Knee Update

Well it has officially been 2 weeks of knee pain for me!  And I sure hate it!  But I had my appointment with the Orthopedic Specialist this morning, so I was hopeful.  I got there early to do their eleventy-billion pages of paperwork before I actually got to see someone with a doctor's degree.  They sent me for Xrays right off, which I thought was good that they have all that equipment in the office so the pictures were there within 30 minutes. But I did have to wait a while (good thing I brought by Nook.  Read about 20 pages just sitting in the waiting room and more waiting for the dr).

FINALLY the doctor came in and asked 100 questions and then looked at my knee.  He actually looked kind of concerned, which in turn, concerned ME! I told him about my history with this knee pain and how my diagnosis' have gone from Juvenile Arthritis (JA), to Rheumatoid Arthritis (RA), to Weight issues (as I said before, probably not ALL wrong, but they didn't hurt when I was pregnant and at my heaviest), to possible Gout. 

The Doctor told me that my MRI didn't really show anything worth while for him, and my Xrays came back pretty normal as well.  He did say that my knee caps are being pulled to the side by some tendons, but that it shouldn't be the main cause of all my pain.  However, if that issue doesn't get corrected by whatever treatment he's going to put me through, knee surgery might be in the future for the knee caps. (Joy...)

He then asked if I've had my senovial fluids drained before (now this is the procedure that I mentioned previously that I've had done twice.  The first time wasn't that bad, and the doctor got some fluid out to be tested.  But the second time I did it, NO fluid came out and it was the single.most.painful experience in my LIFE.  And I've given birth, practically naturally, to a 9.6lb baby who got stuck coming out and I had to have 2 nurses jump on top of my stomach to help me push her out.  And yet, I still say that having the fluid drained from my knee was the MOST.PAINFUL.THING.IN.THE.WORLD!!!!!).  So I politely told the doctor that Yes, I've had it drained two times previously and no conclusive results came out of it.  He looked at me and said in all seriousness "Well, I see that there is a lot of fluid on your knee right now, and I'd really like to drain it so that we can see what the fluid itself looks like and we can then proceed with either cortisone shots or see if there is another problem that we will need to take care of."  I swear my face must have gone pure ghost white, because the doctor said "Are you ok?" I, as calmly as I could, which probably wasn't calm at all, said that I didn't want to do that! That it was the worst experience and it hurts so bad.  He promised that he would numb me up really good and that I shouldn't feel a whole lot.  He even sympathized with me about the time they got no fluid and said that he understood that it was a painful experience and that if he starts to pull and no fluid comes out that he will immediately stop.  So I sighed (really loudly) and said ok.....

He then came in with a bunch of needles and gauze, etc.  I immediately started getting very nervous and panicky.  He promised that he would numb me up really good (again).  And boy did he stick to his word!! :)

He sprayed my knee with numbing fluid, then injected numbing medicine, waited 5 minutes, and injected MORE numbing medicine. (WOO HOO)  When he went to touch my knee I said "Oh hey, my knee really is super numb! Thank you!" He laughed at me!  Then he put in the syringe to pull out the fluid.  That sucker was HUGE.  And I'm not exaggerating cause I'm a baby (maybe a little, but it was still massive).  I really didn't feel a whole lot of the excretion, just pressure. 

**Disclaimer: This is NOT my knee! This is an image I found to show what the procedure I went through looks like.**

This is basically what I had to do today. 

YUP...I big arse needle stuck into the side of my knee cap intended to pull FLUID out.

And YUP...it's as painful as it looks!

This is a 50cc Syringe. 

This is what they used to extract the fluid from my knee

He filled this up PLUS another 20cc

He showed me the fluid when he was all done and it was a golden color.  He said that it was completely normal and he wasn't going to even send it off for tests because he saw nothing in it (no crystals-which would be apparent if it was gout; no blood-which would show a possible infection; and no discoloration-which could also show infection.)  He put in some cortisone and I'm hoping that within a day or so I'm back to "normal".  He wants me to do some physical therapy and get a medical knee brace, instead of the store bought ones I've been using for years.  I'm also on the hunt to get my medical records from the RA specialist I saw in Dothan, AL.  Hopefully that will show this doctor if I have any signs of RA or what that doctor thought was wrong.

So far, no one has given me a DIAGNOSIS of what's wrong with me.  I swear I am some freak of nature.  My BFF Jen said that I should be on that tv show "Mystery Diagnosis".  I laughed, but I'm starting to seriously think about this!!!!!

On the paperwork I got today it says "Left Knee Joint Effussion" under Diagnosis.  So I googled it (I heart google): 

What Is Joint Effusion?:

Joint effusion (not to be confused with joint fusion) is also referred to as "water on the knee" and "fluid on the knee". What is the significance of joint effusion in terms of arthritis and related conditions?

A small amount of fluid exists in normal joints. When a joint is affected by arthritis, particularly an inflammatory arthritis such as rhematoid arthritis (RA),  increased abnormal amounts of fluid build up, the knee appears swollen. The fluid is produced by the tissues that are affected by the arthritis and that line the joint.

Why Drain Fluid From A Joint?

Often, your doctor will drain the fluid from a large joint such as the knee to help relieve the pressure in the joint, thereby helping with symptoms. In addition, if infection is not suspected, they may elect to inject a small amount of cortisone in the knee to help prevent the fluid from returning.

Why Is The Fluid Tested? What Does It Show?

Studying the removed fluid can help with diagnosis. For example, if the patient has a warm and red knee, there is a chance that the joint is infected. Sending the fluid off to the lab for culture can help confirm or rule out an infection. In addition, a blood count on the fluid can be obtained. If there are a lot of white blood cells in the specimen, the fluid may be cloudy. Cloudy fluid can be seen in patients with infection, rheumatoid arthritis, and gout.
In addition, gout fluid may have a golden color. In patients with osteoarthritis, the fluid is often clear. Finally, in patients who have injured their knee, the fluid may be clear or bloody.

SO......basically we have no idea and I'm still in the same boat I was in when I was 12 and went to the dr for my knee pains the first time.  ::Sigh::
But I'll be sure to keep everyone posted.

EDITED TO ADD:

Last night after I got home, I took some pictures of my knee.  There was still benadine on it (the orange stuff) and the streak from the numbing spray that the doctor used (bless him!!!), but you can see the HUMUNGOUS hole in my knee.  And you thought I was over-reacting! PPTTHHHH!!!!

Yes...that 'little' red dot is where the needle went into my knee!

Makes my whole body cringe seeing it!

But on a happy note: I feel SOOOOOOOO much better today! I can actually walk without limping, got some decent sleep, and my knee looks somewhat 'normal'.  I probably should have let Dr. Armistead (the original doctor I went to before going to the Orthopedic Specialist) drain it, but he's the one that hurt me a couple of years ago...and honestly at this point, he's not coming at me with a 9 foot pole! =)

I haven't gotten my knee brace yet (mainly because my insurance SUCKS and I have to pay for the whole thing: $182.70, plus $350 for yesterday's doctor visit because I have a $1500 deductable that I have to meet before insurance kicks in.  And then I'll have a 50% co-insurance that I'll have to meet.  For as much as we're paying for this insurance I'm thinking about cancelling it and getting a private policy. Boy insurance is horrible!!!!!)

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