Body Pride

I am not an active person although many people who know me ask if I ever stop and rest. What I mean is that I have never sustained any exercise program more than a month and I am “chunky” or as my daughter calls it,  “fluffy”. The Yiddish words zaftig fits.

So it is with extreme pleasure I can announce that I am healing well from my latest surgery and can see – and feel – the proverbial light at the end of the tunnel.  And it is MY flabby, fluffy undisciplined body that is reaching the benchmarks easier and faster than average.

As I sat on the bleachers at the pool where my husband and my friend were participating in what we call “geezer aquatic aerobics” I ached to be in the water with them. I have 2 more weeks to go until I reach the magical 6-week post op mark where the doctor assures me that the surgical incision will be healed enough to block infection from the outside. And since there are kids in the pool right before the low-impact exercise class, we can assume there are elements in the water that could introduce a problem. I will be patient.  

This journey through pain and repair has been over two years now. I’d like to run through the story so perhaps others can feel they too can feel better.

First of all, when I was 19 I went skiing and had a spectacular fall. I laid in the snow off to the side of the run for a while and my memory is that the ski patrol came by and asked if I was okay. My answer was “I don’t know” and they left. Unlikely, but that’s the way I remember it.  I managed to get down the mountain and went back to school and never saw anyone at the health center because hey, I was 19 and healing is pretty magical at that age.

The next time the knee was assaulted was when I was 50 and contracted bacterial meningitis  working at Vanderbilt Medical Center. To be fair, no one else who handled the piece of equipment got sick. The doctors believed that as I was in the 6th year (of what turned out to be 10) of my husband’s fight with brain cancer, my adrenal system had been under assault for some time.  Fight or flight….and since I was choosing to stick with him and fight that cancer, I was bombarded with bad news all too often. That’s when the slow weight gain happened and that’s when my immune system weakened.  

So,  there I was all of a sudden, feeling like I had a horrible case of the flu and thankfully friends who came to take care of my youngest son made me go to the hospital.  I was that woman you hear moaning when you walk down the halls of a nursing home….too unable to articulate anything except “I feel miserable”. And then I remember nothing until I woke up and the doc was drawing about a liter of fluid from my knee.

Anyway, I survived, obviously. A year later my knee started hurting and I immediately invaded the doctor’s clinic (one benefit of working in a hospital) and he assured me that the meningitis was not back, but that I had arthritis in that knee.

I controlled the aggravation with glucosamine in various combinations and topped up with Advil if I needed more help. I started acupuncture when I moved to Oregon and sometimes had relief for 10 days without any Advil.

Until June 28, 2016 when I twisted my knee and could barely walk. We were heading to the farmers’ market and poor Graham had to set up everything without much help from me. I went to my doctor a day or so later and she did got me a referral to one of the local orthopedic docs here in town. It took 6 weeks to get an appointment and he took a look at me walking and decided, without the benefit of any x-ray or other imaging that I “just have arthritis and will never need surgery.”  When I asked him why it hurt so much differently and more than before I twisted it he was too busy to answer.

It will be no surprise to you that I refused to go back to him when I asked my primary doctor for a second opinion about 3 months later.  His partner had the benefit of an x-ray at that time and a ct-scan but he said just about the same thing the first doc had said…..I would never need surgery.

And so, while I waited for this knee to magically heal itself, I asked my doctor for PT and continued with the acupuncture. The physical therapy helped some but I was always in pain and always unable to do things I had been able to do before.  A marvelous friend stepped in to help Graham close down our farmers’ market booth each week.

And a year passed. And then my opposite hip started hurting. I had been “walking wonky” for a year because of the knee and the physical therapist opined that my pelvis had tilted because of the knee being out of alignment and the pressure of the femur into the pelvis was different from the way it normally should be.

So, that sounded like the purview of a chiropractor.  The acupuncturist and my primary care physician recommended the same guy so off I went.  There was some relief but when I asked  how long I could expect the treatments to effectively readjust the pelvis I was told “it had taken a while to get to that point and it will take a while to fix.”

Admittedly I was losing patience. And expressed it. So the chiropractor tried some other kind of adjustment and it HURT!  When I went back I saw his associate and that first treatment gave me 3 days of relief. I was looking forward to the next treatment but negated the positive effect by walking six blocks to meet my eldest son for lunch.  Six blocks……and I was in deep pain again. The next treatment the chiropractor tried some other aggressive treatment and that was it. I asked for a referral to a new orthopedic doctor not in this town and went “to get information”.

