Pre-Op!

Yesterday was my pre-op doctor’s visit. Its getting real. And just to make sure the inner me doesn’t weasel out of this surgery, I have taken to leaning on counters, shuffling when I walk, circling the parking lot for the closest parking space–all those things that really old people do (haha, I know that to some people I am already really old.)

I had a lot of nerves leading up to the visit, including worrying that they would tell me I was too fat for the surgery (even though I’ve been this same weight at all my visits for the past year.) Ah, the mind is a mysterious and wonderful place. Of course, my weight was not even on their radar.

Multiple X-rays were first. They asked me to get into and stay in positions that were foreign to me. “Now hold very still” the X-ray tech would say as he walked out of the room. “Take that picture before I topple over!” I would think back in my mind.

After a few preliminaries with a young nurse (during which I gave her encouragement and financial advice 🙂 ) –my blood pressure was a perfect 114/73–it was finally time to see the doctor. The doctor was pretty impressed with how flexible my knee still is (its so nice to see some positive results from keeping up my PT exercises all these years.) And after looking at all the X-rays they took, he said what would I think about a partial knee replacement? WHAT WOULD I THINK ABOUT A PARTIAL KNEE REPLACEMENT?!! I would love it if that could be done. At the previous visit, he had said a total knee would be needed. He won’t know until he gets in there and looks around, so I won’t know until I wake up. But it would be wonderful if he could do that. I’m all for keeping original body parts if they are still useful, and of course, the recovery is much quicker. I asked him what my hips looked like on the X-rays. I’ve been very concerned that they were shot too, but he said they looked fine. That was a great relief to me.

After that, it was a visit to the lab, and then some time with the nurse specialist reviewing dates and facts and all the nitty-gritty of surgery. One of my biggest concerns is that so far, stronger pain medications make me nauseated. So she reassured me that they would work on that while I was in the hospital.

All in all, I was in the clinic for about four hours!

Did I already tell you that they will do this surgery with conscious sedation instead of general anesthesia? I am very happy about that as well. Conscious sedation is what they do when you have a colonoscopy. Its also how they did my carpal tunnel surgery. You are not aware of anything. But its much easier on your system than general anesthesia.

So, a good plan is in place, equipment has been borrowed from several friends, and all that is left is all the pre-preparing and planning that I like to do before any big change.

I totally admit to over-eating some favorite foods after the visit. A combination of stress relief and celebration I suppose. Fortunately, I don’t like how I feel after I overeat any more, so there is no danger of that becoming a habit. And today, its back to the gym for a swimming celebration!

My Healthy Life

Hmmm. I said I’d write this post weeks ago. I have thought about it ever since then, but avoided putting it to paper. I remember when I started this blog. I couldn’t stop talking about healthy food, exercise, weight loss, weight maintenance. It was a relief to have an online group of friends who were interested in the same things. I didn’t have to worry about people rolling their eyes back in their heads as I prattled on enthusiastically about all this stuff. Well, its been twelve years since I first darkened the W.W. doorway, and ten years since I started “maintaining.” Yeah, that maintaining is in quotes, because for me maintaining has been a bit of a roller coaster. Up thirteen, back down to 100 lost. Up 25, back down to 100 lost. Now, currently, up 40. So that’s still a net loss of 60 pounds. And I tell myself that that is a lot better than almost every study I’ve read, which usually ends with the participants losing an average of 17 pounds over a year’s time. Most of those studies conclude after that one year period. Their information is basically useless for me.  If you only study what helps people to lose weight without studying what helps them to maintain that loss, you are providing false hope for so many people.

So…about what is working for me now in living the healthiest life possible at age 62. So many of the good practices and habits that I have learned about and applied over the years has stuck.

Food: From W.W. I learned about the evils of high fat foods (I don’t necessarily believe this any more.) But eating low fat is a way of life that has stuck. I enjoy the fresh taste of most foods without added fat.

From my personal trainer, Vickie, I learned about so many new healthful foods. I got a little more adventurous in my food choices. And I learned that good fats make food taste better 🙂

From friends, the internet, other bloggers, books, maybe even Dr. Phil(!) I learned lots of new ways of keeping fresh foods available, new recipes, new healthy food combos. I love to cook and experiment with food.

So now, I still shop the perimeter of the store (where all the whole foods are kept,) I almost always eat fresh vegetables and fruit. The meat I eat right now is salmon, chicken, and ground turkey. Just my current fav’s.

I try to listen to what my body is asking for. I’ve noticed that I am not as hungry in the morning as I used to be. So my breakfast is usually 2-300 calories, and that is enough to satisfy me until lunchtime.

I try to have a vegetable with every lunch. If I remember, I like roasting green beans, cauliflower, beets, rutabaga, or butternut squash. Lately, my favorite lunch is a simple strawberry smoothie. I get it ready and drink it on the way to the gym. 1 cup yogurt, 1 cup strawberries, spinach, splenda, cinnamon and vanilla. Very satisfying! Oh, that reminds me. That is one thing I have changed. For better or worse, I changed to using whole milk for my homemade yogurt. And I started using real butter sometimes. Do you want to know what I still do with that? When I put a new cube of butter in the butter dish, I mark the top in 8 even slices. That way I know how much a tablespoon is, and I can use 1/3 of that marked piece for a teaspoon.

