During this time of year, my thoughts grow increasingly contemplative. I prod the inner recesses of my mind, seeking to extract some bit of wisdom I have forgotten. Though the days are growing longer again, as this hemisphere begins its slow tilt towards the sun, there is a certain gloom hanging upon everything. The starkness of black and bare branches slashing across the sky and endless days of frigid temperatures can become almost overwhelming. Each little hint of a flake and glistening icicle seems to drag you down, reminding you of all that is lost. I long for the warmth of sunlit rays, piercing my pale skin and melding with my soul, the first signs of green peaking from under their snow-covered resting place.
Today, the sun is out and I am in the mood to write. With the first rays, the weight seems to vanish. It hadn’t lasted long, but it was enough to remind me of endless quiet days, not so long ago. I was sadder then. As I write, I am listening to the sounds of birds twittering and waves washing up upon a distant shore. Neither the birds or the waves are mine, so I must thank technology for bringing me to this musically inspired sanctuary. (Note: I am listening to Still Waters by David & Steve Gordon, if you were curious.) Though I find it cathartic, writing is an emotional process for me. It uses whatever stores of energy I accumulate throughout the silent days. The physical, mental, and spiritual sparks of my life race from me and I am rent asunder. In some ways, this very essence of me on the pages is both more and less painful than what happens on the outside. And now that I have spent all this time being morose, it is time for a change. Of style.
So, let’s get down to it, shall we? On Saturday (20th January), I had the displeasure of experiencing a subluxation (temporary dislocation) in my left knee, which occurred spontaneously and caused my leg to collapse under me. My initial thought, after the intense pain subsided and I managed to avoid going into shock, was that the subluxation occurred at the main joint where the femur (thigh bone) and the tibia (shin bone) had moved off track. Given more time to process, it is probably a medial patellar subluxation, where the patella (kneecap) temporarily dislocated by moving towards the inside of my leg. Yes, I realize, that if you have an imagination nearly as vivid as mine, you may be cringing at this point. That said, I have been kind enough to leave out most of the details that are seared into my mind. However, while I have your attention, here is some easy to read information while you are still feeling the vague pangs of nausea.
As one does when an acute injury occurs, I decided to pursue a course of home care. Let’s be honest here, emergency room visits are expensive, I was fairly certain I hadn’t broken anything, and I do have substantial experience with subluxations. Unfortunately, this experience was gained from my own body misbehaving. Did you know that you can close your hand in a car door and not break anything? I digress…
For this type of injury, the traditional approach is called RICE (rest, ice, compression, elevation) for short. I pulled out crutches and my knee brace, and I rocked RICE. I also gave myself daily assessments to best track signs of potential problems or progress. I even checked in with several stellar nurses I have the privilege of knowing. As Tuesday rolled around, having experienced nothing in the way of relief, I scheduled an appointment with my primary care. Unfortunately, she was out of the office and I saw another doctor in the practice. For my trouble, I received a few pokes at my knee, confirmation that my softball sized knee was indeed swollen, and a brief discussion about cartilage, tendons, and ligaments. I also picked up a handy referral to an orthopedic surgeon. Interestingly, I wasn’t feeling much pain at the time, but then again, living with chronic pain certainly changes your baseline tolerance for all sorts of things. You have to be a certain type of tough or you are never going to leave your bed. So, I headed home to do my thing and patiently await my appointment on February 7*.
By Thursday, I was in a horrendous mood. I was tired of the crutches, I was tired of icing and feeling freezing, and I was tired of the accumulation of mini-annoyances that built up during the days. When you are the most tired, that is when the pain gets to you and begins siphoning off every last bit of resolve. I couldn’t meditate or distract my way out of the misery, even with multiple cute animal GIFs. My generally cheery and empathetic self had left and was replaced by a monstrous creature, not fit for being around others. Rie needed RIE-LIEF!** So, I called the nurse line available through my primary care provider. To be honest, when you are on multiple medications and/or have chronic illness, tossing back some over-the-counter remedies is never a good idea. Do not do it! In my situation, the pain relief part is a bit challenging because NSAIDs (nonsteroidal anti-inflammatory drugs) are the preferred method of relief and I am already on a daily dose of a prescription NSAID as part of my treatment for fibromyalgia and arthritis. It was suggested that I try adding paracetamol (acetaminophen) every 4-6 hours. Now, I have nothing against paracetamol, but for most chronic pain patients, it offers about as much relief as taking a sugar pill. I was not hopeful. I am now on my second day and I feel like writing an ode to paracetamol and singing its praises. While I am not pain-free, it has taken off enough of the edge that I am more comfortable overall. If you don’t believe me, you must have missed my Twitter discussion of fish faces, gratitude, and whale linguistics.
*I could have seen the specialist I was referred to, but I opted for someone closer to home, who my parents highly recommend. If you do this, make sure to check with your insurance first! There is not much worse than a very large and surprise invoice.
**I am sure you are curious about the titling of this post. Sadly, I cannot take credit for it. However, I have been granted use for all of eternity, by my very lovely friend Becky (@bbhomebody), who is half of the dynamic duo responsible for Central Pain Nerve Center.