Disintegration… and Hope

That’s been my thought for the past week or so. We’re all disintegrating, you know that right? We can fight it (and most humans do,) but its relentless. Time marches on, and bit by bit, our bodies crumble.

Geez, debby, I can hear you say. What got into you? We come to your blog for a bit of sunshine and some good recipes. Wellllll, its like this. In November, I had had it with my knee hurting all the time, not being able to bear weight on it when I step out of a car, losing sleep because it aches when I lay down. I was ready to give those gel shots a try. So I started trying to call my ortho doc and get an appointment. Many thanks to the insurance system, I had to jump through a couple of hoops to get to him, so I finally saw him in early December. He agreed with me on the gel shots, and put through the request to the insurance company that day. More insurance hoops and hoopla to jump through, yada yada yada, and I still had not had the gel shots by the beginning of February. In the meantime my ortho doc had given me a referral to the ortho KNEE REPLACEMENT SURGERY docs “just to get them acquainted with your case.” Okay. Once the doctors start referring me to other doctors, I am generally very compliant.

So a week ago I went to see these guys. I say “guys” because in the university system (which I am well aware of, since that’s where I worked) a resident comes in and sees you first, gives you the once over and gives you his professional opinion. And then the attending physician comes in and gives you his professional (and more experienced) opinion. And often, those two opinions are different.

So after sitting in the waiting room and seeing people with infinitely more serious problems than mine, and filling out a four page questionnaire (do you use one cane or two when rising from a chair?) I did start thinking that maybe my little knee pain was not that big a deal.

After taking multiple specialized x-rays of my knee, I was finally taken into the doctors exam room. Mr. Resident comes in (and really, I liked him.) He poked and prodded my knee “does it hurt here? here? does this mimic the pain?” Believe me, next time I am going in with a Sharpie pen marking the exact spots that it hurts. He reviewed the x-rays with me, and concluded that I did not need surgery at this point. He was very complimentary and said that I was doing the two most important things–taking NSAIDS and exercising correctly and regularly. I asked him “I notice you did not mention losing weight as something important to do.” And he just said, “well, of course losing weight always helps, but you had already told me…” (I had given him a brief overview of my weight loss/maintenance history.) I have to say, I know I am lucky, but I have not had a really bad experience with a doctor and weight loss issues. Even when I was “morbidly obese.”

Okay. so now the attending physician comes in. And he says, “well, up until I just now talked to my resident, I thought I was coming into a room to talk to someone who needed knee replacement surgery.” All I can think is that he read that questionnaire a little more thoroughly. I tried to give as much detailed information as I could in it.  So the three of us chatted quite a bit more. Neither of them were huge fans of the gel shots. The attending physician said, in comparing the gel shots to steroid shots–either of them have varying results, from only working for a week, to sometimes working for several years. 

Long story short, what I finally decided to do was to change from Ibuprofen to Aleve (which they recommended,) and to try a “medial unloading brace.” I didn’t want to try too many things at one time. I bought some Aleve on the way home, and I do think it is working better for me than the Ibuprofen, maybe just for the fact that I take it routinely twice a day instead of thinking (or not thinking) about taking the ibuprofen. I don’t have the brace yet. And I have a follow-up visit with these guys in March.

In the meantime, one thing I had started to think about was this. I got all gung-ho for the knee surgery because my carpal tunnel surgery was such a success. But then I remembered that they are two different things. One of them (carpal tunnel surgery) just fixed up a poorly working part of my body. The other one (knee replacement surgery) completely removes a poorly working part of my body and replaces it with an artificial part, which of course can never do the same thing as the real thing could do. I know quite a few people who have had knee replacement. I haven’t kept count, but I think the results would be just about 50/50 positive to negative outcomes.

So in talking all this over with my BF a few days later, I said, “I just have to work to come to terms with things disintegrating. When do you stop fighting it and learn to accept it?” And she said, “well judging from my parents…NEVER!” And that made me think about my own mom, and yeah, she has not stopped fighting the aging process either.

