Here is the gallery from inside my knee operation:

Time for another health update. I view these as writing exercises, so please bear with me as I go through this one.

You’ll note that this update’s picture is of a knee X-ray (not of my knee). That’s because I’m having arthroscopic knee surgery, two days before Christmas. I’ve had problems with my left knee since 1984, when I crashed a bicycle into a curb and went flying ten feet over a sidewalk and into a parking lot. I tore my medial meniscus and scraped the back of my kneecap in the crash. They did arthroscopic surgery, which was still very new in 1984 – in other words, it didn’t go well. Now, I’ve got more torn and degenerated meniscus, severe arthritis on the back of my kneecap, crepitus in my knee, and severe pain when doing daily activities.

It’s going to be a rather rushed job when you factor in our family Christmas trip. How’s this for a schedule:

• December 19th – Pre-op appointment with surgeon
• December 21st – Drive to Austin for family Christmas
• December 22nd – Family Christmas, then drive back to the D/FW area
• December 23rd – Knee surgery
• December 25th – Christmas
• December 27th – Physical therapy

Quite the compressed schedule, eh? To make things worse, my surgery is scheduled for the afternoon, which means I’ll be fasting (no food, no water) all day long on the 23rd. I’m going to be miserable. The doctor’s assistant has advised me to “hyper-hydrate” for 48 hours prior to surgery, so that a) I won’t be so miserable, and b) I’ll have a good vein somewhere for them to start the I.V. (I have terrible veins – they run and hide at the mere sight of an I.V. needle).

This isn’t the only issue pending surgery. My back is screaming at me again; specifically, my left lumbar region. I’ve had a new MRI done under a 3 Tesla machine (my last one was under a 0.75 Tesla machine), and I’m waiting for an appointment in the new year to schedule another lumbar rhizotomy (due to insurance restrictions). I’m hoping the new MRI will give my doctor a more accurate map of where my problems are so that he can perform a more precise rhizotomy that will last longer this time.

I’m also looking at the possibility of surgery on the bottom of my right foot. I keep getting calluses in the spot where the doctor removed the metal shard, and a recent MRI showed that there might be a deformity below that are that he could shave down which would prevent them from building up in the future. He gave me a cortisone shot in the sole of my foot first (yikes!), but that’s wearing off. I don’t know if he’ll operate or not.

Finally, I’m recovering from an endovenous ablation of my lower right leg. The vascular surgeon accidentally damaged a nerve as she performed the procedure, causing numbness at the top of the skin and pain below. There’s also swelling along the outside of my leg from the bottom of my calf to my ankle, for which she has no clue as to why that’s happening. She could only recommend the passage of time for the swelling, but for the nerve damage she gave me gabapentin – yes, my favorite drug again – and ordered me to take 300mg 3x a day for a month.

That’s about all for the major situations going on in my life. I know none of them are really major major, but they sure add up quickly. I’ll be happy enough to subtract a few rather soon.

Welcome to a health update. Several things have happened since the last one. Let’s begin.

First up is my right foot. It started developing problems after a follow-up appointment with my podiatrist. I felt a sharp pain in the ball of the foot, behind the big toe. The pain eventually developed an accompanying ulcer, which required daily treatment and antibiotics for a couple of months. The ulcer waned, then began to grow again. I managed to take it in to my podiatrist early during the re-growth phase, when the doctor finally caught the root cause: a sliver of metal had worked its way inside my foot. The doctor debrided the area and dug out the deeply-embedded sliver, then put me back on antibiotics to clear up the ulcer. So far, his treatment has worked, and I am pain- and ulcer-free.

During one of my latest appointments with my podiatrist, I asked him to refer me to one of his doctor group‘s knee specialists. You see, I walk with a cane for many reasons, one being arthritis in both knees. The doctor I was referred to had an MRI performed and found that I had bone spurs on my left knee and severe arthritis behind my left kneecap, and not quite so severe arthritis behind my right kneecap. I was hoping for arthroscopic surgery to fix the problems, but instead the doctor insisted on using something called GELSYN-3. It’s a gel-based product that’s injected into the knee joint, once a week for three straight weeks. I’ve already had injection number one, and will have my next injection in two days. All I can say so far is that it’s made my knee quieter for a few days, but the pain remains. True relief is supposed to kick in between 4-6 weeks. We’ll see if that happens.

Finally, and most complicated, has been my teeth and the nerves in my face. To start with, I had a tooth break on me one evening. It’s a pretty hefty break, almost half of the surface of a lower left back tooth, but fortunately it doesn’t go down into the nerve. I tried to see my regular dentist about it the next day, but she was on jury duty and a substitute was seeing her patients. He saw me and said that the tooth was “salvageable,” and added that it didn’t need immediate treatment. So, I waited until my regular dentist had an appointment available.

My dentist went to work on appointment day, numbing the area. The first shot went deep into the lower back left side of my jaw and was accompanied by an audible “pop.” I had a very hard time getting numb—in fact, it took a total of seven shots to get me numb (four in the jaw and three directly around the tooth). After the appointment, I went home and slept off the numbing agent.

When I woke up, I found two things: one, the tooth that had the break was still broken, and two, I had a very odd sensation in the left side of my face. I immediately called the dentist to try and figure out what happened. I learned that the substitute dentist had reported two broken teeth (my very back tooth, plus the one in front of it (the tooth in question)), and that my dentist had worked on the very back tooth first. Second, I was told that I needed to see my primary care physician for the sensation in my face.

I should probably describe the sensation in my face at this point. I mean, that’s why I chose the picture I did for this update. What I had was numbness on the exterior of my face, combined with severe pain that ran through the center of my jawline, the middle of my cheek, and the left edge of my eye. On a scale of one to ten, I gave it almost an eight.

Of course, my primary care doctor was booked for the rest of the day plus the following day (a Friday), so I wound up seeing his assistant. She looked me over, went and talked with my doctor, and came back to give me my diagnosis: post-procedural nerve pain. She gave me a prescription for 100mg of gabapentin, to be taken three times a day. Unfortunately, that didn’t do any good, so I called and got a new prescription from my regular doctor on Monday – 300mg three times a day. Now, I don’t know if you’ve ever taken gabapentin, but trust me—at that dose, it will turn you into a zombie but quick.

A week later, my regular dentist called to set up an appointment to see me. She examined me and told me that she had probably bruised a nerve when she gave me one of the shots, and that it’d just be a matter of time before it healed. It’s been a couple of weeks now, and things have only got marginally better.

However, while she was looking things over, she noticed something else. I had a swollen lymph gland on my lower jaw. With the report of pain in my eye, she decided to take some X-rays of my upper left teeth. Sure enough, she found something: an abscess at the base of a tooth that had had a root canal performed (apparently badly) several years prior. It’s going to require re-treatment through the porcelain crown on top of it, along with more antibiotics. I’m going to have to pay a huge out-of-pocket charge, and it’s not going to be any fun getting the work done.

So, let’s see—foot, knees, tooth, facial nerve, root canal … did I miss anything? Dear Lord, I hope not …