terrible awful no-good very bad knee

[TwoBadKneesUSA]

You have been through it alright.  I just have to add a snarky comment to the "too many appointments" thing.  "Well of course I just LOVE going to PT when I would rather be doing something productive!".  That comment just made me so angry for you.  I mean this would not be what most people would choose.  It might be worth a try to get copies of everything (I mean your own set) the you could forward anything to another doc.  I have a ton of mine for that reason.  Insurance can be a nightmare, not matter where it originates.

Milly

[mdk]

13 weeks post-op. Still doing absolutely terrible. Did some essential chores yesterday, like carting all my accumulated trash out to the dumpster, vaccuuming some dust, etc. I've been in blinding pain ever since..... dunno how I made it to work, but I haven't done a single thing since I got here on account of the pain just shutting my brain down completely. I haven't medicated yet, and since the military considers painkillers to count towards DUI, I'm not gonna be able to take anything until I get home anyway. Spent most of the day yesterday browsing online wheelchair stores, because right now and for the forseeable future, I'd welcome it if it would bring any kind of relief at all. But I'm not even sure that it would -- even just sitting in an office chair all day long is bad enough. I have an appointment tomorrow with my PCM, who probably won't be able to do anything to help really, and one more on Thursday with the OS. I have no idea how that one's gonna go. I'm about ready to lose it though. My "good" knee has been noticeably better, but still hurts pretty regularly -- I dunno if I just wrenched it real bad or something last week, but I'm well and truly terrified that I'm about to start this whole process over again. And then I won't have ANY legs left.

Anyway..... All my paperwork stuff is (theoretically) set in order, and I've got my own copy now just in case I need it. Speaking of paperwork, I have to revisit the DMV to renew my special parking sticker -- they screwed up my home address on the current version, so my temporary-temporary permit is gonna expire without ever getting the permanent-temporary permit. So now I have to get a replacement-temporary-temporary permit. Love it.

[Brambledog]

Oh mdk! Crap crap and yet more crap for you...

I'm gutted for you that things are still so bad. I will be keeping my fingers crossed on Thursday that the appointment with your OS actually results in something positive for you - not another op (toes crossed as well!) hopefully, but an answer to why you have so much pain... And some flippin' proper painkillers that work and aren't doled out like sweets to a naughty child  Honestly, these people just have no idea what living with this crap is actually like...

With regard to the weird temperature and colour changes on occasion, I'm so glad they've at least 'taken note' of it, but make sure you mention it again to your OS, just in case, you know, it might be *that* (lol at your code!) - getting the right treatment is key and if they are running out of ideas  it might just be worth asking to at least try one of the nerve calming drugs like amitriptyline or pregabelin to see if it makes any difference. Amitriptyline is pretty freely prescribed in the uk, I know loads of people who have had it or are on it, and it worked amazingly for me.

I think the 'good' knee panic is common on here... One automatic consequence of having a bad knee is that you immediately have to start punishing the other one - working it harder, at slightly different angles as you limp, for all the hard work stuff like stairs and bending down... Poor thing, it's hardly surprising it starts to suffer! But yes, it is seriously scary. I once spent a morning in blind panic sat on the floor in my hall - my bad knee was in no shape to push me up and my good knee had suddenly developed a blinding stupid pain through it whenever I put any weight through. I just could not get up. Rang people and no one was answering. I sat there and went through the range of panic - should I call an ambulance? What if I ended up in a wheelchair? What if this was IT now? What if my right knee was completely fecked? What if, what if.... Luckily a mate rang me back eventually and got me up and it eased off gradually, but that was a hard cold scary two hours. Glad yours is feeling so much better!

Thinking of you, keep fighting, and good luck this week.

Brams 

[TwoBadKneesUSA]

I think if we put together some of these stories we could make millions with a medical sit-com.  Geez!  Hope the OS has some good news for you.  Too bad you can't have proper meds at work.  Understand how that goes though.  Brother what a mess.  Get the parking permit fixed up right at least.  Hang in there and keep plugging away.

Milly

[mdk]

A few nonmedical developments today.

First, my biggest headache -- my stupid job with my idiot boss and my pain-inducing desk -- is gone. I've been somewhat-amicably fired from "Stan/Eval," which is a huge load off my shoulders. Probably not the *best* thing for me career-wise, but hey, I might not have a career for much longer anyway, so I won't complain. I go back into limbo-status effective tomorrow, which should give me a lot more freedom, and hopefully I land somewhere that makes a little more sense.

