Saturday, February 5, 2011

In Spite or Despite, Life is Still Good :)

I know, I know…I haven’t blogged since Tuesday. What a crazy week! I was helping out in the Conti Infirmary where everyone – my two g-babies, son-in-law and very pregnant daughter – have been alternately sick the last two weeks. The illness has passed, so they can welcome g-baby #3 into a relatively germ-free house within the next few days. Cassie’s due date is Friday, but she went a few days early with Claire and Luca...so…Monday? Tuesday? So exciting!

I brought the kids to the mall on Friday to ride the carousel and those 50-cent rides that jolt kids around for a couple of minutes, but they imagine they’re driving a car or flying a space shuttle. Amazing what joy a roll of quarters will bring a 3- and almost 2-year-old and their Grammy.


The other thing that’s kept me from blogging is the news I got Wednesday from my knee doc. What we thought was just a meniscus tear (something that could be repaired with a simple scope) turned out to be much more, and the knee surgery I had in June, the one we thought bought me at least 5 years with my original equipment, turns out to have been in vain.

I’m getting pretty good at reading MRIs and x-rays. Most anything in bright white isn’t good. No, no, no. You don’t want to see bright white. But we did see bright white. A big old mass of bright white on my upper shin bone, lit up like the Griswold Christmas tree. It was fluid, which means, for lack of a better word, death. The bone, said my doc, is dying.


“We see this in women ages 40-65,” he said. “But usually it’s in women who are heavier than you.”

Doc doesn’t know about my obese past; all the years I spent going up and down the scale. At that moment I figured why tell him? Nothing I said would change the diagnosis.

So I walked out, a little stunned. My five years of reprieve from a total knee replacement is most likely down to 12 months or less. But rather than be angry, I was resigned. Sad, but resigned. I’ve done the anger thing. Anger is like snake oil. It cures nothing.

The sign on the exam table in knee doc's office
In April and May 2010, I wrote two blogs about how I live with the consequences of living most of my adult life on a weight roller coaster and more importantly, being morbidly obese for several years.
In the Refuse to Regain post, I wrote: “I haven’t wanted to explore this, mostly because there’s not a damn thing I can do about it now and I can’t change the past. But the question is begging to be asked, the question I’ve avoided since making goal three years ago: Do I have all this arthritis in my knees, shoulders, wrists and toes because I was overweight and obese for so many years? Like stretch marks and loose skin, is arthritis my daily reminder that, for years, I fed my insatiable desire for starches and sweets; gained and lost and gained and lost a lot of weight; and for the most part treated my body like it was separate from me?


“The answer is probably not a resounding ‘Yes’, but it’s not ‘No’ either. I am, in many ways, responsible for the shape of my body now. The choices I made about diet and exercise and the things I declared acceptable (basically ignoring the weight elephant in the middle of the room) accelerated the degeneration of my knees and feet, and perhaps contributed to the degeneration of my wrists and shoulders.


“Even though I give myself a lot of credit for stopping the weight before it got any higher and for losing the weight which has given my other systems better health, here on the other side of weight, displaced anger still exists.”

We all lose weight for a variety of reasons: to avoid heart disease or avoid or regulate diabetes, to look better or fit into a size-smaller wedding dress, to be able to play with our kids, to fit in an airplane seat. All good reasons. But how many of you have lost weight because of the potential for osteoarthritis? My guess is not many. I certainly didn’t have a clue obesity could cause this arthritic mess of a body I’ve got now.

On Lynn’s Weigh last year, I wrote: “Even now, I get angry when I think about what I’ve done to [my body] and for what it can’t do anymore, much of it due to having been morbidly obese. But…I promise myself to do my best to stop the cycle of anger, grief and guilt I put myself through with much frequency. I will do this by journaling more positively and finding alternatives to self-flagellation as solutions to my perceived failings.”

Nearly a year later, I’m…eh…doing OK with stopping the anger cycle before it gets looped around. I try not to live in regret, but it still pops up once in awhile.

My plan now is to: 1) pay close attention to the pain, which right now isn’t too bad; 2) get educated about total knee replacement in “younger” people; 3) play with my grandkids; 4) keep working out; 5) keep my weight stable; 6) don’t beat myself up.

G-baby #3 will arrive soon. Very soon. And right now, despite the knee and wrists and everything else, that’s all that matters.

Life. It’s good. And if I’ve learned nothing else through this, it’s that there’s redemption, regardless of what we’ve done to our bodies or ourselves in the past.

