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I’m free!

In a dashing break from my imprisonment, I threw a walker through my hospital room window, cleared the broken glass with a crutch, and then rappelled down some hospital sheets tied together, to run away from angry orderlies waving hypos filled with calming drugs…

Nah, not really. I endured four or five boring hours of waiting while paperwork was filled out, took an elevator, and hobbled slowly home. My knee is much better now — I won’t exactly be tap dancing, but I can get out of a chair and walk across the room without blistering the cat’s delicate ears with profanity, anyway.

Interestingly, I ran into what has to be a common doctor’s dilemma. They had multiple hypotheses about what was wrong — gout was high on the list, with a bacterial infection in the joint capsule running second — but you don’t get to do the nice tidy sequential controlled experiment when your patient is in great pain. So they treated me for both possibilities simultaneously, while doing lots of diagnostic tests. And then they discover both that my synovial fluid had none of the crystallized uric acid characteristic of gout, and was also delightfully clean of bacteria. But I was getting better anyway. They had some other hypotheses that they were interested in looking into, but dang, the patient was healing and their interesting disorder was fast disappearing. So I checked out, and we still don’t know what caused the problem, or what fixed it. This is why I never wanted to be a doctor: it’s so unsatisfying to not be able to treat the patient as an experiment.

Although I am warned that if the knee worsens once I’m home, I need to report in to the hospital immediately, and count on staying there for at least a week while they dismantle the joint. I’m hoping I don’t have to give them closure on this one.

Comments

  1. Kevin Kehres says

    Hope for the best — expect the worst. And be your own fiercest health care advocate. Don’t just accept their “say so” (which amounts to guessing).

  2. unclefrogy says

    I hate intermittent problems especially the ones that go away as soon as you start testing looking for them.
    it’s not like you can just disassemble the body and its parts and see what is going on without stopping it working all together and then putting it back together with making even more trouble.
    wish I knew some magic words to use
    uncle frogy

  3. bcwebb says

    now if was both knees, you could cut one leg off and preserve it while doing experiments on the other.

    just saying.

    I’ve had mystery knee stuff too. Good luck.

  4. eveningchaos says

    I know why you got better. I prayed to St. James who is the patron saint of :

    Against arthritis, against rheumatism, Antigua, Guatemala, apothecaries, arthritis sufferers, blacksmiths, Chile, Compostela, Spain, druggists, equestrians, furriers, Galicia, horsemen, knights, laborers, Nicaragua, pharmacists, pilgrims, Pistoia, Italy, rheumatoid sufferers, riders, soldiers, Spanish conquistadors, tanners, veterinarians.

    The prayer work best when a veterinarian is using pharmaceuticals to treat an arthritic knight with a knack for leather making from mixed Antigua/Guatemalan/Chilean/Spanish/Galacian/Nicaraguan/Italian decent.

  5. Amphiox says

    And this is why biomedical research has to content itself with 2 sigmas, unlike the physicists.

  6. dorght says

    Doctors must hate it when you start getting better without their permission. That’s almost like taking some Oz QD (quack doctor) herbal remedy and getting better, thereby proving you where going to get better on your own anyhow.

  7. Al Dente says

    Some years ago I tried to donate blood but was rejected because of anemia. Shortly thereafter I had my annual physical exam and mentioned the anemia to the doctor. Over the next three months I was given a whole series of tests. I joked that my anemia was possibly due to giving so many blood samples and the doctor seriously considered that. The tests were all inconclusive and when I tried to donate blood again my blood count was in the normal range.

    Nobody has any idea why I was temporarily anemic and why it went away. But it did give a couple of doctors and some lab techs some work to do for a few months.

  8. machintelligence says

    It is probably a variant of mechanic’s syndrome. No mechanical device ever acts up when there is a mechanic on hand.

  9. moarscienceplz says

    They had multiple hypotheses about what was wrong — gout was high on the list

    PZ you gotta stop eating so many human babies. They’re just too rich of a diet. Try eating more Christian apologists. All those strawmen they carry around are high in fiber.

  10. Gorogh, Lounging Peacromancer says

    Happy to hear you’re better, PZ. Who else would be the ambassador of humans when the Deep Ones rise?

    Reading your comment about St. James, eveningchaos, reminded me of Santa Muerte and the fact that yes, those saints do have fascinating portfolios sometimes.

    This is obviously God’s way of telling you to walk on your hands from now on.

    Ann Coulter approves, Naked Bunny with a Whip!