Second, I got to visit with the PCM. It was pretty much as-predicted, but I got some unexpected positive news too -- namely, according to this guy the fact that I've been on medical status for so long isn't necessarily a job-killer. Thanks to bureaucracy, the most recent surgery *allegedly* resets the clock. If that's the case, then I've got until January of next year to get better. Then again, this guy didn't seem entirely confident, so I'm not counting those chickens yet. But it looks like maybe I'm not gonna get kicked out of the Air Force maybe. That would be nice.

Third, the PCM and I..... disagree.... on how the painkillers should be used at this stage. He said "Wean yourself off." I replied "Well, I did already, and now it's so bad that I can't even hear myself think, so I need to be back on them." And he explained that "Well you're thirteen weeks out, so you're past that stage." And he would not be convinced that, actually no, I was not "past that stage." But whatever. I'm not trying to return to my drug dependency or anything, I'm taking them only a fraction of the times that I need them. And I'm not gonna stop because some guy who doesn't know what a Fulkerson is read his calendar.


Anyway, today wasn't a single bit better than yesterday pain-wise -- in fact they were kind enough to take pity and fire me nice and early, so I could go home and put some ice on it and eat some magic pills. If this trend keeps up...... well, no. I have my Thursday appointment, that's where all my attention is going from now on. Tomorrow doesn't even exist; it's all about Thursday, and the help I'm probably not gonna get. Sigh. Thanks for the encouragement.... I know I don't SOUND like I appreciate it right now, but I do, pinky-swear.

[Brambledog]

Hi mdk,

Well, in an ironic kind of way, phew. At least you have one less stress to deal with now, even if it did involve being somewhat amicably fired! Gives you some space to breathe and regroup ready for the OS and whatever transpires there...

Your PCM, with no respect to the guy whatsoever, sounds like a complete and utter tw*t (no, the missing letter is not an i). People like him are what healthcare is all about. Not. As you say, disregard his witless remarks, and carry on as you are until you see the surgeon. I hate that 'you should be here' attitude. People heal at different rates, and things do (duh) go wrong with surgeries sometimes. Dismissing intense pain out of hand is stupid and dangerous. He needs a kick in the danglies and we'll all see how he likes it for a while...

Glad to hear your status with the Air Force might be more positive than previously thought.... Fingers crossed for you on that one!

Keep at it. You're doing stormingly, all things considered...

Brams 

[Lottiefox]

Hi mdk

I hope the appointment with the OS tomorrow brings some answers. This isn't sounding right to me - something is not working correctly either mechanically or at a different level and it needs to be tracked down so you can start getting some function back and the pain down. Your PCM sounds like a complete and utter idiot. I am still needing pain medication for my CRPS in my foot a year after surgery. Do I like taking it? Nope. But gradually my symptoms are reducing and my foot is normalising - its a long process and I bash it into the ground at the gym every day literally to tell it to be a foot again. I could not do that without the right meds to let me make it work properly. The PCM should be kneecapped and then told to suck it up buttercup after 6 weeks.

Keep us posted

Lottie

[mdk]

Ah, the long-awaited follow up has been completed. Any help making sense of this would be greatly appreciated -- there's still a lot of blanks.

First and foremost -- new X-rays were taken on arrival. They show a more or less healed surgical site (I say "more or less" because it doesn't look healed to MY uneducated eyes -- OS says it's healed though). They also show some bone loss. In the OS's exact words, "I don't.... I haven't.... I mean I've never seen that before." I believe it's on the head of the tibia, but I could've been looking at it wrong. Why would that happen? Typically I guess it's a by-product of not putting any weight on your leg, but god knows I've been putting weight on it. As of now, there's no other explanation for why that would be happening, which brings us to....

X-rays are "consistent with" CRPS. However, as I don't show any other symptoms of CRPS -- ie, all pain is localized to the knee, all poking, prodding, stroking, etc. feels normal, there's no extreme hot or cold, no "burning" sensation, etc. -- this is basically a wild shot in the dark. I came equipped for the "RDS/Really Don't know S&!+" diagnosis, and when I asked all my follow-up questions, the OS admitted that this was basically the only box left on his checklist. Not exactly the level of diagnosis I was hoping for, but that's what I got.

