Well it has been a long time coming and I’ve needed this procedure for awhile now. I started having dislocations from an early age. My ankles first, then my knees, then my hips. My knees have always been the worst. My right knee, in particular, has had at least over 100 dislocations, each fall worse and worse. The fear was that with each fall I could break a bone and do permanent damage to my cartilage and knee.
My (hopefully) last dislocation.
I decided enough was enough when I fell at a wedding reception. I was having a great time dancing with my husband when I tried to twirl and my knee gave out. I was humiliated to fall in front of all these people and knew that I had hurt myself pretty bad. The pain was excruciating. Luckily I ended up with just bruising this time, but I knew the MPFL surgery that was recommended to me back in 2019 was the only way to prevent this from further happening.
My two Orthopedic appointments that were in the same week! On Monday I scheduled a MPFL procedure at UT Health and canceled it by Wednesday to proceed with TX Orthopedics
The first step was finding a surgeon. You do have a choice in your care and deciding who operates on you. I had narrowed it down to two orthopedic surgeons. I originally went to UT Health. I actually had gone here two years prior, but was too scared to proceed. I liked the doctor I saw, but ultimately chose Dr. Rodriguez because he actually broke down how I could feel better and what my goals were for this procedure. He was confident in his ability to fix my problem and explained everything I would go through.
Post-Operative and ready to go home!
The day was scheduled originally on 5/19, but due to some last minute concerns (on my apart, I’ll explain this) we switched to the hospital instead of the surgery center. The surgery was rescheduled for the following Wednesday which came soon enough. Personally, I am thankful I had that extra week because it meant another week of Peloton training and more time to complete chores and work that I had put off.
I had everything set to have surgery scheduled on 5/19 and the weekend before the procedure, my dad called and said he was worried about the anesthesia and me going under due to my increasing mast cell issues. Over the past month or so, I have had three “attacks” where my body has overreacted to unknown stimuli causing urticaria rashes and severe stomach cramping and pain. I hadn’t really thought of this being an issue with surgery because my MCAS symptoms had been mostly related to food related.
I ended up talking to the anesthesiologist and we ultimately decided to go ahead with the surgery, but the day before anesthesiology decided the hospital would be the safest route given my history. The procedure was postponed for a week and I felt better, along with my dad and husband. Having the operation in a hospital meant being able to have a team of doctors to help if I needed them; peace of mind.
My knee plush alongside my MPFL repair.
My MPFL repair was done via arthroscopy using an allograft and reinforcement meaning I have a cadaver’s ligament inside my knee. Whoever this person was they are giving me new hope; a future without dislocations. I am truly grateful for this gift and the person that contributed it to me. For pain management I have an On-Q Pain Relief Management System which is a catheter placed in my leg and is slowly administering a lidocaine-like drug into my right leg essentially numbing my knee and leg for a projected 82 hours. After the pressure released pain pack is empty, I remove the catheter from my leg. I also am taking a prescription alongside to ease the pain as the nerve block is good, but not 100%.
Post-Op Day 1: The Block works!
My bandage comes off in three to five days and my stabilizer will be on for six weeks. Crutches will be my go to for the next several weeks alongside help from my family. I prepared for surgery by purchasing a few necessities that I will share with you in a later post and for now I am focusing on giving myself grace and self love.
I have a long road ahead with physical therapy and getting back to my “normal,” but I am hopeful this will be an end to my chronic dislocations and knee pain. My surgeon is highly confident in the surgery and it’s outcome, so I can’t help but be optimistic that this may be the end of my knee troubles (at least for the right side).
🦓 I am joining the EDS Awareness Month Challenge – May 2020.
