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.

Discouraging Truth

Knee pain, its limitations, and the anticipation of a year to fix this broken part of myself  (setting aside the fact a start date on that year-long fix has yet to be determined) .... well, heck, it is a tough pill to swallow for me.  

My health was pretty good until I hit 75.  I guess I should be grateful for that.  I had my ups and downs but it has always been a fix-it fast kind of thing and move-on.  Cataracts in those eyeballs?  There is a fix for that.  Get new lenses and in 24 hours see as good as the day I was born.  Gallbladder making me sick?  Cut that sucker out. The body can go on just fine with just a few diet modifications.  Kidney tumor camping out in my body?  Get that invader out along with the traitor kidney that harbored it.  After all I have a spare!  Seriously, it has been like that most of my life.

Don’t you think, however, that all my other body parts would notice what happens if it step "outside the box” and make waves in my health??  Clearly someone wasn’t paying attention.

This knee. While I do have “a spare” knee, we aren’t designed to walk just on one leg. And right now I am walking on “6 legs” (my 2 and the walker’s 4.)

I think I finally might have hit a wall on body parts that can be separated from me with little to no impact.  

And . I . Hate . It !!

At the same time, I hate that reaction.  After all, this isn’t cancer or organ failure.  This is not a life ending disease or the total loss of all my worldly belongings due to a disaster.  And while there isn’t a fix for that small cushioning tissue in my knee - there IS a fix!  Replace the whole knee.  

Regardless, I can’t help being upset that a small cushioning tissue inside my knee - the meniscus - something smaller than a small McDonald’s beef patty (don’t ask how I know this)  - as well as a few other even smaller connective tissues have totally and completely failed beyond a surgeon’s ability to fix it ... and the result is a year long struggle to grab back knee function with a new rookie knee. It just seems unfair.

What is totally fair and discouraging - this whole post demonstrates a significant failing in my personality.  While I can have complete and total compassion and dedication to others dealing with serious life changing health issues, I am pretty brutal in dealing with less serious failings in my own body!!  I should be grateful that medical science has a a fix to offer.  For heaven’s sake - this isn’t even a “new” fix ... they have been doing this surgery for decades!!!!

Well, the simple discouraging truth is this.  

I have bemoaned the fact that I need to exercise and take good care of myself to be normal.  Now to be normal I need a surgical intervention.  I am not ready to be this much of a patient, or an old woman with a worn out “something,” or a person who is clearly perceived to need help. When I look in the mirror, that is not who I see.  Even though in that reflection I also see my walker, pain patches, ace wraps, ice packs, Tylenol - (none of which really mask the pain - darn it) ... that image is not me.  The reflection lies.

What doesn’t show in the mirror is the pain!   I guess it is me after all.  

I am scheduled to start those gel injections on June 9th.  I am hoping to shed all those "reflection lies" for a while.  Gel injections are not a “fix” - just a bandaid, but I'll take it.  If they work, I can pretend with the best that I am once again my nibble self.  That I can walk on only 2 legs just like everybody else.  That I am me when I look in the mirror.

And when the time is right for me and my husband, I’ll get that rookie knee put in and be grateful for it - even if it takes a year of fighting it into submission to function normal like discarded knee before it got broken.  I’ll dig up some gratitude at the same time.  I’ll dig deep and I’ll find it.  

That is a promise.

PS

Listen up other body parts...especially those that are thinking of going rogue in the future.

 Pay attention on surgery day.   I know this doctor with a saw and a drill!!  

You and I can part ways.

😄

 

Who is this person?

Hello All,

Once again I have let things slide in the blogging department.  Sorry.  It seems to be the story of my life now.  The reality is that dealing with limiting health issues both for myself and my husband have become a full time activity. And this “activity” - while it is voluntary and necessary - is just emotionally and physically exhausting sometimes.  It is definitely worrisome.  It seems like every step forward is accompanied by 2 steps back.  And at 78 years of age, backward steps are not always recovered, no matter how much desire you have.  Some may argue this is not true, but the stark reality is that our older bodies simply don’t have the building blocks to fully recover all that is lost.  It is just a fact of nature.  We are not “designed" to be fully functional forever.

In March I was hopeful that I had a reprieve - at least a window of time when I could be “normal” again. But normal for me is a very low bar these days.  While I have a few conditions related to low kidney function, being able to walk around my condo without a cane or a walker was the “normal” I was seeking.  I was “normal” for about 3 weeks.  

