It all started, I thought, at the end of April with my right leg suddenly buckling as I ran down a slope to catch a walk signal. There was a sharp pain at the outside of my right knee and a sudden inability to run any more. I don’t think at first I connected that moment with the pain I was feeling by the middle of May as I attempted to continue my daily walks. I tried to do exercises I’d been given in the past, involving lifting ankle weights and found I could not manage with my right leg. Hmm, I though, I must be getting weak because of activity changes with the pandemic lockdown. On the last Saturday of May I had a virtual visit with my physiotherapist and she gave me some exercises as I asked, to help me get those muscles back in shape again. I did them that evening, and again on Sunday morning and thought, they are helping already!
Then just before we left to have lunch with our “bubble” family I decided to get summer clothes out from an under-the-bed box. I pushed another one out thinking as I did so, I must make sure to push that back out of the way so hubby doesn’t trip over it. However I apparently have the attention span of a mayfly. Just then I noticed the window wasn’t open, went to open the window and promptly tripped over the box, slamming my left knee down on the floor as hard as I could. Painful much!
I walked downstairs to the parking garage, got in the car, and we drove the five minutes to our son’s home. By the time we got there I couldn’t get out of the car or up the steps without help. We ate lunch but I think I was going into a bit of shock. Later I realized my mouth had gone really dry which was why I couldn’t eat much. I was given a little ice pack for the knee and after the meal everyone insisted I go to the emergency department. I wouldn’t be long, I was assured, hardly anyone is going there these days with the pandemic. To the emergency department we went. Although at that point masks weren’t yet required I wore one. I sent hubby home to fetch my Kobo so I’d have something to read, and settled down to what I thought would be a short wait.
I suppose I kept being triaged down the list. About five hours later the doctor saw me. Told me the orthopedic specialist was in that evening and she would ask him to look at the knee. She said I shouldn’t have anything to eat or drink, except water, in case I needed emergency surgery. A couple of hours later I was taken to be x-rayed. Some time after that the orthopod looked at the knee. By then I would cheerfully have murdered for a cup of tea. When he came in I was using the ice out of the water I’d been given to help with the swollen knee. He was very nice, told me it didn’t look like anything was broken but they would put me in a plaster splint to go home and he would see me in the outpatient clinic on Wednesday. I told him how much my right knee had been bothering me and he said he would have it x-rayed at the same time as the left knee was checked later; he did say something about an MRI and when the time came I should have been a bit more strong-minded and asked him to please go ahead with an MRI. A bit more time went by. Then the man with the plaster arrived and wrapped me up in what I would have called a cast but is called a splint. He told me I could not put weight on the leg.
A little more time when by and then, over ten hours since I had arrived at the emergency department, it was almost tomorrow, a wheelchair and attendant arrived to take me to the entrance to be collected. It was the kind of wheelchair with no way for me to rest a leg completely straight in plaster. I was asked to hold the leg up. As I was there in the first place because I couldn’t use the leg that was no go. Could I rest it on the edge of the foot rest if they folded the foot rest up? That seemed a bit risky to me. And by then I was starving and dehydrated and getting cross and probably irrational. I got out of the wheelchair and, using it as a support, hopped on the right leg, the one that hurt so much I was doing physio for it, quite a distance to where hubby was waiting in the car. I had to hop a bit more until we got crutches in the morning.
Hubby had made tomato soup for supper. Starving as I was I demanded yoghurt in the soup and bread on the side, and several cups of tea. That night and for some time afterwards I slept half sitting up in a chair in the living room with my legs up on an ottoman. After supper the next night I wondered why I was feeling so shaky, and then it occurred to me that I was probably literally starving. Supper was some sort of braised celery! I demanded calories and more calories!
