zjrog

Sometimes I think that 50 post limit on PMS is a pain... Was for me.

My first visit to the orthopede was a big eye opener. Could have replaced my knee at that point. But thought I could work through it. A year later and the decision was made... Had no choice but to replace it, bone on bone... I still have some swelling, I know it doesn't look like much in the pic, but it is and it really is bugging me. Like you, if the other knee needs replacing, I am NOT going to hold out. My therapist could have let me go from therapy sooner, but I wanted to keep going. Mainly because its winter, and I wanted the activity. But now I'm in the gym regularly, and on my bike on the trainer. (Bike Nashbar has a good deal on an indoor mag trainer for about $80) had it for years but just didn't use it. Till now. yeah, sitting indoors all the time sucks, but at least it is winter and not good weather... And I work outdoors, so sitting at my desk is a real "joy"...

And thanks, wife is doing better, but has a long road ahead still...

Peter_C

Gee, my incision is bigger than yours~! Although, somehow I do not think that is anything to brag about

zjrog

No no, bigger is better Peter!!!

Peter_C

Heh - not on everything, just on some things...

/wink

zjrog

Had a busy weekend, lots of time in the gym. Maybe too much, pretty stiff tonight.

Decided to pull the hybrid off the trainer later this week and put the Cannondale R200 CAAD2 on instead. I don't intend to ride the hybrid but want to ride the R200. Needs tires but will have to wait till I go into town Friday.

And, I have a line on a Total Gym for free... That should help me keep my ROM.

zjrog

After last night's ride on the hybrid, I just couldn't get comfrtable on it. Took some measurements and stretching it out as best I can, it is still 3" shorter in length than my MTB or even the R200... No wonder. (and it was cold out in the shed getting measurements last night!!!) Seals the deal. R200 Friday.

In other news, I spent a chunk of last evening going over my plans to build a tandem. I want a tandem so my wife can ride a bike (she has balance issues and has an adult trike), at a reasonable speed. And, yes, she sort of has to participate. About 18 months ago I bought a pair of 1989 model Trek 950 MTBs. One is a 16.5" and will be the rear section, the other is a 18" and while it is short, it is just less than an inch in length than my Fisher MTB top tube. So I can make it fit me without too much trouble. It is also nice to get two bikes that are the same model and build... There are plenty of home made tandems out there. Some look funky, some look nice. I hope, in the end, folks think mine will look nice. I'm going to stretch the rear cockpit out a bit more than some folks do, Trek uses about 26" top tubes, I'll go to 27", though might go abit longer so my wife doesn't have to be quite so close to my backside. And I'll use tube that will fit over the original tube. Adds strength without adding too much weight, since both bikes are lugged frames (something I didn't consider when I found these two bikes at one time). As for the bottom tube, I'm divided on two tubes, or one larger diameter tube. And since I will be stripping the paint off both bikes, I might as well add braze-ons for accessories. And add a mount for a rear disk for later. In some ways, this will be an overkill build. But I might as well make it something solid, workable, will last, and if we don't ride it, something I can sell. Still need to find someone that TIG weld thin wall steel...

Friend of mine says I have too many bikes for someone that doesn't ride... Seeing if I can fix that this year. Make him change his tune to just too many bikes... Is there such a thing?

nutcase

To many bikes? Naw thats not a problem. The problem I have is storage, My shed is full of bikes and parts. It's getting real hard to move around. My bike is in the garage,cause it gets used the most. That is until the TKR. It's still there though to give me inspiration to ride it again someday.

zjrog

So I got home from work last night, heard water in the basement... Uh oh, sub zero temps the night before, not good... Opened the door, and man, it was like walking into a DC Wet Trainer!!!! *I* forgot to turn off my sprinklers last fall!!! Shut the valve off... Spent the evening moving stuff around, used the shopvac to pick up low lying water... Floor drain works! Nice to live at the top of the hill so the water flows DOWNhill quite well. Took half a day off to get more done. Moving the plastic tubs about (man that was a great idea!!!), but there were some boxes that got wet. Mostly kids stuff. Will get it all done this weekend. Wish it were warmer (even in the 30s) so I could open windows for a bit to get some humidity out.

