Health Update: The Knee From Hades

So, I saw the orthopedist yesterday. I suppose there was a little good news, along with the bad.

The good: there is no sign of bone infection as the cause of the increased pain I’m having.

The bad: the knee is continuing it’s disintegration from “severe degenerative arthritis” which all goes back to several injuries, and the reactive inflammatory arthritis caused by the viruses my body has been fighting, which include Epstein-Barr (EBV), Parvo, HHV-6, and, quite likely, the new retrovirus, XMRV.

X-rays show the joint space has narrowed even more since the last set, from July, ’09. There’s really not much in the way of joint space left – he said there should be 4 – 5 times as much space between the bones. Joint space is there because you have cartilage in between the bones, shielding them and protecting them, helping things move smoothly. In my case, the cartilage is pretty much non-existent at this point. Bone on bone.

The bone spurs are starting to reform – three of them, but they are not nearly as bad as they were last year before he ground them off of there. But they are growing, and will keep growing.

As he explained, as I knew, I’m gonna have to have a knee replacement, but he doesn’t think I’m quite there yet. From my understanding of this, in order for insurance to cough up and pay for a very expensive procedure with hospital stay of around 4 days, plus in my case likely a short stay in a rehab facility, and extensive physical therapy, you have to have tried everything to stop it, and it has to seriously impair your ability to perform everyday activities. He quizzed Rhiannon about this while I was getting x-rayed.

One reason to delay is because they don’t last forever, and they aren’t usually needed or performed on someone my age, so it will make it even harder to get through insurance.  And, replacing them when they wear out is not at all an easy thing to do, so they want to wait as long as possible, hoping the technology improves and they last longer, which is happening.

For now, he’s put me back on Celebrex (once we get it pre-approved by insurance, that is), told me to exercise it as much as possible, and gave me a new brace to keep the bones aligned when I’m walking, especially over uneven ground or ice, etc. Without the cartilage to hold everything in place, it’s slipping and sliding all over the place.

He doesn’t think steroid injections would help at this point, and I’ve already had the injections of the joint fluid that sometimes helps people. In my case, any help was very minor, and temporary, so I’m not eligible (by FDA & insurance rules) for another round of them.

I’m feeling kind of down about all this. It just sucks. Knowing I’m going to have to have what is major traumatic surgery, I don’t heal well because I’m immune-impaired, and with the CFS & FMS the recovery is going to be very hard. Four to six weeks on crutches would be hard for a healthy person. For me, with no stamina, no strength, it’s going to be hell.

So I have this period of waiting, impending doom, sort of, during which the level of pain is increasing. I think I’m feeling sorry for myself.

Time for an attitude adjustment. It’s just one more challenge, right? Right! (and the mind grumbles “Cause I don’t have enough already!”)