My mother's knees are both bone on bone and during the past six months she is in unbearable pain. How should we proceed? - AgingCare.com

My mother's knees are both bone on bone and during the past six months she is in unbearable pain. How should we proceed?

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She is 83 years old and diabetic so she is not a candidate for knee replacement. She is on oxy cotton and another pain medicine but today she was in so much pain she was crying. We've been to the ER and back and forth to the doctor over the last 30 days and it's hard to see her in so much pain. Not quite sure how to proceed since the doctor just has an attitude of this is how it's going to be.

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cherokeewaha: Corticosteriod injections should NOT hurt. The orthopedist should put a liquid numbing agent on the area first. If they injections hurt, it's time to get a different orthopedist.
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I have had both the injections and surgery. The injections worked for about 10 years before I had to have the total knee replacement on the right and a month later had laser surgery on the left. It has been almost 4 years and I am beginning to need injections in the left knee again. I am overweight which doesn't help. But, check on the injections. Hurts like crazy to get them but so very worth it. 15 seconds of pain for weeks worth of comfort.
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Check into if she is a candidate for bilateral corticosteriod injections.
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Surgery at 83 is not unheard of. Find another dr. Sounds like you are not seeing a orthopedic doc with a lot of geriatric patients.
Even if they answer is "no" the injections that people are talking about are noting short of amazing! My friend in her 70's staved off knee replacements for years by having Synvesc (sp) injected into her knees once or twice a year.
Being diabetic doesn't make you unable to have surgery. It complicates things a little, sure, but it wouldn't be the one thing that makes her not a candidate. (Obesity, yes, since very heavy people struggle more with rehab, but if he weight is relatively OK for her height, that shouldn't be a problem.)
BTW, the ER will only address the immediate problem (pain) and the dr is asleep at the wheel if he/she isn't referring your mother out to an ortho doc!!
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Surgery of course can be very dangerous for the elderly and others as they are exposed to infection and other post operative complications such as pneumonia.
The key here is in that is your mother cable of rehabbing the knee if the surgery can be done. If she is grossly overweight, uncooperative or pain lazy she is not going to have a very good result. It does take a lot of hard work to get results from the PT which can be done in a rehab center or as an outpatient. It is often done under spinal anesthesia with heavy sedation so the danger of general anesthesia is removed. Once she has recovered say in 3 -6 months she will be able to do far more than she did before and walk without a cane if she is safe. She should leave a minimum of 6 months between surgerys if both knees are done. Climbing stairs or at least a few steps is also very possible. All depends on her attitude and general health. Diabetes in itself is not a reason not to do it but if her circulation is impaired then she won't heal. granted i was only 68 when i had a knee and hip done but after five days in the hospital i was able to climb a couple of steps into the house and get around unaided to the bathroom etc using a walker. the patient certainly needs a lot of help with meals, bathing eat and of course won't be driving for several weeks.
In this case I would try whatever injections are available before embarking on the surgery at 82. After all people of that age and older have successful surgery for broken hips in an emergency.
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Just took my 84 year old father to the Orthopedist who injected both knees that are bone on bone.
Dad says he is pain free!!
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Hyaluronic acid injections are a great suggestion! Please stop taking her to the ER for pain. The ER is not where she belongs because you know the source of the pain. Research done by infectious disease physicians and microbiologists indicates: "A visit to the emergency department was associated with more than a threefold increased risk of acute infection among elderly people." (Source: Risk of infection following a visit to the emergency department: a cohort study by Quach et al. Division of Infectious Disease, McGill University.)
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Take her to the ortho. Ask for her to get Hyalurnic injections

This is basically the same stuff that is a lub in the knee naturally. I have been getting these injections about every 12 months for this same issue.

I first learned about it from thoroughbred trainers at the race track. Horses that are nearly lame can be brought back to run pain free with these injections. I do not plan to run 5/8 of a mile...so the effectiveness lasts longer for me!
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My mother has the same problem with her shoulder, but we know people who had the new injections in the knee that have helped. Some brands are Flexogenix and there are some others I can't remember. It puts the fluid around the joints back in and it does require a few visits. Doctor said that Medicare will cover it.
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Thank you all. I will push for the injections today. She is in a medical program and while it has been wonderful in some areas, I'm feeling a "warehouse", "assembly line" affect in others since she will often see a nurse rather than the doctor. So, goals for today: get the shot and make appointment for a pain specialist. I'll let you know how I make out
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