In one way, I think that is healthy. But in another way, for me, I do think that acceptance can lead to a more peaceful existence (and you all know peace is big with me.) For example, I have wanted to take a trip to the British Isles for a long time. I dreamed about walking the moors like, you know, James Herriot. Now I don’t want to walk anywhere. And that was bugging me. And I wanted to get fixed so I could walk those damn moors. But now I’m thinking, “just change your perspective. You can still travel to the British Isles. You just need to take a different kind of a tour. And if you’re honest with yourself, you didn’t even like walking the hills when you were a kid and your dad took you for a hike. You just like the idea of walking the moors.”

And for me, that’s where hope comes in. I know that people cannot live without hope. I know that from my years as a NICU nurse. No matter how grim the situation, parents would latch on to that one tiny bit of hope. Some nurses would get frustrated by that. I just said, “everyone has to have a little hope.”

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19 thoughts on “Disintegration… and Hope

  1. I appreciate you’re sharing this part of your journey with us, Deb. My mom had total knee replacement over 20 years ago and it went well for her. Three years ago, she had a second surgery on one of the joints that had gone bad, worn out. She again did very well, but I have heard stories of others that have not done as well. I’m hoping that the brace and the aleve will be your answer for now. Thanks for being honest in this blog post. Praying things go better with the pain in the future.

  2. I’m 4 month post total knee replacement surgery on my left knee. While I can’t say it has been fun, it was well worth it. I was recently able to do a 2 mile hike on uneven ground, dirt & gravel, with no problems & NO pain! The gel shots never worked for me but I did use the same type of knee brace before my knee got bad enough that I was finally ready for replacement. 2 very important things to consider for surgery – make sure the surgeon uses a knee made just for you (not a one size fits all) & do your physical therapy religously!!! It has certainly paid off for me.

    • Wow! Thanks so much–great info. Congrats on the hike! You described the terrain around my house EXACTLY 🙂 I’ll ask about the custom knee–that is very interesting to hear. I wonder how many of the poor outcomes I’ve heard about are due to the one size fits all knees. This is a major medical center I’m going to, so they are supposed to be one of the best hospitals in the country for orthopedic issues. And yes, I have tested stopping my PT for a week or so. It is definitely worth the effort to do it regularly. I’m sure that post-surgery PT is even more important.

  3. My coworker who had the gel shots for a while ended up having surgery because they basically stopped working. She went in to surgery (at the ripe old age of 50!) thinking she was going to have a total knee replacement and they ended up only replacing her knee cap. The recovery was tough but now she says it’s the best thing she ever did. She’s back to complete and total exercise, including boxing and running.

    You’ll know when the time is right, I’m sure! And I agree, I feel a bit more distintigrated every day.

    • Oh, that’s interesting too. That’s one of the things I want to talk to them about–are there any less invasive surgical options.

  4. I remember reading that after one is pregnant for nine months, the placenta starts to die, because it technically is no longer needed – the baby is ready for the outside world. And that once you’re born, yes – things start their march toward expiration. Lovely thought, no? But it’s true, and much like what you wrote here, real.

    I’m not at the point of being willing to accept that a certain body part has stopped working. Even my vision, which has been going downhill for the last 40+ years – I’m all, nope. I can see just fine. Hahahahahaha. But I willingly wear glasses and contacts. So I guess it all comes down to quality of life, and what YOU want to do. Personally, I’d want to be without pain on a daily basis, and if the Aleve helps, then hurray! But if it stops helping, then I’d be moving mountains (figuratively, natch) to have something done to relieve the pain, be it shots, or TKR, or that brace (which looks pretty impressive after googling it, I have to say).

    • LOL at the vision. Yep, I gave up that one. Still working on the wrinkles 🙂

      And I can’t believe I never thought of googling the brace! Off to check that out.

  5. OMGOSH I LOST MY COMMENT AFTER READING SHELLEYS.
    it makes so much sense.
    it’s sad but it is also such a good reminder of the BUDDHA notion of THE PROBLEM IS YOU THINK YOU HAVE TIME.

  6. There are options for partial knee replacements, or maybe an arthroscopy and a release to buy some time.
    Doing so many ortho reports and you realize that accepting the surgery is when you feel the need for it. Some people have a higher pain tolerance than others or they fear the operation itself and put it off.

