Progress!

 

Project self-rehabilitation has been going ok.  Nothing fantastic and the progress is slow, but I am seeing progress.

 

The more time that passes, the more I doubt that the doctor looked ‘deep enough’.  I think that the ortho specialist saw arthritis and stopped looking and thereby missed something else happening.  And I don’t deny the arthritis diagnosis; it was just a repeat of what I already knew.    But popping in my knee when I do certain movements…yeah, the ones accompanied by the sharp take your breath away pain…. yeah, that’s new and unique.  Ohhh and it radiates up and down my leg.  Hmmmm  But that is neither hide nor hare….my response is still the same.

 

Self-Rehabilitation Time!

 

I have been continuing with my plan to work various muscles to help balance out my muscles.  I’m talking to you, glutes and hamstrings!  Yes, I’ve read the reports that my glutes may be weak causing the quads to overwork…causing an imbalance that affects the knee.  (Ok, that was a dumbed down explanation, but it works!)  So, I am working on my glutes.  Because of the pain in the knee, I must watch what I am doing…..don’t want to aggravate it, I want to help!  So, I have started with really basic exercises….and low and behold they HURT to do.  Which tells me that my glutes need some help!      As for the hamstrings…. well…. Almost every physical trainer that I have read talks about the quads but never mentions the hamstrings.  Yet I know that sometimes I can FEEL the hamstrings in the back of my leg as I’m sitting.  Hmmmmmm  Then, just last night I read something in the book that I am reading, Built from Broken.  

 

 

  It talked about and imbalance between the quads and the hamstrings…if the quads are overpowering the hamstrings…. or if they pull a fast load quick and the hammy’s aren’t ready, it can cause issues that reverberate down the leg and really mess up the…..you guess it, the knee!  Hmmm…so I am starting some basic hamstring work.    I am not jumping into any machines at the gym….first because I can’t lower and rise from a seat without either good pain and a loud grunt or some assistance (hello grab bar in the work bathroom!).  But secondly, I am doing this rehabilitation slow and measured…. Large/high weights isn’t the answer….that is what I was doing the night this happened. (pushing large weights on ‘leg day’….as per my trainer’s advice) so simple body movements right now to pinpoint the weak spots in my body! 

 

I have been trying to walk as much as possible. Self-explanatory of course……

 

I have been trying to use my muscle roller more consistently on the leg muscles…because another Physical therapy dude mentioned knots in the muscles of the leg that can wreak havoc.  So, I am rolling those muscles…CHECK!

 

And of course healthy eating and water consumption.  I am doing pretty good with my food and water intake.  The weight is coming off…..slowly.   I get frustrated with how slow it is coming off.  I think it’s my age, it wasn’t this hard way back when.  But that’s ok, we aren’t looking backwards, only forward. 

 

  And it is coming off!

 

 

Self Rehabilitation

 

It has been almost 3 weeks since I went to the orthopedic doctor, and he dove in with the diagnosis of relatively serious arthritis and the plan of waiting for the pain to become unbearable and then we will start pain management treatment and start on the path toward a knee replacement.  I have accepted the diagnosis, but I am not accepting the future he described without a fight.

Firstly, I am in total agreement with the doctor’s diagnosis.  I fully accept and understand that I have some serious arthritis in my knees.   That is not disputed.   I will even acknowledge that the week of intense pain was a baker’s cyst that ruptured.  The diagnosis fits with my symptoms.  So, I accept that just fine too.   

 

What I do not accept is his prognosis for my future.  “Wait for the pain to escalate’ is quite simply not acceptable.  Furthermore, I feel as if the doctor saw my knees in the x-ray and glossed over the pain that I was experiencing up and down my leg.  He saw advanced arthritis and looked no further. 

 

 

 

So where does this leave me?

 

The first and largest (pun intended) thing is to lose weight.  I got serious immediately upon the doctor’s dire prediction for my future.   In the first few days I lost 2 pounds.   Yay me!   And then came vacation!   I had plans to splurge a little but mostly keep my eating under control. Toward the end of vacation my water consumption really suffered though!  I am proud to say that we went on vacation and ONLY gained those two pounds!   Immediately upon the end of vacation, I got serious again and I am proud to say that 4 days after vacation ended and I am not only right back where I was the first day of vacation, but I am also ½ pound lower!    I am 2.8 pounds down from where I was 19 days ago and 11 of those days were vacation!    I have to say, this is probably the first vacation EVER for me where 4 days after vacation I am not multiple pounds higher and in fact lower than my pre-vacation weight!  Go me!  

