tag:blogger.com,1999:blog-66496067461359704222024-03-20T10:50:22.507-07:00PVNS SuccessPVNS Success Blog is a research site which provides links to professional information, case studies, medical glossaries and interactive visual aids. I invite you on my journey as I discover what PVNS means in my life.CJhttp://www.blogger.com/profile/07441864217304744390noreply@blogger.comBlogger76125tag:blogger.com,1999:blog-6649606746135970422.post-12559519983664046652014-08-12T13:39:00.000-07:002014-08-13T04:04:21.391-07:00Questions to Ask Doctor About MRI's and Radiologists<br />
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<span style="color: #cc0000; letter-spacing: 0.0px;"><b style="background-color: white;">Random Radiology Information </b></span></h3>
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<li style="font: 12.0px Helvetica; margin: 0.0px 0.0px 0.0px 0.0px;"><span style="letter-spacing: 0.0px;"> If your MRI imaging report is sparse, you have questions or are not satisfied? You can request a second opinion and have the scan read by another radiologist. </span></li>
<li style="font: 12.0px Helvetica; margin: 0.0px 0.0px 0.0px 0.0px;"><span style="letter-spacing: 0.0px;">Radiologists are often generalist while others have specialty fields.</span></li>
<li style="font: 12.0px Helvetica; margin: 0.0px 0.0px 0.0px 0.0px;"><span style="letter-spacing: 0.0px;">The best doctors that I've had are very picky on where tests are performed and who reads the results. </span></li>
<li style="font: 12.0px Helvetica; margin: 0.0px 0.0px 0.0px 0.0px;"><span style="letter-spacing: 0.0px;">Machines, techs and radiologist are not created equal. </span></li>
<li style="font: 12.0px Helvetica; margin: 0.0px 0.0px 0.0px 0.0px;"><span style="letter-spacing: 0.0px;">Bigger facilities are not always better, but the radiologists read more films and see more obscure conditions, however, the reports may or may not be as detailed due to the work load.</span></li>
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<span class="Apple-style-span" style="color: #cc0000;"><span class="Apple-style-span" style="font-size: 14px; font-weight: bold;"><b>What to Ask When Being Sent for a Scan </b></span><span class="Apple-style-span" style="letter-spacing: 0px;"><span style="letter-spacing: 0.0px;"></span></span></span></div>
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<li style="font: 12.0px Helvetica; margin: 0.0px 0.0px 0.0px 0.0px;"><span style="letter-spacing: 0.0px;">If you are being sent to a specific radiology clinic, ask why? </span></li>
<li style="font: 12.0px Helvetica; margin: 0.0px 0.0px 0.0px 0.0px;"><span style="letter-spacing: 0.0px;"> Is this the best place to have the scan done, or is the facility being chosen for convenience or location?</span></li>
<li style="font: 12.0px Helvetica; margin: 0.0px 0.0px 0.0px 0.0px;"><span style="letter-spacing: 0.0px;">What size and type of imaging machine do they have and is it the best to diagnose the possible ailment? </span></li>
<li style="font: 12.0px Helvetica; margin: 0.0px 0.0px 0.0px 0.0px;"><span style="letter-spacing: 0.0px;">Would contrast "such as Gadolinium" be of benefit in the scan...why or why not? </span></li>
<li style="font: 12.0px Helvetica; margin: 0.0px 0.0px 0.0px 0.0px;"><span style="letter-spacing: 0.0px;">Notify the doctor and imaging center, if you have metal implants. Special arrangements may have to be made.</span></li>
<li style="font: 12.0px Helvetica; margin: 0.0px 0.0px 0.0px 0.0px;"><span style="letter-spacing: 0.0px;">If you are claustrophobic, notify the doctor so he can prescribe a sedative during the scan. I'm claustrophobic, I shut my eyes and keep them closed, well before they place contraptions on me, and being slid into the mri machine. I think about being on the beach looking at the wide open sky. I also let them know it helps if they talk me through the exam while in the machine. I had a very bad experience when they didn't say a word for an hour and the tech didn't respond to the squeeze ball that he gave me for emergency communication. </span></li>
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<span class="Apple-style-span" style="color: #cc0000;"><span class="Apple-style-span" style="font-size: 14px; font-weight: bold;"><b>What to ask the Radiology Technician</b></span><span class="Apple-style-span" style="letter-spacing: 0px;"><span style="letter-spacing: 0.0px;"></span></span></span></div>
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<li style="font: 12.0px Helvetica; margin: 0.0px 0.0px 0.0px 0.0px;"><span style="letter-spacing: 0.0px;">When will my scan be read and when should my doctor expect the report?</span></li>
<li style="font: 12.0px Helvetica; margin: 0.0px 0.0px 0.0px 0.0px;"><span style="letter-spacing: 0.0px;">Have the technician provide a disc of your mri. Bring it to your f/u doc appointment, but always get it back after they are finished with it. </span></li>
<li style="font: 12.0px Helvetica; margin: 0.0px 0.0px 0.0px 0.0px;"><span style="letter-spacing: 0.0px;">Be pro active and pick up your reports from the imaging centers, even though the imaging center sends them to your physician. It's terrible how often the ball gets dropped, even on abnormal test results. Bring the disc and the report to your next appointment. </span></li>
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<span style="color: #cc0000; letter-spacing: 0.0px;"><b>Finding A Good Radiologist</b></span></h3>
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<li style="font: 12.0px Helvetica; margin: 0.0px 0.0px 0.0px 0.0px;"><span style="letter-spacing: 0.0px;">Ask your doctor, family and friends if they have a preference and why. </span></li>
<li style="font: 12.0px Helvetica; margin: 0.0px 0.0px 0.0px 0.0px;"><span style="letter-spacing: 0.0px;"> Call radiology centers and ask who they prefer and why. </span></li>
<li style="font: 12.0px Helvetica; margin: 0.0px 0.0px 0.0px 0.0px;"><span style="letter-spacing: 0.0px;">Research radiology centers and their credentials on the net. </span></li>
<li style="font: 12.0px Helvetica; margin: 0.0px 0.0px 0.0px 0.0px;"><span style="letter-spacing: 0.0px;">If you've had many scans, look at the radiologist name on the "well written" detailed reports, and request that your images be read by that person. Be aware that this could slow down the report processing time. </span></li>
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CJhttp://www.blogger.com/profile/07441864217304744390noreply@blogger.com8tag:blogger.com,1999:blog-6649606746135970422.post-86598483975878842202013-03-28T15:53:00.000-07:002014-08-13T04:05:51.672-07:00Success with Adjuvant PVNS Radiation Treatment, Story<br />
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<span style="color: #cc0000; letter-spacing: 0.0px;"><b><u>Why Did I Choose To Have Adjuvant PVNS Radiation Treatment</u></b></span></div>
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<span style="letter-spacing: 0.0px;"> I had my first "open knee synovectomy" for diffuse Pigmented Villonodular Synovitis on Dec 14, 2011. My oncologist orthopedic surgeon assured me that she had removed all visible signs of the pvns - which is a very aggressive nonmalignant tumor of joints with synovial tissue such as the knees, hips, elbows, ankles etc. She emphasized that it only takes a single PVNS cell to reseed and begin the process of tumor growth. I was uncomfortable with the variable yet high recurrence rate of up to 60%, even when all visible tumor had been excised.</span><br />
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I read many research studies comparing the short and long term statistics of chemotherapy, and radiation therapy as an adjuvant treatment for diffuse pvns. I found that I wasn't a candidate for chemotherapy due to having polyneuropathy, so the only other treatment available in my case was external radiation treatment. </div>
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<b><u><span class="Apple-style-span" style="color: #cc0000;">Radiology Oncologist Assessment</span></u></b></div>
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<span style="letter-spacing: 0.0px;">I constructed a <a href="http://pvnssuccess.blogspot.com/2012/07/questions-to-ask-your-radiologist.html">{list of questions}</a> to ask my radiology oncologist, at my consultation appointment. The answers to these questions are case specific, but the following is in general.</span></div>
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<span style="letter-spacing: 0.0px;">In my case, pvns recurrence after an open synovectomy was estimated to be in the high 40 percentile. Open synovectomy with adjuvant external radiation would reduce my recurrence rate to the mid-teen percentile. </span><br />
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<span style="letter-spacing: 0.0px;">I was concerned about rumors of external radiation treatment dangers such as the possibility of forming a secondary cancer. I was assured by my radiology oncologist and years worth of research, that this fear was totally unfounded. There has never been a reported case of secondary cancer from PVNS radiation treatment. </span></div>
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<span style="letter-spacing: 0.0px;">The level of risk as explained by my radiology oncologist..."you are much more likely to suffer from a serious adverse reaction to anesthesia during surgery than to experience a secondary malignancy caused by radiation treatment for pvns." There are possible complications and risks associated with all treatments, including repeated surgeries... so the risks and benefits must be carefully evaluated.<br />
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<span style="letter-spacing: 0.0px;">I'm neither for or against radiation or chemo in the treatment of PVNS, because they both have a place in it's treatment with their own unique risks. Recent studies are showing that they have nearly the same effectiveness. However there are additional concerns that should seriously be looked at when using a systemic drug on a disease that is confined to one joint. Unfortunately, I've found that many of the physician promoting chemotherapy agents have some type of association or financial interest in promoting chemotherapy drugs and their trials. </span>A consultation with an oncologist or radiology oncologist will be able to provide you with a personal risk for these adjuvant treatments.</div>
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<span style="color: #cc0000; letter-spacing: 0.0px;"><b><u>Radiation Therapy Experience</u></b></span></div>
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<span style="letter-spacing: 0.0px;">On my seventh week post synovectomy, I decided to have 18 external radiation treatments of 200 greys each, Monday - Friday for 3 1/2 weeks. This is the normal radiation dose used by most physicians for the treatment of diffuse pvns in the knee. </span></div>
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<span style="letter-spacing: 0.0px;">Second week of radiation treatment: I've had four treatments, flexion range of motion (ROM) 84º, extension is normal, pain 3-4 with increased activity, increasing fatigue and swelling.</span></div>
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<span style="letter-spacing: 0.0px;">Third week: I've had nine treatments, flexion ROM 84º, I'm feeling the cumulative effects, pain 3-5, slight burning sensation, vice grip feeling, heat at site, darkening of skin, swelling, fatigue is overwhelming. I had to back off on physical therapy due to the swelling interfering with proper positioning of my knee during RT delivery. Compression, elevation, ice, and medication is helping to control the side effects. </span></div>
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<span style="letter-spacing: 0.0px;">Fourth week: I've had 14 treatments, flexion ROM 74º. I'm finding that it's a challenge to keep my attitude in check as the fatigue drains my ability to keep pace with my normal daily activities. I'm told that the fatigue will pass as my body recovers from the treatment. </span></div>
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<span style="letter-spacing: 0.0px;">Fifth week: I've had 18 treatments and I'm now finished with radiation. Flexion ROM 81º It is now 12 weeks post op and I have physical therapy 3-4 days a week to work on increasing my ROM.</span></div>
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<span style="letter-spacing: 0.0px;">16 wk post synovectomy, 4 wks post radiation therapy and my flexion ROM has been stuck at 81 degrees for 2 wks. Prior to RT my ROM was at 84 degrees. I lost 10 degrees during RT= 74 degrees, regained 7 degrees the 1st 2 wks post RT</span></div>
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<span style="letter-spacing: 0.0px;">18 week post op my flexion ROM is stuck at 81º and I am now having a knee manipulation under anesthesia followed up by aggressive physical therapy. This procedure worked well in breaking up scar tissue and my flexion ROM is now at 113º.</span></div>
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<span style="letter-spacing: 0.0px;">PVNS and Pain Free 15 months post synovectomy, RT, manipulation, false pvns recurrence and arthroscopy, several months of physical therapy, partial knee replacement with flexion ROM now at 118º. Normal knee flexion is 130</span>º<br />
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<span style="letter-spacing: 0.0px;">In summary, I feel that I've attacked this disease as aggressively as possible, and only time will tell if my choices were worth the risks. I know that the radiation treatment damaged my knee in the sense that it caused additional scar tissue. Although, surgery also caused scar tissue. Hopefully I will remain in remission, and I'll have MRIs done every six months and eventually yearly for the rest of my life. The partial knee replacement will make the MRIs even more difficult to read, but it was necessary since the pvns and treatments left me with painful bone on bone arthritis. </span></div>
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<span style="color: #cc0000; letter-spacing: 0.0px;"><b><u>Making The Right Decision</u></b></span></div>
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<span style="letter-spacing: 0.0px;">I will be very cautious in approaching any surgery for a possible recurrence of pvns, since I've already had one false positive recurrence on the MRI reading (scar tissue). One year after my synovectomy, I had an arthroscope which ruled out a pvns recurrence, my meniscus was repaired, and that's when they discovered that I needed a knee replacement. </span><br />
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<span style="letter-spacing: 0.0px;">Nearly a year after making my decision to have external radiation treatment after my first synovectomy....I'm seeing a trend toward more aggressive treatment on the onset of pvns and not waiting until there has been a recurrence. I honestly don't know if this is a good thing or not. Once again only time will tell. Obviously my thoughts were to throw every weapon at it, to kill it off on the initial assault, and so far it has worked for me. I can't say this is the right route for others because there are just too many variables in each case, and I'm not a doctor. The information that I share, are links to empirical studies, otherwise it's just my personal opinion based on my experience, and it should not be taken as medical advice. </span><br />
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<span style="letter-spacing: 0px;">When I was under the impression that there was a recurrence of the pvns...I questioned whether I made right decision to be treated with radiation. However, I feel strongly that it was worth decreasing my recurrence rates by having the radiation treatment, and I would do it again. Only time will tell if I will remain in remission. One year after my open synovectomy I had a partial knee replacement. Nearly three years later, I remain pvns and pain free, but I will never know for sure if RT has played a role in my positive outcome or not. Statistics point to yes, but there are others that have had less than satisfactory outcomes. </span></div>
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CJhttp://www.blogger.com/profile/07441864217304744390noreply@blogger.com7tag:blogger.com,1999:blog-6649606746135970422.post-80669469419006070132013-03-15T15:00:00.001-07:002014-08-13T04:06:06.651-07:00Riding Accident Led To MRSA...How To Avoid Infection <br />
<b><span class="Apple-style-span" style="color: #cc0000;">Personal Experience With MERSA</span></b><br />
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Playing horse tag and racing our horses at the ranch seemed like a harmless activity, but on this particular day in the mountains of Montana, my life was nearly changed forever. Growing up I had been graced with the presence of horses in my life, and being challenged to a sprint was common place. I had accepted the challenge, and my horse and I were determined to win. With the cool Montana wind blowing in my face and thundering clap of my horses hooves hitting the trail, he had a misstep. I suddenly found myself being forcefully thrown to the ground and my horse tumbling along side of me.<br />
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I was panic stricken as my first thought was of my horses safety, but he had immediately returned to his feet and motionlessly stood next to my body on the ground. To much relief, my horse was fine but my wellbeing was yet to be determined. <br />
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As a search and rescue trauma medic, I proceeded to assess my own injuries. Even with a helmet on; the buzzing in my head made it obvious that I had sustained a concussion. Trying to draw in my first few breaths were near impossible since the impact had knocked all of the air out of my lungs. After a few seconds, I was finally able to take a few short gasps. I began going through my mental check list. Conscious-check, Breathing-check, No numbness or tingling of extremities and neck in alignment-check, No obvious broken bones, however, my shoulder was questionable-check. A few minor scratches but no gushing blood-check<br />
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I appeared to be ok, and had escaped serious injury, even though I knew that many bruises and muscle strains would become obvious within the next few hours. Others helped me to mount my horse, because my injured shoulder was being uncooperative. We all returned to the stables and I went for x-rays, which turned out to be ok. I finished out a rather painful week at the ranch and I was anxious to return home.<br />
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Back in Arizona, and terribly bruised, I noticed a minor scratch had become severely inflamed, even though I had been putting antibiotic cream on it. Within a few hours I began feeling ill and feverish so I went to the emergency department. As suspected I had a raging infection, but what I didn't expect to be told was that it was MRSA staph infection.<br />
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I was admitted to the hospital on IV antibiotics but they had little effect on the infection. Within a few hours, the once tiny scratch above my ankle had turned into an oozing hole of necrotized tissue. As I was being wheeled into surgery, fear began to take root as I realized that I could loose my foot and possibly my life. I had just moved to Arizona, I didn't know a soul and this was not a good time to be alone.<br />
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I awoke in recovery not knowing if my foot was still attached, but the nurse calmed my fears by letting me know that they were able to save the limb. I wasn't out of the woods yet, but I had my bags packed for the journey. After a few days had passed, I was discharged to outpatient wound care.<br />
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It took months of specialized care for my wound to heal, and in the process I learned much about infection control. Although I didn't contract my infection in the hospital, I had to learn how to avoid a hospital acquired infection, since I would be facing surgery for pvns in the near future. <br />
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You may realize that the hospital is a harbor for life and limb threatening bacteria, but have you thought about how they could find their way into your body?<br />
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<span class="Apple-style-span" style="color: #cc0000;"><b>General Information About Staph</b></span><br />
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First of all, studies show 25-30% of people in the general population carry staph without any signs or symptom and this statistic is much higher in hospital personnel.<br />
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Secondly, staph is easily passed on through physical contact, or even when people touch the same objects and surfaces, like silverware, towels and railings.<br />
