Thursday, August 09, 2018

About CKS (crabby knee syndrome)

I have a story about my right knee.

Picture the following scenario: I am a 67 year-old, overweight, under-fit female, in a foreign city (Barcelona), in the ladies room of a teaching venue. The 3 stalls are little rooms, with complete privacy, ordinary doors, not the kind we are used to here which are just partitions. I quite like this foreign version of toilet privacy, but it's a bit off topic so I'll head back to the point: when you gotta go you gotta go.
I use one of the little rooms, and completely forget that the little room is up a step that is about 4 inches high. I presume the plumbing had to be accommodated or something, but before I wander off topic yet again, let me just say I didn't notice myself stepping up to go into the stall (jet-lagged probably), and my brain did not account for the height-of-floor-difference coming back out again.

Long story short, I made a predictive motor error. Or at least my brain did. I thought the floor was all one height, and when it suddenly wasn't, I landed pretty hard when finally the floor came up to meet my descending foot. My foot that descended surprisingly farther than anticipated. With all my considerable overweight jolting down an extra 4 inches to stop more abruptly with a lot more gravitational force than I had expected. Four inches in which apparently a lot of acceleration can occur, within mere nanoseconds.

I didn't fall over or anything.. I carried on.
The knee felt weird though. Not right. Like it wasn't quite me. Stiff and unnatural. Like there wasn't any room for "me" in it. Like a mechanical thing more than an alive thing. The interoception felt cloudy, and the proprioception seemed to be missing. My brain didn't trust it anymore.  It didn't really hurt at first, but I could feel machinery running in the background of my awareness as though my brain was trying to figure out where it had gone wrong. And the knee acted slow and stiff. But I hobbled around for the next 5 days, teaching, sightseeing on foot (slowly). The best thing to do with stuff like this is ignore symptoms and keep moving, right? Treat whatever it is as though it were normal, make normal demands on it, don't baby it, just keep going. And that is exactly what I did.

Pain set in during the long flight home, but I just kept going. I had to go to Taiwan, then Winnipeg. Then Minnesota, just last week. Four months have elapsed since the bathroom floor predictive error encounter.
It has been variable, with entire days pretty much nociception free, but it would wake me up at night, pain shooting through my knee. I would have to wake up fully to change position. I did not let this worry me. I would just go back to sleep, easily enough.
Some days it really hurt, so I would baby it with some stretchy tape and keep on going.
It was always worse after sitting for a long time.
Like on airplanes.
And a number of different people helped me by treating it, which always made it feel better, for a little while at least. 

It did not slow me down at all, really, except when descending stairs. Then I knew I still had a knee pain problem. I live on the fourth floor. Three flights of stairs. About 60 steps in total. Going up was easier than coming down. Yes, there is an elevator. Yes, I took it, but I tried to make myself do stairs as much as I usually do, which is about half the time going up, and all the time going down. So, I worked it under load.


The backstory: I had a terrible time getting paid for the work I did in Barcelona.
Finally, after a lot of back and forth and several attempts (according to the party that had hired me) to wire the payment through, I got paid through good old Paypal, at my suggestion.
I was in Minnesota when the money from Barcelona finally came through; I emptied the Paypal wallet into my account, mentally heaved a sigh of relief that that particular psychosocial worrisome bothersome irritation was over with, crossed off my list of things to be dealt with.


Here's the weird part, the gist of this whole story, the juice in the blogpost: Almost immediately with the experience of relief of this formerly noxious situation, I felt a reduction in pain, like someone flushed a toilet in there, and "me" gushing back into my own knee, able to "re-inhabit" it physically, much much better. Such a peculiar feeling.
Slept through the entire night that night, didn't wake up once.
The psychosocial aspect of pain perception.


I'm back home now, and 8 or 9 days later, I can feel my knee getting better with each day. (FINALLY!)(After 4 months!)
I can do stairs normally now, descending straight down without needing to have a hand on the handrail. I even noticed, today, I led with my left leg! Unconsciously! I could not do that for the entire 4 months the right knee was being a pain. There are still little twinges in it, but I can fully flex it now, just as far as the other knee, and the twinges feel a lot more superficial, medial knee, saphenous nerve, not throughout the entire joint as though it were made entirely of wood and discomfort. Now it's time to work on squatting.

So much more space inside it for "me."
I love endogenous opioids, so much. Especially when they hit at the precise representations in the various somatosensory cortices where they've been dried up for however long an accompanying situation has been grinding along, unresolved. Another neurotag bites the dust! 

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