Down, is of course, my knee
Saw the surgeon and his team on Monday. I’ve been crying on and off since.
The easy bits are that I got another shot of synvisc under my kneecap. What is it and what’s it for? “SYNVISC is a viscosupplement injection that supplements the fluid in your knee to help lubricate and cushion the joint. SYNVISC is for people with knee osteoarthritis who have not received enough pain relief from diet, exercise and over-the-counter pain medication.”
Read more here.
I’m also still wearing the knee brace and it’s helping on days when I’m on my feet a lot. I spent the weekend in New York and even though I took the subway more than usual and hopped in a few taxis for good measure, I still got 13,000 steps in on Sunday including a walk through Central Park. Thanks knee brace. I did some shopping for more leggings for under the brace and for short skirts and dresses to wear over the leggings. The brace presents some fashion challenges and I’m warmer than usual with black leggings on no matter what.
I’m still going to physio and doing lots of knee-supporting exercises.
I still meet the conditions for knee replacement surgery (in both knees actually though only the left hurts) but neither of the surgeons I saw recommend it. I’m too young and I’m too active. The surgeons made me laugh, which is something, given the general message they had to deliver.
They said they like to make people happy. The person they make the most happy through knee replacement is somebody who arrives in their office, sad and older. Someone who just wants to walk to the grocery store without pain, the kind of person who says they want to lead a normal life, get a decent night’s sleep, and not suffer all the time. Knee replacement apparently makes that person very happy but they said for someone like me it wouldn’t make me happy.
Why not? Because I want to regain function and their line on knee replacement is that you shouldn’t do it to regain function, you should do it to lose pain. Also, knee replacements don’t last very long maybe 20 years and I’m young. I want to do things like ride my bike and some patients after knee replacement have difficulty bike riding because they don’t have the full range of motion back necessary for riding a bike.
So, no.
Instead they discussed a different surgery called high tibial osteotomy. That surgery involves breaking bones and resetting them so I have a bigger gap in my knee cap on the side that’s in a lot of pain. It’s a good sign that the brace helps because this does surgically what the brace does mechanically. But it’s not a permanent fix. There’s a chance the other side of my knee will become painful as arthritis advances. So it’s good for 2-10 years maybe. Also, it’s big deal surgery. Like knee replacement it’s months and months of recovery. I’d trade off 10 years of active living without pain for six months painful time consuming recovery but I’m not sure about 2 years. There are no magic globes I can peer in to see the future.
I’m trying to decide. See them again in three months.
In the meantime my fit feminist friend Sarah is having that same surgery. Wishing her well.
But the other depressing piece of news from the surgeons was the strong recommendation of weight loss, both as a way of avoiding surgery and as essential to recovering from it. Either way I should lose a lot of weight. It will definitely, they say, help with pain relief. The pain is all about weight bearing. That’s why downstairs is harder than up. It’s all about force on the kneecap. And as far as motivation goes this is pretty horrible pain. Like pain that makes hard to think about other things.
Now as I’ve said before I wish that it were the case that medical reasons for weight loss changed the facts. But that’s not so. Your body doesn’t care how good, how “pure” your motivation is. It’s still tough. It’s tough losing weight and tough keeping it off.
I don’t have any choice but to try. The worse case scenario is that I lose it, gain it back, and more and need knee replacement surgery. But that’s the same worst case scenario I face now. I’ve lost significant amounts of weight in my life, 70 lbs in grad school, 60 when I turned 40. The trick, the hard part, is keeping it off. This time, if I actually lose weight, I’ll be unicorn training, learning the habits of people who actually keep weight off.
Don’t worry. This won’t become a weight loss blog. Likely I’ll save any angst, any updates, to my monthly check in posts. I’ll also add content warnings.
I thought about leaving blogging but making this pain manageable and movement possible is a big part of my life right now. And I’m very much still a fit, feminist just one who is coping with injury and aging and hoping to keep in moving.
Wish me luck.
