- CASE FILE
I'm 56 , both legs are equally in pain everyday. Started suddenly Aug 2018. Mobility greatly reduced. In pain everyday. Can't find answers.
ABOUT THIS CASE FILE
This started in Aug 2018 very suddenly. The pain started in both of my knees and the pain was equal in both. I had not fallen, nor been injured in any way. The pain just stared suddenly. The only thing I noticed about a year prior, I started to lose strength in my legs, i.e. had trouble going up steps and getting up off the floor, but I thought it was because I was out of shape. Had seen my PCP in Aug 2018 after pain had started, took x-rays of my knees and could not see anything wrong. Was tested for Lyme disease, did a SED rate blood test. SED rate came back only at 23 and Lyme test came back negative. Rx prednisone and OTC naproxen. Treatment did not help. I was still in pain. Shins were now hurting, Went back to PCP in SEPT or Oct 2018 and was referred to an Ortho and a Rheumatologist. By October 2018, I wasn't able to finish walking around the grocery store without being in horrific pain. I wasn't able to do things around my home like make dinner, clean, garden. What I call the everyday things in life. Saw Ortho in Oct 2018. Took x-rays of my knees and he noticed very slight thinning of the outside of both my knee caps and recommemded physical therapy, Meloxicam and Tramadol. Did physical therapy for 2 1/2 weeks and could no longer afford the $600 + charges just after two & 1/2 weeks and had to stop. The physical therapist did not think I had an issue with my knees. They recommended I see a neurologist. The Meloxicam helped some and the Tramadol helped some with the pain but I was having mild depression from the Tramadol or both meds and still having mobility issues. Took six weeks before I could see the Rheumatologist my PCP referred me too. He looked at my x-rays of my knees and said you probably have bone spurs. Did not do any blood tests or order any other tests. Referred me to another Ortho and got that appt for Jan 2019. In between all of these Drs, just before Thanksgiving, I got a kidney stone and was prescribed oxycodone, hydrocodone, along with lots of other meds and had already been on Tramadol since Oct 2018. I went back to my PCP in Jan 2019 due to pain and MAJOR depression. PCP prescribed duloxetine. I was still taking Tramadol and Meloxicam. He thought it would help with my anxiety/depression and possibly help with my pain. Within four days of taking the RX, I had a horrible adverse reaction to the medication. After talking to my husband on the phone for 3 hours, I started to calm down and feel better. By the time I saw the second ortho in Jan 2019, I was so VERY depressed, emotionally drained, no relief from pain, mobility had been taken away, other parts of my legs were now in pain, like my shins, and had been on one form of opioid or another. Second Ortho wanted to do injections into my knees and ordered a MRI of my right knee. He wanted both knees MRId but insurance would pay for only one. At that time, I was still taking Meloxicam, Tramadol, still having pain and still having mobility issues. I went ahead and did the injections that day, hoping I would get some relief and get back to my life. Went back to the second Ortho two weeks later, told him knee injections provided little relief, and that I had stopped taking the Tramadol because "I was losing my mind and the depression was taking me to places I never thought I would go." I also got my MRI results. I was told Mild age appropriate cartilage loos. Possible congenital or related to remote trauma. No evidence of acute bone contusion. Intact menisci and cruciate ligaments and mild lateral patellar subluxation without Hoffa's fat pad edema. Both the Medial and Lateral compartment had mild cartilage loss. I asked since the MRI was done one leg only why do I have same pain in both when the results indicated there may have been some kind of trauma to the right knee how could I have equal pain in both? How could I equally hurt both legs the exact same way which would cause the exact same pain. I got no answer. Also, since the report stated "MILD" why was I in so much pain and was not able to do the simplest things without having so much pain? Why was the pain and swelling affecting other parts of legs? Why did this come on so quickly? Not sure was the answer. Dr wanted to try another type of injections called I think 'ACID' or 'Gell' injections. I scheduled the appt to have this done two weeks later. I decided not to go back to the second Ortho because all he wanted to do was injections which did not provide any relief. I also had an adverse reaction from the injections which caused me to have to have a nuclear stress test and a heart ultra sound test because I reported to my cardiologist my heart was skipping a beat a couple times a day ( had a double CABG 11 years ago when I was 45). The cardiologist thought it might be caused as a side effect from the injections but wanted to make sure. So, having the heart side effects was part of the decision factors not to continue with injections. But also after appt. with second ortho I also did some research on PRP injections. So I found a D.O. who did PRP injections. Saw him in Feb 2019 and he looked at results from x-rays and mri and said I was not a candidate for PRP injections and that he did not believe I was a candidate for "ACID/GEL" injections either. That I would not benefit from such. I was absolutely devastated! I left with no hope and the only thing I had to look forward to was a life of pain and loss of my ability to take care of myself and my husband. So I went back to the first Ortho trying to find more answers and relief from my pain. He basically told my there