The new plan is to return to PT and avoid any exercises that cause pain -- aka, return to PT and do nothing. Again, pressed him on this and he said "Well, NOT going to PT certainly isn't helping, is it?" I had to agree -- the last week and a half since the PTherapist called a break has been the worst so far. We'll be scheduling a "lumbar block" and generally assuming it's CRPS until the treatment inevitably fails to produce any positive results. As -- get this -- as an afterthought, while we're scheduling stuff at the desk, he decides why not, let's do an MRI too. I'm not complaining about getting one, I just sort of assumed that would be one of the first things you'd think of. I'm to stay on crutches and keep the brace until further notice; I stopped short of asking for a wheelchair because I still think that would look really awkward, to show up for work in uniform and on wheels, but I might bring it up with my PCM tomorrow, because the last thing I want to do is blow out my good knee on this OS's watch. It isn't that I don't think he'll figure me out, just that, well, then again maybe I guess it is that.

Oh, one more piece to the puzzle for your consideration is that, at the time of the surgery, all the cartilage seemed to be fine -- nothing that would appear to be cause for this level of pain.



Now, some questions to the community.

1. What else could be causing this? The problem really, really, truly FEELS mechanical, and the only mechanical thing I know of that we haven't checked out yet is a rotational issue.

2. What could be causing bone loss? I promise, I'm not gonna latch onto the first random disorder someone throws at me like a hypochondriac -- but legitimately, is there a possibility of maybe some previously-unnoticed condition showing up? I've had pretty extensive workups done in the past, cuz they don't let just anybody be AF pilots, but the bone doctors seem to be out of regular answers.

3. We're doing CRPS treatments as a diagnostic tool to see if I have CRPS. Are there any potential long-term side-effects of this kind of thing? Like let's assume I don't have it, and I get the "lumbar block" anyway.... am I going to suffer down the road because of that?

4. In general, how rough is CRPS treatment? Risks, rewards, etc..... What does this do to me in the near-term?

5. Someday soon, somebody is going to ask me how much longer I'm gonna be on the Air Force's disabled list. I know without a real diagnosis there's no such thing as a "ballpark figure," and I'm sure that if there WAS, the internet (even you guys) wouldn't be the place to find out what that ballpark-figure was. But if I had no choice, and I HAD to guess how long this might take -- and if I was to ask any of you what your guess might be -- what would you say? Three months? Six? A year? Let's pretend that CRPS is exactly correct, and the treatment works beautifully -- what's the FASTEST I could be done? Understanding of course that this is not going to be the perfect answer, I just need *something* to guess with.

[Brambledog]

Hi mdk,

Whoa. Really feel for you here, the 'lots of questions' state seems pretty reasonable to me.

Before I go any further, I want to tell you that I had a simple (ha ha) arthroscopy in August last year, and after a few months of bizarre pain, pt not working, muscle wasting etc, building up to colour and temp changes, burning and sensitivity - I was diagnosed with CRPS in my knee. So I do understand some of what you're feeling. And I have to say that following your story, I am sadly not hugely surprised that you've been diagnosed given your descriptions at times. Some of what you've said at times sounded warning bells, but only your doc can diagnose, and I'm glad in a weird way, that it's been recognised. I know you're still not sure, especially given the 'well it can't be anything else' but CRPS is a strange beast, and can indeed explain much of your woes...

The most important thing with CRPS is to treat it ASAP, because if got under control it can be well managed. See what the lumbar block brings, but if its what they suspect, I would push for a trial of either amitriptyline or pregabelin to see if they make any difference to your pain levels. CRPS treatment can be rougher 'down the line'. It seems that they start with the easier stuff like pills and only move up to the more complicated stuff if they don't work. Working with the 'risk/reward' thinking is not necessarily a plan here (just my opinion!) because NOT treating it is NOT an option. Left to itself and untreated, CRPS can be a nasty nasty thing. Seriously not worth it. Much better to treat it and get your life back to a large extent.

Re the mechanical pain feelings - I would have sworn 100% (and did!) that my pain was solely caused by something wrong with my actual bones etc. no way did it feel like what I would call 'nerve' pain. But within five days of the amitriptyline the pain was so much lower. I was so relieved, and couldn't quite believe it was the drugs. There are different types of CRPS pain, it's not all 'burning' pain. Sometimes it is deep and dreadful, but that is the type of pain that the drugs have helped most with. I still get the burning type of pain sometimes, but rarely the horrible awful pain I used to.