Up, still Snipe racing
It can be tricky moving around in a small boat in ways that don’t hurt my knee but I’m learning how to do it. I haven’t raced a small sailboat ever. All of my sailboat racing experience is on relatively big boats so this is new to me. With all the knee misery, see above, it’s good to have something new to focus on. It’s fun and exciting and lots to learn.
Sending you a huge hug. Being so constrained physically when you’ve been able to move so freely is a profound challenge to your identity — I’m sending you strength and faith that you will find your way through this to your next fitness life xxxc
^^She said it better than I can. I’m sad to hear that this is such a painful time for you (both physically and psychologically). I’m glad you’re willing to share that with us, and to continue blogging–I hope we don’t cease to be a community or support system during injuries or aging.
Wishing you peace with your choices, and luck with the journey.
Sending you a big hug! I struggle through my knee issues as well. I am sure you will find your way through this and come back stronger!
Unfortunately, there are no proven ways to keep of weigh long term (beyond 5 years), although 3% of the populations can through very disordered means. I hope you can make peace with your body, and that your doctor/surgeon can see through the weight of your body. It’s so sad that doctors make these recommendations.
the doctor is only making an honest recommendation.
When it comes to joints it is a matter of force, which correlated to weight and exertion.
We wouldn’t tell a structural engineer to ignore the weight of the building when designing the supports. You also can’t avoid that reality with a knee. The body presses down on the knee.
That said, if the doctor was unwilling to replace her knee with out weight loss it would be a different story. Instead he laid out the options and realities. I’ve seen people with knee replacements. Some do have significantly restricted mobility.
Please don’t stop blogging. Sharing what you learn as you go through this will be valuable for many of us, I am sure. I wish you didn’t have to blog about this and that your knees would get better quickly and painlessly.
I will say that the doctors, both of them, were very matter of fact. I didn’t feel judged for size. It’s a sports medicine clinic and they see a lot of former football players, men a lot bigger than me. I also didn’t feel they were blaming my size for the osteoarthritis. They said they have a lot of thin patients too. And the were offering this as a way consistent with my goal of avoiding surgery. They didn’t make it sound like weight loss should be easy and they admitted that they had no expertise in this area. All in all, given the news, I thought these guys did a pretty good job delivering it.
Sorry this is so tough right now. I had no idea you were considering stopping blogging and am glad you’ve decided to continue.
My husband at 40 had bilateral partial knee replacements – Oxford Knee- Dr Rathbun Scarborough Gen Hospital. He did cortsone, synvisc, knee brace and physio all prior. This was an alternative to the high tibial osteotomy. They just replace the medial side of the knee and it leaves the option of a full knee replacement in the future. He could barely walk down the street without pain and now can cycle and hike with no issues- it was life changing. I just make sure he avoids skiing as a precaution and I do not want him to mess those knees- he is still in his 40s. This ay be another option to explore. Age is not a reason to avoid surgery when medical advances can change in twenty years. He also finds reducing processed foods and sometimes more of a paleo way of eating can reduce pain (still has OA other areas) even without weight loss and even without adhering 100% to a way of eating. You are already doing the right things by being active but I have been surprised by active people who are in the late 50s/60s who were going to need pain meds to remain active and have replacements and be very happy with the results. Only you can decide how much this is impacting your life.
Don’t quit blogging. This is it, the real life stuff that people need to hear about. Talking about fitness is easy when everyone is healthy, has full mobility and life is hunky dory. It’s when things don’t go as planned, (which is life) that is so needed when we talk about fitness. I experienced this myself after my controlled autoimmune condition took a turn for the worse about 2 years ago. Things changed and even though I kept reading fitness articles and blogs and whatnot, none of them were speaking to me. It has been a journey to adapt and modify and I personally would love to hear more about how others do it. Including the messy emotional part of the loss of the person you once were or at least, thought you were and remaining active and positive.
Thanks. This helps.
I’m so sorry this is going on for you, Sam; it sounds really hard. Thank you so much for continuing to share so honestly and straightforwardly with all of us. You mean a lot to me and to the whole large FIFI community.
très bien et c’est enrichissant