... another round of doctors and tests. I had my appointment with Dr. Scott F. Dye this morning. I tried really hard not to have any expectations about him or what he may have to say. I was anxious to possibly hear something new, nervous that I would be treated poorly, but I was also tired of the whole process in general. I brought my old X-rays and MRI films and my surgery report from Dr. Anderson and filled out the usual new patient paperwork.
Dr. Dye walked in and shook my hand like a businessman. For a second I felt like I was with the "rock star" of knee doctors, but pushed that thought aside still feeling nervous whether he would care much about my ongoing knee pain. Dr. Dye started right into the questions about my knee and was quite formal but straightforward. No wasting time here! One of the first questions he asked was how I found him. I told him I read about his research in Runner's World and the information from Mr. Ingraham in Canada where more of his research was noted. Dr. Dye just nodded his head and kept on with his questions. He seemed especially concerned about my comments involving the burning sensation in my knee and that my knee has never felt normal since the day back in March 2006 when the pain started. He performed the typical tests bending my knees, manipulating my bad knee and my good knee, all along asking if what he was doing caused me pain or not. He mentioned that my left knee had the typical swelling of an inflamed synovium, and that my right knee did not.
Dr. Dye then left the room, "to take some notes" he said, and I changed from my athletic shorts back into my work clothes. He came back 5-10 minutes later with my MRI films and told me our next step was to get a current run of imaging done. He asked me to set up appointments for a new MRI, a bone scan, and a special type of X-ray called a Rosenberg. Up until this point, I have not had a bone scan or Rosenberg X-ray. Dr. Dye put my old MRI films from before my knee scope up on the light box and pointed out how they showed an unusual amount of fluid built up around my left knee cap. Usually there is just a thin white line surrounding the dark kneecap, but in my film there is a much larger area of white. Dr. Anderson didn't mention this and wasn't overly worried about anything in my MRI other than the fact she was concerned about my knee pain. Dr. Dye explained that based on the old MRI he felt it I have a case of Patellofemoral Syndrome where the synovial lining is inflamed. In his opinion, the synovial lining is what causes the pain and burning sensation. Dr. Dye would know, he had his own knee scoped without anesthesia to discover this problem. Like I've mentioned in a recent posting... OUCH.
Dr. Dye then asked me about my physical therapy after surgery last year. He was really upset when I told him they had me doing things like lunges and leg presses. He said he never has his patients do things like lunges since they are among the exercises that trigger knee pain and hinder recovery. The last thing he did during my appointment was hand me some medical papers on Patellofemoral Syndrome (although he commented that it seemed like I had been doing my homework already) then said to me, "Let's get these new images done and see what we can do to help you." He gave me a small smile, shook my hand, and walked out of the room.
I didn't ask Dr. Dye about prognosis and recovery because I knew he couldn't say or do anything more until he has seen the new images of my knee. I'm going to try to set up those appointments for next week and then make a return appointment with Dr. Dye. Maybe within the next month I'll have a new plan for recovery. I figure it could go a few ways: 1) Dr. Dye will not see anything he can do surgically. That said, my guess is that he will have a better physical therapy plan for me that manages my "envelope of function" better and will get me on a real road to increasing that envelope. 2) Or Dr. Dye will see something he can do surgically, such as a synovectomy, and will advise to move forward with another scope. We'll see what happens.
Hmm... I'm wishing I had decided to contribute more money to my flexible spending account. Oh well. Here we go again.
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