A Very Important Appointment With My Family Doctor
[ Monday March 20th 2017 at 3:38 pm ]
I've had a productive and very serious appointment with my family doctor today. When my family doctor first entered the examine room for my appointment his face lit up. He didn't realize I was on the list for today. I have a very special relationship with my family doctor. I'm thankful for this.
The reason this appointment was so important is that my ability to walk has been reduced to the same fashion as a penguin over the past 5 weeks. Now when I try to walk normally it creates out of control pain in my knee joints. The cause of this is the repeated bending and straightening of my knee joints.
The health related challenge in this is not to loose my bone density. Otherwise my artificial hips will come loose inside of me. Either of my artificial hips coming loose inside of me is now the only remaining setback that may possibly happen. The approach to avoiding this is what I've been doing: Using the swimming pool and conditioning center equipment each week day. While I do my exercises to the best of my ability I try to avoid hurting my knee joints further. Through a whole lot of help from others and trouble shooting we've worked out what exercises I can do.
I've done a lot of planning during the past few weeks about my day to day life. I needed to decide if I am able to manage the tasks of daily living and still have time to live life instead of just keeping myself alive. I've decided to deep clean my home and with the wheelchair modifications I have planned (especially changing the foot rest so it will move at the touch of the button to lesson my knee pain) I should be able to. This most recent setback means at the absolute bare minimum I have another 5 years of treatment ahead of me. I haven't been able to go through my belongings since this started in 2006. I want to get rid of everything that doesn't fit in my life and change some of the furniture so I am able to properly manage house cleaning. I think if I do this I should be good. Four of the youth at the gym offered to help move my furniture when I am ready for this step. Overall I am expecting it will take me the remainder of 2017 to re-calibrate my life. Then I should have the frame work for the next 5 years of pursuing health care treatment. I know I've been talking about selling my home and moving. With my physical disability becoming much worse I need the connections to the health care I've made in this community.
My local hospital is getting a new MRI machine installed right now. It is expected to be running in 4 weeks. Today I asked my family doctor to have both of my knee joints imaged. He readily agreed to this. This will be the first MRI of my left knee joint and the third for my right knee joint. My family doctor prepared the requisition form. He asked me to wait until the new MRI machine is installed and patients are beginning imaged before I submit this. Effectively the thought behind this is that the bugs will be worked out of the MRI machine before it is my turn. I was offered a high priority MRI at another hospital. Part of my concern from the May 2015 MRI of my right knee joint is that the images produced by the machine were not detailed enough. The press release my local hospital made stated this new machine will produce higher resolution images. This new MRI machine is the latest technology. It is worth the wait. My family doctor agreed with my thought process.
I am expecting up to four things to happen when the imaging is completed:
- If there is something which immediately requires surgical intervention I am confident I will be offered this. However the ultrasound of my right knee joint performed on February 28th 2017 showed the tendons and ligaments were intact. One of the only few items that could trigger an immediate surgery is if I have a torn meniscus. This is a tissue that lines the bone between the ankle and knee joint. It supports the function of walking. We know from my May 2015 MRI this cartilage is thinning.
- I asked my family doctor that I be seen by a sports injury doctor once the imaging is completed. These are the specialty doctors that end up with the set of patients that don't make a normal recovery. I tried to reach out to the one who helped me in 2007 without success. My family doctor thinks this is a very good step. Other patients of my family doctor have dealt with a particular sports injury doctor. My family doctor found this sports injury doctors work to be thorough. He is happy to prepare a referral for this. The reality of this remains very serious: After 25 months of physiotherapy and not making a recovery with the oversight of 2 separate physiotherapists there is likely to be only 1 of 2 helpful resolutions by going through route:
- One resolution is to go the route of knee replacement surgery. I will talk more about knee replacement surgery in a minute.
- The second resolution would be for a stem cell transplant into my knee joints with the hopes that the tissues would re-grow. Only part of this procedure is covered. I would need to fund raise $7,000 CAD (roughly $5,500 US) to pay for the uninsured portion of this. If my MRI imaging supports this as even a remote possibility it is something I want to pursue.
- The practical reality of the situation I am in is the need for ongoing exercise. I have a friend who is a physiotherapist. He lives in a city about 90 minutes from me. I will e-mail him to ask if he would spend a few hours with me once my MRI scans take place to brain storm possible exercises for me that won't cause debilitating pain. My imaging is able to be obtained from my local hospital without a charge for this purpose.
- The final option is paying for a physiotherapist to watch me do my exercises 2 or 3 times a week for 12 weeks. This isn't a practical right now. It would be the necessary follow up to either a stem cell transplant or knee replacement surgery. I would need to fund raise $1,500 CAD (roughly $1,200 US) for this to happen. The physiotherapy coverage I have is only for a home exercise program. With the uniqueness of what I'm dealing with this would not be appropriate.
It was medically warranted that my hip joints were replaced because of the arthritis stemming from my childhood Legg Perthes disease affecting my left hip joint. This has helped me a great deal. The pain was non stop. I really can't risk either of my hip joints coming loose inside of me. I am prepared to travel to Spain to pay for knee replacement surgery if I can't get help where I live and the risk of my artificial hips coming loose inside of me remains. There are bone density tests available. I would want this performed on me as part of my decision making to pursue out of country knee replacement surgery. There has been numerous times where I've had to pick the lesser of all evils. I am not afraid to make 'lesser of all evil' decisions.
There is an immediate 'silver lining' I see in this most recent setback. There is a statistic I was made aware of: That it takes between 3 and 5 years to make a career out of posting regular videos on youTube. I've been enjoying make videos about my life and inspiring people. I receive a constant stream of positive feedback. It is quite possible that I could come through this without having financial concerns. It is going to be a while before I reach this. I am being afforded the time to work on my web sites. I want to seize upon this opportunity.