Ortho visit

You ever get up and try to convince yourself to have a gung-ho positive attitude against your usual disposition? I tried to think of a good mantra-ish statement like “every day is a new day” and my twisted mind remolded it into: you’re alive whether you want to be or not. Might as well try to make it the least amount of miserable you can. That’s what happens when you’re not a morning person.

The orthopedic appointment wasn’t that bad, all things considered. In short, no surgery can fix anything. Whenever I need surgery, it’ll be a full knee replacement, and we’re not there yet. The tendon is completely separated and there’s no fixing it. It’s completely useless. First option will be go back to PT (pain and torture) and strengthen all the supporting muscles to reduce pain and suffering. Next option if/when it gets super bad is cortisone injections, which usually calm things downhopefully for 6+ months. The more injections you get, the less effective they eventually become. They also offer PRP – platelet rich plasma injections, though insurance doesn’t cover that, so it’d be on my own bill. They believe there’s decent evidence it can promote healing (of whatever is left) and provide relief up to a year.

On a good note, they said there are no activities I need to avoid based on this evidence. Listen to the pain and take it easy and use home remedies as needed (rest, ice, wrap, whatever). I don’t have to be paranoid that doing something I don’t perceive as painful will cause more irreparable damage that I have no idea I’m causing. Hey, maybe I can get in super duper shape and go hiking again. They didn’t say I couldn’t. Several years ago when someone first diagnosed me with arthritis, they said stay away from hiking and inclines. While I wasn’t in great shape then either, that took away a lot of possible motivation. I’m not a runner; never will be. But I could convince myself to hike up the incline and sweat and toil away knowing it builds muscles and endurance for hiking, which I loved. Come on, people, you have to give me incentive of something. The idea: "maybe you won’t be as painful and miserable someday" doesn’t cut it for me. Well, not 10 years ago, anyway. Today might be a different story. That’s how we arrived at the mantra to make one’s existence the least amount of miserable as possible. Wow, how my dreams have changed, huh.

Knee Surgical Consult Reserved

PCP (primary care provider) advised the MRI results are such that natural healing through conservative methods (rest, ice, compression, physical therapy) are less likely. The good news is that the orthopedic surgeon can get me in next week. Yay. Can’t wait to see the look on my work-place manager’s face if I have to have another surgery, even if it’s a minor one. And who knows, maybe they’ll recommend to try and exhaust conservative methods first to be absolutely sure. it still creeps me out a little that who knows what state one’s tendons are in unless one gets an MRI, which is super expensive. I mean, what if we try PT and a few months from now, it’s better, but not great. How do you guess at what condition the tendons are in at that point without another MRI?

It’s a bit irritating and unfortunate how long it took to figure this out. Trying not to hate or resent all the previous providers, but it’s a yucky situation. The most helpful one thought I merely needed to be put on strong prescription anti-inflammatories every couple of months to reduce sweelling and call it good. They never entertained the idea it could be anything worse than healthy, strong, tendons getting inflamed from time to time. Now I’m envisioning them torn, chewed, and possibly semi-mangled and, well, yuck. I do have a chronic inflammatory “disease” so I get it, but . . . Is it because I’m so fat and this type of tendon damage is usually from athletic sports injuries? Not hating on them, but good grief it took a while to get here. Even my insurance would probably have rejected an MRI request earlier in the year without proof of a traumatic injury.

Will try to focus on the idea that hard word towards losing weight WILL come eventually. It’s been so slow, and so arduous the past few months. As I mentioned, all things considered, even with a supposed “significant” weight loss so far, I don’t feel much better than before. I have to force myself to believe that even if it’s seriously delayed, and I don’t see the payback yet, that it will come someday. I realize it’s not immediate or dramatic, but oye, it’s been tough to hang in there. You get to the point you start to think eh, what does it matter if I eat this or that? I feel semi-cruddy either way. Why bother?

Knee MRI

Got MRI results for my knee; sounds like multiple “complex” tendon tears everywhere. At least, sounds bad. No idea, since I don’t have access to a real doc for another 2 months to interpret the clinical terminology and tell me what to do next. Sad thing is my knee is actually feeling and looking a lot better. How bad was it earlier this year? Has it healed a bit since then, or is it worse from not getting any treatment? How much can tendons heal by themselves? No idea.