The left knee healed. The plaster came off on Wednesday and after that I wore a brace, rather an ill-fitting one, for two weeks, and then just walked with care. Meanwhile right knee was being over-used. Nevertheless by the seven week visit when both knees were x-rayed, I must have had enough rest that I wasn’t demanding enough to have the right knee cared for. X-ray showed osteoarthritis in both knees, worse in the left than in the right. No broken bones in the foot,
Time went by. Sometimes I could hardly walk, other times I felt nearly all right. But there was a definite slow trend down and eventually I thought, maybe I need a brace to stabilize this right knee so that I can go for proper walks. In late October I attempted to get a brace. I am so thin now it’s hard to fit me. Then my skin reacted to the one which might have worked for me, if any brace was actually what I needed. The brace already kept slipping, and after I had to wear a cotton sleeve to protect my skin I had to strap it on so tight I think I was harming my circulation. Nevertheless I persisted with the trial and at the end of November (remember, this all started in April) I walked from the ferry terminal in Halifax all the way to a bookstore near the Public Gardens, and back again. Half of this walk is on a hill, first up and then down. By the time I was home, near the ferry terminal on the other side of the harbour, I was practically crippled. I had thought the brace would stop that from happening, but in fact the brace did nothing for me at all. I needed to break out the crutches for a day after that walk.
Then I – finally – plugged this question into Google: why, if I hurt the right side of my knee, does the inside hurt. The answer – ACL injury! It was like a light bulb going off. Someone had mentioned that when she had a minor ACL injury when skiing she’d worn a brace which kept her knee straight for a while. I decided to not bend my knee as I walked, and to be very careful not to go down slopes or navigate anything other than necessary steps even when the knee felt better. I did this for several weeks, right through Christmas and into the new year.
I asked the orthotist if I had presented with the same symptoms but no OA would she have been able to fit me with anything else. She said no, only a kind of sleeve, which we had tried and which I’d found uncomfortable, and I would have reacted to its material anyway. I phoned my soon to be former doctor (she was moving, I wasn’t leaving her) and asked for a referral to an orthopod, but she told me to let the “new man” deal with that. All this time she’d been somewhat unhelpful. At my request she’d given me prescriptions for physio and for the brace, and had only diflofenac rub to suggest as a treatment. I read the package insert and realized not only is Voltaren not recommended for people over 60 it is actually contraindicated for people like me who have already had stomach bleeds.
After about a month’s break for Christmas I went back to the physiotherapist with my bright idea about the ACL. She examined the knee very carefully and said there was no sign of ACL issues. However by then I’d been doing my no knee bend walking for weeks, and I could tell things were better inside the joint although still too much swelling. It was about this time I learned that all that extra fluid actually damages bones, erodes joints. I did not know this. I’d have been more assiduous about elevating the leg and icing the knee during the day as well as only at bedtime.
I phoned the new doctor and asked for an MRI and referral to a specialist. He suggested I had gout. I humoured him by letting him send me for the appropriate tests, and he humoured me by agreeing to send me for an MRI and to seek a specialist referral. I do not have gout. However he was very interested in some blood results and said he wanted to see me. I don’t know how he did it. I went to my appointment expecting to have a date (or not) for the MRI, and a copy of the x-ray report, and instead he took my blood pressure and pulse and listened to my chest. Later I realized he never even looked at my knee. He talked about wanting to run a complete blood panel (whatever that is) and I just sat there like a bump on a log and didn’t even ask what he was looking for. I did have the presence of mind to say at the end that all I wanted was to be able to take walks again. I feel that I am losing life expectancy by not being able to walk properly.
Just before I left the building I remembered I hadn’t even asked for a copy of the x-ray report so I ran (well, slowly walked with my urban poles) back in and the receptionist printed it off for me to take to my physiotherapist. And I still don’t know how long I will have to wait for an MRI, or if it’s worth getting one done privately. The doctor wants me to taper my prednisone down to 1.5 mg, from 3, then take in the new blood requisition. So I suppose in about a month or six weeks I’ll have another visit and this time I shall have to direct his attention back to what is concerning me – my injured knee, my need for exercise to maintain health. Not his searching for some interesting ailment which may or may not be of significance but which right now is just something I need to keep putting out of my mind so I don’t worry.
And was the beginning really that moment as I ran down the hill? I think it went back to the days of late 2019 when I did not get to the store to buy new sneakers, and my footwear was no longer properly supporting my feet. My right foot had started to hurt me. I’d got exercises for my feet as well as the knee at that first virtual physio appointment, and they helped very quickly. I also remembered a pair of sneakers I’d had from before and kept only for using on our treadmill in our former home, and with some orthotics in them I was now looking after my feet better.
Even before that, we’d moved in early 2019 and now with no stairs of our own I’d made a point of going in and out at least a couple of times a day and nearly always using the stairs. With the covid lockdown I only went out once a day, and that meant much less physical activity.
So I suppose it all began with covid.