For many years I’ve been troubled by a creaky left knee. And the older I’ve gotten the more trouble it’s given. A few years ago I went to an orthopedist whose waiting room was half teenage linebackers and gymnasts in casts and slings and half old funds like me barely shuffling or lashed to wheelchairs or walkers.
You could almost see the doctor rubbing his hands as he manipulated my knee, listened to it make the sound of castanets and sent me down the hall for X-rays. He was clearly figuring out how he’d spend another $10,000 fee for another knee replacement procedure.
But no. I was spared the pain and he was spared the payday. The bones looked fine (for now), but the kneecap was misaligned. I may have simply been made that way, a factory second. The kneecap rubbing on the femur and tibia that it was supposed to float between was causing the pain and grinding off flakes that acted like sand in gears.
An operation might try to fiddle with all the intricate strings and pulleys holding it in place, or in this case out of place. But that would be a lot trickier than full-bore knee replacement. Tendons and ligaments and suet, of my, are problematic. Tinkering might make me better, but it could just as easily make me worse. He seemed unenthusiastic about the lawsuit likely to follow when I was crippled for life by him instead of by nature.
He recommended trying steroid shots for the inflammation, (they did nothing), and quad exercises to try to tighten things up. They are a little tricky to execute because of the risk of, in the process, straining my also creaky lumbar spine. Still, they’ve helped somewhat. At least the knee hasn’t gotten dramatically worse and the back flairs up only every few weeks. And I’ve had a strong right knee to help me limp along. Or had, until recently.
Then, out of the blue with no precipitating strain or torque or trauma to explain it, the good knee one fine day began to hurt, a lot. Worse than the other. This seems to me the very definition of aging. As a far greater doctor than mine might have said:
One knee, two knees,
Bad back screw me.
Doctors charge fees,
But can’t renew me.
The doctor’s PA says the too-busy-to-see-me actual doctor could do a little arthroscopic prowling around. Fill my knee with saline, insert a light and an emery wheel, sand down the kneecap and flush out the debris. It might make me feel a little better, until it doesn’t. But no real cure, just a slightly more mobile, less painful pause as even more of me erodes away. Until, presumably like all of us, I am whittled down to nothing. “It could be worse,” is what we decaying wretches are supposed to think. But it will be worse. I have seen the future and it is the no-longer-walking wounded in the orthopedist’s waiting room.
Meanwhile I am sent on my way with the following prescription. I should avoid putting unnecessary weight on the knees, which the PA helpfully parsed for me as meaning lose weight and exercise more. Which means I should keep doing the knee exercises that hurt my back and stop doing one of the few things I enjoy that is still possible, feeding my face. However, it would probably be better if I quit walking for exercise and started swimming. I should also keep popping the pain pills that have no effect, unless they have the unwanted side effect of causing gastrointestinal bleeding. I should avoid stairs.
So lets recap, all I have to do is move to a one story house with a swimming pool where I can fast and take dangerous drugs. I’ll get right on that, Doc. Meanwhile, maybe you guys could do something other than keep whittling or unlikely-to-help major surgery.
How about figuring out a fix? This is the age of medical miracles, isn’t it? How about the medical version of WD-40? It fixes everything else. You guys ought to be highly motivated. By my count there are about 14 billion knees on the planet and most are going to go bad.
But wait, you are already getting between $10,000 to $20,000 per knee for the old-fashioned method. Which comes to a potential worldwide payout of $280 trillion. No wonder the search for a treatment that would help my situation is, shall we say, languid. Why cure the knees that lay the golden eggs.