What is north of fifty caliber across, made of bone, and has enjoyed a storied career as a secret ninja torturer assigned to yours truly?
This thing, that’s what.
The astute will make note of the fact that the first picture differs from the next two in one critical and glorious detail. Yes, today I am a happy boy.
As with any good spy story, once the secret identity was discovered, it was “game over” and simply a matter of time. And so today I was happy to let a very good man* dig around inside my knee joint and rip this (not-so-)little troublemaker out.
The short story is that this thing has probably been floating around in there for years. I had many knee dislocations as a teen and twentysomething, and chances are that this bad-boy chipped off during one of those, but went unnoticed. If I’m hearing things right, it sounds like my body may not only have regenerated the larger bone it chipped off of, but it may have started growing the chip itself, at some point–and of course with enough time, it may have grown to a size that started…well…intruding beyond my ability to ignore it. (You can imagine, perhaps, what it might feel like to have had that thing pinched in the wrong place under full weight. Yessir, I did not fail to notice when that happened.)
And the intruding was random.
That’s a key point. I have been terrified of my right knee for years now, not knowing when it might suddenly seize up or otherwise demand my full attention with several exclamation points. There was never any pattern I could figure out, so my fear became dishearteningly general. And of course I would feel like a complete idiot trying to explain how I suddenly lost my knee’s range of motion after enduring the staggering physical rigors of…say…a nap. (That’s not hyperbole–it’s happened several times.)
So, let’s say it has been a bit reassuring that it wasn’t my imagination, or my making a mountain out of a molehill. The moment when I first saw the X-ray, which wasn’t supposed to turn up anything (it was merely supposed to make the case to go get an MRI), and saw both the fact and the size of this thing, was pretty cathartic. The thought went something like this:
Hugo Foxtrot Sierra and boy howdy now, that freakin’ thing, that thing right there, could quite precisely explain every otherwise random and arbitrary thing that has so long been vexing me about my knee.
I had an explanation–and for me, that’s nearly the price of admission right there.
So! Appointments, paperwork, prep–and today, execution. (Or, perhaps, excavation by arthroscopy.) It seems as though everything went swimmingly, and I expect my convalescence to be pretty short. Already I am encouraged to predicate both any pain meds and crutch assistance, entirely on what feels stable to me.
I’m not going to do anything stupid, but somehow I certainly feel like jumping up and kicking a soccer ball around. 🙂
And I can already envision my first contact with the physical therapist, which will probably go something like this:
PT: So, Mr. Wilmeth, what is your primary goal here?
Me: I want you to make me forget how to fear my knee.
Thank you to everyone who helped make it happen.
* Dr. Adcox’ excellent reputation was absolutely in evidence in my case, and I find more to like about him with each contact I have.
Update, January 25
Things looking good at the follow up visit, and I learned of a couple of details I don’t want to forget.
The only thing I’ve found notable about the knee thus far is that I notice the inflammation just a bit when I’ve not been in a good practice of “elevate and ice”. (I’m happy to be back at work, but I do still have to be careful for a bit, and integrating the icing cuff into a daily routine is not quite trivial.) I’d forgotten that there was actually extra fluid put into the knee, that will just take a bit more time to re-absorb into the system. The fact that PT found the two knees within a degree or two of each other already, on range of motion, is the notable bit about which everyone seems happy.
The left-side incision wound up nearly twice the size that most arthroscopies would indicate, simply because of the size of my “loose body”. (It seems to be healing fine.) Also, Dr. Adcox said that he wound up extracting the body with a regular hemostat, since his usual tool simply couldn’t grab something of that size. [Cue primal-grunt noises here.]
And it sounds like he got lucky in finding it, too. As it turns out, the piece was hiding out behind the patella in a fat body, and he actually didn’t notice it in the first look-around. They shaved off a bit of this fat body (something that happens commonly in total knee replacements) so they could see better, and found our little ne’er-do-well in the process. What was lucky was that the body actually got pinned into place by the scope’s saline jet (in order to see around inside there, the scope has its own little positive-pressure jet that clears a small visible area in front of it), which instead usually floats “loose bodies” away rather like reverse polarity on a magnet. Thus pinned in a convenient place, it then came out quickly enough, and we were good! (IIRC, Dr. Adcox said it was the anesthesiologist who commented that he’s seen the whole “chasing it around” nonsense take up to three hours before, and this was indeed good fortune.)
So: healing nicely, with inflammation understood and PT plan in place. Huzzah!