Bone loss - sadly, one of the things CRPS can do is to cause bone loss, in fact it's one of the symptoms on the list for the drafted condition. That and muscle wastage, and PT not being as effective as expected. Bone loss can come about due to lack of use too, but as you say, you've been weight bearing where you can, not off it completely for months.

Skin sensitivity, prodding etc. - I'm with you there. By and large, my knee is not super-sensitive to stroking or prodding. But if the CRPS has flared up then it certainly can be sensitive! Prodding still causes little pain for me. Doesn't mean it's not CRPS.

Hot and cold, colour changes - I didn't have these for the first couple of months, they only came in a little further down the line. One of the marvellous things about CRPS is that it is different for each person. There is a list of symptoms that you generally need to have a certain number of to be diagnosed, but those symptoms aren't there all the time.

Cartilage looked ok - well that is nothing but good. And CRPS can give you horrible pain even if everything in that joint is exactly as it should be.... CRPS messes with your sympathetic nerves that control colour, heat, pain, sweating, hair growth....my knee is shiny, feels tacky at times, goes odd colours, gets hot or cold, and hurts oddly at times. Even when I'm sat still. Very weird thing.

What could it mean for you? Well, if they can get it under management with regular medication, then the awful pain will subside. That means you can actually do the PT. That will strengthen your muscles and allow you to weight-bear easier. All of which means that you could be back to much more normal activity - but I can't suggest a time-span, because everyone is different. You've had surgery that I haven't, you have a different knee, etc. What I will say is that in the five months since my drugs started working, I can now walk without crutches (still a bit slow, but loads better), my quad muscle is strengthening at last (although leg is still skinny), I can stand for an hour now (still swells a bit though) and I have started rowing at a club near me. I am starting a small business that allows me to work the hours I choose in a manner that suits my knees, lol, and generally life is vastly improved.

Treating CRPS won't solve all your knee problems, but if treated then you can sort of peel off the cloak of the CRPS effects, and tell what state your knee is mechanically in. If CRPS is what you have, you might be pleasantly surprised at how much better it is than you think! Especially as that surgical site on the bone looks good.

In a strange way, mdk, this could be a good thing. Much better to have something that has been diagnosed and can be treated, than to be in a world of pain that cant be controlled and not knowing why. CRPS is pretty crappy at times, you get flare-ups, bad days, etc., but mostly if it's treated you get your life back. Once it is under management, do as much as you can that is sensible, and you can keep the thing mostly in its box!

It is very important to keep that knee moving. Doesn't have to be loads, but just small movements are better than none. CRPS doesn't like sitting still for long periods. Even just bending it a bit, or flexing that quad helps. And keep touching it as often as you can without looking like a weirdo as it helps with the skin sensitivity, blood flow etc, all of which are messed with by the CRPS.

One thing CRPS does not like is surgery, so if you do have it it is much better that it has been recognised. There are things they can do at the time of surgery (and after) to minimise problems afterwards. Cutting into a joint that has CRPS risks aggravating the condition, and healing, pain management etc are all affected. If they know what they're dealing with it is a LOT better for you as a patient. Plus, because CRPS can cause such nasty pain, if you've been diagnosed then docs are much more sympathetic about pain meds - better than the 'well you shouldn't have that bad a pain with your surgery so go away' reaction that too many patients get.

Hope I've helped with a few of the questions. If I can be any help then do PM me.

Take heart mdk, at least you're getting somewhere with this now.

Brams 

[mdk]

It is now official -- paperwork is being initiated to proceed with a "Medical Evaluation Board," the purpose of which is to determine whether or not I am fit for duty in the military. Answer is probably no. I should be scheduled soon for an appointment with the VA to determine exactly how disabled I've become thanks to all this, and how much compensation I might be eligible for should the board decide to separate me. Possible outcomes are (a) declared fit for duty -- since this is a long process, sometimes in excess of a year, this is technically possible, but I'd call it pretty unlikely; (b) placed on "Temporary Disability Retired List," or TDRL, for up to five years or until the condition has stabilized. This seems like a likely option; of course, there's always (c), medically separated, either with severance pay or permanent disability compensation, since the initial injury occurred in an official capacity during combative training. I'm fortunate in that, I suppose -- if this had been, say, a motorcycling accident, I might not be entitled to anything at all.

