Random Thoughts of a Disordered Mind

The Knee’s the Thing


X-ray of an Arthritic Knee (not mine)There’s good news and bad news from today’s visit to the new orthopedist. Good news: very prompt, almost no waiting. Bad news: he is a joint replacement specialist.

Good news: He didn’t dismiss me or my problem as being caused by obesity. I was worried about that, actually, and did volunteer that I knew the excess weight was not helping. Which he agreed. But he didn’t say that surgery was impossible until I lost weight, and he didn’t yell at me for being so heavy when my joints were suffering. Clearly he’s been here before with other patients. And he understands that it’s hard to exercise when every step, every rotation causes pain. He also approved of my current meds, including the infrequent Percoset for pain.

Bad news: I need a knee replacement. There’s really no other solution given the bone-on-bone nature of my joints, especially the right one, which is the biggest problem right now. I’m not a candidate for Synvisc, which I’ve had several times before. My only real temporary alternative will be cortisone injections every 3-4 months until I’m ready for the surgery.

More bad news: Losing weight between now and surgery will undoubtedly help. If I am considering WLS, I should probably schedule that before a knee replacement, since it will make knee recovery easier. And the longer I can postpone the knee surgery, the greater the possibility (but only the possibility) that it wouldn’t need a revision (i.e., “do over”) in my lifetime.

Contributing factor: I’m still in my first year of my new job and my saved up vacation and sick time is minimal because, well, I haven’t been here long enough to earn much (*thinks wistfully of the 130 days of sick leave I had to leave behind*). Knee replacement surgery will require a minimum of six weeks out of work because you can’t drive for 6 weeks and I have no other way to get to work. If I have WLS, too, I have to factor in the time needed for that surgery. It would be a lot better if I could just get my act together and lose weight on my own.

Good news: I don’t have to do anything right now. I am the one who will decide when it’s time. I got a cortisone shot and that will help short-term. I also got a pedicure which did nothing for my knee but gave my spirits (and my toes) a lift.

7 thoughts on “The Knee’s the Thing

  1. I SO sympathize. I’m awaiting an orthopedist appt. myself. Pretty much the same problem(s) you describe. Although, thankfully, they aren’t talking knee replacement (yet).

    Currently, I have self-diagnosed fluid on my “bad” knee and anticipate a drainage of that and a cortisone shot. Both of which are nasty in the moment, but quite helpful for a while afterward. Unfortunately, my doc’s on vacation this week and I couldn’t get in until the following Friday, so it’s limping along I go for now.

    If you find the magic formula for making all of this inspire you to get on with it and lose weight, be sure to let me know. So far, even this problem hasn’t been enough to get me going. 😦

    Good luck with your knee.

  2. Glad to hear that the doctor treated you with respect, though it’s too bad that’s not just expected. Sounds like you have some time to think things over and store up some sick leave.

  3. So sorry. And it SUCKS (my new phrase living with teenagers as I do) but you might find comfort that it is definitive – at least you know and are not living in limbo.

    Glad that you have good docs.

    there are probably ways around the driving – lots of services out there. you might find a stay at home person or retired person that would be glad to help in exchange for $ – by word of mouth or watching ads or yellow pages.

    There is a kidz cab service here – for working moms that had kids with routine ortho appointments, etc. My mom has a whole list of services available to drive her husband when she is not able.

    And if you are not driving – you are not spending $ on gas – so it might not be as expensive as you think.

    or you might find someone else that needs help another time – and will just trade you services.

    hugs to you as you deal with all this.

  4. Anne, I just finished reading an update in the NYT by Jane Brody and her knee replacement. It’s good reading. (It’s in the health section.)

    First up, I’m glad your doctor was good to you; you already hurt so I’m glad he treated you well. I’m just sorry that the news was so grim. I’m glad you don’t have to make any big decisions right away.

    In our area and you know we are kind of a mix between rural and urban, we do have bus service for the handicapped, elderly, and out of towners. There might be one in your neck of the woods. That might be one solution to your transportation problems. Also, would you qualify for short-term disability with the surgery and that might make a difference with your leave? It’s just a thought because all businesses and agencies, etc. are different. (Oh, and there might be a leave bank available at your institution.)

  5. Another knee pain/problem sympathizer chiming in here! I have horrible horrible knees and had surgery about the same time you did in 2006. I know that someday I’ll have to face knee replacement and in some ways that will be a relief because I’m told that it’s like all new knees — in fact, I know some people who had replacement around the same time I had my surgery and who healed MUCH faster than I did.

    I know it’s very hard to lose weight when you can’t exercise due to pain, discomfort or instability (that last one is my major problem now) — for me, it is close to impossible. I also know that my knees have been MUCH happier since February when I started to lose my weight again. So…order of surgery if you have to have two sounds right.

    If you have to do the surgery (either one) like the others above, I think you might be able to get around the “no driving” rule…I couldn’t drive for 3 months back in 2002 due to a back problem and managed to get to work and PT, etc. most days via friends, cabs, etc. It was hard to ask for help, but it was a good lesson for me. There is no way I could afford to be off work for 6 weeks so I had to figure out something!! 🙂

    Thanks for mentioning synvisc…I never heard of that…wonder why my orthos never mentioned it to me. I’ll have to check at my next appointment.

  6. I am 56 and just had my right knee replaced on February 23rd. I was off of work for 6 weeks. I live alone and have no family or close friends to help. I did this completely on my own with a nurse coming in twice a week to monitor my coumadin and a physical therapist twice a week for therapy. My insurance covered both. After the 6 weeks, I went to outpatient therapy twice a week for 5 weeks.

    For several weeks I have been back to walking my 3 dogs for the same distance as I was before I began having knee problems. No more pain. I also had bone on bone and nothing helped. If I had it to do over, I would have the surgery as soon as possible.
    It is so worth the few months of recuperation.

  7. Well, for me it isn’t a knee, just an ankle. Just an ankle…mm if is was just that simple. 30 pounds overweight doesnt help any. Ok, so I didnt need surgery, only a splint and boot for 5 weeks. That threw my whole alignment off. So anyway, I was very appreciative of the day when I could wear my gymn shoes and go walking. I never enjoyed the benefits of walking before. I had my yoga class Sat morning (I take yoga 1-2 times per week no matter what.) But Sat morning I noticed that in one of the stretch poses, I was extremely tight on the opposite side of my fx ankle. I worked slowly into the pose, not pushing it. So then I went on with my busy day, vaguely noticing tightness from my rump all the way down to my heel. Now Im walking funny and my healing ankle is beginning to ache. I go to bed, but when I got up to go pee pee, I jammed my toe (the side with the aching leg) on the leg of a table. I went back to bed. When i got up in the morning, I was limping on both sides of my body. My toe is black and blue and very sore, my leg is hurtin butt to heel now my tail bone and hips are hurting, and my ankle is aching. Also I got on the scale and found a 3 pound gain. I feel like a 55 year old basket case geriatric mess! The moral of the story is: dont have injury #1 because it leads very quickly to #2,#3,and #4.

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