Day 01: Meet Me! – I am Cass! I’m 27 years young, a mama to an 1.5 year old son, Griffin, and a wife (& best friend) to @calebrobnson. I live in Austin, Texas and work in a laboratory as a clinical research assistant and have spent the past month working with microbes to test the efficacy of preservatives in cosmetic products. I graduated in 2017 from Texas Tech with a degree in biology. (Wreck’ Em). My favorite past time is Netflix and Paint. I love doing custom work to create artwork for nurseries. I am a pug and sphynx mama and my fur (& furless) children bring me so much joy. My husband and I go hard at Modern Warfare (gamer tag: motherpuggy) – we play on the weekends and evening when I have energy. My favorite things besides my babies, are Diet Coke, pad thai, sour candy, burritos, tiny houses, modern interior design, tattoos, Harry Potter (and all other geeky series) and scary movies. I have Ehler’s Danlos Syndrome along with comorbidities of Chiari Malformation (brain surgery in 2015), Mast Cell Activation Disorder, and Undiagnosed GI & autonomic issues. I live with chronic debilitating pain in my neck, back, and knees and suffer from frequent dislocations. Despite my conditions and prognosis, I still have a fighting spirit and aim at being the best mom I can be. 💄
Some fun facts about me: I’ve lost about one-hundred pounds since 2013, my husband and I met and got married within two months of knowing each other, & I grew up as a military brat and lived in several different places including Cuba!
If you haven’t seen Netflix’s Diagnosis by now, you’re definitely missing out! My husband and I started watching it a few months back and we instantly were hooked. For years I have been classified as a medical mystery. So many different doctors told me: “it is in your head” or “it’s just a muscle sprain” and the occasionally “I honestly don’t know what we’re looking at.” I had shingles at seven (rare at that age) which confused a lot of medical personnel, but this was nothing that was to come.
Throughout my childhood I was seemingly healthy. I had chronic nosebleeds most summers, my ankles rolled so many times I lost feeling in them, and my knee caps started dislocating around the age of 12, but other than those issues I was pretty healthy. I had my tonsils and adenoids removed around the age of eight for chronic inflammation and I had ear tubes put in as a baby because of ear infections. Other than being overweight I looked and acted like a normal child.
Dislocations
It started with my ankles. From the time I could first remember I often rolled and twisted my ankles. I had such instability in my ankles that my ankle became numb from how many time I rolled them. Then fast forward to 2003. I did gymnastics and was always super flexible. I was at a K-Mart reaching up for an Easter Basket when I experienced my first knee dislocation. I’ve never experience such pain in my life. Unfortunately many more dislocations in both my knees and hips would follow.
Raynaud’s
Around sixteen my hands and feet started turning blue especially in cold environments or stressful situations. I went to the ER once for “diabetic” like symptoms in my feet (they were blue and numb) and was discharged with a migraine. My primary care physician (PCP) diagnosed me with Raynaud’s Syndrome and I was told to try to limit my extremities to cold temperatures. I bought some special gloves for when the temperature dropped, but we went forward not knowing this was a clue to the puzzle.
Idiopathic Anaphylaxis
Around the age of twenty-two, I started having major issues. It began with an allergy problem. I would have anaphylactic reactions out of now where and to foods I have had multiple times with no problems. I lived in fear as I was terrified that whatever I ate could cause my throat to close. I had one emergency room visit where they administered epinephrine and one allergy clinic emergency where they administered it as well.
I had extensive allergy testing done and thought I had something called mass cell activation disorder. Based upon a blood study the allergy specialist said that I have higher amount of basal cells or the cells that cause a reaction to allergen. I kept Benadryl and my epi-pen on me at all times. Despite testing several allergens, no food could be pin pointed as a trigger and I was thought to be allergic to some unknown spices.
Fast forward a few more years I had a skin and bone marrow biopsy done after I went to see a dermatologist for urticaria and allergic reactions. My skin basically overreacts to stimuli. I was diagnosed with idiopathic anaphylaxis. My bone marrow biopsy came back normal, so they ruled mastocytosis out, yet I am still having allergic reactions. I was told by one doctor that I have irritable bowel syndrome and maybe that was causing these reactions, but since becoming pregnant in January 2018, I have gone into a bit of remission.
Gastrointestinal
I started having gastro problems in 2014 (around 22 years of age). I had chronic diarrhea and a lot of nausea with vomiting. I lost a lot of weight unintentionally because I was so sick that summer. I had a colonoscopy done and all that was reported was inflammation. I am picky about what I eat because I am afraid of the outcome. I started cutting out heavy sugars, fats, and spicy foods. I later went on to have such bad abdominal cramping that it caused me to almost faint. I had my gallbladder taken out at seventeen from rapid weight loss and from cutting out fats from my diet that caused gallstones, so I knew it wasn’t a gallbladder issue. My PCP prescribed dicyclomine for stomach cramping and diagnosed me with what he though was irritable bowel syndrome. Another doctor I saw said he thought I had diverticulitis because of the extreme pain I was in. I remember driving to the hospital and then changing my mind and pulling over to ride the pain.
