JOINT HEALTH

UPDATE Saturday December 4, 2021
WELCOME TO MY NEW NORMAL….

kicking it up a notch

I’m getting a lot of my current circumstances out on my website today, and passing stuff along on Facebook. I believe I am the master of my own circumstances, which makes it easier to work and love. Our bodies and our minds are always changing…though at a certain point you realize it’s not getting better every day no matter how often you play the song to sing along. I have severe osteoarthritis and “lousy cartilage genetics.”

The last time we looked closely was before my below the left knee amputation in April 2018. Though I am being referred to most every bone and joint specialist in Kelowna (which has many good ones)for consultation, surgery is not at the top of my list of pain management strategies, however I have a pinched nerve in my neck causing pain to run down my right arm like the mice ran down the clock. This pain is now added to the pinched sciatic nerve (yes, sciatica, the mice run down my crotch), and  you can literally hear and feel my bones klick klack when I’m being arranged on my back on the x-ray table. Just put those vertebrae anywhere you want them I said to the X-ray tech.

SO I am having my opioid  dose increased from 20 mgs a day to 30 mgs a day, in two grey 15 mg tablets. I am having to spend a few days “out of service” getting used to my slight increase. Some context…the maximum daily dose in Canada once was 200 mgs, and is now 100mgs due to the opioid overdoses in the country. My increased dose takes me to 3o mgs, 30% of the maximum recommended dose. Also wheelchairs.

Take a look at this baby. Direct Mid-wheel Drive, mid-century modern Sea Foam colour if I can get it. I was not keen on the powered wheelchair. And I was right to expect I would get another round of why would you use one. “It” can’t be that bad.  YES, damn it, it is. That is why I have reprinted the bald facts below, my bones and joints are wrecked. The less gravity I expose my joints to,  the less pain I have. My wheelchair serves as a pain management technique as do my meds, my meditation, and the carers coming to the house to clean house and fix our meals. I have been lucky to meet and marry Michelle Hewitt, a disability rights advocate with MS who does not question if it hurts, how much it hurts, and if I lay perfectly still, well yes there would be less pain. I only mention the last because I was being written up for an MRI requisition and one of the questions was whether I could lie still for an hour! 🙂 Well yes, I’m pretty good at it, in fact I will be doing that exact thing in about 15 minutes. Wresting, I call it.

Victor Enns’ Report
Hip and Pelvis X-Ray, Foot/Ankle X-Ray IExam(s): RAD / FOOT ANKLE RT; PELVIS HIP RT Reason for Exam: PAIN TO RT HIP

EXAM TYPE:
C / T / L SPINES; PELVIS HIP RT; KNEE RT w SPEC VIEW; FOOT ANKLE RT

HISTORY:
BACK PAIN AND ARTHRITIS; PAIN TO RT HIP; ASSESS FOR ARTHRITIS; HX OF ANKLE FUSION WITH BROKEN SCREW

FINDINGS:
Cervical, thoracic and lumbar spine:

There is straightening of the normal cervical lordosis. This may be positional, reflect muscle spasm, or secondary to degenerative change. There is severe degenerative disc disease between C4 and C7. Moderate multilevel facet and uncovertebral osteoarthritis noted. There is mild degenerative anterolisthesis of C3 on C4. There is moderate to severe right foraminal stenosis at C4-5, C5-6 and C6-7, on the left at C3-4, with milder narrowing of lower left foramina. No fracture or destructive process.

Moderate lower thoracic degenerative disc disease noted. No thoracic compression fracture.

There is severe degenerative disc disease L1-2 and L5-S1. There is also L5

Printed by: Victor Irvin Enns on 23/11/21 at 5:13 pm from the Patient Portal

Page 1 of 3

                            Victor Enns' Report
                  Hip and Pelvis X-Ray, Foot/Ankle X-Ray

spondylolysis with grade 1-2 spondylolisthesis. Moderate facet osteoarthritis at multiple lower levels.

