Banner - Hide this banner





Author Topic: CARTILAGE JUST ABOUT GONE, SURGERY NOT AN OPTION--ANY HOPE?  (Read 7280 times)

0 Members and 1 Guest are viewing this topic.

Offline asteinsbwt

  • MICROgeek (<20 posts)
  • *
  • Posts: 14
  • Liked: 0
After years of slowly but steadily increasing pain in my right knee, I reluctantly gave up my much-loved 3-times-a-week low-impact aerobics class when one day I realized that every single move the class required, including several modifications I had tried, caused more pain than I was ready to bear.
    Since a vein circulation problem had already resulted in one serious very slow healing infection, my knee doctor assured me that total knee replacement, which I needed, was much too risky. It ws out of the question.
    My health coverage was a managed care facility in New York and I had already previously tried two cycles of physical therapy which was useless because the PTs were incompetent. I saw no point in trying another. So I gave up. Movement caused pain--all I wanted to do was avoid pain. I stopped moving except when absolutely necessary. I put on a lot of weight--terrible for even a healthy knee--and even worse lost a lot of strength in all the surrounding muscles in my legs.
   This past September I decided to try physical therapy again. My managed care facility had joined forces with a major hospital in the city and they were now farming out a lot of their specialty services instead of handing them to on-site hired staff. I thought it was possible that a good physical therapist might help.
   I have been going to physical therapy since September 18, three times a week. When I started I could barely complete one set of three exercises. My standard routine is now 20 minutes of bike plus 3 sets of 10 different exercises, eight of which are done with 3-pound ankle weights. The therapy has been a godsend and it has helped me greatly in my daily life. I have been working out at home in preparation for the end of my PT, and I am getting close to rejoining the gym, though I will probably choose water aerobics instead of my favorite low-impact aerobics class. It has not been all smooth-sailing. I have had several long setbacks. A serious groin pull. Some terrible pain days, especially during the winter. But I have been very pleased with the PT.
   However, I started this with several goals and one has been precious to me: I love to walk. Not for exercise--I know that is no longer possible. But I would love to be able to walk ten city blocks without pain. At first my physical therapist, thrilled with how much progress I was making, thought that was a very possible goal. But we have both reluctantly agreed that it may be impossible. However, I really really would not like to think that walking 2-3 blocks for the ordinary errands one needs to attend to in life need not cause as much pain as it still is causing me.
   That's when my PT started taping my knee with kinesio tape, and it really helped. It did not eliminate the pain but it lessened it so that the last half block to my home did not cause complete agony. Then I developed an itchy rash from the tape. Given my tendency to slow-healing infections, that has at least temporarily ruled out the taping.
    I have gotten a couple of suggestions from this bulletin board which I will bring to my PT on Tuesday, but if it turns out that nothing enables me to use tape without a skin irritation, is there anything else that could possibly ease the pain when walking outdoors?????? Taking taxis everywhere is enormously expensive, and I don't want to go back to the days when I avoided doing things to avoid the pain. I am resigned to taking a taxi to the gym and back, but other neighborhood forays I need to take on foot.
    If any of you has been successful in dealing with the pain caused by the impact of walking outdoors, I would greatly appreciate them.
   Ann :)

Offline lozzie

  • Forum Faithful
  • ****
  • Posts: 329
  • Liked: 0
Re: CARTILAGE JUST ABOUT GONE, SURGERY NOT AN OPTION--ANY HOPE?
« Reply #1 on: May 28, 2007, 12:27:38 AM »
Hi Ann,

I don't know how much it will help, but have you tried glucosamine? You can read about it in other parts of this forum in the diet and nutritional supplements forum. I use it to help with cartilage pain after having great lumps of the stuff removed recently, but I also know someone who was down to bone on bone in her knees and takes it every day with great success. Its not approved by the FDA, but I think you can find it in your health food store. I take a powdered form, which is apparently more readily absorbed. Glucosamine sulphate is made from the shells of shrimps, so you would need to get the glucosamine hydrochloride if you can't take the sulphate form for health or religious reasons.

