Update on the Knees

As some of you will recall, I've had one hellacious time with my knees this year. On or around 10 July I went to the after hours clinic, since I don't have a family doctor. She wrote a referral to an orthopedic surgeon and said to take ibuprofen. Sometime in early August I called the ortho to see what kind of wait we were looking at. The woman on the phone said 18-24 months. Longer story short, I got an appointment, for today, with an ortho in Calais, Maine. It's about 90 minutes on a good day, meaning clear weather and no border wait.

This morning 7YO and I went out to wait for the bus. It is always right on time, 7:30 sharp. At 7:32, I came to call the school closing line. BTW, they've had two closures in the last two weeks. Turned out, the schools were open, but the buses were running an hour late. So, off we went. We had to do the trick of shifting to first to make the first two downhill corners to the main road, Carlisle Road. Then, we slid a tad and I noticed cars a way down that had their flashers on and were crawling. So, I did the same. We made it to the school - the street of which was well sanded. The principal and the two teachers I spoke with looked at me like I was clearly insane to think of driving to Maine. Practically, and stupidly, in tears, I said, "I've waited four months for this appointment, I can't cancel it." I had some extra time so I knew that I could go slowly. It's all secondary roads.

Off I went, at about 8:00, but only after hearing that 18 cars had slid off the aforementioned Carlisle Road. I took it very slowly on 105 and was reassured by those being equally as cautious. After a while - it was supposed to be creeping its way toward 10 C (50 F) today - people picked up the pace, even passing me on a double yellow line. I was supposed to be at the office at 9:15 for a 9:30 appointment. Fortunately they are on Eastern time so I actually had 2 and quarter hours to make the trip. At 9:18, their time, I was sitting at the border. I arrived at 9:20. Whew! They had a sign, "If you are 15 minutes late you will have to be rescheduled." I would have sat down and cried.

I only waited about 5 minutes - after the 10 minutes it took to get me set up in the computer. The LPN, or whatever she was, took some more history and the ortho came in at what was probably about 15 minutes later. Let's even say it was 10:00. Hold on to your hats. I was with him for 45 minutes. I never even got that kind of time with my primary care physician doing a "complete" physical!

I won't bore you with the whole deal, except to say that after actually listening to me - something that the two doctors I saw about my knee in Saint Paul (one acronym: HMO) failed to do - he said that while I did have "very mild" arthritis in my knees, the real problem was Patellofemoral Pain Syndrome. Reading this site I was, like, "Duh?!"He freaked me out when he asked about some things (e.g., Can you bend your thumb all the way down to your arm? Answer: Yes, in my non-arthritic hand.) He said I had "loose joints," said something about collagen, and said that, judging by my history (e.g., I rode 1600 bike miles in the summer of 1998, did the Breast Cancer 3-Day - 6o miles - in 2004 and 2005, have always done a lot of load bearing activity with, shall we say, an extra load?) I have simply trashed my knees. This all combined with being knock-kneed (I always thought it was just fat), a complicating factor.

So, he patiently went through a list of about a dozen options (e.g., do nothing, ibuprofen, heat/ice on up to surgery) and told me what he did (exercise) and did not (MRI) recommend and why/why not. We decided on a cortisone shot in each knee. He would have done my shoulder - which he said is likely a pinched tendon - but didn't want to do three shots and I opted to focus on my legs since they have been soooooo bad.

Then, having talked about the fact that I am paying out of pocket (I still have US health insurance, but it's a $2300 deductible), he said that he wasn't going to charge me for the shots. Huh? Wow. I don't know how much the office visit will be because contrary to the sign which demanded payment, they said they'd send a bill. I opted not to even ask. Ignorance is bliss - until bills and payday.

After picking up some milk (US$3.14 a gallon instead of about US$6.44 a gallon, adjusting for litres/gallons and the $), which we go through like there's no tomorrow, I headed back. The roads were great on the way back. 7YO was having a blast at a friend's house. Thank you, R, thank you!

My legs are a bit sore, but I can already tell a little bit of difference in how they feel when I get up from sitting. He recommended straight-leg lifts to work on my quads, but no leg extensions; ibuprofen, heat/ice, avoid stairs (which I already do when I can), weight loss (of course) and come back in four weeks. We discussed Synvisc, at about $1100 a knee. If the cortisone and dropping some pounds doesn't help I will consider it. At least then my deductible will be done and anything else for the year is covered at 80%! I just can't keep being so immobile if there is a good option.

So, that's the latest. Someday I'll get a call from the guy here. And, I'll go. Who knows what will be happening by then and I wouldn't want to pass up the opportunity to get in the door.

Oh, the really - is this ironic or coincidental? - thing is that on the way to Calais, the Fredericton CBC did a segment on the problems with the after hours clinics. Apparently, even though they post hours, e.g., 6-10 pm, people have shown up at, say, 9 to find the doctors gone. Turns out that the after hours' doctors are volunteers who come after their "day jobs." They have the right to limit how many people they will see or go home if there's nobody waiting. That was interesting to learn. Needless to say, health care here is in serious crisis. Then, I heard a segment about a pediatric nurse from here who has been living in the UK. She wants to come back, but they want to require her to do all kinds of training in areas in which she has no interest (e.g., psychiatry). She's going to come back and fight them.

As always, there you have it!