*** I need to add that if you comment about how you know someone who's had a knee replacement and have said it's the best thing they've ever done and they wished they'd done it sooner, let me know how old that person is. 47 is really too young to have a knee replacement because replacements wear out in 7-10 years and the next knee is never as good as the first. You get mileage on the first one, yes you do, but I'm trying to think ahead. I'd love to hear from folks who had TKR in their 40s. Thank you!

27 comments:

  1. Longtime lurker -- I just wanted to say that every single person I've ever known who has had a knee replacement has come out of it on the other side and said, "I WISH I'D DONE IT EARLIER! This is great! I can RUN! Watch!"

    Seriously. If it has to get done, it has to get done. The sooner you get it done, the sooner it's behind you, where it belongs -- in your rear-view mirror and getting smaller every day.

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  2. Janis, thanks for coming out of lurking! I'm trying to find folks to talk to who've had total knee replacements in their 40s. This is really scary at my age, especially since I need both knees done.

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  3. Lynn -

    Crazy that I just started reading your blog yesterday and I already have a comment to provide. I have a friend through a non profit organization I'm involved with who just had her knee replaced last year (May or June???). I'm not positive on her exact age, but if it isn't 40 something she is in her early 50's. I could ask her if she'd be willing to share her story with you. I'm sure she would. I'll send her this blog post via e-mail and tell her to leave you a comment. Her name is Tracy.

    PS - I had knee surgery the beginning of January due to a hole in my cartilage. It was a result of excessive running. I'm 34; a little too young to be having knee problems. Now I'm restricted to a low impact exercise program...for awhile at least. All of this has made me listen to my body and realize how important it is to take good care of your body especially your knees.

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  4. My friend Diane at 42 had a Knee replacement ... about 3 yrs ago ... she had a skiing accident (her first time skiing and LAST!) and it messed up her knee pretty bad. She can WALK so much better and it was the best thing she did and she had no choice ... she HAD to do it!! The recovery was hard for her as she had two kids under the age of 12 at the time .. but everyone helped out and things worked out well for her. Good luck with what you decide. Tracy K.

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  5. Hi, Lynn, I'm a 49 yo woman who has been a long time lurker at your blog. I had a knee injury when I was 15, never saw a dr. for it, and at the age of 47, had no cartilage left. I am in Nursing School and knew I could not do clinicals unless I had my knee fixed. I had a TKR 2 years ago. I can't say it was the best thing I've ever done but it was necessary if I wanted to continue going to school. My knee doesn't hurt nonstop now but it is a bit uncomfortable at times almost every day. I can't run and I can't go up and down stairs easily. The thing that has been most hindering in my particular life is my inability to kneel or to get down on my hands and knees. This cramps my style when I garden, work in flowerbeds, or on the rare occasion when I want to get something from under a bed. All this being said, I would do it again - because I could not go up stairs before, and I could not walk in the mall because my knee always hurt. I think for older people this surgery can be a huge blessing. For someone our age, it is also a blessing, but it comes with a price, and, like so much of life, it all comes down to a balancing act.

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  6. Not that walking the mall is my main goal in life! I should have said "could not walk for extended distances or lengths of time." I can walk now - all day, if necessary. that is wonderful.

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  7. Hi Lynn, I have a friend at work who had bilateral total hip replacements at (I think) age 48. Just recently I heard her talking about it to someone else. She said she felt like a new person--like she had a new life--all that stuff. She is and always has been extraordinarily thin. Obsessively ran. Said it was a hereditary problem. Anyway, don't know if her experience is encouraging. I was surprised to hear her talk about it in such glowing terms.

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  8. Becky, I'd love to hear from your friend. My email address is lynn.haraldson@yahoo.com. Thank you so much for passing this on to her.

    TracyK, I've heard it's a rough surgery/recovery, even rougher than what I had done in June, and I'm still rehabbing from that. I hope your friend continues to do well.

    Ann, thank you for sharing your story. Has your doc said anything about how long your knee replacement will hold out? Are you still in rehab?

    Debby, my brother is 44 and he had his hip replaced late last year. I've heard hip pain is the worst of all the joint pain, so if your friend/collegue had both of her hips done, I can only image the pain she was in. Yikes.

    I've got a lot of thinking to do.

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  9. Hi Lynn - Ughh! Man, I'm sorry to hear your news. I've wondered the same things about the damage I've done to myself via the yo-yo of a hundred pounds I used to play with.