 

The second thing is that I have really started to look at other causes of the pain.   I find it hard to believe that I was walking and moving fine a month or so ago and overnight the arthritis took a nosedive to the point that I can not walk and can’t rise out of a chair without an intense flash of pain.    Couple that fact with the instances where I have talked to Jason about how my calf muscle feels so tight or that the movements that I can feel pulling that then causes the knee to hurt.  Thus, I am mostly convinced that the bulk of my pain is somewhat muscular in nature.

I have researched and stumbled upon what may be quackery…but here goes. 

 

 I stumbled upon one person who is supposedly a Doctor of Physical Therapy. (I say supposedly because it is online and I haven’t felt the desire to research his credentials.)  This doctor dude indicated that knee pain is usually not pain that starts in the knee…the knee is just the part that gets the attention. He said that the pain is from the quads in the thigh.  He said that they get tight and hard knots form.  Thos knots then cause more and more tightness and pulling/compressing and it throws everything out of balance and that imbalance is what is causing the pain (and most likely the arthritis issues in the first place).  Hmmm……I can buy into that theory.  So much so that I pulled out a massage stick that I bought years ago when I was running and started running it up and down my quads…..and placebo effect or not, I think it may have worked …….a bit.  So I plan on continuing that process. (I haven’t paid any money to see the ‘full program…..just researched what I could online)  But he says nothing that I could find online about the calves…and my pain seems to radiate there too.

 

But then I stumbled upon another potential quack.  Another Doctor of Physical Therapy.  (Supposed, because once again…online.)  This due also states that it’s not the knee that is the issue but that it is the muscle.  I believe this dude actually used the phrase that the knee is reactionary to other issues.  This guy talks about quads AND calves.   HELLO, tell me more!  So I read further.  And didn’t get much more…other than the fact that if those muscles are weak or over stimulated…seized or loose…….or if one muscle is weak and one is strong that it is causing imbalances that are causing the knee to hurt. I haven’t ruled out paying for the $20 online class for this one.  But then again…quackery?

 

So where does that leave me?

1. Continue to lose weight
2. Massage rolling my muscles
3. Creating a routine where I am stretching and building those muscles SAFELY (and not full bore ahead to 100 plus pounds of weight which is what the personal trainer did).  And to make sure I am working ALL of those muscles!
4. Movement….walking as much as I can.  (and getting that exercise bike back into my daily routine…..and or getting to the gym for the bike/elliptical)
5. I am forcing myself to try to do as much as I can without the aid of grab bars, altered movements, etc.   Don’t get me wrong, it hurts….but my theory is that movement will help!

 

I’m telling you……I accept the diagnosis.  I do not accept the prognosis.  So it’s time for my self-rehabilitation.

Not Without A Fight

 

In my last post I wrote about my updated diagnosis.  I wrote about the prognosis, which wasn’t a shock…not really.  Yet I was shocked.

 

You see, I was diagnosed with arthritis 27 years ago when I was 29 years old.  I learned ticks and hints to keep my knees from hurting.  In fact, there were long stretches in that period where I barely felt any twinge of arthritis pain.  Let me tell you, those periods were glorious.   However, I wasn’t really doing anything to forestall the arthritis getting bad.  I wasn’t really doing anything but living my life.  Sure, I knew that the arthritis was there…. but in the far distant future we would deal with that.  That was my thinking!  My head was firmly in the sand and ignoring the problem.  I wanted to lose…and I knew that my weight would help the knee issue.  But well, you can see how that has turned out for me.

 

So that is where the stupid comments came from.  I knew that I was hurtling toward a more dire diagnosis…..I just ignored it!  Stupid.

 

The diagnosis that I received this past week was dire.  The doctor held out no hope that this pain would ease up.  We are now in treat the pain mode with an expected acceleration of methods of treating said pain. 