General web recommendations are RICE: rest, ice (and elevate), compression, exercise. I can tell you it’s hard to ice and elevate it several times a day, so that’s not gonna happen easily. Maybe beginning and end of the work day, and right before bed? Tried to figure out how to ice and/or elevate it at work before, and propping my foot up on my trash receptacle only made it feel worse b/c it was jammed at a bad angle. I got some ice-packs in anticipation of my surgery. Maybe I can lash them to my knee, but have a feeling it’s not gonna be very comfortable either (gee, isn’t cutting off circulation bad?).

Compression – I did use a compression sleeve earlier this year, but after the steroid rx, it feels worse to use it. We’re talking pain after putting it on, and a lot more pain after taking it off, vs. no or very little pain all day long. It’s not merely pain at the end of a day, not having the helper compression sleeve on. More like pain all night long after using it.

Exercise. Usually after the appropriate time of rest and ice. But what exercise can I do or what is going to make it worse? My PCP isn’t available for two months. I can try to get digital images and take them to a walk-in place. They are probably going to get sick of me.

Ups & Downs

The nutrition place cancelled on me the day before. Kinda ticks me off since I had another provider cancel the day of, recently. Even though they were separate places, my workplace sometimes seems like it’s this huge burden on them to let us miss work for appointments, you get everything in place and arrange to made up the time, and boom, never mind, you can’t come in.

This begs the question, do I need to see some specialist? Am I doomed to be resentful of half the stuff they suggest I do? What is the goal here? Show up once and see what they say, make notes and never go back? I probably can’t implement everything even if I try to take small steps and don’t reject everything they say. Is it more to get that other provider off my back who keeps giving me advice that I don’t ask for?

It may not hurt to go since maybe they could give advice on foods or supplements for inflammation, since that’s a large issue for me. I’ve been taking ginger and turmeric for a while, and in my experience, the supplements are usually higher doses than I would ingest in “real life” eating. Taking a spoonful or two of chia seeds every day like medicine, since still dislike them. Yeah, should probably reschedule when I’m not quite as miffed.

My mood is still very up and down. One day I’m trying to give myself encouragement thinking thigs like “I’m going to lose weight and feel better” and before long I turn it into a hokey affirmation of “I’m losing weight and feeling great.” Then a few days later the best I can muster is “It’s easier to be miserable and thinner than miserable and overweight.” Not that I’m about thin for the sake of appearance. But hey, when you need to reduce yourself drastically, smaller is going to happen somewhere.

Tried a new video today and pushed myself harder than I have in quite a while. 30 minutes straight walking in place (if we’re not counting having to stop and press the “skip ad” on youtube 4-5 times). Haven’t done that in quite a while. Hopefully my body doesn’t hate me tomorrow. I got 7000 steps by the end of work, including 49 minutes of “intense” activity, according to my fitbit. Would hope that’s something. Maybe help counteract all the junk-food I ate last weekend. Maybe subconsciously I thought I had to eat those Halloween themed Cheetos before the nutritionist scolded me to never touch them again. Yeah, that's it. Sad how it doesn’t matter how long you go without them, they still taste great. I keep hoping they won’t taste as good, but somehow they always do.

I admit the amped up exercise was good for me, and possibly even for my mood. There’s another point against that one provider with the unsolicited advice. Long time ago they told me to forget cardio and only do strength. Whatever. I think what they meant to say was that with my advanced age, it’s probably a good thing to focus more on strength and maintaining muscle. Not sure if people always listen to what comes out of their mouths. I don’t need people scolding me as if I need to feel guilty for still doing activities that get my heart rate up. Come on. Let’s scold the obese person for exercising while they’re already feeling down. Grow up. Where did that good mood go from my exercise? Huh, dissipates quickly, doesn’t it. Sure, it helps, but I have yet to see it solve everything.

Nutritionist Appointment Paperwork

I finally got all the paperwork completed for the nutritionist. It kept timing out on me, and I think I forgot a few food preferences/non-preferences to mention. They’ll probably tell me to eat fish all the time. Meat seems to be the craze, and the only thing “better” than that would be the omegas in fish, right? Glack.

I should be happy the questions seemed very holistic. One of the medical directors at my insurance company once called holistic health voodoo. Was that the word? Either that or witch-craft. Probably voodoo. It's supposed to be covered by my insurance, but if they decide not to pay, I won't go to more than one visit.

