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Author Topic: Mom has bad knees!  (Read 932 times)

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Offline costumer

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Mom has bad knees!
« on: June 16, 2007, 03:34:14 PM »
Now that she's in her late 70s, my mom has developed bad knees! She's one of those medical anomilies: a heavy smoker, overweight, doesn't go to a dr or ever have yearly exams (never in her life had a mamogram) and she's probably the healthiest in the family! well, now she has a lot of arthritis in her back (had surgery last year) and has some sort of undiagnosed trouble with one knee.

After limping around for the better part of a year, she was walking 'normally', took a step forward and fell to the floor! couldn't put any weight on her leg at all. She grudgingly went to a clinic and the dr claimed she had sprained her knee. that made no sense. I could see spraining it from the fall, but what cause the fall? She finally went to an OS and saw the PA. He took some xrays and did various pokes and prods and said 'you have arthritis'. I think he gave her vicodin, but she took 1 and it knocked her out so badly she refuses to take another, says the ibuprofen mostly works fine.

But lately it's been giving her trouble, and being really stiff again. So she went to the PA.. he drew off 40+ccs of fluid! and then gave her a cortisone shot. She's confused how the arthritis could have come on so strong with no warning at all! Aside from the fact that it's pretty much what it did to me (except that I'm only 47), I at least have a history of crummy knees, I suspect she may have had a little warning and just chose to ignore it until it dropped out from under her.

Sounds like she's at about stage 3 arthritis in that knee. I'm thinking that this might be a good time for her to try synvisc? Doesn't it do better if you still have a little cartilege in there? She can manage to stand having a needle stuck in her knee (I can't. I'll freak. way too phobic), so I think it might be good for her. What's the opinion on synvisc at this stage?

I'd tell her to join the forum, but while she has email (she lives in Roanoke), she flat out refuses to ever go on the web. <sigh>.. mothers.

Anyway, so now I'm trolling for info for both of us  :D

        -Judy

PS they have no idea what is wrong with the first knee. They've manipulated it, xrayed, MRI'd.. nothing shows up. It just hurts with occasional stabbing pain. The PA just tested again for torn meniscus and said 'no'.
Dx: bi-lat subluxating patellae w/chondromalacia 4/1977
6/78 LR - LK
1/80 TTT-Hauser LK; 12/80 Proximal Realignment Mystery- RK
1/82 Maquet TTT- LK
11/06 Meniscectomy; Mild OA- RK, 12/06 Meniscectomy; Mod OA- LK
3/07 Bi-lat severe arthritis
9/18/07 bi-lat TKR

Offline Nola

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Re: Mom has bad knees!
« Reply #1 on: June 17, 2007, 03:59:33 AM »
I mean no disrespect to Physician's Assistants, but they are not board certified Orthopedic Surgeons.  I would insist that my mother be thoroughly evaluated by an Orthopedic Surgeon and not get off the phone until she has been.  If she lives in Roanoke, VA, USA, and she is 70 years old, then she is on Medicare, a thorough medical / surgical evaluation by a physician is a basic minimum requirement.

I would avoid any specific diagnosis until she is thoroughly evaluated, examined and diagnosed by an OS. 

Good luck!
Nola

9/24/06 Fall while horseback riding. Ruptured 100% ACL, torn meniscus, MCL (grade I)
2/14/07 ACLr B-PT-B autograft Murcia, Spain
5/25/07 US Arthroscopic LOA, meniscectomy, chondroplasty
www.dominiobuenavista.com My winery!
www.frappr.com/kneegeeks  place where you can map where you live.

Offline costumer

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Re: Mom has bad knees!
« Reply #2 on: June 17, 2007, 04:52:57 PM »
I mean no disrespect to Physician's Assistants, but they are not board certified Orthopedic Surgeons.  I would insist that my mother be thoroughly evaluated by an Orthopedic Surgeon and not get off the phone until she has been.  If she lives in Roanoke, VA, USA, and she is 70 years old, then she is on Medicare, a thorough medical / surgical evaluation by a physician is a basic minimum requirement.

I would avoid any specific diagnosis until she is thoroughly evaluated, examined and diagnosed by an OS.

   Yup, I wish she would also. But she had a choice: wait 3 months to see the OS, or get in to see the PA that day. And considering she could barely put any weight on that leg at all at the time... she opted for that day. And frankly, the guy at the clinic (I don't think he was an OS) suggesting it was a sprain, just didn't sound right - and it didn't feel like a sprain. She doesn't really go see doctors, I don't believe she even has a primary dr - never needed one. I know she really doesn't want surgery if she can at all avoid it.

    I just talked with her this morning (I live 5 hours away). It feels better having been drained, but now the pain is different and without all that fluid buffering things she says it feels more like what I've been saying about bone-on-bone. At least she's taking my advice when she does laundry and only making 1 round trip to the basement instead of 3 - she has a lovely guestroom near the laundry, she just takes a nap or reads a book or something for the duration and then takes the clean laundry back upstairs.

