Saturday May 30, 2009: MRI is scheduled

When I got home from work on Thursday the 28th, Henry told me that Arthritis Associates called to say I didn’t need pre-approval for the MRI and I should call Northeast Radiology for an appointment. So I called and have an appointment for Monday June 1 at 11AM. I was offered appointments for Friday or Saturday but each happened to fall in the 4-hour period I was scheduled to work on those days so I took the Monday appointment. I got a reminder call on Friday afternoon before work. I need to be there between 10:30 and 10:45 for paper work. The appointment, btw, is for an open machine in the Brewster office, which is very convenient to home. Hoping to have to pick up the disk before my appointment so I’ll get to see (possibly) the report before my June 16 appointment, although if there is something bad (like some kind of tear-which I doubt), I’ll get a call before that.

And my new knee has been doing very well this week, with all the hours I've worked, including several days in a row. I'm working tomorrow for 6 hours and then I'm off until Thursday.



On my Google alerts for knee replacement earlier this week, there was a link to an article that was mangled by a web site. I contacted the writer who liked my silly knee pictures. I think it's the funniest thing (only because of the manging) I've ever read about knee issues. It makes me wonder if people with knee issues should've used more Tilex (read the article to see why I ay that)! Here is a link to the mangled article:

http://www.knowreally.com/insurance/surgical-treatment-of-knee-knee-arthroscopy/

Wednesday May 27, 2009: The shoulder

I'm home from my appointment. Other knee wasn't touched, but discussed briefly. We discussed the posterior tibial tendinitis. SHe poked my shoulder and determined it is mostly the bicep tendon again which is causing the most pain. So I got a shot in the tendon (done anteriorally) and I found out it's Kenalog in the shot, with Marcane (sorry if I'm misspelling those). We also discussed the fact that I've had numerous issues with the shoulder (right) and haven't had an MRI of it in at least 4 years so another will be done---waiting for a call. The prescription for it actually says "persistent pain despite cortisone x3. R/O rotator cuff tear." Hopefully there isn't a rotator cuff tear----that was the reason given for my 1st shoulder MRI so I shouldn't be surprised to see those words again. We also discussed that there is some syndrome or disorder (can't recall the name) that causes multiple tendon issues, but she doubts that's the problem since I have known looser joints making repetitive injuries easier. She also mentioned (we discussed a lot) that Supartz has now been approved for shoulders. which might be an option, along with some more PT. I go back on June 16, which is when I had my original appointment scheduled for to get the results of the MRI and if my other shoulder is bothering me then (it isn't nearly as bad as the right shoulder), maybe I'd get a shot in it then.

Tuesday May 26, 2009: My Aching Shoulders

Arthritic shoulders are really bothering me so I called the rheumy office because there is no way I can wait until mid-June for the already-made appointment. Lucky for me I have an appointment for tomorrow morning. I can barely reach behind me without pain and could barely pick up a large bottle of dishwashing soap this morning. Feet are feeling better, although slightly worse than they were before I had to work 3 days in a row this past weekend. Don't know what will happen working 4 days in a row, from Thursday-Sunday later this week but I guess I'll manage.

Saturday May 16, 2009: A diagnosis!

Despite the anterior tibial tendon bothering me (he says it's irritatated), I actually have posterior tibial tendonitis. I am to ice the area once a day until I see him next and he gave me an additional pair of orthotics to use for additional arch support with the pair he liked the other day. They apparently will move the stress from the tendon. He said (and I only saw after he said so) I have swelling below the medial side of my ankle and some thickening in there. I need to research but at least I know what it is. I go back in 5 weeks, and if there is no improvement, he'll give me a shot of cortisone which can possibly cause rupturing of the tendon, but that is unlikely. Hopefully things will not come to that. I do have to go out today and get some different socks because my shoes, with 2 orthotics in them, won't fit with the regular socks I wear and I can't count on it being nice out so I can just wear my little quarter socks.

I've added the picture of the problem. Actually here's another picture, labelled better!

Wednesday May 13, 2009: MRI day

The right ankle MRI this morning at 9:30. It was done in the extremity machine (Orthone) in the morning. My leg was killing me by the end of it---actually not my leg, my ankle and my foot was ready to fall asleep as well. I wasn’t home more than 10 minutes when I got the reminder call for Friday morning’s follow up appointment. So now I'm just waiting for Friday. I wore the Sof Sole orthotics today without a problem but by the end of the day, my feet were sick of my sneakers, so after my shower, I switched over to Crocs, which Dr. Gray said were fine. I have to wear shoes with soles that aren't flexible (or a lot flexible) so they're okay to wear.

