Thursday, November 17, 2011

Being handicapped and chronic pain

Most people, unless they are good friends, see me walking around SF cons, and they usually don't realize I'm handicapped. Yes, that's right, handicapped. Officially. Car placards and everything. I have a congenital malformation in both knees that caused them to wear out at twice the normal rate. The cartilage is shredded and gone, and I am bone-on-bone in both knees. My orthopedist says it's only a matter of time before I need knee replacements.

Now, I know that's a very successful surgery and I've collected stories from people who've had it done, singing its praises, by way of research. The problem is, I've been cut on enough lately and am not over-eager to have more cutting anytime soon; and frankly, the idea of hacking out my bones and replacing them with metal and plastic gives me the willies. Yes, I'm a scientist. Yes, I think it's wonderful technology. But there is a psychological factor involved that I haven't yet managed to overcome. May never overcome.

In fact I went through a period of depression after he told me. I've never really considered myself athletic, per se, but I've always been very active in sports - everything from golf and tennis to karate and polo. Most of those have had to be curtailed. I fought it, tooth and nail, but these days my athletics come mostly in the gym. I eventually came out of the depression when I found I wasn't relegated to a rocking chair on the porch - yet.

When I bend my knees it sounds like a whole mixing bowl of Rice Krispies. It feels much worse. There is hardly a day that goes by that I am not in pain as a result. But you get used to it. You learn to deal unless something happens to really make 'em flare, and you learn to use other body parts to compensate. My arms and shoulders are stronger because of using them to assist; there are down sides to that, however. Like impinged rotator cuffs, which has happened something like 4-5 times since my knees were diagnosed. I no longer even see a therapist for that - I simply start the appropriate exercises. I have a nice collection of canes for the really bad days, too. Most people don't see those much anymore; sometimes they're more in the way than they are help.

Now, there are things that I do periodically to help the knees. One of the most normal and most regular is to get into the gym and keep my leg muscles strong. My orthopedist is in agreement that this helps stabilize my knees. But the most invasive, and most effective, of these things I do is to have an artificial lubricant injected into the joint to take the place of the cartilage that isn't there anymore. It used to require a six-week protocol, 3 weeks for each knee. Now that I'm used to it, they do both knees at once.

The first step in the process is to swab the injection site on the outside of my knee with alcohol, then hit it thoroughly with "freeze spray" to numb it. Next comes a novocaine injection directly into the joint. Leaving the needle in, my orthopedist swaps out the empty novocaine syringe for a full Synvisc syringe, and pumps that in. Back out, apply a band-aid, and repeat on other knee. Do this for 3 weeks, to give each blob of Synvisc time to spread out around the joints, and I'm good to go for anywhere from 6 months to a couple years. Yeah, it's kinda cringe-worthy. I don't watch while he's doing it. (I did once.)

But the cool thing is, between the novocaine and the Synvisc, there's a period of anywhere from 12 to 24 hours when my knees DO NOT HURT. At all.

This is an incredible blessing and it always surprises me. When you're used to living in pain, no matter how small (and this is not especially small, but like I said, you deal and you ignore) and that pain suddenly goes away, it's amazing. I had the first injections of the 3-week protocol this morning, and I am so relaxed I could easily fall asleep sitting here. There is a tension missing from my body, something I'd grown used to that's not there right now, and as a result I'm all but a puddle of Jell-O.

It's nice. I intend to enjoy it while it lasts. I'm not allowed to work out today or tomorrow, due to the potential of swelling. But I'm certainly not going to let this wonderful, relaxed, pain-free feeling go to waste.

I'm going to take a nap. The pain can wait until tomorrow.

-Stephanie Osborn