The new doc ordered a few more x-rays and then showed me on the computer the actual reason for the pain. And he said, very clearly, “you have arthritis which has worn away all the tissue that protects the joint and you are now “bone-on-bone”. There is no getting around the fact that you need surgery.”

This is the x-ray AFTER the surgery and may look funny because I have porcelain and plastic as part of the appliance because of a concern about a metal allergy. 

I continued with physical therapy and went into the knee reconstruction with muscles prepared as much as possible. I was able to drive in 2.5 weeks (it was my right knee so my driving leg)  which was important because I am the driver in the house. Graham is legally blind and no longer drives. Our friends were fantastic…taking him to the grocery store and me to PT but the relief of being able to get there myself was golden.  I had been told it would take me 6 weeks to be able to drive but I worked my exercise routine at home often.

I wondered how I was going to deal with right knee pain as well as left hip pain during the recuperation. The doctor told me that the hip might be okay after the surgery and it was quiet for about a month, but then starting speaking …and yelling….again.  I was very thankful for that quiet time which permitted me to sit up and get out of bed more easily.

Taking a walk around the block 3 weeks after the knee surgery. Yes, I was in pain.

And so, the hip was replaced 4 weeks ago.  Bone on bone there also, no getting around it any more.

People who have had both surgeries told me the hip would be easier healing and it has been. Pain levels were not as high and more easily handled with the Tylenol. The issues I had related to feeling like a beached whale having trouble turning over in bed and the bowel issues caused by the anesthesia and the narcotics I took the first couple of weeks.  That issue improved after a few weeks and moving in bed has gotten easier as well.

A few days ago I realized I had not taken any Advil that day. And now I am walking without a cane with an almost normal gait.

The financial side effect of all this is that I had to take money out of my retirement funds to pay my share of the bills. Medical insurance has gotten more and more expensive in the past two years with co-pays and out of pocket requirements higher.  Once I finish paying my share of the bills I will have paid out $7300 and that does not even count my monthly insurance premiums.

The upside to all that is that any additional medical help I need is now without cost. I still need to pay my monthly premium but my prescriptions will be free and the cataract surgeries will be scheduled before the end of the calendar year to take advantage of this benefit.

So, I started with a headline called “Body Pride”. There was a time, in 1983 where I experienced a wonderful glowing sense of pride in my body: I had just given birth to my eldest and was sustaining him by breastfeeding him. This was a perfectly clear example that my body worked well.

The faster than usual healing I have had from the knee and hip surgeries is also a mark of my body responding to the work I was doing, both actively through PT and more passively through acupuncture. I was making sure my nutrition was good and my body was getting the extra fuel it required because of the stress on it.

So, for all out there who have similar aches and pains, my best advice is to seek out those things you can do to supplement what you may be doing at home for self-care.  And get yourself to a doctor who will treat you fairly and communicate well. Do not give up and do not set restrictions on where you are willing to go. Yes, it is not fun to drive an hour plus to the orthopedic doc in Portland instead of 10 minutes to the guys here in my town. But it is worth every single red light and I have discovered some beautiful back roads that take me through gorgeous countryside.

I have so much I want to do….I am too young to feel as old as the last two years of pain made me feel.  Now, if only the new joints had amazing other attributes! 

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It’s a Puzzlement

Sorry for mixing my Broadway musical metaphors but I need your two cents because, like Tevye, I’m getting a lot of On The Other Hand  in my decision making.

Back in January I wrote about my experience with six decades of wading through medical care with all its various changes.  (I wrote that blog to help people who might not understand why the ACA is so important to people who have difficulty obtaining health care that can be within financial reach. Many of the comments I received were that people were sad I had gone through all that. The point was, many many many people do.)  And even as I wrote of all my issues, that was before my left hip started protesting loudly the year plus of walking “wonky” with my bad right knee. After a gait adjusted for pain, my pelvis had tilted. It wasn’t enough to juggle the stupid knee and then the cornea transplant, I had a new medical issue that provided a new education. Lucky me.

The increased level of pain led me to think I would have to close my business, Can-Do Real Food, My logic said that was the right decision. My emotions were not in agreement. (You can see how Tevye’s dilemma discussion seems to be part of my DNA, or at least cultural norm.) 

My regular doctor offered me pain pills.  While I filled the prescription for the muscle relaxant, I soon discovered not only did it not work, but neither could I with a muddy head. I decided to go outside of standard medical practice and found a chiropractor who might help move that pelvis back into alignment.  Between his gentle pokes and prods as well as physical therapy inside his office environment, the screaming pain has diminished and I can see a glimmer of dim light ahead.

