Something is stopping Mel and I from being where I want to be in my life.
Our bodies.
The last few weeks I had an inflamed meniscus (in the knee that still has something left to inflame, the right); and being the idiot that I am I still insisted on walking around some.
The inflamed meniscus made me walk funny, which caused me to pull a muscle in my calf.
The pulling the muscle in my calf caused me to walk even funnier which strained the other knee and calf; and did a number on my back. Which of course makes me walk funnier, and causes cramps in both the pulled and non pulled muscles (I was very careful about and constantly watching for clots. I know ALL about DVT).
Remember, at this point I'm still refusing to stay laid up in bed; because I am an idiot.
Finally, Tuesday night the inflammation has died down, but the walking on pulled, and cramped muscles has made my knees and calves swell up all to hell.
So yesterday, instead of staying in bed like I should have; I decided instead, I was going to sit in a chair for about 10 hours.
My swollen irritated, pulled muscle, cramped up legs responded by inflating like balloons (peripheral edema).
All because stubborn idiot that I am "won't let these damn knees stop me from doing what I want to do goddammit".
Yes, that is a direct quote from last weekend.
I'm fine. I know what all this is, I've been through it before... and knowing me I'll probably be through it again.
... but I think I'm going to finally break down and go get a handicapped registration on the car.
According to the docs I'm only "20% disabled". It feels kinda lame (no pun intended) to get a handicapped placard for that; but some days, I NEED that couple hundred feet of difference.
Just as a temporary measure, I've ordered some patellar straps. I've thought about ordering them before, but no-place ever had the right size for me when I checked. I found a manufacturer that makes one large enough (Cho-Pat) and ordered two of them a few days ago.
Now that I'm on good insurance again, I'm going to look into getting some new custom fit knee braces. I need the knee support; and they now have very comfortable designs that specifically support the patella (which is my particular knee issue - patellar instability, and associated joint, ligament, and tendon degenration, due to past injury).
They're also considerably cheaper than they used to be (my last one cost almost $2k. The knew ones are under $1k each) so even if insurance wont cover them, or will only partially cover them, I'm still going to get them.
I REALLY want to avoid further knee surgery, and especially knee replacement; mostly because the knees that are currently used in mainstream surgery (the only kind insurance will generally pay for) have about a 20-25 year lifespan. That means I would need at least two sets, one sometime in my late 50s when the body heals much slower... likely resulting in very limited mobility for my remaining years.
The doctors and engineers tell me that within a few years I should be able to get a knee replacement that will last me the rest of my life; I just need to hold out 'til my mid 40s if possible.
Of course none of this matters if I can't lose the weight I need to lose. When I can work out, I do great at losing the weight, but when I can't (and the repeated knee injuries often keep me from working out for weeks or months at a time), no matter what diet I try, I only have limited success.
Up until now, I haven't even considered bariatric surgery. Now however, I have to face that I need to do something fast if I want to keep my knees intact long enough to only need one set of knee replacements.
The knee braces and patellar straps will help, but the fact is, I need to lose more than 100 lbs; and get to around 265; if I want to preserve my knees.
My best diet projections have that taking two years, and that presumes I can maintain my excercise schedule. I've been able to take that first 40 pounds off a couple of times, but then I re-injure myself and it comes back on again.
I HAVE extablished much better and healthier eating habits then I had when I started on this whole diet thing a while back; but it isn't enough.
So, although I am still very resistant to the concept, and I may still choose not to do so; I am investigating lap band surgery, with associated liposuction and abdominoplasty.
It's going to take two years or so with a lap band to come down to where I need to be for my knees (presuming no additional excercise). Since I need to reduce the weight on my knees as fast as possible; and I'm going to need the abdominoplasty afterwards anyway given the amount of weight loss I need to achieve; I'm also looking at thereaputic liposuction and abdominoplasty.
The thing about the lap band surgery that I like is that it is adjustable to my needs and conditions; and eventually can be removed and reversed with far less complication than other surgeries.
The problem with it, is that in general docs don't like doing it for people with UC; however, because of comorbidities like diabetes risk, and my knees, I believe that it's justified.
Thankfully, Mel has far less, and far less severe issues to deal with. She's only a little overweight in comparison (about 50 lbs, on a 5'9" woman), she has severe panic attacks and anxiety issues, and she has pretty poor vision.
We're already working on the first two issues. Mel has been losing weight, slowly and with setbacks; but losing still.
We've been working together on her anxiety and panic attacks from the first time I noted she was having one. She didn't know what it was, and had never really heard of them; and had been mis-diagnosed several times as a teen as having some psychological issue or another. None of the treatments worked because none of them were actually useful for the problem she had.
Just talking it out, teaching her methods to control her anxiety, and her emotional state and its effect etc... worked very well. It brought down the frequency and severity of her anxiety and panic attacks greatly; but didn't completely eliminate them.
We were very resistant to the idea of pharmaceutical treatment for a long time. As I have said before, I believe most of the people taking psychoactive medication not only don't need it, but it isn't effective for them, and has lots of potentially negative side effects.
That said, there are still a lot of folks out there who can benefit from the right medication. It's important however that you have clear goals and targets in mind. You have to have a very good understanding of the problems you are trying to treat, and target the correct medications and dosages for the individual appropriately; making adjustments as necessary.
That means you need a real psychopharmacologist, who really knows their business. Most psychoactives today are prescribed to women by their gynocologists (yes, seriously)... and that's just not a great idea.
So, finally, together we decided that that last hard knot of issues couldn't be addressed without some clinical help; and that hopefully with medication she could finally work out the emotional issues that cause the anxiety (which could then obviate the need for the medication).
A couple months back, we found a therapist and a psychopharmacologist (who don't work together directly, but who do work together in her treatment, which is important) who she likes, and now she's on medication that is controlling her anxiety very well. They're still working to find the optimum balance, and that's a slow process (it takes about six weeks to stabilize on a new dosage or a new medication), but it's working. Mel is getting better every day.
Oh and the psychopharmacologist is a sharp one. Mels meds are on the $4 list at WalMart and the discount list at costco, k-mart etc... So even without insurance coverage, we'd be OK.
The hope is, as I said above; that the medication will control her anxiety enough, that she can address the underlying emotional issues that cause the anxiety in the first place.
Before the meds, any time she got down to a certain depth of emotion, she would just break down because of the anxiety. Freeze up, and start doing self destructive things etc... Now, she's able to start working through those deeper things, in the same way we have been working through the shallower things for the past few years.
The final health issue is one we share; we both wear glasses. I'm only moderately shortsighted, but Mel is both severely shortsighted, and astigmatic.
So, we've got a health care savings plan with our insurance; and we're putting enough into it every year that we should both be able to get eye surgery by the end of this year.
So, hopefully, in two years or so... maybe three; we'll be where we want to be with our bodies.
