When Good Knees Go Bad

As luck would have it, at a time when it seems that Humira is controlling my arthritis pretty well, I go and injure my left knee in kickboxing.

About a month ago, I remember my knee hurting more than usual after kickboxing.  While I have never really had significant arthritis problems in my knees, I told myself to wait and see if things improved after my Humira injection.

Things didn’t improve, but since I am so used to being in pain, I walked around with my knee slightly swollen, killing me walking up and down the stairs and while bending down.

I quickly realized that the pain I was having was very different from arthritis pain.  And that the pain was from an acute injury. 

I talked to my kickboxing instructor, and he suggested that I give things another week, but that if they didn’t improve, I should go to the doctor.

So that’s what I did.  And now I am going to physical therapy.  They think that there is a combination of things going on, but definitely an acute injury occurred.  The most likely cause is a misaligned kneecap, which has caused inflammation of the joint. 

In some ways, I guess there’s something to be said for being “athletic” enough to actually injure oneself by exercising.

On the other hand, there is a lot of frustration on my part that the situation is happening at all. 

So where does chronic illness fit in with this?  Well, it’s front and center, as you might imagine.

According to my physical therapist, the injury is being exacerbated by some bad habits I’ve picked up walking with arthritis. 

I think we unknowingly make a lot of accommodations in an attempt to reduce pain and increase mobility, but these changes can cause other problems, sometimes to previously unaffected areas.    

I am hoping that my knee gets back into shape, and that I will be able to continue kickboxing. 

For now, the prescription is icing my knee three times a day, wearing some support tape, and going to physical therapy once a week.

I suppose that things could be far worse than this, but it feels a bit like adding insult to injury, when you have an acute problem on top of being chronically ill. 

Like wasn’t one thing enough?

And I’m pretty sure that given my health issues, it will probably take longer for this to heal than it would for some people who don’t take as long to bounce back from things. 

As Independence Day approaches, it makes me think about personal independence and what we lose from illness.  I’m lucky in that I can do almost all things myself that I should be able to do.  However, given this injury, it’s not hard to see the slide that can occur. 

It’s also a hard lesson to learn that I should listen to my body, rather than attributing everything to the same old, same old.  Hopefully I didn’t cause myself further injury by ignoring it for several weeks. 

Hopefully this knee issue is a minor setback.

Lesson learned. 

Not Out Of The Woods Yet

I started physical therapy again last week.  Unfortunately, my old PT moved to a satellite office, so I have to see someone new.  And as of right now, my insurance only approved a consultation visit.

I think this must be GI purgatory.  This is the place where they send people whose bowels are possessed by the devil. 

Apparently I have a sluggish colon, plus some of the muscles at the end of things are just frozen.  They’ve stopped working.  Explains why taking a dump has become akin to an Olympic sport.  Seriously, it’s freaking exhausting to be tethered to a toilet, not knowing when you’re going to shoot blanks, or actually drop some kids in the pool.

I’m sorry for being so blunt.  Actually, I’m not.  Not really one bit.  I pride myself on presenting my illness experience in the most truthful, if not funny, way.  And sometimes, you have to laugh. 

Forget Moves Like Jagger.  I’ve got moves like Elvis.  It’s all in the pelvis.  Ha, ha, ha, ha, ha.

So anyway, back to purgatory I go.

And it’s great to get a rectal exam from not one, but two doctors.  The joys of this place are just unending, let me tell you.

Hopefully we can avoid the word throw-up that included bible verses from a religion that I don’t belong to. 

So the new PT is asking me about health issues.  And she says, Aside from lupus and RA, you are in perfect health?  Is that a sick (pun intended) joke?  Is she mocking me?  Me?  Perfect health?  Ship shape?  Mint condition?

I don’t think so.

This body, with its freezing joints, and the possibility that anything I come into contact with could make my body go crazy?  Is that the definition of perfect health?  I certainly hope not. 

