Monday, March 13, 2023

Hope is Good


About a month ago, I slipped and fell in the Target parking lot and through a variety of contorsionistic moves was diagnosed with "an acute avulsion fracture of the deltoid ligament at the medial malleolus as well as the anterior capsular." Translation: the ligaments in my foot were stretched so far that they tore off some bone chips. I was given the boot and sent on my way. 
My parting gift from the Parker Adventist Hospital was the ortho follow-up with Dr. Alex Romero a few days later and again today. Today was my four week foot follow-up.

So, he had an X-ray taken and found that all is well in the foot world. Just keep adding movement steadily and expect occasional flair up issues for up to 4-6 months. It'll heal completely slowly.


Then, I bravely asked, “can we talk about my knee?” It had been briefly discussed four weeks ago, but mostly tabled for the future.


The last time anyone medical said anything decent about my knee, it was 2015. Today, that changed.


We began reviewing my knee history, quickly made it to the micro fracture surgery that never happened because, as the Doctor (who will remain nameless) said at the time, “WAY too much arthritis in there to do that.” So, she scoped around, charged me a bundle and it hurt within 8 months. 


A few years later came the ortho surgeon guys (who will also remain nameless) in Denver. “There’s a lot of arthritis in there. The best thing you could do is get it replaced.” We actually scheduled that little "procedure" twice, first time cancelled by me, second time by COVID. And I should make this clear: I was NEVER comfortable with the idea of a replaced knee.


Dr Romero then asked, have you had an X-ray lately? Uh, nope. So, he poked and prodded, twisted and played, then sent me off to x-ray. In the end, here is what we discovered today: the italicized stuff is from his notes:


“Examination of the left knee demonstrates that the patient's skin is intact. There is no significant soft tissue swelling or edema. There is negative patellar grind. There is range of motion from 0-125.  There is tenderness to palpation peripatellar medially. There is a ligamentously stable knee and a grossly normal neurologic and vascular examination distally. 


Other than my range being off, supposed to be 0-135, all of that stuff is pretty “normal.”


Then came the biggie: The patient's left knee he has underlying moderate grade osteoarthritis greatest in the medial compartment.  Today we discussed multiple different modalities to help him continue running.  We discussed the option of having an off loader brace utilized.  He has expressing some interest in this but is not ready to commit.  We also discussed the option of viscosupplementation (gel injections) versus PRP.  He would like to wait until he is closer to returning to running after rehabbing his ankle before he makes a decision on injection therapy.”


SOOOOO…… he said that the surgeons I had visited were mostly interested in doing what most surgeons are interested in doing which is surgery. He thought a strength program, along with weight loss (duh?), and then trying the gel injections might lead to a return to pain free running. The early key: cycling. He said it’s the quickest way to build strength in the knee, increase circulation, and help with range of motion. So set up that bike trainer!


I have spent the last, almost, decade, being without any concrete hope. Today, I have some. 


Hope is good.


Run on, maybe?

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