    I know the gel shots work fantastic when they work for people, but you have to be the right candidate for it. The arthritis can’t be so bad that it is bone on bone and it’s really meant for early OA. They do eventually stop working, but if you can buy 5 years before replacement, it could be totally worth it.

    Your talk about aging reminds me the other day how I looked at John and the light caught his hair just right and highlighted the gray at his temples. It made me a little sad because I don’t ever want him to age.

  7. I could say so many things but you are on the right track. I do think Alieve is a better choice. Muscle exercises to strengthen the area around the knee…..quad strengthening etc. I’ve had steroid shots when things got bad (usually due to exercising more), but I’m getting to the point where there is no room in my knee for that. Knees are doing great right now and it has been 2 years since my last injection. I’m not taking glucosamine,. I’m not running. I’m not walking as much as I normally do because of my lung, but when I do walk a lot they are ok. I’m not even taking any pain meds. None of this was the case a couple of years ago. I also don’t exercise 7 or 8 hours a week. My goals are more about movement, feeling good, mobility , health.

    I have so many thoughts and feelings about aging and how my body is changing which doesn’t coincide with my mind and spirit. I also wonder about how my body will be , God willing, if I live 5 or 10 or 20 years longer. I also want to visit the British Isles. …not the typical London trip (though that would be cool.) I want to drive /gaze/ walk a little in the moors and the countryside and at the seaside. I want to spend time at tea shops and restaurants and book stores and just looking around and visiting gardens and houses.

    anyway, glad you are posting like this.

  8. I’m sorry you’ve been struggling with your knee. 😦 You’re wise to take it slow and evaluate You’ll know when is the right time to take the next step. Or not. “There is a time to every season…”

  9. You made my day. Thank you for sharing. You have made so many positive strides in your own life, and even though I don’t know you, know you, I love reading your messages. I am 61 with arthritis in my hips. They offered me shots. I told them I wasn’t ready for that yet, but I know it is a first option. So changing my perspective and walking my normal 2-3 miles a day with my dogs will continue to be my goal each day until I can’t anymore — right now I think I can for a long time!!! Thank you again!!!
    Debi

  10. Thank you for sharing your story. My best friend had the gel shots, they did not last long and steroid shots helped with the pain longer. She stopped Zumba and step classes now she mainly walks or does very low impact cardio, takes NSAIDS,. She is doing well but has decided like you not to have a knee replacement. She wants to age gracefully as possible, except for her hair, she said she will always have red hair no matter what age she gets to. LoL.
    I love reading your blog since you work at having a balanced and happy life. Since I am in my early 60’s I am learning to live my life with more peace and happiness. Having already gone through a health crisis with cancer 5 years ago , my life is not like it was and there are adjustments I have had to make but I feel fortunate to be here with my fur children, friends, family .

  11. You can use generic Naproxin too, I found when my knee started to complain that when I took it my hands felt better too. I sew all day at work so anything that helps is wonderful.

  12. Some more input from someone who’s on the other side of a knee replacement: I was alarmed that observations of the ones you know of were only 50/50. Your ortho/surgical team seems to have a good relationship with you which is crucial. Don’t go with anyone you’re not sure about.
    Any long term use of pain meds is not good. I’ve had friends end up in the ER with as little as 6 months of use. And the intestinal problems may not go away when you stop their use.
    It is also crucial to have exercise be a regular part of your day both before and after. And after, it will get better and better. (And yes, the first couple weeks are a bear.)
    Of the people I know, the ones who did their PT, and have kept up with exercise are 100% positive
    on their results, regardless of whether they are at ideal weight. The ones who don’t like to exercise and don’t do it are the less than happy ones.
    My Dr. stated before the surgery that in 3 months he wanted me walking a mile, which sounded impossible. I was able to do it though. Today I don’t take any pain meds, can walk as far on any terrain I care to, and over 3 years have passed.
    Note that Aleve has a higher sodium content than ibuprofen, so keep a closer eye on your blood pressure while you’re on it. Good luck to you, it sounds like you’ll know when the time is correct for you.

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