  11. says

    {…}I threw a walker through my hospital room window, cleared the broken glass with a crutch, and then rappelled down some hospital sheets tied together, to run away from angry orderlies waving hypos filled with calming drugs…

    All right! You go Adam West!

  12. says

    moarscienceplz:

    Try eating more Christian apologists. All those strawmen they carry around are high in fiber.

    You’re really recommending that PZ devour William Lane Craig, Ken Ham, and Kent Hovid? Geez, what did PZ ever do to you?

  13. ericjuve says

    Its lucky you weren’t at Princeton-Plainsboro Teaching Hospital with Dr house or you’d still be there getting experimented on.

  14. Matrim says

    Gout sucks, I feel your pain. Mine tends to hit me in the ankles and sometimes the fingers. Colchicine, indomethacin, and allopurinol; make them your new best friends.

  15. John Horstman says

    @Al Dente #10: You might well have just been over-hydrated. I donate blood on a regular basis, and despite little change in my diet and habits, my hematocrit results can vary a lot (one time I was out of the normal range on the high end; typically it’s within normal). I looked into it, and it turns out that hydration impacts the test a lot. More water (well, plasma – even if your kidneys are in good working order, over-hydration will temporarily increase your plasma levels) relative to red cells reduces concentration.

  16. James says

    Not that it’s probably any help to you, but when my knee swelled up it turned out to be psoriatic arthritis, which is one of those forms of arthritis that doesn’t leave markers in the fluid or your bloods. Hope things work out well for you (I’d cross my fingers for you but, you know, a) superstitious and b) arthritis).

  17. opposablethumbs says

    No no no, you have to rip out a drinking fountain with your bare hands and hurl it through the mesh-reinforced window to make your escape to Canada. Possibly by running in slow motion, I’m afraid I don’t remember that bit clearly enough.

    Glad you’re out, PZ, and I hope you don’t find yourself requiring any further experimentation either.

  18. blf says

    It was actually a plot by the NSA, Trilateral Commission, Mossad, the Illuminati, daleks, peas, and teh cat to implant an espresso machine in you. Now, when you start saying something they don’t like, they’ll just turn it on and cause you to gush forth froth and steam. No actual coffee, however. That would be silly.

  19. Sili says

    16.
    Tony! The Queer Shoop,

    You’re really recommending that PZ devour William Lane Craig, Ken Ham, and Kent Hovid? Geez, what did PZ ever do to you?

    Ham and Hovind are hardly apologists, are they?

  20. says

    Perplexing. But that’s no reason to look a gift recovery in the mouth. At least now you know you can have all the liver paste on crackers that you care to have.

    As for hospitals … they give me nightmares and I understand how grateful you are to have escaped, even if window-breakage was not required. I was in a hospital yesterday to visit my mother (who is doing well). It turns out that the ICU is not a restful place where a patient can get a few winks. It’s full of electronic devices that randomly or rhythmically go beep-bop-boop and medical personnel with “quiet” rubber-soled shoes that nevertheless rush to and fro, opening medicine cabinets, pushing gurneys, and answering pages. Around the clock. Mom is happier now that she’s receiving less intensive care in a regular care ward. I think, however, she’s perturbed that she got the same surgery as Henry Kissinger on the same day as he did. What’re the odds?

  21. says

    Dang, PZ, I thought you were already out with all the blog articles you’ve been posting. I am no stranger to hospitals, crippling pain, the meds used to control it and endless tests. When I’m in that state, it takes everything I’ve got to string full sentences together verbally or sign my own name…

    There you were blogging the whole bloody time! Kudos to you sir. Bravo!

    I do hope that whatever your mystery ailment was, it never, *ever,* recurs.

    Best wishes.

  22. Olav says

    kc9oq #17:

    This is, I think why they call it “practicing medicine”.

    It is as much an art as it is science.

  23. otrame says

    Sorry to hear that you were interesting to a doctor. That is seldom good. And I am a horrible person because I find myself kind of interested. Knees are delicate, but fairly simple, so there is a limited number of things that can go wrong and your orthopod(s) should be familiar with all of them,. Still sometimes things fix themselves. Hell, I had a car that fixed itself once. You should be able to manage it.

    But, seriously, if it doesn’t get better do go back to see them.

  24. says

    wordsgood:

    Dang, PZ, I thought you were already out with all the blog articles you’ve been posting. I am no stranger to hospitals, crippling pain, the meds used to control it and endless tests. When I’m in that state, it takes everything I’ve got to string full sentences together verbally or sign my own name…

    There you were blogging the whole bloody time! Kudos to you sir. Bravo!