Given the fact that I’m 26, but I feel like I’m 80 years old part of the time would suggest to me that my body has seen younger, better days. 

Things could be worse, for sure.  But they could definitely be better.

Then she tells me that my posture is bad and that because I am short and my legs are longer than my torso, I’m basically pre-destined to have a difficult time doing my business. 

What the heck is up with these PT people?  They are so tactless, it’s unbelievable.  And don’t you just love it when healthcare professionals start nitpicking and telling you you’ve got more wrong with you than you previously thought (in not necessarily a medical way)?

So I’m annoyed with the whole PT experience.

And I’m not being a good patient, and am avoiding the flu shot like the plague.

After the whole pneumovax debacle, you can say that I’ve developed a slight aversion to shots.  While getting vaccinated may help me in the long run, in the short run there is a lot of anxiety.  Will the shot be given correctly?  Will I have a reaction to the shot?  Am I better off not getting the shot at all?  I will probably just wait until my rheumatologist appointment that’s in the middle of November and get it then.

But even then, I’ll do it with my eyes peeled.      

If you go to the Lupus Foundation’s website, go to the Research tab, and then select Lupus Research Summaries, there is a flu link.  The two summaries basically suggest that people with lupus who are immune-suppressed may not gain full immunity from one flu vaccination, and that getting two might offer better protection.

I really hope that’s not the case, because for me, this is going to be a one shot deal.  Literally. 

As the weather changes to cold and gray, there is a strong sense of foreboding.  

I’m ever vigilant.  I have to be.  In 2009, I was hospitalized in October.  In 2010, I was hospitalized in November.   Are you sensing a pattern here?  And not a very good one.  This year I probably won’t take a sigh of relief, until, um, I don’t know, spring?

So please, just let me get through the rest of 2011 without any health crises.

Is that so much to ask?

As winter creeps up on us, I feel a weight bearing down on my shoulders.  

The cold has increased my pain and stiffness to a significant degree. 

Clearly, I’m not out of the woods yet.   

Physical Therapy Redux: “It’s All In Your Butt”

The theme for the next edition of PFAM is memorable advice. I think my experience of physical therapy over the last few months fits well with this.

Besides the colonoscopy and defogram, this has been the worst experience I have ever had in the medical system.

Not only was the physical therapy itself uncomfortable and antiquated, but I felt like my physical therapist and I were living on two different planets

“At least now you know, it’s not all in your head, it’s in your butt.”

Yes, that lovely phrase was spoken by my physical therapist. I’m not sure whether to laugh, cry, or smack her. Or all three.

Overall, the experience was a little too touchy-feely for me, literally and figuratively. I have never been one of those people who can really zen out or find mindful breathing to be helpful. It’s just too much granola hippie-ness for me. Or maybe I’m just far too high maintenance. Either way...

My physical therapist and I engaged in a variety of conversations. Thank goodness for the distraction, because it’s not like I could just pretend that her finger wasn’t up my ass.

After telling my PT that I was Jewish, she started spouting off Christian verses. Holy uncomfortableness. I think it is probably the most unprofessional thing I have experienced at the hands of a medical professional.

And it’s hard to commune with a part of your body that you can’t see, and is only used to evacuate excrement. I’m pretty sure even if I could see it, I wouldn’t like it very much.

I know, maybe I’m being too much of a hard ass.

But I’m supposed to be getting in touch with my bottom-side. I’ve tried to be as open-minded as possible during this process, if for no other reason than to hope that it helps, and that all of the uncomfortable-ness was worth something. And in some ways, it has helped; and in other ways it hasn’t. (But I won’t go into that in depth, because I fear, my dear readers, that I may have actually found something that is just TMI for you…and for me…)

Truthfully, I counted down the days until therapy was over. And today, it finally was!