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<b><span class="Apple-style-span" style="color: #cc0000;">Precautions that I take </span></b><br />
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<li>Shower with Hibiclens prior to surgery and continue until wound is completely healed. Hibiclens helps to get rid of staph bacteria on the skin. </li>
<li>Be conscientious of what has been touched by others, food trays, blankets, pens, crutches, physical therapy equipment, etc. </li>
<li>I’m not a germophobic but honestly you can’t wash your hands enough. Staff should always wash their hands (where you can see) prior to touching you or your items. If an item falls on the floor be aware that it is now contaminated by germs that hitchhiked on the soles of everyones shoes. </li>
<li>Upon arrival home, I immediately shed any clothes that I had on at the hospital, wipe down my possessions and sponge bath with Hibiclens. </li>
<li>Everyone becomes anxious to take a real shower after surgery, however, getting an incision wet "before the exterior incision is totally healed" puts you at great risk of infection.</li>
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I haven’t had any problems with infection since I began taking these precautions.<br />
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<b><span class="Apple-style-span" style="color: #cc0000;">Links</span></b><br />
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Click<b> <a href="http://www.foxnews.com/health/2012/06/06/staph-bacteria-in-household-boosts-infection-risk/">here</a></b> to read an informative article about staph infections.</div>
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CJhttp://www.blogger.com/profile/07441864217304744390noreply@blogger.com1tag:blogger.com,1999:blog-6649606746135970422.post-5984329200633947642013-03-13T16:23:00.001-07:002014-08-13T04:06:19.809-07:00Wonderful Exercise SiteBody Building.com is an informative <a href="http://www.bodybuilding.com/fun/workout/exercise.html">Exercise Site</a> were you can choose videos on stretching, exercise by body parts and even track your work outs. This is my go to site when I'm not in physical therapy.CJhttp://www.blogger.com/profile/07441864217304744390noreply@blogger.com1tag:blogger.com,1999:blog-6649606746135970422.post-17420661199127951822013-03-06T16:50:00.002-08:002014-08-13T04:06:30.773-07:00References For Children with PVNS<br />
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<span style="letter-spacing: 0.0px;">I've been working on finding childhood cases of pvns for a few weeks now and wanted to post some of my findings. My hope is that this will help with your individual research into the different types and ages of childhood PVNS. </span></div>
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<span style="letter-spacing: 0.0px;">Numerous incidents of PVNS occurrence within the pediatric population have been well documented, yet it has been stated that PVNS occurs primarily between the ages of 20-50. As I reviewed articles with the terms infant, pediatric, adolescent and teenage populations, I found the following references. Based on a meta-analysis of reports between 1968 and 2007, the age range was found to be between 8 months and 17 years.</span></div>
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<ol style="list-style-type: decimal;">
<li style="font: 12.0px Arial; margin: 0.0px 0.0px 0.0px 0.0px;"><span style="letter-spacing: 0.0px;">Maheshwari A, Muro-Cacho C, Pitcher D. Pigmented villonodular bursitis/diffuse giant cell tumor of the pes anserine bursa: a report of two cases and review of the literature. Knee 14:402–407, 2007. </span></li>
<li style="font: 12.0px Arial; margin: 0.0px 0.0px 0.0px 0.0px;"><span style="letter-spacing: 0.0px;">Freedman BA, Lin DL, Tis JE. Pigmented villonodular synovitis of the <span class="Apple-style-span" style="color: blue;">calcaneocuboid joint</span> in an <span class="Apple-style-span" style="color: red;">11-year-old child </span>with subtalar coalition. Foot Ankle Int 28(4):511–515, 2007.</span></li>
<li style="font: 12.0px Arial; margin: 0.0px 0.0px 0.0px 0.0px;"><span style="letter-spacing: 0.0px;">Brenner JS. Pigmented villonodular synovitis causing painless chronic <span class="Apple-style-span" style="color: blue;">knee</span> swelling in an <span class="Apple-style-span" style="color: red;">adolescent</span>. Clin Pediatr 46(3):268–271, 2007.</span></li>
<li style="font: 12.0px Arial; margin: 0.0px 0.0px 0.0px 0.0px;"><span style="letter-spacing: 0.0px;">Sekiya H, Ozawa H, Sugimoto N, Kariya Y, Hoshino Y. Pigmented villonodular synovitis of the <span class="Apple-style-span" style="color: blue;">elbow</span> in a <span class="Apple-style-span" style="color: red;">6-year</span>-old girl: a case report. J Orthop Surg (HongKong) 15(1):106–108, 2007.</span></li>
<li style="font: 12.0px Arial; margin: 0.0px 0.0px 0.0px 0.0px;"><span style="letter-spacing: 0.0px;">Mukhopadhyay K, Smith M, Hughes PM. Multifocal PVNS in a child–followed over 25 years. Skeletal Radiol 35:539–542, 2006.</span></li>
<li style="font: 12.0px Arial; margin: 0.0px 0.0px 0.0px 0.0px;"><span style="letter-spacing: 0.0px;">Tavangar SM, Ghafouri M. Multifocal pigmented villonodular synovitis in a child. Singapore Med J 46(4):193–195, 2005. </span></li>
<li style="font: 12.0px Arial; margin: 0.0px 0.0px 0.0px 0.0px;"><span style="letter-spacing: 0.0px;">Cussotti S, Ingrosso G, Parola PG, Mellano D, Linari A, Pucci A, Di Rosa G. <span class="Apple-style-span" style="color: blue;">Tendinous</span> villonodular synovitis: a rare case of <span class="Apple-style-span" style="color: red;">recurrence during childhood</span>. Chir Organi Mov 89(2):167–170, 2004.</span></li>
<li style="font: 12.0px Arial; margin: 0.0px 0.0px 0.0px 0.0px;"><span style="letter-spacing: 0.0px;">Saulsbury FT. Pigmented villonodular synovitis of the <span class="Apple-style-span" style="color: blue;">knee</span> in a <span class="Apple-style-span" style="color: red;">9-year</span>-old child. South Med J 97(1):80–82, 2004.</span></li>
<li style="font: 12.0px Arial; margin: 0.0px 0.0px 0.0px 0.0px;"><span style="letter-spacing: 0.0px;">Eckhardt BP, Hernandez RJ. Pigmented villonodular synovitis: MR imaging in pediatric patients. Pediatr Radiol 12:943–947, 2004.</span></li>
<li style="font: 12.0px Arial; margin: 0.0px 0.0px 0.0px 0.0px;">Aydingoz V, Leblebicioglu G, Gedikoglu G, Atay O. Pigmented villonodular synovitis of the elbow in a <span class="Apple-style-span" style="color: red;">6-year </span>old girl. J <span class="Apple-style-span" style="color: blue;">Shoulder Elbow </span>Surg 11(3):274–277, 2002.</li>
<li style="font: 12.0px Arial; margin: 0.0px 0.0px 0.0px 0.0px;">Pill SG, Adams SB, Hubbard AM, Carpentieri DF, Dormans JP. Soft tissue mass of the second <span class="Apple-style-span" style="color: blue;">toe</span> in an <span class="Apple-style-span" style="color: red;">11-year</span>-old boy. Clin Orthop Relat Res 401:265–270, 2002.</li>
<li style="font: 12.0px Arial; margin: 0.0px 0.0px 0.0px 0.0px;"><span style="letter-spacing: 0.0px;">Bruecks AK, Macaulay RJ, Tong KA, Goplen G. Nov 2000: <span class="Apple-style-span" style="color: blue;">13 year</span> old girl with <span class="Apple-style-span" style="color: red;">back</span> pain and leg weakness. Brain Pathol 2:263–264, 2001.</span></li>
<li style="font: 12.0px Arial; margin: 0.0px 0.0px 0.0px 0.0px;"><span style="letter-spacing: 0.0px;">Rosenberg D, Kohler R, Chau E, Bouvier R, Pouillaude JM, David L. Pigmented villonodular synovitis. Diffuse and localized forms in children. Arch Pediatr 8 (4):381–384, 2001.</span></li>
<li style="font: 12.0px Arial; margin: 0.0px 0.0px 0.0px 0.0px;"><span style="letter-spacing: 0.0px;">Kaneko K, Nakahar D, Tobe M, Iwase H, Inoue Y, Ohbayashi O, Kurosawa H. Pigmented villonodular synovitis of the <span class="Apple-style-span" style="color: blue;">ankle</span> in an <span class="Apple-style-span" style="color: red;">adolescent</span>. Int Orthop 23:234–237, 2000.</span></li>
<li style="font: 12.0px Arial; margin: 0.0px 0.0px 0.0px 0.0px;"><span style="letter-spacing: 0.0px;">Vedantam R, Strecker WB, Schoenecker PL, Salinas-Madrigal L. Polyarticular pigmented villonodular synovitis in a child. Clin Orthop Relat Res 348:208–211, 1998.</span></li>
<li style="font: 12.0px Arial; margin: 0.0px 0.0px 0.0px 0.0px;"><span style="letter-spacing: 0.0px;">Ganley TJ, De Ruiter CJ, Dormans JP, Meyer JS, Collins MH. <span class="Apple-style-span" style="color: blue;">Ankle</span> pain and swelling in a<span class="Apple-style-span" style="color: red;"> 10-year-</span>old girl. Clin Orthop Relat Res (348):282–284þ287–289, 1998.</span></li>
<li style="font: 12.0px Arial; margin: 0.0px 0.0px 0.0px 0.0px;"><span style="letter-spacing: 0.0px;">Hansen P, Nielson PT, Wahlin AB. Pigmented villonodular synovitis of the <span class="Apple-style-span" style="color: blue;">extensor tendon sheaths</span> in a <span class="Apple-style-span" style="color: red;">child</span>. J Hand Surg Br 13(3):313–314, 1998.</span></li>
<li style="font: 12.0px Arial; margin: 0.0px 0.0px 0.0px 0.0px;"><span style="letter-spacing: 0.0px;">Hoeffel JC, Mainard L, Champigneulle J, Claudon M. Pigmented villonodular synovitis of the <span class="Apple-style-span" style="color: blue;">wris</span>t in <span class="Apple-style-span" style="color: red;">childhood</span>. Clin Pediatr (Phila) 36(7):423–426, 1997.</span></li>
<li style="font: 12.0px Arial; margin: 0.0px 0.0px 0.0px 0.0px;"><span style="letter-spacing: 0.0px;">Minisola G, Porzio V, Ceralli F, Grillo LR, Porzio F. Polyarticular pigmented villonodular synovitis associated with multiple congenital anomalies: a case of <span class="Apple-style-span" style="color: blue;">noonan-like/ multiple giant cell lesion syndrome.</span> Clin Exp Rheumatol 14(2):207– 210, 1996.</span></li>
<li style="font: 12.0px Arial; margin: 0.0px 0.0px 0.0px 0.0px;"><span style="letter-spacing: 0.0px;">Kay RM, Eckardt JJ, Mirra JM. Multifocal pigmented villonodular synovitis in a child: a <span class="Apple-style-span" style="color: #6aa84f;">case report.</span> Clin Orthop Relat Res 322:194–197, 1996.</span></li>
<li style="font: 12.0px Arial; margin: 0.0px 0.0px 0.0px 0.0px;"><span style="letter-spacing: 0.0px;">Meehan PL, Deftari T. Pigmented villonodular synovitis presenting as a <span class="Apple-style-span" style="color: blue;">popliteal cyst</span> in a <span class="Apple-style-span" style="color: red;">child</span>. J Bone Joint Surg Am 76(4):593–595, 1994.</span></li>
<li style="font: 12.0px Arial; margin: 0.0px 0.0px 0.0px 0.0px;"><span style="letter-spacing: 0.0px;">Kang GH, Chi JG, Choi IH. Pigmented villonodular synovitis in the <span class="Apple-style-span" style="color: blue;">sacral joint with extensive bone destruction</span> in a <span class="Apple-style-span" style="color: red;">child</span>. Pediatr Pathol 12:725–730, 1992.</span></li>
<li style="font: 12.0px Arial; margin: 0.0px 0.0px 0.0px 0.0px;"><span style="letter-spacing: 0.0px;">Soifer T, Guirguis S, Vigorita VJ, Bryk E. Pigmented villonodular synovitis in a child. J Pediatr Surg 28(2):1597–1600, 1993.</span></li>
<li style="font: 12.0px Arial; margin: 0.0px 0.0px 0.0px 0.0px;"><span style="letter-spacing: 0.0px;">Curtin WA, Lahoti OP, Fogarty EE, Dowling FE, Regan BF. Pigmented villonodular synovitis arising from the <span class="Apple-style-span" style="color: blue;">sheath of the extensor hallucis longus</span> in an <span class="Apple-style-span" style="color: red;">eight-month-old infant</span>. Clin Orthop Relat Res 292:282–284, 1993.</span></li>
<li style="font: 12.0px Arial; margin: 0.0px 0.0px 0.0px 0.0px;"><span style="letter-spacing: 0.0px;">Bruns J, Schubert T, Eggers-Stroeder G. Pigmented villonodular synovitis in children. Arch Orthop Trauma Surg 112(3):148–151, 1993.</span></li>
<li style="font: 12.0px Arial; margin: 0.0px 0.0px 0.0px 0.0px;">Green A, Sutherland W, Trafton PG. Localized nodular synovitis of the <span class="Apple-style-span" style="color: blue;">ankle</span>: a case report. Foot Ankle 12(1):47–51, 1991. </li>
<li style="font: 12.0px Arial; margin: 0.0px 0.0px 0.0px 0.0px;"><span style="letter-spacing: 0.0px;">Givon U, Granel A, Heim M. Pigmented villonodular synovitis. Arch Dis Child 66:1449–1450, 1991. </span></li>
<li style="font: 12.0px Arial; margin: 0.0px 0.0px 0.0px 0.0px;"><span style="letter-spacing: 0.0px;">Matejicek M, Dungle, Trnka V, Havelka S, Hoza J. <span class="Apple-style-span" style="color: blue;">Multiocular </span>pigmented villo- nodular synovitis in a <span class="Apple-style-span" style="color: red;">child</span>: a <span class="Apple-style-span" style="color: #6aa84f;">case </span>report. Acta Universitatis Medica 37(1-2):31–36, 1991.</span></li>
<li style="font: 12.0px Arial; margin: 0.0px 0.0px 0.0px 0.0px;"><span style="letter-spacing: 0.0px;">Aghasi MK, Robinson D, Reif RM, Halperin N. Pigmented villonodular synovitis of the <span class="Apple-style-span" style="color: blue;">talus</span> in a <span class="Apple-style-span" style="color: red;">child</span>. Foot Ankle 9(3):139–142, 1988. </span></li>
<li style="font: 12.0px Times; margin: 0.0px 0.0px 0.0px 0.0px;"><span style="letter-spacing: 0.0px;">Wendt RG, Wolfe F, McQueen D. Polyarticular pigmented villonodular synovitis in children: Evidence for a genetic contribution. J Rheumatol 13(5):921</span><span style="font: 12.0px Helvetica; letter-spacing: 0.0px;">–</span><span style="letter-spacing: 0.0px;">926, 1986. </span></li>
<li style="font: 12.0px Times; margin: 0.0px 0.0px 0.0px 0.0px;"><span style="letter-spacing: 0.0px;">Walls JP, Nogi J. Multifocal pigmented villonodular synovitis in a child. J Pediatr Orthop 5:229</span><span style="font: 12.0px Helvetica; letter-spacing: 0.0px;">–</span><span style="letter-spacing: 0.0px;">231, 1985.</span></li>
<li style="font: 12.0px Times; margin: 0.0px 0.0px 0.0px 0.0px;"><span style="letter-spacing: 0.0px;">Wagner ML, Spjut HJ, Dutton RV. <span class="Apple-style-span" style="color: blue;">Polyarticular pigmented villonodular synoviti</span>s. AJR 136(4):821</span><span style="font: 12.0px Helvetica; letter-spacing: 0.0px;">–</span><span style="letter-spacing: 0.0px;">823, 1981.</span></li>
<li style="font: 12.0px Times; margin: 0.0px 0.0px 0.0px 0.0px;"><span style="letter-spacing: 0.0px;">Lindenbaum BL, Hunt T. An unusual presentation of pigmented villonodular synovitis. Clin Orthop Relat Res 122:263</span><span style="font: 12.0px Helvetica; letter-spacing: 0.0px;">–</span><span style="letter-spacing: 0.0px;">267, 1977.</span></li>
<li style="font: 12.0px Times; margin: 0.0px 0.0px 0.0px 0.0px;"><span style="letter-spacing: 0.0px;">Leszczynski J, Huckell JR, Percy JS, LeRiche JC, Lentle BC. Pigmented villonodular synovitis in <span class="Apple-style-span" style="color: blue;">multiple joints</span>: occurrence in a <span class="Apple-style-span" style="color: red;">child </span>with cavernous haemangioma of hip and pulmonary stenosis. Ann Rheum Dis 34:269</span><span style="font: 12.0px Helvetica; letter-spacing: 0.0px;">–</span><span style="letter-spacing: 0.0px;">272, 1975.</span></li>
<li style="font: 12.0px Times; margin: 0.0px 0.0px 0.0px 0.0px;"><span style="letter-spacing: 0.0px;">Bobechko WP, Kostuik JP. Childhood villonodular synovitis. Can J Surg 11:480</span><span style="font: 12.0px Helvetica; letter-spacing: 0.0px;">–</span><span style="letter-spacing: 0.0px;">486, 1968</span></li>
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CJhttp://www.blogger.com/profile/07441864217304744390noreply@blogger.com2tag:blogger.com,1999:blog-6649606746135970422.post-38868649521004457492013-02-23T10:49:00.000-08:002014-08-13T04:06:42.015-07:00What I Would Have Done Differently with PVNS<span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;"><br /></span>
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<span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif; font-size: small;">The following question was asked in the pvns is pants site "Open synovectomy or TKR?"</span><br />
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<span class="Apple-style-span" style="color: #cc0000; font-family: Georgia, 'Times New Roman', serif; font-size: small;"><u><b>If I Had only Known </b></u></span><br />
<span style="font-family: Georgia, 'Times New Roman', serif; font-size: small; letter-spacing: 0.0px;"><br /></span><span style="font-family: Georgia, 'Times New Roman', serif; font-size: small; letter-spacing: 0.0px;">I was newly diagnosed with diffuse pigmented villonodular synovitis of the knee, in November of 2011. The game plan for removal of the tumor was to begin with arthroscopic surgery to confirm the pvns via intra operative biopsy. the tumor was extensiveness so my orthopedic oncologist surgeon reverted to an open synovectomy. this procedure gave me the best chance of a cure. </span></div>
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<span style="font-family: Georgia, 'Times New Roman', serif; font-size: small; letter-spacing: 0.0px;">Per mri I wouldn’t need a knee replacement for several years if at all. Looking back, I feel that the surgeon must have known when doing the synovectomy, that I would be left with severe arthritis. I don’t believe the discovery that I needed a knee replacement was a surprise to the surgeon in December when she performed an arthroscope for possible pvns recurrence (which turned out to be scar tissue) and meniscus repair.</span></div>
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<span style="font-family: Georgia, 'Times New Roman', serif; font-size: small; letter-spacing: 0.0px;">Prior to open knee surgery, this is where I wish that I had discussed knee replacement in the event that the synovectomy would leave me with little to no cartilage. If it had been determined that I would be left with severe arthritis, I would have had them fix the meniscus, excise the pvns that they could with the arthroscopic procedure and close me up. I still would have done radiation but then I would have had the open synovectomy and the knee replacement done as soon as I was healed. </span></div>
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<span style="font-family: Georgia, 'Times New Roman', serif; font-size: small; letter-spacing: 0.0px;">This strategy would have save me from needing a manipulation 4-5 mo post op/starting me all over in the healing process. It also would have saved me from an additional arthroscopic surgery to fix the meniscus. Not to mention the financial hardship of being off work for over a year due to severe pain and the inability to do my job.</span></div>
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<span style="font-family: Georgia, 'Times New Roman', serif; font-size: small; letter-spacing: 0.0px;">With all of the said I had a partial knee replacement two weeks ago and for the first time in over a year I am not taking narcotics or anything else for pain. Note; with a minimally invasive knee replacement, they don’t cut through the quad muscle like with a traditional tkr and open synovectomy. This cuts down on discomfort and increased rehab time. </span></div>
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<span style="font-family: Georgia, 'Times New Roman', serif; font-size: small; letter-spacing: 0.0px;">TKR is not a cure for pvns although it does seem to show that it may decrease the recurrence rate. Again there are risks no matter what you choose. I found that the open synovectomy was by far a much longer, more difficult and painful recovery than the arthroscopy and the partial replacement. I would never choose an open syno knowing that I would shortly need a TKR. When I was in rehab from my open syno I was very slow in my recovery compared to the people who had TKR. There are many peeps on this site that have had TKR and could direct you better than myself. Best of luck and well wishes. </span><br />
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<span style="letter-spacing: 0.0px;"><span style="letter-spacing: 0.0px;">I am not a physician and the above is in no way to be taken as medical advise. This is my interpretation of what I have been told by my physicians and from what I have read. Always consult with a professional for case specific accurate information.</span></span></div>
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CJhttp://www.blogger.com/profile/07441864217304744390noreply@blogger.com3tag:blogger.com,1999:blog-6649606746135970422.post-3228085118494815892013-01-18T15:44:00.000-08:002014-08-13T04:07:04.806-07:00PVNS, Hospitals Are Not Created Equal, TKR or Partial<span class="Apple-style-span" style="color: #cc0000; font-family: Georgia, 'Times New Roman', serif;"><b>MRI Bad News</b></span><br />
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<span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;">Energy drained and my heart plummeted when I read my 6 month follow-up mri report "new areas consistent with pvns, lateral meniscus tear, new medial meniscus tear, and tendinopathy." After an open synovectomy, months of physical therapy, radiation treatment and surgery to break up adhesions... I was exhausted and couldn't bear the thought of more surgery. However, that is exactly what I needed to do because the pain had become debilitating.</span><br />
