New Doc - New Hope?

[DesertPeach]

Seeking opinions - is it better to go into an appointment armed with facts and demonstrate that you have done your homework or to go in appearing to be "dumb" and innocent so as not to offend the doctor?

 

[kneeper]

In my experience with docs, it is better to be able to ask good questions. In my pre surgery appt with my OS I let him go through his explanations (most of which covered what I was going to ask) but then had a couple of other questions he didn't cover. He said they were good questions and was willing to answer them. He seemed pleased that I was an involved patient.

I'd say go in armed with your info, but start by getting a sense of the doc and his/her approach. He may want to start from square one so to speak in getting his own assessment. Which imho is probably a good thing. But be assertive in explaining your situation and asking questions. Does that make sense?

Other bonesmarties may have a different opinion.

 

[VancouverUSAgal]

I agree with kneeper. I'd say let the OS explain and then ask about what he hasn't answered for you. I don't think you need to act dumb by any means, but he might get defensive if you start off too aggressively. They're always so time conscious that they sometimes talk awfully fast but you certainly have a right to ask questions and the appointment is YOUR time to get the info you need.
I'll be giving myself this same talk before I go for my pre-op visit.

 

[Tweet25]

Desert Peach. Wow I see you are only 35. I am 45 and am scared to have knee replaement at such a young age. Does your doctor not want to do it? Are both your knees bothering you?

 

[DesertPeach]

Desert Peach. Wow I see you are only 35. I am 45 and am scared to have knee replacement at such a young age. Does your doctor not want to do it? Are both your knees bothering you?

Tweet25 - until recently it has always been my left knee, but a couple of weeks ago my right knee gave up on me and has had enough. I think/hope my right knee is just torn meniscus, but I am afraid there may be more to it because it has been handling all of my body weight for several years now. I have been to several doctors - back in GA, before we moved the OS said my left knee was shot and I needed a replacement before too long. Since we moved to AZ I have been to 2 OS who said in the own unique patronizing way that there was nothing they could do until I was closer to 65. Neither doc considered for one minute my quality of life. I am going to see a 3rd OS this week with the hopes that he will take the time to listen to me and come up with a plan to help me. If it isnt a TKR then he needs to have another plan of action because I can not live like this anymore..

While I am worried about how hard a TKR is on your body and the amount of pain/recovery involved, I can honestly say I am completely terrified of having to live another 30+ years in the current state I am in before someone will help me.

 

[Tweet25]

DesertPeach I hear you. Well my doc didn't say I was too yound and didn't really say to do it right away just the next step is knee replacement. We didn't get into the details. I just started crying when I left. So I sought out a 2nd opinion with a sports med doc who watched me walk and did some other stuff and said no you still have some cartilege and lets try PT. So that is what I am doing starting tonight. Will it help I don't know. Did you do that as well? My OS wouldn't even give me script for PT since he thought I would do the surgery right away. I was quite upset over this. I can get through the day but at night the pain hurts really bad and I don't sleep. I can't go another few years like this. So I understand what you are going through. Waiting until 65 will not be a good thing.

 

[VancouverUSAgal]

Most people on here say they waited too long and should have done it sooner. It IS about your quality of life. Some people aren't having much pain so they can wait longer. Only you know how bad it is for you. It's easy for docs to set arbitrary guidelines but they aren't the ones living with pain. However, I also wanted to try other things before surgery. When none worked, I knew it was time for me. It's going to be harder now because my general health has declined due to age and sedentary life because of knee pain. So, take all factors into consideration and make your own decision. When you're ready for surgery, talk to several OS until you find one you're comfortable with. My OS is with a sports medicine group and seems much more willing to take on patients that other OS don't want to be bothered with because they have "problems" such as overweight, allergies, or whatever.

Best wishes as you travel this path.

Linda

 

[DesertPeach]

I have probably spent almost an entire year (12 months) doing PT if you added up the multiple sessions over the last 3 years (6 wks here, 12 wks there) - all resulted in the physical therapist saying this is as good as it will get. Due to the last 3 years of becoming more and more sedentary due to the increasing pain I have gained weight, lost muscle mass in my left leg and started having issues with depression and anxiety which I strongly feel are directly related to my knee. I am not a sedentary person - I am fiercely independent and constantly on the go. The last year has been miserable. I am not sure what will happen if this new doctor says I am stuck like this until I get old "enough" for a new knee.

 

[VancouverUSAgal]

It seems like you've tried a lot of things all right. I say keep searching for an OS who's willing to do the surgery. I started calling around and just asking their office staff if they had restrictions on who they were willing to operate on. That's how I found mine. Keep trying. If you have to, maybe you can travel out of your home area to a larger metro area where maybe there are more OS or try one of the teaching hospitals or UCLA, Stanford, or something. I wish you all the luck in the world. Linda

 

[possum_here]

Congratulations in finding and OS and getting the appointment. I hope you get the answers you seek, nothing worse then OS shopping.

