More "What It's Like to Get Old"

Another post in my series "What It's like to get Old:"

Arthritis

It is an unfortunate fact that, as we age, almost all of us develop an acquaintanceship with arthritis – or “Uncle Arthur” as my family orthopedic surgeon calls it. My wife began her relationship early and by age 70 has had both knees replaced and arthroscopic surgery in her shoulder. The arthritis in her feet and ankles has been pronounced inoperable and she now walks only with the help of a walker.

My personal relationship with Uncle Arthur began with MRI and x-ray examinations of my knees which showed that my right knee was “bone-on-bone” and the left knee wasn’t much better. Since my wife had already had two successful knee replacements, I decided (age 66) to have a knee replacement - my right knee.

I had the knee replacement surgery, recovered well and did some intense physical therapy. But the pain in the knee didn’t improve beyond a certain point. I returned to my surgeon and had more knee x-rays. The images showed that the upper end of the tibia, below the artificial knee, was crumbling. The diagnosis: I needed a second knee replacement. A partial replacement to replace the fitment on the tibia with a different type of fitment.

I had to repeat the entire replacement process a second time within the same year. I missed essentially a whole bowling season.

As earlier, I recovered from the surgery and had intensive physical therapy. But as time went on, the pain did not go away. It’s been 7 years now and I’ve not taken a step without pain in my right knee.

I’ve returned to the surgeon, of course, several times and had more x-rays. They cannot do an MRI any more on my knee since it’s full of Tantalum metal components.

So, once again I’m stuck with a diagnosis:

·       We don’t know why it still hurts

·       Everything looks fine

·       We don’t know any way to fix it

My personal belief is that the surgeon somehow upset the natural leverage angles by which my tendons pull on the various bones, and I am stuck with chronic tendonitis in my right knee. The metal parts seem to be perfect but the soft tissue still hurts 7 years later. Despite having two knee replacements on the same knee.

So, of my wife and my four total knee replacements, we have two successful (hers) and two failures (mine).

Needless to say, I’m babying my left arthritic knee to avoid the necessity for another knee replacement. 

My wife (age 73) had her left shoulder joint replaced this week. Appreciate your natural joints while you still have them. As we age, most of us are in for cut-and-paste, cut-and-paste. 

I've been a league bowler my whole life, and I've kept statistics on my scores. For the six years before my knee surgery, I averaged 190. For the six years since the surgery, my average is a depressing 177 - 13 pins poorer. My knee doesn't hurt me especially when I'm bowling, but something is surely different that seems to be beyond my control. 

Bursitis

Like arthritis, as we age we almost universally develop bursitis. A bursa is a sac filled with lubricating fluid, located between tissues such as bone, muscle, tendons, and skin, which decreases rubbing, friction, and irritation. As we age, these bursa can become damaged or irritated. The result is pain.

My wife has had various bursitis treatments including cortisone injections and even surgery to remove a chronically damaged bursa.

My first experience with bursitis was when I tried to clean our deck by brushing on a cleaning solution with a push broom. I felt a tightening in my right elbow – not a pain, but a tight feeling. I looked down, and I had a swelling on the back of my elbow about the size and shape of a baseball!  I‘d never even heard of anything like that. Off to urgent care. Diagnosis – bursitis. Treatment: elastic bandage and rest.

My second experience was the time (age 70) I dumped my motorcycle while stopped on uneven pavement and strained my left knee (the “good” one). Back to the orthopod. Diagnosis: bursitis. Treatment: cortisone injection and exercise.

Peripheral Neuropathy

Beginning in my sixties, I began experiencing vicious itching attacks in my feet. My wife experiences the same thing. In her case the attacks occur mostly at night. Mine can happen any time.

My mother, in her seventies, also had this problem.

In my case, I’ve also lost a great deal of the feeling in my toes. As best I can tell, we’re both suffering from peripheral neuropathy, a type of nerve damage.

While peripheral neuropathy can be caused by a variety of things, including diabetes, it often occurs with no known cause. From my blood tests, there is no known cause for my neuropathy – except age.

Another of those: We don’t know what causes it, and we can’t fix it. But we do know what to call it.

About all we can do is use counter-irritants to suppress the itching, and local anesthetics. I’m also using a foot roller as a counter-irritant. My doc says that Vitamin B12 might help. Research on the web says that the Methylcobolamin formulation of B12 is recommended – so now I take that daily. Haven't noticed any improvement.

My wife also experiences the loss of sensation in her fingers. So far I'm no affected by that (knock on wood). 

If you're afflicted by peripheral neuropathy, you begin to think of it as the beginning of a slow death, creeping up from your finger tips and toes. 

Dental Issues

It’s an unfortunate fact of life that, if we live long enough, most us will outlive our teeth. I’ve always had good dental care, but I’ve also not been blessed with the best teeth. So, in my early years I had lots of fillings in my permanent teeth. But as I aged, I started breaking my molars and needing crowns. By my 50’s, all my molars were crowned. Then I started developing problems in the root structures and needed root canals – even in some teeth already crowned.

Then I developed problems with cracked roots – problems that crowns and root canals couldn’t fix. I’ve had two molars removed. After the first one was removed, I began biting my tongue, especially in my sleep. Had to get a mouth guard made.

In my 50’s I developed Temporal Mandibular Joint Syndrome – from a highly unnatural bite from all those crowns. I suffered bad headaches. I saw a specialist who eventually solved the TMJ problem.

Two years ago I had the second molar removed, and decided to get an artificial implant to replace it. A year and thousands of dollars later, I now have the implant. While that has solved the tongue-biting problem, it still hurts a little to chew hard foods with the implant.

Lacking any dental insurance, all this dental work has cost me a small fortune. But so far, I still have all but two of my original teeth (not counting my wisdom teeth). Knowing the problems my dad and grandparents had with false teeth, I vowed long ago to hang onto my own teeth as long as I possibly could. So far, so good.

The best advice I can give you? Take care of your teeth and get dental insurance.

De Quervain’s Syndrome

This past year (age 72) I developed a chronic pain in my right thumb. Back to the orthopedic surgeon, more x-rays and an MRI of my hand.

Seems I developed a problem whereby a tendon at the base of my thumb no longer slides smoothly through a sheath of tissue like it’s supposed to: De Quervain Syndrome. I guess it’s a form of tendonitis. Treatment: cortisone injection, ibuprofen, exercise and ice. And try to avoid whatever it is I’m doing to exacerbate the problem.

So I stopped using the thumbwheel roller mouse I’d been using. I think that bowling might also be partly responsible – although not bowling all summer didn’t make it go away. I’ve got a thumb brace, but it doesn’t help much (and my dog keeps chewing it!).

How can you stop using your right thumb, for chrissake?  So, De Quervain’s Syndrome has become another one of the things I’m having to live with.