This is where I had the MRI done and the picture on the bottom of the page is the machine that was used:

http://www.nerad.com/mri.htm

Tuesday May 12, 2009: Back to the ortho

Back to see the ortho this morning with all my shoes and orthotics in tow in a Trader Joe's bag. He told me to stop the Voltaren, which I was using sporadically anyway. He is worried about stomach issues (and starting to think about it, I came home from the Chinese restaurant, had the Mobic right away [usually take in the middle of dinner, not at the end], had cake a while later and a while later threw up). He went through all my shoes, saying the Easy Spirit ones didn't have enough of a stiff sole and they aren't a good choice. He really likes my Ryka shoes (as I expected). The CRocs are fine (just keeping an eye on the ankle) as are the sandals for pronating feet. He also went through all my orthtics and said a pair I got in the brand (Soft Sole) recommended way back in October by a doctor (a knee patient) on my knee board, probably were the ones I should be using. So I came home and switched out my old orthotics for them. I had only used them a couple of times back then (not really rbeaking them in) but he said to try them again. Meanwhile, he is still worried about the tendon thingp---forgot, stupidly, to ask for a shot and he didn't mention it-so to make sure there is nothing else going on in there, I also mentioned the bike issue and he said that might explain things. However, lowering the seat, although possibly good for the ankle, might not be so good for the knee! Can't win! We'll see which body part wins. I've lowered the seat but haven't noticed any difference yet (although I didn't bike alll weekend and Monday as kids were staying in that room). He wants me to have an MRI of my ankle and lucky for me, Northeast Radiology called this afternoon and had an opening tomorrow morning for the Sandpit office where there is the extremity MRI machine. Once that appointment was made, I had to call back CT Family Orthopedics to make an appointment for the follow up on the MRI. That is scheduled for this Friday afternoon so I don't have to wait too long.

Tuesday May 5, 2009

I went shopping yesterday with my friend Lenita who is a non-practicing physician. I was telling her about my ankle and anterior tibial tendon issue. She sent me an email this AM with a possible cause of the problem, which sounds good to me. I'll mention it to Dr. Gray next week at my appointment. She quoted an article.

It seems possible that you are not using cycling shoes , the kind that has a rigid sole and prevents you from pedaling wrong and stressing the ankles and the Achilles tendon....also pay attention to the proper length between the seat and the pedals, Please read:The Achilles tendons are the tendons at the back of the ankle, connecting the calf muscle to the heel. If you have pain in these tendons, it usually indicates a problem in pedaling technique. Achilles tendon problems often result from "ankling" during the pedal stroke. This is occasionally related to having the saddle set too high, forcing the cyclist to point the toes excessively to reach the bottom of the pedal swing.It can also be caused by having your cleats set too far forward, or otherwise pedaling with the toes. The farther forward the contact between the foot and the pedal, the greater the stress on the Achilles tendons.There is a widespread belief that you should pedal with the ball of the foot centered over the pedal shaft. I believe this is not necessarily desirable, though it dates back to the high-wheeler era.Back in the high-wheeler era (1870s through early '90s) long legged riders had an advantage, because they could straddle a larger diameter wheel, effectively giving them a higher "gear." By pedaling on the balls of their feet, they could get a bit more leg extension, permitting a given rider to straddle a larger, faster machine. The development of the safety bicycle rendered this concern obsolete, but the habit (and advice) persisted.The other reason for pedaling on the ball of the feet is if you are riding in soft-soled shoes, the ball of the foot is better able to bear weight than the arch is. However, with rigid-soled shoes this is a non-issue. For short distance, low intensity riding even with soft-soled shoes this is not generally a problem in practice.AnklesAnkle pain while cycling is often the result of "ankling" while pedaling. It may also result from being flat-footed, in which case orthotic shoe inserts are a likely remedy.Another possible cause of ankle pain is a bent pedal or crank, causing the foot to wobble back and forth as the pedals turn.

That might explain it since the problem only developed after the surgery. In any event, I'll mention it next week.