But then I ran out of insurance benefits.

The chiropractor reminded me it had taken me a year to get into the twisted position and it would take a while longer to get out of it. His thinking was once I got that part aligned I would be functional and need only pop back in to see him when I realized I was hurting again.

But I can’t afford him.

So, back to my primary care doctor who offered to send me to the same doc who said my original injury to my knee in June 2016 was “only arthritis” and “I would never need surgery”, all without the benefit of a scan. I told my primary doc I would not go back to him. I expect my doctors to base their advice on information and avoid those who don’t.

Also, since I’ve been hearing I have arthritis for years now and the pain is increasing in the affected joints, I asked to speak to someone with arthritis expertise to give me advice.  Turns out that specialization is a rhemolotolgist and the first clinic said I was not bad enough to take up their time and the second clinic gave me their first available appointment four months from now. Since I don’t have rheumatoid arthritis it is perhaps not a needed visit anyway, but it sure would be nice to get some better info.

Yesterday I had an appointment with a new orthopedic doc. I went in wanting info, very much convinced I am not a surgical candidate nor is my knee hurting that badly right now so why would I want surgery?

He convinced me I need to have the surgery.  The pelvis will NEVER be right until I am walking more normally. My knee will never be better and will only get worse. I wanted to know the probably progression of the deterioration and he was able to take the time and explain it.

So, straddling the conventional/nontraditional medicine routes gets sticky when I opt to lean one way or the other; the other side of my care spectrum voices their concerns. Some are valid. Some may be self-serving.

Here are the issues of my dilemma:

• My insurance will be changing. I have received notice that the plan I currently have is not going to be offered. The next “best” plan not only will cost me almost $300 a month more, but will not provide for any “out of network” benefits. Since I am not always only in my town, I understand that  even a day trip to the Coast with some level of accident could end up bankrupting me. So this next “best” option is not viable. I have an appointment with an insurance navigator next week when the markets open, so we will see what we will see then.
• Since my insurance will be changing, any additional help beyond the immediate post-operative period by this new doctor may be a financial hardship. Do I wait to chose a new orthopedic doctor after my insurance changes, pushing me into a later calendar schedule for the surgery and recovery during my busy season with Can-Do Real Food (no, I’m not closing the business). Or do I just hope he is “in network”? Or do I just hope I can switch to another ortho doc who is “in network”?
• Will I even be able to afford any health insurance plan next year? Since Trump has eliminated the subsidies, that means my health insurance premium will most likely take up 60% of my social security payment. That is before I actually go to the doctor and pay my co-pay and pay for all the medicines I need for my asthma and blood pressure. How can I afford this?

And then, on the nontraditional side,

• I learned on my trip to New England that the CBD portion of marijuana does an extremely effective job of reducing my pain without making my head affected. (It amazes me how many conventional medical people I have spoken with HERE IN OREGON seem not to know anything about the usefulness of this herb. But here, have some oxy. The restrictions by the Federal government have muzzled them at best and stunted their education at worst.)
• My knee pain is very tolerable right now. My hip/pelvis problem is moving in the right direction. I can still get more physical therapy and of course I have the exercises to do at home.  If I do them…..but that’s another issue.

The new ortho doc said something that sounds real: “Many people opt to wait because they are not feeling “that bad”.  And then something happens and they are in horrible pain, wanting the surgery and then needing to wait a month or two to fit into the schedule.”

And he also said “Most likely you will heal better and faster than someone who is in high pain prior to the surgery because you are still pretty mobile.”

We have mundane but real issues also.

• I will be restricted from driving, of course, for a while. Typical is 6 weeks but it could be shorter if I can comfortably and in good time move my right foot from the accelerator to the brake sooner. Graham, being legally blind, can not drive. So while we are going into our quiet season with the business, there are normal things we do: grocery shopping for example. Also Graham teaches one forensic chemistry class each week at Western Oregon University, about 40 minutes south of where we live.  So, we will need driving help.  We have many good friends who offered with my eye surgery and that was only needed for two days, so we haven’t abused them too much yet.
• Sleeping spaces. The master bedroom is upstairs. I have been sleeping in the guest room, a room too small to transition permanently into the master bedroom, for months now, only climbing the stairs when we have overnight guests.  Following this surgery any guests will get the master upstairs. That part was easy enough to figure out. LOL

So, like the King of Siam, it is a puzzlement to me. A time of change is upon me. A decision needs to be made that will have consequences. Those issues, with the exception of the health insurance costs, are not easily quantifiable.