I look forward to my afternoon coffee break every day, and I will admit that I still have a protein bar (Quest or Oh Yeah) with that coffee. These bars have 20 grams of protein in them. So that means dinner is usually simple and light. Most nights its meat and a vegetable. Most nights dinner is about 300 calories.  But who’s counting? 🙂 I am not logging my foods right now, but there is always a running total going on in my head. I am eating between 1400 and 1800 calories a day.

Lastly, I really enjoy having one diet Coke, a bowl of Skinny Pop popcorn and a small piece of chocolate after dinner.

So, you can see that although my food choices are not 100 per cent optimal, I eat a very healthy diet. I didn’t talk about grains, but I do have pasta very occasionally, granola on my yogurt sometimes, and of course, almost always breakfast includes some sort of whole grain. I don’t try to stay wheat free any more (wheat tastes good 🙂 ), and I do have sugar occasionally.

Cutting back to lose some weight would be great. But that is not happening right now. So continuing to make healthy choices every day is a good thing.

Exercise: as I’ve said before, exercise is very important to me. That said, I will admit that my knee REALLY hurts, and many other parts hurt as well. So I avoid walking, and my walks with my dogs have become shorter and shorter. All this is a good reminder to me that I really do need that knee surgery. Which is scheduled for July! I decided that I really wanted to get my baby chicks first, and they are coming in a week! I can hardly wait (for the chicks 🙂 ) This will probably turn into a chicken blog very soon.

When I take a walk and everything hurts so much, that makes me feel bad about myself. It makes me feel like I am a failure and that if I kept my weight down, I wouldn’t hurt and would be a more successful person. Intellectually I know that is not true. But that’s what it makes me feel like. So that is one reason I have had trouble writing this.

I love going to the gym and exercising hard. The bike doesn’t hurt, and running in the pool and swimming doesn’t hurt. The weight machines don’t hurt in a bad way, and I am working on increasing my upper body strength in preparation for my knee surgery. I go to the gym three days a week, and I’m thinking about increasing that to four days until I have the surgery. It just takes a big chunk of time out of the middle of my day, so that’s why I only go three days right now.

Sleep: Well, that is hit and miss. I know that my older friends (haha, I’m fast becoming one of them) cut out caffeine more and more. So far I’m not willing to give up my afternoon coffee and my evening diet Coke. But I go to bed at a normal time and wake up at a normal time. I rarely set an alarm. It seems like 7 hours is good for me. Sometimes a take a melatonin before bed if my mind is racing or I have not slept well for a few nights.

For a retired person, I think I have a fairly disciplined life. I start every day doing some sort of housework. And then I spend a large amount of time every day working on my art in my studio. When I am done in the studio, that is usually when I go to the gym or take the dogs for a walk. I spend most of the evening working on my quilted embroidery. Of course, I work a bit in the garden every day. I could do a lot more out there, but bending over… well, you know.

I hope this review is helpful for someone. I know it was helpful for me to think about all the healthy habits I have worked on and maintained over the years. I personally think that it is much healthier to eat well, exercise, and get a decent amount of sleep even if you never achieve your “ideal” weight.

Bone on Bone

I’ve heard lots of other people use those words to describe their knees. But never had it applied to my knee. Until yesterday. My insurance company finally approved the gel shots, and so yesterday I went in to my knee doctor for the first of three shots. I like this doctor SO MUCH. He is kind and encouraging, and not an alarmist. And for a surgeon, he has always been more interested in trying other less invasive methods rather than “surgery is the only option” like so many surgeons seem to think.

So yesterday he started the conversation by asking “have you been thinking about surgery at all?” To which I replied honestly, “I think about it ALL THE TIME.” I think about how my knee hurts  and how I avoid walking places and how I wish I could walk longer and farther. And then I think about how I don’t want a part of my body REMOVED FOREVER and replaced with a hunk of plastic and metal. And I think about my friend whose knee surgery was botched and how it took five years and almost as many doctors to get someone to listen to her and she had to have the first device removed and then wait 6 weeks WITHOUT A KNEE and then have another surgery to have it replaced. And I think about my sister-in-law’s dad, who died 2 days after his knee replacement surgery. And, of course, I do think about the many people who have had successful surgeries, and report lack of pain, and even the ability to take long hikes.

Anyway, then he told me he had reviewed my August X-rays, and my knee was now bone on bone. After a couple of minutes of that setting in, I said I was almost relieved to hear that, because now I didn’t feel like such a wimp for feeling that my knee hurt so much. And he said kindly, “no, you are not a wimp.”

So we discussed a bit more. And the plan is to go ahead and try these gel shots, but if they don’t work, we will go ahead with planning for the surgery. It is almost a relief to me to have more of a concrete plan in mind. For someone like me, its much better than the ubiquitous “you’ll know when its time.”

