As Ready As I'll Ever Be...

Well, here I am. Less than 1 day before surgery. In the past 2 weeks I've had more x-rays and blood tests than one could imagine, and I guess Im as ready as I'll ever be. I've rearranged my bedroom furniture so that it will be easier for me to get to the bed after surgery, stocked up my fridge, attended the pre-operative class, and washed the area with the Hibiclens soap, just like the doc said. I took a long hot shower this morning and washed my hair. I'm going to take another tonight. All thats left now is making sure I dont eat after midnight. This time tomorrow, I'll be on an operating table, getting my new knee. I'm a little nervous about anesthesia because of my already low blood pressure, but I feel pretty comfortable with everything that is going on. So the next thing you'll hear from me will be Lexi after surgery. Send up some prayers for me, I appreciate it. :)

Im 27...and Getting a New Knee

Hi Everyone. My name is Lexi. I'm 27 years old and have rheumatoid arthritis. I started this blog as a means to keep track of the progress of my knee replacement surgery, but in order to do that, I'll give you a brief summary of what brought me to this point. 


About 7 years ago, I woke up one night in extreme pain all over my body. Having been an athlete and dancer most of my life, I was terrified and rushed to the emergency room. They had no idea what was causing the pain that I was experiencing, so they gave me a shot of Demerol and sent me on my way. The shot lasted a few hours, and when the effects wore off, I just felt really stiff and sore. Prior to this, I was always extremely tired, but I assumed that it came from the fact that I was a full-time college student, working part-time, and had a newborn. I never for a second thought that something was wrong. Had I done so, I might have been in much better condition than I am at the present. But that's the problem with women. We often miss the subtle hints that our bodies give us, because we consider them a part of the stresses of life. I wish I had listened to my body at that point. Would have gained some years of pain free life if I had.


So a little while later, my knees began to ache. I went to my primary physician who put me on prednisone, a corticosteroid that helps to fight inflammation, but also affects your adrenal glands, and slows your metabolism to a standstill. 3 months later, I was 45 lbs heavier. When he placed me on prednisone, he also ran several blood tests. When the results came back, I had a seriously elevated Rf, or Rheumatoid factor, a determinant for Rheumatoid arthritis and sometimes Lupus. Having an aunt that has lupus, the doctor ran additional tests to rule it out. After having about 2 years on the prednison, I began taking Plaquenil, which should have slowed the progression of damage. However, my disease progressed very rapidly, and plaquenil offered little in the way of relief. I began seeing a rheumatologist, who introduced me to more aggresive therapies like methotrexate and Humira, both injectable medications that I had to learn to inject myself with at home. He also reduced the amount of prednisone that I was taking, which along with exercise helped me lose the weight that I had gained, which at that point totaled 65 pounds. The knees continued to deteriorate as the cartilage was eroded, and eventually I began experiencing problems in the wrists and one elbow. 


I received kenalog (a type of steroid) injections into the knees and elbow, and once the wrists had gone out, the deformity cause two tendons to rupture in one hand. I went to visit an orthopedic surgeon, who told me the type of surgery that would be required to fix the problem, but because the tendons were not painful, I decided to forgo the surgery until a later time, although I've very limited use of two fingers at this point. Throughout the years, the knees have hurt off and on, and sometimes I would have a year or so with little pain. This year, my right knee completely went out, and the pain is excruciating to say the least. I am nearly totally incapacitated. 


My rheumatologist referred me for total knee arthroplasty (replacement) surgery. The first surgeon that I saw was uncomfortable performing the surgery on someone my age, because the youngest person he has replaced was 34 years old. But he stressed that my first surgery would need to go near perfectly, considering I'll have to have two or three of them on each knee in my lifetime. He then recommended a surgeon that he felt could perform the surgery well. The hitch? My then Blue Cross Blue Shield HMO would not cover the surgery, because the surgeon was in their PPO network and not their HMO network. Soooo, I had to put the surgery off for 2 more months while I switched my coverage to PPO. I am now scheduled for surgery on February 1st, 2010. The surgeon has chosen to replace only the right knee, although admitting that neither leg was in good shape, because he wants to try another treatment on the other knee before deciding to operate.


Initially, the thought of having this surgery terrified me, so I put it off for a few more years and dealt with the pain. I am now at a point where that is no longer an option. It saddens me to think that this is only the first of several surgeries that I may require in my lifetime, but there is nothing that I can do to chance the hand that Ive been dealt. So I am ready for this surgery, and pray that all goes well. I havent yet decided if I will go to inpatient rehab afterwards, but it is very likely, as I dont have the right support system in place at home for self care considering I am a single mom. My son will be staying with relatives, so that is not an issue. At this point, I just want as much of the pain to go away as possible. I just want to be able to run on the beach with my son, just once. That would make all this pain worth it.