    I don't know anyone who has been young - yes, we are young - who has had a knee replacement, but I do know someone who had a total hip replacement in her early 40s - yes, early 40s. It was a really tough decision - you're right. I don't keep in regular contact with her, but I'll track her down again and see if she has any pointers.

    Hang in there, and keep up the positive attitude. Remember, Snickers would only make it worse. :-)

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  10. I am sorry I have nothing to contribute on the subject of knees but I do understand the anxiety and fear that this life has led me to health issues in the future I don't yet know about but will come and get me...I'm not exactly angry but full of regret. Its hard to step away from useless negative thoughts over things we cannot control, like regret. I do understand
    Dawn

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  11. I am angry too. I am going to be in your shoes within 10 years I am sure, so I am watching with great interest.

    Sometimes I get so angry about my knees that I just fume and then cry. But there's no way to know if it would still be the same if we'd not been so heavy.

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  12. I know little to nothing about knee replacement. But I do want to say that I'm sorry you're going through this.

    Wishing you the best of luck with the surgery. It's a good reminder to me to get this weight off before I do some more damage.

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  13. Just a quick note to say that your blog is truly inspirational. Thanks.
    Merja UK

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  14. Sorry to hear this, Lynn, but I hope to see a post in the future proclaiming that this was the best thing that could have happened. Hugs - I know it's not what you wanted.

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  15. So sorry about your knee! I have no doubt that you will weather this storm with grace and dignity...and a tantrum here and there to prove you're human. :) My inbox is always open, should you need it.

    On the brighter side, you'll soon have a brand new grandchild to cuddle and spoil. How exciting...and, I hope, distracting!

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  16. Hi,
    Just stumbled across your blog. I'm an occupational therapist with rehab experience. TKRs are rough- recovery time will take a few months. Your low weight will work in your favor for recovery/rehab. I've never known of anyone in 10 years to come back for a 2nd revision/replacement. As long as there aren't any other health issues involved, your surgery/rehab shouldn't be complicated.

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  17. Cammy, I prove nearly every day that I'm human...LOL I'm the queen of mini trantrums, but usually I throw them alone :)

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  18. I would be very cautious about automatically blaming osteoarthritis on weight.

    Women are like dogs: we have a lot more hip dysplasia than men, as well as badly positioned knees.

    I had a hip replacement in my 40s. I now know that I have extremely poor architecture: both my hips and my knees have always been misaligned and I could have weighed 50 pounds soaking wet and still ended up with arthritis. I also have an extremely fragile spine. All of this is no fun at all.

    One of my knees is seriously going. My surgeon specializes in my particular knee problem--which also strikes the skinniest of the skinnies: ballerinas. I'm going for my TKR at the end of this year.

    My knee is so misaligned that I cannot do any exercise that involves flexing. No bike, no elliptical trainer. It even hurts when I swim. Fortunately, I can walk and that's what I do, plus yoga (though very gently and with many props).

    Stop giving yourself a hard time over what "may" or may not have brought up your arthritis and keep doing what you're doing to stay as healthy as possible.

    One thing about the TKR: if you overuse your new joint, you will be in earlier for a revision. Don't even think about running or jogging, no matter what anyone says. I met a guy in rehab after I had my hip done. He was rehabbing his knee revision and it was tough. But he admitted to playing hockey after his first TKR. Now's there's a real causal example and not just one of correlation.

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  19. my heart started racing seeing the weight limit on the table :( all the more reason for me to continue on my journey so that weight limit isn't a problem.

    It sounds like you've had a heck of a time of things, I hope the doctor has you feeling better soon. I expect my knees aren't far behind yours.

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  20. Hey! Becky asked me to read your blog and comment if I felt like it. I had my knee replaced January 18, 2010 at the ripe ol' age of 48. Like many people I wish I had done this at least 5 years ago. Doctors said that I needed a knee replacement, but that I should hang on until I was closer to 65. This started when I was about 42, so I was looking at 20 years of immobility. Some doctors said it was my weight, some said that while my weight might make it worse, it was not the cause. I kept telling them that I hurt my knee rollerblading and it never fully healed. Finally I had a doctor who did an MRI, not just X-rays. Turned out I had an unexplained growth on the back of my knee. He sent me to a sarcoma specialist who said, "How are you walking?!" I wasn't walking well by then at all. I told him that other doctors said that the knee replacement wouldn't last very long. He said that he has done knee replacements that are still good after 20 years. Some did not last as long, but many did. There are new knee types and are improving all the time. There is no way to know how long they will last.

