Help Please

[shutterbug]

I am 51 and in need of a TKR. I have been needing one for around 15 years.
Before I was too young.... Now after 15 years of suffering. I have gained a bunch of weight. (over 90 lbs) Now they tell me I weigh too much. I cannot walk without a cane, and soon to move to crutches(next week). Stairs are very painful. Sleep is ok.. I have been on hydrocodone 10/325's since Jan.
I take 1 to 3 a day depending on my day. My quality of life has gone down hill mostly in the last 8 months. I have been working out fairly reg, and cut cals, but the weight is very stuborn coming off. my other knee is aching almost as much as my bad one. Tendon problems in both ankles and now my hip is starting to pop when I Walk. Should I push my doc to do it or should I wait ? Please help. The last few months my depression has been getting worse.

 

[Simon]

Shutterbug

Many of us were in the same boat of either by choice waiting it out or like you being told you are too young. The problem with that is just what you found weight gain, depression, pain and a crappy quality of life.

Now this might not work for you but this worked for me weight wise and I lost 100 pounds but it took more than a year and I don't know if you can last that long. What I found though as the weight came off the knees felt better so that might help you make it. For the first part, I just paid more attention to what I was eating, got rid of the junk and exercised more (I was in pain but nothing like you). Then I gained 40 pounds back and just could not lose it so I knew I had to shake things up and for me reducing the carbohydrates to about 80 gram a day (mainly fruit, veggies and oatmeal in the morning), increasing protein, no white food (pasta, bread, potatoes, rice, corn) and drinking lots of water helped alot. I also had a good breakfast, lunch was the main meal and a light supper. Others have tried 5 meals a day. Eating different things each day also helped jump start the metabolism. Water is a critical element.

Losing the weight will make surgery and rehab easier but if life is so full of pain and depression then you need to take care of the knees first and the rest will follow. The other thing would be to push them for some kind of inpatient weight reduction/physical therapy program.

Keep writing, people here are great and will help you get through those bad days.

Good luck to you.

Simon
Simon

 

[Josephine]

That's so horrid, shutterbug. You need to keep searching around for a surgeon who will do your knees despite your weight. Just before I retired 18 months ago, I looked after a lady who had her knee done and she weighed nearly 400lbs! And she did wonderfully well! I weight nearly 260lbs but my surgeon (same surgeon) would do mine if needed. Happily, mine seems to be in some kind of remission right now!

Keep searching! You need it done, never mind the age thing. You're plenty old enough!

 

[AlaskanTKR]

Shutterbug
My heart breaks for you. I too struggle with my weight. Up and down all through my life. 2 years ago I had 4th arthroscopy with removal of remaining cartilage to due trauma. OA progressed rapidly. After surgery decided it was time - lost 120 lbs in about 15 months - healthy eating and WALKING everyday about 7 miles on my wonderful treadmill, plud skiing and working the weights and eliptical at the gym 3-4 times per week. I was extremely dedicated and my knees really started to feel good - UNTIL>>>>>>>> Wipe OUT! (By the way - I looked the best I have since being a Junior in HS). Not once this winter - but twice. Totaly screwed the knee up on the last wipe out - the kind when you are falling forward and have the time to try to figure out how you might land so you don't hit your head. Well I landed so hard on my knee I thought I split the knee cap. Smashed the elbow and still had to get me and the 137 pound dog I was walking home. That was it - I knew I smashed the knee bad, but unfortunately had no time to see the OS. Could no longer use treadmill or ski - lucky to make itthrough the day at school. Long story short - put back 60 of the pounds rapidly due to lack of activity. Finally got into the OS and told him what happened and I didn't really care how we fixed it but I had to get back to being able to use the treadmill. Xrays - OS couldn't believe I hadn't come in sooner - TKR was scheduled. (I thougth synvisc or maybe partial). He and I talked about the QUALITY of life. How could I stop the weight gain - simple use the treadmill - proven fact - it worked once it will work again. How to get on the treadmill - fix the knee!

I am struggling a bit right now - but I know in the long run it will all be worth it. I feel a bit better everyday and have actually used the treadmill at PT and hope to begin using it (under pt guidance) next week at home.

If I were you I might look for a second opinion. It is very difficult to get the weight off with dieting alone - Eating properly is just on eof the components - that EXERCISE is really the key!

Good Luck in your search. Begin with the healthy eating - but don't give up on finding someone who wil help you return to an active lifestyle. In the end the issues with this TKR of mine will seem like nothing when I can get my life back!

