Random Thoughts of a Disordered Mind


Feeling Fragile Today

Did I mention that I fell again this week? This time it wasn’t my knee or a balance problem. Instead, on a beautiful snowy day (which was really lovely for this transplanted New Englander to have), I drove home and promptly slipped on a puddle of slush and fell with a crash to the garage floor. The very cold, very wet concrete floor. My head jerked, I smacked the left elbow on the golf cart, and hit hard on my right hip. Yup, that side. The same one with the neuropathy in the foot and the torn MCL. Now my whole right side is very stiff and sore and sitting for any length of time, even on a soft cushy pillow, is very uncomfortable. Falling on carpet was a lot easier. Note to self: Work on not falling at all.

So my body is feeling fragile. My ego is, too, because I lost an election to the club/HOA board. I knew going into it that there was at least a 50% chance I wouldn’t win: there were 6 candidates for 3 positions. And honestly, I’m happy that I’m not going to have to deal with actually being on the board for the next three years. But there is still some hurt that I lost, though I’m in excellent company with the other losers. Enough hurt that the last bits of my chocolate stash are gone today. Note to self: Don’t run again. Lesson learned.

And my soul is fragile today as the president was impeached for inciting the insurrection and attack on the Capitol last week. They did so today in what is a crime scene. I am terribly afraid of what is going to happen next. I’m baffled by the many who still believe that the election was unfair just because he said so without any evidence. I’m feeling so lonely here in East Texas, feeling like a lone Maine blueberry in a great big bright red cherry pie. So I watch TV news, knowing I’m watching too much of it but unable to look away. Because I don’t want the world to blow up around me without my understanding why.

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The Knee – Second Opinion

You go for a second opinion for a bunch of different reasons. Maybe you don’t trust that you got full information from the first person. Maybe you want a different explanation of something complicated that you don’t really understand. Or maybe because what’s recommended is big or expensive or complex and you just want to hear if someone else agrees with it. I got mine for all of those reasons.

My problem is a torn Medial Collateral Ligament (MCL) on the right knee, which already had a total knee replacement. The MCL on the inside of the knee and its partner the Lateral Collateral Ligament (LCL) on the outside act together like hinges to keep the knee stable and not wobbly. Tearing one makes the knee unstable and left me prone to falls. I’ve learned not to straighten my knee completely when I walk or stand which helps a lot, but at night it straightens as I sleep – and the movement wakes me up with pain. And I’m afraid of falling.

I tore the MCL in May 2020 and saw my primary care doctor a few days later. I got x-rays and not much else, but at the time we thought it was a sprain. But it didn’t go away and I got very fall-prone. In August I saw an orthopedist who did more x-rays and confirmed I had a complete MCL tear, which is only corrected by surgery. Since I already had a knee replacement, we were talking about a revision surgery, which meant replacing the replacement. It’s a big surgery and not something to jump into without a lot of thought. Plus he also told me that I couldn’t have it anyway until my BMI was lower than 40. He also sent me to get a custom brace which I didn’t actually have in hand until just after Thanksgiving. It’s large, cumbersome, and the velcro on the thigh portion rubs the inside of my other thigh too much for me to want to wear it. So I’m not.

Then I fell a month ago. You remember that, right? It was fun. I sprained my foot and twisted the knee, and decided it might be a good idea to get a second opinion about what was actually wrong with it. That appointment happened this morning with a knee and hip surgeon at Azalea Orthopedics. They took more x-rays, then talked to me about what’s happening.

Yes, I have an MCL tear. And you fix it with surgery. But having already had a knee replacement, what I would need is not just revision surgery. It would involve a very long and complex surgery to take out everything there and installing a new joint with a hinge. Part of the femur would be cut down. It’s not a long-term solution and if it failed in a few years, it would mean amputation. So it’s not something he recommends for someone young and healthy. He said I should take the idea of it off the table. He had me at “amputation.” He also showed me on the x-rays why he suspected that the MCL was already compromised, possibly even from the original surgery. While we couldn’t prove it, he was concerned that a second surgery might not be successful.

What he DID recommend was a knee nerve block for the pain and physical therapy. I had asked the first doctor for a PT recommendation back in August but never heard back. I left the second doctor’s office with a PT prescription for 6 weeks of 3-4 times a week of therapy. I also got the name of the specific nerve block he said should solve the problem of nighttime pain. It might only work for 6 months but hey, 6 months is 6 months. I see my pain doctor soon for a follow up so I’ll ask him about it. If it’s not a procedure he does, the folks at Azalea do.

My biggest fear going into the appointment was that my weight would be a factor. Turns out the doctor doesn’t think surgery is the right choice for me no matter what my weight is. He explained that larger people have greater risk of infection following surgery because they have more surface area to infect, and therefore a greater possibility of implant failure. Orthopds use BMI as a cut-off because they want surgery to be successful and infection is to be avoided at all costs.

This second opinion visit was definitely worth the trip. I understand what’s going on in the knee far better than I did after seeing the first doctor. I didn’t want surgery anyway but man, I really don’t want it now. And I know why.


Feeling the Covid fatigue

Cape Breton Island, Nova Scotia

When I’m stressed, I either eat or shop. I’ve been trying not to eat, although I’ve had a couple of iffy days lately, but I’m going great guns on the shopping. Ask me about velvet pumpkins, my new computer, and leggings. I went a little nuts on leggings.

No, I haven’t lost any more weight and in fact, have gained back a few pounds. But since I know I didn’t eat as many calories as would make those pounds actually stay attached to my body, I’m not particularly worried. But it must be stopped and I’m doing it.