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<span class="Apple-style-span" style="color: #cc0000; font-family: Georgia, 'Times New Roman', serif;"><b>Not My Usual Hospital</b></span><br />
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<span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;">Fortunately, I was able to schedule an arthroscopic procedure with the same surgeon exactly one year to the date of my first pvns surgery. This time I had to have surgery in a different hospital and I wasn't comfortable with my surroundings. This particular hospital had the look and feel of an inner city hospital on the wrong side of town...if you know what I mean. My admittance to the presurgical area seemed to be rushed even though it was thorough, which made me feel uncomfortable. However, my confidence in the hospital continued to diminish when the nurse couldn't get an IV started and began freaking out about it. The upside to this is that my IV was started in the surgical suite and the block was given after I was already unconscious. I didn't realize at the time that having the block administered after I was asleep increases my chances for possible nerve damage. Fortunately I was fine but would have liked to have known. </span><br />
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<span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;">In recovery I was given morphine and my arm turned red and itchy. Not a true allergy, only a sensitivity so I was given benedryl. Within 5 minutes I was asked if I was ready to sit in a chair. "well I guess so." So they transferred me to stage two. </span><br />
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<span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;"><span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;">While in stage 2 recovery my husband notified me that there was good and bad news. "Bad news?" Nope I don't want to here any bad news. "I'll take the good news first." Thankfully, the suspected recurrence of pvns turned out to be scar tissue. Finally, I catch a break with this dreaded disease. Then "the hammer" shatters my good fortune. In a hesitant voice my husband informs me that I need a knee replacement and they could do it in about 6 weeks. Yikes! More surgery is not what you want to here when you are just waking up from a surgery.</span></span></div>
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<span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;">My groggy head was still trying to comprehend the news... when after only being in stage 2 recovery for five minutes I was asked if I was ready to go home. Being drugged, uncomfortable in my surroundings, questioning the qualifications of the nursing staff, home seemed like the safest alternative. The nurse handed my husband some papers and asked if she needed to call transportation or if I could walk. I'm barely conscious, just had knee surgery...what the heck. </span><br />
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<span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;">On the way home, I realize the nurse never gave any verbal instructions and I didn't have a clue as to what I needed to do for follow up. Folks this is not what you want to experience from a hospital stay. Thankfully it was just an outpatient procedure but this is why it's important to check out the hospital and make sure you are comfortable with it.</span><br />
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<span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;">It has taken me a couple weeks to wrap my head around needing a knee replacement. I'm only 48 and the thought of a total knee replacement is terrifying. I figure knowledge is power, right? So I went on utube and watched several TKR videos and was cringing the entire time. </span><br />
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<span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;">Now that I had desensitized myself to the idea of a knee replacement, I made an appointment with my surgeon to ask her some questions. After a couple more weeks and much research I finally saw my surgeon. Long story short she feels that I may be a good candidate for a uni-compartmental replacement/resurfacing which is a fancy description of a partial replacement. So I make an appointment with an orthopedic surgeon who specializes in this technique and waited 2 more weeks which just gave me more time to do additional research on partial replacements. Well, what I was finding in the literature was not promising and quite frankly discouraging for the long term success of this technique.</span><br />
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<span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;">Finally the day has come to get some questions answered from my possible new knee replacement surgeon. I was equipped with a list a questions fueled with the ability to test the surgeons personality, preparation, skill and experience. All of these traits and aspects are very important to me. I was impressed and it's not easy to impress me. He prepared for my appointment, thoroughly knew my case, and had already read all of the reports prior to my arrival. The only thing that he needed to see was the photos that were taken of my knee at the time of my last surgery...which I brought with me. He thoroughly in a non rushed manner answered every last question. </span><br />
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<span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;">He presented a couple of different options. #1 He could put plugs of cartilage in my knee, do a Patello Femoral Resurfacing, or go back to my pvns surgeon for a total replacement. As we discussed what role the pvns could play in the different choices we both agreed that cartilage transplant probably would not be the best way to go. I told him of my aprehension of a partial replacement due to the recent studies. He informed me the studies reflected the old hardware and patient selection guidelines. The problem have been identified and they corrected the design flaws in the hardware and the short term reviews are wonderful but obviously there aren't any long term studies yet. </span><br />
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<span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;">He is confident that the resurfacing (partial replacement) would buy me some time and that it would be a better choice instead of a full replacement since the damage was confined to the patello femoral area. In a couple of weeks, I'll be having a resurfacing, in other words a partial knee replacement. I also learn about many other procedures and forthcoming bio joint replacements. Yup, they have grown new joints for animals. The links are in the side bar of the home page. Immediately after this appointment I went across the street and checked out the hospital to see if I felt comfortable, talk with workers and pick up information about the hospital.</span><br />
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<span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;">I'm happy to say that I'm approaching three years of being PVNS free and the Partial knee replacement was an outstanding success...for a year. I chose the partial because the only area in my knee that was showing arthritis was in the central area. I'm not sure why, but it only took one year and now the lateral and medial aspects of the knee are showing severe arthritis. I'm not sure whether the having previous pvns or the radiation therapy has played a role in the accelerate of cartilage destruction or not. My instinct says that it's been a factor. If I'm correct, than I wouldn't suggest having a partial knee replacement, because in the relatively near future, I will need my partial knee revised to a full replacement. Which is a nauseating thought. </span><br />
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<span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;"><span style="letter-spacing: 0.0px;">I am not a physician and the above is in no way to be taken as medical advise. This is my interpretation of what I have been told by my physicians and from what I have read. Always consult with a professional for case specific accurate information.</span></span></div>
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CJhttp://www.blogger.com/profile/07441864217304744390noreply@blogger.com13tag:blogger.com,1999:blog-6649606746135970422.post-13210543009179993072013-01-10T09:55:00.000-08:002014-08-13T03:26:40.427-07:00PVNS, Is Profit A Driving Force Behind Clinical Trials? <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgp1HS5gAr205hLDn4ep_QT-6MZcl4sD_W5ghe4yV9fi1215lW8IR0umex9cYaxXPW9y8zVg-R4MkJAa4d6GtNUFUB4oBq8tJBS9BwT_SR-qrBHzurDdHVm-5IrMqaaWiuRZvp2jE7oTOds/s1600/Pills+Money.png" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgp1HS5gAr205hLDn4ep_QT-6MZcl4sD_W5ghe4yV9fi1215lW8IR0umex9cYaxXPW9y8zVg-R4MkJAa4d6GtNUFUB4oBq8tJBS9BwT_SR-qrBHzurDdHVm-5IrMqaaWiuRZvp2jE7oTOds/s1600/Pills+Money.png" /></a><span class="Apple-style-span" style="color: #333333; font-family: 'lucida grande', tahoma, verdana, arial, sans-serif; font-size: 13px; line-height: 17px;">Many of us who have pvns are desperate to find any treatment modalities that may offer us a chance at irradiating this flesh eating monster from our joints. In doing so we must be very careful and ask many questions before participating in clinical trials. I thank everyone who has participated in a clinical trial and I'm neither for or against any given treatment option. With that being said I am very concerned... What Happens when Profit Margins drive Clinical Research? Check out this article to find out.</span><span class="Apple-style-span" style="color: #333333; font-family: 'lucida grande', tahoma, verdana, arial, sans-serif; font-size: 13px; line-height: 17px;"> </span><span class="Apple-style-span" style="color: #333333; font-family: 'lucida grande', tahoma, verdana, arial, sans-serif; font-size: 13px; line-height: 17px;"><a href="http://www.motherjones.com/environment/2010/09/clinical-trials-contact-research-organizations" rel="nofollow nofollow" style="color: #3b5998; cursor: pointer; text-decoration: none;" target="_blank">http://www.motherjones.com/<wbr></wbr><span class="word_break" style="display: inline-block;"></span>environment/2010/09/<wbr></wbr><span class="word_break" style="display: inline-block;"></span>clinical-trials-contact-researc<wbr></wbr><span class="word_break" style="display: inline-block;"></span>h-organizations</a></span><br />
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<span style="letter-spacing: 0.0px;">I am not a physician and the above is in no way to be taken as medical advise. This is my interpretation of what I have been told by my physicians and from what I have read. Always consult with a professional for case specific accurate information.</span></div>
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CJhttp://www.blogger.com/profile/07441864217304744390noreply@blogger.com4tag:blogger.com,1999:blog-6649606746135970422.post-17320355943576993422013-01-09T14:09:00.000-08:002014-08-13T03:29:57.110-07:00 Finding A Balance With PVNS Pain Management<br />
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<span style="font-family: Georgia, 'Times New Roman', serif; font-size: small; letter-spacing: 0.0px;">The pain management for PVNS can be difficult. I see a pain management specialist but not for the pvns. If you have chronic long term severe pain issues that physical therapy and healthy living is not able to get under control, then pain management may be for you. They have many modalities of treatment available such as injections, blocks, and non narcotic medications which help many people. </span></div>
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<span style="font-family: Georgia, 'Times New Roman', serif; font-size: small; letter-spacing: 0.0px;">I have a pain pump inserted in my abdomen which requires very expensive maintenance every 3 months and if something goes wrong with it or insurance, I can die. I take oral narcotics for break through pain but I am not pain free and never will be. I have learned that staying mentally healthy and moderate activity is the best way to decrease the pain. If I just pop a pill when I hurt they cease to have any effect. In the meanwhile the higher the narcotic dose the more your brain function declines. </span></div>
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<span style="font-family: Georgia, 'Times New Roman', serif; font-size: small; letter-spacing: 0.0px;">In the end most pain management patients understand there is a fine line in balancing medication, pain, brain function, activity, physical and mental health, biofeedback, self hypnosis, acupuncture techniques...in order to live a healthy happy productive life. The people that go into pain management and solely depend upon medication to control pain become medication dependent with very poor pain control. So if you feel pain management is for you ask you primary care physician for a referral and schedule a consultation to inform you of what is available to help control your pain. </span><br />
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<span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif; font-size: small;"><span style="letter-spacing: 0.0px;">I am not a physician and the above is in no way to be taken as medical advise. This is my interpretation of what I have been told by my physicians and from what I have read. Always consult with a professional for case specific accurate information.</span></span></div>
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CJhttp://www.blogger.com/profile/07441864217304744390noreply@blogger.com1tag:blogger.com,1999:blog-6649606746135970422.post-63447011513020233612013-01-09T13:52:00.002-08:002014-08-13T03:35:56.428-07:00Were You Recently Diagnosed With PVNS?<br />
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<span class="Apple-style-span" style="color: #cc0000; font-family: Georgia, 'Times New Roman', serif; font-size: small;"><b>PVNS is a Marathon Not a Sprint</b></span><br />
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<span style="letter-spacing: 0.0px;"><span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif; font-size: small;">It's helpful to understand that pvns is not a race in which you sprint, but a marathon that takes time, proper information, pacing and preparation in order to successfully reach the finish line with grace. PVNS is not a trip to the grocery store, but a family vacation in a foreign country with an undesirable passenger along for the ride. In car terms pvns is not a drag race but an Indy 500 which takes endurance. </span></span><br />
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<span style="letter-spacing: 0.0px;"><span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif; font-size: small;">If you were told that you had to run a marathon tomorrow...that would freak you out pretty bad, right? Well, being diagnosed with pvns elicits similar feelings. So the feelings that you are experiencing now are completely normal and healthy. I know it sucks, but just go with it. </span></span></div>
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<span style="font-family: Georgia, 'Times New Roman', serif; font-size: small; letter-spacing: 0.0px;">I always hate when people say "it could be worse." "like this isn't bad enough? WTF." Sure I'm glad that it's not cancer that is going to kill me, but like cancer it has a voracious appetite and I can just envision it eating away at my joint like a Pac Man in a race. Just when you think it has had it's fill...it starts eating away like a crazed bulimic again. How do we tame this monster? Take a deep breath and realize that you are going to learn how to control this beast by educating yourself and fighting back with knowledge. </span><br />
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<span class="Apple-style-span" style="color: #cc0000; font-family: Georgia, 'Times New Roman', serif; font-size: small;"><b>Informed Decisions</b></span></div>
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<span style="font-family: Georgia, 'Times New Roman', serif; font-size: small; letter-spacing: 0.0px;">Making informed decisions in your treatment and long term care will give you the weapons to fight and prevent the pvns from sinking it's elongated villinous claws into your throbbing joint. Most feel overwhelmed and frightened as to how the pvns is going to effect their finances, lifestyle, family dynamics and socialization. This is understandable since your not so friendly carjacker is trying to gain control of the vehicle, but remember it's your life and you can fight to regain control. Hopefully, you will be one of the fortunate people that will be able to kick this beast out of your car and tow him behind in a trailer and semi-forget about him. Understand that you will be driving your vehicle at times and at other times you will be an unwilling passenger. However, it is up to you to design the road map in which you are going to travel. Learning to anticipate and plan for the possible potholes, financial cliffs and rugged terrain. This planning will make for a much more enjoyable trip. I didn’t want to take on this passenger/carjacker either but fortunately, most are in a country where they have access to some of the best medical care in the world and I am very thankful for that. </span></div>
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<span style="font-family: Georgia, 'Times New Roman', serif; font-size: small; letter-spacing: 0.0px;">Once again, pvns is not a sprinting race but a marathon that takes time, education, proper pacing and preparation in order to successfully guide your way gracefully to the finish line.</span><br />
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<span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif; font-size: small;"><span style="letter-spacing: 0.0px;">I am not a physician and the above is in no way to be taken as medical advise. This is my interpretation of what I have been told by my physicians and from what I have read. Always consult with a professional for case specific accurate information.</span></span></div>
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CJhttp://www.blogger.com/profile/07441864217304744390noreply@blogger.com2tag:blogger.com,1999:blog-6649606746135970422.post-34713519773737419032012-12-09T08:19:00.003-08:002014-08-13T03:36:41.041-07:00How is Swelling Harming My PVNS Joint?<br />
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<span style="color: red; font-family: Georgia, 'Times New Roman', serif; font-size: small; letter-spacing: 0px;">I found this wonderful article explaining the importance of minimizing swelling. It was written by verycoolrunner at coolrunning.com.au and it goes like this.</span></div>
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<span style="font-family: Georgia, 'Times New Roman', serif; font-size: small; letter-spacing: 0.0px;">One of the main reasons for using ice post-injury is to slow down the metabolic rate of the cells in the area (like a vet putting a lizard in the fridge before surgery, you know...). By doing that, you can temporarily decrease the cells' requirements for oxygen, and hopefully fewer cells in the area of your injury will suffer damage related to lack of oxygen, in the acute phase of your injury. (A complete aside, here - the rooms used for heart surgery and the like are also cooled, for the same reason as the lizard going into the fridge - to decrease the metabolic rate, and decrease cell damage as a result. Neat, huh - but VERY cold for the theatre staff)</span></div>
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<span style="font-family: Georgia, 'Times New Roman', serif; font-size: small; letter-spacing: 0.0px;">The reason that your tissues in the injured area are at risk of damage from lack of oxygen, is due to THE SWELLING, because swelling increases the pressure surrounding the cells in the injured area. That makes it harder for the blood supply containing oxygen and nutrients to battle (or diffuse) their way into your cells. Like trying to pump up a bike tyre with a fat guy sitting on the bike - it's a pressure thing, you know? (and thank you to my spouse for that particular analogy). </span></div>
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<span style="font-family: Georgia, 'Times New Roman', serif; font-size: small; letter-spacing: 0.0px;">The reason that the swelling is there in the first place, is because when you injured yourself (and damaged some of your tissues - you reckless maniac!), the damaged tissues called for their own ambulance - and a fleet of them arrived. This is the response we know as inflammation, and it involves an increase in blood flow to the area, an increase in the permeability of the walls of your capillaries, so lots of fluid leaks into the space in your tissues surrounding your cells, and often clots there (read - stacks of ambulances parked all over the place), and the cells themselves swell. The effect this inflammation is intended to have, is to put up a barrier around the injured area (read - police roadblocks), to slow the passage of any bacteria or toxic products that may be in the injured tissue, into the surrounding healthy tissue (read - quarantine).</span></div>
