State of the Knee Address

This is an old blog posting that got lost when the hard disk in my server crashed over the summer; I have recovered it from a backup and I'm just now putting it back up.

Chapter 1. Bad Doctors and other Evils

I have been fairly active all my life, or at least all of my "young" life. I played organized basketball since I was 8 years old, and play volleyball in 8th grade, high school and college (was on the reserve team for Ball State for one year). Then I got hooked into running. This was the 80s craze, as some of you might remember, everybody was running. I participated in a lot of road races (5k and 10k distances). I was even decent, having ran a 42 minute 10k and 20 minute 5k. This, I think, made my knees weaker than usual and in '83 it happened.

I was playing volleyball at a high school reunion and I landed on my left leg and my knee gave in towards the inside. I heard a distinctive loud pop and was carried off the course. That's when all the medical history of my knee began. First, I went to the emergency room, where someone who I am sure was not a medicine doctor, "treated" me. This person was joking with another person, also pretending to be a doctor, or at least wearing a white gown in the emergency room at the hospital. He came back with my XRays in hand and said: "You are ok, you have nothing broken, just go home." My response was "sorry, but could you tell it to my knee? It is in a lot of pain, very swollen and I can't bend it." He looked at the XRays again, and squinted his eyes, as if trying to see something that was not there before. Then he said "well, this section here" and pointed to a portion of the xray with his finger, "does seem to have a lot of blood, so why don't you come back tomorrow and see the orthopedic doctor." That concluded chapter 1 of this saga.

Chapter 2. More Bad Doctors

The next day, I did as suggested. The orthopedic doctor proceeded to take all of the blood that had accumulated in the knee using a big syringe (ouch). It did not hurt physically as much as it did emotionally. To see the needle going into your knee from the outside, and see him extracting large amounts of blood was something that I was not prepared for. (warning: if the last sentence made you dizzy, skip to the next paragraph.) But, then it got better. He left the needle stuck there and put a plate under it and removed the syringe. It was like a little fountain pouring out of my knee (told you it was gory). They extracted something like 50 cc of blood (or so I recall now). The doctor proceeded to put a cast on my leg, from mid thigh all the way down to my toes. I was on that monster thing for 4 weeks. Later I learned that you don't really put a cast for a knee injury... but again, I was destined to see a series of people pretending to be doctors.

Four weeks later, the "doctor" took off the cast and said "your are good to go". I went running to my best friend's house that evening, 4 weeks of a cast and I went running (about 1 mile) the moment they took it off. Not very smart, but the "doctor" said I was ok, right? That is what ok means to a 21 year old. Needless to say that within 3 months I was practicing volleyball and I fell and injured my knee again. What better opportunity for another "pretend" doctor to practice on me.

This time I saw two doctors. One of them was even the orthopedic doctor for the Puerto Rico Olympic delegation. He was a friend of the family but that didn't stop him to say the same thing that others had said: "Ah, you don't have anything there, just go exercise". So I did. Honestly, I don't remember if I fell again or if just my knee started hurting.

But I do know that then I went to the first "real" doctor. He actually ordered tests! Wow, what a concept. They injected my knee with some blue fluid and took pictures. He was able to see that there was damage in the cartilage of the knees. So, he scheduled my first arthroscopic surgery. The surgery went well, but in it the doctor found that my Anterior Cruciate Ligament (ACL) was practically gone. He prescribed a Lenox Hill de-rotation brace and told me to use it when I play sports.

Off I went to grad school with my big and clunky brace. I continued to play volleyball and sure enough, it was 4 months later when I fell again. This time I had my knee brace on, but it still did not save me. I saw another "doctor." "There is nothing we can do" he said.

I later scheduled an appointment at the nation's best sports medicine clinic, I wanted my knee back. I went to Athens, Georgia to a clinic called Houston. (Yeah, I know the names are all wrong). The doctor there saw me for a total of 5 minutes. He asked me if I played professional soccer. After all a guy named Manuel measuring only 5'5" at this high priced clinic must only play soccer. When I said I didn't, he said "then go home." What a let down. I was ready for them to repair my ACL. But no such luck. Apparently this good "doctor" was good only for "really good" patients. I wasn't one of them.

Chapter 3. Finally we know what is wrong

At this point I had completed my MS degree, was starting to get old in years (I was a whopping 25!)... so I decided to be more careful about how I exercise. I had taken to ride a bike and done a lot of riding in Indiana in my last 6 months there.

