Wednesday, April 12, 2017

Hyaluronic Acid Injection for Osteoarthritis in Dialysis Patients: My experience



To address the first problem among the two I mentioned here, I got an injection of Hyaluronic Acid in my left knee yesterday. The thought of getting an injection in the knee can be quite disconcerting even for a dialysis veteran like me who gets daily injections in his left upper arm for dialysis. I had all sorts of questions. Would the needle be put into the bone? How big would the needle be? Would they be giving me a local anesthetic? Would the entire experience be painful?

I was called to the hospital at around 4 in the evening. I reached there promptly. The injection was called Synvisc One. The Orthopedic Doctor was to administer it. He had done this many times and was very confident. He first cleaned the entire left knee with Betadine (Povidone-Iodine solution). He then injected good old Lidocaine. I use this for my dialysis too just before inserting the needles. For this procedure though, he probably inserted a whole lot more than what I do. I couldn't see what was happening because I was asked to lie down and all the action was happening in my knee.

The next step was to put in a needle and position it carefully so that it is in the knee joint. For this he inserted a syringe and then drew the piston. If blood came, the needle was not in the joint. If clear fluid came, then it was in the joint. The first time, only blood came. He then tried repositioning it. Blood again. Every time he drew the piston of the syringe, I felt some pain. It was not unbearable. It was more like a momentary shock. After about three such tries, finally, he got the needle into the joint. He quickly removed the syringe leaving the needle there. He inserted the syringe that was prefilled with the 'miracle juice' as he called it and inserted it into the needle and pushed all the contents into the joint. He removed the syringe with the needle. It was done!

It was a tough task. The Doctor was brilliant with it. To insert a needle into the joint without anything to guide you is like shooting at a target in the dark. He kept assuring me, talking to me and calming me down. I love such doctors.

Yesterday evening, I had a lot of discomfort. The knee joint felt very stiff. I found it difficult to walk. After a while, I became very restless. I couldn't sit still. I tried to distract my mind by watching a movie. The knee wasn't painful at all. It was just discomfort and restlessness. I took a low dose sleeping pill and went to bed.

Sleep was quite disturbed. I kept waking up due to the restlessness and discomfort in the knee. I had a final stretch of good sleep though and woke up feeling refreshed and much better than last night.

Overall, I think the entire experience of taking the injection was not painful. I would call it 'discomfort'.

The Doctor said the injection would take 4-6 weeks to kick in. I hope this resolves this knee pain, at least for a year.

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