I imagine I'll learn more as this process goes on. For now, at least, it's strangely liberating. A while ago I made an analogy for this whole nasty situation, that it was like getting stuck in the Lincoln Tunnel for a year on your way to New York City. Obviously the best possible solution would've been to continue on through, and get to New York, because who wants to turn around and drive back to Jersey City? But what I've learned from the experience is that, you know, say what you will about New Jersey, but it beats the hell out of the Lincoln Tunnel. Every tunnel in the world has a light at both ends, and just because it's not the light I wanted to see, doesn't mean I don't appreciate the illumination. So I'll manage. I thought I'd be disappointed to hear that my career is probably ending before it really got started, but the truth is, I'm just tired of being where I am. If this door closes, I know another will be opened.

[TwoBadKneesUSA]

That is the positive spirit you need! Hope the review turns out positive for you. As you said at least it was a active duty injury so that would likely be in your favor disability wise.  Hang in there and who knows maybe by the time the buracracy (sp?) turns, things may start to feel better?  Take care.

Milly

[TOMMAX]

MDK,

I know its heart breaking that all of this could be a career breaker but I think health comes first and that should be top priority. The fact that the AF would be able to pay you for up to 5 yrs for disability is not a bad thing, it could be worse like you said, could have crashed a bike ouside of duty and they wouldnt give you squat. But this could be the proper thing in order to get your life back together, a blessing in disguise as some may say.

Im not in your body/knee but I think if your problem is so localized, how could it be CRPS? If you google or talk to people that truley do have CRPS it is pretty wide spread and usually accompanies a number of deformities, color changes, and other abnormalities, none of which you seem to have (to my limited knowledge of your situation).

Honestly, Im not in your body obviously, only you know how your knee felt pre injury, after the intial injury, how much time you gave it in physio before having your first surgery, then second surgery. My personal opinion, coming from a pure laymen/ fellow struggling patient and Im going on a hunch here, is that either 1)you didnt give physio and healing enough of a chance before your initial surgery and you might have had an unnecessary surgery to begin with 2)the lateral release was unnecessary and caused more problems 3) the TTT was unnecessary and caused even more problems. From my experiences and what Ive gathered from a few others in my travels is that there are many unnecessary knee surgeries performed each year that are either useless or create more problems. I believe many surgeries can be avoided with conservative methods in the first place. It seems the routine course for surgeons with limited knowledge is 1)cleaning up the knee, if that dosent work 2)Lateral release, if that dosent work 3)TTT, if that dosent work than maybe more cleaning or the doctors give up. Now this is just a trend Ive noticed from the limited knowledge and experience I have as a patient but its my opinion, take it with a grain of salt because Im  just a man looking for answers just as you are. It is possible that you may have had all the correct procedures and just need more time for healing though.


Lets see what we do know. Your knee is messed up. Your using PKs (theres no shame in that btw). Its bad enough to want/ need to use a wheelchair. Work/ AF is blowing you off. So what can you do, what is possible?



Im going to use my favorite parrot line that I use here all the time, try to find a PF specialist close to you or an OS that will check for all abnormalities from hip to foot. The good ole CT rotational study as they call it. The one that addressess the femoral and tibial torsion, TT-TG offset, trochlear groove depth. A skilled surgeon that can do all of the proper testing to see if things are in the right place.

Do I think you should jump into another surgery, hell no, for all we know you might heal up just fine in the next 3-6 months, for some people healing can even take about 12-18 months. The general rule of thumb amongst doctors though is that after 18 months things will not usually improve much beyond that point although they still do probably slightly. But by 18 months post op you should be a good 80-90% healed.

If you need to use a wheel chair for the time being, I see no shame in that and youre a young man and if that is what you feel you need than use it. I think one of the most important things at this point though is to get the proper clinical evaluation, xrays, MRIS, CT Rotational, etc. Just to get an opinion. An opinion dosent hurt. You dont have to jump in to surgery. Just an opinion. Hell, your leg could be twisted 180 degrees in the opposite direction and nobody could force you into surgery, it is ultimatly your decision. I am a conservative man so I take my time to see if things work out naturally, others are looking for a more immediate fix. There are so many factors, it all depends on the person and all of the variables that accompany the situation.