Atrial Fibrillation
While I was ongoing my allergy and gastrointestinal issues in fall of 2014, I stood up and immediately felt faint. I went to the bathroom and I looked white as a sheet. I felt clammy and my heart felt like it was palpitating out of control.
I had previous “attacks” where my heart would beat so fast for no reason. I went to the hospital once when I was sixteen for it and they ruled it as an anxiety attack, although I disagreed at the time. I know anxiety and I was watching a movie in a hotel room complete relaxed at the time.
I felt beyond sick. I collapsed to the ground and told my boyfriend at the time I needed to go the emergency room. I felt like I might die. I began feeling nauseated and I knew it was serious. Upon arriving I told them I was having chest problems. I thought maybe it was a heart attack. I was already crying because I could feel my heart. It pounded. It felt like it would explode. They did an EKG right away and called the cardiologist on call. They said it was atrial fibrillation. The doctor had never seen someone my age with it. They tried administering drugs to get my heart back in rhythm but to no avail. I consulted with my dad (a nurse) and we agreed I had to be cardioverted back. Basically my heart need to be shocked. They put me to sleep with an anesthetic and I woke up not long after with a pain in my chest but a normal heartbeat.
I had a couple more episodes after this one but no where as severe. I was tested for POTS because of the problems I had feeling faint upon standing and I had almost passed out several time while using the toilet. Despite matching on a lot of the symptoms the test came back negative.
Muscle Pain & Weakness
This has been the most persistent symptom of them all. I have pain every day in my back and neck. I thought when I had my operation (posterior fossa decompression) that I would be better, but it’s much worse. It started in the summer of 2015. My neck and back would put me in tears it hurt so bad. My PCP at the time told me it was a muscle sprain. I tried muscle relaxers to no improvement. Doctor after doctor told me the same thing. Must be a sprain. I finally received a MRI and my doctor failed to mention that the results stated I had a cerebellar tonsil herniation. She told me that it shouldn’t affect me and basically it’s all in my head, so I fired her immediately and went to a neurosurgeon that specialized in Chiari Malformation (after doing extensive research about what cerebellar tonsil herniation meant). Combined with the other symptoms I will further talk about in this post, with the herniated tonsils was too much to “be in my head.” I continue to have major cervical instability pain that makes everyday a challenge for me, but I have great days and I have bad days and keep progressing to hopefully a manageable pain future.
Memory Loss
In that summer of 2015 I began having severe short term memory loss. I used to have such an amazing memory and was quick to recall facts, names, etc., but now I was constantly arguing with my boyfriend at the time about things I didn’t remember. Where did I put my keys? Did I take my medicine? I couldn’t remember doing the most basic of tasks. It was terrifying. How would you feel if you couldn’t remember a good portion of your actions? I started having panic attacks because of what was happening.
Slurred Speech & Aphasia
In addition to the memory issues, my speech began to slur. I wasn’t even aware of the issue until I called my dad and he asked if I was intoxicated. I began to have difficulty speaking my thoughts. A sort of aphasia, I guess you could call it. I often confused words or had a difficult struggle in getting out my thoughts. Going from a scholar to this was extremely defeating. I was in what was supposed to be my senior year of college when this hit. It took a toll on my grades and my self-esteem. I was terrified. As we were formulating ideas (before the Chiari results of the MRI), we were thinking possible brain tumor. Was this the beginning of the end for me? I began to mourn the person I once was. I went from running 5Ks for fun to being a lifeless shell of my former self.
Migraines
The migraine were extreme. I’m talking full on nausea, ocular issues, light sensitivity. I basically lied in a dark room praying for it to end. I couldn’t open my eyes. The pain shot throughout my head and felt as if it were going to explode. I began to see a neurologist. I tried several anti-migraine medications: zomig, amitriptyline, rizatriptan, and others. The migraine were almost daily. I would have to miss class and basically laid there in agony. Too sick to eat, in too much pain to move. I currently am going through a remission of this symptom ever since getting pregnant with my son. It’s been a miracle from suffering so frequently to having them so rarely and I hope it’s something that will continue this trend.
