Knee Infection

On Wednesday (11.29.17) I had lunch with Paula, have this great chicken curry at Tommy's.  Head down the hill and make my first stop at Grocery Outlet.  Feel an ache in my knee.  Rub it and keep walking.  In the store, the ache becomes more annoying but again, just grab it for a bit and on I went.  Went to go pick up Abby from practice, pull up my pants and see that it is a little red and swollen.  Thought it will go away, was feeling tired so didn't give it too much thought.  Get home and swelling gets worse and painful.  Need to lie down.  Put on a patch at bedtime.

Morning...pain seems a little better, patch worked?  But more red and pretty warm.  Had a chiropractor appointment so I asked Chip.  He said, prolly infection.  No signs of bug bite marks so prolly not that.  If it don't get better in 3 days see doc.

Friday... decided to get seen.  Just in case it gets worse over weekend and they're closed.  Plus had read if infection spreads, it could get serious.  Better safe than sorry.  He prescribed Doxycycline Hyclate 100mg, a tetracycline antibiotic.  10 day dose.  Its supposed to stop the growth of bacteria.  No dairy (no calcium and minerals) within 2-3 hrs.  And a Methylprednisolone 4mg steroid.  Pharmacist says this is pretty potent.  6 days at specific times.  Some of the side effects were pretty scary.  Change in personality, mental/mood changes, problems thinking/seeing.  Looking up both drugs, so far haven't come across any alcohol interactions except that the steroid may cause dizziness and alcohol could increase dizziness.

Saturday morning..  has taken first dose of antibiotics last night.  Reddening gone down a little, swelling and pain still there.  Started the steroids this morning.

Day 5:  Got a little better at the beginning of treatment but seemed to plateau.  Ran into Marlin at the dump.  My thought was I have knee bursitis and that's why antibiotics not really working.  Marlin thought it might be some sort of inflammation in the patella.  He advised I continue with my antibiotics as prescribed for 10 days and then go back if not better.  Everything seem to fit that I have "housmaid's knee" when I look back and remember getting sharp pain in my knee when I clean floors.

Day 10 (Dec 11):  Finished antibiotics, still somewhat red, swollen, and warm.  Been having occasional sharp pain in the knee, mostly dull pain.  Pain sometimes goes down to side of heel and side of lower leg.  Halfway feels like nerve pain?  Saw Dr. Browning again, he says it takes time, given we are older now.  I mentioned the pain and he said, you said it didn't hurt last time.  I thought the pain was caused by the swelling and with the meds it will go away.   He sounded like I should just give it time to heal.  Anyways, he ordered an xray and took blood again for a CBC (complete blood count) which hopefully will show if I have arthritis or not.  So going down to Hemet to get xray later today.  Dr. B doesn't seem to think its bursitis.  He says bursitis usually doesn't get red, just swollen.

Dec. 20:  Went back to doctor for x-ray results.  Findings:  "No acute fracture, dislocation, narrowing of joint space or opaque foreign body is seen.  3mm calcified density projecting to the middle of knee joint is possibly a loose body."  Impression:  "Possible 3mm loose body in knee joint.  Otherwise unremarkable exam."  So Dr. B decides to order an MRI.

Jan. 22:  Went in for MRI.  Pain intensity thus far varies depending on day.  Most days not too bad, mainly dull ache that gets stronger at times.  Occasional what feels like nerve pain down into foot, mainly outside heel area but sometime moves to middle area of foot.   About one week ago pain caused me to walk slower, pain ran up entire leg.  Was the day Sage went back to SDSU and we looked at his new apartment.   MRI tech noticed inflammation but didn't seem to see any loose bodies, though she mentions she's not a radiologist.

Feb. 26:  Went in for Ortho consult with Chris Alexander in Temecula.  He said possible synovial fluid built up, or loose cartilage flap.  Knee "grinds" when bending/flexing so he suggested arthroscopy to look around and see what's going on.  Said MRI didn't show loose body but MRIs don't get everything.  Overall knee is 'remarkable'. Had my issue only been a few weeks he would of suggested to wait and see if there's improvement but since its been about three months we decided to go ahead with the arthroscopy, scheduled for April 20.

Late March:  Find out Ortho is no longer in my network.  He needed to renew his contract so I wait a little before the pre-op appointment in early April.  Still not renewed so cancelled procedure.  Will work on gait and see if things get better over summer.  If not, will find another ortho.

April 23:  Woke up with some knee pain.  Hurts to walk up/down stairs but adjusting which foot goes first, I was fine.   Pain seems to get less as the day went on.  Passed out on 4/21, don't remember if I fell onto my knees.  Small cut on right knee I don't remember when it got there.  Seems random.

April 24:  Woke up with swollen knee and a lot of pain to put any weight on knee.  Knee not red, slightly warm but not hot like back in Nov.  Got crutches and ibuprofen which helped and I was able to move around.  Iced/elevated before work and after.   Took ibuprofen before bed.  Knee area hurt in most positions, trying to sleep.  Best position seemed to be to hang off side of bed and let foot touch floor.  Pain in back of knee, (inside) side, down shin, and lower thigh (in front).

April 25:  Still swollen but less pain.  Was able to clean library this morning.  Can walk without support but slowly/cautiously.  Vacuuming was possible with crutch.  Slight twist in knee causes pain.  9:30am, sitting at computer.  Pain in front of knee (knee cap?) and calves.

