Monday, May 12, 2008

Update

I suppose I should let folks know how things are going, especially since I surfaced on Friday when I did my column.

Sometimes life just backs up a truck and dumps a whole load of crap on you. The usual crap is bad enough -- I've been on a low for a while and haven't done much of anything. But after nine months of slow improvement, my bad knee (my souvenir of a writing retreat in Vegas back in August) took a sudden downturn, bad enough to finally get me to drag my butt (with gimpy leg attached) to the doctor. It seems I have arthritis in my right knee. The doctor figures it's been building up for a while, and that one awful day standing and standing and standing just pushed it over some sort of threshold.

I'm still hoping she was wrong and something else will turn up; I went for X-rays before leaving, and there was a vague hope that the bones would look fine and it'd be something else. I went to the doctor almost a week ago, though, and I have to assume that if that'd been the case, they'd have called me by now to let me know that my kneecap was fine but some major tendon was hanging by a thread two cells thick, or whatever. That hasn't happened, so....

This really sucks, though. Arthritis isn't curable, it can only be dealt with. They basically give you bandaids until you can't walk at all, at which point the only option is a joint replacement. I'm taking glucosamine sulfate supplements, which are supposed to help encourage cartilage development; if it helps at all, I'm supposed to see results in three or four weeks. And I'm taking ibuprofen horse pills -- 800mg, three times a day, yay! After almost a week of the ibuprofen, I'm back up to walking about a quarter as much as I was before. :/ I've gained four pounds in the last two weeks, and am not at all happy about it.

Pretty much every older woman in my family has or had arthritis in her knees, so it's not like this came popping up out of nowhere. It's still depressing, though. I've got to be able to walk. I was losing weight, very slowly but still losing, and now I'm gaining again, a heck of a lot faster than the loss ever was. I need to exercise. If the glucosamine doesn't do its thing, and I can't find a level of whatever pain medication that lets me get back to walking for exercise, I'm strongly considering arguing for a joint replacement immediately. It won't do me any good to wait until I'm stuck in a motorized scooter; by that time I'll be up to four hundred pounds (for anyone who doesn't know, that four pound gain put me just over three hundred, which I'd hoped to never see again) and even a new joint won't get me walking. If it's going to do me any good, it'll have to be now while I'm still only borderline.

Anyway, that's what's going on with me. I've only written a few thousand words of fiction since the new year, and I have no idea when that's going to change.

Hope everyone else is doing better than I am. [hugz]

Angie

14 comments:

Shauna Roberts said...

Your age is an important factor. Artificial knees have an anticipated life of about 20 years (as I recall, but ask your doctor to make sure), but that's in the standard patient who's elderly and not particularly active. They probably deteriorate faster in a middle-aged person, particularly one who's walking a lot for exercise. So if you're 40 or 50, you're looking at at least one and possibly two revision surgeries in future years.

On the other hand, after my mother-in-law had her knees replaced, the pounds starting dropping off without any effort on her part. Just being able to engage in everyday activities again used up many more calories than her inactive state before the surgery.

One thing you might ask your doctor about before going through surgery is joint fluid replacement (hyaluronic acid derivative [Synvisc] or sodium hyaluronate [Hyalgan, Supartz]). These are injected into the joint to create a liquid cushion between your bones so they don't grind against each other.

One other thing to know is that people respond differently to different NSAIDs. If ibuprofen doesn't work as well as you'd like, there are many other NSAIDS to try out. Also, if you can't tolerate ibuprofen's effects on your stomach, there are six NSAIDs (if you count Celebrex as an NSAID) that are easier on the GI system.

Angie said...

Shauna -- thanks for the info. I'll definitely be trying everything else before I start arguing to have me knee hacked out [wry smile] but if everything else doesn't work, I'm not willing to just sit around getting fatter for the next ten years or however long it takes me to become unable to walk. :(

I'm forty-four, so definitely down in the "middle" years. Maybe with the right meds and such, I can stick it out long enough for the technology to improve enough that I wouldn't have to go in for a warranty replacement...? And hey, my family isn't particularly long-lived; I never thought I'd see that as a plus. [rueful smile]

But thanks again. Definitely taking notes. [hugz]

Angie

Charles Gramlich said...

I'm sorry to hear about this. Getting older is such hell. I've been having horrible problems with my legs and lower back just for the past six months and it doesn't look to get too much better anytime soon. For me this is a problem about walking as well, since I hoped to really increase my exercise over the summer berak.

Shauna Roberts said...

Angie, I remembered one other helpful thing—knee exercises. By strengthening the muscles that hold the knee in place, the knee is more stable and the bones grate together less.

