Just got back from the doctor, and the x-rays were fucking normal. The verdict: Patellofemural Pain Syndrome.
Why do I say "ugh"? Because it means they can't fix it with surgery, won't go in with a scope to see what's under the kneecap, won't spring for more effective imaging than an x-ray, and pretty much the only treatments available are the ones I've already been using with less than spectacular results. Those treatments--taking painkillers, walking to relieve the discomfort, and applying ice--are either inconvenient or of questionable effectiveness.
How much does it hurt? Well, speaking as someone who has given birth to an 11+ lb baby the natural way, this latest flare-up--at its worst--hurt as much as early to mid-stage labor. Only you don't get that couple of minutes between each wave of pain--it just hurts all. The. Time. And it isn't dull or throbbing, either. It's like someone is jamming a knife under your kneecap.
All. The. Time.
The swelling is disturbing. The heat of the inflamed tissues, even immediately after you take the ice pack off, is alarming. Advil (even twice the maximum recommended dose) does not touch this pain. Codeine is its bitch. The only things that have worked for me is walking, and ice. Unfortunately, I can't even use this as an excuse to take time off work--being a waitress means my job is like physiotherapy.
Not being somnambulatory, I am left with one option at night. Every three hours or so, my knee wakes me up to let me know my ice pack needs changing. The walk to the freezer is a welcome relief, and by the time I return to bed, I can usually almost stand it. Sometimes, I need to walk circles in the living room for five or ten minutes before I can lie back down.
Of course, this flare-up could not have happened at a worse time. Sitting hurts. Driving is excruciating. Driving six hours so I could sit through my cousin's wedding ceremony and reception dinner was agony, even with an inexhaustible supply of ice from a cute bartender at the reception, and enough codeine to drop a bull elephant. In spite of all that, I managed to have a wonderful time. My cousin was handsome and charming, his bride beautiful and gracious. The ceremony was short and sweet, the venue stunning, the weather glorious, the food delectable and--most importantly--the bar open. Wild horses stamping violently on my bad knee couldn't have dragged me away.
That was more than a week ago. The pain and swelling have mostly subsided now, but the doctor gave me a prescription for naproxen sodium to take the next time it acts up. Of course, after looking at the list of side-effects in the product monograph, ice is looking better all the time. Generally, ice doesn't give you intestinal bleeding, heart attack or stroke.
But ask me again during the next flare-up. I'm notoriously fickle when I'm in agony.