was nothing he could do for me, that the narrowing of my outside knee caps were not enough to be causing this pain, loss of mobility, leg strength and I was not a candidate for surgery. Again, I was devastated. Desperate, I asked about the ACID/GEL injections, the Dr said he would do it, but they do not typically do those injections in his practice. I asked him if he thought it would help, his answer was he didn't know but would do the injections if I wanted. By this point, I was lost, depressed, in pain, and felt like I had a cancer. Not a cancer that would kill me right away, but one that would take something from me just a little but every day and drag me down bit by bit until there was nothing left to take. After that Dr visit, by word of mouth, I heard about another rheumatologist. Made an appt and we meet. He ran several blood tests and had x-rays taken of my hips, feet, and left elbow because now I was having pain and what felt like swelling in those areas now. He told me that my blood tests came back normal and I did not have RA, that I have mild osteoarthritis in my left foot, mild OA in my knees and moderate OA in my hips. I asked why do I have the same pain in each foot, he could not tell me why. I asked if diagnosed with MILD OA in my knees, why do I hurt so and why do my shins hurt? That my legs hurt all over and I am not able to walk much or do much anymore and I had lost leg strength. I was told try to exercise in a pool. That would help with my stiffness. He also RX Diclofenac, and OTC Tylenol. I am also taking osteo-biflex. I can go grocery shopping, and clean my house in stages, for short periods of time but that is the only improvement. I'm still in pain, my mobility is not the same, and I know at some point what relief I do get from the anti-inflammatory will stop and the dosages will have to be increased and the type of anti-inflammatory will be changed. Since I am heart patient, I am at a greater risk for heart attack taking anti-inflammatory meds and the risk increases the longer I take this med. I also started taking hormones. I read that sometimes joint pain can be caused by hormone loss. So my OB-GYN has prescribed such. I've been on the hormones for 3 months now and not seeing much of a difference. I've asked all of the Drs I've seen since Aug 2018 if any of the meds I been taking for hypo-thyroid, Atenolol for heart rate, or Lunesta could be causing this leg pain. I was told not likely. I thought it might be a med causation because I was on a cholesterol medication after my heart surgery (even though I did not have high cholesterol) for about 6 years, until one year I start having severe shin and knee pain. I went to my PCP and he took me off the cholesterol med and the knee and shin pain went away in about a week or two. Something else I would like to share. I am a 34-year cancer survivor. I was treated for Hodgkin's disease when I was 22 years old and I had a daughter who was 2 years old at the time. I endured a staging laparotomy, two bonne marrow biopsies, and radiation therapy. I have been blessed and am grateful to have lived all these years and to have remained cancer free so far. At 45 I had to have a double artery bypass (CABG) emergency surgery and have veins taken from my legs to use as new arteries in my heart. My Dr told my husband if I had a heart attack, I would not have survived it. I was fortunate, I was able to have the surgery before I had a heart attack which was just hours away the Dr said. The cardiologist told me my heart issue was caused by my radiation treatments years earlier. That radiation treatments to the chest cause blood vessels to thin. I mention these past heath issues because during the cancer treatments and the heart surgery, I knew my life was going to be different, that new challenges were ahead of me. But my ability to take care of my self, my daughter, my family, my home, and my ability to do everyday things were never in question. I knew I was going to get better and get back to my life. I was going to be clear minded and enjoy things like walking with my husband, going on day trips, gardening, taking care of my animals, helping my neighbors, and keeping up with my grandson. Since Aug 2018, the quality and impact this leg pain has had my life has been drastic. I'm always in some sort of pain. I can't walk for any length of time without pain. I have trouble going up and down steps. My leg strength has diminished. I need help getting off the floor most times. There are days getting dinner ready for my husband, who works 12-hrs a day, causes me to be in bed in pain. I can't take opioids because they cause me severe depression. I am very concerned with the long-term effects of taking anti-inflammatories. I am at a point that I almost have nothing to look forward to anymore. That things are not going to get any better. They are getting worse for me and the Drs I have seen are not offering much to me other that some sort of pain mgmt. That is not living to me nor a solution at 56-years old. What good is living if I can be clear minded, not depressed, not in pain. I'm not asking at 56 to run a marathon nor take up ballroom dancing. But I sure as hell would like to be able to go watch the marathon and cheer on a friend. I would like to be able to dance a waltz with my wonderful husband. I want to enjoy being with my 15-month-old grandson! I've tried all that I know and have read up to this point. Is it possible there is something else wrong? Is it possible my meds are causing my leg issues? If it is OA, what other treatments are there? How can I get my mobility back and be pain free? I appreciate the help and thank you ahead of time for wanting to help me find answers, solutions, and giving me hope.