Monday, December 5, 2016

Under the Knife? Seeking solutions for Arthritic knee pain...

The options available for eliminating the debilitating effects of arthritis these days makes one's head spin.  It starts simple, maybe just a heating pad and a tube of Aspercreme but then it can progress to more serious solutions including injections, medications and surgery.  I myself, ended up with the surgical option 1 1/2  years ago and have not regretted my choice. However, now my other knee is giving me "trouble" with a torn meniscus, a Baker's cyst and the ever-present arthritis.  I'm not really relishing the idea of having another surgery, but nervous that I don't want to wait too long before any damage becomes irreparable.

That being said, I just attended a really interesting seminar to think about future solutions for my non-surgical knee.  The information was presented by Progressive Health & Rehabilitation (you can find their site at: chicagoregenerativemedicine.com
The information presented and the questions brought up made me realize several things.  First of all, my first hand experience with surgical and non-surgical options for arthritis is just the tip of the iceberg.  As with so many medical and pharmaceutical discoveries, the landscape is constantly changing. Yet, I can't emphasize enough, what might be good and the "best thing" for one person, might be a disaster for someone else. Not only do you have to trust your doctor, but you have to trust your instincts and do what is best for you.  You have to do your homework, that is just why I attended the seminar today.  Really informative, but it made me realize I have more research to do.  Some the things brought up today sure provided food for thought.

One of the most important things I learned today is that the degenerative effects of arthritis, just like cancer, can be classified into stages.  There are 4 stages of progression with osteoarthritis: 1) swelling and minor discomfort, 2) wearing down and diminishing of the cartilage 3) beginning of bone on bone stage 4) actual fusion of the joint, whereas it is no longer able to move.  Learning which stage you are in is so very important in terms of which treatment is appropriate for you.  The  discussion at the seminar was about the options of several types of  medicinal shots and their effectiveness.  They explained that they achieved an 87% success rate if given during the 2nd or 3rd stage.  Here's the thing that makes me take a second look at those statistics: they may be successful, but for how long?
Lindsay Wagner as The Bionic Woman

When I had my total knee replacement, I did consider gel injections instead. I was told they have a "healing" rate of any where from 6 months to possibly 2 years.  Total Knee Replacements generally last 10 years and sometimes up to 15 years. Hmmmm.... let me weigh that one....6 months or 10 years pain free? I chose total knee replacement. It wasn't easy and required rehab and 8 weeks physical therapy, but it was worth it. After my surgery my sons teased me that with my artificial knee I now had become "The Bionic Woman". Cool.  Now I can run faster and jump higher, and my days of fighting the evil in the world have just begun. Move over Lindsey Wagner.
     Another thing that was really an eye-opener for me, was the discussion regarding over-use of cortisone shots.  Yes, they do provide immediate and wonderful relief, but they also have the effect of diminishing the synovial fluid in your joints which is the body's natural lubricant.  Cortisone helps to reduce pain by reducing inflammation.  In this process, the synovial fluid is also reduced. This is why cortisone shots can cause more harm than good.  They are a quick fix, but not a long term solution.
     The medications they were discussing include Hyalgan and Genvisc 850.  They are both injected into the knee as a series of 5 shots: once a week for 5 weeks.  They have been approved for this use by the FDA since 1997. This particular office uses an imaging technique to pin point the exact location for the injection to be the most effective.  With the imaging technique, the medication has proven to be 99% effective.  Very good odds I would say, I do not doubt for a minute that these injections are very helpful for eliminating pain and restoring flexibility.  However, I just am disappointed in the time frames they are giving (or not giving) about how long the relief lasts.  A gentleman in the audience, brought up this issue of how long the shots last? I was thinking the same thing.  The presenter, said..."Yes, we will get back to that..." He never did.
     An additional therapy they discussed is stem cell injections.  They have had success with these, but more research needs to be done. Additionally, until the manufacturing has been fine tuned, the cost is pretty prohibitive for most patients: approximately $4,000 per shot. Out of my budget for sure, and I can't help but wonder if insurance companies would cover that, or what percentage they would cover?  Hmmm...more food for thought.   I think some of these medications and therapies are very valuable, that is why I am looking into many different options.  I really don't think I am anywhere close to needing surgery, but it is good to know what is out there.  Always good to be an informed patient.
     I am not really sure what the future holds for knee #2, but it is truly amazing what has progressed within orthopedic medicine and the advances that have helped patients like myself in treating arthritis.  For more updates and the latest info., check out the Arthritis Foundation at: http://www.arthritis.org/
   

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