This evening, my wife and I are going to go meet a kid we almost adopted. That was.... 17 years ago. He was 15 then. He was a foster kid and we parted under less than pleasant terms. He recently reached out to us, APOLOGIZED for being a "punk" (his word...). Had a nice chat with him on the phone this evening, he and his family are in the area for the week, and I just can't let this go without seeing how he grew up. In a way, he has always been family. We just wondered what happened to him all this time... I'm nervous, and I can't tell you why.

I should get some sleep. I'm tired and sore all over from moving my stuff around the basement... And I gotta see my doc in a few hours....

jagraham

How did you fare at the doctor's and your meeting yesterday?

zjrog

The doc appointment went as expected. Positive feedback from my therapist. Better explanations of why I still have swelling (since I am impatient for it to go down). Otherwise the doc was pleased with my progress and we fully expect further success...

The meeting with the "kid" turned out very well. Wasn't as long as we wanted, since his young kids had had a full day and were very tired. He credits us with some of what helped him through being a teen. Too bad it took more negativity in life for him to see all we wanted was to see him succeed. He tried college after high school, but that didn't work too well so he joined the Army and met his wife. Their kids are 4 years old and 20 months... Cute kids. He has a great outlook on life, and we're glad he has done well. We will be staying in touch, and we consider them family. He reached out, and he wanted to get together. We always figured he would do time. Real glad we were wrong. And very glad, that we went last night.

Lucky for me, the basement is drying well. What wasn't in plastic is being gone through. And what can be saved will be, what can't is in the trash. Still a lot of humidity, but I've had a lot of help from friends. Again, thank goodness for plastic tubs...

Talking with one of my friends, turns out he has a lot of experience with brazing steel. So we discussed my tandem plans. While the basic plans are unchanged, HOW it gets built has changed. But I have other projects to finish before tearing apart the MTBs to begin the process. (And one of those is putting the bead blast cabinet together at work!) And I'm not so sure I'm going to convert my old road bike to Single Speed... More later on that.

jagraham

Sure sounds like your "down" time hasn't been idle time...

zjrog

Judy, I have gotten more done during my "downtime" since the replacement than I did in the months before my surgery. I have been very lucky to have very good friends and good neighbors to help with the heavy lifting. Even when I'm reluctant to ask them. Once I got to the point where I wasn't on meds anymore, I just couldn't really stay sat much...

zjrog

How about some pics...

Unknown year KHS Fiero, 61cm frame. Exage 400 rear der., 6 speed freewheel, Altus front, yeah, its a mixed bag. I especially liked the Profile Aero clip on bar... But now do I make it ridable as is, or make a single speed. If I could find clamp on shifters (quality) that index, I might keep it on the street. Either way, the bike needs new wheels.



Blue 950 is a 16.5" frame the white one is a 18". Both are complete Mountain LX groups. And both are 1989 models. The blue one will become the rear section of the tandem I want to build, the white will be the front.


1998 Cannondale CAAD2 R200 58cm. Shimano RSX group, we swapped in the Shimano 105 triple and front derailleur. I can make it fit me just fine.

zjrog

Took the opportunity while watching the Superbowl, to chuck the Cannondale into my Ultimate Bike Stand. Cleaned it, ran it through the gears. Needs new brake pads, the old ones are hard as rocks, so they don't need to touch the rims. Freehub runs quiet, all the shifts are smooth and almost immediate. Going to take some time to get used to "brifters".


So, now the Cannondale is on the trainer. After 30 minutes I felt pretty good. Not cramped into a too small cockpit. I will get the aero bar off the KHS though, less stress on my wrists. The old tires seem to be holding air, They were in better shape than I thought they would be, but will still get new tires before hitting the streets. Also, In know that I will need to further adjust the bike to fit once I get more comfortable. I wonder, how this bike will feel on the street. Its so light... Are the 700x23 tires too narrow for my weight? Too bad none of my friends have roadbikes... crazy talk... The Scwhinn is back in the shed, back to slumber again. I did thank it for getting me rolling...

Barring snow, I think I am ready to venture out on the MTB this coming weekend. I have to beat this irrational fear I now have of falling. I was never really afraid of falling until I had the TKR...