I digress. The more it asked, the more defensive I felt, like whoa, what are they gonna make me try to do? Not merely food, but sleep, exercise, screen-time. The beginning asked how ready one is to make changes: from not at all, to ready to make drastic changes. I started the questionnaire with the response that I’m ready to make small changes. By the end I revised it to I’m ready to think about changes.

Does all screen-time count if you’re doing an exercise video, or if you are watching tv, but doing mild exercises or stretching? Does take-n-bake count as eating out? Yeah, I know.

Say whatever you want, I am not going to lock my pets out of the bedroom even if they say it is unhygienic to allow them in. We have one with abandonment issues, and we’re lucky if we can keep them from going berserk. See, super defensive.

The biggest ego-crusher was exercise. I asked my husband his opinion on several questions to keep me marginally honest. His impression was that I don’t exercise regularly at all. Maybe not super regular exercise. I don’t do much on weekends because I hang out with him and he’s tired from his physical job. So maybe that doesn’t count as “regular” exercise? My fitbit and I thought I’ve been doing ok, still logging an average of 25+30 minutes a day (averaging out over the entire week). It goes nuts buzzing at me when I reach 150 minutes for the week, and sometimes I hit that by Wednesday. Whatever. Told you I’m too defensive. We’ll see what happens.

State of Affairs

Not sure how I’m doing. Trying not to be paranoid getting a couple of tired body parts returning, you know? I’ll just say that it’s sad when you think oh is that a good thing because keto makes you feel like crap, and that means you’re burning fat, therefore it’s a good thing to feel like crap?


I am not doing keto, nor do I think it would be a good idea for me. I once tried a program that resulted in mild keto-ish flu-like symptoms for less than a week and I made a couple ofcritical mistakes at work so that I spent the rest of the year trying to get my accuracy up to an acceptable level for my annual review.

I made an appointment for an official nutritionist today. First appointment is 90 minutes. Will I have the discipline and determination to do what they tell me? No idea.

Autumn

Well, Autumn is definitely here, where I live. Almost unseasonably early, but no complaints from me.

Had my annul physical, and my PCP (Primary Care Provider) congratulated me for being down 42 pounds since last year. I should be more happy about that. At least they weren’t in my face how that wasn’t good enough, and pushing semaglutide. They also agreed a meat only diet should not be required. But . . . they did have a free sample of Ozempic. Not sure if I will take it, though free is free. Like protein bars or shake mixes, is it ok if it’s means to an end? Certainly one free month’s worth won’t get me to my goal, but if it nudges in the right direction, one could argue I might have less pain and more energy to keep at it.

This is my last day of the corticosteroid prescription that has kept my pain at bay. A little bit on my shoulder and knee has crept back in while weaning off the dosage, but I’m trying to remain optimistic. I’m certainly doing much better when my whole upper body doesn’t feel like I’ve been in a wind-tunnel slapped repeatedly with debris going 180 mph for an hour.

Speaking of that, I had heard counseling can help dealing with chronic pain, so I found one that can work with my schedule, and finally had an appointment. I’m not in a lot of pain now, but I’m sure I have plenty of issues to work through. They gave me a nice pep talk that 40 pounds, even slowly, is still 40 pounds and I’m progressing in the right direction. The also noted it’s “not been that long” since my major surgery in May. I must be very lucky because I swear after 3-4 weeks I was ready to get back to normal life. Sure, I’m not an athlete, but I was antsy to start exercising and was hardly in any pain from the actual surgery. Considering my age and lack of superb health, hallelujah.

I was ordering some items online and snuck some compression gloves into my cart. I have not tried them yet, and if I continue feeling great, maybe I won’t have to. But I wanted to be prepared, and they weren’t that expensive. I don’t think that makes me too pessimistic; just realistic. And if the gloves could make a positive difference to keep me feeling great after the rx, even better.

Ha, speaking of that, I was able to get on an old size 4.5 ring yesterday. The 4 ¾ felt more comfortable, but I could get into the 4 ½. The time those fit, when I had them sized down, was when I was 100+ pounds less than I am now. What the. We’ll see how my hands are after the rx ends, though, right?

Now what to do with all this yarn . . . perhaps I should save that for another post.

Pain-Free, What a Concept

Strangely mostly pain-free. Wow, is this what it feels like to be normal? It’s a short-term prescription, but hopefully it will have long-lasting effects. Might as well enjoy it while I can.

