Mobility Then and Now

When I moved into my apartment, I had full use of my legs. My right leg had foot drop problems, but I used a cane to remind me to just lift the foot higher when I walked. Things were unboxed and hung or stored in the apartment the way any of you would do it – some high, some low. I could bend down or stand on tiptoe if needed to get something.

I came home from rehab in a wheelchair and everything was wrong. Things got moved around so they could be more easily reached from a chair. Example: nothing on the top shelves of the fridge. Lots of clothes were stuffed in the dresser so I could avoid navigating the closet in the chair. Glasses and cups were left on the counter so I could reach them instead of putting them away in upper cabinets.

This weekend I discovered what it was like to navigate the apartment using a walker, and it was hard. I couldn’t bend down to get things I could easily reach from the chair, and things that I could reach made me feel unbalanced when I let go of the walker to reach for them, even with one hand. Feeding the cats and cleaning out the litterbox aren’t possible using the walker; I just can’t get low enough to be safe.

I can’t bend and keep my balance, which is precarious. I’ve been afraid for the last three days that I would fall as I used the walker even though using it is a step in what should be the right direction. I’m much more comfortable with a wheelchair now after using it for 9 months, though I still despise the temporary one that I will be able to ditch today when my new one comes. I have questions for therapy that I didn’t know to have about how to navigate this new normal of using a walker for primary mobility while still feeling and being safe.

So naturally I had a hair appointment and dyed my hair purple. “Lusty Lavender” is the color, but it’s really, really purple. To be honest, it’s more than I expected or wanted, but it’s what I got so I’m going to embrace it – and wash my hair sooner and more often than really you should when you get color if you want it to stay vivid, which I don’t. We’ll see how it goes.

The Knee – Second Opinion

You go for a second opinion for a bunch of different reasons. Maybe you don’t trust that you got full information from the first person. Maybe you want a different explanation of something complicated that you don’t really understand. Or maybe because what’s recommended is big or expensive or complex and you just want to hear if someone else agrees with it. I got mine for all of those reasons.

My problem is a torn Medial Collateral Ligament (MCL) on the right knee, which already had a total knee replacement. The MCL on the inside of the knee and its partner the Lateral Collateral Ligament (LCL) on the outside act together like hinges to keep the knee stable and not wobbly. Tearing one makes the knee unstable and left me prone to falls. I’ve learned not to straighten my knee completely when I walk or stand which helps a lot, but at night it straightens as I sleep – and the movement wakes me up with pain. And I’m afraid of falling.

I tore the MCL in May 2020 and saw my primary care doctor a few days later. I got x-rays and not much else, but at the time we thought it was a sprain. But it didn’t go away and I got very fall-prone. In August I saw an orthopedist who did more x-rays and confirmed I had a complete MCL tear, which is only corrected by surgery. Since I already had a knee replacement, we were talking about a revision surgery, which meant replacing the replacement. It’s a big surgery and not something to jump into without a lot of thought. Plus he also told me that I couldn’t have it anyway until my BMI was lower than 40. He also sent me to get a custom brace which I didn’t actually have in hand until just after Thanksgiving. It’s large, cumbersome, and the velcro on the thigh portion rubs the inside of my other thigh too much for me to want to wear it. So I’m not.

Then I fell a month ago. You remember that, right? It was fun. I sprained my foot and twisted the knee, and decided it might be a good idea to get a second opinion about what was actually wrong with it. That appointment happened this morning with a knee and hip surgeon at Azalea Orthopedics. They took more x-rays, then talked to me about what’s happening.

Yes, I have an MCL tear. And you fix it with surgery. But having already had a knee replacement, what I would need is not just revision surgery. It would involve a very long and complex surgery to take out everything there and installing a new joint with a hinge. Part of the femur would be cut down. It’s not a long-term solution and if it failed in a few years, it would mean amputation. So it’s not something he recommends for someone young and healthy. He said I should take the idea of it off the table. He had me at “amputation.” He also showed me on the x-rays why he suspected that the MCL was already compromised, possibly even from the original surgery. While we couldn’t prove it, he was concerned that a second surgery might not be successful.

What he DID recommend was a knee nerve block for the pain and physical therapy. I had asked the first doctor for a PT recommendation back in August but never heard back. I left the second doctor’s office with a PT prescription for 6 weeks of 3-4 times a week of therapy. I also got the name of the specific nerve block he said should solve the problem of nighttime pain. It might only work for 6 months but hey, 6 months is 6 months. I see my pain doctor soon for a follow up so I’ll ask him about it. If it’s not a procedure he does, the folks at Azalea do.

My biggest fear going into the appointment was that my weight would be a factor. Turns out the doctor doesn’t think surgery is the right choice for me no matter what my weight is. He explained that larger people have greater risk of infection following surgery because they have more surface area to infect, and therefore a greater possibility of implant failure. Orthopds use BMI as a cut-off because they want surgery to be successful and infection is to be avoided at all costs.

This second opinion visit was definitely worth the trip. I understand what’s going on in the knee far better than I did after seeing the first doctor. I didn’t want surgery anyway but man, I really don’t want it now. And I know why.

What’s wrong with this picture?

At first glance it’s that one foot has a slipper and the other just has pretty red toes. But what’s really wrong is that I’m sitting on the floor. And not on purpose.

My right knee has been wobbly since I tore my MCL back in May, throwing my balance off. The right foot has neuropathy from spinal stenosis which began 18 months ago. And I’ve been dealing with back pain with injections and nerve burns but my right SI joint is still a mess. In fact, I was supposed to get an injection in the joint yesterday until they rescheduled the appointment.

