My doctor appointment went fine today.  I was sitting in the examining room and waiting for him when I realized I’d forgotten my MRIs from a couple years ago at the house.  Fortunately, after I apologized for forgetting them, he told me they were essentially useless to him, so I felt better.  He took a history, asking several questions to get the information he needed.  Then he performed a fairly comprehensive examination.

He talked about what he’d recommend, then I had a few choices to make.  First and foremost, he emphasized the benefit of weight loss of any kind, so my efforts in that arena, as I’ve known, will continue to pay dividends.

Second, he’d prefer to see me eliminate taking the Aleve except in instances where I’ve overdone and need temporary relief for a few days to a week.  In conjunction with that, he recommends I increase my Tylenol to 2000 mg a day.  Apparently, there are some concerns with Naproxen (Aleve’s generic name), and intake should be reduced.  Tylenol dosage should remain less than 4000 mg a day, and current practice is to try to limit to 3000 mg a day, so his recommendation of 2000 should be very safe and allows for some variance for any number of reasons.  Naturally, periodic liver function tests are recommended (I get them every six months any way).

Third, he recommended I do some simple isometric exercises each evening to strengthen my quads.  Interestingly, these are the same exercises I’ve been doing naturally once or twice in the morning before I get out of bed to help my legs get started for the day, so doing them in a chair in the evening before bed will probably reap better benefits.

Then he described how steroid injections work as well as one other type of injection that uses a product made from rooster combs to replace the lubricating fluid that my knees no longer make on their own. I don’t recall the official term for it, but it isn’t used without a great deal of consideration, because it’s expensive and not all insurance covers it, so if someone’s going to wind up paying for it, they want to make sure they are a good candidate.  He asked if I was interested in an injection or not.

I discussed my thoughts that my broken foot bone was probably aggravating the knee, and how I want to see if getting that healed with help.  I also explained I had decided to come see him now, because of our vacation in October, which will require a great deal of walking.  He said I definitely wouldn’t want an injection today, because if it didn’t work for longer than  a month (and we don’t know how I’ll respond, because I’ve never had a steroid injection before), it would be too early for another one before my trip.

So, I’m going to pursue the other avenues with my foot, but I also scheduled a visit for late September just in case I want to get the shot before the trip.  If the knee is doing better, I can cancel the appointment.  If it isn’t, I have the appointment for the optimal day prior to needing to do a lot of walking later on.

He sent me for x-rays of my knees, and he’ll be able to use those to help determine how effective the treatments he has available to him will be.  I look forward to hearing what he thinks in September.  I guess the most interesting thing I took away from the day was what appeared to be his holistic view of my problem (which, I understand is what rheumatology is all about).