Torqued Hip, D & A going vegan

About three months ago, my right hip started to hurt.  Mainly when sitting and driving.  Had Chip look at it and he said that my hip was torqued.  Happens when you sit a lot, I guess.  Some muscle starts getting used to being shortened, when in sitting position, and just gets weaker.  Also caused by repetitive motion, such as vacuuming.  Woodland vacuuming is usually no more than 15 min but cuz I started vacuuming longer at the library, plus the sitting a lot, it just messed it up.  So he says lower back muscles tight which I guess is all related.    After a while the pain in general got better but it comes back when I vacuum and when I drive.  Trying to stretch when I remember, seems to be better the next day on days that I do.  Also been trying to take the dogs out walking more.  More exercise is always better.  The chiropractor visits had gone back to every two weeks to fix my hip but it's now back to four weeks.

Neck overall better.  Certain lying positions still aggravate it sometimes.  Mild, dull shoulder blade pain comes and goes depending on posture.

Been good on taking BP meds, having been taking readings much tho.  The dietary supplements have been maybe one every two weeks.  I should take my readings more often to see where I stand.  David went vegan about two months ago and Abby about a month ago.  So all the food cooked at home has been pretty much vegan.  I still eat cheese occasionally and some salami when I get a meat craving, prolly more like a salt craving.  I have a chicken sandwich or chicken on my salad when i'm out.  So i'm sure the new diet change at home will affect my BP and cholesterol.

Adding Hydrochlorothiazide back & trying Tramadol

BP still been high even after upping metoprolol to 100mg so Deborah decided to add back Hydrochlorothiazide instead of increasing metoprolol. Been about 10 days, BP been getting low, 117/74. 

Its been a while since I've had a brain fart. But had one today. Couldn't figure out how to open the electric kettle to add the water.  Messed around with it for about a minute before I remembered how to open it. I wonder if the low BP is making me slower.

Three days ago took first dose of Tramadol, a pain killer.  Supposed to be stronger than Tylenol but it didn't seem to really work for about 5 hrs then it kinda worked. Ended up sleeping about 10 hrs that night. just didn't want to move. Next day felt nauseous around 3 pm.  Took tramadol again that night. Went to bed early again. next day around noon nausea kicks in. No tramadol last nite.  Nausea possible side effect when coming down? We'll see later today.

Pot enhances nerve pain

Not relieve pain.  Note to future self. 

Nerve pain came back

Kinda all of a sudden, the nerve pain down my right arm and triceps came back.  Not as bad as when I first had it but close.  Maybe pain in month 3 or so.  Had been having mild dull pain in hand and arm, more like overworked soreness so didn't think much about it.  Was feeling a little crummy on Sunday but still went to work Woodland.  Towards the end of shift I started feeling bad.  Had to lie down a few times. Was hoping to lie down after i got home but ended up making dinner and stayed up. Feeling a littler worser at night.  Next day, drive to Redlands.  Driving hurt.  Had Sage drive home from Banning.  Was hard to sleep and getting up hurt a lot. Working at computer at work brought on the same pain.  Had just seen Chip on Thursday but got myself back in on Wednesday.  He says there's some swelling.  But I can't recall doing anything out of ordinary. Cracked a few things. Then he says he's going to put me on this list for an ultrasound.  Good, maybe  I can not get those MRIs Deborah wanted me to get. $1500 for 3 tests. That's a lot. So the appointment was made for tomorrow.  Sounds like a Nerve Test instead of an ultrasound, but will test if I have nerve damage.   Best thing, I think it won't cost me anything.

Medicine switch: Metoprolol

A few months ago Deborah added a second dose of amlodipine, so second dose at night. Seemed to be bringing my BP down.  Then I started to get weird tingling sensations on my tongue.  Best described as an unhealed tongue after scalding with a hot beverage.  Someone else had the same symptoms.  Further research led to amlodipine being banned in the Netherlands.  Also read that its something you don't want to be on long term.

Decided to go back to just the morning dose. Couple months pass but I still got the funky tongue intermittently.  Kept  hoping it would go away but it never really did though it wasn't as intense. 

Told Deborah this who decided to take me off amlodipine and hydrochlorothiazide and try Metoprolol instead since we hadn't tried a beta blocker yet.  This lowers both BP and heart rate.  Since my heart rate is usually high, this might be a good switch. Just need to monitor and take daily readings.  If heart rate drops below 60 or top BP goes below 100 then stop for a day and call her. 

She also told me to consider taking a medical grade fish oil called MonoPure for cholesterol support, plus it also acts as an antiflammatory support for arthritis joint aches.  30 day supply costs $33 so will try mixing it up with the fish oil I still have to make it last a little longer.

Original lab results about 4 months ago showed signs of high cholesterol and insulin resistance so re-did some labs again.  Cholesterol lower this time, roughly in the high normal. No signs of diabetes. Vit D still same but could be higher

Results of last labwork:

Cholesterol 199
HDL 52 (up from 42)
LDL 116 (down from 151, but goal is <70 for stroke patients)
A1C 5.4 (stable from 5.5)
Vit D 44 (no change from 43 last time)

So trying new med for one month. Some possible side effects were BP and heart rate dropping too low. Possible tiredness/fatigue for about 2 weeks till body adjusts. Beta blockers could increase chance of getting gout. Am on a ExtendedRelease capsule so important to take at same time daily.  Will try 9:30am.  Other side effects:  swelling in hands, ankles, feet.  Chest pain.  Diarrhea. Mild dizziness or tiredness, lightheadedness, dizziness, itching or hives, swelling of face or hands, tingling in mouth or throat, chest tightness, trouble breathing.  Cold in extremities, hands/fingers, feet.

I am kinda glad to be off the diuretic. Felt my mouth was always dry.  Peed alot at times.  I hope this new med works.