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My wife has an artificial mitral valve and a pacemaker. She's over weight. Both her knees are bone on bone. She's 76 years old. Her orthopedic surgeon said due to her physical issues and age he doesn't recommend knee replacement. She had the cortisone shots in both knees but it only helped for a few hours. What can she possibly do?

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I lost 85 pounds at age 69, maintained the loss for 7 years, and now am in the process of losing 10 or 15 pounds more, in hopes of reducing a questionable diagnosis of sleep apnea.

The choice she has is simple (not necessarily easy), but direct. If the pain is overwhelming, your wife will need to associate her solution with her behavior- eat poor quality foods often= pain, eat high quality foods FOR EVERY SINGLE MEAL = reduced pain.


This is what she can POSSIBLY do. I would NEVER SAY THIS if I hadn’t been morbidly obese MY WHOLE ADULT LIFE.

Any other “solution” will ultimately fail unless she is willing to commit to loving herself enough to take charge and do this.
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OldBob1936 Oct 6, 2019
I applaud your answer....Eating anything with sugar or refined/processed foods, can be a MAJOR factor in any number of health situations. In my opinion the general public does not grasp the fact that with give or take 60% of Americans are overweight, is due to addiction to "goodies." Can be arrested one day at a time with rigid adherence to "good food diet" with no "once in a whiles." I know. I did it. Over one hundred pounds lost and now 5'9" in height and weigh 175.
Grace + Peace,
Bob
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Water walking will be very beneficial. First, the water supports part of her weight so there's less force on her knees during the exercise and she can exercise more. Second, the water pressure exerts an even force to push built-up fluids and swelling out of the knee joint. Third, water provides a gentle resistance to motion that strengthens all the muscles supporting the joint without over stressing any. Fourth, in water the joint can be worked through a more complete range of motion without any pain. Find a water _walking_ (not aerobatics) class and encourage your wife to attend at least 3 times a week. If there's not a water walking class in your area but you do have access to a pool, find some videos on youtube or purchase a video and get started. Even just walking across the pool forward, backward, and side stepping is a good start for the knees.

My mother used water walking to relieve pain, and to build muscle and cardio fitness prior to hip and knee replacements as well as to rehab afterwards. She required minimal rehab efforts because she had good muscle strength post surgery. Many people spend a lot of rehab time rebuilding muscle strength they loss when exercise became too painful.

I only have bone on bone on one spot of one knee while about 2/3 of the bad knee has some cartilage remaining, but I do have osteoarthritis and swelling issues in both knees.

Additionally using a gel pack wrap around each knee helps a lot too (Reusable Knee Cold Pack Wrap with Flexible Gel Ice Pack for Joint Pain). I wrap my bad knee just barely tight enough to keep the ice pack in place at bed time and leave the wrap on most of the night. Like the water pressure from the pool, the gentle pressure from the gel pack molding to the shape of the knee takes the swelling down.

Most medications for inflammation are hard on the stomach or (like NSAIDS) have undesirable side effects. For me, buffered aspirin taken with food helps the most. I can even take the buffered aspirin before bed with a small bowl of cereal. I also take capsules of the spice turmeric, use it in my cooking, and eat spinach and tomatoes.

Hope some combination of this helps your wife.
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Not a lot. I know you will have heard the one about "overweight" and likely your wife has as well, and we all know it may not be likely she will address that. And even if she DOES address that, she is bone on bone and that is excruciating. Now it is on PT visits to see what she CAN do given she will not be having surgery. Ask the doctor for PT specialist in this. They can recommend what assistive devices are best from walker to braces to whatever. The cortisone is the best they have. There will likely need to be pain evaluation treatment. Your wife may become addicted to pain killers and there may be no way around it; the prime imperative is that she doesn't fall because of either pain or too many meds.
Your wife is facing immobility and wheelchair at this point, because at this point it is either that or a total knee surgery. And the latter is not on offer.
Again, on the weight. Have you asked the surgeon "If there is less weight can she have surgery, or is surgery still out due to medical issues?" That may take the weight off the table as an issue. Or may give incentive that if there IS weight loss there may be surgery and less pain.
So very sorry. There are few things more depressing than constant pain. Docs are afraid of opioids and giving them now to the extent they will often not prescribe when they SHOULD. The pendulum swings one way, then the other, and seldom stays in the middle common-sense area.
So sorry.
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Mthr is on tramadol for arthritis and our doc said he was not concerned about her getting hooked on them but relieving her pain.
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anonymous828521 Oct 4, 2019
Yes, 'surprise', agree that most Drs don't get concerned about addiction when elderly have inoperable pain. My mom's Drs freely gave her whatever she needed (she was on lots of norvac (lortab) at age 88, & they didn't 'bat an eye'....the poor thing had to be able to walk to dinner without knee cartilage, or risk being sent to nursing home side. Thank God she rests now. But she was a real trooper.
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Ask her doctor to write her a script for physical therapy. PT will allow her to strengthen the supporting muscles. The PT may also recommend a brace. There are topical pain relief gels. Does she ice her knees? This helps too.
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Terry, just one more word of caution. Knees and backs are as individual as thumbprints. What helps one won't necessarily help another. And with the bone on bone you want to be very careful of anyone telling you should should "exercise" in any way without passing it past the Ortho MD and PT. Exercise doesn't help bone on bone. It hurts it. You would hope for a way to strengthen muscle and help them SUPPORT but not exercise any bones, if you see what I mean. This is SPECIALIZED stuff. So plumb all our comments, but before you take up any exercise of any kind, pass it past the ORTHO MD and a good physical therapist. You cannot afford to make this worse.
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Judysai422 Oct 6, 2019
Exercise strengthens the muscles around the joint which helps keep the knee stable and takes pressure off the bone 9n bone which results from misalignment. A brace also helps in this way. There are different kinds.
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I had bone on bone with my right hip and nothing helped me, except prescription pain medication for a couple of hours. I wound up having hip replacement surgery which did fix the problem. Am facing replacement with my left hip as well, sometime down the road.

Sorry to hear of your wife's situation. What does her doctor recommend for chronic pain? If she were to lose weight, would he consider knee replacement surgery, or he hesitant because of her heart issues? I mean, life with chronic pain of THIS magnitude isn't much of a 'life'. See what it would take for him to reconsider, or get a second opinion. Then you can weigh the risks and make an informed decision.

Best of luck!
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anonymous828521 Oct 4, 2019
Lealonnie1, That was very brave of you to have that THR surgery, (I've seen them done when I worked in the O.R.). Rehab is very tough too...(I'm a big crybaby with pain, so I'm really impressed with those who have tackled it). 👍
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Change insurance if needed to a PPO, not HMO. And go somewhere else to get a second opinion like Mayo Clinic in Rochester, MN-- number one in orthopedics. They usually do many things other doctors say it's not possible to do.
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PT, lose weight, CBD oil, topical analgesics, and if all else fails, oxy.
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I Love Biofreeze for my knees..back, hips, etc. It really works, and works for quite a long time...so I only apply it twice....you can do it in the morning and at night before bed.
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