I also coincidentally had an appointment with my GI doc today. This is the woman who I have seen randomly at the hospital and there’s no recognition on her part. Well, today she came in and asked how my Crohn’s is. I said I don’t have Crohn’s. Colitis, she asks? And I’m like no. And she says she should probably look at my chart. And then she’s like, oh yeah, you have lupus and rheumatoid arthritis. All those autoimmune diseases just run together.

So the outcome of that appointment was that I need to have another colonoscopy. But should I really trust this doctor to do it? I just hope she knows which end is up…

Are you the butt of every joke? No, but my butt is!

I’m laughing so hard I can’t go on…

What To Expect When You’re Unsuspecting (Or The Things Your Doctor Doesn’t Tell You)

I started physical therapy for my gut last week. I was hoping to write a post about it once it was over, but that is at least six weeks away, and I really needed to vent about the experience.

I really didn’t know what to expect going in, but I assumed that you just lay on a table and someone palpated your stomach in such a way that it would get things moving. Not so. Are you ready for this? Brace yourselves…

Someone takes their finger and sticks it up your butt. And they manipulate the muscles that way…

(Read until the end. I promise, it gets better.)

I had no idea. And this is partly my fault. I did not ask my GI doc what physical therapy would entail. Mainly because I didn’t want to know the answer, because if I had known the answer, I probably would have refused. And because, at the time, anything, well, almost anything, sounded better than having to have surgery.

But shouldn’t someone have warned me? Shouldn’t I have had the opportunity to escape before I was knee deep in the situation? Given the tests that my GI doc has sent me for, I guess I shouldn’t be all that surprised, because they go from unpleasant to unpleasant-er. But don’t good doctors tell their patients what to expect from therapies and treatments? I’ve said it many times before: my GI doc is an uber-specialist, but the more time I spend under her care, the more I think it’s time to jump ship and find someone else.

Don’t get me wrong, the physical therapist was kind and gentle. But when someone’s got their finger up your ass – I’m sorry, but I don’t know a nicer way of saying it – at some point you just have to dissociate, like your body is there, but your mind is not. That’s the only way to get through it.

Modern medicine continues to disgust me with some of the antiquated methods it seems so hell bent on using. Really? In the 21st century, we really have no better way of dealing with a barely active colon other than to stick something up there, especially since I thought the goal was to get stuff out?

Some of you may be shocked by my openness here. But the truth is, there is no privacy anymore. No matter how depersonalized I felt things were in the past, this experience beats them all. I’m sharing with you all because I feel like I have a relationship and rapport with my readers. And because I’ve opened myself up in far more intimate ways to a total stranger.

I feel violated. Like a piece of meat that has to lay there and take it. I am just a specimen. My feelings and emotions don’t matter. I should remain mute. My boundaries have been crossed, and now there’s no way to go back.

As patients, are we allowed to have boundaries? Or being chronically ill, is it simply a fact of life that our boundaries will be tested?

When I went to my first rheumatologist appointment, and he had me get 27 tubes of blood drawn, that certainly tested my boundary of breaking out into a cold sweat for just one tube. In that moment, I had to grow up, and I had to accept the situation because I really had no choice. Had I resisted, I would have probably been considered non-compliant, and refusing something that was directly related to being diagnosed, would have seemed contradictory.

So should I just expect that from now until forever my boundaries will be tested and my threshold for what I am able and willing to handle will continually go up?

Have you ever found yourself in a compromising situation that you can’t get out of because your doctor put you there?

I so did NOT sign up for this!

And don’t worry, the irony of the fact that my physical therapist’s last name is BUTTS, isn’t lost on me. Only in my life would something like that happen. And I have to say, there needed to be some humor in this situation.

And a friendly warning: Don’t get caught unawares, because someone might just come and stick their finger up your ass. Yes, apparently there are people who spent years being educated on how to do this. And they enjoy it! Well, maybe they don’t enjoy it, but they don’t dislike it, either. There are no ifs, ands, or butts about it.

Okay, I’m going to stop now…