I read about your taping issue, but was too late to reply. I have no adhesive allergies, but taping my knee (which I tried years ago) made me come out in a horrible rash.

Take care, and I hope this helps,
Lorraine.
Aug '06 Right knee LR and chondroplasty
Feb '07 Left knee LR and chondroplasty

Offline Nettan

  • SuperKNEEgeek
  • *****
  • Posts: 13862
  • Liked: 7
  • Stronger then yesterday...thanks Sis...
Re: CARTILAGE JUST ABOUT GONE, SURGERY NOT AN OPTION--ANY HOPE?
« Reply #2 on: May 28, 2007, 06:09:15 AM »
Ann, have you tried any braces ?
Surgery 6 times left knee torn meniscus, RSDS,chondromalacia, nervdamage cause constant nervpain,chronic inflamm.
Spinaldamage wheeler 100%.
Right knee damaged aug-06, use brace surgery 4/9-07.LCL tear.

Offline asteinsbwt

  • MICROgeek (<20 posts)
  • *
  • Posts: 14
  • Liked: 0
Re: CARTILAGE JUST ABOUT GONE, SURGERY NOT AN OPTION--ANY HOPE?
« Reply #3 on: May 28, 2007, 06:31:38 AM »
Hi Lorraine,

I am usually terrible about taking pills faithfully, but I have tried glucosamine several times. During my last attempt, I took it without exception for an entire year and unfortunately it had absolutely zero effect on my knee pain. I even made sure I took the brand that supposedly was used in the largest test they did on it. I personally know several people who swear it helped them, and I took it with great hopes, but it just didn't seem to make the slightest difference.

Thanks for the suggestion, though.
Ann :)

Offline asteinsbwt

  • MICROgeek (<20 posts)
  • *
  • Posts: 14
  • Liked: 0
Re: CARTILAGE JUST ABOUT GONE, SURGERY NOT AN OPTION--ANY HOPE?
« Reply #4 on: May 28, 2007, 07:06:41 AM »
Hi Nettan,

I have tried so many knee braces and sleeves that I have thought about opening a side business in knee braces. I haven't had any custom-made and haven't spent many hundreds of dollars on a single brace (though I certainly have spent that and more on the variety) but all of the ones I have tried have been awkward, have either threatened to kill off circulation or fallen out of place with movement, and have otherwise failed to do the job.

The best of them was an open patella sleeve I purchased about six months ago and I use it sometimes. It isn't the most comfortable thing in the world, and that discomfort causes some pain of its own, but I think it might help a tiny bit so perhaps if I can't find anything better, I will go back to using it more often. Clearly if I can't even be sure it is helping, the reduction in pain is minimal.

In contrast, until it reached the itching and horrible rash stage, the Kinesio tape not only didn't hurt; it was so comfortable I didn't even know it was on. And it produced the most improvement in pain.

Does anyone know how one goes about choosing the right knee brace? I've basically been playing hit and miss with online catalog descriptions. I brought one of my many purchases in to my knee doctor and he looked at it, suggested removing the side stays, and said it wouldn't hurt me, but in general seemed disinterested. Disinterested is probably not the correct word. He's a nice enough doctor and my primary care physician says he's an excellent surgeon, but he's unhappy that he can't help me and seems to think it's more about his failure than my pain. I gave up the brace after a few weeks because it kept loosening and falling down my leg even though it felt quite tight when I started out.

I brought the sleeve in to my physical therapist and she liked that it wasn't neoprene and instead allowed my skin to breathe but thought it would probably not stay in place with much movement. It stays in place longer than most and remains the best of a bad lot.

Thanks.

Ann :)

Offline Nettan

  • SuperKNEEgeek
  • *****
  • Posts: 13862
  • Liked: 7
  • Stronger then yesterday...thanks Sis...
Re: CARTILAGE JUST ABOUT GONE, SURGERY NOT AN OPTION--ANY HOPE?
« Reply #5 on: May 28, 2007, 01:26:08 PM »
A physical therapist should be able finding you a brace that works. What kind of braces have you tried ? Can you give any example ?
I am thinking of unloader braces and OA braces, have you tried any of these ?
How did you have the knee taped, maybe some custome brace made out from the taping could help ?
I have tested so many braces myself and not easy to find good ones that stay in place and works.
But if you find one that works, they are so great.
Surgery 6 times left knee torn meniscus, RSDS,chondromalacia, nervdamage cause constant nervpain,chronic inflamm.
Spinaldamage wheeler 100%.
Right knee damaged aug-06, use brace surgery 4/9-07.LCL tear.