The Hoo-Koo-E-Koo is on the stand now... Just to be cleaned and adjusted. Bad pics... Better ones later...

Suntour XCE 21 speed group.

zjrog

Wow, wow wow... This bike is so much nicer on the trainer. No, the trainer isn't all that new, we bought it 4 years ago, but it has very little use on it other than dust collection. Maybe too smooth. I blew up after 20 minutes. Might actually be a good thing, gives me an idea of how bad off I really am. Lungs gave out before my legs. And that makes me happy. Well, if I have to be happy... Friends want me to join a spin class... I didn't spin in the past, I hammered. I'm just not ready yet.

Need to adjust the bike on the trainer, it leans a little to the left. Not much, but noticeable. I need a FAN aimed on me.

Icing the knee. I've pretty much abused it the last few days and its not happy. Just swelling, no pain.

I'm committed to an outdoor bike ride this weekend. One friend has threatened to build me some training wheels...

Neil_B

Ok, I don't have a replacement knee, or knees.

But they are probably coming at some point. So here goes.....

I saw my new PCP yesterday about my knee problems, the problems that have kept me from exercising for close to two months. He looked at me and went into the standard doctor speech about climbing stairs and walking around in the grocery store. I interrupted him and explained that I ride centuries and hike up mountains. "The stakes are a little higher than climbing stairs" I said.

I'm not sure if he entirely believes my recounting of mountains and centuries, because he didn't give me a referral to an ortho. Instead I have a couple of weeks on Mobic and a follow up when that doesn't work. He favors switching me to Synvic treatment, although that didn't work well the last time I had it. While my new doc isn't opposed to my getting new knees, he doesn't think I should rush into it, even though he agrees I'll wind up with metal joints eventually.

Peter_C

I know you 'fired' me many months ago because you did not like my advice, or suggestions Neal. So please read or not as you wish. I am writing this, and taking the time to type with 4 fingers simply because I care, and I have had knee issues for 30+ years, and you know about most of my surgeries.

I will not go into other suggestions, as I have no wish for a flame war with other "non-doctors" on this fine forum.

The general advice give by PCPs, and Orthos when they first see you, is under 200LBS, and over 55yrs old. You (like me) flunk both. The other reason they try to discourage (or put off), is that parts wear out roughly every 10-15yrs, depending on weight and exercise. And the surgery is just as dangerouse as the original.

SO, when you *fail* to meet the criteria, you have to prove you have done everything else that you can, and that the need is due to a "Quality of life issue".

You can demand a referall to an Ortho if your insurance requires one, your PCP can not say no. Another way to get referred to a Ortho is through the ER - injury, too much knee pain, etc...

One more point? Doctors will not take you seriously if your pain level is not *averaging* a "5" or a "6" most of the time. And, that level should be while on some good anti-inflammatories. A good example of a '5' is that you are not able to focus on a book when reading -you go over and over the same page, then you give up. A '6', is you mad at everone and everything, very short fuse, doing whatever you can to lower the pain, a '7' is when you drop everything and go to the hospital, regardless of the time or cost. - IMHO

In closing, the guy you need to convince is only the Ortho - the guy that would actually do the surgery.

FYI - *I* say, do not rush into surgery, until your daily life sucks badly because of your knee or knees, and even then, shame on you if you have not tried the other *possible* fixes first. All the above said, all you need to do, is convice the Ortho there is nothing left to try, and you QoL (Quality of Life) sucks because of your knees - Just thought of it - function (I bet) is just as good as pain - say "Look at me~! I love biking, camping, hiking, and big mountains - and I am SO tired of how much it takes out of me because of these - point at knees while wearing shorts (always visit the Ortho with a pair of shorts)

Anyhow - think as you must, but I do believe what I write, and I took the 27 minutes to write it because *Neal* asked the questions..

zjrog

When you go back, ask for, or demand a referral. Surely, a pic or three of you on a bike should convince the doc that you need to move forward.

Weighed 285 this morning. Third time in a row. So hope to see it go down again soon... I do NOT weigh on any schedule.

I'm spending a lot more time stretching than I ever did before. My calves and hamstrings have been rather tight of late. And that has caused a problem for my left heel in the past. I have a special boot to wear in my sleep. But its tough to sleep. And I don't want to cause any twist issues to my knee. For now.