Sadly my right knee pain that has become self absorbing.  Pain is triggered by weight bearing activities.  It is mostly an inflammatory condition - that is mostly helped by non-invasive measures such as icing and ace wrapping, sometimes pain patches and anti-inflammatory gels, and arthritis level Tylenol.  But relief is fleeting - never for longer than about 15 minutes ... when normal movement overpowers all the good from my non-invasive measures.  I feel like if I could just take anti-inflammatories - life would be tolerable.  I have come to accept knee replacement is necessary if I want to recover any of my previous life.  After seeing the pictures inside my knee from my Arthroscopy, I know this condition won’t just heal itself.  Those tissues looked like raw ground beef - not like a normal smooth white meniscus.

I am, however, holding up my surgery for 6-8 months.  My husband has further testing and maybe further treatment (a surgery) for his esophageal cancer.  We can’t both be patients at the same time.  I will not put that burden on my children.  In the meantime, my ortho doc has ordered Hyaluronic Acid Knee Injections (called gel shots) and my insurance has approved this treatment.  While these “gel” shots are not an immediate fix, they have a high improvement rate over time.  And time is what I need.  The gel shots have been approved for a year.

Meanwhile I am mostly fighting with situational depression - my enthusiasms in life activities are pretty low.  My main “bandaid” for moodiness is walking - which I can’t do.  I have continued my leg exercises so that I am as strong as I can be.  But I hit a really low point when I could not participate in Maryland Sheep and Wool with my family.  I made it to the fair grounds ok, and I have a handicapped parking lanyard (due to my husband), but the walk from the parking lot into the fair grounds was tough.  I did meet up briefly with family, but they had agendas further than I could go, and I knew I couldn’t keep up, so we parted.  I arrived at the fair at 8:30 am and left at 9:30 am!  I saw some vendors, but my heart wasn’t in it.  My knee was so painful I thought it might buckle - which it had done once before.  I thought it best to leave and not test fate.  I was alone and had only a cane with me.  If the knee buckled,  I would not be able to make it back to the car.  Driving away from the fair grounds was the lowest I felt in years.  And stupid me - I didn’t have tissues in the car.

It took me a few days to recover from that event.

In hindsight, I think the fair was the beginning of this current pattern of pain.  I probably further injured the tissues.  

So I am in a "hold and wait" pattern right now.  I find that days spent at home with no plans or appointments are far more welcome than I care to admit.  It is like the safety of my “cocoon” is what I desire - because it is less painful and safer.   However, as we age, nothing ages us faster than inactivity and social isolation.  And yet, that is what I crave right now.  

Sometimes I feel like I am stepping outside my body and seeing this person I do not recognize.

I am hoping at a bare minimum - that these gel shots give me back just one thing - the ability to take a walk outside like a normal person, and not worry about pain or loss of function.

No promises on when I will be back here - but I will be back!  Somehow it helps me sort out all the things that are piling up in my brain if I put it into words on the blog.  I guess it is sort of like saying it out loud to a therapist ... and like a good therapist, it doesn’t give you solutions - it helps YOU to find your own solutions.

Arthroscopic knee “repair”

Hello all.  I have been meaning to sit down and blog an update but the days are full and the energy is low.

My Right Knee

I had a surgical procedure of my right knee meniscus on February 20.  The procedure went very well.  I was able to walk on it right away - of course, they use nerve blocks to mask the pain and the blocks last anywhere from 10-18 hours or so.  But even once it wore off, I thought there was a big improvement.  It wasn’t 100% perfect but the improvement in the knee was evident. 

But what was really unbelievable was the impact on the rest of my body.  

Although the surgery was on the right knee, my left knee was also having problems and on some days it was as bad as the right knee.  After the surgery - no pain in my left knee.  And as of today - two weeks post surgery - my left knee is still symptom free!

And then there is my lower back.  I have significant arthritis in my lower back - enough that I have received 2 treatments of steroid injections to relieve the pain.  Remember, I have low kidney function due to a kidney surgery in 2023 - and I can’t take most pain relief drugs because of that.  So steroid injections are my go-to.  After this surgery - no more back pain!

So what accounts for the improvements in the non-surgical areas!  Well I have been limping for at least a year and using a cane for the last 8-10 months.  Apparently my alignment was so out of wack that I was causing myself more problems.

Bottom line: I should have done this sooner.

All of that is the good news.

