Diagnosis Me!

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Hello, hello! I hope your Monday is going well.   I just ate a fabulous lunch:

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I grilled a burrito in the George Foreman for about 4 minutes.  It was a nice, crunchy change!  Inside my burrito was black beans, zucchini, yellow pepper, onion, and cheddar cheese.  Plus salsa on the side.

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And a bowl of watermelon:

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Plus, Dove Dark Chocolate for a little dessert:

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Diagnosis Me!

 

I tweeted last week that I have an appointment with an orthopaedic doctor this Thursday.   As many of you already know, about 2 years after I began to run, I developed a knee condition called Chondromalacia.  Read about my diagnosis here.

 

I’m going back to the doctor because (1) I’m not 100% confident in my diagnosis and (2) I want to better understand my treatment options (like Physical Therapy).  The first doctor did not bother to discuss treatment options with me at all.

 

I have a problem at the doctor’s office — I get really nervous and I forget to say everything I wanted to say.  Also, I know most doctors make a dignosis within 2 seconds of meeting a patient.  So, I’ve written out all of my symptoms and I’m going to force the new doctor to read my list.  That way, I KNOW I don’t miss anything!

 

Let’s play "Diagnosis Caitlin’s Knee Problem." 

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Here’s the information I’ll be giving the doctor:

 

  • 25 years old.  Began to run in Spring 2006.
  • Onset of knee trouble: January 2008
  • Prior to April 2009, ran 20 – 25 miles/week.  Only ran 7.0 miles from April 2009 to present.
  • Current exercise: low impact (walking, biking, or elliptical 2- 4 times week); running 2.0 miles max (1 time a week)
  • Issues present themselves equally in both knees
  • Popping noise in knee with flexion (no pain) — this popping is present at all times and is my biggest symptom
  • On a scale of 1 – 10, with 10 being what I imagine labor to be, the pain is a 3 when present.  Following a long run, it is a 7.
  • When present, pain centered on lateral anterior surface of knee above and below the patellar
  • Aching and tightness in lower anterior quads 
  • Stiffness in knee and quad upon waking following low-impact or high-impact exercise
  • Water on the knee after long runs
  • Mild popping noise in hips with rotation (no pain)
  • Supplementation includes: 1500 mg of glucosamine and 250 mg of calcium.  Taken daily for the last year.

 

Is it my cartilage?  Or my ligaments?  What do you think? πŸ™‚

{ 50 comments }

 

  • Brandi June 8, 2009, 9:02 am

    I have no clue what it could be, but great idea writing all that stuff down to take with you. I always forget to tell them stuff, too, so I think that will help a lot (having the dates, pain levels, etc).

  • SuzanneRN June 8, 2009, 9:04 am

    sounds like cartilage to me but im no MD! good luck and very smart to bring that list!

  • Low June 8, 2009, 9:05 am

    I'm pretty clueless when it comes to knee injuries, but that's an awesome idea. I hope the doctor has enough sense to read through the list thoroughly and take everything into consideration. Good luck! I hope everything gets better as soon as possible.

  • lindsey June 8, 2009, 9:08 am

    Good luck at the doctor's! I work for a hospital, and even spending all day long immersed in healthcare issues doesn't make my own appointments less intimidating.

    Just stumbled upon your blog, and have to say, as a recent vegetarian, I'm glad to see someone else acknowledge how hard it can be to find healthy options when eating out. Sometimes it seems counter-intuitive when you're forced to eat chips & cookies just to avoid the BBQ!

  • jenngirl June 8, 2009, 9:10 am

    A lot of the popping issues you're having sound like cartilage, but when you say that the pain extends down your leg, could be pointing to ligament issues. I hope your doc gives you the time you deserve and good luck at the appointment!!

  • Amelia (AC/DC: Highways to Health) June 8, 2009, 9:10 am

    That's a good idea to have everything written out. I'm guessing that will be a big help to you AND the doctor. I have no clue when it comes to injuries, so I can't help diagnose you.
    Your wrap looks amazing! Foreman grills are the best.

  • Tyler June 8, 2009, 9:12 am

    I'm so sorry about your knee, but I have no idea what it could be! Injuries are so frustrating.

    Your wrap today looks especially delicious…I just bought a huge zucchini from the farmer's market and I'm dying to use it πŸ™‚

  • Amanda's Eats June 8, 2009, 9:12 am

    I have no idea what's wrong with your knee, but I wish I did because I have the exact same problem. Although, mine don't have issues at the same time like yours, sometimes its one or the other. I can't wait to hear what the doc thinks is up! I have had my issue since Jr High and had gone to PT for a while with no luck πŸ™

    One thing I was told was that I grew too fast when I was younger and the cartilage never got a chance to catch up to the growth so I have gaps. I don't know if that still stands but the issue has never been fixed so I have to assume.

