Miniscus tear and surgery

[Sam]

My knee down to the tops of my toes blew up with swelling, redness, heat, pain and soreness on Sunday, October 11th. I had a vacation planned the next day so flew out to Vegas, walked that city, and on Wednesday, drove to and hiked through the Grand Canyon. Mostly bus touring but lots of walking on paths. That afternoon drove to Sedona, Arizona and saw beautiful sunset. The rock and mountain formations are nothing like I had seen in person. We drove to Scottsdale Thursday morning for a wedding we were to attend. By 11:30, I am in the ER. They thought it could be DVT, and did a CT scan and ultrasound, negative. So next thought was cellulitis, a skin infection. But blood work showed no elevated white blood cell counts and I had no fever. Given IV antibiotics and pain meds. Discharged me to fly home Sunday and told to go see primary care or ER Monday. Well, I have not been sick, other than with chronic psoriasis, so my primary would not see me Monday, Pain not better and could never get comfortable to sleep. Went to bed 8:30 Sunday night and it was not until 3:30 that morning before I just passed out from exhaustion. The Memphis ER did an Ultrasound and found a Bakers Cyst had ruptured. Gave me 4x200 Ibruprofen for pain and Hydrocodone in small dosage for pain, but I use it as a sleeping pill (should take it 4 times a day, I just do it when I go to bed).

Saw Orthopedic surgeon yesterday. Did Xrays. Wants to do MRI to confirm a miniscus tear. Says 50% of baker's Cysts are due to tears like that. My insurance sucks, one of those high deductibles, but I am into it for two ultrasounds and CT scan so I can't worry about what my part of the bill will be. Swelling is down but pain behind the knee and in calf still present

Anyone had experience with this? I don't mind surgery, it's rehabilitation I am told could be six weeks. Being an attorney, that means every day monitoring my office and making calls to clients and other attorneys to get cases reset if I have to be off my feet, If I can do rehab around 4pm every day, much more manageable.

[ThePossum]

Sam, you saying your are an attorney gives me insight as to why you have the avatar you do. Good ol' Rumpole.

I have had meniscus surgery on my right knee twice. Nothing with a cyst but did have it. Not too painful after the surgery and was off my feet for a couple days and then walked with a cane for another week. Forget how long after the surgery I started the rehab but all it entailed was strengthening my leg and knee joints. No pain there.

I would assume that you will not have the long involved rehab like you do after knee replacement (that is next in line for me when the arthritis pain get unbearable). You may not be able to go to court for very long periods without some type of support like a cane or being able to sit at a table or on a stool to do what you do. I am sure that any decent self-respecting judge would accommodate you.

Will be interested to hear how you are doing especially with the cyst factored into your problems.

[Sam]

Bryce, thanks. Funny thing is, my swelling and the heat in the calf area is present. Swelling is done in ankle. Mobility is improved by 75%. I can actually walk instead of sidle. I can lift my leg higher to put my sock on or cross my legs a bit.

Reading up on like WebMD or Mayo sites, it can be caused by arthritis. I did not have it, but taking Otezla for psoriaris, I started Otezla three days before. I assumed that what I had was the Otezla forcing psoriatic arthritis on me. So in some way, I am thinking this is medicine related, and I am going back to the dermatologist today. But the ultrasound in Memphis showed a cyst, so don't know that it is actually psoriatic arthrtis. Guess it ruptured? So I have to trust the docs and though I hate the thought of paying for tests that rule out stuff, well, that is what docs have to do. Not their fault that I do or dont have something. I have been blessed to be heatlhy, except for psoriasis until age 55 1/2, so this is a small setback. But it does get you to thinking and plays havoc with your mindset about how your future will be (like age 65), travel, playing with grandkids, etc.

[malocchio]

I have no experience with this,but here's hoping you make a swift and full recovery..

[Squire]

It's a tough call Sam, we just have to keep testing and settle on the best apparent solution. I didn't mind the subsequent surgery either but an unplanned absence from the office and having to juggle all the stuff already on the calendar was a real gripe.

[ShadowsDad]

Sam, I had my left knee 'scoped possibly 20 years ago now. The surgery itself is no big deal. For me it was a no brainer. I could be walking along and that piece of cartilage would get caught by the joint and I'd be in category 10 pain. I was in a knee immobilizer for a month after the surgery.

