Pain is a funny thing. It’s obviously not something most people welcome, but it’s necessary to let you know when something is wrong in your body. When it’s time to take a break. That you’re not invincible. Pain is also a great teacher. When you were a kid and touched that hot burner, you learned quickly not to do it again. But sometimes, pain is just… a pain. It gets in the way of progress.
When I was working with my physical therapist, he explained to me that it wasn’t the best idea going into surgery with as much pain as I had because that could make the recovery harder. He also wanted me to be able to strengthen my quad muscles before surgery to help with the rehabilitation. He suggested that I go see a pain doctor to help me get things under control. I was reluctant at first because I wasn’t sure what pain control might entail, but I’d run low on options by that point.
I was scared walking into the doctor’s office because I had no clue what to expect. Of course, there was all the requisite new patient paperwork. Then there was the taking of my blood pressure, weight and temperature. And that was followed by a drug screening. I wasn’t at all prepared for the drug screening; they’d never mentioned it in their communications with me, so I hadn’t had much water to drink. I spent an awkwardly long time in the bathroom with that cup.
When I finally met with the pain doctor, he asked me all about my history with knee problems. When did it start? (About 2 years ago.) How bad did it get on a daily basis? (Pretty bad.) Did it ever keep me awake at night? (Yes.) Wake me up at night? (Often.) Feel better in the morning? (Rarely.) What made it worse? (Pretty much just looking at it.) What made it better? (Vodka. Only kidding! What I meant to say was ice and elevation.) He started listing my options, and we quickly agreed to take the path of least resistance. He suggested narcotics and Euflexxa injections. The drugs I would take only on an as-needed basis, and the injections would happen over the course of two weeks (3 injections total). I agreed to the pain medicine, but I decided against the injections because the Synvisc didn’t help all that much or last all that long.
Everything was fine the first time that I took one of the pain meds. It helped take the edge off of the pain so that I could get to sleep one night. I think the key is that I took it just before I went to bed because the next time I took one, I ended up curled up in a tight little ball on my couch with my head in a bowl. I couldn’t see straight with the nausea that it caused. One good note was that I was so nauseous, the knee pain didn’t bother me as much! I wasn’t quite sure what to do. My next appointment with the pain doctor wasn’t for another month because he wanted to give me time to take the meds and get back to physical therapy before coming to see him again. I tried to take the meds again one more time, but I just couldn’t handle the nausea.
When I went back to the pain doctor, I asked for something that would be a little easier on my stomach, and I said to go ahead with the Euflexxa injections. Something had to help. I got a new prescription and the first injection. The new medicine wasn’t helpful when it came to reducing my pain, but at least it didn’t make me nauseous. I kept up with the PT and went back for my next injection a week later. Something happened in the week following the second injection. It was a gradual decrease in the amount of pain I was having. I didn’t even realize it at first, but I was waking up in the morning without pain, and I was moving more easily throughout the day. I was happy to go get the third injection.
After the third one, I was able to really start doing serious PT. I started doing things that I hadn’t done in a long time. Most importantly, I was able to get back on my bike! I started riding again for the first time since late January. But it took me a few weeks to start to build the miles, and by that time, the injection was wearing off. This series lasted barely a month before all the pain was back.
One more trip to the pain doctor. This time, I asked for anti-nausea medicine so that I could take the stronger medicine that actually helped the pain. So far, it’s worked… I’ve continued with the riding and the PT to keep strengthening my leg before the big day. I take one pain pill and one Zofran together right before I get on the bike, and I can usually get through the ride with minimal problems. I always have to ice and elevate afterwards, but things are manageable right now.
The pain isn’t gone, but I’m learning how to cheat it. This pain isn’t helping me; it isn’t teaching me anything. It’s just standing in the way of progress. Only now, I’m forging my own detour.