 

[DesertPeach]

I have been putting together my packet for my trip to the OS Thursday and found my CD of knee xrays from May 2013. Thought I would upload them here and see what the "experts" have to say .


These are NON-WEIGHT bearing films. Can't wait to see what the weight bearing ones look like..

 

[possum_here]

What lovely bones you have LOL.... The weight bearing and non weight bearing difference probably wont who much different to the above. Have you had your MRI?

 

[DesertPeach]

So very disappointed right now. New OS wants to get an MRI to check out the soft tissues, but it didn't sound like he was willing to help me. According to the new xrays today I still have marginal (less than 2mm) joint space, I am too young and too fat to be a candidate for TKR. He said if I lost some weight, my knees probably wouldn't be such an issue. I have to see my PCM for treating the pain as I live too far away from his office (75 miles) for him to "keep an eye on me". The OS said that in 5-10 years they would be able to replace my cartilage, but that the technology isn't there yet. I just need to "wait it out" and find someway to lose weight. I left his office in tears. No idea what I am going to do now. I know I can't live like this..

 

[Tweet25]

Really I can't believe your OS. If you are in pain which I can relate to you need to find a OS who is willing to do it. I have lost 10 pounds in a month due toe stress from all of this and it hasn't taken any of the pain away. I was given cymbalta which made me sick and now Tramadol but I haven't taken it yet because of the side effects. I would get at least one more opinion from a OS. By the way I am only 45.

 

[kneeper]

How disappointing. Losing some weight I'm sure would help your pain a bit, but it's awfully hard when you can barely walk. And it won't fix the damage to the knee.

Have you tried strengthening the quad even with isometrics? Again, not a cure, but it can help slightly to stabilize the knee when you walk etc. I have found a slight improvement in my walking & stairs by working on my quad strength. I still need the tkr but it may be helping me get to May in not such bad pain.

Maybe the MRI will give your OS some more clues. Or you'll find a doctor who has a clue. ;)

 

[VancouverUSAgal]

Oh, so sorry. Unfortunately, I don't have much to add beyond what the others have said. I know what it's like to be told they won't operate due to weight - humiliating and frustrating. I hope something can be worked out to ease your pain and make life easier.

 

[DesertPeach]

I know I am overweight - I have put on 35lbs in 2 years because of my knee. I am not terribly large (204lbs, I am 5'3") - but OS says I have to get my BMI down to 25% atleast.

 

[Kissy]

Sorry to hear that... I know it's frustrating, but keep looking. Definitely do the MRI, It can show that your knees are worse than the X-rays show. If you still have cartilage it might not be time for your TKR (doesn't mean they can't do something else.. or maybe a unilateral). I'm 39 and obese.... having my TKR in October. I am bone on bone and have no joint space left. Been through everything.. found a great doc... actually two who had no problem doing my knee.. and my weight never came up!!

 

[Bionic woman2]

So very disappointed right now. New OS wants to get an MRI to check out the soft tissues, but it didn't sound like he was willing to help me.

I was so excited reading through your thread thinking that you'd get the help you needed. I could feel your pain. When my OS told me that I had 70 yr old knees, I laughed. I told him that would never work because, I have a 5 yr old spirit. Then I went home and cried.


He gave me the wait and see approach at first too. He sent me to P/T which made me more miserable. My knees started giving out in my 40's. By my 50th birthday I was like.... "Houston, we have a problem!" Last year @ 51, they went kaput! It even hurt to stand, let alone try and bend them. In the morning, I walked down the stairs like a spastic Tin Man. I went back less than a year later and he agreed to do the surgery.

I am older than you, but considered young for knee replacement. SO DON'T GIVE UP! If he told you that losing weight is the answer, then ask him for a prescription med to help with that cuz you DANG SURE can't exercise. If he refuses, (it's probably not his area) ask him to put his diagnosis in writing so you can take it to your GP and get a prescription. Try your best to lose the weight and bring yourself right back to him with your 80 yr old knees and say, NOW WHAT DOC? If he's still not willing to operate, tell him you have "No Quality of Life." If that doesn't work, ask him about in injections like Supartz. Just DON'T GIVE UP!

I've gained about 25 lbs since my knees gave out and I plan on returning them to sender asap! I know it's not just weight. Bone on Bone is Bone on Bone. Hopefully you'll get the help you need SOON!

Wishing you the best and hoping you have lots of Knee-easy days.

 

[leejaa]

I am so sorry for you and what you are hearing from these doctors. Weight cannot be the only issue. I am much heavier than you much of it due to not being able to walk or do much for years. I was never light but 12 yrs of not being able to do things less and less due to pain just made me gain and not lose. Keep trying to find someone who will hear your pain.