It’s funny to see what people are calling HIIT (high intensity interval training) on youtube, especially since I avoided it for so long. See, I get the idea to push yourself for a bit, and then let up. But back when I was in shape I was already hitting BP 140-180 and I thought what, you’re telling me that’s not enough? And if you’re going to push yourself say, 2 minutes (or whatever), I thought you might as well push yourself as long as possible, right? Get that much more out of it? Why “only” do intervals if you can push yourself and haven’t keeled over yet?

Right now I’m looking at the stuff I’ve been dong and seeing it labeled HIIT and I think you’ve got to be kidding – this is easy. Some of them are doing the activity for 50 seconds, resting for 10 (or various combinations). I’m trying to see if I can push through and not use the 10 second break because that would be even better, right? Let alone the ones that are 45 seconds work and 15 second breaks. Geesh, if I had know it was this easy I would have gotten on board long ago. Of course maybe it’s because some of these are old-people exercises, but not all of them.

Then this bizzare idea that a person can exercise for a smaller time-frame and it still counts. 10 minute cardio? Unheard of when I was younger. I thought one had to do at least 25 minutes in order for it to “count.” I came from the background of ok, how long to we want to exercise? Am I ready to commit to 30+ minutes? Is it worth dragging out the treadmill if not? I wish I had contemplated a less serious approach could still be beneficial instead of a more all-or-nothing approach. Now when I work from home I can do a few minutes on each break. I don’t have to wait until lunch or after work to do a “serious” work-out. What a thought.

Silly Girliness

I’ve never been particularly feminine or girly. One of my mother’s chief complaints was that I didn’t like to dress up and she didn’t want to be seen in public with me (thanks, mom). My one weakness is sparkly stuff. As a child, it’s glitter or crystals. If you try to adapt it to being grown-up, it becomes jewelry. I don’t go for expensive jewelry, but since there’s so much variety of cheap and pretty stuff out there . . .

Last year when I had the cancer scare and waiting for yucky tests and results to come in, I got a ring that ended up kind of having that specific meaning associated with it - hope I don't have cancer. Somewhat recently I thought maybe I should wear the “hope I don’t have cancer” ring more often to see if it could motivate or scare me into eating better. You can tell that didn’t work.

I was on this cheap website my spouse told me about (therefore it’s not my fault, right?), and I thought hey, this one could be a sort of “condolences you can’t eat food like that anymore, but you can look at this ring instead.” Ha. I eventually gave in and bought it, cuz, why not. Now the funny thing is that my size 6 rings are so loose I’ve discovered I’m almost a size 5. Good grief. I still need to lose 100+ pounds, how am I already a size 5? The lowest I ever was, when I had 17-point-something body fat, and WW threatened to kick me out, was a ring size 4.5. Even if one loses weight from the extremities first, this seems weird. I’m still in the “morbidly obese” range (not merely obese, morbidly so). But more importantly, my stupid ring hasn’t even arrived yet and it won’t fit. Wah. How much does that serve me right? I have little ring sizers, so it’s not the end of the world, but still. Of course it’s the cheap kind of website where returns and exchanges are not allowed, and I knew this before purchasing. Oh well.

Weight Loss Desperation?

The prescription I’m taking the next few weeks makes me monumentally hungry. It commonly causes weight gain. I’m upping protein and plants, but may not be enough. Think I may need to resort to incorporating drink meal replacements into my life. Is that an indication of failure? Maybe I should use things like this to re-kick my weight loss even after I'm on the short-term rx? Idk. In theory it's at least partially my fault for being in pain since I'm so heavy. And if it hurts so much to move . . . Of course there are also those injectables and weight-loss surgery one could try. People have been pushing keto type diets on me. After researching and discussing with a nutritionist at work, I don't think that would be a balanced and healthy idea for me. Maybe it could work for some people, but I believe it is also my right to pursue other options (I've been kinda scolded for not doing keto lately). Hopefully the rx helps, so maybe I'm getting ahead of things.

I am not going to have bariatric surgery to lose weight, and I am skeptical about the injectables. Guess I wondered if drink meal-replacements were a gateway act of giving up hope.

Work drama has not helped overall well-being, but not going to go into that. Let's just say escalating stressors there.

Score One for the Rheumatologist

Yay, another provider doing a good job. Maybe you have to see specialists to get better results? Is that the secret?

They did a great overall exam even though I was only complaining about my one knee and one shoulder. Unfortunately they said I was inflamed pretty much everywhere (hands wrists, elbows, knees, ankles) even though I felt pretty good today. They are going to have me get more imaging and a 5 week prescription and see how to proceed based on those results.