       -Judy
Dx: bi-lat subluxating patellae w/chondromalacia 4/1977
6/78 LR - LK
1/80 TTT-Hauser LK; 12/80 Proximal Realignment Mystery- RK
1/82 Maquet TTT- LK
11/06 Meniscectomy; Mild OA- RK, 12/06 Meniscectomy; Mod OA- LK
3/07 Bi-lat severe arthritis
9/18/07 bi-lat TKR

Offline TIBBAR

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Re: Mom has bad knees!
« Reply #3 on: June 21, 2007, 03:23:22 AM »
Judy
 Does your mother livein Roanoke VA? I live in Roanoke an had bi-lateral TKR in Nov. I might be able to help in some way. I also am about 70 lbs. over weight,but my OS did not have any problem in doing it. Just ask anything you want to know. I will be happy to help in any way I can.  I will check back tomorrow afternoon.    CAROL
« Last Edit: June 21, 2007, 06:28:57 AM by lafalot »

Offline costumer

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Re: Mom has bad knees!
« Reply #4 on: June 21, 2007, 02:14:44 PM »
Judy
 Does your mother livein Roanoke VA? I live in Roanoke an had bi-lateral TKR in Nov. I might be able to help in some way. I also am about 70 lbs. over weight,but my OS did not have any problem in doing it. Just ask anything you want to know. I will be happy to help in any way I can.  I will check back tomorrow afternoon.    CAROL

   Oh wow! Yup, she's over on Commander Dr.  Biggest thing with her is that she's very independant, and generally healthy (in spite of her heavy smoking), so she hardly ever goes to drs, doesn't even have a primary! She's more likely to consider that she can't live in her house any more than major surgery - heck, she's been told it's getting time for cataract removal, and she'd rather see a little blurry with glasses! <sigh>.

   right now she's trying to find adaptations for her knees. No one has said anything to her about TKR, and I can well imagine how tha twould go over since she lives alone (luckily a single floor, except for the basement laundry). I'll have to ask her who the PA/OS is!

       -Judy
Dx: bi-lat subluxating patellae w/chondromalacia 4/1977
6/78 LR - LK
1/80 TTT-Hauser LK; 12/80 Proximal Realignment Mystery- RK
1/82 Maquet TTT- LK
11/06 Meniscectomy; Mild OA- RK, 12/06 Meniscectomy; Mod OA- LK
3/07 Bi-lat severe arthritis
9/18/07 bi-lat TKR

Offline TIBBAR

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Re: Mom has bad knees!
« Reply #5 on: June 21, 2007, 10:30:24 PM »
Judy
 Well your mom lives near the airport and the golf course. I live on the other side of town near Towers Shopping Center and a few blocks away from the old Victory Stadium. Who did she see as an OS? I see the PA in my OS's office about 1/2 of the time and like him just as well as my OS. He even assisted with my TKR's and my MUA. How did you get her to see an OS in the first place?  I also live alone and had bi-lateral TKR in Nov. I had BUNCHES of help from people in my church  and my friends. I am also very independent( at least I was). I was in the hospital 16 days and had PT 2x a day there. My insurance agreed to pay to have me stay. I am still working and have good insurance through my job. Anyway, someone stayed overnight for the first 4 nights and days then I banished everyone  away till I called and needed someone.. Couldn't stand everyone jumping up every time I breathed. Some one brought me dinner 4x a week for the first 3 weeks. I did ok on my walker for breakfast and lunch. Someone from my church came and got me for PT 3x a week till I started driving in Feb. Had the MUA in April and have made slowwww but steady gains from there. Actually I have an OS appointment next week and I suspect he will discharge me from PT or at least maybe only 1x a week. I was off work for 4 mo. and believe me I needed every bit of that time. I went back the end of March and I am still only working 4 hrs. a day. I am just now getting so I want to go back full time.
So, that is my story. How can I help you and your mother? First I guess we need to know who she saw. Can she drive herself to appointments? What exactly did the PA tell her?   Is she guessing she needs a TKR? Has there been any x-rays taken?  Does she mind taking meds and if not is she able to keep up with them herself? If she does have a TKR I can suggest the best Rehab to go into for a couple of weeks. I can suggest a good PT. I have been to 2 different places. She will need someone to drive her to PT 3x a week when she gets out. A lot of Questions but also a lot to think about. I will help with any thing I can.
I wish you and your mother well!!!               CAROL














