More importantly, she didn’t think the recovery would be all that bad as I will be fully weight bearing from the start. From what I’ve been reading, this seems to be reduce recovery time significantly.
Anyway, my surgery is booked for April 4th which hopefully will give me enough time to recover so that I might miss only one term of my tai chi class this year. The physio even suggested I might be able to get back to it much sooner but I will just have to wait and see how it all goes. And fortunately I only have to fast from 7am and don’t arrive for admissions until 11am. So no rushing out into early morning traffic for us.
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Physiotherapy
Back when I originally dislocated my kneecap, I was referred to the local physiotherapist to aid in the healing process. The physio I saw was an older lady and was perfectly nice and seemed to know what she was doing. She taped my foot to provide support, told me I needed a knee brace and should see a podiatrist for orthotics. Then she told me to do this very specific muscle tightening exercise where it was difficult to be sure I was doing the right thing. I followed her instructions and eventually my knee did get better. I’m not totally sure it wasn’t just due to the passing of time and the healing of the muscles or a combination of the two.
Since then, the problem has recurred from time to time and I have procrastinated about going back to the physio. After the current flare which doesn’t seem to have any specific cause, I finally got around to making an appointment and saw somebody today. The previous physio must have retired as the practice now has three young practitioners.
The practice had changed to a new computer system and it seems they didn’t get my old notes so there was no information on my previous visit. The physio today took a new history then had me lie on the table for examination. Then she suggested that we first try some dry needling, which seems to be a form of acupuncture. I was rather surprised at this since there isn’t scientific evidence of its efficacy. It wasn’t going to incur an extra charge so I thought I would go with the flow and see what it was all about. Three needles were used and placed in muscles in my thigh. The first one I hardly felt but the second one made me jump and the third was much like the first. Except that I was anticipating more that time and was probably a bit tenser than before. The needles only stayed there for a couple minutes and that was the end of that. I was told I might feel a bit sore there for a few hours but that didn’t happen and I haven’t noticed any effects. I think it was supposed to relax the muscles.
Then she had me try some exercises that she wants me to practice twice daily for the next three weeks. Unlike the one I was asked to do before, this one  made sure I was working the correct muscles and was easy to do. She then had me do a variation on the exercise and that was pretty much the end of the consultation. I am booked for another appointment in three weeks to see how I am going and to check how my knee is functioning. Also she doesn’t want me to wear a knee brace as it doesn’t let the muscles strengthen enough to function properly. Aside from the dry needling, I was pretty satisfied with the consultation and felt confident with the program prescribed.
I am now wondering if the previous one was a bit old school and possibly not up to date on current practice, especially as she was nearing what I assume was retirement age. I think she stopped practicing a couple years ago. It was quite a different experience from the first visit, considering this is the same problem.
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Mostly recovered
It seemed likely I was going to need medication when my tonsillitis flared up late last week, but it has settled down after all. The way it flared so quickly, I wonder if maybe it was some sort of allergic reaction instead. My cough has also improved considerably in the past couple of days, which is a relief.
So what’s left is that ongoing kneecap problem which is making movement and exercise difficult. Every so often it pops slightly and it feels like it’s back where it’s supposed to be but doesn’t stay there. Earlier today, it was feeling a bit better so I took the opportunity to take the puppies out for their walks. And now it’s back to the usual problem.
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A few odds and ends
My temporary job finished a few weeks ago and a Kenyan-born Indian woman invited everyone to lunch at her house. She cooked a lovely vegetarian meal with a dry potato curry, a mixed dahl soup, rice, chapatis, papadums, raita, and a carrot halva for dessert. It had some beautiful spices that just burst forth as you continue to eat. It was all quite delicious although it was a bit heavy on the carbohydrate with the rice, potatoes and breads. It was a pretty healthy meal but the dessert was rather rich and filled with butter.
I got home late in the afternoon feeling a bit sleepy so decided I should do at least a bit of exercise. All was going pretty well until the last part of my personal training routine when I had to do an exercise where I lifted my knees repeatedly. Towards the end of that I think my left kneecap popped off track, causing some pain and discomfort. I took a short break and managed to complete the last couple of minutes of the program although it I had to modify one of the exercises a bit to complete it. At the time I thought it was just a bit sore but hours later I notice that knee is quite swollen and this after taking anti-inflammatory painkillers. Hopefully the swelling will go down tomorrow but I will probably need to switch to some other exercise for a few days as most of the exercise program includes lots of knee movement.
Last week Lego Lover and I went to see a doctor with regard to taking part in a medication trial on low-dose Prozac to treat certain autistic behaviors. I met this doctor many years ago when I took Game Fanatic to see him about anxiety issues. He still remembered us after all these years even though we only met him once or twice. He thought our boys had some interesting neurochemistry going on. We have to go through three pre-trial interviews and assessments before it starts so we are still in the early stages and don’t know for certain if Lego Lover will be eligible.