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<span style="font-family: Georgia, 'Times New Roman', serif; font-size: small; letter-spacing: 0.0px;">So the swelling does have a purpose, but it also comes at a cost to the tissues in the "quarantined area" - with all those ambulances parked all over the place, it's hard to get on with things. Then, when the quarantine period (read - acute inflammatory phase of injury) is over, the tissues have to repair their damaged lives. This includes rebuilding and remodelling, and this is where your friendly physio will start raving on about collagen fibres in disarray, and scar tissue in abundance. To avoid this (both the scarring and the raving, I mean), most people set out to minimize the inflammatory response as far as possible, when they get injured.</span></div>
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<span style="font-family: Georgia, 'Times New Roman', serif; font-size: small; letter-spacing: 0.0px;">Now Macattack may get hot and bothered when I type this, and demand to see references (sorry, Macca) - but when I was a student, there was more evidence to suggest that the best way to prevent swelling, was to elevate the affected part, and put a pressure wrap on it. The wrap increases the pressure from outside the body, and makes it harder for the extra fluid to leak into the tissues etc., as part of the inflammatory response, while the elevation serves to make it an uphill drive all the way for those darned inflammatory ambulances to get into the tissues. Meanwhile, the rest and ice part of the RICE equation, are meant to decrease the metabolic rate of the cells in the injured area, to hopefully minimize the damage to those cells, and therefore lessen the rebuilding and remodeling that will be required.</span><br />
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<span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif; font-size: small;"><span style="letter-spacing: 0.0px;">I am not a physician and the above is in no way to be taken as medical advise. This is my interpretation of what I have been told by my physicians and from what I have read. Always consult with a professional for case specific accurate information.</span></span></div>
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CJhttp://www.blogger.com/profile/07441864217304744390noreply@blogger.com1tag:blogger.com,1999:blog-6649606746135970422.post-41187414309826569332012-11-01T19:07:00.001-07:002014-08-13T03:40:38.178-07:00PVNS Tears, Bridges, Journeys<table cellpadding="0" cellspacing="0" class="tr-caption-container" style="float: left; margin-right: 1em; text-align: left;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEilVoELt3Zh29Lqet5RnI3n5YYbtsVGiBUO5aLZ22PeteCwKVEA85yZhYHJy3KlfRPcrEV1Uel_fDoGMUlEOH8PRCdrzK7jFJnAOcY-o0KuV9pUoInTGzZ4EstUIX-gvHkyjJ1Z-7qaPXTt/s1600/Yoda.jpg" imageanchor="1" style="clear: left; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEilVoELt3Zh29Lqet5RnI3n5YYbtsVGiBUO5aLZ22PeteCwKVEA85yZhYHJy3KlfRPcrEV1Uel_fDoGMUlEOH8PRCdrzK7jFJnAOcY-o0KuV9pUoInTGzZ4EstUIX-gvHkyjJ1Z-7qaPXTt/s200/Yoda.jpg" height="150" width="200" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Yoda Jedi Master</td></tr>
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<span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;">I've been using my time doing origami and finding new articles for this site so I haven't written lately. You may ask what does origami have to do with pvns. Origami is a way that I refocus my senses away from the constant burning pain of neuropathy in my back/legs and the insistent dull knee pain of PVNS. I love the textural feel, pliable character and the sounds created when folding the many different types of paper. It may sound weird but it's exciting to take a flat piece of paper and make an art form out of it.</span><br />
<span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;"><br /></span><span class="Apple-style-span" style="color: #cc0000; font-family: Georgia, 'Times New Roman', serif;"><b>Autoimmune Testing</b></span><br />
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<span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;">Finally finished with all of the massive amount of testing for immune deficiency and auto immune disease workup. Fortunately all of the tests came back good and at least for me there isn't any type of connection with those types of diseases and the PVNS. This was important to check out since I've been feeling so poorly and due to the possible recurrence of PVNS at the 6 mo follow-up. Well that was the good news but my brilliant research rheumatologist asked if I wanted her to tell me the truth. I'm thinking, hmmm??? No!!! because it doesn't sound like anything that I want to hear, on the other hand yes!! because that's why I'm here. Now the problem with hearing the truthful answers to my many questions is that it can be quite difficult to swallow, internalize and digest.</span><br />
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<span class="Apple-style-span" style="color: #cc0000; font-family: Georgia, 'Times New Roman', serif;"><b>Not Fibromyalgia</b></span><br />
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<span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;">My doctor was unconsciously shaking her head as she mulled over my extensive medical history. Reviewing the long list of illness, injury and trauma... she explained how each malady and it's residual effects has effected my body long term. She eventually looked at me and stated in a very serious manner "You have residual effects from previous illness, arthritis, PVNS, a chronic pain syndrome and polyneuropathy that is making you feel so bad...and no you don't have fibromyalgia." "Your pain is severe and has known physical causes which means that you need to trust and work with your pain management doctor." Now I'm usually the eternal optimist but not today. Today I am crushed knowing that I will never enjoy another day without pain. Some days will be better and some worse but never pain free.</span><br />
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<span class="Apple-style-span" style="color: #cc0000; font-family: Georgia, 'Times New Roman', serif;"><b>Momentary Despair</b></span><br />
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<span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;">This is a day that I wish to forget my weaknesses. Today I will cry a river for my broken spirit. I will curse my knee for giving-way nearly hurdling me down stairs. I will huddle in a corner and hide from bills, worries and responsibilities. Today I will mourn for the activities that my body refuses to participate in. My mind is young but my flesh has aged beyond its years and is foreign to me. With this insight I acknowledge my shame and fears. Before giving in to total despair let me take a closer look at my life.</span><br />
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<span class="Apple-style-span" style="color: #cc0000; font-family: Georgia, 'Times New Roman', serif;"><b>Memories of No Hope</b></span><br />
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<span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;">Today, I also cringe at a road map of scars which has built a bridge of memories. I crawl into my past filled with battles won and lost, times of sadness and great joy. I look at photos of myself in a wheelchair... remembering the doctor telling me that I must accept this fate. I refused and today I smile for I walk. Today I confidently breathe knowing that only a few short years ago I had was attached to high flow oxygen, an IV providing continuous morphine, a tube inserted into my intestines to provide nourishment and a life expectancy of a week. I have bled and suffered to save strangers lives...for those occasions I am most proud. This pride and strength allows me to stand tall in the face of all adversity. It doesn't matter how deep your river may be for the importance lies in how well and quickly you are able to build a bridge, cross the river of tears and continue on your journey.</span><br />
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<span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;"><span style="letter-spacing: 0.0px;">I am not a physician and the above is in no way to be taken as medical advise. This is my interpretation of what I have been told by my physicians and from what I have read. Always consult with a professional for case specific accurate information.</span></span></div>
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<br />CJhttp://www.blogger.com/profile/07441864217304744390noreply@blogger.com3tag:blogger.com,1999:blog-6649606746135970422.post-74190068923999112092012-10-03T10:37:00.000-07:002014-08-13T03:44:41.392-07:00Building Resistance to PVNS Tumors<span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;"><br /></span>
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<span class="Apple-style-span" style="color: blue; font-family: Arial, Helvetica, sans-serif; font-size: x-small;">{Correction<span class="Apple-style-span" style="line-height: 15px;"> 02/13/2013): 6 mo f/u MRI 06/2012 showed a false pvns recurrence. It was proven during f/u surgery 12/14/2012that the mri was showing scar tissue and not pvns. After you have surgery the mris become more difficult to read accurately. After the 6 mo f/u mri I had two more mris done showing that the (false) pvns was remaining stable (unchanged) that was the clue that it was scar tissue and not pvns.} The tests that I referred to in this article all came back good. I do not have an over or under active immune system nor anything besides osteoarthritis from age and pvns.</span></span><br />
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<span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif; font-size: small;"><span class="Apple-style-span" style="color: #cc0000;"><span class="Apple-style-span" style="line-height: 15px;"><b>Being a Pioneer</b></span></span></span><br />
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<span style="letter-spacing: 0.0px;">I am well aware that we are all guinea pigs and it doesn’t matter what treatment we choose. On a positive note the more data that is collected increases the chances that a common link could be found. I commend everyone who is willing to try adjuvant treatments because you are the pioneers that may someday make a cure possible. Note please make sure your physicians are sharing your information (positive and negative) with researchers and not just keeping it in their private files. </span></span><br />
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<span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif; font-size: small;"><span style="color: #cc0000; letter-spacing: 0.0px;"><b>MRI Report of a False PVNS Recurrence</b></span></span></div>
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<span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif; font-size: small;">Why did my treatment regimen fail when others (approx. 80%) with the same amount of PVNS, damage and treatment remain in remission? During surgery the joint was visualized arthroscopically then an open complete synovectomy was done. My orthopedic oncologist is a top rated surgeon familiar with pvns. She removed all visible signs and areas that showed on the mri. I followed up with 18 treatments of 200 greys each which would have disabled . My six month follow up mri showed a new area of recurrence. Something is making my body more susceptible to the pvns and until that is corrected I’m afraid it will continue to recur, destroy my joint as it has caused the chondromalacia to worsen in just one year even with surgery. <span style="letter-spacing: 0.0px;"></span></span></div>
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<span style="font-family: Georgia, 'Times New Roman', serif; font-size: small; letter-spacing: 0.0px;">The cellular composition of diffuse pvns is exactly the same in each individual so this means that pvns itself has the same strength and destructive properties in everyone. What makes some bodies more susceptible to a recurrence? I have arthritis in both knees and throughout my spine that is well out of proportion to my age and lifestyle. </span></div>
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<span style="font-family: Georgia, 'Times New Roman', serif; font-size: small; letter-spacing: 0.0px;">I’m working with a research arthritis specialist who is running many tests to see if I have some type of defect that makes me more susceptible to arthritis and or pvns. I am also working with an immunologist who is checking to see if there is a link via the immune system. some of these blood test take a month to get the results so I will post any information that they may provide. For now the doctors are trying to build up my body as much as possible immunologically by addressing my allergies (they have already done allergy testing for which are minimal), with diet (I’m looking into cancer diets), and supplements including Vit D because it was very low and low vitamin has connections to tumor growth. Hopefully along with what they find out from the blood tests I will be in better shape to resist future tumors (recurrence) after my next surgery. </span></div>
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<span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif; font-size: small;"><span style="letter-spacing: 0.0px;">I am not a physician and the above is in no way to be taken as medical advise. This is my interpretation of what I have been told by my physicians and from what I have read. Always consult with a professional for case specific accurate information.</span></span></div>
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CJhttp://www.blogger.com/profile/07441864217304744390noreply@blogger.com17tag:blogger.com,1999:blog-6649606746135970422.post-62716472981778925392012-08-29T01:07:00.001-07:002014-08-13T03:45:46.194-07:00Vitamin D Deficiency and PVNS<span class="Apple-style-span" style="color: #cc0000; font-family: Georgia, 'Times New Roman', serif; font-size: x-small; line-height: 15px;">(Correction 02/13/2013): 6 mo f/u MRI 06/2012 showed a false pvns recurrence. It was proven during f/u surgery that the mri was showing scar tissue and not pvns. After you have surgery the mris become more difficult to read accurately. After the 6 mo f/u mri I had two more mris done showing that the (false) pvns was remaining stable (unchanged) that was the clue that it was scar tissue and not pvns.</span><br />
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<span class="Apple-style-span" style="color: #333333; line-height: 15px;">Having pvns I have become hyper aware of any pain or swelling that occurs in any of my joints. I’ve had rapidly recurring pvns in spite of radiation in my left knee with pain that seems out of proportion to the pvns along with my right knee beginning to swelling and be painful. I also started noticing other joints and muscles were aching along with severe fatigue. This resulted in other joints having mris which showed no pvns. I started thinking I was becoming a hypochondriac or at least a bit crazy but that wasn’t the case.</span><span class="Apple-style-span" style="color: #333333; line-height: 15px;"> </span><span class="Apple-style-span" style="color: #333333; line-height: 15px;"><br /></span><span class="Apple-style-span" style="color: #333333; line-height: 15px;"><br /></span><span class="Apple-style-span" style="color: #333333; line-height: 15px;">Funny but not. I live in the sunshine state of Arizona and look pretty good for being 48 because I have always used sunscreen to protect my skin unknowingly blocking the rays that I needed to make vitamin D... resulting in a severe vitamin D deficiency. Keep using your sunscreen, however, be aware you may not be getting enough vit D from the sun and your diet especially if your lactose intolerant like myself, avoid milk and use sunscreen.</span><span class="Apple-style-span" style="color: #333333; line-height: 15px;"> </span><span class="Apple-style-span" style="color: #333333; line-height: 15px;"><br /></span><span class="Apple-style-span" style="color: #333333; line-height: 15px;"><br /></span><span class="Apple-style-span" style="color: #333333; line-height: 15px;">The last few months I have been reading about research done on the cellular mechanisms of pvns. I then started to look further into the cellular mechanisms involved in vit D deficiencies which led me to this and many more related studies.</span><span class="Apple-style-span" style="color: #333333; line-height: 15px;"><br /></span><span class="Apple-style-span" style="color: #333333; line-height: 15px;"><br /></span><span class="Apple-style-span" style="color: #333333; line-height: 15px;">Low levels of Vitamin D are associated with increased incidence of many cancers. Vitamin D normalizes cell to cell communication, impacts uncontrolled cell growth and allows cells to differentiate into normal cells with a normal life cycle. “Breast cancer patients with suboptimal vitamin D levels were more likely to have tumors with more aggressive tumor profiles and worse prognostic markers” by Nalini Chilkov, L.Ac., O.M.D.</span><span class="Apple-style-span" style="color: #333333; line-height: 15px;"><br /></span><span class="Apple-style-span" style="color: #333333; line-height: 15px;"><br /></span><span class="Apple-style-span" style="color: #333333; line-height: 15px;">PVNS is not cancer but it is a tumor and I’m just wondering if having a severe vitamin D deficiency has had anything thing to do with the pvns recurring so quickly and aggressively in my knee in spite of surgery and radiation. I have seen many people with multiple joint complaints that turned out not to be pvns related yet not seem to have an explanation so I decided to share this information as food for thought. I will write more on this subject as I </span></span><br />
<span class="Apple-style-span" style="color: #333333; font-family: 'lucida grande', tahoma, verdana, arial, sans-serif; font-size: 14px; line-height: 15px;">continue my research.</span><br />
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<span class="Apple-style-span" style="color: #333333; font-family: 'lucida grande', tahoma, verdana, arial, sans-serif;"><span style="letter-spacing: 0.0px;">I am not a physician and the above is in no way to be taken as medical advise. This is my interpretation of what I have been told by my physicians and from what I have read. Always consult with a professional for case specific accurate information.</span></span></div>
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</span>CJhttp://www.blogger.com/profile/07441864217304744390noreply@blogger.com0tag:blogger.com,1999:blog-6649606746135970422.post-63080092611261469362012-08-24T07:57:00.000-07:002014-08-13T03:48:02.858-07:00PVNS Questions to Ask Your Doctor<br />
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<u><b><span class="Apple-style-span" style="color: #cc0000; font-size: small;">Questions to Ask at your PVND Doctors Appointment:</span></b></u></h2>
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<li style="border-bottom-style: none; border-color: initial; border-left-style: none; border-right-style: none; border-top-style: none; border-width: initial; line-height: 1.4; margin-bottom: 0.25em; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; text-indent: 0px;"><span class="Apple-style-span" style="font-size: x-small;">What type of experience do you have with PVNS? diffuse, nodular, open/arthro, clinical trials</span></li>
<li style="border-bottom-style: none; border-color: initial; border-left-style: none; border-right-style: none; border-top-style: none; border-width: initial; line-height: 1.4; margin-bottom: 0.25em; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; text-indent: 0px;"><span class="Apple-style-span" style="font-size: x-small;">What type of PVNS do I have? diffuse, nodular, mixed, intra-articular, extra-articular</span></li>
<li style="border-bottom-style: none; border-color: initial; border-left-style: none; border-right-style: none; border-top-style: none; border-width: initial; line-height: 1.4; margin-bottom: 0.25em; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; text-indent: 0px;"><span class="Apple-style-span" style="font-size: x-small;">When will biopsy be taken, how long for the results and will surgery be done at that time? </span></li>
<li style="border-bottom-style: none; border-color: initial; border-left-style: none; border-right-style: none; border-top-style: none; border-width: initial; line-height: 1.4; margin-bottom: 0.25em; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; text-indent: 0px;"><span class="Apple-style-span" style="font-size: x-small;">How has this disease affected my joint? what damage is the mri showing if any?</span></li>
