Josh Schmieg

At the end of April Josh injured his left knee when he stepped in a payloadder rut.  Due to his history with gout he went to visit our family doctor and they changed his gout medication thinking that it was no longer working.  


May 6th his knee was still not getting better so he returned and was sent to have an MRI done.


May 9th, while attempting to help treat a calf, the calf fell against him causing new pain in his left ankle. 


May 11th Josh goes to the orthopedic doctor to learn about the MRI.  He found a patellar year in the tendon of his left knee and planned for a brave for him.   While there Josh mentioned his ankle, but it was dismissed. 


After many days of pain and redness increasing in both his ankle and knee we decided to take Josh to the ER.  They attempted to aspirate fluid from his ankle.   They were unable to get fluid,  but believed that he had an infection so they sent him home with a 7 day dose of antibiotic (Doxcyclene)and a referral to podiatry.   Josh improved but still required crutches and pain in his left knee and ankle. 


 On Memorial day he spiked a fever again and we returned to the ER where this time he was admitted to the hospital for 5 days.   During his stay they put him on very strong antibiotics (Rocefin, Vancomicin, Zyvox) with little progress.   He was switched back to Doxcyclene (10 days)and high dose prednisone(21 day tappering) which began to improve his condition again and he left the hospital.  


June 17th Josh was doing much better.   He visited with many doctors including podiatry and made a plan to biopsy his ankle on Monday the 21st.  He was instructed to refrain from any ibuprofen usage or any other pain medication.   At his last appointment 3pmish that day he mentioned that his "good knee" (the right one) was started to hurt.  The doctor thought it was probably just an over compensation and instructed him to come back for his pre-op for the biopsy on Friday. That evening the pain and swelling increased to unbearable levels. 


June 18th he called right away in the morning to let them know that his right knee was growing rapidly in size (small cantalope) and that he needed something for pain.  At 5:10pm we finally received the prescription for pain medication.   At 6:30 after the pain meds,  his fever spiked to 102-103 and we again returned to the ER.  Once there they removed almost 50ccs of fluid from his right knee and determined that it and the left knee needed to be flushed.  He was taken to the OR and then admitted again for another week where he received the same strong antibiotics ( Vanco, Rocefin, and Zyvox) in addition to some very strong pain medications.   Though he was not feeling any pain,  he also did not appear to be getting better.  In fact he started to have pain and swelling in his right ankle and foot.   He continued to be a hard case to solve,  but the doctors (rheumatologist, orthopedics, podiatry, infectious disease, and the hospitalist) started to believe it was only pseudo gout.  So we made the decision to transfer him to the University of Minnesota in hopes of finding answers because many bright minds that love him believe there is more going on.