If I was your horse, I would understand why we were taking a walk toward that hole you recently dug in the south pasture.
Not long after I wrote a column about my gimpy right shoulder, my right knee started whining for attention by hurting after I ran on it, and months later, it still hurts. My knee bone may not be connected to my shoulder bone, but it appears to be jealous of its distant synovial relative.
My initial response to the knee pain was to take two aspirin, call myself in the morning, and ignore my calls hoping the problem would go away. I took a few months off from running to see if rest would help, but it did not, and now I cannot run regularly for exercise.
That may not mean much to most of you, but I have been running pretty happily and regularly for more than 30 years, shedding calories and worries in equal measure. I am so ticked off about not being able to run regularly that, when I see others doing it, I could just about spit cleats in frustration.
My family doctor said I need an MRI scan of the knee to diagnose the problem, because I probably have torn something in my knee by beating the tar out of it running thousands of miles on tar. I knew that before I talked to him, but wanted an opinion other than my own because the physician who treats himself has a fool for a patient and a jackass for a physician (thank you, Ben Franklin).
My health insurance would probably pay for that MRI scan without batting a bean counter’s eye, but I feel guilty doing things as a patient that I encourage my patients not to do. I thought I should subject that knee MRI recommendation to the test of responsible patient decision-making that I try to apply to my patients, and to my gimpy shoulder.
Do I have enough of a knee problem that, if this test tells me what the problem is, I will seriously consider getting it fixed? If yes, I should get the test. If no, why get an expensive test someone has to pay for that may show a problem I am not going to fix?
First question, then: If an MRI shows something like a torn cartilage or torn ligament in my knee, is it causing me enough of a problem that I would seriously consider getting it fixed?
With my shoulder, the answer was no. With my knee, the answer is yes, because it’s not just the running for myself I will miss in the future. I want to be able to run for many more years, with my kids, my kids’ kids after the ice cream truck, from the bull moose I was photographing, etc.
So I am going to get an MRI scan of my knee someday soon. If the MRI shows some knee damage that a surgeon with sharp tools and a strong right arm can fix, I will then get the first surgery I have had since an ear, nose and throat doc straightened out my septum in 1986 (a procedure with downsides, including having two nasal packs the size of Winnebagos parked in my nose for five days, and the mind-warping effects of Percocet).
I figured I would then use that experience — to the MRI scanner and beyond — as a lens for examining how our health care system does and does not work. I will not use it to look at the people taking care of me (I want them to focus on me, not what I might write), but rather to look at the system around patients and caregivers.
I had thought about using my recent colonoscopy for this purpose, but figured you might find the review of my wazoo less appealing and interesting for teaching purposes than the knocking of my knee around the health care world.
Next step? Shopping for an MRI scanner, where this intrepid patient/ writer/physician searches the marketplace for a reasonably priced MRI scan. How hard can it be to find that?
Erik Steele, a physician in Bangor, is chief medical officer of Eastern Maine Healthcare Systems.