This past May I work up and stepped over a dog and I had that long gone but quite familiar cat' 10 pain in my right knee, so I was fairly certain I knew what the problem was. I was on crutches on and off for 2 weeks as the pain would come and go. After x-rays and an MRI it was determined that I was right and I had another meniscus tear on the other knee. I'm going to try to put off the surgery until spring, when nothing is going on. Right now my knee feels good, but it can turn at any time with absolutely no provocation. Yes I have a Bakers cyst behind that knee also. My Dr. tells me that's a characteristic of the cartilage problem and no cause for alarm.

But after all that story, you should know the surgery is no big deal. But yes, you'll probably be using crutches for a month afterward unless they do things differently than they did 20 years ago. I was also 20 years younger then, maybe the recovery will take longer this time.

I wish you well with it. If I was in pain as I was the first time I'd get it done immediately, you need to gauge how soon you'll get it done, but as my Dr 20 years ago told me, you can put it off, but eventually I'll see you in the operating room. I was in for surgery the next day.

[ichabod]

My wife (coincidentally an attorney) blew out her knee pretty comprehensively while skiing a couple of winters ago. She did several weeks of "pre-hab" before her surgery and then wasn't off her feet afterwards very much at all - the pre-hab took time out of her days, obviously, but she was able to get around. The aim of it, as I remember, was to have a certain amount of movement in her knee before the surgery. Post-op she made a pretty quick recovery, as in a week plus. She's pretty tough.

A friend of ours (coincidentally also an attorney) blew out her knee last winter (also skiing - attorneys shouldn't ski, maybe?), and didn't do the pre-hab process before her surgery. It meant she was under the knife more quickly, obviously, but she was off her feet and unable to do much of anything at all for 6+ weeks after her surgery. She's also no softie.

So -

• attorneys should be careful skiing
  check into the pre-hab concept

[Squire]

No, Attorneys shouldn't ski, which involves going downhill at speed, because even the most skilled counsel cannot appeal a decision made under the law of gravity.

[fallingwickets]

Sam, wishing you a speedy recovery and Dominic, nice to see you out and about

clive

[GA Russell]

My best wishes to you, Sam! It sounds like even in a worst case situation, the doctor won't order you to abstain from alcohol!

It does occur to me that you have two problems simultaneously - making sure that your law practice continues to function while in pain.

[Sam]

Well, I don't have the practice that most people envision. My practice is as a solo, without staff. After my divorce, I ended up living in the same building where I practice. so I ride an elevator to work. Today, took a two hour nap due to the pain. Besides, I am seriously considering moving to Atlanta and going to work for someone so I can be near my daughter, her husband and her new Goldendoodle

Range of motion in the knee is almost back to about 80% and I have residual swelling, maybe 30%of what it was I am guessing. The hack of the knee can throb, the calf, wow, big time dull ache all the time, and my foot feels like it has gone to sleep at times with pins and needles. However, I am feeling 70% better than when it was at its worse. If it is not a torn meniscus, then I in my heart believe that the new psoriasis medication threw me into psoriatic arthrtis big time in the knee, and that caused the baker's cyst. I chose Otezla as the medication because it is not one where you need blood tests or liver biopsies. Drugs like Humira, Enbrel, Stolera, they affect the liver and I have a fatty liver, thanks to a complete physical I did at age 45.

[BiffBuff]

On a recent holiday I jumped from the deck of a boat to the shore and somehow managed to twist my left knee. Just as you mentioned in your OP, I still had a great deal of vacation left, so I just ignored the pain (3 or 4 naproxen a day seemed to work OK). I was limping around Paris and keeping up with the itinerary, but I thought I would heal up quickly.

Back home, I noticed that things weren't getting better with my knee -- if anything, worse. I thought I should probably see a doctor, but I wanted to let nature take its' course. Bought an elastic bandage which provided a lot of relief, and eventually bought a dedicated compression brace (neoprene, elastic, and nylon) and used a cane for a couple of weeks.

Slowly (Oh so slowly) my knee began to heal and now, over three months later, it is finally back to normal (or 99.9% anyway) and I'm SO grateful not to have needed surgery. Funny, but now my only problem regarding the knee is that I was limping for so long, it is sometimes difficult to walk normally -- I still tend to want to favor the injured knee even though the need to is gone.

No complaints here though -- I'm too old to be leaping off boats and should have known better. I hope your injury heals as thoroughly as mine has.