Thats just what I think. It is tough to give good advice to people over the internet, but we still try to help anyway. I dont know what else I can tell ya but Im hoping youll be able to at least get a great specialist to look you over and give an opinion and for you to work hard toward your health, regain it, and follow the hopes and dreams that you have ahead of you.

[mdk]

Im not in your body/knee but I think if your problem is so localized, how could it be CRPS? If you google or talk to people that truley do have CRPS it is pretty wide spread and usually accompanies a number of deformities, color changes, and other abnormalities, none of which you seem to have (to my limited knowledge of your situation).

I disagree with the diagnosis, but I'm willing to try. There have been periodic color changes and a few instances of the symptoms -- who knows, maybe there's even just the earliest stages of it. I have no reason to rush anymore; the minotaur is dead, I can focus on solving the labyrinth. Might as well give the CRPS treatment a try -- worst case scenario, we rule it out, right? If it's even a possibility it's worth checking out.

But let the record state, I don't think it's going to be solved/explained by CRPS.

Honestly, Im not in your body obviously, only you know how your knee felt pre injury, after the intial injury, how much time you gave it in physio before having your first surgery, then second surgery. My personal opinion, coming from a pure laymen/ fellow struggling patient and Im going on a hunch here, is that either 1)you didnt give physio and healing enough of a chance before your initial surgery and you might have had an unnecessary surgery to begin with 2)the lateral release was unnecessary and caused more problems 3) the TTT was unnecessary and caused even more problems.

Without bandying too much, I regret nothing. My decision-making process has been driven by the very pragmatic goal of getting back into a cockpit. From the outset, I said I'd do whatever it took to give me the best chance of making it back up to speed, even if it meant taking some risks and making some sacrifices. So I'm paying a price.... so what? It was a good bet. I guess that's all I really have to say about that. I'd do it all again, hell, maybe I'm about to. Worth it. When they talk about me someday, they aren't gonna say I was too scared to act. Too dumb to know better, maybe, but I made my choices and I can live with that.

try to find a PF specialist close to you or an OS that will check for all abnormalities from hip to foot. The good ole CT rotational study as they call it. The one that addressess the femoral and tibial torsion, TT-TG offset, trochlear groove depth. A skilled surgeon that can do all of the proper testing to see if things are in the right place.

I believe that's exactly what I'll do.

If you need to use a wheel chair for the time being, I see no shame in that and youre a young man and if that is what you feel you need than use it.

I'm gonna fight that one just a little bit longer 

[knee2no]

Bone loss = disuse osteopenia.  Many of us have this even without RSD.  If you dont use it ,you lose it best explains what is happening.

I dont understand how amitriptyline/elavil is used to treat the condtion. This is an antidepressant but maybe as a secondary use?  I can see the need for an antidepressant in this circumstance.   

[TOMMAX]

Without bandying too much, I regret nothing. My decision-making process has been driven by the very pragmatic goal of getting back into a cockpit. From the outset, I said I'd do whatever it took to give me the best chance of making it back up to speed, even if it meant taking some risks and making some sacrifices. So I'm paying a price.... so what? It was a good bet. I guess that's all I really have to say about that. I'd do it all again, hell, maybe I'm about to. Worth it. When they talk about me someday, they aren't gonna say I was too scared to act. Too dumb to know better, maybe, but I made my choices and I can live with that.

Totally understandable and I feel that getting back to flying was/ is really important to you and there are time constraints and such, theres always some kind of pressure in life that challenges us to do things and strive to meet our goals and make sacrifices. Im just glad you have no regrets, I think thats important in life and not all can say the same about their situation. Life has its lessons and now you have gained the knowledge to seek out the proper care. I look forward to things being sorted out for you and I think you have a chance to set things right. Good luck, hang in there, and keep fightin.

knee2no, many chronic pain specialists adminster these types of meds (amytrip/ gabapentin, etc) in their arsenal to treat chronic pain, neuropathy's, and issues such as CRPS/ RSD. I do not understand how it is helpful either but at one point early on after my botched knee surgery, at about 6 months post op when I had extreme razors/ burning pain, they put me on these drugs along with percocet but it was not helpful at all for me. I am glad others are finding relief with it though.