The Beat Goes On

Anyone who has ever worn a cast can tell you how unpleasant it can be. Because it covered my entire leg, normal everyday things that everyone takes for granted become difficult. Even going to the bathroom was...challenging.

After two and a half weeks, a brownish discharge started leaking through the cast, and there was a decidedly unpleasant odor emanating from my leg beneath the cast. I was worried that I might be bleeding, and I went to the doctor. They cut off the cast, and it turned out that I had a "tunnel infection" on my knee. I went on antibiotics, and saw Doctor A a week later. The infection had not cleared up so Dr. A prescribed another course of antibiotics with the warning that if this did not clear up the infection he would have to operate.

Fortunately the infection did indeed clear up, but, unfortunately, my leg did not become completely straight, so Dr. A sent me to physical therapy to work on straightening, strengthening, and bending my leg. After a total knee replacement in June, I finally started outpatient physical therapy in the last week of September.

I truly worked very hard. The therapists tried their best to help me, but after a month or so, it became obvious that I could no longer bend my knee very well. In addition, I continued to be in a lot of pain, and the swelling was terrible. It was about three times the size of my other knee. I also discovered that many nights I had a low grade fever, so I asked the doctor about the possibility of infection. He said that if my knee were infected I would have other symptoms. He continued to prescribe pain medicine and told me it was just taking me longer than most to heal. As far as the swelling was concerned, I remember his explanation clearly. His words were, "It's swollen because it's swollen." My knee was always warm to the touch. He felt this was insignificant as well.

As December came around, the physical therapists were convinced that no amount of physical therapy would bend my knee. One said to me, "It will be difficult to justify continuing the visits because you are clearly not progressing." They were certain that while I wore the cast, an excess of scar tissue grew and was blocking my knee from bending. One of the therapists remarked, "There is nothing normal about your knee."

In early December, Dr. A suggested that another manipulation would be needed to bend my knee. He said there was no need for urgency, but I wanted this whole process over with, so the procedure was scheduled for December 24. This time I would be admitted as an inpatient, and would plan to stay in the hospital for a few days. I was hoping this would end all of my knee woes, but I was not destined to be that lucky.

After I woke from the anaesthesia, Doctor A informed me that he had been unsuccessful in his attempt to manipulate my knee. He tried, but he was afraid that the force he would need to use could break my thigh bone. He said that my only possibility of bending my knee would be through more physical therapy.

We gave it a good try. I went to pt for five times a week, and then down to three. It became clear that I would never get better. Everyone I knew advised me to seek other opinions, and so I made an appointment with Dr. B. He was highly recommended, not only as a joint specialist, but as a revision specialist. We heard several stories of how he had repaired knees and hips that other surgeons had replaced. He was known for "fixing other doctors' mistakes."

I saw Dr. B in April. He examined my X-Rays and he examined me. I gave him my history, and told him how much pain I was in. My problems were the pain, the swelling, and my inability to bend my knee.

My hopes for help were quickly dashed. Dr. B offered several pieces of advice. He noted that as it appears I get worse after each surgery, I should never consider having additional surgery on my knee. In addition, he pointed out the mottled scar tissue that was the remainder of the blister I had developed after the original surgery. He said he believed that this was an indication that the skin had almost died, and any further surgery could cause me the risk of needing very painful skin grafts. He, along with Dr. A, advised me that I needed to learn to live with it.

I was spiraling downward into depression. For the first time since the surgery, I was beginning to believe I had no chance of getting better. I was in constant pain, using a cane to get around, and unable to drive. I had been unable to work since June because the only way I could ease the pain was to lie on my sofa or bed with my leg elevated. Walking, even standing, were difficult and painful. My life consisted of watching television, reading, doing crossword puzzles. There were many days I considered suicide. What did I have to look forward to? I'd had a knee replacement in order to "improve my quality of life." My life was worse. My life was as far from normal as one could get. I was lonely, bored, and depressed. We gave my car to my daughter since it appeared I would never drive again. I cried a lot. I couldn't go shopping, couldn't sit in a restaurant unless I stretched my leg out across a booth. I didn't want to talk to anyone.

Time passed slowly, but eventually a year had passed since the surgery, with no hope of improvement in sight. In August Dr. A officially gave up. He sent me to a pain management specialist and told me, "There is nothing more I can do. I believe that any further surgery will only make you worse. Unfortunately your doubts about having the knee surgery were correct. You shouldn't have had it. I'll see you in a year. I'm so sorry."

Sorry? See you in a year? This was the official kiss-off. Now what?

I continued to see the pain management specialist once a month. I'll call him Dr. C. I don't know what I expected, but my pain started getting worse instead of better. Dr. C prescribed narcotics, switching medications and raising the doses, but nothing even remotely eased the pain. My knee became more swollen, and continued to be warm to the touch. I clearly needed help.

I decided to try once more. I made an appointment with yet another joint specialist. Yes, I'll call him Dr. D. Here we go again. I saw him in October of 2007. More X-Rays, telling my long story, examining my knee. He decided that, because of the continued pain and swelling, he wanted to rule out the possibility of infection. I needed a two-day test where my blood would be extracted, mixed with radioactive material, and then replaced into my body to see if there was any indication of infection in my knee.

A week after the test, I still hadn't heard anything, so I called Dr. D. The answer shocked both of us. This test showed that my knee was indeed infected. I made an appointment to see him a week later in order to learn my options. The news he gave me when I saw him again confirmed my worst fears.