trying to hang on till 50

[Dammit Janet]

Went to my ortho doc again today. We discussed my "case"...lol. Basically I am a mess. I am riddled with arthritis but since he is a knife guy, all he does is well...cut. Or well...he also does things to limp you along until you need to be ...cut. He is an excellent knife guy. When I need a knife guy...I want him.

We know I have arthritis in my knees, hips, lower back, and now my ankles. We strongly suspect my hands are affected but we arent even dealing with such small stuff now. Bigger fish to fry.

I have had both knees scoped in 04 and 05. Supartz shot series done twice before. Numerous steroid injections in knees, hips and lower lumbar area.

Today we decided to do the Supartz again in my knees one more time and see how long it lasts. Outward limit is 6 months. The longest I got relief was 4 months. I will take it. 5 weekly shots in my knee for another 3 months of relief is ok. Maybe. Sigh. I can do it once a year I think.

I also got steroid shots in my ankle and two in my lumbar spine area. We may have to look at some sort of surgical intervention on my ankle if it doesnt get any better soon.

My knees we are trying to baby along until I am 50. No one wants to replace them until I am at least 50. Really they want to shoot for 65 but there is no way on this earth I am gonna last that long. I am dreading it with everything I have in me because I just learned to walk again and I really dont want to do it a second time! If I have to, I want to do both at the same time because I know I can do it. I know I can!!!! I have done it! I will just get sent back to me favorite rehab...lol.

Ugh...I can already feel the steroid shots kicking in on my brain though...lol. I have already taken a klonopin. I know I will be taking extra's for a few days while this works its way through my system. Hypomania here it comes!

[klmno]

I don't know how you do it. Hang in there though- your family needs you to be able to chase those babies around! LOL!

[GoingNorth]

Janet, I know that you struggle with your weight. What has your doctor advised in terms of that? I know that since I put on 45lbs due to the APs that my arthritic knees are really complaining.

According to my ortho, each pound of excess weight puts up to 10 lbs of additional stress on the knees and more than that on the lumbar spine.

I know you mentioned checking into weight loss surgery in the past. Medicaid/Medicare will cover weight loss surgery if you have accompanying comorbidities. Joints breaking down from arthritis qualifies.

The problem is that they also require (I think) at least six months of medically supervised dieting before they will consider coverage.

Did you have problems with your joints before you gained the weight? Old injuries?

I know in my case that (I'm your age) I started with arthritis in my knees and back in my twenties due to injuries and knee surgeries due to injuries.

I am struggling to get my weight down so I can exercise more and so I can put off the knee replacements for as long as possible.

I have mild fibro as well, and that can make it even harder to exercise.

I am sorry you are going through this. I hope you can find a solution, especially one that allows you to avoid the steroid shots. Steroid shots help short term for inflammation in joints, but in the long run they destroy the cartilage and other joint tissues.

[Dammit Janet]

I dont know how I do it either K, but I really wasnt given a big choice....lol.

Tony annoyed the HELL out of me this morning when I called him to tell him how my doctor appointment went. I told him he really wouldnt have wanted to have been in my shoes at this particular appointment because I got all those nasty shots in all those nasty places. He is a really big wuss about needles and shots. He thinks I just go do it for fun or something. He remarked that maybe I would have liked to have traded places with him and gone down and worked in his place....HUH?

I said...hmmmm...no...but I would give my right arm to be able to go work in MY profession again. I dont go get needle after needle and shot after shot into parts of my body that most normal people really dont want to get needles in. I dont ENJOY this stuff. I do it because I want to attempt to have some semblance of a live without resorting to extremely strong narcotic painkillers. I could just go down and beg and cajole my GP into increasing my pain meds until I was back on oxycontin or morphine which Im sure I could do. However, I am trying everything under the sun to do anything I can to keep myself on the lowest amount of pain pills I can. I do things that HURT me in order to do this.

Sheesh!

[Dammit Janet]

GN.....

I have looked into the WLS. I really would consider it. Hell I would do it tomorrow.

I should be considered to have done a medically supervised weight loss because in 2003/2004 I dieted under my GP's care and checked in monthly and charted my weight loss. I actually did lose almost 90 pounds but I lost insurance, county mental health stopped my lamictal and topamax, through me on lithium and zyprexa for a few months and there went the weight loss. By the time I convinced them they were crazy...topamax didnt work for weight loss properties anymore at all.

[GoingNorth]

Janet, I think the medically supervised diet has to be done as a direct leadup to the WLS. In other words, several years ago wouldn't "count". You would have to do it over again to qualify.