 

But here is where I am struggling now.  “It’s JUST arthritis”  Yes, that is what I overheard someone say.  JUST….JUST…JUST.    (Ok, ignoring the ruptured baker’s cyst…..)   BUT that is what is making my blood boil.  Because it is not JUST arthritis.

It’s terminal!   Not in terms of death.  But this very well could be the death of my Zumba classes that I just rediscovered (and that I love).   This diagnosis could very well be the end of my hiking up mountains.  This diagnosis could very well be the end of any pain free day.  It is very terminal to my way of life. 

 

That is depressing!  I am not ready to give up hiking.  I don’t want to give up Zumba.  I have been hoping to lose a bit of weight and start running.   Things I love.  Things that may never happen again for me.  It could be quite terminal for those hobbies!

 

 

But I have to tell you, I am hoping and praying that he is wrong.  I am hoping that this really is a flare up, just like I have been having for years (albeit a worse one that started with that baker’s cyst issue).   I am hoping that the pain eases. 

I accept it.  I have already started different supplements…or as I call it my potions and lotions. I have also gotten quite serious about actually losing the weight.  Recommitted (again).  I recommitted 4 days ago and I am down 2 pounds.   Early days yet, but I'm tickled with the 2 pounds!

 

I also have been researching moves that a PT would use for someone in my situation…because obviously what the personal trainer was not the right thing. (HA).  So I have a whole list of  knee exercises for people with arthritis to build strengh (And they don't include the personal trainers method of deep knee squats and lots of resistance training on those knees.) 

 

 I have been reading and researching some other things about arthritis .....and read somewhere that my current flare up could be because of an imbalance in my muscles....the thighs and/or calves being too strong and putting pressure and more weight on the knee (ok I explained that horribly).  THe answer.......build up the booty muscles....the glutes.   I watched a few of videos from a PT and the comments were very encouraging.   Let the butt help carry the weight. 

 

 

I may be depressed, but I am not going to go down without a fight!!!

 

Stupid....Stupid...Stupid

 

Plans…why do I even make them.  Seriously.  I come up with so many plans, so many ideas, so many thoughts and then I fail.  What in the world is wrong with me?  I  must be just plain stupid!

 

So it’s been 18 days since I last wrote and the leg saga is still ongoing.    After those first awful days where I could barely function, things started to feel better……kinda.   I got to the point that my knee only ached while I was walking…and no real issue while sitting or immobile moments.  However, random acts just drive a searing pain through my knees.   What things?   Ohhhh standing up from a chair…. lowering myself to a sitting position on a chair.   Going to the bathroom was absolutely the best.  (note the sarcasm).    Steps…. or even a curb…. not fun.  Any step that is not a normal to small step.   Turning and changing direction.  Also, painful.  Manageable right?

But then let’s add in the ‘wrong step’…. the “too many steps’….or just the “insanity that seems to happen to me.”

The wrong step.   I was walking through the yard about a week ago and wasn’t paying close enough attention…. apparently!   You see, I stepped on a walnut that had fallen from the tree, it threw me off balance, and I thought I was going down. (Just imagine the staggering stumbling forward).  Let me tell you, PAIN!     I was on the phone with a friend and that friend heard me and literally was saying, “I’m calling an ambulance for you.”    That wrong step set me back a few days where no matter what I did it jus HURT!

Too many steps?  Well, that is self-explanatory……too many steps,  too much incline….too much uneven ground and eii yii yii!

The insanity…. well let me tell you that getting zapped by the electric fence around the chicken yard was torture!   That electric jolt seemed to go straight to that knee!  I had literal tears for about 15 minutes!  And the next couple days were extra rough.

So about a week ago I decided that enough was enough.  The urgent care had said to seek further advice if it hadn’t gotten better within about 10 days.  I waited close to a month.  But I went to an orthopedic specialist today. 

The diagnosis…….

First of all, apparently it was a baker’s cyst. But those really bad early days where I couldn’t function.  Apparently that was when the baker’s cyst ruptured.   No worries…..once ruptured the body steps up to the task of taking care of the fluid that is now running loose through your body. 

Secondly, the arthritis that I have been dealing with for YEARS has apparently gotten a LOT worse. I was 29 when a doctor first told me I had arthritis and there was no discussion about anything but management of the pain. I lost all the weight and the knees felt fabulous.  I regained and the pain came back. 

