The Knee Issue... Part 2

So, if you have been keeping up with the knee issue, you know that I've had surgery to fix what was thought to be a meniscus tear, but it wasn't. Instead, it was lots of fluid and synovial clots in the knee joint. A synovial biopsy revealed that I had "severe, chronic synovitis." With elevated ANA (antinuclear antibodies) levels, which my orthopedist believed to be indicative of lupus, I went to see a rheumatologist. That's where we left off since my last update.

Since then, I've seen the rheumatologist, and he does not suspect lupus at all. Not only do 25% of females have higher ANA levels with no lupus, but I have no other signs or symptoms of this connective tissue disease. SO... what does he suspect? Well, he thinks that the swelling and pain are due to a form of rheumatoid arthritis, a form that can be undetected by the blood work my orthopedist did prior to surgery. Because my knee is still so swollen, and because he can't tell if the swelling is still due to surgery or not, examining me was difficult. He prescribed an anti-inflammatory drug to take for the next few weeks and see if that helps. In the meantime, we are awaiting the results of X-rays and blood work for more information. The good news is it's probably not lupus. The bad news is I still have no answers.

Just before leaving the rheumatologist's office, I asked the doctor if the physical therapy I'm doing could be worse for my knee if I did end up having arthritis. His answer was a definite yes - depending on what kind of therapy they are doing. So, as soon as I could ask the physical therapist about that, I did, and he agreed that if this is arthritis and I'm having a "flare," the exercises I've been doing for two weeks could, in fact, be hurting me more than healing me. UGH! How confusing! Anyhow, my homework for this weekend is to rest the knee, ice it, and elevate it. He says we'll reevaluate my status at my next appointment to determine the best course of action to protect my knee without causing any deterioration to my right quad.

I'm at a state of mental frustration not only because I'm in pain and have so much discomfort that keeps me from activities I'd like to be doing (mostly chasing Banner!), but because everything's so confusing. First I thought it was a meniscus tear, then there was no tear. Then I was told lupus, but it probably isn't. I was told it was not rheumatoid arthritis, but it may be. I was told PT would be helpful, but maybe it's not. I was told I should be less swollen by now, but I'm not. I was told to do knee exercises, but now I'm supposed to rest it. I just don't know what is best, and the doctors don't really know yet either.  I'm wondering if it was really necessary to have the surgery. I'm wondering if it was really necessary to do the blood work before surgery - obviously the orthopedist can't interpret the lab results the same way a rheumatologist can, and seemingly the orthopedist didn't order all of the right tests. Or, maybe I'm just a puzzle. Maybe the radiologist who read the MRI was wrong - seeing a tear when there wasn't one. Maybe my orthopedist misread it. Who knows? Either way, I feel like the surgery was unnecessary, the PT may be unnecessary, and the first round of blood work was inconclusive. We've spent a LOT of money for all of this and still have no definitive answers. (I know, welcome to medicine.)

I'm hopeful that we'll know more in the coming weeks. I have another orthopedist and another rheumatologist appointment right after Kira's wedding. I was really hoping to have all this behind me by then so I can fully enjoy my time and live up the night - dancing all night and not limping down the aisle. Still, that's a couple weeks away, so there is hope. I would just like to know more and to have more answers sooner rather than later.