Let’s tally the positive points. By saying I was inflamed, they validated my suffering. Not only that, but they apologized for not getting me scheduled sooner (what? It was only 3 or 4 months? Everyone is booked out that far). They were interested in what remedies had or had not worked, and asked if I had any questions before leaving. Follow-up appointment scheduled scheduled without issue.

What a refreshingly positive experience. Even better the front desk was nice. Overall score? Pretty decent, even if I had to wait a while since they were running almost 45 minutes late. Still, I'll take it!

Anti-Inflammatory Foods

As I sit here in pretty immense back pain, already having taken an NSAID prescription (for the shoulder,) muscle relaxants, and Tylenol, I’m thinking ok, maybe I really need to get more anti-inflammatory foods. Yes, I know they have whole recommended diets, and books, and so on. I’ve read numerous articles off and on, and since that isn’t sinking in, I switched it up and watched a youtube video. As if that would be more convincing. It was not, but probably because I didn’t choose a great video. Here were some of the highlights they suggested.

Ginger, garlic, and omega 3s I’m more likely to get from pills than actual food. A few years ago I had high cholesterol and got that warning to do something about it. I already love garlic and used large quantities in food (actual garlic, not merely powder). I tried taking a garlic supplement religiously. I dropped 20 points in 3 months. I figured ok, diet is fine, but the supplement probably has more than I could realistically eat. Same with ginger. I used to eat ounces of dried ginger daily, at first because I thought it might be cheaper than pills. But in order to make it palatable, sugar is the usual go-to, and sugar causes inflammation. So again, taking a high dose pill seemed more straight-forward than eating it.

Broccoli. I’ve gotten so broccoli-ed out lately. It’s not evil, but . . . can we put it in a blender with all those other things like kale and somehow transform it into something I don’t mind ingesting? I jest, because I’ve been taught so adamantly that one should never drink their calories if trying to lose or maintain weight loss. Maybe I can do cauliflower sometimes. That’s still in the cruciferous category.

Chia Seeds. See above, but even more so. I know one can mix them into other things, but I haven’t found a desireable mix-in strategy yet. Still, I ate a spoonful today after being reminded that inflammation is one the reasons it's good or me.

Avocado. I can do that. Expensive, but not disgusting.

Leafy greens. Sure, I can do that (already am).

Berries – YES. I could do berries all day long, every day, if I could afford them and not get lightheaded due to lack of protein.

Of the options available today, I took my supplements for ginger, garlic, omegas, had some chia seeds, berries, and cauliflower. I know there are more foods out there; this is just what I looked at today. Still in enough pain that it is difficult to concentrate right now. Probably time for more biofreeze or salonpas or something.

Yay New Knee Sleeve

For starters, miracle of miracle, Amazon.com delivered to the correct address (gasp) and I didn’t have to go to a dozen apartment buildings, up all the stairs in an attempt to track down where they left my package. I put “special instructions” for them to verify the street address, and re-stated it. Gee, maybe it worked (knock on wood).

Even better, it fits how I want it to and feels great on my knee. The first one I got earlier this spring, professionally recommended and fit by a Durable Medical supplier, is too lose on my knee and keeps falling down no matter how I try to fold it over or jimmy-rig it to stay in place. Not sure if it wore out, or the 5 pounds I lost since then were isolated to my knee, but suffice it to say I needed a new one.

After way too much time reading reviews, evaluating total number of reviews and ratio of 4-5 star vs. 1-2 star review . . . measuring every which way and comparing to my exiting, sleeve, I took a stab in the dark while sleep deprived and ordered one. It’s a tad snug and sits a little lower than it should, but my body is not correctly shaped for these in the first place, so in my opinion, it’s perfect. Trust me, the last one was always baggy around the bottom because of this. Anyway it provides the perfect amount of compression and feels great (except a tiny bit itchy from being new). Happy happy joy joy. And it was a SET of two sleeves instead of one. I only need for one knee, so I have the luxury of using one and washing one at the same time (ooooh, aaaaah). I might actually be able to walk without my knee getting swollen and feeling like it’s going to explode. You know, the unwanted pressure, like when you have a sinus infection so horrific you have difficulty concentrating on anything except the fantasy about pounding a nail into your forehead to release the pressure? You don’t know that feeling? Ah, maybe it’s just me.

Fingers crossed this sleeve holds up well and keeps my knee supported for a few more months.