The rheumatologist made the promised call, sharing the recent bloodtest results. Blood is fine. No indications for auto-immune disorder. So, it looks like the inflammation has been halted. Yeah.
Then his question: how are you? Well, the knee is still normal after almost three weeks. Good. Sounds like you are back to normal. With this restriction: no peak muscle stress advised for the next three months.
So, refereeing will have to wait till January. In the meantime it’s important not to trigger a new inflammation and not put too much pressure on the knee muscles.
I’m ok with that as long as I can go about without pain and stiffness. And no new medication. Four months of a weird sudden inflammation seem over. Maybe ignited by a heavy sports season afterall. Full circle after all.
After seeing the sports medical doctor, I learned to accept that my swollen knee wasn’t due to a sports injury, but rather an ailment. Changing from the orthopedist (mechanical) to a rheumatologist (inflammatory) should be regarded as logical therefore. Suffering twelve weeks of this kind of swelling (and only a swift pain attack) simply can’t be blamed on excessive sports stress or trauma.
No, the diagnosis probably goes in the direction of my GP’s first hunch back in May: gout or pseudo-gout (chondrocalcinosis). Gout is an ailment in the rheumatic line, caused by christalized acids heaping up in the knee after errors in the body’s metabolism. After reading about the gout causes, I understand why the doctor is studying the ‘pseudo-gout’ option. This ailment looks similar to gout, but this time the chrystals are formed by calcium and not acids. And the circumstances are different.
Some 90ml of excessive (yellow) fluids were extracted from my knee last week and are now being examined, along with new bloodtests and X-rays. A new medication makes me feel lots better and should reduce the inflammation cause. In total, it feels like getting more serious attention, but with a less clear outlook.
A cure for pseudo-gout isn’t around the corner unfortunately. But it can disappear as sudden as it started. Your body has to recover by itself and wash out the calcium chrystals. In two weeks I will know what my physical future holds in terms of sports and exercise. Maybe the current medicins will do the trick and will allow me to start training again.
My insurance company was one of the first to show compassion with my knee injury. “How long did you say you have had this knee injury? Wow, almost three months without a clear diagnosis. Let’s try a 2nd opinion before you see yet another specialist.”
I felt mentally supported after seeing 3 GP’s, the orthopedist (more of his assistant). Swallowing three different anti-inflammatory drugs, getting injected with cortisone and being X-rayed and MRI-ed.
The sport medical doctor was the one to give me the obvious word: you have stressed yourself too much as referee in futsal and field football. After such a hectic season the knee can’t cope any longer and blows up. Layman’s talk.
Well, none of that. He studied both the X-ray and MRI scan in my presence. Read the accompanying GP letter with their procedures so far. Checked my swollen knee and just nodded. His verdict was shockingly direct: this is clearly not a sports related injury. At least, it’s not the way a knee reacts to being overly stressed – even after a total inner-meniscus removal (40 years ago) and a heavy season where I pushed hard to get promoted. No mechanical cause to be found, just like the orthopedist told me.
He simply would have given the same advice: go and see the reumatologist. He will probably ask for a puncture and examine the excess fluid. Maybe he has a an idea what causes the knee (and possibly other body parts) to react so vehemently. He wished me luck and said to be sorry not to be able to help any further.
And just when I wanted to hit the ‘publish’ key, the reumatologist called me if I wanted to fill a last-minute opening in his agenda. Sure, let’s do it! Seeing him in 60 minutes. To be continued.