SUMMARY:

Page 2 of 3

1. Severe cervical spondylosis with moderate to severe foraminal stenosis, right greater than left.
2. Severe L1-2 and L5-S1 degenerative disc disease.
3. L5 spondylolysis with grade 1-2 spondylolisthesis. Milder degenerative disc disease elsewhere in the lumbar spine and in the lower thoracic spine.

Pelvis and right hip:

There are bilateral total hip arthroplasties, with no osseous or hardware complication. Bony pelvis is intact. No significant SI joint arthropathy.

Right knee:

There is minor medial compartment joint space narrowing and marginal spurring. There is moderate to severe medial patellofemoral joint space loss with mild marginal spurring. Lateral compartment is preserved. No effusion, erosion or fracture.

SUMMARY:
Moderate to severe medial patellofemoral and minor medial femoral tibial OA.

Right foot and ankle:

They were is a lateral fibular plate and multiple screws with no hardware complication. The underlying fracture has healed. There is mild degenerative spurring at the margins of the intraosseous ligament and distal tibiofibular joint. There is also mild ankle joint OA, predominantly at the superolateral joint space.

Multiple orthopedic screws transfix the hindfoot. 1 of the navicular-talus screws is fractured. There is solid osseous union of the subtalar joint and talonavicular joint. Minor joint margin lipping evident at a few midfoot joints. There is fusion of the first IP joint. No erosive change. No acute fracture.

SUMMARY:
Extensive hindfoot fusion. 1 of the orthopedic screws is fractured. No acute

abnormality. Minimal to mild degenerative change at several sites with no erosive change.

Michael E Partrick MD,

Dictated by: Partrick,Michael E Transcribed by: IHSVC.TRAN Technologist: LEED21

Dictated Date: 16/11/21 1452 Transcribed Date: 16/11/21 1452 Signed Date: 16/11/21 1501

“Produced by Speech Recognition technology. If a clinically significant error is identified, please contact the Medical

Printed by: Victor Irvin Enns on 23/11/21 at 5:13 pm from the Patient Portal

 

WHERE DOES IT HURT?

In every joint and then some

CREDULITY

 HOW MUCH DOES IT HURT

Journal entry, undated

There will always be someone who suffers more deeply, more righteously, more rigorously, more appropriately with higher levels of pain, with higher levels of accomplishment achievement than me like the amputee running a super marathon across the Sahara desert. Good for you. Good for God!

Me how do I tell you about my puny sorrows, and even those have been commandeered by someone suffering more successfully than me and even yet from jahnt siede.

You share the story about the boy who used an axe to chop up the radiator hosehis dad beat him with.  Pat commented on his father’s fury grown by his church and  by extension, then at least, his God. I have to admit I may have been strapped half dozen times, a practise that stopped when I was 13 when we moved to Winnipeg. Only twice however did my father strap me black and blue. Both before I was sexually assaulted.

Always me me me-like a warm-up for choir. https://i0.wp.com/www.ballaratosm.com.au/wp-content/uploads/2017/05/3554222.png?ssl=1Then in September of 1968 my parents would not believe my pain which had started earlier, they accepted our rotund and jolly GP’s, word that nothing was wrong. Mayeb was having trouble “adjusting” to the move, the new school, was the missed diagnosis.https://i0.wp.com/www.eorthopod.com/images/ContentImages/child/child_hip_transient_synovitis/child_hip_trans_synovitis_diagnosis01.jpg?ssl=1

Then one simple test 2 months later, and the GP knew what was wrong, confirmed by  an X-ray, and that he had been wrong, and that I suffered, finally enough. Suffering for me was not a team sport, As the pain stopped in my hip it grew in my heart and in my mind. My parents and I were through.

 

 

 

 

Victor Enns reads and writes poetry and fiction. Afghanistan Confessions, poems in the voice of Canadian soldiers, was published in 2014, boy in 2012. Lucky Man (2005) was nominated for the McNally Robinson Manitoba Book of the Year award.