  • K from ksgoodeats June 8, 2009, 9:12 am

    Not sure on the diagnosis but I do know that physical therapy can help strengthen the muscles around your knee to help. I hope you find some help πŸ™‚

  • lilveggiepatch June 8, 2009, 9:16 am

    That wrap looks insanely delicious. Cheese and beans are hard to beat!

    Good luck at the doc! When I remember, I write down a list of things I want to remember, too… I also get flustered when I'm having arguments with people and completely forget my points. Oh well!

  • Erica June 8, 2009, 9:30 am

    Good luck at the doctors! I hope you get more of the information you need! What a yummy lunch! Salsa is my favorite condiment!

  • Nicole (anotheronebitesthecrust.wordpress.com) June 8, 2009, 9:37 am

    That is a GREAT idea to write everything down! I always forget something when I go to the doctors. I hope you feel better!

  • Hallie June 8, 2009, 9:38 am

    GOod luck today! I have no idea what could be causing your problems, but exploring all of your options is def a good start.

    I went to PT for ankle problems (a mild sprain made my overpronation WAY worse) and I got some good stretches and advice from her. The GP I went to wasn't much help, though. I basically had to force them to give me a referral to the PT. The joys of an HMO, I guess (but at least I have health insurance, unlike so many others!).

  • Bridget June 8, 2009, 9:39 am

    Three weeks ago, I sprained (more like strained…but…it was all in Japanese, so sprained is good enough) a ligament in my knee playing soccer. (I also bruised a rib and got a massive arm bruise! Ouuuuch!)

    Your injury sounds more like a cartilage problem. My friend had the same kind of problem and she had damaged her meniscus. It could be any number of things, so I am glad that you are going to see a *different* doctor. I hope that your appointment goes well, and you are SMART for writing all of that stuff down. If the doctor tries to leave before your questions are answered, don't let him or her do so. You're paying for his/her expertise–they damn well better give you something that can help you with the healing process!

  • Emily June 8, 2009, 9:41 am

    After a couple of years of pain, I was diagnosed with chondramalacia in my knee when I was in my mid teens; the doctor said it was a result of a gymnastics injury several years earlier. Most of my pain was under/below the kneecap, it was sort of a hot pain, my knee generally felt very weak, there was a lot of fluid, the kneecap felt very loose (don't know exactly how to explain it, esp after this time). The exercises I was given to do didn't do much to help. I actually injured the ankle on my opposite leg about a year after I saw the ortho for my knee, and being on crutches for over a month really strengthened my knee and that was the last of the problems I had with it! It may not have been chondramalacia per se, but again, that's what the doctor said. And I am not advocating 2 months of hobbling on crutches, but it worked wonders for me πŸ™‚ (and thankfully, my ankle healed completely and I have had no lingering problems with it).

    Hope you get everything straightened out soon! Just stay positive πŸ™‚

  • Sistercooks.blogspot.com June 8, 2009, 9:47 am

    honestly, it sounds like my symptoms of condramalacia of the patella…just friday I had surgery where the dr did a lateral release so my muscle could move back on top of my knee, since I have been doing pt for 6 months with no real help, altough I should say I also had a maniscal tear they fixed at the same time….

  • april June 8, 2009, 10:04 am

    I'm so glad your wrote all your symptoms down. I've seen a bunch of patients who forget what they want to say! Writing down all the symptoms helps you and the doctor!

  • Island Girl Eats June 8, 2009, 10:11 am

    Why is it that doctors don't like you to question them? Are you going to a different doctor for a second opinion, or to the same doctor? It looks like you are very well prepared with your list of ailments!

    That veggie burrito looked amazing!

  • Marissa June 8, 2009, 10:19 am

    I have no idea what it could be. I went to PT for two months and now my knees don't hurt. My IT Bands are another story though! Trying to work through it with my foam roller and taking a break from running.

  • Jenny June 8, 2009, 10:26 am

    good luck at the doctors girl, i hope everything goes well for you!

  • Amy June 8, 2009, 10:32 am

    no idea, but it sounds like your well-prepared for your appointment–good luck!

  • Matt June 8, 2009, 10:33 am

    I'm no doctor, so I honestly have no idea. If you want a good sports doctor, ask some local runners at a running club or running store. Runners are always getting hurt and they know who is going to get them fixed up!

  • Mica June 8, 2009, 10:35 am

    Best of luck with the doctor. You sound well-prepared this time!