Offline lozzie

  • Forum Faithful
  • ****
  • Posts: 329
  • Liked: 0
Re: CARTILAGE JUST ABOUT GONE, SURGERY NOT AN OPTION--ANY HOPE?
« Reply #6 on: May 28, 2007, 03:09:20 PM »
I'm with Nettan. My physiotherapist has great piles of brochures for braces, supports and so on. And yes, if there was a type of brace that mimicked what the tape does, I think that would be perfect. I'm sorry about the glucosamine not working for you.

Take care,
Lorraine.
Aug '06 Right knee LR and chondroplasty
Feb '07 Left knee LR and chondroplasty

Offline taekwonmo

  • MICROgeek (<20 posts)
  • *
  • Posts: 9
  • Liked: 0
Re: CARTILAGE JUST ABOUT GONE, SURGERY NOT AN OPTION--ANY HOPE?
« Reply #7 on: May 29, 2007, 07:36:35 PM »
I'm in a similar position to yours... I had surgery to clean out my knee, and they found bone spurs and severe loss of cartilage, but since I'm 31, knee replacements are out for a long time.  10 months after surgery, I still had extreme pain, and it was hard to walk a mile.  I'm usually very athletic, I'm not overweight, etc, so it was hard for me.  Within the last month and a half, almost a year after having no improvment, I did a lot of research and came up with a plan.  This is what has worked for me, reducing my pain by 60%:

Keep trying supplements.  Every day, I take the following: 3,000 mg of fish oil (get the "enteric-coated" ones to avoid nasty fish taste).  I make myself a hot drink (tea, coffee, hot cocoa) every day with a packet of plain, unflavored gelatin melted in.  No weird flavor or texture... you can't tell it's there.  I take chondroitin glucosamine with ASU, MSM, and vitamins C and E.  I got it here:http://www.drtheos.com/prodinfo.asp?number=AC1.  I tried a zillion other brands, tried this out of desperation, and it works.  I am not related to this product in any way (I've posted here in the past, and you can read all about my knee pain ;-)

I switched to biking as a main form of exercise.  I got a good bike with a rack and I can do my errands on that. http://www.sportscenteraustin.com/ suggests that biking at 70-90 rotations per minute has been shown to help rebuild cartilage.  It strengthens my quads and helps my legs get stronger. (note: keep your knees pointing ahead when you bike, not flaring off to the sides, or you're bound to create more problems; also, ride in a very small, easy gear).

Sports Center Austin also suggests strengthening remaining cartilage with a weight program that starts at the highest weight you can tolerate without any pain for a whole heck of a lot of repetitions.  I do leg press on a machine for 75 repetitions at a weight of 65 lbs.  I started only being able to do 50.  I weigh about 120 lbs, so I know I need to be able to do at least that much to hold up my body weight.  I also do other weighted exercises to gain muscles strength.  Your physical therapist seems to be doing well, so keep it up.

Make sure your posture is perfect, so that your knees are not being worn down because of more weight being applied to one leg.  Explore the website www.egoscue.com.  Think about getting orthotics.  Stand normally in your underwear in front of a mirror and see if both sides of you look equal in height, weight-bearing, shoulder level, etc, and if not, do the exercises mentioned on the egoscue page to fix it.  I recommend the books.

Finally, keep up a positive attitude.  I know it's horrible and depressing and everything, but you have to tell yourself over and over, every day many times a day, that you are stronger than this, that you intend to overcome it, and that you will impress everyone by going further than most people would go.

I have autoimmune thyroiditis which has led to osteoarthritis that has been worsening since I was about 15.  A month and a half ago, I was barely able to walk up stairs and couldn't walk more than a mile without pain.