The bad news is that I will need a knee replacement at some point in the future in that right knee.  I guess the damage that he cleaned out was considerable - and that cushioning between the bones is much reduced increasing my risks for knee replacement.  I really didn’t want to hear that.  

But for now I am off my cane.  I am walking like a normal person.  I am back to doing my leg exercises and will return to the gym on Friday.  Walks for exercise right now are tough.  It does aggravate the right knee some and I am loath to push my luck (it has only been 2 weeks!).  

I have two goals right now.  

• Right now I am taking very short walks.  I have no energy - so improving my stamina is #1. 
• Number #2 - improve my balance.  Apparently if you walk on “three legs” (a cane and 2 legs) long enough, your balance degrades.  If I can’t make improvements on my own, I’ll go back into PT.

For now I am happy with the improvements even if they didn’t make “everything like new.”  I am focused on whatever I can do to avoid knee replacement surgery - but if the right knee side-lines me enough, I guess I will be forced to do it.

Focusing on the positive for now!

My Ostrich Rendition

I really had positive expectations for 2025!  I really, really did!

After all, 2023 was my year - the year of the kidney and tumor surgery and all that trickled down from that medical event.  And 2024 was my husband’s year  - the year of the Esophageal Cancer diagnosis and the side effects of those treatments.  And both of those events have continued to impact the current year in one way or another it seems.

My husband had a follow up with his oncologist this week.  The PET scan from December still showed a small area of swelling or uptake of the nuclear infusion at the site of the cancer.  The doctor has ordered a second PET scan for the end of March.  It is possible that this swelling is still part of the healing process.  But it could also mean that the cancer remains.  We won’t know until the end of March.  His blood work has also not returned to its normal status yet.  That may also take time to sort out.  If the swelling remains at the next PET scan, the next step is an EGD to view the swelling up close and take biopsies of the area in question - to determine definitively if it is cancer.  If it is, the next step is surgery.  It is rather a difficult surgery as they cut out the portion of the esophagus with the cancer and “attempt” to reconnect the esophagus to the stomach.  Literally that is what the oncologist said.  Attempt.  Although I knew all of this from my own research - including the surviablity statistics from this kind of cancer, it is hard to accept.  While I have a positive outlook most of the time, I couldn’t help feeling pretty depressed by this news.  The odds are not in his favor with this cancer.  But I keep reminding myself that the odds were against me as well with the kidney and tumor removal in 2023 - 90% chance the tumor was cancer - and it wasn’t!  I can’t help the feeling we are just putting one foot in front of the other as we walk through this cancerous condition - hoping for the best on the other side. 

My own contribution to the train wreck that 2025 is building up to be is my right knee.  I saw the ortho guy last week.  He said I was an "ideal candidate" for an arthroscopy because I have “plenty of room” in my knee to make that repair if it is a meniscus tear causing the pain.  He ordered an MRI.  That test was completed, and beyond the normal degenerative changes found in a 77 year old knee,  the MRI found multiple complex tears in the medial meniscus.  hmmm ... I was expecting the meniscus tear (single) - but not 'multiple complex tears' (plural.). I will be back in ortho again in a week to see what his recommendations are.  My goal is to have any surgical recommendations done asap, so that I am healed enough to support my husband should he need surgery.  Having been through a meniscus repair before in 2017 - I have some idea of the recovery time line.  But the diagnosis of multiple tears is worrisome. Regardless, I have my mind set to fix this knee whatever it takes.  I want to be able to take a 30 minute walk outside without a cane - like normal people, and be able to climb stairs again like normal people.  

So,  2025!  I am trying not to cross any bridges before we get there. But the "writing on the wall” for both these conditions isn’t hard to read.  I suspect when all is said and done, I will be glad to see 2025 gone - just like 2023 and 2024! Or if luck holds - maybe 2025 will clean up the mess that 2023 and 2024 left behind.  Not sure we have THAT much luck left to us.

Already - I am welcoming 2026!

(not a good thing when it is only February!!)  

I think I will focus only on the next month for now ... We are both in a holding patterning for the time being.  I will enjoy my favorite season of the year - winter.  Participate in my favorite hobby - knitting - having signed up for my first MKAL (Mystery Knit-a-Long). Binge watch my favorite TV shows - currently Bones - which has a ton of seasons! And enjoy my favorite books - currently Gravewater Lake: A Thriller by A. M. Strong. Keep my ear buds in my ears while my husband watches the news of Trump dismantling our government.  Basically do my rendition of an Ostrich with his head in the sand!  

This is the year for that I believe.