Physical activity has come to almost a crashing halt. I can walk just fine in a store holding on to a cart, and try to do that several times a week, although that does open me up to the “Oh, we must buy something in this store” mentality. But the bad knee is very sore when I try to do other things, and now I think I pulled a groin muscle doing something or other. Clearly I need lessons in how to stretch better so I don’t do this crazy stuff to myself. It is completely logical that this lack of movement is the reason for my basically stagnant weight situation. I’ve heard nothing from the guy who measured me for the super expensive custom knee brace; I think it’s time to order a cheaper one from online to see if it could help.

There is good news, though. My A1C has dropped from 6.1 to 5.3! Still higher than I’d like, but way better (and finally under pre-diabetic) for the first time in years. I thought I’d get updated cholesterol and triglyceride levels with the last blood work but surprise! they didn’t do those. I don’t know why. My arm was there and filling up blood vials nicely. They could have taken more!

But then there is bad news. The back is still a problem. The left side neurotomy was quite effective and only twinges pain a little now and then. But the right side, the bad side, is only about 40% better. Maybe 50%. When I get in the car, I can get about 1/3 of the way to town before it starts to hurt instead of 1/2 mile. And I can do things without wanting to cry. But I’m not getting in a car anytime soon to go on a trip or just get “windshield time,” as my brother calls it, because it hurts.

So instead of doing much, I’m sitting in my chair after work with ice rotating on various body parts, doing gentle stretching, and working on puzzles with the cats. I’ve noticed that my temper flash point is very low and my patience for criticism and correction is almost non-existent.

I’m tired of sore body parts. I’m tired of coronavirus and people who don’t wear masks. I’m tired of being stressed. I want my scalp psoriasis to calm down. And I want Purina to NOT discontinue Emma’s favorite food. And I would really, really like for the election to be over.

Did I mention I put a Biden sign in my yard?

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I keep almost falling

I almost fell twice yesterday, once walking down my driveway and once in the bathroom. On Wednesday I almost fell in the parking lot at the eye doctor, tripping over some weird metal thing sticking out of the concrete. That one was a close call and I only avoided actually falling because the lot was tightly packed and I fell into a close-by SUV.

I don’t like it. I don’t like that I can’t trust my body to keep me up. I don’t like having to walk looking down at my feet ALL THE TIME in hopes I don’t stumble over something the size of a twig. I don’t like that this knee that was so strong and trustworthy is now so unstable.

The kneecap is wobbling around because I tore the MCL and some other stuff on the inside of the knee. The solution is to wear a brace to help keep that stable but the custom-made one maybe out of my price range ($900 and up) and not paid for by Medicare, so I’m looking at other options made for fluffy people like me. But it’s clear I can’t pretend I don’t need it. It doesn’t hurt as much as it did earlier but pain isn’t the problem, instability is.

I don’t like it. And I don’t like the idea of using a cane when I’m feeling stronger and more healthy except for this stupid knee. I want to go take walks but am afraid of falling just going to the mailbox, so how can I trust myself on a walk? So a cane or walking stick is going to be needed even if I don’t like it. And I don’t.


Knee worries

My knees have been terrible for a long time, and although I only have two of them, I’ve had five knee surgeries from arthroscopy for meniscus tears to bilateral total knee replacements seven years ago. Unfortunately for me and the knees, I’ve gained weight since then, a lot of it, and my right knee is again a worry.

It was doing okay with walking with only a little pain around the edges, and since I have arthritis everywhere, I sort of expect it all to hurt sometimes. But then I saw the pain doctor about my back a few months ago. I have acute spinal stenosis because of arthritis, causing neuropathy in my right foot and sciatica on the right side. The doctor had me twist and move, and put one leg on the other knee while he pushed down, to see which movements caused more or less pain.

Putting my right ankle on the left knee while he pushed down on the right knee made the back hurt, alright, but I think it also did something else. WHAT else, I’m not sure. The next day I noticed that the knee felt like it was buckling when I’d stand up, and it got worse. I went to my regular doctor, working her in around the sinus surgeon and the pain guy because why have one doctor if you can have several. She thought I had sprained it and that it would heal in about 4 weeks. They did an x-ray and didn’t see anything wrong.

But it still hurts and I’m limping. Actually, it’s more lurching because the back still hurts because the neurotomy (nerve burn) hasn’t killed off the nerves yet. Anyway, I’m offsides. It hurts to sleep because I touch the knee to the bed and wake myself up when I move. It’s wicked sore all around the kneecap. And now I’m scheduled to see an orthopedist next week for an evaluation.

Deep in my heart I am afraid that my knee replacement needs revision, that the weight I gained damaged it enough that that one push by the doctor triggered something. Maybe it’s loose. Maybe it’s something else. But whatever it is, I’m afraid that it’s my fault for not taking better care of my body for all these years.

I had lapband surgery and lost 145 lbs to get myself to a weight where a knee surgery would be easier to do and to recover from. And then I gained a whole bunch of it back. I knew it was not good but I couldn’t stop myself. Or wouldn’t. There was lots of stress in there, but the one thing I can control is what I put in my mouth. So it’s past time that I actually honor that knowledge.

I’m proud of myself for having lost 55 lbs but wish I didn’t need to have lost them in the first place. I need to get over that, and get over the guilt and fear so I can deal with whatever I learn next week. I suspect an MRI will be in my future. I hope the nerves in the back die soon so sitting in the car on the way into town doesn’t hurt so damned much.

And if I need another surgery, I can figure it out. It’s what I do.