<li style="border-bottom-style: none; border-color: initial; border-left-style: none; border-right-style: none; border-top-style: none; border-width: initial; line-height: 1.4; margin-bottom: 0.25em; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; text-indent: 0px;"><span class="Apple-style-span" style="font-size: x-small;">What are my treatment choices and which is the best treatment for this type of PVNS?</span></li>
<li style="border-bottom-style: none; border-color: initial; border-left-style: none; border-right-style: none; border-top-style: none; border-width: initial; margin-bottom: 0.25em; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; text-indent: 0px;"><span class="Apple-style-span" style="font-size: x-small;"><span class="Apple-style-span" style="line-height: 15px;">Do you prefer open vs arthroscopic surgery and why? How many have you done? Outcomes?</span></span></li>
<li style="border-bottom-style: none; border-color: initial; border-left-style: none; border-right-style: none; border-top-style: none; border-width: initial; margin-bottom: 0.25em; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; text-indent: 0px;"><span class="Apple-style-span" style="font-size: x-small;"><span class="Apple-style-span" style="line-height: 15px;">Will I be given a nerve block along with general anesthesia?</span></span></li>
<li style="border-bottom-style: none; border-color: initial; border-left-style: none; border-right-style: none; border-top-style: none; border-width: initial; margin-bottom: 0.25em; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; text-indent: 0px;"><span class="Apple-style-span" style="font-size: x-small;"><span class="Apple-style-span" style="line-height: 15px;">Do you use staples or sutures to close the incision and why?</span></span></li>
<li style="border-bottom-style: none; border-color: initial; border-left-style: none; border-right-style: none; border-top-style: none; border-width: initial; margin-bottom: 0.25em; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; text-indent: 0px;"><span class="Apple-style-span" style="font-size: x-small;"><span class="Apple-style-span" style="line-height: 15px;">Knee joint: will a continuous passive movement machine be available after surgery? </span></span></li>
<li style="border-bottom-style: none; border-color: initial; border-left-style: none; border-right-style: none; border-top-style: none; border-width: initial; margin-bottom: 0.25em; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; text-indent: 0px;"><span class="Apple-style-span" style="font-size: x-small;"><span class="Apple-style-span" style="line-height: 15px;">How long will I be in the hospital?</span></span></li>
<li style="border-bottom-style: none; border-color: initial; border-left-style: none; border-right-style: none; border-top-style: none; border-width: initial; margin-bottom: 0.25em; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; text-indent: 0px;"><span class="Apple-style-span" style="font-size: x-small;"><span class="Apple-style-span" style="line-height: 15px;">What will I be given for pain management?</span></span></li>
<li style="border-bottom-style: none; border-color: initial; border-left-style: none; border-right-style: none; border-top-style: none; border-width: initial; line-height: 1.4; margin-bottom: 0.25em; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; text-indent: 0px;"><span class="Apple-style-span" style="font-size: x-small;">When will I begin physical therapy and for how long?</span></li>
<li style="border-bottom-style: none; border-color: initial; border-left-style: none; border-right-style: none; border-top-style: none; border-width: initial; line-height: 1.4; margin-bottom: 0.25em; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; text-indent: 0px;"><span class="Apple-style-span" style="font-size: x-small;">Will I need crutches or any other equipment after surgery?</span></li>
<li style="border-bottom-style: none; border-color: initial; border-left-style: none; border-right-style: none; border-top-style: none; border-width: initial; line-height: 1.4; margin-bottom: 0.25em; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; text-indent: 0px;"><span class="Apple-style-span" style="font-size: x-small;">When will I be able to return to work and normal activities?</span></li>
<li style="border-bottom-style: none; border-color: initial; border-left-style: none; border-right-style: none; border-top-style: none; border-width: initial; margin-bottom: 0.25em; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; text-indent: 0px;"><span class="Apple-style-span" style="font-size: x-small; line-height: 15px;">What are the risks of delaying or opting out of surgery?</span></li>
<li style="border-bottom-style: none; border-color: initial; border-left-style: none; border-right-style: none; border-top-style: none; border-width: initial; margin-bottom: 0.25em; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; text-indent: 0px;"><span class="Apple-style-span" style="font-size: x-small; line-height: 15px;">What will your long term follow up plan for monitoring the PVNS be? Check ups/MRIs</span></li>
<li style="border-bottom-style: none; border-color: initial; border-left-style: none; border-right-style: none; border-top-style: none; border-width: initial; line-height: 1.4; margin-bottom: 0.25em; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; text-indent: 0px;"><span class="Apple-style-span" style="font-size: x-small;">Are there any complementary or alternative therapies that I should consider?</span><span class="Apple-style-span" style="font-size: x-small; line-height: 15px;"> radiation internal/external, chemo, cryotherapy, homeopathic?</span></li>
<li style="border-bottom-style: none; border-color: initial; border-left-style: none; border-right-style: none; border-top-style: none; border-width: initial; line-height: 1.4; margin-bottom: 0.25em; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; text-indent: 0px;"><span class="Apple-style-span" style="font-size: x-small; line-height: 15px;">What are the risks and possible side effects of each treatment including long term effects?</span></li>
<li style="border-bottom-style: none; border-color: initial; border-left-style: none; border-right-style: none; border-top-style: none; border-width: initial; line-height: 1.4; margin-bottom: 0.25em; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; text-indent: 0px;"><span class="Apple-style-span" style="font-size: x-small;">Are there any clinical trials that would be appropriate for me?</span></li>
<li style="border-bottom-style: none; border-color: initial; border-left-style: none; border-right-style: none; border-top-style: none; border-width: initial; line-height: 1.4; margin-bottom: 0.25em; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; text-indent: 0px;"><span class="Apple-style-span" style="font-size: x-small;">Do you recommend any herbs or other supplements- such as fish oil or glucosamine?</span></li>
<li style="border-bottom-style: none; border-color: initial; border-left-style: none; border-right-style: none; border-top-style: none; border-width: initial; line-height: 1.4; margin-bottom: 0.25em; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; text-indent: 0px;"><span class="Apple-style-span" style="font-size: x-small;">What should I do if my symptom worsen?</span></li>
<li style="border-bottom-style: none; border-color: initial; border-left-style: none; border-right-style: none; border-top-style: none; border-width: initial; line-height: 1.4; margin-bottom: 0.25em; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; text-indent: 0px;"><span class="Apple-style-span" style="font-size: x-small;">What can I do to decrease the discomfort?</span></li>
<li style="border-bottom-style: none; border-color: initial; border-left-style: none; border-right-style: none; border-top-style: none; border-width: initial; line-height: 1.4; margin-bottom: 0.25em; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; text-indent: 0px;"><span class="Apple-style-span" style="font-size: x-small;">What can I do to preserve my joint?</span></li>
<li style="border-bottom-style: none; border-color: initial; border-left-style: none; border-right-style: none; border-top-style: none; border-width: initial; line-height: 1.4; margin-bottom: 0.25em; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; text-indent: 0px;"><span class="Apple-style-span" style="font-size: x-small;">What kind of out-of pocket expenses can I expect; are payment plans available?</span></li>
</ul>
CJhttp://www.blogger.com/profile/07441864217304744390noreply@blogger.com2tag:blogger.com,1999:blog-6649606746135970422.post-66671625784105447162012-08-13T09:12:00.000-07:002014-08-13T04:02:13.818-07:00PVNS Estimated Time Of Recovery 2<span class="Apple-style-span" style="color: red; font-family: Arial, Helvetica, sans-serif; font-size: x-small;">Journal Of My Recovery From Open Synovectomy, Radiation, Manipulation, False Recurrence of PVNS</span><br />
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<span style="letter-spacing: 0px; text-decoration: underline;"><b><span class="Apple-style-span" style="font-size: small;">SUMMARY OF PVNS</span></b></span></div>
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<span style="letter-spacing: 0px;"><b>Current Status: 04/25/2013</b></span></div>
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<li style="color: #333233; font: normal normal normal 11px/normal Arial; margin-bottom: 10px; margin-left: 0px; margin-right: 0px; margin-top: 0px;"><span style="letter-spacing: 0px;"><b></b>Remission since first surgery 12/2011, Partial knee replacement 02/2013, 95% normal, no swelling, pain free</span></li>
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<b>Type of PVNS:</b> </div>
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<li style="color: #333233; font: 11.0px Arial; margin: 0.0px 0.0px 10.0px 0.0px;"><span style="letter-spacing: 0.0px;">Diffuse PVNS, Bakers Cyst of left knee</span></li>
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<span style="letter-spacing: 0.0px;"><b>Surgeons:</b></span></div>
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<li style="color: #333233; font: 11.0px Arial; margin: 0.0px 0.0px 10.0px 0.0px;"><span style="letter-spacing: 0.0px;"><b>Dr. Amelia DeComas</b>, orth oncologist, PVNS specialist, Core Institute, Phoenix, AZ., <a href="http://www.thecoreinstitute.com/physicians/amalia-de-comas-md.html"><span style="letter-spacing: 0.0px color: #1919a7; text-decoration: underline;">http://www.thecoreinstitute.com/physicians/amalia-de-comas-md.html</span></a></span></li>
<li style="color: #1919a7; font: 11.0px Arial; margin: 0.0px 0.0px 10.0px 0.0px;"><span style="letter-spacing: 0.0px color: #333233;"><b>Dr. John Brown, </b>Sport Medicine/ ortho surgeon, Partial knee replacement/minimal invasive procedure, Sun City, AZ. <a href="http://www.thecoreinstitute.com/patient-and-visitor-information/sports-medicine-program/sports-medicine-physicians/john-a-brown-md.html"><span style="letter-spacing: 0.0px color: #1919a7; text-decoration: underline;">http://www.thecoreinstitute.com/patient-and-visitor-information/sports-medicine-program/sports-medicine-physicians/john-a-brown-md.html</span></a></span></li>
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<b>Diagnosis</b>: </div>
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<li style="color: #333233; font: 11.0px Arial; margin: 0.0px 0.0px 10.0px 0.0px;"><span style="letter-spacing: 0.0px;">11/2011 per MRI</span></li>
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<span style="letter-spacing: 0.0px;"><b>Surgeries: </b></span></div>
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<li style="color: #333233; font: normal normal normal 11px/normal Arial; margin-bottom: 10px; margin-left: 0px; margin-right: 0px; margin-top: 0px;"><span style="letter-spacing: 0.0px;">12/14/2011, open, frontal synovectomy of left knee</span></li>
<li style="color: #333233; font: normal normal normal 11px/normal Arial; margin-bottom: 10px; margin-left: 0px; margin-right: 0px; margin-top: 0px;"><span style="letter-spacing: 0.0px;">04/18/2012, 18 weeks post op. Manipulation Under Anesthesia</span></li>
<li style="font: normal normal normal 11px/normal Arial; margin-bottom: 10px; margin-left: 0px; margin-right: 0px; margin-top: 0px;"><span style="letter-spacing: 0.0px color: #333233;"></span><span style="letter-spacing: 0px;">12/14/2012 Arthroscopic knee surgery (out pt)</span> <span style="letter-spacing: 0px;">for possible recurrent pvns, lateral and medial meniscus repair and to address the catching and pain. PVNS recurrence, per MRI, proven wrong; it was scar tissue, need replacement</span></li>
<li style="font: normal normal normal 11px/normal Arial; margin-bottom: 10px; margin-left: 0px; margin-right: 0px; margin-top: 0px;"><span style="letter-spacing: 0.0px color: #333233;"></span><span style="letter-spacing: 0.0px;">02/07/2013 Minimally invasive, quadricep sparing, partial knee replacement; using the Arthrosurface HemiCAP wave system. PVNS remains in remission</span></li>
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<span style="letter-spacing: 0.0px;"><b>MRI:</b> </span></div>
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<li style="color: #333233; font: normal normal normal 11px/normal Arial; margin-bottom: 10px; margin-left: 0px; margin-right: 0px; margin-top: 0px;"><span style="letter-spacing: 0.0px;">11/2011 Initial MRI showing diffuse PVNS in left knee, Bakers Cyst, effusion</span></li>
<li style="color: #333233; font: normal normal normal 11px/normal Arial; margin-bottom: 10px; margin-left: 0px; margin-right: 0px; margin-top: 0px;"><span style="letter-spacing: 0.0px;">06/14/2012, 6 mo. f/u- recurrence (false positive)</span></li>
<li style="font: normal normal normal 11px/normal Arial; margin-bottom: 10px; margin-left: 0px; margin-right: 0px; margin-top: 0px;"><span style="letter-spacing: 0.0px color: #333233;"></span><span style="letter-spacing: 0px;">09/28/2012, 9 month f/u, pvns stable </span>(false positive) </li>
<li style="color: #333233; font: normal normal normal 11px/normal Arial; margin-bottom: 10px; margin-left: 0px; margin-right: 0px; margin-top: 0px;"><span style="letter-spacing: 0.0px;">1</span><span style="letter-spacing: 0.0px color: #000000;">2/10/2012, 11 1/2 mo f/u, pvns stable </span><span style="letter-spacing: 0.0px;">(false positive), Bakers cyst gone</span></li>
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<span style="letter-spacing: 0.0px;"><b>Physical Therapy:</b> </span></div>
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<li style="color: #333233; font: 11.0px Arial; margin: 0.0px 0.0px 10.0px 0.0px;"><span style="letter-spacing: 0.0px;">3 weeks post surgery; started</span></li>
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<span style="letter-spacing: 0.0px;"><b>Adjuvant Treatment:</b></span></div>
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<li style="color: #333233; font: 11.0px Arial; margin: 0.0px 0.0px 10.0px 0.0px;"><span style="letter-spacing: 0.0px;">External Radiation Therapy: 7 weeks post op. 18 treatments, 200 greys each.</span></li>
<li style="color: #333233; font: 11.0px Arial; margin: 0.0px 0.0px 10.0px 0.0px;"><span style="letter-spacing: 0.0px;">Steroid Injections: 06/28/2012. (unsuccessful)</span></li>
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<span class="Apple-style-span" style="color: #333233; font-family: Arial; font-size: small;"><b><u>Detailed Time Line:</u></b></span></div>
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<span class="Apple-style-span" style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">November 7th <span class="Apple-style-span" style="color: #cc0000;">MRI Diagnosis PVNS</span></span></div>
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<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small; letter-spacing: 0px;">November 15<span class="Apple-style-span" style="color: #cc0000;"> Researching </span>pvns, treatment options, finding surgeon. What will pvns mean to my lifestyle? Making a list of questions for surgeon.</span></div>
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<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small; letter-spacing: 0px;">Dec 3 met <span class="Apple-style-span" style="color: #cc0000;">Dr DeComas</span>, xray taken, discussed if biopsy confirmed pvns she would switch from arthroscopic to open synovectomy.</span></div>
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<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small; letter-spacing: 0px;">Dec 14, 2011, Open front <span class="Apple-style-span" style="color: #cc0000;">synovectomy left knee</span>, 23rd surgery from other stuff</span></div>
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<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small; letter-spacing: 0px;">1 day post op in hospital, worked with <span class="Apple-style-span" style="color: #cc0000;">PT</span> department on crutch use. 36 hrs post op <span class="Apple-style-span" style="color: #cc0000;">femoral block wore of</span>f. I was taking Tylenol, 10 mg Oxycontin ER every 12 hrs, Oxycodone 5 mg for break thorough pain, and injectable morphine every half hour and I was still crying like a baby. In the middle of the night switched to Dilaudid which controlled the pain but made me nauseated, Reglan & Zofran to control vomiting. <span class="Apple-style-span" style="color: #6aa84f;">pain 6-8</span>. Drain still expelling much fluid.</span></div>
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<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small; letter-spacing: 0px;">2 day post op, Johnson Pratt <span class="Apple-style-span" style="color: #cc0000;">drain pulled</span> in late afternoon.2-3 seconds of intense pain.</span></div>
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<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small; letter-spacing: 0px;">3 day post op, <span class="Apple-style-span" style="color: #cc0000;">discharged</span> from hospital, medication, ice, many pillows useful to secure leg in drive home. Large zip lock bag for nausea. good leg and hip are hurting due to the extra stress.</span></div>
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<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small; letter-spacing: 0px;">Day 4 post op, feeling better, <span class="Apple-style-span" style="color: #6aa84f;">pain 4-,5</span>, narcotics, lymph massage, ice, elevate. washed hair in kitchen sink and sponge bath </span></div>
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<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small; letter-spacing: 0px;">Day 6 post op, <span class="Apple-style-span" style="color: #6aa84f;">pain 3-4,</span> take meds prior to getting out of bed in a.m., tempted to use only 1 <span class="Apple-style-span" style="color: #cc0000;">crutch</span> at home but knee gives out without warning. need to get out of house.</span></div>
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<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small; letter-spacing: 0px;">1 wk post op, <span class="Apple-style-span" style="color: #6aa84f;">pain 2-3</span>, 1st regular <span class="Apple-style-span" style="color: #cc0000;">shower</span>, reduced breakthrough narcotics, bruising is showing now, prefer to use 2 crutches in order to focus on correct strides. <span class="Apple-style-span" style="color: #cc0000;">Good knee is aching </span>due to the additional stress of compensating for pvns knee.</span></div>
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<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small; letter-spacing: 0px;">2 wk post op, pain 2-3, <span class="Apple-style-span" style="color: #cc0000;">stabbing pain</span> begins, <span class="Apple-style-span" style="color: #cc0000;">staples removed</span>, <span class="Apple-style-span" style="color: #cc0000;">unable to drive</span>, use crutches only on outings. narcotics evening only to sleep. crutches in storage, resumed sex </span></div>
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<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small; letter-spacing: 0px;">3 wk post op <span class="Apple-style-span" style="color: #cc0000;">began physical therapy</span>, beginning to <span class="Apple-style-span" style="color: #cc0000;">drive</span> short distance</span></div>
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<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small; letter-spacing: 0px;">4 wk post op <span class="Apple-style-span" style="color: #3d85c6;">ROM 56</span> degrees, frustrated with being gimpy, mentally anxious to return to my desk job but physically not ready. </span></div>
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<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small; letter-spacing: 0px;">6 wk post op <span class="Apple-style-span" style="background-color: white; color: #3d85c6;">ROM 70</span> degrees, <span class="Apple-style-span" style="color: #6aa84f;">pain 2-3</span><span class="Apple-style-span" style="color: #cc0000;">,</span> stabbing pain intermittent, family stresses, financial stresses as <span class="Apple-style-span" style="color: #cc0000;">bills</span> start rolling in. Driving normal distances. Will make decreased monthly payment arrangements until return to work. </span></div>
