Oh, my knees!

I'm just beginning my WLS journey and I'm worried about getting the walking in. My knees are just about shot. I developed Psoriatic Arthritis about 2 years ago and it has been kicking my butt. Despite having severe flat feet, I have never had hip or knee pain--until last fall. It's mostly been confined to my feet and hands. I've been taking Enbrel and Voltaran (NSAID) for about 1-1/2 years. The Voltaren doesn't seem to help much, but when I stopped taking it for 2 weeks, I could really tell the difference. Since last October my knees have gotten dramatically worse. It really picked up in February and by the end of April I could barely even climb the stairs to my bedroom. All my bathrooms are upstairs, too. I have a good sports medicine specialist who had an MRI done--oh brother!  I have torn meniscus in both knees, a ruptured bakers cyst and a large amount of fluid on my right knee especially. I had cortisone injections(total FAIL) and a series of Supartz injections to both knees in May. For about 3-4 weeks I thought I had died and gone to heaven. But since mid-June I have steadily gone downhill. I've been doing PT for about 3 weeks and my PT was reallly concerned Friday that my knees are deteriorating so badly. I have an appt to see my Ortho on Monday. I know what he's going to say--he said it before. The whole point of the Supartz was to postpone double knee replacements as long as possible. I had really hoped to get a couple years out of it.

Anyway, to my point...I can no longer walk the dog other than a quick run out to the yard( and I'm struggling with that.) I'm having a hard time with curbs and even flat surfaces, such as grocery shopping.   I'm really hoping that I can hang on until I can get the WLS done to see if that would make a difference. But I'm worried that I won't be able to do the walking I need to do. How to others deal with this? Would you postpone teh WLS and start knee replacement surgeries? Would you just grin and bear it a little longer?

Hi,

    I have only had a scope on my left knee which was very successful. No problem since but still general arthritis pain and weakness in my knees and whole body. I just received news the other day the honey mixed with cinammon taken a little each day reduces inflammation in the body. Even if you're diabetic it shouldn't hurt you. It can be put into a beverage, etc. I am going to try it myself and see if it works. It's worth trying.   Ivypie44

I , too have problems with my knees and that is why I am having the sleeve done. The ortho Drs won't do anything untill I can lose weight , which I understand why, it is just so hard for me to lose with out exercise. I have finished my 6 months with the nutrician and have lost some, waiting for the surgeons date. I hope you are doing better, but I sure understand the pain in the knees situation. does make it harder. If you have any ideas as you go along on your journey please email me and let me know , and I will do the same for you. Prayers and good luck..... Snowdove

I  so understand what you are going through.  My weight was at 415 lbs.  Both knees were shot!  I also did the Cortisone injections every 4 months and Supartz a few times.  Guess I did this for almost 2 yrs before finally deciding on WLS.  ( my ortho wouldn't even consider surgery till I lost weight).  Anyways, I did do WLS in Nov 2009 started losing the weight.  Had my first knee replacement in June 2011 and 2nd one done in Aug 2011.  Losing the weight help the pain a "little" but not enough.  It's so much better now!  Oh, I think I had lost about 120 lbs when we scheduled the 1st knee.  Lost about 40-50 more by time I actually had the surgery.  My total weight lost is 220 lbs. 

Brenda

Wow! That's impressive! 

The most recent update is this--My doctor wants to do an arthroscopy to clean the right knee out. If it were just bone-on-bone arthritis he'd do a replacement, but I have a lot of other stuff going on in there. He is hopeful that I could get a lot of relief just from that. In the meantime, I can proceed with the WLS evaluation.  I was hoping to have the knee done this month, but my DH needs to have his thumb joint replaced and since that surgery has a shorter recovery(no crutches, etc) I'm going to let him go first. THen when he's up to driving again, I'll have the knee done.

when I read your reply to another, I felt inspiration. I too have bad knees , just had surgery recently and found out it is gone too,.The right one has been bone on bone for 2 years now the left is too. I am so hoping to follow in your foot steps and have the sleeve done and than when weight is off enough  Have the right one done than the left soon as I can , than I am so looking forward to walking, playing with my grandchildren.Talking a walk will be so wonderful. I will follow you if I may to see how you have done and to stay inspried. Prayers to you and thanks for letting us know how yours did. .... Snowdove

are you starting to have healthy diet, talk to your doctor and know about the foods that will  help reduce pain, and effectively help you eradicate the disease. one i want to suggest is broccoli, broccoli is very effective in arthritis prevention. know more about broccoli in arthritis prevention  http://www.themedguru.com/articles/broccoli-may-slow-down-prevent-arthritis-49375.html

UPDATE--

I decided to put the knee arthroscopy off last summer, after the knee improved with PT.  Unfortunately, I have gone on to injure the knee 5-6 times since October.  Thankfully, I was able to lose about 21 pounds prior to surgery and that did make some difference. I was sleeved 12/31/13, so I've lost an additional 20 pounds (40 total).  My ortho did another MRI about 3 weeks ago and it looked worse--complex meniscus tear radiating in all directions.

I bit the bullet and had knee arthroscopy 5 days ago. The ortho told my DH that it was worse than he thought it would be. There was some arthritis which he smoothed off, trimmed the meniscus up, and did some microfractures to promote the bone to make a patch where the arthritis is.  I'm in non-weight-bearing mode for 2 weeks, which is a PITA, but the knee pain hasn't been too bad.  I'm hoping this will hold off the total knee replacement for a few years.  I do NOT have time for that!  DH had a knee arthroscopy about 15 years ago and it fixed him right up! I'm hoping I'll have the same result.

I do think that losing 40+ pounds has helped with the knee pain.  Well, that and a few cortisone shots along the way.  I'm sure that at some point a TKA will be on the horizon, but not today.

The damage already done to your knee(s)or hip(s) is not going to get better, only worse.  Weight loss will significantly reduce the wear on your joints but cannot undo the damage done.  The point to my post is simply this:  yes, loose the weight!  But do NOT be afraid of joint replacement!!  The pain you feel now is so much worse than what you would feel after joint replacement surgery because most of it, you won't remember.

In the recovery phase, you absolutely MUST do physical therapy.  It can easily be scheduled around your work, etc. and if you do not have it, you will not have a great rehab.  And yes, you will be in pain the first few weeks but you can manage it and they give you pain meds.  After about 2 months, you will wonder why you waited so long.

And for those docs *****fuse joint replacement until after WEIGHT LOSS, find a better doc!  The current thinking is more realistic in that, we are in a vicious circle with joint pain and weight.  You can not reasonably lose one without losing the other.  The docs now should and most do, realize this to be true and are doing the joint replacements AND strongly suggesting weight loss by any measure, surgical or not.

I had both knees replaced within 5 years of each other and after the first, for about 5 days, I swore I would never do the other one.  But I did and will NEVER regret it!  For the first one, 10 years ago, I weighed 321.  For the second, I was up to 355 or so.  I do not suggest having both done at the same time.  My mother had both hips done, within 3 months of each other.  That is more realistic for the rehab phase.

I have no medical knowledge and the posts that I put n this and any board is from my own experience only.  Seek medical knowledge from the doctors.