    PZ would never deny the world his tentacular goodness. No matter how much rain, nor sleet, nor snow, nor pain of knee.

  25. cartomancer says

    You haven’t recently given up a life of adventuring in a fantasy Nordic kingdom to become a town guard have you?

  26. chigau (違う) says

    PZ
    What cat?
    That cat that you are ‘fostering’ until you find it a good home?

  27. Trebuchet says

    After all too many experiences in recent years, my rule of thumb for hospital/nursing home discharges is as follows:
    Take the time they tell you absolutely MUST quit cluttering up THEIR room or be charged for another whole day. Because there’s another patient coming in.

    Add six to twelve hours before they actually figure out how to do the paperwork to let you leave.

    Then there was the “care manager” for my dad. He’d been in the ICU for five weeks and we’d never seen her before, and he was finally regaining consciousness and showing some healing on his surgical wounds. So she talked a substitute doctor, who’d also never seen him before, into “pulling the plug”, so he quit taking up space. She consulted with neither the surgeon on the case or his primary care doctor. Medication was already being withheld before we got there and raised hell.

    He lived another five years. We watched her like a hawk after we discovered she was in charge of my mom’s case a year later.

    On a brighter note: Congratulations, PZ, on finally being able to admit you are owned by a cat. It’s all right. Lots of us are.

  28. magistramarla says

    I feel for you, PZ.
    I’m also an interesting case for the docs.
    They have had all kinds of theories:
    1. Obvious autoimmune problems can be Sjogrens, Lupus, RA, Psoriatic Arthritis (Sjogrens is the only one that is definite)
    2. Skin rashes can be lymphomatoid papulosis, rosacia, lupus rash, psoriasis
    3. Joint problems can be osteoarthritis, RA, osteonecrosis, etc.
    4. Mobility issues can be MS, Parkinson’s, spinocerebellar ataxia, spinal stenosis, hereditary spastic paraplegia, etc. The only one of these that has been verified is the spinal stenosis. MS, Parkinson’s and SA have been ruled out. HSP was suggested by docs at UCSF and now the neurologist at UT Medical Center thinks that is right.
    I am so tired of being such an interesting case. I just want to live without pain again!

    I’m glad that you are home with your kitty and I hope that your problem either resolves itself or is easy for the docs to figure out. Get well soon.

  29. cicely says

    Glad that you’re ambulatory again.
    Don’t look a gift Spontaneous Remission in the mouth, is what I always say.
    -

  30. ledasmom says

    Look out for that cat. They enjoy getting under the feet of the already-injured and making everything worse. Glad it’s not gout. Husband has gout. Were camping once in Yellowstone without his gout medicine; ended up driving him to the park clinic in my uncle’s pickup, a size of vehicle I had not previously driven. There aren’t any twenty-four-hour pharmacies near Yellowstone, or at least not any then that we could find. Not the husband’s cleverest vacation-packing job ever.
    My latest set of irritatingly undiagnosable symptoms was constricting pain in the chest plus jaw pain, which resulted in an EKG and “eh, probably some digestive thing” from the doctor. Well, that is certainly reassuring, doctor. That plus a migraine aura of one-sided numbness pretty much assures me of a cardiovascular-related exit, since there’s no way I’ll actually take those symptoms seriously quickly enough.

  31. phiwilli says

    Years ago I had the chance to audit some courses in epidemiology at Chapel Hill. One thing they said that stuck with me: about 80% of the time, when people complain of a medical problem, if nothing is done they will get better! Maybe that’s your situation.

    Or you could submit your case to Dr. Lisa Sanders who does the diagnostics articles for the NYTimes magazine!

  32. Tigger_the_Wing, Back home =^_^= says

    ledasmom @ 40:

    My latest set of irritatingly undiagnosable symptoms was constricting pain in the chest plus jaw pain, which resulted in an EKG and “eh, probably some digestive thing” from the doctor. Well, that is certainly reassuring, doctor. That plus a migraine aura of one-sided numbness pretty much assures me of a cardiovascular-related exit, since there’s no way I’ll actually take those symptoms seriously quickly enough.

    “Some digestive thing” was pretty much the diagnosis I had for ten years, for pretty much the same symptoms; until my coronary arteries went into spasm during an angiogram, and I was diagnosed with Prinzmetal’s (aka unstable) angina. I also have hemiplegic migraines and the cardiologist said they are related to the angina. Methinks you would do well to get a second opinion.

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