    Your wrap looks fantastic!

  • MarlΓ¨ne June 8, 2009, 10:35 am

    My personal suspicion is that Doctors do something to the air quality in their exam rooms. Whenever I sit in one, I get really drowsy and unable to formulate proper sentences. It doesn't matter how perky I am when I walk in, by the time the doctor comes in for the exam (usually 5-10 minutes later), I'm totally sedated and ready for a nap!

    I think they do it so that patients won't challenge their diagnosis, or spend too much time in their overcrowded schedules. Arg!!

  • Justine June 8, 2009, 10:40 am

    Wow, those knee issues do NOT sound fun! I hope this doctor is able to give you an accurate diagnosis AND tell you what you can do to treat it and get back to running! Good luck!

  • Jenn Eats Nutritiously Now June 8, 2009, 10:40 am

    Wow, I really hope you can get a diagnosis you feel confident in. And a doctor who listens to you.

  • seesaraheat June 8, 2009, 10:40 am

    I have no idea! But I hope this doc will be better than the last and that you get some answers. Its great that you wrote it all out, that will let the doc know you mean business πŸ˜‰ Good luck!

  • Trish June 8, 2009, 10:53 am

    I hope you're able to get some answers and some proper treatment. I've been having foot issues and the last doctor I went to didn't really give me any other options to help the problem. I'm hoping a new doctor who can actually help me.

    It's so sad when you are dealing with a doctor who isn't willing to really help – they are just quick to give you a bottle of pills and send you away (minus your money).

  • tfh June 8, 2009, 10:55 am

    A 7 after a run? I had no idea it was so painful! I'm glad you're getting a 2nd opinion and hope this dr. will be more helpful. I have no idea what it could be, but I'm guessing cartilage.

  • rediscoveringlauren June 8, 2009, 11:25 am

    wow, i hope your docs prepared for you πŸ™‚ i think its great you made a list..i always forget what i want to say when i get to the docs too!
    lunch looks great πŸ™‚ good luck at the appointment!

  • Niki June 8, 2009, 11:29 am

    I'm glad your going to another doc to get a second opinion! Hopefully he will give you some better answers!

  • Anonymous June 8, 2009, 11:31 am

    Doctor's can be intimidating, but just remember they work for YOU!!! If you feel rushed, are not being given thet ime to ask the questions you have, etc… let your doc know that you have more questions.

    If you are not comfortable with the answers, attention or advice you are receiving, never hesitate to go see another doc. Also, we are the keepers of our own health and bodies, so listen to your body.

  • Caitlin at Healthy Tipping Point June 8, 2009, 11:32 am

    island girl – this is doctor #2.

    anon – truer words have never been spoken!! amen!

  • Kayla June 8, 2009, 11:42 am

    hey! I've posted this before but I'm not sure if you saw, look into ART (active release technique) activerelease.com it's AMAZING!! I go to a Dr in Altamonte, near the mall, but you can input your zip code into their website & it will bring up Drs close to you. I have TMJ, a ridic messed up neck and it's worked wonders for me. The BF has knee problems and it's been amazing for him as well!!

  • Caitlin at Healthy Tipping Point June 8, 2009, 11:48 am

    kayla – i will ask him about that as a treatment option!

  • Anne June 8, 2009, 11:55 am

    Hey girl,

    My mom is a doctor, so I linked her to this and asked what she thought. She says that knee problems can be really tricky to diagnose, but she thinks it might be a combination of patellofemoral syndrome and IT band syndrome. If you have flat feet, she recommends orthotics (I have ridiculously flat feet and got custom orthotics. I was prescribed them, so they were covered by my insurance. Thank god! I know they're super expensive). My mom said that chondromalacia is an oldish term for what happens in patellofemoral syndrome.

    She also recommends physical therapy for strengthening exercises for muscles around the knee (I went through this too, and it did help).

    She says it's a good idea to write things down, but cautions that if it's the same doctor, it may not help and he may just get mad. I went to an awful doctor at first– he didn't even listen to me and what I wrote down. But then I went to a good sports doctor.

    She recommends going to a sports doctor (and so do I!), because they're more likely to help you treat it, instead of saying something like "well just don't workout if it bothers your knees." We know that's not an option!

    Good luck! And I totally get all flustered at the doctor, too. I hope it goes well! I know it really sucks when you get a bad doctor. I was in tears after my first visit about my knees–the doctor was so awful. I hope you can get to a good sports doctor!