Two days ago, I walked most of a mile and JOGGED (without pain) for 1/2 a mile.

I'm not saying it's possible for you to do this, but I hope what worked for me can work for you. 

It takes dedication, which usually comes from sheer desperation.

And, by the way, I read somewhere that in a dissection study of elderly knees, almost all knees studied had osteoarthritis in them.  However, only about 1/2 of the subjects had any symptoms of it.  So pain and arthritis do not always go together.  I'm just trying to figure out how to get rid of the pain!  :-)

Keep your chin up, as my daddy would say.  Sorry this was so long, and I hope it helps!
Mo
Osteoarthritisy, post-opish, chondroplastic fun!

Offline lozzie

  • Forum Faithful
  • ****
  • Posts: 329
  • Liked: 0
Re: CARTILAGE JUST ABOUT GONE, SURGERY NOT AN OPTION--ANY HOPE?
« Reply #8 on: May 30, 2007, 03:30:48 AM »
What a fantastic post! I don't know about Ann, but I for one am going to keep this, and use it as a reference. I have some cartilage left, but things are just not fun at the  moment. There's some great ideas in there.

Thanks so much,  :)
Lorraine.
Aug '06 Right knee LR and chondroplasty
Feb '07 Left knee LR and chondroplasty

Offline asteinsbwt

  • MICROgeek (<20 posts)
  • *
  • Posts: 14
  • Liked: 0
Re: CARTILAGE JUST ABOUT GONE, SURGERY NOT AN OPTION--ANY HOPE?
« Reply #9 on: May 30, 2007, 06:00:43 AM »
Hi Nettan,
    I really appreciate your continuing interest. Most of the braces I have tried have been neoprene ones found in drugstores and sporting goods stores. Then, over the past three years, I have bought the following online braces and sleeves: a Donjoy Drytex hinged knee brace and a Donjoy Cartilage Comfort Knee Sleeve (said to specifically be good for arthritis); a Safe-T-Sports neoprene knee stabilizeer; and a Cartlage Knee Sleeve at such sites as Jansenmedicalsupply.com; jointhealing.com; and feelgoodstore.com.
    I have focused on knee braces and sleeves that included arthritis in the list of ailments; that would fit around my large and often swollen (both from weight and from my circulation problem) knees and would fit my limited budget. While I would surely be happy to invest a lot of money in a knee brace if I knew it stood a very good chance of working, my experience with  the ones I've tried has not encouraged me. So far, the most expensive braces I've tried have been under one hundred dollars.
    You seem to have hit upon a brace that works for you. I'm not asking what it is, since every knee is different, but how did you find it? Did you buy a lot of them in random, hit-or-miss style as I have been doing and just get lucky, or did you approach the problem in a more organized way? Approximately how much did it cost? Was it custom-made?
    I will bring the subject of braces up with my physical therapist once again. Last time we discussed it, she said she liked the taping better because it was more comfortable, more flexible, you didn't really know it was on, and you were in control of applying the tape in exactly the right place. That was until I started developing a skin rash.
    If the undercoat tape suggestions I've gotten in my last topic on kinesio tape sensitivity don't work out, we may have to settle on trying to find a workable, affordable brace. My guess is that given all my problems including the swelling, the right brace, if it exists, would have to be custom made. Since the DonJoy ready=made braces run as high as $700 or more, I shudder to think of how much a custom-made one would cost. Again, I would be willing to cut expenses elsewhere to pay for it, if I had a reasonable chance of it working. Perhaps if I find a less expensive one that comes close to working, I would consider a custom-made one with that as a model.
    Thanks again.
    Ann