Didn't get my outdoor ride in today. Friends are quite upset with me. They will be over tomorrow to make SURE I get out for a ride... I did get a ride on the trainer in though...

zjrog

Peter, *I* will disagree somewhat. If you specifically seek out a sports orthopedic doc, that is your age or so, you won't get the same advice. My PCP is actually a PA, and she is really REALLY good. And I really hate docs in general. My QoL was crap. Bone on bone. NSAIDs quit working, Cortisone was all that as helping and then only barely. The gels had quit being effective. Graduated through Tylenol, to Ibuprofin, to Lortab, to Percocet. I didn't get a lot of things done here at home no matter how much I wanted to. I was in pain, or didn't trust myself with power tools. And then I couldn't get comfortable no matter whether in my recliner, or in bed. Rolling over in my sleep woke me up most every time. I had to wait longer than I wanted to for replacement because I changed jobs last year and had to build up vacation time. That was a very long 4 extra months.

But I do agree to see the doc in shorts. And to go to therapy in shorts. Yes, even in the dead of winter. It is sort of fun to watch other folks' reactions.

I've been pain free for almost 2 months now, and without meds nearly as long. Yes, therapy hurt. And I did push a little more than I should have. I'm still not 100% at almost 15 weeks, but I am back in the gym, on my bike (on the trainer, not outside YET), doing more and doing it pain free.

I'm 48, and will probably have to go through this again when the knee wears. I'm glad I did this. There is no way I could have made it to 55.

Neil_B

Peter and Roger,

My doctor has a perfectly legitimate reason to not give me a referral immediately - I'm a new patient. He'd never seen me before. He had no current bloodwork. He hadn't had the chance to go through my medical history.

At the follow up visit, we have a range of options based on what I want:

- continue with Mobic
- switch to a different drug
- switch to Synvic, which he can inject for me
- get a referral to an ortho

Look, the guy recognizes that I'll have replacements some time. He cautioned me that I'm the only one who can decide when. So I need to think hard about it. And I am.

I think I shocked him when I told him I had planned to ride across the US. I have that effect on people.

Peter_C

I do not feel that you are disagreeing with me at all - you just proved QoL above here. Neil has not been on pills daily for a year plus, or to my knowledge, anything like that. The only difference between you and I is all my Docs are "DOs", and I spent some 18 months in Pain MGNT on morphine, and my heart doc told the other docs I'd be soon for the grave if I did not have the TKR. We all are different cases in the eyes of the Doctors. Part of the reason it was so hard to get mine done, was all my prior knee surgeries - including a "realignment" - so no one wanted to do it til I found an Ortho that specialized in knees and hips. And he was willing when I was willing.

Neal - if you go to an Ortho, he will have an MRI done of both knees - usually PCPs do not do this - it's all in how fast you want to go - I'd suggest stronger pills - if you want names, let me know...

Peter_C

Synvic either works or it doesn't. In my book, why try it again if it didn't work the first time?

If "Mobic" helps you, you do not need surgery (due to pain), but possibly for reconstructive reasons - again, the PCP can't help there - see an Ortho (in shorts, or bring shorts and change when you get there).

Neil_B

Peter, the reason I don't take pills daily is that I don't take pills period, if I can avoid it. I'm fortunate I've been able to avoid taking anything stronger than over the counter things for pain for years. When I broke my rib in 2008, I could have had Percoset, but I never got the script filled. I'm sure if I didn't consider knee pain a part of my daily life for decades I'd be taking stuff regularly.

Neil_B

Understood. I don't want to do Synvic again either, but I was listing ALL the options I was given.

zjrog

Niel, I had a round of gel (Eflexor I believe, similar to Synvisc and others) that was very effective. But when it wore off, I went back for another round and it didn't take. If it didn't work for you before, it won't likely work again. I spent the next few months with Cortisone shots. Maybe Cortisone will buy you some time, just an option. Always your choice of course. Just, I hate to no someone is uncomfortable or suffering. Yeah, I hate taking even aspirin for any reason. Understand you completely on that. Glad we had that chat the other day.