Adjusting with the Third Gel Shot

So far this 3rd gel shot has been a disappointment.  The 1st and 2nd shots both provided some marginal and encouraging improvement.  The last shot which was 6 days ago has not provided a positive bump in reducing pain.  Fortunately, it hasn’t made things worse either. I know improvement can take longer with this type of treatment.  Just keeping my fingers crossed that I don’t lose any progress.

I am trying, however, to be efficient and somewhat productive.  While I can’t really do a lot of social activities or any major condo cleaning, I keep focused on doing whatever small things I can do in whatever location I find myself.  I do my best to put things back where they belong, complete some minor surface cleaning, and keep my To Do list updated (even if I don’t get to the “doing” part) so that on good (and bad) days, I can get something done.  These small actions are really “mental health” crutches for me. Right now I need order and structure in my life - since my health is not orderly.

I do sit more than I would like, but the knee can only withstand so much activity.  As a result, I stream a lot of movies and TV shows while knitting or doing other sedentary household tasks like menu creation, bill paying, etc.  But to stay focused on movement, I track my step counts.  The “actuals” on the step counter were not a surprise.  Before the knee issue, I could hit 10,000 steps a day pretty easily with 30-40 minute walks included.  When focused on movement, I could reach 11,000 to 12,000 steps with little effort.  On days when I didn’t take a walk, my step counts naturally fell in the 5,000-7,000 range. Now things have changed.  I noticed my counts fall around 2,100.  One day we went food shopping, and my count was around 4,500. While these were pretty low counts, they were higher than I expect.  I really thought I wouldn’t break 1,000 steps.  I suspect these counts have been typical for me for almost a year because I have been growing into this limited state since July 2024.  I find myself hammering down a panic feeling of what this reduced life style is doing to my overall health.  I already know it has created balance and fatigue issues (and if I am being totally honest, some depression as well.)

On the upside, my husband’s EGD is 48 hours away.  That test will determine not only his future health path, but the timing of mine as well.  I know now that surgery is my only next step - but it is a fix I can’t schedule until I know what the course of his treatment.

I am doing my best to not wallow in self pity - which is very very tempting at times.  When I force my self to look for positives - I do find them.  Because I cannot walk through most of the large grocery stores typical in my area, I have discovered the joy of shopping at a smaller grocery store called Trader Joe’s.  They have almost everything I need, they also carry items you can’t find in other stores because the store is almost entirely their Trader Joe’s own brand, and their prices are actually competitive.  Grocery shopping has turned interesting again.

Another thought.  While I can’t keep up a social calendar - I have more time for binge watching TV shows and movies.  I am knitting and reading more and I am back to blogging again. 

Recently I recognized another positive (well, not really a true positive but a reflection of a personal concerns I have for myself due to family history.)  I am at an age when friends and acquaintances are beginning to fail in even bigger ways than me.  One friend has been moved into Assisted Living due to her declining mental state. It has been a bumpy transition for her causing much sorrow and financial difficulties for her spouse.  It makes me sad to see that happening to friends - especially a friend who was so smart and well educated.  While my husband and I are struggling with some serious life changing health issues, we are still independent.  Our financial outlook is more stable because we downsized and sold an over-sized property 10 years ago. Those actions were taken when we were strong, younger and relatively healthy.  They made our current situation manageable without extra expense or intervention by our children.  But dementia can happen to anyone and it can run in families as it does in mine. No signs of it yet in me - as best as I can judge. So I guess it is a positive for me - until it isn’t.  It is, however, a constant shadow that never really leaves.  

I find a good reminder to reflect more on the things that are working well - and not dwell on challenges of aging. The balance of working well and not working well becomes harder to manage as time passes.  I think my husband and I are still on the plus side of elder life.  At least I hope we are.

... until we aren’t!

So in my next few blog posts I am going to share some pictures and non-health related updates!  This introspection stuff is too much like “work.” 😆

Test Cases

Since the beginning of May there have been 3 occasions - 3 times when I had to be in public on my own coping with this knee. Looking back, they were like “test cases."

The first test occasion was the Maryland Sheep and Wool Festival at the beginning of May.  In that effort I was on a cane.  I headed home one hour after I arrived because I wasn’t confident my knee would hold up.  Soon after in the days following I was on a walker.   Small panic feelings started to build in me.  I tried to keep those emotions out of sight around others, but my pain grew and my world shrunk.

