Saturday, January 17, 2009

What a revoltin' development this is!

So much for delaying the inevitable until I get past fifty, let alone sixty.

In April, I am having a total knee replacement on the right side.

The injections have ceased to be effective enough to justify continuing with that treatment strategy, given the inherent risks to kidneys, bones, and the endocrine system that are part of the bargain when corticosteroids are used for a prolonged period of time.

In reality, when it comes to orthopedic problems, there are only five avenues open to your physician - casting, physical therapy, pain medication, ignore the patient, or operate - and after that, another simply doesn't exist. In the case of my knees, there is only one that will help. Putting my knees in casts won't do anything, so scratch that. Physical therapy won't do anything to correct the bone damage from all the years of wear and tear that have led to the osteoarthritis that is impacting my quality of life. Prolonged pain medication? No thank you. My goal in life is to avoid anything that can lead to a perforated bowel. I have had knee surgery nine times already, and I have taken a boatload of opiates in conjunction. I am also a supremely competent medical lab professional. I know exactly how that stuff works. I can explain the mechanism to the satisfaction of the state board of healing arts, and I know what the side effects can be. I know that I don't have the gene for addiction, but I am not immune to developing a habit of use - no one is, regardless of genetics - and I have weaned off them before and can tell you flat out that it is not pleasant. I assume that since you are reading this, you have some idea of what a stupid move it would be to ignore me - the doctor who will perform the surgery knows I am not one who will stand for being ignored. He has worked a trauma or two with me - in fact, he was in the bay the day I physically picked up and moved a resident who ignored my warnings and kept getting in my way and moved him out of my way. And he had a good six inches height and 60 pounds on me. He never got in my way again, tho.

That leaves us with one option, the only one that will to replace the diseased joint.

I have known for several years that it was coming to this, but I have been stalling. I can count on getting maybe 20 years out of the first set and ten to fifteen out of the second. Each time the surgery is done, you lose an inch of bone on either side of the new joint, and I am not a tall, willowy, long-legged fawn of a woman. I am a 5'4" well-muscled athletic body type. I don't have a runway models physique, I am built more like a figure skater with boobs. In other words, I don't have a whole hell of a lot of bone to spare. I can do it twice, and after that...

I was originally scheduled to have bilateral replacements four years ago, and I bailed at the last minute. I lost confidence in the physician, the practice and the hospital where the surgery would be performed. And hey, in four years, we have gotten better at doing the procedure and made improvements in the replacement parts.

There is a lot of stuff to do in the next six weeks, and since my ISP has gone the way of the transgressor, I am getting a head start. I will be working on getting new internet service come Monday, but for now, the weekend calls, and we are blissfully kid-free.

Carry on without me, I'll be back asap.