Marianne

 

[carolinagirl]

Shutterbug,
How terrible. I agree with Jo. Please go for a second opinion. I did and am sooooo thankful. The OS I HAD been seeing, has scoped both knees, (one last Nov and the other this past Jan). He was the one who dx. me with
Osteoarthritis. But he would not do a replacement. He wanted me to wait until I was in my late 50's. Well I was 43 at the time. I am 49 now and the pain had gotten so bad since the scopes I could not walk without a walker.
So, fine, if he would not do it, then I would find someone who would.
Just so happens I went to the other ortho group in my town and
that doc took one look at my x-rays they took and scheduled my surgery for 3 weeks later! Now here I am 5 weeks post-op and doing great! Doing things I could not do months before surgery. I have gotten my life back and it is getting better everyday. Sure I have my good days and my bad days, but to be truthful don't we all have those? Best of luck to you. Find someone who will help you. There are surgeons who will do this at your age.

 

[Rowdy66]

I Was In Terrible Pain The Last Two Years Before My Surgery And Needed To Lose Over 100 Pounds. In Fact, I Refused To Have The Surgery Until I Had Lost A Lot Of The Weight. I Was Successful And Lost About 70 Pounds Prior To Surgery And Am Still Losing. From What I Have Read Though I Would Have To Say I Was Pretty Stupid To Live In That Much Pain For The Year Prior To Surgery And Had I Had Someone Life Josephine To Talk To At The Time I Would Have Gone Ahead And Had The Surgery And Worried About The Weight Afterward. I Do Not Think Josephine Would Steer You Wrong And That You Would Do Well To Follow Her Advice And Find Another Surgeon Willing To Do The Surgery And Worry About The Weight Afterward. You Will Be Able To Lose Those Stubborn Pounds After The Surgery When You Can Move. The Pain Is Just So Terrible I Don't Know How I Stood It And Waited. Good Luck To You. Hope We See A Post Soon Where You Are Telling Us Of Your Upcoming Surgery. Rowdy

 

[shutterbug]

Thank You all so much for your words of encouragement. I will talk to ortho doc and see if he will do it. I have a appt next month. If not I will find one who will. Went to the gym today. Did some time on the eliptical and hand pedal machine. I will most likley pay for it later tonight. I am so glad I found this board. Reading the other posts have really enlightend me on what lays ahead. Talking to people who have delt with and still dealing with what I am going through really helps. Thank you all again!!!!

 

[hollyhobble]

Hi there -

I recently had both my knees replaced and though it has been a struggle getting through all the stiffness, aches and pains, I have never regretted having my surgery. I found that I lost over 27 pounds thus far and have gone from a weight that is in the "obese" category to the upper reaches of "normal" which was a special bonus to me. I found that when I was in the hospital and nursing home, I had very little appetitie due to meds, having my PT right before my meals and to be honest, the menus were not that appealing. The little appetite has carried home with me so the weight loss is a bonus.

Never once have I regretted having the surgery on both knees but have regretted from time to time not having it done earlier and missing out on some very enjoyable bits of life I could have been participating in.

I have no idea how heavy you are and true 90 pounds is quite a bit of extra weight, but I have a dear friend who is also VERY heavy but could not possibly put off her surgery any longer. She chose to take it one knee at a time, about a year apart and is doing marvelously. She also joined Weight Watchers after she was up and around to help a bit. At 73, she clearly does have health issues but none of them involve her knees any longer and she is just thrilled to be able to get around well with no cane or walker or anything anymore.

So my personal feeling is, go ahead with it! It will be the toughest thing you may ever do in your life but for me, even after three months, it is one of the most worthwhile! My knees are starting to feel like part of my body already and although I am still siff in the morning and after getting up from a chair, I can move with the rest of them!! Take care, good luck and know that there are a host of people out here that have been through the same thing and willing to support and cheer you on.

Holly

 

[shutterbug]

Being 6'3 330 lbs my doc told me he would like me to get to 240-250 range.
I have modified my diet... no junk.... well maybe a small DQ Blizzard once a week. my only treat. I try to get to the gym 3-5 days a week as long as my knees are with me. I did buy a total gym. Been using that on days my knees do not want to cooperate. Again I thank everyone here for their words of encouragement.

 

[Rowdy66]

Shutterbug My Husband Is About The Same Height As You And Weighs In At Right Around 300 Pounds But He Is A Very Large Boned Man And When He Gets Down To 240-250 He Is Actually Thin Looking, Maybe The Right Word Is Lean. He Had To Lose Weight A Few Years Ago To Get His Job With Corrections, He Had To Pass Some Pretty Tough Physical Challenges And He Lost The Weight In About Three Months Just Cutting Out Ice Cream And Eating Three Well-balanced Meals A Day. He Has The Job And Has Had For Several Years And Is Among The Officers That Move The Fastest And Are Depended On The Most. Yes, His Weight Crept Back Up To The 300 Range And It Stays There Even With Him Watching What He Eats. Iin 1998 When I Became Totally Disabled Due To My Back He Began To Do The Shopping And He Is An Avid Reader Of Labels And Is Very Particular What He Puts In Our Diets. I Cook It And Incorporate All The Little Tricks You Learn With Age To Make What You Eat Less Fattening, So Together We Have Managed To Eat Healthy. Don't Get Discouraged, It Is Going To Be Easier Than You Think For You To Lose The Weight And You Can Do It While You Are Recuperating From Surgery As Easily As Before. Probably Easier To Lose Afterward. I Look Forward To Hearing About Your Progress And Wish You All The Luck. Once You Have Your Knees Done You Will Have Such A Different Outlook On The World. I Look At This Surgery As Life Saving In My Case And I Am Sure Others Feel The Same Way. Rowdy

