18 months post-op with a cautionary message

[SusieSW]

Hi All - I posted a few weeks ago with a new concern - after 18 months, I found myself with a "snapping" in my BTKR knees and hip pain. I finally was able to get into see my OS a few weeks ago, had xrays of both knees and hips. The good news was that both implants looked fine and although there are signs of osteoarthritis in both hips, there was nothing alarming. But the OS scared me with speculation - he told me that I had progressed quite a bit with my arthritis and that I had a lot of inflammation in all my joints - fingers are getting distorted - OA everywhere. Then he said he suspected an auto-immune disorder. I looked that up and got so scared I stopped looking. I got in to see a rheumatologist about a week ago. He reassured me there is no sign of an auto-immune disorder - whew!!! But - I have too much swelling and inflammation in all these joints and we are trying to get that down. He also referred me back into PT! Yep - after all this time, I'm back in physical therapy.

So here's the cautionary message. First, for those of us who had arthritis before our TKR's, we still have it after and need to take care of it. Also - I think I let myself down and stopped really taking care of myself. I started working again and got really busy - working six days per week and some evenings. With all the walking I was doing and going up and down stairs, I told myself I was working those knees and I got sloppy about working out. Sometimes I went to the gym, often I didn't. When I had my first PT Monday this week, I found I had lost some ROM and my muscles are incredibly weak. She has started me on a regimen to work the muscles and all that stuff in there that supports both the knees and the hips. Eventually I guess we'll get to my aching shoulders.

I feel like I had to have someone knock me on my head to wake me up! What was I thinking? I confess I feel pretty stupid at this point. I worked so hard in those first months after the surgery. Then, I let life take over and I put paying attention to really maintaining all that progress on the back burner. That just doesn't work.

I do feel a renewed energy to fully commit to regaining my strength and flexibility and hopefully to get in even better shape than ever. I just wanted to share my story in the hope that it encourages anyone reading this to keep the momentum going even after the initial recovery period. My best to all of you!!!!

Susan

 

[Jamie]

Susan, thank you for a wonderful post!!! We can all learn from what you've been through! I wish you the best as you tackle this new challenge. It certainly sounds like you have excellent medical support with your doctors and PT. You are doing all the right things and I'm sure you'll be back where you want to be in no time. I guess the old tried and true still apply to any of your parts that hurt and swell - anti-inflammants, ice, rest, elevate. Post again and let us know how it's going.

 

[Josephine]

Oh no, Susie - do not lay that on yourself! Your recent activities can in no way have even contributed to the extra arthritis. That has been simmering away inside you for years. It doesn't just come on in a matter of months!

What your doctor is describing is also known as rheumatoid arthritis and is generally thought to be genetic in origin. Also, it's not an auto-immune disease like AIDS or similar. What happens with RA is that the white cells which normally consume foreign bodies like bacteria and dead tissue, suddenly have a genetic switch thrown and begin to 'see' some normal tissues as foreign bodies. In this case, it's the synovial membrane in joints and then the articular cartilage. That's why it attacks pretty much all the joints, also getting the name polyarthritis (poly=many). It first begins to attack the synovial membrane which causes it to become inflamed and grow and also to produce a lot of synovial fluid, nature's joint lubricant. Then it progresses to attack the articular surfaces. It varies a lot in degree of damage and can suddenly be swtiched off as quickly as it was switched on. Nobody knows why.

I read a few months ago that some scientists are working on the theory that it is activiated by a virus and are trying to create a vaccine for people who have a family history of RA but which might also be usable in people who already suffer from it. We live in interesting times .....

 

[Simon]

Hi SusiSW

i can relate to the fact you will always have OA as at about 10 months I thought I would cut back on the aspirin (my NSAID of choice) from 12-14 a day to 2 and within a month, the knees were starting to feel alot like they use to. My annual blood work also showed a low white count and increased monocytes a combo that indicates chronic inflammation. Well I cut back a bit on the exercise and things just got worse (the repeat WBC went down again) so it is back on the aspirin. I still do my exercises most days but I always ride my exercise bike.

Thanks for the heads up.

Simon

 

[backbay38]

Susan -- I also have arthritis in my hands and probably elsewhere but - my surgeon says - not in my knee with the implant anymore because he cut out the diseased joint. I hope he's right and osteoarthritis is totally different from rheumetoid arthritis as Jo describes. But whatever -- you DO need to keep up the gym work for the rest of your life. I made that mistake years ago after ligament operation and was working round the clock and let my weight work go.. and slipped on ice and stretch the ligament out again.. and started all my problems... On days when you really hurt you have to cut back but then on the days when you're OK you work out. You will get back in the grove with the PT.... and it's great that you wrote your post for everyone to see and profit from. I hope they discover what you have and that it doesn't impact your life. RA is no fun so I hope it's something less painful -- but there are drugs which help as well as the exercises when you feel OK. Good luck and try not to let it get you down!!!