[Sam]

Brian, yeah, I am doing the surgery tomorrow as an outpatient. Arthroscopic. I just can not get this leg comfortable. I have been going to bed between 7:30 and 9:00 every night hoping that I get 3 or 4 good hours of sleep. I tried drinking a couple of beers to go to bed. Sure, I go to bed but I am up in an hour. Small dosage of Hyrdocodone/Acetimenophen, not working. 5mg of ambien, not working. Just cant get the leg comfortable. If it is not achey or balky, it throbs. The foot can go to sleep at times. I don't know how people let these things heal normally. Now the tear is not one from gradual wear-and tear, he said it was a traumatic event. I can not think of how that happened. It is not like I had something happen and then I was in pain. I had started a new medicine for psoriais, Otezla, and third day of it, my leg started swelling. Oh well, main thing, is I am going to get relief.

Found one of the old-school knee braces from 30 years ago, white, metal things to the side. Actually helps when I sleep.

Funny thing is that no one in Scottsdale caught the baker's cyst, I bet if I had caught it that Friday when I was there, they may have opted for surgery that weekend. Can't say that they missed it, but the ER in Memphis two days after my AZ discharge caught it,

Im thinking that surgery tomorrow, Ill be getting up Saturday and they will have me going to rehab by Wednesday. Probably get one of those velcro-type knee braces and crutches.

Now, I think I have a high pain tolerance. That scares me. I had worked a whole day at the office thinking I had a nauseous tummy when in fact I was having appendicitis. But I was cutting the grass on a riding mower two days after being released. I am sorta concerned that I will be having a heart attack and think that this too shall pass. Or just wanna lay down and take a nap. People assure me I will know but will I? I had a client who had a headache for 4 days and told her family before going to bed that if she woke up and still had it, she would go to the ER> Well, she never woke up, it was an aneurysm and she died.

[brothers]

Sam, all the best to you! I'm confident we'll be getting a positive report from you within a few days.

[ShadowsDad]

Sam, I hope you never have a heart attack to find out what they're like. That isn't the voice of experience, I just don't want you to experience it.

Since you have a high pain threshold follow the Dr's rehab instructions. Don't reinjure the knee by doing too much too soon. I hope the procedure and rehab go smoothly for you.

BTW, That was pretty much my experience when my meniscus was acting up as far as sleeping. I had some Ambien and would use it. I also slept in a chair for relief of the pain and just slept a few hours. I'd turn the TV on and if it put me to sleep while nursing a toddy, well, OK. But the cartilage slowly did go back into place. It took about 3 weeks. Forget about it healing beyond childhood. Up to then there is blood flow to it and there's the potential for healing, but that flow stops shortly after childhood and there is no more healing to be done without blood flow; just trimming and removal.

My insurance was just changed to what's called a high deductible and I was thinking that I'd get mine taken care of before Jan 1, but we had a meeting for retirees yesterday and I'll meet the deductible next year, so it makes no difference whether it's gets fixed this year or next. Once I reach the deductible it's covered 100%. As long as it remains the way it is now I intend to wait until the ugly grey, muddy, and useless spring weather. That's a great time of the year to be indoors.

[Sam]

Oh, high deductible. That is what I have. Private policy I had to get when ex-wife, wife at the time, swtiched jobs. I don't get the free physicals each year and it had ridered Psoriasis. I called and it's $5000 max out of pocket. Got the ER bill from Phoenix. $17,700 and that included $178 for vaccine administration, which I guess is the flu shot they said I should get. $25 at Walgreens

Im researching new marketplace plans and they have some with $5000 deductible and 50-50 coinsurance and stuff like that and are about $100 or so more than what I pay. Seems better off stick where I am and maybe the $5000 incurred in October and through the end of year may apply (or maybe that was in the old days) to next year's deductible.

[ShadowsDad]

My new insurance is through United Healthcare through the place I retired from. It's not what we had but it's actually not bad. Meet the deductible, $1300, and everything covered beyond that is 100% paid for. Some things aren't covered, dental and such. I haven't seen what it's going to cost me every month. That information has yet to arrive.

[Sam]

Got a call 20 minutes ago. Surgery center did not get approval of insurance, it is still under review. Cancelled surgery tomorrow. Reset it one week. Upset is not going to do any good. I can not sleep and I eat one meal a day. I have lost 12 lbs or so since October 10th. Doc gone for the day so tomorrow nurse will ask him about more powerful sleep medicine. And I have to drive to get the prescription instead of them calling in it. Great, Ill take a cab. I want to be knocked out for six, seven hours straight.

Squire, this has played a bit of hacov with court, and my income stream has gone kaput. Maybe a good time to move to Atlanta and consider a career change. I could go to work for someone.

[ShadowsDad]

That's ridiculous! Do they expect you to live with a torn meniscus that has you in constant pain!!??

[fallingwickets]

Sorry to read about your misfortunes Sam....wishing you a speedy recovery

c;ive