Some links on exercise for knee OA you might want to look at:

http://www.hyalgan.com/consumer/manage/exercises.aspx

http://health.yahoo.com/arthritis-living/exercising-with-osteoarthritis/healthwise--tr4782.html

http://bmj.bmjjournals.com/cgi/content/abstract/325/7367/752

http://www.webmd.com/osteoarthritis/news/20030414/osteoarthritis-knee-exercise-bad-in-some

Also, in addition to NSAIDs, other things that may help pain (but don't slow progression) include heat, cold, capsaicin cream, other rub-on creams like Ben-Gay, TENS (tiny electrical shocks to the area), acupuncture, taping (sometimes--you'll need physical therapist to show you how), and arthroscopic surgery (to clean out gunk that makes the knee hurt more).

The Arthritis Foundation puts out a book on osteoarthritis (my copy is still packed up from the move, so I can't tell you how much is devoted to knees) as well as books on pain management, joint replacement, and tips for everyday living with arthritis.

[turn off medical writer mode; turn on blog friend mode]

Hope everything works out and you can find a way to be comfortable and get your exercise in.

Angie said...

Charles -- getting older definitely sucks. [nodnod] I'm forty-four, and was hoping to go a bit longer before this sort of thing hit. I suppose that at my weight, though, I shouldn't be surprised. :/

And yes, I remember that you walk a lot. :( Any idea what exactly is wrong with your legs and back? Whatever it is, I hope something comes up to fix it soon. [hugz]

Shauna -- the doctor told me to do "bicycle exercises," the ones where you lie on your back and "bicycle" in the air? And mentioned capsaicin cream. [nod] I'll check out those links for more exercises; I can use more of that anyway. :)

Speaking of cleaning out, my grandmother and her sisters had arthritis in their knees too, and were all gimping around by their fifties. My grandfather got sick with cancer, and was home sleeping one afternoon while my grandmother was doing some gardening, in a raised bed, behind a retaining wall about three feet above a cement patio. The phone started ringing and she was worried that it'd wake my grandfather up, so instead of going to the other end of the yard where the steps were, she jumped off the wall, from about three feet high onto concrete. [wince] She felt these CRUNCH! things in both knees and the pain shot through her. She limped as fast as she could to get the phone, then later went to the doctor. It turned out that she'd shattered all the little mineral build-up nodules and whatever around her knees. It hurt like anything, but once it healed up she was fine, and never had arthritis problems again. [bemused smile] She used to brag to her still-limping sisters about that until they wanted to smack her. :P

I've thought about finding a wall to hop off of.... [duck]

No, really, I've been walking as much as I can. And that's been a bit more every day; I guess the ibuprofen's anti-inflammatory stuff has been working. I'm a lot more hopeful right now than I was a few days ago. :D

Angie

Anonymous said...

Try Hyaluronic Acid on top of glucosamine. The stuff made a huge difference in my massive arthritis problem, so much so that I halved the naproxin I take to once a day.

It sucks getting something like that, but I've had horrible arthritis in my back and now in many other joints for nearly 20 years. It can be dealt with and managed.

writtenwyrdd

Angie said...

WW -- thanks, I'll make a note of that. Whatever works, right? I hope you're doing well too. [hugz]

Angie

Bernita said...

My poor Dear! That is terrible news!
I've read that ibuprofen elevates blood pressure too.
At least knee surgeries - thanks to sports injuries -are much more successful now.

Angie said...

Bernita -- thanks, hon. [hugz]

High blood pressure is one problem I don't have, even with my weight, so hopefully that particular side effect won't hit me, especially if I can get back up to my original level of exercise. [crossed fingers]

And you're right about the technology improving [nod] so if it does come down to a replacement, I have high hopes for it. I'd rather it not get to that point, but it's good to have a viable option sitting there, for if nothing else works.

Angie

Sarai said...

Wow sending you lots of good wishes and hugs! It always seems like when it rains it pours.
I hope it gets better for you soon!

Angie said...

Sarai -- seriously, it's like everything comes crashing down at once. :/ Murphy working overtime, and all that. Thanks! [hugz]

Angie

Ello said...

Hey Angie, sorry about the arthritis! I have the same fear that I will get arthritis because I have a lot of joing problems and have been told I have to lose weight and take it easier on my joints. Hard right?

Take it easy!

Angie said...

Ello -- thanks hon. [hugz] And yes, it's much easier to do it before you actually have active arthritis. :/ I have to stay active or I gain weight like crazy, and hobbling around makes it really tough to get any exercise. I'm doing better now than I was when I posted this, though, so I guess the ibuprofen is helping.

Angie

Ello said...

I'm glad to hear you are doing better!