But, then I moved to DC. And the bike riding wasn't as much fun as before. There I met something called hills that somehow are totally missing in Indiana. So, bicycling was not fun anymore. I started doing a bit of running and that went ok for a while. But soon enough, my knee started bothering me again.

My knee locked up while getting up from a chair. Yeap, my next "war story" came from getting up from a dinning table. Boring! This time around, however, I was in DC. So, I asked around and went to see a "real" doctor. Dr. Rabbit (what is it with the names in this story!) saw me. Without any tests he could tell that my ACL was not doing much. He moved my leg and knee in ways that I didn't know they could be moved.

In the summer of '91 I had my 2nd arthroscopic surgery. After the surgery he gave me the first real bad news. "You have the ACL missing. It is barely doing anything as it is now. We need to replace it." He scheduled an ACL reconstruction for the following year. He recommended that I strengthen my leg for a year so that rehabilitation will be a lot easier.

Chapter 4. A New Hope

Ok, that was a bad pun, get it?. Along came the summer of '92 and in I went to surgery. The ACL was repaired. Rehabilitation was a pain in the ... well, knee. Shortly after I developed back problems (I was diagnosed with a lumbar sprain). But my knee was good as new. I had practically no problems for 15 years. In my opinion, the surgery was successful. I played intramural volleyball, old-guys softball, and even did a little bit of running (not much in comparison with before, but enough to keep me happy).

Chapter 5. The Golden Years

Somehow in late November 2007 my knee started hurting again. It would swell up, it was locking up when I got up form a chair, etc. I got an appointment to see Dr. Lebolt (yeah, that is his name, no kidding - would you go to a knee doctor whose name include "bolt" in it? I mean I already had screws in my knee, what would be more apropiate!). He ordered some XRays and an MRI (wow, that thing is loud!). He said, you have a "ton of damage on that knee, we need to at least clean it up". I showed some of the XRays to my cousin in PR, an orthopedic surgeon too, and he told me "If you were 55 I would replace your knee" but apparently I am too young to have the knee replaced.

Off I went to my 3rd athroscopic surgery. Things went wonderful, or as wonderful as surgeries can go. If you ever have a desire to have knee surgery, I highly recommend Dr. Lebolt and the staff at the Montgomery Regional Hospital. They were attentive, I was totally out and felt nothing. I was home by 3pm. Recovery went well. I started physical therapy and things were on the way to a full recovery (or so I thought).

Two weeks later I went back to see Dr. Lebolt. He said in a serious tone "your knee is in bad shape." He proceeded to show me pictures he had taken during the surgery and explain what he found there. It was nice to see all the damage in the knee caused by years of bad doctors, but it was more reasuring to finally have a doctor that was talking about fixing my knee not just for this surgery or incident, but for future occasions.

My options are limited. He too said that he would replace my knee if I were older. Apparently my knee is in such bad shape that we can just count on getting a replacement down the road. The bad news is that knee replacements today are a one-shot deal and they last about 20 years. So, if I have this knee replaced today, I would be without a knee by the time I am in my sixties... isn't that when life begins? I would miss on all those golf games in Florida among my other retired buddies.

So, the outcome is to "protect" the knee to see if I can make it to my sixties with my "original parts." By then, we can replace it counting that I will be able to walk till well into my 80s. By then, my knee is not what will prevent me from walking, it might be my back, or my senility or simply the fact that I might be dead :)

Chapter 6. Riding into the Sunset

But this morning, as I got up I got a sense of a renewed lease on life... oh cut the crap. I am being melodramatic. I have a bum knee and I am sentenced to hobble around for a while. It is no big deal.

The amazing thing of this is how it all started. See, the day I fell playing volleyball at my high school, I was not supposed to be in Puerto Rico. As a matter of fact, that very morning I was in Venezuela, with my father, watching the Panamerican Games. But, my brother got sick with kidney stones and my mom fell down the stairs at home and hurt her ankle. Because dad had to stay in Venezuela, we decided that I would go back home to help out. When I got home I found my brother almost pain free, my mom was walking around with some difficulty but ok, and my grandma and aunt at home helping. My mom said, "well, you are back, you can now go to the high school activity." My sister wanted to go, she was in high school at the time. So, I thought "well, if you guys are ok, I'm there!" So, off I went and you see how it all turned out. Was it fate? Who knows.

Posted on 02/09/2009





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