Yesterday I finally got to see a traumatology doctor about my goddamn knees. To recap… it was less than a year ago that I was doing my (almost) daily 10,000 steps and suddenly last May my left knee decided to give out on me. Then it all went downhill with trips to Heartless GP, then an MRI and later a visit to emergency when the pain in my right knee became unbearable. I was dismissed by the ER doctor saying I didn’t have a Bakers Cyst (though all symptoms pointed to that) and was given a prescription for Nolotil, a painkiller that has been banned in 20 countries because one of the many side effects is DEATH.
So fuck that shit. I got back in touch with Heartless GP and she said she would book an appointment with a traumatologist, which finally happened today. To be honest, since my serious disappointment after seeing The Endo last summer I was preparing myself for the worst. And hey, that’s what I got.
This woman was dismissive from the start. Barely looked at me other than to tell me to not move my chair closer to her desk. A good 6 feet away, I also noticed the window was cracked open, but of course she was not wearing a mask IN A FUCKING HEALTH CENTRE FULL OF SICK PEOPLE. But I digress…
Trauma Doc had a look at my history on her computer screen, then a look at my initial x-ray and the MRI and when I told her the pain was getting quite unbearable she asked me what I was taking for the pain. I said… well nothing. I can’t take Ibuprofen because of blood pressure issues and Paracetemol damages the liver. And ANYHOW I don’t think living a life taking daily painkillers is actually a viable solution. Omg the withering look I got from her. Then I asked her what other treatment was available and she actually said… “What do you mean?”
So I asked if there was an operation available, or at least some physiotherapy or ANY other kind of treatment. She continued to look at me like I had two heads and said there was no treatment for my osteoarthritis BUT she could treat the Bakers Cysts behind BOTH knees. And I was like… what? I have Bakers Cysts behind both knees??? Apparently this was clearly visible on the fucking MRI that the ER doctor chose to ignore when he told me I did NOT have a Bakers Cyst.
Meanwhile, Trauma Doc was busy writing prescriptions and when I asked what they were she said it would all be on the printout she was about to give me and I COULD READ IT OUTSIDE. What the actual fuck. She handed me the printout and I said… wait can you not take a minute to explain this to me? She insisted it was ALL THERE and I insisted she could at least explain what she was prescribing and why… and finally she did, very briefly, and at that point I gave up and left. Fuck. It was either that or punch her in the face. My god, I felt so angry and frustrated.
This was the new pharma cocktail…
· Naproxen (500mg) with Omeprazol (20mg) every day for two weeks while checking my blood pressure.
· Capsiaiçin cream – one application every 24 hours, also for two weeks.
· Paracetemol/Tramadol – every 8 hours for pain
And of course, lose weight and do regular exercise. RIDE A BIKE was Trauma Doc’s recommendation.
Can I tell you? Just over eight years ago when my KNEES first started making themselves known (before that I barely knew they were there, they just functioned, ya know?) I went to the gym 4-5 days a week, plus walked a LOT every day. And at the gym I’d do a good 45 minutes on the recumbent bike. UNTIL it started hurting my knees. A lot. I was okay doing other things, though stairs were becoming an issue, but the bike really hurt. So I stopped and got into the daily 10,000 steps thing. And so having these docs (more than one) telling me that to get rid of knee pain I should ride a fucking bike… guess what? A one size fits all pain relief strategy does not actually fit all.
It looked like Naproxen might help with the inflammation, as it seemed somewhat less scary than Ibuprofen, but I tried the Capsiaicin cream today and omg my knees are ON FIRE. Serious skin reaction so I guess so much for that. And so I am back to… now what? Fuck.
casa azahar 
This, my friend, is the rankest bullshit. (Puts on “I work with hurting people” hat)
First off, while there may be a reason to prefer Naproxen (it does seem to have more of an affinity for joint tissues) to ibuprofen, it is still an nsaid and capable of stressing your kidneys; there’s no excuse for this bitch to be so dismissive about that.
Second, there is a topical gel form of ibuprofen that you can apply directly to the painful joint. Mileage may vary (didn’t help my hips much, Engineer’s dad swears by it for hand arthritis) but worth trying. The US generic name is diclofenac. https://www.mayoclinic.org/drugs-supplements/diclofenac-topical-application-route/description/drg-20063434 (the article confusingly says it is available in the US without a prescription right after saying it isn’t; so far as I know it’s prescription everywhere. First marketed in Germany as Voltaren if I remember.) This means your system has to process only a tiny fraction of what it would if you took the drug orally. Someone in the Spain health service ought to know what it is. I wish it had occurred to me sooner.