Balance
My balance was beginning to become terrifying. I would suddenly feel as if I would fall over when walking normally. I was on high alert as I was afraid I may fall at any moment. It got to be so bad I’d use a walker to make sure I didn’t fall right before my surgery. I felt like this was an all time low in my health. Here I was. I was supposed to be a healthy, happy twenty-three-year-old and I was using a walker to get to my college classes. I was humiliated, but more so terrified for what was to come.
Nystagmus
Another symptom that appeared mysteriously was found at my eye exam. I ended up having vertical nystagmus that had previously not been seen. I later found out that it was a symptom of Chiari Malformation that had not been caught before. It was very slight, but sure enough my eyes made uncontrolled repetitive movements up and down. Nystagmus can indicate central nervous disease, so I was on high alert after I was told I had it.
With all of these symptoms coming in different waves, I knew it was time. I needed answers. I am tired; tired of the doctors juggling different diagnoses and medicines back and forth. It’s physically and mentally exhausting having to explain myself over and over and people not understanding half of what I go through; Not understanding why I can’t make it to their event and why it’s hard for me to confirm plans and how hard it is for me to put on a mask, pretending everything is okay. I’m tired of answering “I’m fine” or “I’m okay” because explaining that my chronic illness is eating away at me everyday is too long and difficult to mention. I’m tired guys.
I decided to email the doctor from Diagnosis and she led me to the online Facebook support group that aims at trying to diagnose you. And… I got my answer. All this time of not knowing and I’m fairly certain it’s correct and I mean that I am 90% certain. Ehler’s Danlos Syndrome (EDS) with Mast Cell Activation Disorder and Chiari Malformation, both side conditions of EDS. In the past I thought I might have this, but I was told there was no test for it and that is incorrect. I have all of the matching identifiers of this connective tissue disorder.
I couldn’t believe it. I had heard about EDS being in the spoonie community, but I had never really pinpointed it as the cause of my many issues. I took the Beighton Scale Test and I am a 8/9! I am making an appointment soon with a geneticist to have a blood test done and to determine what the odds would be of carrying on my Hypermobile EDS on to my son and future children. I can’t help, but feel comforted that I have a label now. Maybe the doctors will finally take my pain seriously with this diagnosis.
My future is uncertain, but I strive to be one thing: happy.
This past week has been an especially difficult one. I worked Monday thru Friday, which as a part time employee is a rarity. Getting through the week is an achievement for me with the much needed reward of a weekend of rest (for the most part, minus chores). I talked to my NS and it has been concluded that I need to have genetic testing done to determine if I have any underlying conditions. One suspect in mind is Ehlers-Danlos Syndrome.
Ehlers-Danlos syndrome is a group of disorders that affect the connective tissues that support the skin, bones, blood vessels, and many other organs and tissues. Defects in connective tissues cause the signs and symptoms of Ehlers-Danlos syndrome, which vary from mildly loose joints to life-threatening complications.
After talking at length with several members of my Chiari support group, it was suggested that I may be suffering from Ehlers-Danlos Syndrome (EDS) and that my Chiari might actually be a secondary condition caused by the EDS. I have suffered from frequent dislocations and sprains since the age of ten without much of answer as why. I have hypermobility of my joints and my skin has always been very smooth, but I generally develop keloids when healing from surgical incisions.
One condition that EDS can cause is Craniocervical Instability (CCI), or the instability of the craniocervical junction due to the lack of connective tissue support. The condition mainly occurs from repetitive stretch injuries of the neck (which can cause Chiari Malformation, nerve dysfunction, thickened odontoid capsule, retroflexed odontoid, and cranial settling [source]). Unfortunately EDS can only be managed and there are no definite treatments. CCI, however, may be helped drastically with a craniocervical fusion where the skull would be pulled upward into the correct position.
I’m not sure what the future holds for me. I have an appointment with the rheumatologist for additional testing on July 18th and I will be tested for EDS along with other rheumatic diseases to see why I am having this chronic pain. For now, I am back to wearing a soft cervical collar when I am not at work. It’s not the most fashionable of things, but it does provide a bit of relief. If you have to wear a cervical collar, too, you might want to try a collar to snazz your look up.
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