The usual deal seems to be that you first do the diet and then once you 'pass' that phase, they schedule the surgery and put you on a liquid protein sort of fast. This gets even more weight off and also shrinks the liver which makes it easier for the surgeon.

WLS is NOT a surgery to be considered lightly. It can have a LOT of side effects and takes a total committment to a new lifestyle. I think you also have to commit to followup classes and stuff as well.

I guess it wouldn't hurt to look into it again. AP weight is awful to lose as the APs don't just make you eat more, they also alter your carb metabolism as well.

I take Depakote and that's not too bad for weight gain in my case. It's the darned APs that are horrible.

Add in that due to intestinal strictures I have to eat a low fiber/low residue diet (can't have raw fruits or veggies or lots of whole grains, legumes, etc.) and it is just awful.

I can't safely eat the sort of foods I have to eat in order to eat a healthy diet.

Do you have access to a 'Y' or something that offers water exercise classes? I don't up here, but my mother does and she's found them to be very helpful (she has spinal stenosis and bad hips)

[Dammit Janet]

We dont have a Y or anything like that. There are several Health Clubs but they cost money...LOTS OF MONEY! LOL. One I cant go back to because I reneged on a membership back in the 90s. Im sure they still remember. I did pay out my membership at the other one here locally but they dont have a pool and I really didnt like their whole system. They claimed to be able to work with disabled people but they never even had someone there to help me when I went. I went for two months and then stopped going but paid the monthly membership for the next ten months and then canceled it. I have tried to see if a hotel here has an indoor pool but so far no luck but Im still calling around. I do know that next summer I am buying one of those 4 foot above ground Walmart pools.

If I had to do something like Curves or WW or something like that, it is simply not an option.

[GoingNorth]

Janet. Yeah. The problem with the "health clubs" is that you are signing a loan and contract to make monthly payments. If you don't fulfill your end, they can not only refuse to sign you up in the future, but it can go on your credit reports as well.

I don't know if it is reasonable to expect a commercial 'retail' health club to have physical therapists specializing in working with the disabled.

I think there is a way to do WW online without spending a fortune. I know we have/have had at least one person on line who works for WW. May a posting in the Healthy Living forum would help?

Are you in an area where you have access to bariatric specialists? It is possible that medicare will cover that.

I haven't looked into that because I am too fat for my bones and joints and not fat enough to be considered a bariatric case.

I am getting really concerned about the number of steroid joint injections you have had. Are you able to get a second opinion from another ortho? There's a weird thing with Medicare/Medicaid where the surgeons actually get MORE money from a course of injections than they do from surgery.

Also, some orthos will not do a joint replacement in a morbidly obese patient. There are a lot of risks of blood clots and other complications.

It really turns into a Catch-22 situation.

[Dammit Janet]

I could do that GN. I think we have a bariatric center that just opened up here. Our hospital is enlarging. There is only one other ortho here and I do not like them. Bad episode dealing with one of the kids years ago. They missed a fracture then were very rude to me about it. I could understand missing the fracture but being rude to me and yelling at my kid...no way.


I just get so tired of the doctor-go - round. Im trying to get a referral to a rhuemy now. If I can do that maybe I can try and get on methotrexate and avoid the steroids for a while. Im trying desperately to find a way to slow down, if not fix, this arthritis stuff. I would really like to have a joint that isnt turning into gravel at an alarming rate!

[GoingNorth]

Boy Janet. Do I hear you! It's really weird how as this progresses, you sort of suppress the pain so you can go about your business (I try to avoid the narcotic pain meds as I have horrible problems with dizziness and nausea when I take them)

Back in March, after a change in my dosage of APs, I got so dizzy that I basically folded up and fell in my kitchen.

I knew right away that I'd broken several toes and possibly a bone in my foot. The ER xrayed my ankle as well because of how swollen and bruised it was. Luckily it wasn't broken, but the doc and I were both stunned at the amount of bone spurs and loss of joint space.

He outright asked me how I was walking on the thing! I told him that it seemed okay once I got the stiffness worked out of it when I got up in the AM or stood up after sitting for a while.

I seem to have some weird ability to suppress the pain and just get stiffer and stiffer. My gait is really bad. I almost waddle when I walk due to the legs and the back (I have spinal stenosis as well--it runs in my family and I suffered a compression fracture in my back years ago when I fell off a horse).

Of course, the great thing with the back is they tell you in one breath that they can hopefully fix it with surgery, but in the next breath they tell you there's a big chance it will recur in a few years. Sort of like 'why bother?'