Apparently it came back with a vengeance.  The doctor advised that while its by no way the worst case he has seen, there is significant amounts of arthritis…..in all three (apparently there are three areas) areas of my knee.  

We are still on the over the counter meds to manage.  But the doctors words were, when it gets unbearable (he also used the phrase, ‘when you can’t sleep at night from the pain’) then come in and we sill start steroid injections (offers a few weeks of pain free) and when you need more we will move to the hyaluronic acid injections. (He freely admitted that the injections will hurt).    There may be the addition of a ‘pain management doctor’ at some point to possibly do some kind of nerve reatment.  And as a last resort a knee replacement…both knees.

I liked the doctor.  He actually talked about the replacement as a total last resort and did admit that it was 50-50.  Some people are absolutely in love with the results and do both readily.  Others do one and refuse to do the other.    (Not good odds.)

We talked about some other things to do in the meantime.  Things like the arthritis creams, the over the counter pain relief (and if I start eating ibuprofen like candy to start getting my kidneys checked regularly), braces and of course staying as active as possible.

But he also recommends

• Collogen powder
• Glucosamin chondroitin  - He actuall said this stuff really makes a difference.  He said his aged dog who hobbles around got into and ate a full bottle and for the next three weeks the dog acted like a puppy!  (Course the dog also had a bad case of diarrhea….but I don’t plan on taking a whole bottle)
• Vitamin D
• Red Light Therapy
• Ice and/or heat – depending on what feels good (ice always at the beginning)  Ice to reduce inflammation….heat to loosen the muscles

  He said losing weight would ‘help’ because any weight loss helps. But he said it would most likely not be the solution to my woes…the damage has been done. 

 

So where does that leave me right now?

• Still in pain…but focused and determined to get back to moving as much as physically possible.
• Heading to the pharmacy after work to pick up the supplements
• Checking into the red light therapy room that my gym offers (and I have access to at my level of membership
• 100% focused on losing weight.

 

So here I am.   Stupidly, I knew this was hurtling toward me.  I’ve known since I was 29 and originally got diagnosed.   Yet I allowed the weight to come back.  Maybe not allowed….I mean I didn’t invite the weight back, but I didn’t do what I needed to do to stop it!  So here I am…….DANGEROUSLY close to the REALLY bad side of arthritis…..at age 53.

The plan

 This Baker's Cyst thing is really cramping my style.  I was on a good path.  I was making headway with my weight loss efforts.  Now I am on restrictions with what I can do.  Now I am in pain when I even try to walk.  Now.............  ARRRGGGGHHHHHHHHHH

In my post where I talked about the issues and how it unfolded I wrote about how I have a plan for my eventual return to Zumba.  I am super excited just thinking about returning!  It will come....in time!

But in the meantime I knew I needed a plan because I don't want to erase all the good that I have done for myself in the meantime!  So I came up with a plan!   

 The first item in my plan is that I need to keep moving.  That is the most important thing.   With that said, I need to be using my exercise bike  It is low impact and 'should' be a good plan.  Of course this is in theory, as I haven't tried to ride yet with this bum knee!    I have a tv in the office but it is not plugged in and I have no roku/firestick for it.  So getting a tv hooked up to watch in there is on the to do list.  

 As soon as my knee is good enough for me to actually be able to sit and stand without serious pain (and without me thinking that I am going to have to ask someone to help hoist me up from the sitting position) I plan to hit the gym and work on arms, shoulders, backs, etc.    I will add the leg training in asap.

The third thing is my diet.   The trainer wanted me at 1600 calories which hasn't typically worked for me.  I was trying it while I was trying to build muscles.  But with this new (hopefully temporary) phase, I have decided to restrict the calories down again.   Not so low that it's dangerous.  I know that 1200 is the lowest an adult should ever go.  But I need to go into a larger calorie restriction to get this weight off.

You see, this knee issue is a symptom of a larger problem....arthritis.  I can work through arthritis pain and have for years.  I can not work through this bakers cyst pain.....it's almost virtually impossible to walk when your knee buckles.  It's early impossible to do anything when your breath catches when you go up or down a step.   It's just not doable.   So I have to attack the arthritis the only way I can at this moment and that is through my eating!   