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<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small; letter-spacing: 0px;">7 wk post op, <span class="Apple-style-span" style="color: #cc0000;">Radiation Treatment</span> begins, 18 treatments at 200 greys per. </span></div>
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<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small; letter-spacing: 0px;">8 wk post op 2/13/2012, <span class="Apple-style-span" style="color: #cc0000;">Ready to return to work managing a physicians office, if not for the up coming RT</span>, <span class="Apple-style-span" style="color: #3d85c6;">ROM 84 </span>degrees, pain spiked <span class="Apple-style-span" style="color: #6aa84f;">3-4 </span>with increasing activity, good knee continues to hurt due to extra stress. 4 Radiation Treatments done, increasing fatigue, swelling. Rarely take narcotics.</span></div>
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<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small; letter-spacing: 0px;">9 wk, 9th RT session, feeling the <span class="Apple-style-span" style="color: #cc0000;">cumulative effects</span>, <span class="Apple-style-span" style="color: #6aa84f;">pain 3-5</span>, slight burning sensation, vice grip feeling, heat at site, darkening of skin, swelling, fatigue is overwhelming. I had to back off on physical therapy. Compression, elevate, Ice, meds. <span class="Apple-style-span" style="color: #3d85c6;">ROM is still at 84%</span>.</span></div>
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<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small; letter-spacing: 0px;">10 wk post op, At this point it's a mental game of keeping your <span class="Apple-style-span" style="color: #cc0000;">attitude in check</span> and not having too many pity parties.</span></div>
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<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small; letter-spacing: 0px;">12 wk post op <span class="Apple-style-span" style="color: #cc0000;">radiation therapy finished</span>. Physical therapist says one more month of pt. focusing on range of motion.</span></div>
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<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small; letter-spacing: 0px;">14 wk post op. My best range of motion <span class="Apple-style-span" style="color: #cc0000;">prior to radiation</span> therapy was <span class="Apple-style-span" style="color: #3d85c6;">84 degrees.</span> During radiation I <span class="Apple-style-span" style="color: #6aa84f;">lost 10 degrees</span>, 2 weeks after rt stopped I’m at<span class="Apple-style-span" style="color: #6aa84f;"> </span><span class="Apple-style-span" style="color: #3d85c6;">81degrees.</span> </span></div>
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<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small; letter-spacing: 0px;">16 wk post op, 4 wks post radiation therapy ROM has been <span class="Apple-style-span" style="color: #3d85c6;">stuck at 81 degrees</span><span class="Apple-style-span" style="color: #6aa84f;"> </span>for 2 wks. Prior to RT ROM 84 degrees, lost 10 degrees during RT= 74 degrees, regained 7 degrees the 1st 2 wks post RT. </span></div>
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<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small; letter-spacing: 0px;">18 wk post op, 04/18/2012, <span class="Apple-style-span" style="color: #cc0000;">Knee manipulation </span>under anesthesia followed up by <span class="Apple-style-span" style="color: #cc0000;">aggressive physical therapy</span> 4 times a week. Obtained <span class="Apple-style-span" style="background-color: white;"><span class="Apple-style-span" style="color: #3d85c6;">110° in surgery</span></span>, had a reaction to morphine requiring iv benedryl. PT following day rom 110° with help 118°. Healing wise put me nearly back to week 2 post op<span class="Apple-style-span" style="background-color: white;">, <span class="Apple-style-span" style="color: #6aa84f;">pain 5-6.</span></span></span></div>
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<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small; letter-spacing: 0px;">19 wk post op, 1 wk post manipulation, <span class="Apple-style-span" style="color: #0b5394;">ROM 113°</span> with help, <span class="Apple-style-span" style="color: #6aa84f;">pain level 4</span> with nerve pain feeling like a knife jabbing into my knee, with swelling, 10-12 hrs daily in cpm machine for 4 weeks.</span></div>
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<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small; letter-spacing: 0px;">20 wk post op, 2 wk 4 days post manipulation. <span class="Apple-style-span" style="color: #3d85c6;">ROM 113°</span>, <span class="Apple-style-span" style="color: #6aa84f;">pain level 3</span>. The nerve pain has stopped and my knee quickly stiffens up if I have it immobile for an hour. It is a very fine line between working it too much or too little. I continue to have problems with swelling. </span></div>
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<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small; letter-spacing: 0px;">25 wk post op, 7 wks post manipulation 6/6/12. Surgeon is pleased with<span class="Apple-style-span" style="color: #3d85c6;"> rom @ 113°</span> which means I haven't really lost any rom since manipulation. She is hoping that the rom will continue to increase as the residual pain and swelling decreases in the next six months, which will make it a year from surgery date. <span class="Apple-style-span" style="color: #6aa84f;">Pain level is 2-3</span> but decreases with moderate movement. It is a fine line between doing too much vs too little. I finished physical therapy a couple of weeks ago since I have the motivation to do pt on my own, I know all of the exercises that I need to do and I have easy access to a gym. My <span class="Apple-style-span" style="color: #cc0000;">good knee has been hurting for nearly three months </span>but is now constant and hurts nearly as much as pvns knee. Surgeon has ordered mri on pvns knee for follow up and on the good knee to rule out pvns.</span></div>
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<span style="font-family: Arial, Helvetica, sans-serif; letter-spacing: 0px;"><span class="Apple-style-span" style="color: #cc0000; font-size: x-small;">6 month post op follow up MRI 6/14/12.</span><span class="Apple-style-span" style="font-size: x-small;"> 9 week post manipulation 6/21/12. Per mri new diffuse thickening and rare intratendinous of pvns post surgical. Joint effusion and synovitis noted with additional hypointense focus superior margin which is new, decreased popliteal cyst however multiple foci of hypointensity present diffusely. </span><span class="Apple-style-span" style="color: #cc0000;"><span class="Apple-style-span" style="font-size: x-small;">Residual or recurrent pvns</span><span class="Apple-style-span" style="font-size: xx-small;">.{</span></span><span class="Apple-style-span" style="color: magenta; font-size: xx-small;"><span class="Apple-style-span" style="font-family: 'lucida grande', tahoma, verdana, arial, sans-serif; line-height: 15px;">Correction 02/13/2013): 6 mo f/u MRI 06/2012 showed a false pvns recurrence. It was proven during f/u surgery 12/14/2012that the mri was showing scar tissue and not pvns. After you have surgery the mris become more difficult to read accurately. After the 6 mo f/u mri I had two more mris done showing that the (false) pvns was remaining stable (unchanged) that was the clue that it was scar tissue and not pvns.}</span></span><br /><span class="Apple-style-span" style="font-size: x-small;">My good knee continues to be swollen and painful mri showed no pvns but it does show chondromalacia and a small effusion. In pvns knee</span><span class="Apple-style-span" style="color: #6aa84f; font-size: x-small;"> constant dull pain level 5-7</span><span class="Apple-style-span" style="font-size: x-small;">, diffuse swelling, minor swelling in non pvns knee, continuing exercises 3 time wk, ice, elevate. Range of motion at best </span><span class="Apple-style-span" style="color: #3d85c6; font-size: x-small;">110°</span><span class="Apple-style-span" style="font-size: x-small;"> due to swelling. Pain may be much increased due to </span><span class="Apple-style-span" style="color: #cc0000; font-size: x-small;">pain pump being reduced by 15%.</span><span class="Apple-style-span" style="font-size: x-small;"> </span></span></div>
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<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small; letter-spacing: 0px;">06/03/2012, <span class="Apple-style-span" style="color: #cc0000;">UTI </span>treated with 4 days of Cipro, very very ill</span></div>
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<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small; letter-spacing: 0px;">06/28/2012 <span class="Apple-style-span" style="color: #cc0000;">Bilateral steroid injections</span> in the knees due to swelling and constant pain. Experienced a <span class="Apple-style-span" style="color: #cc0000;">Cortisone flare </span>increasing the pain for<span class="Apple-style-span" style="color: #6aa84f;"> 2-3 days</span>. Had a <span class="Apple-style-span" style="color: #cc0000;">mild systemic reaction to the steroids</span> causing severe anxiety, moodiness, flushing of the face, slight difficulty breathing and increased heart rate, necessitating Valium to avoid asthma attack and tachycardia... this lasted about 4 days. The symptoms are slowly abating and my <span class="Apple-style-span" style="color: #6aa84f;">knees are feeling much better</span> with very little swelling. Do your research prior to having steroid injections, systemic reactions are rare but can be quite severe and far outweigh the benefits of the shots especially if you are menapausal. I'm unable to have the Cortisone shots again due to the reaction. In the end I only had 6 weeks of good pain control and 8-10 weeks of moderate pain control from the injections. The shots are very expensive and in my case totally not worth the expense and side effects.</span></div>
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<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small; letter-spacing: 0px;">07/08/2012, <span class="Apple-style-span" style="color: #cc0000;">2nd UTI</span> treated with 10 days Cipro, flank pain, very very ill</span></div>
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<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small; letter-spacing: 0px;">07/23/2012, <span class="Apple-style-span" style="color: #cc0000;"> 3rd UTI </span>treated with Cipro, bad flank, abdominal pain, appointment with urologist 08/01/2012. Wondering if the subsequent infects have anything to do with the steroid injections.</span></div>
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<span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small; letter-spacing: 0px;">07/30/2012, <span class="Apple-style-span" style="color: #cc0000;">1 month post steroid injection</span>, pain level <span class="Apple-style-span" style="color: #6aa84f;">prior to steroid injections 5-7</span> nearly a month later it is now a <span class="Apple-style-span" style="color: #6aa84f;">2-3, </span>swelling is very much reduced. <span class="Apple-style-span" style="color: #3d85c6;">ROM estimate 120+</span>. Knee continues to stiffen after being sedentary. Felt comfortable going down an escalator for the first time since surgery. The posterior knee cyst continues to enlarge causing minor discomfort. Knee constantly aches but actual pain is finally dissipating. My body feels very worn out probably due to all of the procedures and recurrent UTIs this past year. I had a dream last night that I had returned to work and I was so happy. Someday :-) The last 8 months has been more then challenging and I see it wearing on everyone around me. The battle becomes most fierst at the end.</span></div>
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<span class="Apple-style-span" style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;"><span style="letter-spacing: 0px;">08/01/2012, I saw the <span class="Apple-style-span" style="color: #b45f06;"><b>urologist</b></span>, flow, nuclear study and cystoscopy all came back normal. Been very ill and with less movement I'm not able to exercise my knee so it is stiffening more, heat is still coming off of it but from what I hear it is normal. Difficult to deal with pvns issues and other illness at the same time.</span></span><br />
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<span class="Apple-style-span" style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">08/21/2012 appointment with new <span class="Apple-style-span" style="color: #b45f06;"><b>primary care</b> </span>doctor. Diagnosed<span class="Apple-style-span" style="color: #cc0000;"> high cholesterol, low vitamin D, post menopausal. </span>Wow isn't that all a slap in the face and I actually thought I was in good shape for 48</span><br />
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<span class="Apple-style-span" style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">08/29/2012 <b><span class="Apple-style-span" style="color: #b45f06;">neurologist</span><span class="Apple-style-span" style="color: #e69138;"> </span></b>appointment, dx <span class="Apple-style-span" style="color: #cc0000;">primary peripheral axon loss polyneuropathy,</span> brain mri normal.</span><br />
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<span class="Apple-style-span" style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;"><span style="letter-spacing: 0px;">09/12/2012, <span class="Apple-style-span" style="color: #cc0000;">11 weeks post bilateral steroid injections, </span><span class="Apple-style-span" style="color: #3d85c6;">ROM normal w/o swelling</span>, <span class="Apple-style-span" style="color: #6aa84f;">pain level 4-5 in pvns knee and continue to get that crushing sledgehammer feeling intermittently, pain level 2 in non pvns knee.</span> </span></span><br />
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<span class="Apple-style-span" style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">09/20/2012 Two hour appointment with <span class="Apple-style-span" style="color: #b45f06;"><b>arthritis specialist</b></span><span class="Apple-style-span" style="color: #cc0000;">,</span> 12 vials of blood and very thorough exam</span><br />
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<span class="Apple-style-span" style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;"><span class="Apple-style-span" style="color: #cc0000;">09/28/2012 Nine month f/u mri</span> showing pvns stable, saw PA for Dr DeComas f/u</span><br />
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<span class="Apple-style-span" style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">10/01/2012, 4 month post bilateral knee steroid injections, positive effects totally worn off. <span class="Apple-style-span" style="color: #6aa84f;">Pain 5-7 </span>in pvns knee probably due to <span class="Apple-style-span" style="color: #cc0000;">tendonopathy</span> and <span class="Apple-style-span" style="color: #cc0000;">bakers cyst </span>pressing on nerves. Non pvns knee <span class="Apple-style-span" style="color: #6aa84f;">pain level 3</span>. appointment with <span class="Apple-style-span" style="color: #b45f06;"><b>immunologist</b></span> today, allergy testing done, immune system checked 11 vials. Increased vit d to 50,000 IU 3x week and given allergy medicine. </span><br />
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<span class="Apple-style-span" style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">11/04/2012 Returned to physical therapy due to muscle weakness and balance problems from <span class="Apple-style-span" style="color: #cc0000;">polyneuropathy</span>. Left knee is <span class="Apple-style-span" style="color: #cc0000;">giving way</span> and <span class="Apple-style-span" style="color: #cc0000;">locking</span> is making my leg swing way out during strides. Bupivicaine was taken out of pain pump 1 wk ago, now burning back radiating to bilateral legs. <span class="Apple-style-span" style="color: #6aa84f;">Pain 4 in pvns knee, Right knee 2, burning back, legs 6.</span></span><br />
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<span class="Apple-style-span" style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">11/20/2012 <b><span class="Apple-style-span" style="color: #b45f06;">Returned to PCP</span></b>, <span class="Apple-style-span" style="color: #cc0000;">cholesterol and blood sugar levels</span> are all within normal levels now since changing diet and increasing activity.</span><br />
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<span class="Apple-style-span" style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">11/29/2012</span><span class="Apple-style-span" style="color: #cc0000; font-family: Arial, Helvetica, sans-serif; font-size: x-small;"> Pain </span><span class="Apple-style-span" style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;"><span class="Apple-style-span" style="color: #cc0000;">Pump increase 20%, Bupivicaine put back into pain pump</span><span class="Apple-style-span" style="color: red;"> </span><span class="Apple-style-span" style="color: #cc0000;">with pump fill. </span><span class="Apple-style-span" style="color: #6aa84f;">Burning in back and legs has decreased to a 2.</span></span><br />
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<span class="Apple-style-span" style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">12/10/2012<span class="Apple-style-span" style="color: #cc0000;"> Follow up mri 11 1/2 mo, </span>showing pvns stable. I can no longer take a normal stride due to catching in my joint which is causing my hip to hurt and the knee pain is increasing. If I bend my knee while sleeping I wake up in pain. <span class="Apple-style-span" style="color: #6aa84f;">Pain is 6-7, Right knee 2,</span><span class="Apple-style-span" style="color: #cc0000;"> </span><span class="Apple-style-span" style="color: #6aa84f;"> </span><span class="Apple-style-span" style="color: #3d85c6;">0% swelling and great ROM</span></span><br />
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<span class="Apple-style-span" style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">12/14/2012 <span class="Apple-style-span" style="color: #cc0000;">Arthroscopic knee surgery (out pt) </span>for possible recurrent pvns, lateral and medial meniscus repair </span><span class="Apple-style-span" style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">and to address the catching and pain.<span class="Apple-style-span" style="color: #6aa84f;"> </span></span><span class="Apple-style-span" style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">Exactly one year ago to the date I had open synovectomy on the same knee.</span><span class="Apple-style-span" style="color: #cc0000; font-family: Arial, Helvetica, sans-serif;"><span class="Apple-style-span" style="font-size: xx-small;">{</span></span><span class="Apple-style-span" style="line-height: 15px;"><span class="Apple-style-span" style="color: magenta; font-family: 'lucida grande', tahoma, verdana, arial, sans-serif; font-size: xx-small;">Correction 02/13/2013): 6 mo f/u MRI 06/2012 showed a false pvns recurrence. It was proven during f/u surgery 12/14/2012that the mri was showing scar tissue and not pvns. After you have surgery the mris become more difficult to read accurately. After the 6 mo f/u mri I had two more mris done showing that the (false) pvns was remaining stable (unchanged) that was the clue that it was scar tissue and not pvns.} </span><span class="Apple-style-span" style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">No PVNS, repaired meniscus, cleaned up joint, Patello-femoral joint is bone on bone and I will need a knee replacement. Drove car and began PT day 3, <span class="Apple-style-span" style="color: #38761d;">Pain steady 4, is a decrease since meniscus repair. </span><span class="Apple-style-span" style="color: #0b5394;">ROM 109 after couple weeks of rehab. </span>Used crutches one day. Could have returned to my desk job at 4 weeks but 6 weeks would have been better.</span></span><br />
