Wednesday, May 04, 2011

"Kneed" I Say More

Medical Report

OK, so I met with the orthopedic surgeon this morning. He is a young man, fine by me, with a long list of credentials.

He asked me about my knees, and I gave him the history. I mentioned that I'd been treated with prolotherapy and PRP therapy, but no longer felt it was doing much good. He was a bit skeptical about those approaches, but I know they worked, so I just told him that.  He asked the famous question about how much pain on I had on a daily basis...that scale of 1-10.  I never know how to answer.  I just told him that they hurt most of the time.

Then, he said I needed some new x-rays and off he went while I got the pictures taken.

Well, tune changed when he came back in to see me after looking at the pictures. In his words, my knees are beyond repair.  They are completely "bone on bone," on the inside of the joint, and there is arthritis elsewhere.  When he did a brief physical exam, he was a bit taken aback by how unstable the joints are--far too easy to move about. But, again to a bit of surprise, I have plenty of flexibility in that both knees can bend to their full extent.

At this point, aside from painkillers, total knee replacements are my only option, so it's just a matter of when.

As Jen so wisely commented on my last "knee" post, this doctor does not do two knees at the same time.  Three days hospital recovery is the norm, as is about a week in a rehab facility when the patient, like me, lives alone, although I could cut that shorter if I were able to demonstrate an ability to care for myself.  Then, usually a therapist comes to the home for some in house PT and then PT outside afterwards until the knee is at its best.

The only dispute, was about riding post-surgery. This doctor seems to think it's not a good idea, but my research on the Internet is quite the contrary. As a matter of fact, horseback riding is one of the recommended low impact exercises for TKR (total knee replacement) patients.  Of course, falling off a horse is NOT recommended, but I would not exactly plan on much of that.

The doctor was very surprised that I could ride at all now, considering the state of my knees at the moment.  Well, that only means one of two things to me: Either I have an amazing ability to do the impossible, or riding is not as big a stress on the knees as my doctor supposes.

Anyhow, there are some big logistical problems to sort out. First, of course, is the horse care during my layup.  The doctor again said I would not be able to take care of the horses for at least six weeks of recovery.  But then I asked if that all I needed to do was go out to feed them, if that was OK.  That, he seemed to think, would be fine once I was able to walk around safely.

Fact is, if I had to, I could do that on crutches.  So, it looks as if as long as I am home, I can do the basics as long as I can get someone to do the heavy work including stall cleaning.  Hopefully, I can figure something out.

I am semi-upset by all of this, mostly because of the time I will need for my own layup.  In some ways, doing only one knee at a time is probably better, but it does take longer. On the other hand, I would be more mobile sooner, so that's a plus.  I am also a bit surprised myself at just how bad my knees actually are.  I did not see the X-rays myself...a little frustrating, but the computer was not loading them...but they must have been pretty bad from the reaction my doctor had. I am rather surprised that I am actually able to do as much as I do now. It's going to be darn incredible to have new knees after all this!

I am currently thinking of perhaps one replacement in September, and the second soon after...or a wait until spring if it looks like we will have another bad winter. I do not want to be laid up during a blizzard.  Not only would it be nearly impossible for me to get out to the barn myself, but there would be no way for someone else to get in here to take care of the Boys in a bad snowstorm. As noted, I plan on swimming this summer, so that's out as an option.  Besides, I also figure that a summer of swimming will get me fit, a little thinner, and in a much better physical state to face the surgeries.

So that's where things stand. I have a lot to think about.

7 comments:

  1. Brett had a total knee replacement in December of 2009. He was in the hospital 4 days if I remember correctly. He started out walking a few feet on a walker, a week later he was going up and down the hall with a cane. If you live alone, a rehab facility is a must. You will be learning to walk all over again. The progress is slow but then one day, you are walking painfree and loving life. My husband rides all the time - and his riding has improved. His surgeon didn't say "no" he just worked with Brett on "when." Go for it -

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  2. That's a lot to face, but if it improves your quality of life and ability to ride and do all the other things you want to do, it'll be worth it. Wish I lived closer so I could help out with the horses.

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  3. (((((((HUGS))))))))
    I hope you make the right decision for you. I agree that swimming and muscles building and proper diet will definately help you before surgery.

    But teh goal to be pain-free is fantastic.

    Good Luck ^-^

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  4. I agree with you that it is upsetting to find out just how bad your knees actually are. Had the same problem with mine (bone on bone) so I feel your pain. When I had my knee done I waited and did it in the middle of Sept. figuring I had the summer to ride and enjoy the horses before the weather turned bad again. I did go to a rehab for a while and they really do help because you do PT a few times a day.

    I think I was in the hospital for three days and the first day they get you up and you are walking down the hall etc. with a walker. Then off to rehab where I never used crutches but went from walker to cane within a day or two and up and down the stairs. Pretty intense but doable. The best thing I used was a machine that you lay your leg in and it exercises bending your knee so you don't get adhesion's. Take that home with you for a few weeks. You use that a few times a day.

    Recovery is a little painful until you get the range of motion back but since we're horse people I believe we are tougher than most and can deal with injuries. I also have no trouble walking or riding. I'm not crazy about the idea of ever falling off and hope I don't but my leg/knee is much stronger now and there is no pain so I think it was worth it for me. Good luck, wish I was closer to you to lend a hand.

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  5. guess the surgeon doesn't ride, LOL.

    i'd be inclined to get the one done as soon as, and try and get both done when the horses can be out and save the work.

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  6. You do have a lot to think about and I would be upset too. It certainly has lots of negative aspects and the recovery seems long and complicated. But you have to be realistic, as I am sure you are telling yourself. My feeling is - the sooner the better. As Claire noted horses are much less care in the summer. In your case there will most certainly be major relief/reward. Think of how much better you will feel and how much more you will be able to do!

    In a way I am not surprised that you can ride some. There is a natural painkiller that comes into play when around horses - I have no idea what it is but it's pretty effective. I had to smile when you said falling off was not really in the plans. It's not in mine either.

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  7. ARGGH! well, a retired chiropractor friend had I think 2 total knee replacements, (he was even on a billboard in Idaho!) and is back to riding 50 mile endurance rides. but - ARRGHHH! I feel for you!
    - The Equestrian Vagabond

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