So in a way I’ve been expecting to fall. At least yesterday I was inside when I lost my balance and crashed to the floor – the carpeted floor. There were chairs for leverage in getting up. Oh, did I mention that both knees were replaced 8 years ago? Kneeling is like being on broken glass, which is why getting up is so difficult. So having pillows to support the knee helped, though my first attempt to get up did something to my right foot (naturally, the right side again) and I almost cracked my head on the brick hearth. The next attempt was successful and didn’t cause any more injuries.

Being a klutz, I know the R-I-C-E routine of rest, ice, compression, and elevation and always have several ice packs in the freezer as well as frozen peas. I iced both foot and knee last night but by this morning, I could barely walk on the foot. I don’t think anything is broken and suspect it’s just a sprain but am going to the doctor later today to get it checked out to be sure.

I need a better plan for dealing with possible falls since I live alone. Using a cane, at least until I can have knee surgery (after I lose enough more weight). I’m giving a house key to the security guard and making arrangements with friends I could call if/when this happens again. My upper body needs to be stronger and I can work on that with weights. I need to think about some kind of alert system, though the idea of being that “I’ve fallen and I can’t get up!” old lady is hard to swallow. But the idea of falling and not being to get up is even worse.

Nooming along

As of this morning, I am three pounds away from reaching my next goal of 50 lbs gone. Which means, if you’re keeping track, that I’ve lost 47 pounds since January 1st. I had a little hiccup and gain of 3 lbs which in the scheme of things isn’t that much, but it’s taken me another 3 weeks to get rid of them. I want to hit my goal of 50 lbs by July 24th, which is my birthday.

I’m still following Noom but admit I’m not exactly doing it the way I did when I started. I still weigh every morning which is actually a good thing; I don’t get freaked out by what’s there, just log it as information. And I still take measurements on the first of the month (for the record, I’m down 20.5 inches overall). And I log my food. But I don’t always read the articles which are still interesting but take more time than the ones at the beginning.

And I really try to get my steps in. That was very hard when everything was locked down for covid and the gym was closed as well. It has reopened but I haven’t tried it yet because I sprained my knee and have an insanely painful lower back right now. Just walking is as much as I can do. But this week I did actually get 8K steps one day and almost that much the next day, from walking around large stores like Sam’s. Up and down the aisles, moving fast because I don’t really want or need to buy anything in most of them. My Sam’s trips are limited to when I have prescriptions to pick up; then I get extra stuff as long as I’m there, things like berries, apples, broccoli (always broccoli) and maybe English muffins or meat.

I’m also not really doing much with my Noom group because it’s annoying to see so many posts from other group members who ride horses, do aerobics, and other energetic things that I don’t do. I have a LOT to lose, really more than anyone that I know of in my group. Mostly it’s because I’m in 2 unofficial Facebook groups for Noomers, one of them for people with 100+ pounds to lose. We have different issues and time frames, and I’m finding that one to be the one where I get the most support and can contribute.

Maybe I’m just feeling like a normal person. Normal people don’t eat a whole pizza for dinner after snacking all afternoon and noshing on donuts in the morning. And I’m not doing that anymore. I’ve learned to divide my calories really into 3 big groups + a snack, and then I’m ready to stop. I’ve learned how to tell when I’m hungry and when I’m bored. I’m drinking tons of water and am down to 1 soda/day and no coffee. I’m really hyper aware of not referring to things as “treats” or “cheating” because there is no such thing in Noom. Chocolate, while delicious, isn’t a treat now, it’s an occasional food that I fit into my plan. I’d really rather have a French Dip sandwich and enjoy it for lunch and then eat vegetables for dinner.

What I am is balanced. Part of why that’s happening is that these last pounds have come off so slowly, giving me time for my brain to catch up with my body. When I lost fast in the past, that was very hard to do because I thought I was the same person. Well, I was. But I’m not now. I’m more aware and prepared. I haven’t faced big challenges like parties but I’m confident that I can deal with them when they arise. Go Noom! Go me.

Taking My Balance to California

BalanceI leave for California on Saturday to attend a computer users group conference.  It’s one of my favorite events and I’ve attended every one since this started in 1993.  We’ve grown from a group of 300 attendees to 1800 at last year’s meeting.  This year, though, because of the economy and tight budgets, I know that attendance will be down, but it will still be a fun and productive time.

What comes with it, though, is 6 days of eating in restaurants.  I know how to do this but admit that I’m nervous of upsetting my still-new-feeling balance with healthy eating.  Airport eating is particularly hard because I want to eat everything not nailed down.  There’s something weird and “out of place” about airport waiting areas that just make me want stuff, plus there’s a 3-hour time change on this trip on top of having to leave the house at 3:30am to get to the airport in the first place.

I’ve been checking restaurant listings on the local arrangements website to see what kinds of options are available and likely to be visited, and checking foods in the WW book to get an idea of points values.  But really, how hard is it to make good choices – assuming they are available to find in the first place?  I’m bringing some Fiber One peanut butter bars to throw into my bag so I have an alternative to pastries and cookies out for breaks and snacks, and I’m hoping there will be fruit around.  It’s California so hopefully that won’t be a problem.  Maybe I can take a cab to a little market to pick up some stuff after I arrive.  We’ll see.

I just want to be prepared but not so rigid that I can’t enjoy myself with friends while keeping boundaries around this balance that I’ve rediscovered.  To get myself started right, I’m going to a WW meeting on Friday night before I pack, throw some good options in my bag, and not beat myself up if I slip.