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<span class="Apple-style-span" style="line-height: 15px;"><span class="Apple-style-span" style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">02/07/2013 </span></span><span class="Apple-style-span" style="font-size: x-small;"><span class="Apple-style-span" style="font-family: Arial, Helvetica, sans-serif;"><span class="Apple-style-span" style="color: #cc0000;">Minimally invasive quadricep sparing partial knee replacement using the Arthrosurface HemiCAP wave system.</span><span class="Apple-style-span" style="line-height: 15px;"><span class="Apple-style-span" style="color: #cc0000;"> </span>Overnight hospital stay with femo</span></span><span class="Apple-style-span" style="font-family: Arial, Helvetica, sans-serif; line-height: 15px;">ral block. Should</span></span><span class="Apple-style-span" style="font-family: Arial, Helvetica, sans-serif; font-size: x-small; line-height: 15px;"> have stayed 2 nights due to pain when block wore off. Day one/surgery, no drain, <span class="Apple-style-span" style="color: #3d85c6;">ROM 118, </span>walked in hall with PT,<span class="Apple-style-span" style="color: #3d85c6;"> </span><span class="Apple-style-span" style="color: #134f5c;"> </span>Day two<span class="Apple-style-span" style="color: #0b5394;"> ROM 90</span>,<span class="Apple-style-span" style="color: #134f5c;"> 1</span>0 mg oxcycodone q 4 hours, 2 crutches,<span class="Apple-style-span" style="color: #38761d;"> evening Pain 9+ sobbing</span>, meds adjusted 20 mg q 4 hours, minimal swelling, <span class="Apple-style-span" style="color: #38761d;">pain under control in 6 hrs</span>, Day three 15 mg oxcy q 4-6 hrs,1 crutch, Day four 10 mg oxcy 2 times,no crutches/ was supposed to start PT, Day five, PT begins, 10 mg oxcy 1 time. 1 week, CPM 6 hrs day <span class="Apple-style-span" style="color: #0b5394;">110 degrees,</span> no restrictions. Knee moves smoothly and no longer hurts with every movement.</span><br />
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<span class="Apple-style-span" style="line-height: 15px;"><span class="Apple-style-span" style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">02/23/2013 <span class="Apple-style-span" style="color: #cc0000;">Two weeks post partial knee replacement</span>. </span></span><span class="Apple-style-span" style="color: #0b5394; font-family: Arial, Helvetica, sans-serif; font-size: x-small; line-height: 15px;">ROM 114,</span><span class="Apple-style-span" style="color: #38761d; font-family: Arial, Helvetica, sans-serif; font-size: x-small; line-height: 15px;"> Pain 0, Tightness and very mild aches from surgery, </span><span class="Apple-style-span" style="font-family: Arial, Helvetica, sans-serif; font-size: x-small; line-height: 15px;">drove car to have staples removed on day 11, continue to use the cpm a couple hours each day, Day 12 began PT, Using both legs to ascend and descend stairs, no noticeable swelling, energy remains low but improving everyday, not ready yet to return to work but I'm beginning to look. </span><br />
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<span class="Apple-style-span" style="font-family: Arial, Helvetica, sans-serif; font-size: x-small; line-height: 15px;">03/21/2013<span class="Apple-style-span" style="color: #cc0000;"> Six weeks post partial knee replacement. </span><span class="Apple-style-span" style="color: #0b5394;">ROM 118. </span></span><span class="Apple-style-span" style="font-family: Arial, Helvetica, sans-serif; font-size: x-small; line-height: 15px;">4 1/2 wks post op was a passenger on crotch rocket = no discomfort. </span><span class="Apple-style-span" style="font-family: Arial, Helvetica, sans-serif; font-size: x-small; line-height: 15px;"><span class="Apple-style-span" style="color: #38761d;">Pain 0-mild aching minimal activity, 3 from mild swelling(walking 3 miles)</span> full returned to activities except jogging and kneeling which doc wants me to wait until 3 mo post op. Energy hasn't returned yet. I would be ready to return to office work at this point if not for other issues. Extremely pleased with this procedure. Knee feels like better then my biological knee. <span class="Apple-style-span" style="color: #38761d;">Severe bone on bone nerve pain 0% gone immediately post op. </span></span><br />
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<span class="Apple-style-span" style="font-family: Arial, Helvetica, sans-serif; font-size: x-small; line-height: 15px;">07/01/2013 Time to call the surgeon and have her order my 6 month follow up MRI. Keeping my fingers crossed for good results. An update on my PVNS knee; It's been 6 months since my partial knee replacement and I'm doing wonderful. Little to no pain, 2 on the pain scale if slight swelling is present. Range of motion is normal and I don't think about my knee unless I need to kneel down, in which case I am extremely careful and put little pressure on it. My PVNS leg is still a little weak so I'm still careful on the stairs. The quadricep muscle still tightens up and aches, since open synovectomy. </span><br />
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<span class="Apple-style-span" style="font-family: Arial, Helvetica, sans-serif; font-size: x-small; line-height: 15px;">08/13/2014 <span class="Apple-style-span" style="color: blue;">Update:</span> I remain nearly three years PVNS Free. MRI in December is now showing extensive chondromalacia (arthritis) in the medial and lateral aspects of my knee, less than a year after the partial replacement was done. This is disappointing since I will require a revision of my partial replacement into a total knee replacement in the near future. I suspect the having the pvns and or the radiation therapy may be playing a role in accelerating cartilage destruction, since I had no signs of arthritis prior to the synovectomy in December of 2011. </span><br />
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CJhttp://www.blogger.com/profile/07441864217304744390noreply@blogger.com1tag:blogger.com,1999:blog-6649606746135970422.post-935431751081474452012-07-30T23:39:00.001-07:002014-08-13T04:02:53.015-07:00RT...Questions To Ask About PVNS Radiation Therapy<span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;"><br /></span>
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<span style="color: #cc0000; font-family: Georgia, 'Times New Roman', serif; font-size: small; letter-spacing: 0px;"><b>Questions To Ask Your Radiology Oncologist</b></span></div>
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<li style="font: 12.0px Arial; margin: 0.0px 0.0px 6.0px 0.0px;"><span style="font-family: Georgia, 'Times New Roman', serif; font-size: small; letter-spacing: 0px;"> Why is radiation a good or poor choice for me?</span></li>
<li style="font: 12.0px Arial; margin: 0.0px 0.0px 6.0px 0.0px;"><span style="font-family: Georgia, 'Times New Roman', serif; font-size: small; letter-spacing: 0px;"> How many PVNS patients have you treated?</span></li>
<li style="font: 12.0px Arial; margin: 0.0px 0.0px 6.0px 0.0px;"><span style="font-family: Georgia, 'Times New Roman', serif; font-size: small; letter-spacing: 0px;"> What are my chances of recurrance with or without radiation treatment? </span></li>
<li style="font: 12.0px Arial; margin: 0.0px 0.0px 6.0px 0.0px;"><span style="font-family: Georgia, 'Times New Roman', serif; font-size: small; letter-spacing: 0px;"> How does radiation effect the PVNS and healthy cells in my joint? </span></li>
<li style="font: 12.0px Arial; margin: 0.0px 0.0px 6.0px 0.0px;"><span style="font-family: Georgia, 'Times New Roman', serif; font-size: small; letter-spacing: 0px;"> What dose of radiation will you be using and how/why did you select that dose?</span></li>
<li style="font: 12.0px Arial; margin: 0.0px 0.0px 6.0px 0.0px;"><span style="font-family: Georgia, 'Times New Roman', serif; font-size: small; letter-spacing: 0px;"> How often and how long will I receive radiation treatment?</span></li>
<li style="font: 12.0px Arial; margin: 0.0px 0.0px 6.0px 0.0px;"><span style="font-family: Georgia, 'Times New Roman', serif; font-size: small; letter-spacing: 0px;"> What are the chances that radiation will cause a secondary cancer?</span></li>
<li style="font: 12.0px Arial; margin: 0.0px 0.0px 6.0px 0.0px;"><span style="font-family: Georgia, 'Times New Roman', serif; font-size: small; letter-spacing: 0px;"> Will the dose of radiation have any effect on fertility?</span></li>
<li style="font: 12.0px Arial; margin: 0.0px 0.0px 6.0px 0.0px;"><span style="font-family: Georgia, 'Times New Roman', serif; font-size: small; letter-spacing: 0px;"> What kind of side effects will I experience during the treatment? Fatigue, etc</span></li>
<li style="font: 12.0px Arial; margin: 0.0px 0.0px 6.0px 0.0px;"><span style="font-family: Georgia, 'Times New Roman', serif; font-size: small; letter-spacing: 0px;"> What is the process for setting me up for radiation and how long will it take?</span></li>
<li style="font: 12.0px Arial; margin: 0.0px 0.0px 6.0px 0.0px;"><span style="font-family: Georgia, 'Times New Roman', serif; font-size: small; letter-spacing: 0px;"> Will I need a post surgical MRI or CAT scan?</span></li>
<li style="font: 12.0px Arial; margin: 0.0px 0.0px 6.0px 0.0px;"><span style="font-family: Georgia, 'Times New Roman', serif; font-size: small; letter-spacing: 0px;"> What is mapping and will my surgeon be participating it?</span></li>
<li style="font: 12.0px Arial; margin: 0.0px 0.0px 6.0px 0.0px;"><span style="font-family: Georgia, 'Times New Roman', serif; font-size: small; letter-spacing: 0px;"> If I have radiation now will I be able to have the same joint radiated in the future?</span></li>
<li style="font: 12.0px Arial; margin: 0.0px 0.0px 6.0px 0.0px;"><span style="font-family: Georgia, 'Times New Roman', serif; font-size: small; letter-spacing: 0px;"> What is your follow up care plan?</span></li>
<li style="font: 12.0px Arial; margin: 0.0px 0.0px 6.0px 0.0px;"><span style="font-family: Georgia, 'Times New Roman', serif; font-size: small; letter-spacing: 0px;"> Is there anything that I can do to reduce adhesions from forming?</span></li>
<li style="font: 12.0px Arial; margin: 0.0px 0.0px 6.0px 0.0px;"><span style="font-family: Georgia, 'Times New Roman', serif; font-size: small; letter-spacing: 0px;"> How much will my treatment cost and do you participate with my insurance?</span></li>
<li style="font: 12.0px Arial; margin: 0.0px 0.0px 6.0px 0.0px;"><span style="font-family: Georgia, 'Times New Roman', serif; font-size: small; letter-spacing: 0px;"> What is the best time of day to schedule my appointments to avoid long waits?</span></li>
<li style="font: 12.0px Arial; margin: 0.0px 0.0px 6.0px 0.0px;"><span style="font-family: Georgia, 'Times New Roman', serif; font-size: small; letter-spacing: 0px;"> If I experience treatment complications who do I call and who handles it?</span></li>
<li style="font: 12.0px Arial; margin: 0.0px 0.0px 6.0px 0.0px;"><span style="font-family: Georgia, 'Times New Roman', serif; font-size: small; letter-spacing: 0px;"> How will my joint be immobilized to prevent movement during treatment?</span></li>
<li style="font: 12.0px Arial; margin: 0.0px 0.0px 6.0px 0.0px;"><span class="Apple-style-span" style="color: #ff1301; font-family: Helvetica;">I am not a physician and the above is in no way to be taken as medical advise. This is my interpretation of what I have been told by my physicians and from what I have read. Always consult with a professional for case specific accurate information.</span></li>
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CJhttp://www.blogger.com/profile/07441864217304744390noreply@blogger.com0tag:blogger.com,1999:blog-6649606746135970422.post-88072189734594216102012-07-15T06:42:00.003-07:002014-08-13T03:48:50.889-07:00PVNS Pain Management <br />
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<span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;">It's my opinion that anyone dealing with long term pain issues should have a pain management doctor. There are many medications and treatment modalities that can be used to control pain much better than narcotics. Before turning to a narcotic do your research and find out the different modalities, devices and treatments being used for pain control. You may just be surprised. "<span class="Apple-style-span" style="color: #333233;">Recent research has shown that the spread of pain receptors near the site of tissue damage is controlled by a chemical known as nerve growth factor (NGF)." </span><span class="Apple-style-span" style="color: #333233;">Tanezumab</span> is an injectable nerve growth factor inhibitor that is in phase 3 clinical trials for osteoarthritis. To learn more about pain management go to <a href="http://www.guardian.co.uk/science/2011/sep/04/chronic-pain-drugs-medical-research">http://www.guardian.co.uk/science/2011/sep/04/chronic-pain-drugs-medical-research</a></span></div>
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<span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;">The bad thing about narcotics is that our bodies get used to them leading to increased dosages in order to have the same pain relief effect...this causes dependence. Eventually the narcotics quit relieving pain because you can't bump up the dosage any higher. They can also mess with the receptor sites and cause the feeling of increased pain when there really isn't any physical cause. It can easily become a vicious cycle and many people form psychological addictions along with the physical addiction that you will form if narcotics are taken frequently and for an extended period of time.</span></div>
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<span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;">Staying healthy, active, ice and elevation has helped reduce the pain far more than narcotics. Narcotics have a place but they must be used sparingly. You may be saying but "you don't understand how much I hurt" I was placed in a coma because my heart couldn't handle the extended period of time and the level of pain that I was experiencing with a neuro condition in 2000. I was on max dosages of IV narcotics. Months later my life depended on having a port placed in my chest. They couldn't numb me because of the level of narcotics my body was used to. I felt every slice of the scalpel and every stitch. This was a very difficult lesson to learn. I do understand pain beyond pain. Save the narcotics for when you really need them and don’t use them as your first line of defense in managing your pain. </span></div>
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<span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;"><span style="letter-spacing: 0px;">I am not a physician and the above is in no way to be taken as medical advise. This is my interpretation of what I have been told by my physicians and from what I have read. Always consult with a professional for case specific accurate information.</span></span></div>
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<span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;"></span>CJhttp://www.blogger.com/profile/07441864217304744390noreply@blogger.com4tag:blogger.com,1999:blog-6649606746135970422.post-54614588487102493922012-07-12T09:13:00.000-07:002013-03-28T13:11:07.440-07:00PVNS Radiation Post TKR<br />
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<span style="font-family: Georgia, 'Times New Roman', serif; font-size: small; letter-spacing: 0px;">Recently there was a question asked if you can have radiation treatment after a TKR? My orthopedic oncologist said that you can have radiation treatment after a TKR. She said generally they would do it to control symptoms vs controlling the disease because their isn't as much of a natural joint that the pvns can harm. The other question posted was “ how can pvns return after a TKR?” During a TKR they don't take out the entire joint capsule (synovial tissue) because you still need it so your joint will function. There is still a possibility that PVNS could be in the remaining tissues but the chances are reduced.</span><br />
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<span style="letter-spacing: 0px;"><span style="letter-spacing: 0.0px;">I am not a physician and the above is in no way to be taken as medical advise. This is my interpretation of what I have been told by my physicians and from what I have read. Always consult with a professional for case specific accurate information.</span></span></div>
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CJhttp://www.blogger.com/profile/07441864217304744390noreply@blogger.com0tag:blogger.com,1999:blog-6649606746135970422.post-83907452516705286612012-07-09T10:26:00.002-07:002014-08-13T03:53:47.943-07:00PVNS Cortizone Injections<span class="Apple-style-span" style="font-family: Helvetica; font-size: 12px;"><b></b></span><br />
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<span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif; font-size: small;"><b><span style="letter-spacing: 0px;">06/28/2012 </span></b><b><span style="letter-spacing: 0px;"></span></b></span><br />
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<span style="letter-spacing: 0px;"><span style="font-family: Georgia, 'Times New Roman', serif; font-size: small; letter-spacing: 0px;">I saw my ortho-oncologist surgeon today and received steroid injections into both knees. The first time she attempted to get the needle in my pvns knee it wouldn't go through the scar tissue and she could only inject a very small amount of medication, pain scale 9. I had her try again in a different location and it hurt but only lasted 5 seconds, pain scale 3-4. She then injected my non pvns knee that's been hurting and that was a breeze. She gave me a hug after she was finished. The wow factor. </span></span></div>
<span style="font-family: Georgia, 'Times New Roman', serif; font-size: small; letter-spacing: 0px;"><br />Bilateral steroid injections in the knees due to swelling and constant pain. Experienced a Cortizone flare increasing the pain for 2-3 days. Had a systemic reaction to the steroids causing severe anxiety, moodiness, flushing of the face, slight difficulty breathing and increased heart rate, necessitating valium to avoid asthma attack and tachycardia... this lasted about 4 days. . The symptoms are slowly abating and my knees are feeling much better with very little swelling. Do your research prior to having steroid injections, systemic reactions are rare but can be quite severe and far outweigh the benefits of the shots. I'm unable to have the Cortizone shots again due to the reaction. </span><br />
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<span style="font-family: Arial, Helvetica, sans-serif; font-size: small; letter-spacing: 0px;"><span style="letter-spacing: 0.0px;">I am not a physician and the above is in no way to be taken as medical advise. This is my interpretation of what I have been told by my physicians and from what I have read. Always consult with a professional for case specific accurate information.</span></span></div>
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CJhttp://www.blogger.com/profile/07441864217304744390noreply@blogger.com0tag:blogger.com,1999:blog-6649606746135970422.post-23462659853942203472012-07-01T12:32:00.002-07:002014-08-13T03:53:23.188-07:00Using Ice Correctly: Making Ice Packs<br />
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<span style="font: 18.0px Arial; letter-spacing: 0.0px color: #3c1592; text-decoration: underline;"><b><span class="Apple-style-span" style="color: #cc0000;">Caution When Using Ice:</span>
</b></span><span style="letter-spacing: 0.0px;">When using ice only use it for ten minutes. Leaving the ice on too long will result in the body sensing cold and it will respond by forcing blood into the area and can result in additional swelling.</span></div>
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<span style="letter-spacing: 0.0px;">So leave ice on, ten minutes and no longer, then remove the cold and allow the body to return to normal temperature then repeat the ice treatment for another ten minutes.</span></div>
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<span style="letter-spacing: 0.0px;">You should repeat this process several times to obtain a process known as "pumping" that removes toxins and swelling from an area.</span></div>
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<span style="color: #cc0000; letter-spacing: 0px; text-decoration: underline;"><b>How to make your Own Reusable Gel Type Ice Packs</b></span></div>
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<span style="letter-spacing: 0.0px; text-decoration: underline;"><b>Type 1:</b></span></div>
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<span style="letter-spacing: 0.0px;">1 cup rubbing alcohol<br />
2 cups water</span></div>
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<span style="letter-spacing: 0.0px;">Food coloring- to identify it as an ice pack and not to be consumed.<br />
2 Ziploc Freezer Bags</span></div>
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<span style="letter-spacing: 0.0px;">Pour liquids into freezer bag, remove air and seal bag. Double bag mixture. Place in freezer and reuse as needed (nice and slushy!). If you have a bag sealer even better.</span></div>
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<span class="Apple-style-span" style="color: #991e4e;"><span style="letter-spacing: 0.0px; text-decoration: underline;"><b>Type 2:</b></span></span><span style="letter-spacing: 0.0px;"></span></div>
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<span style="letter-spacing: 0.0px;">2 cups water</span></div>
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<span style="letter-spacing: 0.0px;">1/3 cup vodka (80 proof)</span></div>
