Not Quite the Bionic Woman

knee braceI have a knee brace.  The little sucker goes from mid-calf to mid-thigh… and it’s going to have a twin for the other knee.  I’m sort of disappointed because I thought it was going to be solely for when I exercise daily.  Only that’s not true; it’s going to be for eight hours a day. How did I so misunderstand what the doctor was saying?

More importantly, what the heck is this for?  I double checked this with the rheumotologist: it’s to postpone knee surgery as long as possible. As I understand it, there’s even a possibility of avoiding the surgery all together. I like that option. It’s also meant to minimize the pain. I like that, too.

The culprit here is osteoarthritis, which has worsened with age.  Lucky me. All those years of dance, judo, Tai Chi, Aikido, and stage movement blueshave done a job on my knees. That doesn’t mean I stop dancing or exercising, though. It also doesn’t mean I start taking more medications, either. Hey! I have Chronic Kidney Disease.

Let’s do our usual back tracking here. First question: What is osteoarthrosis of the knee? The American Academy of Orthopaedic Surgeons has a wonderfully clear explanation with an accompanying diagram:

“Osteoarthritis is the most common form of arthritis in the knee. It is a degenerative, ‘wear-and-tear’ type of arthritis that occurs most often in people 50 years of age and older, but may occur in younger people, too. In osteoarthritis, the cartilage in the knee joint gradually wears away. As the cartilage wears away, it becomes frayed and rough, and the protective space between the bones decreases. This can result in bone rubbing on anatomy of the kneebone, and produce painful bone spurs. Osteoarthritis develops slowly and the pain it causes worsens over time.”

You can read more about osteo and other types of knee arthritis on their site at http://orthoinfo.aaos.org/topic.cfm?topic=a00212.

Well, that explains why the knees clicking isn’t a source of amusement anymore and why getting on my knees to play with sweet Ms. Bella is now agony.

As for medications, sure NSAIDS will help… except I can’t take them. Here’s a reminder why not from What Is It and How Did I Get It? FullSizeRender (2)Early Stage Chronic Kidney Disease:

 “NSAID: Non-steroidal anti-inflammatory drugs such as ibuprofen, aspirin, Aleve or naproxen usually used for arthritis or pain management, can worsen kidney disease, sometimes irreversibly.”

I’ll pass on those. I do take Limbrel, though. That’s not a NSAID and does help with the pain of arthritis. In The Book of Blogs: Moderate Stage Chronic Kidney Disease, Part 1, I defined Limbrel:

“a food medication {By prescription only} to deal with the pain preventatively.“

So now we understand why the knee braces (and the Limbrel). They – the braces – supposedly fit under your clothes. Uh, no, not if you’re a woman IMG_2982who wants to wear anything remotely stylish or not live in longish skirts. I could not get my capris or slacks on over the brace. Living in Arizona, longish skirts may work in the winter time, but they are too damned hot for the summer… which lasts from early May to late October.

So, how do these babies work you ask. I went over to the manufacturer’s website for the answer to that one.

“The Unloader One applies a gentle force design to reduce the pressure on the affected part of the knee, resulting in reduction in pain and thus allowing the patient to use the knee normally and more frequently.

Untreated, the cartilage will gradually wear down. The increased pressure on the underlying bone is the cause of the pain experienced by most osteoarthritis (OA) sufferers. The wear and tear on the cartilage will gradually cause the knee to become painful and feel stiff when moving.”

You can read more about knees on their website, but remember this is the site of a product for sale:  http://www.ossur.com/oa-solutions/unloader-uploaderbraces-and-osteoarthritis/knee-pain/unloader-braces-and-oa-knee-pain

I wanted to know a bit more about how the knee works. The National Institute of Health at http://www.niams.nih.gov/Health_Info/Knee_Problems/default.asp explained in detail.

Bones and Cartilage

The knee joint is the junction of three bones: the femur (thigh bone or upper leg bone), the tibia (shin bone or larger bone of the lower leg), and the patella (kneecap). …The ends of the three bones in the knee joint are covered with articular cartilage, a tough, elastic material that helps absorb shock and allows the knee joint to move smoothly. Separating the bones of the knee are pads of connective tissue called menisci (men-NISS-sky). …The two menisci in each knee act as shock absorbers, cushioning the lower part of the leg from the weight of the rest of the body as well as enhancing stability.

Muscles

There are two groups of muscles at the knee. The four quadriceps muscles on the front of the thigh work to straighten the knee from a bent position. The hamstring muscles, which run along the back of the thigh from the hip to just below the knee, help to bend the knee.

Tendons and Ligaments

The quadriceps tendon connects the quadriceps muscle to the patella and provides the power to straighten the knee. The following four ligaments connect the femur and tibia and give the joint strength and stability:

  • The medial collateral ligament, which runs along the inside of the knee joint, provides stability to the inner (medial) part of the knee.LateralKneeDia_cropped1
  • The lateral collateral ligament, which runs along the outside of the knee joint, provides stability to the outer (lateral) part of the knee.
  • The anterior cruciate ligament, in the center of the knee, limits rotation and the forward movement of the tibia.
  • The posterior cruciate ligament, also in the center of the knee, limits backward movement of the tibia.

The knee capsule is a protective, fiber-like structure that wraps around the knee joint. Inside the capsule, the joint is lined with a thin, soft tissue called synovium.”

CKD brings a new way of thinking about every part of your body… even your knees. Think about it.
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Until next week,

Keep living your life!

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