Treating the cysts might not be a bad idea but I’d feel so tempted to punch her in the face anyway. Honestly I think doctors as a group are increasingly treating patients as The Enemy. I could keep you reading for an hour about a client of mine who has seen five doctors in the past year as her system went increasingly out of whack from unrelenting stress and pain, until she’s been to the emergency department five times (largely because of a drug interaction that shouldn’t have happened), and the docs have not been much better than this.
I’ve used capsaicin and it does help, but you *cannot* apply it to the tender, thin skin at the back of the knee. It’s just got too much burn. I’d stop right at the “trouser seam” midline at either side.
LikeLike
I put the capaicin on just before a tour and about half-way through the backs of my knees were burning up. Might try it again just at the front. A friend has also given me Arnica cream to try but when I mentioned it to Trauma Doc she (unsurprisingly) said THAT STUFF IS USELESS.
Yeah, having done a bit more reading up on Naproxen I think I’ll give it a miss, but an anti-inflammatory cream sounds worth looking into. You can get Volterán here over the counter so I’ll go have a chat with my new favourite neighbourhood pharmacist. She actually did warn me about the capaicin cream, telling me to use a glove when applying it (but unfortunately didn’t warn me about the back of the knee thing).
The hostility brewing in the whole health care system seems to be going both ways. My clinic has signs up warning people that any violence towards medical staff will be dealt with severely. Meanwhile I think masked patients remind doctors that they’re being irresponsible (to say the least) and so we get treated with a certain amount of resentment. Between the mask and being FAT I don’t think they even see an actual human anymore when I walk into the room.
LikeLike
To be fair, most Arnica cream you can buy IS useless because the manufacturers put a piddling quantity of actual arnica oil into the cream and essentially you’re just rubbing Nivea into the painful area. I see “sports rubs” retailing at 7% arnica; 20% is more like it, which I have only found in a small-business label called Pure Pro, which also sells straight arnica oil — not recommended for long term or large area use, but fucken amazing for bashes, bruises and acute sprains. You can actually see the discoloration from severe, purple bruising dissipate before your eyes. Some “natural pharmacy” or whatever it’s called in your part of the world might sell the 20% strength.
The rubric for any counter-irritant (oil of wintergreen, capsaicin) is to avoid hairless skin — insides of elbow and knee joint, throat, palms, bottoms of feet — and don’t aim a hot shower spray anywhere you’ve put it in the past day longer than it takes to rinse you off. Yowch.
LikeLike
Avoid hairless skin?? Heck, that’s all I have! Except for a bit of pubic… my old bod was wiped clean of body hair after chemo (2009), though some of that may have had to do with menopause and my “Indian blood” (I’ve never had much body hair). But it was weird to suddenly have NO HAIR on my arms, legs, underarms, etc. Annoyingly I still get RANDOM HAIRS growing out of my chin, etc.
LikeLike
Oh yikes, I’m sorry! But please be very carefyl with Naproxen. My (now previous) doc put me on it and my body just did not tolerate it well at all, and the difference with ibuprofen was negligible. I’ve heard this from many others.
LikeLike
Thanks Mel, I had my doubts too so today I popped back into my new fave neighbourhood pharmacy – the pharmacist who is usually there looks about 14 but goddam she knows her stuff. For example the other day she had warned me about using gloves with the Capsiaiçin cream (Trauma Doc mentioned nothing about this).
And so today when I said that I can’t take Ibuprofen because of BP and said I also had a prescription for Naproxen she said “oh no, you can’t take that either, they are the same!”. So then I asked her about the Voltaren/Voltadol anti-inflammatory cream and she said that would be safe for me to use. She also recommended one with Arnica (which my friend Sharon has already given to me) so now I have both. It looks like I am on my very pain management programme that does NOT include taking painkillers and anti-inflammatories. Wish me luck!
LikeLiked by 1 person
GOOD LUCK!!!
LikeLike
Pingback: feeling a bit hopeful again… | casa azahar
Pingback: sled was right! | casa azahar
Pingback: got the call! | casa azahar