Meniscus Blues

Like others, I had a meniscus tear while playing sports. When the tear happened it caught me by complete surprise. The tear happened in such a benign way that I'm taken aback by its severity. I was playing in a muddy rugby match and I slid into the try zone, baseball style. I thought nothing of it but when I got up and began my jog to the 50 meter line, I didn't make it that far. As I ran my knee gave out and I fell to the ground with blinding pain radiating from my right knee. When I finally got to the critical care center, they put me in a leg immobilizer and scheduled me for an MRI. When the news came in I was very shocked. I was diagnosed with two severe radial tears in my lateral meniscus and some chondral fissures. This comes as very sad news to a woman who enjoys being physically active. I have been presented with two choices, I could have surgery, a partial meniscus removal, or I could try to rehabilitate myself. I've tried the latter in order to minimize the early onset of arthritis in my knee, so far it hasn't succeeded like I hoped. I've made some serious progress in the last four weeks, but my range of motion while is 90% of normal but I can't achieve the same range of motion while trying to bear a load on my knee.
I'm still plagued with the question, 'To operate or not to operate?'. I was hoping for a better solution that cutting out my precious cartilage. I think that technology and the FDA have finally delivered that solution. There exists a meniscus implant that acts as a biological scaffolding which allows it to become permanently integrated into my existing red meniscus (the part of the meniscus with a vascular system). The company which started marketing this technology as of December of 2008 is Menaflex(www.menaflex.com). My hope is that my insurance provider Blue Cross and Blue Shield, will cover this implant technology. If the implant is covered by insurance then I will truly have a useful surgical alternative. Assuming I have this alternative the question becomes, "At what phase in life is getting the meniscus implant optimal?". I'm no longer afraid of the question, 'To operate or not to operate?', because now there is the possibility of a real knee repair as opposed to just a symptomatic treatment.
I would prefer to rehabilitate my knee, as I think many athletic minded individuals would like to. What is difficult to understand is the general lack of information regarding the best techniques to rehabilitate a knee suffering from meniscus problems. The meniscus pain seems to be brought on by any torque placed on my knee. I have failed to find a brace which can protect the knee from this type of motion. I am beginning to think no such brace exists, I guess we can't escape basic physics applied to the knee. Is it possible to work a torn meniscus enough to bring back regular pain free function? I have seen two separate orthopedists, one of which says the only solution is surgical, removing 1/3 or more of my meniscus. The second orthopedist advocates rehabilitation to the point of wearing down any meniscus folding(from a small tear) to a smooth meniscus which is functional. I wish medicine was more science than an art, because then maybe the orthopedists' advice would converge to the best solution. I suppose a third opinion is in order, especially from an orthopedist who is familiar with the implant technology. I just hope to get logical, sound advice on my options rather than a sales pitch for the implant.

--The Frustrated Flanker

Jealousy with a large helping of guilt

My mother-in-law(MIL) is going on stroke 3 and has been incapacitated for over a year now. We were very close and I'd like to think that somehow we still are. What has been bothering me for a few months now is some jealousy I feel because my spouse dedicates about 95% of her time to care for her mother. First off, culturally speaking a nursing home was and mostly still is out of the question. Neither of us want to do that. I myself can not contribute like I want to because I've taken a postdoc which has pulled me from my home for the time being. My spouse and MIL can't be moved to my location an they shouldn't be because my postdoctoral appointment is a temporary one. This means I get far less time with my spouse that I think is healthy. Hence, when we are together I want to monopolize her time with me, and my MIL, who is still lucid also gets jealous of me. This is proving to be a real problem which reared its head this Christmas vacation. I see all of my in-laws basically ignoring their mother outright, and my spouse shouldering the burden of care and patient advocate almost completely alone. This causes me to experience a huge array of feeling from resentment, jealousy, and despair. Sometimes the feeling are a bit dark and I wonder where they come from. My and my MIL we very close and liked to spend time together, so the darker feelings are scary for me. My wish is everything will get better for my MIL but, the rational scientist in me knows this will never happen. How does one cope with guilt of not supporting your spouse more in their time of need due to career commitments and how do you not let negative feelings spoil your relationship with your incapacitated family member. Especially when their life is so heavily dependent on your spouse for survival.