Meniscus

by Christopher Drumm, MD Norristown Family Physicians, Einstein Medical Center Montgomery

Ispend my days running from room to room seeing patients. My weekends chasing my children. While trying to sneak in time to exercise and improve my health. And also time for punishing my body with chips and occasional IPAs. But you never see the change in your joints coming – and then it is there. I took a step and felt a shearing force in my knee. I was not jumping or hurdling, but something funny happened. I continue my day and pretend that I am fine. Then the next day walking to a patient room I feel my knee give out. Luckily my peripheral nerves, cerebellum, and my vestibular center are still intact. I do not fall. Immediately I feel a click and realize that this joint is now swollen. Fluid pushing posteriorly. There is no Baker’s cyst, but I am sure that I have an effusion. There is not pain but I realize that my knee has failed me. I do not have my partner prescribe me Percocet. I do not stop working. I push through because that is what we are taught to do. I ice my knee and use the occasional ibuprofen. It is now 2 weeks later, and I have still not had it examined. I have been ignoring and hoping it will go away. I often am surprised when patients are not able to explain their pain. I give them descriptive options if they cannot come up with a description on their own – sharp, achy, lancinating, burning, throbbing, crushing, gnawing, tingling, dull and more. Yet I cannot even describe how my own knee feels. It is not pain but discomfort. Yet discomfort is a type of pain. It feels tight. I cannot feel tearing along my tibial plateau. I cannot tell if it is patella vs medial. I worry that I have torn my meniscus. I am a trained physician, yet all I can think about is how my body has failed me. Will it heal on its own? When do I get an MRI? Will I ever play basketball again? Should my weekend runs come to an end? Was this an acute tear or degenerative? Could I be that old that I have a degenerative meniscal tear? I have started some PT and hope every day that the effusion will have disappeared, but it has not. But if a patient came in with this complaint it would be a simple visit. I could get a history, examine, and create a plan in a few minutes. I would ask the patient if they had any questions, while hoping the answer was no. But I am the patient. And it feels so different and yet it is not even a scary medical issue that I am dealing with. If I feel this way, I cannot imagine how patients feel. I realize I need patients to ask me more questions because they have them. They have concerns and fears. As do I. Now that I have finished writing about my fears, maybe it is time for me to see a doctor.