Luckily for me they always say that weight is lost in the kitchen and not the gym!

 

 I went to the gym for my scheduled training session and to officially cancel.   We talked about where I am and what is happening.  We talked about my plans going forward.   I actually listened to what he said and then told him my plan.  His big thing was to keep moving in anyway I can!   He wants me to walk (8000-10000 steps a day as soon as I can conceivably manage it)   As soon as I am able with the knee to easily stand and sit I am to get back to the upper body strength training.  

We talked about what my workouts will be when I get back strength training.   My training profile will remain active so I will still have the access to my workouts. (Although I will be making a copy /screenshot just in case it is deleted.)     Furthermore, I talked to him about the possibility of paying for a single session here and there....and that is a clear possibility.   He is the one that brought it up that I can make an appointment with any of the trainers when I need/want some help....which is cool because I can try out other trainers and their styles (I will pay more for a single session...the deals are in the monthly commitments).   I thanked him for getting me back to a point where I COULD do some strength training (emotionally at least hahaha).   

I told him my plan to cut calories further, no lower than the 1200 in an effort to get the arthritis under control.   When I said that the arthritis isn't going to get better until I get the weight off he agreed and said, "at the worst it will be more manageable with each pound you drop".  He said the larger calorie restriction was a good idea.   

So not that I needed his advice or approval, I got it anyway.  It is nice to have confirmation that my plan is on point.   

Now just to carry out my plan and get this weight off so I can get back to the 'scheduled program!" 

 

 

Progress Found

 This last week has been crazy in terms of my efforts to be healthy. I am not going to talk about it again because I already covered it in my last post.   But just suffice it to say that it was bad.    On Friday I woke up and I consciously made a decision to throw up my hands and indulge.

 

Water?  I didn't fill up any water container to take to work.  I jumped right to soda.  Diet soda at least, but still soda!  

I didn't even take soda from home. On no......I stopped on the way to work and bought a really big diet pepsi.  And of course I didn't just buy a drink.  I got a bacon egg and cheese pretzel melt AND some hash browns!  

Lunch wasn't any better.  We ordered out. I got a big pretzel with cheese dipping sauce (and some honey mustard sauce dip......)   It was delicious!   I topped off my diet soda with another can or two in my cup along with some fresh ice.  

I had a few pieces of candy in the afternoon (starburst).

And for dinner I had pizza.  A LOT of pizza.   And more diet soda for course!

I probably ate 3000 calories for the day.   And let me be clear, I felt horrible!  Not emotionally, physically!  I felt so sick!  

It made me think though.   I used to eat like that all the time.   I haven't eaten like that in years, but I used to!  It used to be nothing for me o start the day off with a big breakfast, eat lunch and a full dinner.  I think in the past I have even wrote on here how mid afternoon I would even contemplate (and complete) a quick stop at a fast food joint to get a mid afternoon snack....nothing big, maybe just a burger and/or fries.     

Yet I ate less than that on Friday and I felt sick.  Above all else, it showed me that while my body is not dropping the weight lie I want, at least I can see progress in how I am eating!  (and what I am capable of eating!)

 

Not So Much

 It has been a fabulous week for my weight loss efforts.......not so much.   It has been a fabulous week for working out.......not so much.  It has been one of my all time favorite weeks this year......not so much!

 

This week started out perfectly dandy.     I saw the trainer on Sunday and had a great workout.  My arm was feeling pretty good and I was set to slay the week!    While I was with the trainer I did mention that my right knee was really bothering me, more so than normal and at the back of the knee not the normal arthritis location.   We talked a bit about zumba and how that could be part of the stress and I did advise that I do tone it down quite a bit and I reminded him that zumba (and running) is my heart....it's the exercises that I find myself happiest.....and that this strength training stuff was only a necessary evil.  We left the session with the comment that in my next session we were going to focus on legs so that he could see what was happening.   Perfect!

