Monday, January 21, 2013

No Doubt, a Bad Knee Can Be a Drag on a Good Walk

By no means do I intend this blog to become some kind of dreary soap opera starring my knee -- "As the Knee Bends," or some goofy title like that. Walking is and always will be a happy time for me, even if I have to drag one leg along because of a balky left knee. Nevertheless, the knee is a vital part of this old codger's determination to continue to pursue fitness through the "golden years," so a report on the knee's condition will be in order from time to time.

Yesterday, as I wrote, my knee hurt perhaps more than it ever has on my daily walk. However, today it just made funny crunching noises for a while as Superdawg and I headed onto the woodsy trail. After that, the pain eased a bit; it was tolerable.

All of these experiences make me wonder about my smartest strategy for continuing to walk for the duration. I am beginning to consider the surgery for total knee replacement more seriously, but I wonder if the time has come quite yet, or even if I should try just to tough it out and never have it. The success rate is high, but there are potential complications for any surgery. For the benefit of anyone having such thoughts, the American Academy of Orthopaedic Surgeons has published valuable guidelines on the Web.

In short, you might be a candidate for total knee replacement if you have . . .

* "Severe knee pain or stiffness that limits your everyday activities, including walking, climbing stairs, and getting in and out of chairs. You may find it hard to walk more than a few blocks without significant pain and you may need to use a cane or walker."

  (My status: Walking brings off and on pain, and a feeling of dysfunction. However, I can still walk a few miles at the max. Climbing stairs is difficult. Fortunately, there aren't many stairs here in the Low Country, but so phobic am I about elevators that I actually walk up two or three flights of stairs at the hospital when doing my Mended Hearts visits to heart patients. To accomplish that, I step up a stair with my right leg and then drag the left leg up to meet it, thereby avoiding any bending of the gimpy knee. Chairs are no problem except I do experience stiffness after sitting for any period of time. I use a walking stick, but I've done so for many years for reasons unrelated to the knee, such as having a form of protection if some beast should attack us. I use a medical walking cane when walking on a hard surface such as at the shopping mall.)

* "Moderate or severe knee pain while resting, either day or night."

 (My status: Only recently have I begun to feel mild pain in the knee when awakening from sleep in the night. But it is certainly not severe, not yet.)

* "Chronic knee inflammation and swelling that does not improve with rest or medications."

 (My status: Nope, I don't think so.)

* "Knee deformity -- a bowing in or out of your knee."

(My status: The gimpy knee does look a bit bigger than the "normal" knee, but I wouldn't call it deformed. Maybe I am just being polite in its company.)

* "Failure to substantially improve with other treatments such as anti-inflammatory medications, cortisone injections, lubricating injections, physical therapy, or other surgeries."

(My status: I have had PT and the therapists basically say they can do nothing more with the knee. A year ago, my orthopedist tried the injections (which are made of rooster comb) into both knees, and as best I could tell, they helped only marginally and temporarily. Maybe I could try another series of those shots. I fervently wish some medical pioneer would invent permanent cartilage that could be injected in the knees and other joints.)

Looking at all this as objectively as I can, I think I am not quite to the point of being a slam-dunk case for knee replacement. However, I am edging closer. Perhaps experiencing pain at rest --especially in the middle of the night -- is the point of decision.

As I plod along and enjoy my walks, I will return occasionally to the knee as one of the challenges that must be overcome in a senior's fitness quest. But no I will not rename this blog, "Knee, Don't Fail Me Now."

© Robert G. Holland 2013

For more information: http://orthoinfo.aaos.org/topic.cfm?topic=a00389

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