I don’t have any travel plans after February, and I kind of think that this eventuality might have been in my mind already. I know I will want to add any exercises I might need beforehand to optimize my outcomes. I’m pretty sure that is all a part of planning for the surgery.

In addition, (and I am reluctant to say this after just one week of success,)  but a little over a week ago, I decided to try restricting one more time. I re-set my calorie limit to 1400 on LoseIt, and what do you know? This time I didn’t internally rebel, it was pretty easy to stick to, and I stayed true to it for one whole week and lost 3 pounds. That is the most I’ve lost in months. Now, always, the big question is, how will you MAINTAIN any loss? I am not optimistic about that. But it is always a part of what I think about when I am in losing mode. With this surgery looming, any weight I can lose will be a big bonus, so that is a huge motivating factor for me right now. As you know, I live alone, and having a good recovery and being independent AS SOON AS POSSIBLE is the most important thing to me.

So that’s the news for now. I am off to the gym for a nice long session in the pool. Yes, we are still having pool weather here in sunny California 🙂

Bionic Me

Yahoo! I finally found a solution to my knee brace problem! But this post is less about me and more about that seemingly rare commodity in the 21st century–good customer service.

Honestly, I’ve been on the verge of writing a post several times about poor customer service. Somehow, receptionists and others whose job it is to interact with the public have gotten the idea that being kind and polite–providing good service–is no longer a part of their job. And I just won’t accept that any more. I’ve decided its part of turning 60, just like “you’re not the boss of me” was a part of turning 50. I try to be polite but firm when confronting their poor service and/or straight out rudeness. But still, its just not a good day when I have to deal with this stuff. Mini rant over 🙂

So. Back to the knee brace. From all my experiments, I somehow figured out that maybe a knee sleeve would work to help the brace stay in place (it kept “migrating” down, which according to Mr. Google is a common problem.) Ever the bargain shopper, I checked out my usual shopping place–Amazon–and had almost decided on one brand, when I clicked on another site, Brace Sox. And I thought, it might be good to pay a bit more and get this from a company where I could talk to real people, and ask if their product would help with my particular problem. Imagine my surprise when I called and a real person answered the phone!! After discussing what I needed, Ann recommended a particular product, told me the size I needed to order, and gave me some tips on how to wear it.

Now, imagine my disappointment when I got my new knee sock, and tried it out, and the brace slipped down around my ankle in less than 50 yards. I was so disappointed. So I waited until the weekend was over, and then, dreading making a phone call to find out about returns, I checked their website. Ahhh, instructions on how to return via email. I sent off an email describing my problem, and asked for a refund number to include when I sent the sock back.

Now, imagine my surprise when Ann called me back. She was very kind and polite. And we discussed what had happened. And she just sounded disappointed that it hadn’t worked for me. But she gave me the information on how to return. And because she sounded so disappointed, I asked, would you like me to try one more time before I return it? And she said, yes, and sounded very happy that I would do that.

Okay. Imagine one more time. I put the sock and the brace on EXACTLY the same way, and it worked!!! It worked so well that I went back and got Noah and we went for a long walk. NO SLIPPAGE whatsoever! I don’t really know what the difference was, but I am thrilled, and so very hopeful that soon I might be taking a three mile hike again.

I talked to Ann one more time, and she sounded so happy that it had worked for me. Cost of buying from a company where you will get good customer service? Priceless!

Storage and Garden Report

First of all, I want to say a heartfelt THANK YOU for all the nice comments on my last blog about Mr. Monk. You all knew him better than most of my friends! All of us are doing fine. Especially Queen Sophie. After she got over her worry that she might be the next to be “banished” from the kingdom, she has taken back her “rightful place” on the chair next to me in the evenings.

And, I also wanted to thank so many of you for your interesting and informative comments on the previous blog about my knee. Since I wrote that, my first ortho doc got back in touch with me. He had been battling the insurance company all this time (over their refusal to approve the Orthovisc injections), and now advised me to file a complaint with the State Department of Managed Health Care. I completed that today. It will be interesting to see what comes of this.

In the meantime, how about a report on some everyday life stuff 🙂

Last week J. the contractor came back to finish the little pantry and add shelves to the laundry room. Squeee!!! MORE STORAGE SPACE. I hardly know what to do with it all.

Here’s the pantry. That’s all I’ve put in it so far. I have those two big corner cupboards with lazy susans in them in the kitchen. I’m not sure what to put there, and what to put in the pantry. If anyone has ideas or opinions, feel free to share.

And here’s the laundry room shelves. Plenty of extra storage up there for I don’t know what!

I also had J. put this little hanging cupboard in the mudroom. It used to be in my bathroom. I still liked it so finally decided that this would be the place for it.

I tell you, for someone whose ONLY storage space for many years was a big closet in her bedroom, I feel like I’ve hit the storage jackpot!

And here is a view of the garden. Still pretty bare, but things are sprouting. There are little buds on all the trees. Its fun to go out there and scope things out every day. I have to be careful to not get carried away with planting, because there’s still a real possibility that we will get some frost, up until May.

The camellia bush is chock full of buds. The Pink Flower Thief is keeping a close eye on it….

 

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.”