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<span style="letter-spacing: 0.0px;">Food coloring (any color)...to identify it as an ice pack</span></div>
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<span style="letter-spacing: 0.0px;">2 Zip Lock Freezer Bags, may duct tape edge for added security </span></div>
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<span style="letter-spacing: 0.0px; text-decoration: underline;"><b>Type 3:</b></span></div>
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<span style="letter-spacing: 0.0px;">Frozen Beanie Babies will stay cold about 20 minutes. great for kids.</span></div>
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<span style="letter-spacing: 0.0px;"><b>TIPS: </b></span></div>
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<span style="letter-spacing: 0.0px;">When taking packs from the freezer to use, wrap in towel first before applying to body. If they freeze too hard and aren’t slushy, simply allow them to melt and then add more alcohol.</span><br />
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<span style="letter-spacing: 0.0px;">I am not a physician and the above is in no way to be taken as medical advise. This is my interpretation of what I have been told by my physicians and from what I have read. Always consult with a professional for case specific accurate information.</span></div>
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CJhttp://www.blogger.com/profile/07441864217304744390noreply@blogger.com0tag:blogger.com,1999:blog-6649606746135970422.post-81968812193682109722012-07-01T10:32:00.000-07:002014-08-13T03:52:38.597-07:00PVNS Radiation, Recurrence Update<br />
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<span style="font-family: Georgia, 'Times New Roman', serif; font-size: small; letter-spacing: 0.0px;">Stats on external radiation are looking good and decreasing recurrance to 15-20% vs 45% in diffuse pvns. That is why an increasing amount of physicians are utilizing it early on in pvns treatment. We know from the stats on malignant tumors the area that the radiation actually dose hits will sterilize the cells so they can't reproduce, but then again treatment is only as good as the mapping and dosage which is not only a science but an art. Radiation does not come without it's own risks and consequences. </span></div>
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<span style="font-family: Georgia, 'Times New Roman', serif; font-size: small; letter-spacing: 0.0px;">In my case I over healed and had to be knocked out again for a manipulation to break up the adhesions. It now feels like there is a tight band around my knee and it stiffens easily. In all fairness you can get the same thing from just having an open synovectomy like I had, so I'm not sure how I would feel if I didn't have radiation. Radiation also increases recovery time, for me it was 6 weeks before I had my normal energy level and it did add onto physical therapy time. The tab for my RT was $26,000 thank goodness for insurance but I still had copays.</span></div>
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<span style="font-family: Georgia, 'Times New Roman', serif; font-size: small; letter-spacing: 0.0px;">The surgeon and I again discussed that it was a right decision to get RT in my case since it was diffuse throughout my knee combined with my past medical history. They removed all pvns that showed in the mri and all that was visible, but it's impossible to get out the microscopic cells. Unfortunately it looks like there are now new areas of pvns. She isn't convinced that it is pvns on the tendons and if it is the only thing that they could do is graft a new tendon into the knee which would cause more problems then the pvns at this stage. Another new area that it is showing is almost into the muscle which it won't damage the joint. There are other areas that are probably pvns and time will tell. My joint is still good but in my case it looks like the pvns may acting very very aggressive. So yes RT was a wise decision in my case. My next mri is in 3 months. Hind site is 20/20. The dice could have just as easily rolled the opposite way and I would never know if I caused unnecessary damage to my knee. Everything is a roll of the dice when making treatment decisions about pvns. Remember certain effects from radiation and chemo can not be reversed.</span><br />
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<span style="color: #cc0000; font-family: Georgia, 'Times New Roman', serif; font-size: small; letter-spacing: 0.0px;">Update: 08/2014 I'm now approaching three years of being PVNS Free. </span><br />
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<span class="Apple-style-span" style="color: blue; font-family: Arial, Helvetica, sans-serif; font-size: x-small;">(During 12/14/2012 surgery discovered pvns had not recurred and the mri was showing scar tissue)</span><br />
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<span class="Apple-style-span" style="color: #cc0000; font-family: Arial, Helvetica, sans-serif; font-size: x-small;"><span style="letter-spacing: 0.0px;">I am not a physician and the above is in no way to be taken as medical advise. This is my interpretation of what I have been told by my physicians and from what I have read. Always consult with a professional for case specific accurate information.</span></span></div>
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CJhttp://www.blogger.com/profile/07441864217304744390noreply@blogger.com0tag:blogger.com,1999:blog-6649606746135970422.post-16861410510725157832012-06-30T16:41:00.002-07:002014-08-13T03:50:51.320-07:00PVNS Doctor Appointment Tips<b><u><span class="Apple-style-span" style="color: #cc0000;">Tips to make your doctors appointment fast and efficient</span></u></b><br />
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Here are some ways to help ensure you utilize your time efficiently, accomplish your goals and receive the best medical care possible.<br />
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<u><b><span class="Apple-style-span" style="color: #cc0000;">Making Your Appointment:</span></b></u></div>
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<li>When making your appointment confirm that the office takes your insurance.</li>
<li>Ask how much time is reserved for a new patient appointment and also follow up appointments. If you have multiple problems to discuss at a routine visit let the scheduler know not to double book during your appointment time.</li>
<li>Be accurate as to why you need to see the doctor. Otherwise the appropriate time may not be reserved or the necessary equipment to evaluate you may not be available.</li>
<li>It greatly increases your chances of being seen on time if you ask for the first appointment in the morning or the first appointment after lunch. This way you are not waiting for the physician to finish with other patients.</li>
<li>Complete new patient forms before appointment. Ask if the office has a website were the forms may be printed out. If not ask for them to fax or mail the forms to you. This way you will have access to all the information needed to fill them out completely and you won't be wasting your appointment time filling them out. Hand these forms to the receptionist when you sign in so she may add them to your chart.</li>
<li>Make a prioritized list of goals and questions prior to appointment and make a copy for the physician. This allows both of you to focus on your concerns and not forget anything that is pertinent. Try to limit your goals to three main issue so there is time to evaluate, fully discuss and come up with solutions. If you have more then three main issues it may require another appointment.</li>
<li>Keep a health journal - Track your medications, supplements, diet changes, symptoms, illnesses, etc. could help your doctor when he or she is trying to investigate your health or prescribe medications.</li>
<li>For new patients: One week prior to your new patient appointment sign a "release of medical records form" a the new office for each doctor that they need to obtain records from. This gives your new doctor a chance to review your case prior to your appointment. Two days prior to your appointment confirm that the new office has received your medical records.</li>
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<b><u><span class="Apple-style-span" style="color: #cc0000;">Items To Bring To Your Appointment:</span></u></b></div>
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<li>Bring completed new patient forms or any forms that you may need to be filled out.</li>
<li>Bring medication bottles, creams, misc. to the apointment. Many people are unable to remember the actual medication names, dosages and instructions or the physician that prescribed them.</li>
<li>Bring your prioritized list of goals and questions with extra space to write notes and a copy for your physician.</li>
<li>Bring a recording device if you prefer to record your visit instead of taking notes.</li>
<li>Bring your health journal.</li>
<li>Bring test, biopsy, MRI, Xray, lab reports ordered by other physicians if you have them.</li>
<li>Bring a friend- Doctors provide a lot of information quickly. It is easy to forget what is said.</li>
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<b><u><span class="Apple-style-span" style="color: #cc0000;">Checking Into Your Appointment:</span></u></b></div>
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<ol>
<li>Before you leave for an appointment, call to find out if the doctor is running late, or ask the minute you walk in the door. If you are over 15 minutes late the doctor may not be able to see you.</li>
<li>When checking in have your insurance card with you and ready to present. You are responsible to know your benefits. If your card has not arrived then get your insurance information before the appointment.</li>
<li>If you need forms to be completed, present them at check in so the staff can start to fill them out. It is your job to bring the forms that you need filled out such as workman's comp, disability, etc. There may be an extra charge for the form unless it was the entire reason for your visit. </li>
<li>If you have long forms to be completed by the doctor the staff will give you an estimate of cost and time required to complete. </li>
<li>If you think you may need to have a urinalysis done ask the receptionist if the doctor has requested one. this saves you time by having the results processed before being seen by the doctor. If the doctor has to wait for the results he will see another patient and then return to you. thus causing you to wait for the doctor twice.</li>
<li>Pay your copay and schedule your follow-up appointment if applicable while in the waiting room. This will save you time after your appointment.</li>
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<b><u><span class="Apple-style-span" style="color: #cc0000;">During Your Appointment:</span></u></b></div>
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<ol>
<li>Remember the doctor only has about 8 minutes to assess you needs, examine and provide treatment.</li>
<li>Provide the doctor with a copy of your prioritized list of issues and questions.</li>
<li>You may ask the doctor if he minds if you record your discussion vs taking notes.</li>
<li>Be clear about what you want the doctor to do, such as refer you to a specialist, prescribe a different medication or go over test results. </li>
<li>Be honest about what you think may be causing the problem and don't be embarrassed. Your doctor has seen and heard it all before.</li>
<li>Ask the doctor to repeat anything that you don't understand.</li>
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<span class="Apple-style-span" style="color: #990000;"><b><u><br /></u></b></span>
<b><u><span class="Apple-style-span" style="color: #cc0000;">Proper Medical Office Etiquette:</span></u></b></div>
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<li>Talking with the doctor about unrelated issues such as family, pets, latest drama is very expensive and makes other patients wait longer. It is a waste of your appointment time and takes away from the time that the doctor has to focus on your medical issues.</li>
<li>Most doctors only have approximately 8 minutes of actual time that they can spend with you. The rest of their time is tied up in administrative duties related to researching, writing scripts, ordering tests and charting.</li>
<li>If you are a family member or friend accompanying the patient, do not "steal the spotlight" by asking questions about yourself.</li>
<li>Don't ask to have your other child checked out.</li>
<li>Don't talk on the cell phone in the waiting or exam room. It is very annoying to others</li>
<li>Treat the receptionist, medical assistants and nurses as an extension of the doctor.</li>
<li>Every member of the office is committed to providing you with the best care.</li>
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<b><u><span class="Apple-style-span" style="color: #cc0000;">These Are The Average Time Goals Of a General Medical Office:</span></u></b><br />
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<b><u>Step Time Spent</u></b></div>
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Patient arrives and checks in: 1 minute</div>
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Receptionist verifies insurance and collects copays: 4 minutes</div>
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Patient wait in waiting room: 13 minutes</div>
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Patient is taken to exam room, vitals and intake are done: 5 minutes</div>
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Patient waits in exam room: 7 minutes</div>
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Physician examines and treats patient, charts, scripts: 8 minutes</div>
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Patient checks out: 3 minutes</div>
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<b>Total Cycle Time: 41 minutes</b></div>
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Total time spent waiting: 20 minutes</div>
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Total time spent with nurse and or physician: 13 minutes</div>
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Total time spent with office administrative duties: 8 minutes</div>
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CJhttp://www.blogger.com/profile/07441864217304744390noreply@blogger.com0tag:blogger.com,1999:blog-6649606746135970422.post-23569146361392592312012-06-26T14:48:00.001-07:002014-08-13T03:49:40.212-07:00Your PVNS Case Is Unique<br />
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<span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif; font-size: small;"><span style="letter-spacing: 0.0px;">We all have our personal preferences and stories but we must remember “what is right for one person may not be the best treatment for another.” Don’t rely totally on others information and interpretations of data. Do your own research to ensure that you obtain the best medical care possible. Remember that each case is different and per my ortho oncologist “ There isn’t any one type of treatment or surgical approach that stands out as the correct way to treat pvns.” However, they are seeing patients joints being destroyed not only due to the pvns but the damage caused by repeated surgeries. My personal opinion is that if you choose to do Rt you will gain more benefits if you have it done prior to severe damage from the pvns and multiple surgeries. </span></span></div>
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<span style="letter-spacing: 0.0px;">Even after the best surgeon has performed a synovectomy on diffuse pvns...there are still microscopic pvns cells that remain. It only takes one of these cells to seed the tumor and get it growing again. RT is used to sterilize the microscopic pvns cells so they are unable to reproduce. Every procedure has risks and the difficult part is determining what risks that you are willing to take. When your doctor suggest a a treatment plan ask him why he believes this particular treatment will be best for you. Everyones personal and physical condition differs so please take the time to do your research to find the best options for your situation. </span></div>
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<span style="letter-spacing: 0.0px;">With all of that said I chose external radiation vs internal radiation because they are able to direct the external radiation exactly (and I mean exactly) where they want it vs the more generalized radiation of the entire joint. Another point to remember is that each body part has a life time limit of radiation that it can be exposed to. I didn’t take this into account when I decided to have RT treatment. It decreased my chances of recurrence to 20% but it seems that may not have been good enough. The mri suggests findings that are consistent with pvns at the 6 mo f/u mri so it may have recurred. </span><span style="letter-spacing: 0.0px color: #cc0d01;">(found out 6 mo later that it did not recur but it was scar tissue sowing on the mri) </span><span style="letter-spacing: 0.0px;">I see the surgeon on Thursday to discus our plan of action since it also now appears to be on the tendons. RT does work but again it only takes one stupid microscopic cell to start it all over again.</span></div>
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<span style="letter-spacing: 0.0px;">I am not a physician and the above is in no way to be taken as medical advise. This is my interpretation of what I have been told by my physicians and from what I have read. Always consult with a professional for case specific accurate information.</span></div>
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CJhttp://www.blogger.com/profile/07441864217304744390noreply@blogger.com2tag:blogger.com,1999:blog-6649606746135970422.post-82325813442815627852012-06-26T08:01:00.002-07:002014-08-13T03:49:20.231-07:00PVNS Negligent or Criminal<br />
<span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;">Being educated and knowledgable about your disease is the only way to ensure that you will receive the best care available. It will also allow you peace of mind knowing that you are making the best health care decisions. The moment that you leave everything up to the physician is the moment that you will be disappointed.</span><br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh7FnnB1mI4vUHY7Q7HEjXkctU1S7NdcFDYTpVBRPzRlD70fd_Oth0t1bTdBvaohl_C5OL90BdyCle_GgorQmor1KAUpKL0fWMSJGXJby0jMcYCVbJgbOO6-KAckBLAi1rImZ4gexORLdIU/s1600/crazy+doctor.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh7FnnB1mI4vUHY7Q7HEjXkctU1S7NdcFDYTpVBRPzRlD70fd_Oth0t1bTdBvaohl_C5OL90BdyCle_GgorQmor1KAUpKL0fWMSJGXJby0jMcYCVbJgbOO6-KAckBLAi1rImZ4gexORLdIU/s200/crazy+doctor.jpg" height="200" width="142" /></span></a></div>
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<span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;">Yesterday I ran across the story of a guy with newly diagnosed pvns that was causing him great discomfort and was interfering with his ability to work. He was told by his doctor that nothing could be done and to go home and learn to live with the pain. Being distraught his parents parents posted a request for information about pvns, which I provided them with resources.</span><br />
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<span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;">It angers me that a physician could be so lazy as to not even run a basic informational search on a disease that he/she is unfamiliar with (prior to telling the patient that nothing can be done). That is not only negligent but criminal. A doctor swears an oath to do no harm above all else.</span><br />
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<span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;">It does remind me that many people have absolute faith in doctors and it doesn't even cross their minds to seek out independent information. I'm fortunate to have a doc that will tell me when he doesn't know something. Peoples, docs don't have the time to keep up on the latest of every disease and it is very helpful to them when you bring in articles and links to specific information that may help them to further their education of your specific disease. You can present the information like this "I was reading the most interesting article about "---" and thought you may also enjoy reading it...as you hand it to them. The two key words are "interesting and enjoy."</span><br />
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<span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', serif;"><span style="letter-spacing: 0.0px;">I am not a physician and the above is in no way to be taken as medical advise. This is my interpretation of what I have been told by my physicians and from what I have read. Always consult with a professional for case specific accurate information.</span></span></div>
CJhttp://www.blogger.com/profile/07441864217304744390noreply@blogger.com0