    I could walk better 1 month after surgery that I had walked in over 5 years. I had it pretty easy - 4 days in the hospital, no catheter, and I was walking on the walker within 2 days. I was on a cane for another 3 or 4 weeks as I needed it. I carried it with me much longer as a psychological crutch - most of the time it stayed in the back of my truck. That unexplained growth was a calcified ligamnent that had ripped in two when I fell rollerblading in 1995. The arthritis was inherited.

    I did develop some scar tissue, a few weeks after surgery and took quite a while to work around that. The doctor had an electrical thing-a-ma-jig that seemed to help. He was going to try it on more of his patients right after surgery to help with pain control.

    The most difficult part was / is building up the muscle tone after surgery.

    I say have the surgery sooner rather than later. There are no guarantees. There are some horror stories out there. Recovery is a journey and your physical therapist is evil incarnate, but you will love him / her. Check out your doctor, I dropped my first doctor who was charming and everything I could hope for, until I checked his public records on the state medical board site.

    Don't blame weight past or present for your knee. You could legitimately have arthritis. And even if your weight is/was a cause you deserve to be pain-free or at least mobile. A dying bone is not going to improve.

    Best of luck on your journey.

    Tracy

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  21. NewMe, please let me know how you do with your TKR. I'm so sorry you're in such pain. Thank you for sharing your story and for your support.

    Tracy, just sent you an email. Thanks so much for all the info.

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  22. Lynn,

    I will definitely let you know about my surgery. I don't have a specific date yet, but the paperwork's gone in and I'm just waiting.

    I'm in Canada and it's elective surgery, so you don't go in the day after the insurance gives the OK. I'm fine with this, so I'm just biding my time.

    Actually, if I avoid all the exercising I want to do (I've got a great stationary bike and elliptical gathering dust), I'm usually not in too much pain. Mostly, I have to be very careful of not doing anything to aggravate my back. Now THAT's pain with a capitol P. To be honest, the idea of rearranging my architecture through TKR scares me a bit since it might set off something in my back. I'm actually taking this waiting time to mentally prepare for the change, which I can only hope will be positive.

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  23. Bonesmart.org has a wonderful patient forum covering the subject of knee and hip replacement. You will find many in your situation age-wise. I was 57 for my first (right) knee replacement and 58 for my second (left) knee. It's now 13 months since the second, and it's true, you won't regret it.

    My first knee surgery was arthroscopic, and was a total waste of time and money. I suffered for a full year until the knee replacement surgery was done. The problem was that I had gone to a surgeon with no replacement experience, so he was not a proponent. When you make the decision to do the replacement be sure that you go to a surgeon with LOTS of experience in doing them (500 or more per year).

    You will learn so much on the bonesmart forum, just go on and introduce yourself and ask any question you have and you will soon hear back from Josephine and Jamie and all the others will the knowledge and experience from which you can benefit.

    Lots of luck to you!

    CG

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  24. Lynn, I had bilateral knee replacement surgery in 2006. I was 53 yrs old. It took me a full 6 weeks to recover enough to start working at my sit down job part time. At the time I weighed 260 lbs. My surgeon believed that obese people needed surgery if they were ever going to be able to exercise again. After the surgery I gained another 37 lbs but then lost 120 lbs. I go to the gym 5 times a week for cardio and weight training. I am a changed person and so thankful I had the surgery when I did. It was painful but that passes quickly. You might want to check out my surgeons website for more research. http://www.johntdearbornmd.com/

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  25. You are such an inspiration! I only have 14-16 kg to go before I reach my target weight and I see your weight loss and think "If she can do it, I can!". Thanks for sharing your story! Mine is available at : http://obesityrehab.blogspot.com/


    xoxo

    carla

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  26. My mom recently passed away at the age of 95. She was mentally sharp as a tack but had to spend her last months in a nursing home (which she hated) because of spinal, hip and knee osteoarthritis. She was in pain for years. She was obese for many years (around 250 at 5'3). I am 61 years old and my knees and back started giving me trouble. I recently lost 30 pounds and I feel so so so much better. Aches are gone. I can go up and down stairs normally again. I lost the weight to avoid/lessen the osteoarthritis. I don't want to end up in a nursing home like my mother did. I know if she would have lost weight many years ago that maybe her later years would have been more pleasant. The fact that you did it while you were younger will always be a great advantage for you.

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