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Offline costumer

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Re: Mom has bad knees!
« Reply #6 on: June 22, 2007, 02:52:36 AM »
Well your mom lives near the airport and the golf course. I live on the other side of town near Towers Shopping Center and a few blocks away from the old Victory Stadium. Who did she see as an OS? I see the PA in my OS's office about 1/2 of the time and like him just as well as my OS. He even assisted with my TKR's and my MUA. How did you get her to see an OS in the first place?  I also live alone and had bi-lateral TKR in Nov. I had BUNCHES of help from people in my church  and my friends. I am also very independent( at least I was). I was in the hospital 16 days and had PT 2x a day there. My insurance agreed to pay to have me stay. I am still working and have good insurance through my job. Anyway, someone stayed overnight for the first 4 nights and days then I banished everyone  away till I called and needed someone.. Couldn't stand everyone jumping up every time I breathed. Some one brought me dinner 4x a week for the first 3 weeks. I did ok on my walker for breakfast and lunch. Someone from my church came and got me for PT 3x a week till I started driving in Feb. Had the MUA in April and have made slowwww but steady gains from there. Actually I have an OS appointment next week and I suspect he will discharge me from PT or at least maybe only 1x a week. I was off work for 4 mo. and believe me I needed every bit of that time. I went back the end of March and I am still only working 4 hrs. a day. I am just now getting so I want to go back full time.
So, that is my story. How can I help you and your mother? First I guess we need to know who she saw. Can she drive herself to appointments? What exactly did the PA tell her?   Is she guessing she needs a TKR? Has there been any x-rays taken?  Does she mind taking meds and if not is she able to keep up with them herself? If she does have a TKR I can suggest the best Rehab to go into for a couple of weeks. I can suggest a good PT. I have been to 2 different places. She will need someone to drive her to PT 3x a week when she gets out. A lot of Questions but also a lot to think about. I will help with any thing I can.
I wish you and your mother well!!!CAROL

Hi Carol,

         Thanks! Let's see, she's been seeing Jimmy Stone, PA at Roanoke Orthopedics - I guess the OS she'd try to see would be Dr Moskal. He's someone a friend's husband went to and had good results. She finally went to see someone because her 'good' knee went out from under her for no discernible reason, and she couldn't put much weight on it, and it didn't get better after a brief amount of rest. So my brother (in FL) and I, and apparently some friends were pingning on her that she needed to get seen, she agreed, but went to some clinic where she was told it was sprained. That didn't help and she agreed she needed a real OS to check her out, but it was about a 3month wait - but she could get in to the PA that day. So she did! She does want to get in to see the OS, it's just getting an appt (might be easier now that she's a patient of the group rather than completely new).
         She was doing better after they drained it last week, but it's getting worse and she's got an appointment with the PA tomorrow. I think she's going to talk to him about synvisc. She admits she's hearing whispers in the back of her mind that she's going to need a TKR at some point. But of course living alone with a cat, that has her worried. If she goes in to rehab, who's going to look after the poor cat? And if she gets sprung from rehab early (she's pretty hardy, and really determined when they won't let her smoke), how is she going to manage the stairs to the basement to do laundry? He other knee isn't 'good', but no one can figure out what's causeing the pain there - at least this one shows up with the arhtritis.

      I think a lot of good PA's take a lot of the work off the OS. I know mine does. It seems that whichever of them is done first goes on to the next patient, so you never know who you'll see. If you need an official diagnosis or something, he gets the OS, but any time you tell the OS what his PA felt it was, he agrees. I believe he helps in surgery as well.

     Unfortunately my mother doesn't really have anyone to help out. She's done a lot of refugee work - technically trying to teach them English, but mostly "adopting" the families and helping them settle in to American life and make sure they do necessary things and help them with all their applications and stuff. Sometimes they help her out, but not terribly often, and usually they only do half the job. Most of the time eveyrone she knows is too busy with their own stuff, and they don't understand that picking up all the trimmed branches and getting them in the trash, and wrestling the trash to the curb is an often lot for a 70+ year old with really bad knees. Laundry help just isn't going to happen. At the moment she's still driving (she's got no one to drive for her), but the step from the carport to the kitchen she finds a little jarring (even if it's just the one step).

    Did you have both knees done at the same time, or a little apart? Sounds like you had some great support there. Unfortunately, her families are all too used to her doing for them, that they don't have a whole lot to do for her.

    She said she'd be more than happy to talk to you about bad knees, if you wanted to call - she said, she can do that easily: it doesn't hurt! I think it would be good to have someone who's been through it help her understand what you can do at what point, and what to expect.

     I don't know if I can PM yet (or how), but if you email me at judymitch(at)oldwaylane.net I'll give you some contact info. It would be great to have someone local who could understand!

            thanks!
           -Judy
Dx: bi-lat subluxating patellae w/chondromalacia 4/1977
6/78 LR - LK
1/80 TTT-Hauser LK; 12/80 Proximal Realignment Mystery- RK
1/82 Maquet TTT- LK
11/06 Meniscectomy; Mild OA- RK, 12/06 Meniscectomy; Mod OA- LK
3/07 Bi-lat severe arthritis
9/18/07 bi-lat TKR