I went to see a doctor today, fully thinking he was going to tell me I needed a total knee replacement. 4 years ago another orthopedic doctor told me I needed a total knee, but I didn't do it then because I could still get around without a lot of trouble. Some of my peers told me not to have it until I couldn't walk across the room without pain, or it interfered with things like grocery shopping. Now I'm at that point. I just figured 4 yrs later, the knee was surely in worse shape. After several x-rays, the doctor came in to tell me that I didn't really meet the criteria for a total knee replacement. I have to say that I was shocked. He explained the criteria: he said that the x-rays would have to show bone-on-bone pretty much in all areas - I saw my x-rays, and the interior side seemed to be pretty much bone-on-bone, but the outside area showed nice space as well as good space all around the patella (which means there is cartilage in those areas). I would also need to have severe arthritis. He felt I was on the borderline between moderate and severe. I would not be able to straighten my knee completely out, and mine (carefully) would straighten. (That's because I've been doing PT to get it to do that!) I would not be able to bend my knee much past a 90-degree angle, and I could bend mine past 45 degrees. (Again, PT working on that.) I would also need to have tried all the conservative treatments and failed them - cortisone injections periodically, anti-inflammatory medications, a knee brace, physical therapy. He said that for people who were borderline needing a total knee ended up with more complications after surgery than those who clearly needed the surgery. He said he could go in and do a partial knee replacement, but didn't really recommend that either. He felt that being off the knee for so long (with my foot surgery) and having arthritis all contributed to all the pain I'm having now. So I went with his recommendation and got a shot in my knee with cortisone and a local anesthetic (oh, how I hate needles in joints!!!!). He gave me a prescription for Mobic, an NSAID, to take orally to reduce the inflammation. He didn't want to put me in a brace because he felt it could possibly hinder the continued recovery from the foot surgery and weaken the muscles of the knee I'm trying to build up. He gave me a prescription to continue physical therapy to concentrate on my knee, and told me to come back in 3-4 weeks.
So I've got three months until the end of the year to see if this all works. I'm going to work hard and give it all the work out I can give it. He said if we can get the inflammation down, I might get 5-10 more years out of it. It just seems to me that someone in their 60s would tolerate and recover from surgery better than someone in their late 70s. While I'm not ready to jump into major surgery that is not needed, and do appreciate a surgeon that is not chomping at the bit to cut you with his knife, I'm just skeptical as to how all this conservative treatment will work. I have so many friends that have had total knees and wondered why in the world they waited so long and have never regretted having them done.
And then I'm just very concerned about health care in the future for people my age. Being in this very large group of baby boomers, who are just coming into the stage of our lives when we are going to need more and more health care, I just think we are going to end up on the short end of the stick, and it just won't be available to us. I look at my parents and all the things they needed in their old age, and it was all readily available to them, allowing them to live into their 90s in relatively good health, enjoying a good quality of life. I just don't think those kinds of things will be available to me. More and more doctors are simply going to stop seeing patients who are on medicare, so you'll not even be able to get the chance to see if some procedure would help you.
I guess I'm feeling just a little discouraged this evening, because I wanted a definite FIX for this knee. I was psyched up for it and ready to do it! That's the kind of person I've always been. If something is wrong, I've always been the one to find a solution and fix it. I'm a fixer! I'm not a very patient person, either. I hit this 4-month "bump in the road" with this foot surgery, and now I'm ready to move on and get back to my usual pace.
I thought about getting a 2nd opinion, but perhaps this is the road the Lord has set out for me right now. I'll travel it until He turns it a different direction.
"Lord, help me to accept your road and your time line."
58. The cartilage that my knee does have.
59. Soft, soft hair of Annie after giving her a bath. (After she rolled in "stink" found in the yard!)
60. Guy's work being so flexible they told him today he can take off time to go to Kansas.