Monday my eating was healthy and I headed to the gym in the evening for my next solo strength session to be followed up with my hour of zumba.   My knee was feeling icky.  Icky enough that I took a knee brace to the gym with me to utilize for support during zumba.  See, I was prepared.   I powered through my strength session (which was a leg workout) and was honestly pretty happy with how my knee felt.  It was no worse than when I had walked into the gym. Yay!   On to zumba!   I actually did talk to the instructor before the class and told her that I wasn't sure how it was going to go down because my knee was crankin'!  I put my knee brace on and started the class.  The class was fun.....not so much!    Yeah, within 15 minutes I was in PAIN.  I thought about leaving.  After-all, I had let the instructor know that it may happen.   But I didn't want to give up.   I stayed.  Another 15 minutes went by and it was bad.   I was still pondering leaving, but well.....I was in the front and didn't want to make a spectacle of myself.  I stayed.   I was barely doing the movements...there was no pep in the step and even my arm movements were surely lackluster and not at all energetic.  I made it through that complete workout!  I even made it out to my car without my knee buckling causing me to fall flat on my face.   I dropped into my car because no, there was no graceful slipping into the car.  I drove home.   And when I went to get out of the car I KNEW I was in trouble.

It was bad.   Bad enough that I immediately started to cry, you know the kind, just silent tears of pain that streak down your face while you do what you need to do.  (I think the last time was when I went  over the handlebars of the bike landing on my face and then rode my bike a few miles back to the car.)  I took advil and crossed my finger for a healing night of sleep!   Yeah, that plan....not so much! 

Tuesday morning was torture.  So bad that I was one of the first people seen at the urgent care center.  If you know me, you know that if I willingly go to have a medical professional look at me, that it's bad.

 

So apparently I have a bakers cyst.  The best way to describe a bakers cyst is that I have a leaky knee.  Ok, thats' the fun way to describe it.   The more serious way is that when there is an injury to the knee (or an arthritis flare up) the body produces a fluid to help cushion and repair....but sometimes it 'leaks' and creates a cyst.  And that is my problem.   The cyst can be up against pushing on those muscles and lots of other things.   Ohh and painful.  Lucky me.....not so much!

Tuesday was pure torture with walking.  I could barely do it.  Each step was like an ice pick straight into my knee.   Wednesday was slightly better.....and each day has improved a bit.  But back to normal....not so much.    It supposedly takes a while to rectify itself.   Most of the times the bakers cyst will rectify itself and the fluid will eventually be reabsorbed into my body.   If it doesn't get better, there are surgical options (yeah, I don't want that!)    It's been a painful week.

So no exercise......unless you count hobbling around as little as possible exercise.

Neither did I feel at all even remotely inclined to cook.  So we ate some processed foods and some other less than healthy options.  

I go back to the trainer tomorrow.  (I need to sign the paperwork to cancel...as my two months are almost up and I have not seen the amazing results that he said I would have......although the computer body scan thingy showed that while I haven't lost weight....I was actually up a pound or two that I gained about 5 pounds of muscle....but do we trust a computer scan?)   I know that a lot of the exercises on my leg day routine I can actually not do at the moment.  Deep knee squats......not so much.  That booty machine.....yeah not so much either.  And I honestly don't even think the big step up thingy (is it 12 inches...or 18 inches??) is even possible as I struggle to take a short normal step or even a curb at the moment.  So he has his work cut out for him to come up with alternatives that I CAN do!

 As for zumba.  That is on hold right now.  But I do plan on going back as soon as possible, I just like it!    I WILL be modifying it further.  I WILL be in the back row instead of the front so that I can dip out without making a spectacle of myself should it turn out to be a no go.    I will also be investing in some dance shoes.  When I was doing zumba regularly way back when, for much of the time I actually used a more 'dance' style shoe.   What in the world am I talking about?   It's all about the traction.   A normal tennis shoe is made for walking/running and the tread is made to help that forward motion.  But dancing there are pivots and turns.   But if your shoe has traction that is working to keep your foot moving forward, that means it is gripping and fighting you while you 'turn'.   SO basically I need a shoe that has good support but limited traction.    I have fleetingly thought about those shoes since I started zumba, but it was always a passing thought.  Well it's not passing anymore.  I will be buying a new pair and utilizing them.....and maybe for a while just marching out the pivots instead of doing them.  But that is all to come.  In the meantime, I'm taking the medications, rubbing the medicated stuff on my knee and resting as much as possible.

 

And this coming week, no excuses.  I need to double down and get this weight off.  That is honestly the only hope I have of bringing this arthritis under control!