 

[exjock]

Shutterbug,
I am 6'4" and weigh the same as you. I am 49 years old and have been bone on bone for awhile. I had my knee done 2 1/2 weeks ago. Would it be better if I weighed 230? Sure it would but the way I felt there was no way I was going to do any exercise. For me there was no decision it had to be done regardless of age or weight. The worst thing that can happen is it will wear out a little sooner. So be it. As a little encouragement I recently met a brother of a freind who is going on 15 years with a TKR. He weighs 360lbs. and is very active.

Don't suffer any longer. If your Dr. won't do it find one that will.

I have found that this surgery was a good jumpstart for losing weight. First couple of days in hospital I did not feel like eating much and the menu at rehab. seemed like it was designed for an 80 year old.

Good luck to you. Hope you find someone that can help you.

 

[schoust]

Hi Shutter I agree with the Jock! If you are suffering like that there is no need! I have to laugh at some of the statements that I here like your to young or your to heavy and other's considering the person that is saying this is not in excruciating pain 24 hr's a day! My Mom had both of her knees done and she is wayyy heavy. Without a doubt there is a lot to be said in being fit and having the ideal weight going into the surgery but feeling much better in my opinion is first and foremost. We can worry about revision another time. Good luck
Ralph

 

[carolinagirl]

My OS made the statement at my first visit with him, having OA and being bone on bone restricted what I did. Therefore, it effected my exercising, etc....... His words were who wants to exercise when in so much pain? He said not to worry about weight loss until after surgery. One thing is for sure, PT is working my whole lower half, not just my knee. Some of the exercises for my leg work my abs also. I lost 60 pounds last summer just by cutting WAY, WAY, WAY, back on carbs. We went on a cruise to Alaska last September and I ate what I wanted. Problem is, I have continued to eat what I want since. I have gained about 35 pounds back. Oh well, only thing to do now is lose it again!

 

[AlaskanTKR]

I am right there with you Carolinagirl!
Marianne

 

[shutterbug]

Thank you.
I went tp the gym today. Forgot to take pain med...... Now I am paying for it.
Went an easy pace. (on eliptical trainer) This wonderful machine is ok on my knees (as long as I remember my meds). My appt with ortho is sept 2nd. I will ask him if he will do it. If he won't I'll tell him that I will find someone who will. I am taking 1 to 3 hydrocodone a day just to get by. The weight is coming off (1 to 3 a week). I have a long road ahead. Again I thank you all
for the encouragement. I was very depressed until I found this board. It is so hard for people I work with to relate as they never been down our road.

 

[AlaskanTKR]

Shutterbug -
Keep up the wok at the gym - I cannot wait to go back and get off what I gained this winter. The PT always laughs at me because no matter how sore he makes me with all this bending at PT - I always jump at the chance to get on the treadmill at the end of the time. I guess it is like a symbol of freedom. I think we need to start a thread for all of us who need to drop a few so we can support each other through this as well. Feel free to message me if you need any moral support - When I lost the big amount 2 years ago it was due in part to a great support team. Unfortunately I do not have the same support anymore so ...... hmmmmm - maybe a new thread to come!

The eliptical - I love the eliptical but I am afraid that may not be in my near future quite yet.

Marianne

 

[Gretchendz]

I'm with all the others...of course, keep trying to lose if you can but I'd find an OS who will operate. Exercise is SO MUCH easier once the pain is gone

Best wishes--and you're right--these boards are great.

 

[shutterbug]

Talked to OS. We are shooting for 1st week in nov. I can't wait!!!!
I am starting all of the testing. I will let you know when I get the exact
date.

 

[Josephine]

Great, shutter! I am so pleased for you.

 

[tennisjunkie]

Dear Shutter- I agree you should continue to try and track down a doctor who will perform the tkr for you. In the meantime, please try to get some different types of pain relief. I had several different doctors prescribe vicodin to me. When it wasn't enough to cut the pain, they would give me more. Later I found out the amount of tylenol I was taking in a day was very harmful to my liver. There are much better drugs out there to relieve the pain. Consider making an appointment with a pain management doctor who can assess your condition and try different medicines. (Make sure you get a referral, as some of these places are pill mills). You need effective pain management to be able to exercise. Have a good day.