Chapters 18, 19 and 20 are an excellent revew of knee replacement. The details are very close to most of the literature that is available but very readable in plain language and very much to the point.
Dr. Kennon suggests that although total knee surgery "has been the term used for several decades, 'knee resurfacing ' ... is more accurate... It is usually half an inch or less tha s actually removed from the ends of the bones and replaced. Itis not unlike a dental procedure in which a bad tooth is capped. After the joint is replaced, there is no longer any arthritis in the joint because the joint surface is entirely artificial."
There are a number of surgical approaches. The best advice is to follow what one's surgeon recommends. It will be the procedure best known to the surgeon and give him or her the best possibility for success. The same can be said for the type of mechanical replacement.
The decision whether half knee replacement is an option is really on the recommendation of the surgeon as well. It's my knee but I'm not an expert and reading a book and 3-4 articles in addition to surfing the net doesn't make me a specialist. The purpose of the research is really only so that I will have a better chance at understanding what the surgeon says. This rings extremely loudly in my ears as a genuine insight. In my business, there are many clients who search for AV equipment on the net and become instant experts telling us what kind of system they want. We spend more time showing clients why state-of-the-art, alpha equipment wont serve their needs reliably. Surely my knees are no different and I, of all people, shouldn't make the mistake of becoming an 'instant spurt.'
I would like to know whether I'm a good candidate for half knee replacement. It also seems important to know what happens if arthritis continues in the other half of the knee in the next two or three years. Other than that, I'm prepared to listen to and follow the advice I receive.
Friday, November 13, 2009
Accident, and the Big Weigh-in
It has been almost two weeks since the last entry. It seems we have been busy and there have not been many developments.
This week my wife tripped on the sidewalk in front of a store in a small plaza and is suffering from a very bad case of road rash on her face. Took her to the emergency at the hospital. We must compliment the Queensway Carleton. Although it was very busy, we waited less than two hours to see the doctor.
The assessment was that stitches weren't needed on the bad cut on her nose and it isn't broken. It looks as though the bruising may extend to two black eyes but we will have to wait for that to come out. Both knees are bruised and one of them has a bad scrape. Her wrist has an abrasion and seems to be sore. There may be a slight sprain on one ankle. The bump on her forehead sometimes causes a headache that comes and goes. With all of scrapes and bruises, the most worrisome is the sore neck. A day after the fall, we went to our family doctor to have everything checked out again. He confirms that bruising and scratches seem to be the only result but we are to watch the headache and neck pain closely for any further developments. Next appointment is with the dentist as she has a cut on the inside of her lip and possibly a loose tooth. Both lenses in her glasses were badly scratched. We were very fortunate that the lenses didn't break and cause serious eye injury. We have been to the optomotrist and she has new lenses which helps a lot.
So, for the moment, the treatment is advil or tylenol and an antiseptic cream to help the road rash heal. The incident has made my wife tired and a bit despondant. We spoke with our lawyer who suggests that the likely remuneration for a 'trip and fall' wouldn't be as much as the legal fees. I think we will ask for the cost of replacement for the glasses and whatever else Minto, the owner of the plaza, will offer. My wife wants them to guarantee that they will change the sidewalk or at the very least mark the indentation properly so that a similar accident doesn't happen to someone else.
The ordeal has brought to mind how dependent we are on my moblity and ability to take care of the two of us. My wifes suffers from early onset frontal lobal dementia and depends on me for the organization and management of our day-to-day lives. Should I be immobilized with a knee operation, it will be very difficult for us to manage on our own.
In all things there is some good fortune. My oldest daughter has just returned to Ontario and now lives about two hours from us. She is taking a few months to settle in and decide what she wants to do next. An operation this winter/spring, would be ideal from her point of view. She has offered to come and help as often and as long as is necessary. I think that will be a detemining factor in my decision. It seems like a pretty good idea to organize optional surgery for a time when we can have personalized home care.
With all of the events, including visitors two weeks ago, the life style schedule has been severely impacted. None-the-less I can report a 7 pound weight loss. Not what I had hoped for over 5 weeks or more but at least a start. Now we can address the issue with more focus over the next 3 weeks prior to the appointment with the surgeon.
Another impediment over the past two weeks has been an attack of gout. This time starting in my ankle but culminating in the more typical swollen and inflammed big toe. The gout, more than anything else, impacted the physiotherapy routines. I had to cancel two appointments. Kept the third and got some more reasonable exercises for a one foot wonder. So it's back to exercise and the food regieme again.
Next blog I'll talk about the reading I've been doing. Books and materials from the Patient Library at the Civic Hospital have been very helpful.
This week my wife tripped on the sidewalk in front of a store in a small plaza and is suffering from a very bad case of road rash on her face. Took her to the emergency at the hospital. We must compliment the Queensway Carleton. Although it was very busy, we waited less than two hours to see the doctor.
The assessment was that stitches weren't needed on the bad cut on her nose and it isn't broken. It looks as though the bruising may extend to two black eyes but we will have to wait for that to come out. Both knees are bruised and one of them has a bad scrape. Her wrist has an abrasion and seems to be sore. There may be a slight sprain on one ankle. The bump on her forehead sometimes causes a headache that comes and goes. With all of scrapes and bruises, the most worrisome is the sore neck. A day after the fall, we went to our family doctor to have everything checked out again. He confirms that bruising and scratches seem to be the only result but we are to watch the headache and neck pain closely for any further developments. Next appointment is with the dentist as she has a cut on the inside of her lip and possibly a loose tooth. Both lenses in her glasses were badly scratched. We were very fortunate that the lenses didn't break and cause serious eye injury. We have been to the optomotrist and she has new lenses which helps a lot.
So, for the moment, the treatment is advil or tylenol and an antiseptic cream to help the road rash heal. The incident has made my wife tired and a bit despondant. We spoke with our lawyer who suggests that the likely remuneration for a 'trip and fall' wouldn't be as much as the legal fees. I think we will ask for the cost of replacement for the glasses and whatever else Minto, the owner of the plaza, will offer. My wife wants them to guarantee that they will change the sidewalk or at the very least mark the indentation properly so that a similar accident doesn't happen to someone else.
The ordeal has brought to mind how dependent we are on my moblity and ability to take care of the two of us. My wifes suffers from early onset frontal lobal dementia and depends on me for the organization and management of our day-to-day lives. Should I be immobilized with a knee operation, it will be very difficult for us to manage on our own.
In all things there is some good fortune. My oldest daughter has just returned to Ontario and now lives about two hours from us. She is taking a few months to settle in and decide what she wants to do next. An operation this winter/spring, would be ideal from her point of view. She has offered to come and help as often and as long as is necessary. I think that will be a detemining factor in my decision. It seems like a pretty good idea to organize optional surgery for a time when we can have personalized home care.
With all of the events, including visitors two weeks ago, the life style schedule has been severely impacted. None-the-less I can report a 7 pound weight loss. Not what I had hoped for over 5 weeks or more but at least a start. Now we can address the issue with more focus over the next 3 weeks prior to the appointment with the surgeon.
Another impediment over the past two weeks has been an attack of gout. This time starting in my ankle but culminating in the more typical swollen and inflammed big toe. The gout, more than anything else, impacted the physiotherapy routines. I had to cancel two appointments. Kept the third and got some more reasonable exercises for a one foot wonder. So it's back to exercise and the food regieme again.
Next blog I'll talk about the reading I've been doing. Books and materials from the Patient Library at the Civic Hospital have been very helpful.
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