  • Stacey June 8, 2009, 1:36 pm

    Can't help you there πŸ™ But whatever it is sounds terrible, and I hope you get it "fixed" pronto!! Good luck with your appt πŸ™‚ We will be waiting for the verdict!

  • Helena June 8, 2009, 1:54 pm

    Sounds like you've researched this a lot. My mom was referred to an orthopedic doctor, I think he called himself a musculo-skeletal specialist (big words!). Anyway, he was a runner and his injury spurred his specialization. Basically he worked on fixing biomechanical imbalances such as one leg slightly shorter than another, or something out of alignment, just by doing exercises and adjustments (not a chiro though). Maybe that's what your doctor will prescribe!

  • kirsten June 8, 2009, 1:56 pm

    hi caitlin, I had a very similar experience where I went to a dr. was diagnosed with runners knee and he offered no help, he just told me to alternate directions I run on the track and that would fix it (it did not.) I was inspired by your post last week to make an appt with a new dr for a second opinion. I went today and he was very helpful. He also said I have runners knee but there isn't actual damage to the cartilage just inflammation. He prescribed Celebrex which is an anti-inflammatory as well as 4-6 weeks physical therapy to strengthen the muscles around my knee cap to try and get my knee cap to stay aligned. I will let you know if either of these things help, hopefully they will!! Good luck with your appointment on Thursday!!

  • Melissa @ For the Love of Health June 8, 2009, 2:21 pm

    I wish I could help you but I lack knowledge in this department. I hope you can get it figured out!

    Amazing looking lunch!!

  • just me June 8, 2009, 2:39 pm

    i hope it's nothing serious, that's what i think of it all! i don't want you not being able to run! no fun!

  • Dori June 8, 2009, 3:31 pm

    I'm the same way with getting nervous and forgetting to tell the doctor all I want to say. I actually have a 6 page Word doc of my entire GI experience to date that I bring with me to new docs. Your list is good and comprehensive. Curious to hear what the dr says. Did you ever get an MRI in addition to that x-ray??? MRI is really what diagnoses the knee stuff in most cases. I have bursitis in my knee, and an intraganglion cyst.

  • Nutritious is Delicious June 8, 2009, 3:56 pm

    NOW THAT is a burrito! πŸ˜€

    I have no clue about your kneee! Sorry,but I hope the doc can help you out!!

  • Lexie June 8, 2009, 4:27 pm

    Hey Caitlin…I have no idea what it could be. I can't wait to see what the doctor tells you. I have the some of the same symptoms especially the popping at all times! Hate it!

    That burrito looks delicious!!!

  • Tammy June 8, 2009, 4:40 pm

    I have no idea what this could be as I don't know much about knees, but I think you are taking the right action by writing everything down! Don't let the doc rush you! I had an appointment with the orthopedist today (I'm about to post about it on my blog), and he was great, but definitely rushing around a lot between me and other patients. I knew I had paid just as much as everyone else there, and I was going to ask ALL of my questions without feeling guilty. So I sat there with my paper and pen and asked away, an he answered all of my questions, looked over what I had written, and seemed very happy to help me. That's the way it should be! Best wishes as you try to get this resolved!

  • Tammy June 8, 2009, 4:41 pm

    PS That wrap looks awesome; seriously, no one makes a wrap like Caitlin. Will you make me one sometime?

  • Bec June 8, 2009, 5:13 pm

    hope you get some good answers at your apt! Thanks for the stretching tips, I am such a lazy stretcher so the tips are great πŸ™‚

  • Lizzy June 8, 2009, 5:31 pm

    If there is a nurse/PA that talks to you before the Dr you could let that person know how you often feel rushed by MDs. That way the Dr will come into the exam knowing how important the dialog is to you. Good luck!

  • Oh She Glows June 9, 2009, 8:23 pm

    I HAVE to get a George Forman grill…Ive been drooling over your wraps for MONTHS now!!! lol

  • Ally July 26, 2009, 9:22 pm

    I had chondromalacia patella years ago! Whenever I put pressure on my knee (kneeling, squatting, etc.), my knee would sort of 'clink' and it would LOCK in a STRAIGHT position for a while (three whole days once). Docs said tiny bits of cartilage had snapped off and were floating around in there. Awesome.

    I haven't had issues with it for about five years, until one week ago. I went for a run and noticed it felt a bit 'crunchy' afterwards…I stupidly continued my workout routine that week, and went for a 5K yesterday. I spent the rest of yesterday after the run in pain, hobbling around, terrified my knee would 'pop' out again and lock.

    I'm off to the doctor today to nip this problem before it gets any worse! My only question is, why now? Well. I've only started regular running in the last few months. Coincidence? Let's hope so…

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