A month later the gel shots began.  Within the first week, hope was back on my radar. After the second shot, it seemed possible I could eventually move away from a cane and walker. In fact, after the second shot, I could move about the condo with no aids most of the time.  It was a stiff halting gait but it was possible.

Ok, then.  Progress.

The second test occasion was last weekend when I visited with my daughter at her house.  Without intending to "test the waters" of my minimal recovery, I decided to stop at a Trader Joes to pick up a bouquet of flowers for her birthday.  Before getting out of the car, I remember sitting for a bit trying to decide should I use the walker or only the cane.  I’d been doing well at home so I picked the cane.  By the time I crossed the parking lot and got on the side walk, I realized I had picked wrong!  The parking lot was on a slope.  The side walk was a bit uneven. There were a LOT of people moving swiftly about me with the shopping carts and kids and bags ... it seemed too much for me to get around.  My knee was not particularly painful (the good news), but my balance was clearly not up to the task of using only a cane in this busy uneven environment (the bad news).  And I was alone - no back up.   I was,`however, already committed to this choice.  Returning to the car for the walker would add many more steps, and I had already learned that “less is sometimes more” when it comes to just how many steps I could take before limiting knee pain might appear. I continued forward focusing mostly on avoiding people so I wasn’t accidentally nudged by someone causing me to fall.  Falling seems like my biggest risk now.  While I made it back to my car without incident (but with the flowers), I was shook by the 15 minute experience.   

I worried that my balance and stamina were lacking more than I was willing to admit.  I felt so uneasy. And unease replaced confidence.  I hated that feeling. 

Today was my third gel shot. It was also my third test case.

Because I was not willing to accept the first 2 tests attempts as “forever” results, I left my walker home. (A bold move, I thought, as I started up the car to leave for my appointment.)  I only brought a cane with me.  At the doctor’s parking lot and sidewalks, the surfaces were flat and even.  There were no crowds to maneuver around.  I wasn’t in anyone’s way so I could take my time.  I made it home with no crisis in confidence.  

So ... while I have to stay at rest for the next 2 days after this 3rd shot - I need to increase my general movement going forward (even if that is only walking around the condo more).  I am definitely not moving enough.  

Before I left, the ortho doc he said this last shot should reach its maximum effectiveness in about 10 days.  “If you find yourself in bad pain at that time, call the office."

In 10 days?  Bad pain?  Guess there is no real magic cure out there - even a temporary one!   

Fingers crossed that he purposely sets expectations low.

Update

I thought it might be time for a short update.

I started the gel injections in my right knee almost 2 weeks ago and have had 2 injections already.  My last one is next week. I will need patience with this treatment as it isn’t designed to give immediate improvement.  Based on what I have read, it is effective in 50-60% of those receiving it.  I expected a higher success rate after everything I have heard from various sources about how good it works.  And the level of effectiveness cannot be determined until 4-6 weeks out from the first shot.  A bit discouraging, but my choices are limited and this was the next step to achieve some relief.  If successful, however,  the time line fits my needs related to my husband’s further testing and possible treatment this summer.

That said, there have been some minor noticeable changes ... even in the short time since the first shot.  

Before this treatment, I was totally tethered to a walker.  Even with that support, stepping on the right leg was at times was so painful. My over-the-counter medications and wraps had stopped providing any relief. I’d wake up in the morning and be immediately depressed by the thought of having to deal once again with this painful knee all day long. I felt very restricted even within the condo.

After the first shot, the intensity of that pain seemed to abate some.  In fact, I was thrilled to be able to use only a cane on occasion.  And a few times I could walk unaided, like Frankinstin’s Monster, but still without any aids.  I also noticed that my over the counter medications were working once more.  

The second shot showed more minimal improvement.  So I am encouraged.

I still sit too much.  I am expected to favor it during the 3 weeks of treatment, but it will be good to be more active as time passes. 

So that is it.  Pretty boring when you are mostly housebound!  Hoping that I can schedule a knee replacement in early fall.  And I am really really hoping my husband does not need surgery.  He has never had surgery in his 78 years of living.  I, on the other hand, have lost count of how many surgeries I have had. Modern medicine has had a very large hand in keeping me alive over my 78 years. My husband has not had that experience - a surgery would be a difficult choice for him.  But that question will be addressed this summer.