Research - Partial Book Review

After a week with a recurrent gout attack, I'm just about back to normal. This blog is really a partial book review of:
Hip and Knee Surgery: A Patient's Guide to Hip Replacement, Hip Resurfacing, Knee Replacement & Knee Arthroscopy. Robert Edward Kennon. c. 2008 Robert Edward Kennon. Thanks to the Ottawa Civic Hospital Patient Library for the loan of the book.

Of the 3 knee compartments, frequently the medial or inner side of the knee wears out sooner. This would be my situation. There are several options available for this circumstance; orthodics, off-loader braces and partial knee replacements. (p 77) I already have orthotics and knee braces though not prescription ones. Assessment is that they help but are not sufficient for long term relief.

There is the possibility of injury which I thought may have happened last week as I slipped on the stairs and seemed to have sprained an ankle. The pain and swelling continued to increase and turned into a symptoms more characteristic of a return attack of gout. Past instances of weight loss have instigated a gout attack so it is not unusual. The customary prescription for an anti-inflammatory appears to have solved the problem as of this morning with the added benefit that my knees feel wonderful. Must be careful not to over do it.

The other development is a popping or slipping feeling at times, particularly in my left knee. It seems that it is possible for a meniscal tear (p. 80) to develop which could create this sensation. Again, this is another question for the surgeon.

Again there is the warning of a sedendary lifestyle developing which is actually worse for arthritics. Swimming, cycling and leisurely walking are recommended as they do not require significant weight bearing. Exercise can be difficult; however, I think that developing upper body strength through the use of weight exercises, many of which can be done seated, will help lose weight and build up the arm and shoulder muscles to help take the weight off the knees when climbing stairs, getting into and out of the shower or tub as well as the car.

The autho- doctor even talks about the use of a cane! I have been using one with the attack of gout.

Hyaluronate or hyaluronic acid is a 'viscuous substance that normally lubricates the joint.' The doctor estimates that about 'two-thirds of patients feel better after the injections.' Benefits include few side effects. The most significant are the possibility of some swelling and most devastatingly, no effect at all. The process is expensive and a typical series includes weekly injections for 3-5 weeks with significant improvement usually taking about a month. Injections can be repeated at 6-month intervals. I may have to reconsider past thoughts on the syndisk prescription. The book does not speak to the long-lasting effect of the treatment which is an issue for me.

The book deals in the next chapters with knee replacement. I've read through the chapters but will re-read taking notes before continuing with the review.

Next week is the big weigh-in after a month of lifestyle changes. I have found that it is easier to make the planned alterations when the customary patterns are in place. With the arrival of my oldest daughter and son-in-law there have been too many opportunities for extra dining and the occasional sip. The gout attack stimulated complete withdrawal from alcohol consumption. I felt I lost consideable weight over the week. However, the last four days have had a party atmosphere. I've been more relaxed than in years and the opportunity to cook for a larger group has been fun. I suspect that much of the weight loss has been negated.

We will see. Afterall this is a lifestyle change not a diet and these occurances are part of life. I guess we will just have to limit their frequency.