Offline asteinsbwt

  • MICROgeek (<20 posts)
  • *
  • Posts: 14
  • Liked: 0
Re: CARTILAGE JUST ABOUT GONE, SURGERY NOT AN OPTION--ANY HOPE?
« Reply #10 on: May 30, 2007, 06:05:37 AM »
I'm with Lorraine. This is a fabulous post. Not a bit too long since it was filled with suggestions. I've already copied it and filed it in my knee and health computer files.
    The only suggestion I can immediately rule out is the suggestion that I take up bike riding outdoors in the streets of New York City. First of all, I am twice your age. Second of all, when I was about 20 years younger than I am now and a regular summer weekend guest at a friend's house out in the suburbs, I bought myself a bike to keep there and used it all the time. Then, when the summer came to an end, I thought I would take up biking in the city and so brought my bike home. After several near-death experiences, I decided that my biking skills which seemed quite adequate in the burbs were simply not good enough to survive city traffic. I live too far from the park to walk my bike there. So any biking I do is limited to stationery exercise biking.
    I haven't had time to go through all the suggestions in depth but I will. Thanks so much for taking the time to write them all out. I really appreciate it.

Ann :)
« Last Edit: May 30, 2007, 06:19:25 AM by asteinsbwt »

Offline Nettan

  • SuperKNEEgeek
  • *****
  • Posts: 13862
  • Liked: 7
  • Stronger then yesterday...thanks Sis...
Re: CARTILAGE JUST ABOUT GONE, SURGERY NOT AN OPTION--ANY HOPE?
« Reply #11 on: May 30, 2007, 06:17:10 AM »
Ann, the brace I have I got from the Ortho technical unit on the hospital. That is one fantastic place.
They have them around the whole country (I live in Sweden)
There you can try out and get the most braces. My brace cost around $300.

It's from Mediband Thämert and the brace I have is called Genu syncro.
I don't know wether you have such places where you live.
Surgery 6 times left knee torn meniscus, RSDS,chondromalacia, nervdamage cause constant nervpain,chronic inflamm.
Spinaldamage wheeler 100%.
Right knee damaged aug-06, use brace surgery 4/9-07.LCL tear.

Offline asteinsbwt

  • MICROgeek (<20 posts)
  • *
  • Posts: 14
  • Liked: 0
Re: CARTILAGE JUST ABOUT GONE, SURGERY NOT AN OPTION--ANY HOPE?
« Reply #12 on: May 30, 2007, 06:22:59 AM »
Nettan, that was super-quick! I will have to look into places in New York that let you try out braces. Thanks again. Ann

Offline Nettan

  • SuperKNEEgeek
  • *****
  • Posts: 13862
  • Liked: 7
  • Stronger then yesterday...thanks Sis...
Re: CARTILAGE JUST ABOUT GONE, SURGERY NOT AN OPTION--ANY HOPE?
« Reply #13 on: May 30, 2007, 06:26:21 AM »
I know, someone has to be Speedy Gonzales ;D ;)
Good luck !!
Surgery 6 times left knee torn meniscus, RSDS,chondromalacia, nervdamage cause constant nervpain,chronic inflamm.
Spinaldamage wheeler 100%.
Right knee damaged aug-06, use brace surgery 4/9-07.LCL tear.

Offline asteinsbwt

  • MICROgeek (<20 posts)
  • *
  • Posts: 14
  • Liked: 0
Re: CARTILAGE JUST ABOUT GONE, SURGERY NOT AN OPTION--ANY HOPE?
« Reply #14 on: May 30, 2007, 05:22:21 PM »
Hi Nettan, aka "speedy gonzales"
    I just saw my physical therapist and discussed braces with her. She said she has a brace representative who will bring various styles on for me to try out--and if we find one, she thinks I can get much if not all of it covered by my insurance. That is possible because i didn't know that a portable TENS unit would be covered, and planned to pay for it myself, but when I inquired, I discovered that if my doctor would give me a prescription it was entirely covered. So I am now the owner of a free portable TENS unit. I am sure I could also get a prescription for a knee brace.
     I'm still hoping to solve the taping problem, however, since I really find braces cumbersome, and the tape minus the skin irritation was a dream. Also, since my knee changes size fairly dramatically (slight exaggeration) quite often depending on how swollen it is at the moment, getting a good fit is a real challenge.
     She tried a new method of taping today, designed to avoid the area of skin that seemed to get irritated. We will see if that accomplishes the same relief that the previous method did, and if it prevents  the irritation problem. I'll keep you posted.
 Ann
« Last Edit: May 30, 2007, 10:08:35 PM by asteinsbwt »