A Bone to Pick

     I am thankful for orthopedic surgeons. Having had both knees, and now a shoulder replaced, has added mobility and reduced pain that would have crippled me before artificial joints were available. Nevertheless, I have a bone to pick with them. I did not meet an actual orthopedic surgeon until I was 24, though I really should have before because my left kneecap had been dislocating since I twisted it badly when I was nine. Although having a kneecap go awol while walking was extremely painful, since it always went back into place, this was not considered worth the cost of a doctor visit at the time. Besides, my body adapted by keeping my left leg from fully straightening so the kneecap was less likely to slip, and making my right leg compensate for everything my left leg could not do. When it finally dislocated so badly I could not walk without my leg bent 30 degrees, I saw an orthopedic surgeon. The operation was called a patellar transfer, which involves moving the patellar tendon and stapling it in place. The good news is, it fixed the problem, the bad news is, at that time laparoscopic surgery was in its infancy and my surgeon was not comfortable doing surgery with an infant for an instrument, so I wound up with a nine inch scar that looks like an ugly, white caterpillar crawling up my left knee.

    But that is not the bone I have to pick, it was that the doctor was so convinced the cause of my problem was my female anatomy and not the childhood twisting episode, he almost operated on the wrong knee. Fortunately, the hospital had me do my own betadine scrub before surgery. And since, when he opened the skin for the operation, my kneecap popped off, I hope he clued in that operating on the wrong knee would have left me without a leg to stand on.

    Another non-funny bone experience happened in my early 30's. After months of lower back pain that was not sharp, but nagging, I saw an orthopedic doctor. He, of course, ordered an x-ray, told me I did not need surgery, to live with the pain, and that for good measure I should probably give up the nurse aide job that I had just certified for. Though my medical training was limited, I thought there was probably some middle ground between those two options. I had never been to a chiropractor before and didn't know what I thought of them, but I had a friend who worked as office manager for a chiropractor so gave him a try. After two adjustments, my back pain was gone.

    Last year, when my ankle rolled and sprained so badly I was willing to hobble my way to orthopedic urgent care, I got an x-ray, a loose, heavy boot that I couldn't walk in, and was sent on my way with the unsurprising news that I did not need surgery. I tried both physical therapy and laser on my ankle, but had to discontinue when my shoulder pain won the award for most annoying body part. Having had fair results from two previous cortisone shots in my shoulder, I decided to see an orthopedic doctor who had a good reputation. He said I did not need the x-ray guided procedures I had at the hospital before because he knew exactly where to put the injection. He did not. The cortisone missed the joint, went into my bloodstream and made my arm and chest red hot, not in a good way. 

    Now back to the ankle portion of my two-for-one joint special, though the pain and swelling have improved in the last year, the stability and muscle strength of my favorite leg have not returned. I have been stuck wearing winter ankle boots or high top tennies for a year. I cannot step on a pebble and know my foot will support me. The only way I can walk on uneven ground is barefoot and, even then, I walk on the outside edge of my foot. For some reason, I did not bother going back to orthopedics. I went to a podiatrist who both my physical therapist and family doctor recommended. He ordered x-rays, asked why no one had done an MRI and if my foot  popped when it sprained, a symptom the orthopedic P.A. totally dismissed. So the podiatrist is doing surgery on my ankle next month. I may be unstable in many ways, but my ankle does not have to be part of the problem. It will be a long recovery, and I hope in the end I won't have a bone to pick with podiatrists either.