Woe is Knee

Hi friends!

So, the good news is that my hip bursitis continues to improve, in spite of 5 miles 5 x per week on the recumbent bike. This must be thanks to Humira. The bad news is that my right knee and achilles is really acting up something awful. The knee is quite swollen and warm and I just don't know what to do for it, other than slather it with Tiger Balm and hope for the best.

I wonder if an injection of some kind might help. I am loathe to go to an orthopod because I don't want anyone cutting on it. My Dad has had both knees replaced and that may be in my future, but I want to wait as long as I can. My son is getting married in late May, so I need to be afoot and aknee.

How many of you have good knee sagas to share ?

Today in NC is it 71 degrees and we are expecting snow on Tuesday. Maybe my knee thinks it is a barometer....

The orthopods are referring a lot of knees to the interventional radiologists. They are doing am MRI injection that is absolutley amazing in outcome. The real beauty of this injection is the material goes perfectly where it is supposed to avoids the tendons etc so very few of the side effects that you get with regular injections. Its a fairly new procedure and not avaiable everywhere. Its a huge game changer. I suspect it will replace the old steroid shoot ups in nothing flat.

Probably not much comfort, but knees are one of those joints that flsre up big time, drive you to the point where you want to cut it off, and then you wake up one morning with zip pain and stiffness.

I agree with what Lamb says. I have not had my knees done but did have it done to my spine. It was amazing! There was virtually no recovery time. It did help us to determine which different areas my hip/spine pain is coming from and what is causing it. If it is available in Vermont now it probably available in your neck of the woods too. Good luck with it mimB and congratulations on the marriage of your son.

I just realized I was mistaken. My injection by Interventional Radiology was done under x-ray not MRI. But I am sure it is similar and will help immensely. Let us know how it goes mimiB.

Thank you, I am Googling now !

Google dance lessons too just in case you are a bit rusty. Congrats!

Here are titles to the dance tunes I could choose :

Do The Hobble

Every Day I'm Hobblin'

I Got Down On It And I Can't Get Up

I Did The Twist ( And Wish I Hadn't)

I'm Too Sexy For My Cane

This is How We Did It

My Achy Brakey Knee

Do You Love Me ( Now That I Can't Dance )

I Like to Move It ( But It Doesn't )

U Can't Touch This ( Cause It's Swollen )

Gonna Make You Sweat ( Methotrexate Remix )

It's Just a Methotrexate Monday

Gettin' Jiggy Wit My Wonky Knee

Oh my goodness mimiB you are so talented! You go girl! I can almost hear it!

Love the list! :)

I was told, at age 17, that I'd need total knee replacements (both!) by age 25. I'm 36 and have never been back to an ortho.

My friend's pain management doctor does injections using live x-ray to place the needles so the meds go exactly where they need. She gets the injections in her neck, but they do back, knees, etc.

In my experience, my knees will majorly flare for no apparent reason and there's nothing I can do or refrain from doing that makes a wit of difference. Like Lamb said can happen, I'll wake up one morning and come to the realization that I have kneecaps and no pain instead of massive inflammation and lots of pain. I do notice that all resting my knees does is make them more stiff.

Interesting Nym ! It might be asking a barber if you need a haircut, right ? Haha. Anyway, I do have an appt with a new ortho next week and I will definitely ask about the injections with flouroscope since I don't think I can have an MRI with all this metal in my back.

Just to be clear, your knees can flare when other things aren't flaring ? Are there different kinds of flares? My knee only hurts mildly when I am exercising, but MAN when I am sitting around it starts throbbing and stabbing like a boss.

I am also really, really fatigued today. And I have an artists meeting tonight. I would cancel if I weren't leading the thing. I guess I will be glad when I get there and see my friends, and have some laughs and hugs,

Wow- that is excellent info!! I am a big fan of the old steriod shot-but if there is something better-you bet I'll take it. Thanks!!

tntlamb said:

The orthopods are referring a lot of knees to the interventional radiologists. They are doing am MRI injection that is absolutley amazing in outcome. The real beauty of this injection is the material goes perfectly where it is supposed to avoids the tendons etc so very few of the side effects that you get with regular injections. Its a fairly new procedure and not avaiable everywhere. Its a huge game changer. I suspect it will replace the old steroid shoot ups in nothing flat.

Probably not much comfort, but knees are one of those joints that flsre up big time, drive you to the point where you want to cut it off, and then you wake up one morning with zip pain and stiffness.

Yes, my knees will flare when nothing else is flaring. They're doing ok at the moment, but I'm hoping to get my indoor bike trainer thingy set up today and start riding (for exercise and because my husband wants us to bring bikes to camp and do some cycling while we're there) so I can figure out how my body will react and build up some muscle strength for the real thing once Spring decides to actually get to CT! I'm wondering if my knees will object to the new activity.

I find I have injury or overuse related flares of specific joints, and then larger flares of "regions" of the body (my upper body will flare while my legs are perfectly fine or vice versa) or I'll have a total body flare (which doesn't happen often).

I'm still learning ! Yesterday, after my bike ride at the Y, I hit that wall of fatigue again. My knee was screaming all day and most of the night. My hips joined in again this morning after feeling better for a few weeks. I'm pretty bummed out and I am taking a break today....seeing the doc tomorrow. I just don't know what to think. Maybe the Humira has pooped out.

I had a conversation with a very dear friend of mine who is a yoga and meditation teacher. I told her that I was doing quite well and that my fatigue was pretty well in hand, as is my inflammation. I told her I was really enjoying my exercise regimen but that my elbows were starting to get a little swollen and sore. I asked for her advice as a yogi on what I might do to help myself so I wouldn't cause swelling. She told me to check my ego!!

She was right no matter how much I wanted to tell her she was wrong. I am the one insisting on a five day a week workout routine. I'm the one who loves yoga and looks forward to every down dog and bead of sweat. And I'm the one who can't admit that while the exercise is helping me in the long term, over the short course an extra day of rest here and there is not a bad idea. And it isn't an admission of failure or weakness, either.

When things are firing on all cylinders and the Humira is doing its job and the sun is shining it is easy to forget that I'm not invincible. One sore elbow and I'm making bargains and deals to get back into the yoga studio instead of resting up and backing off of modifying my practice a little. I have a big ego and very little humility. I might need to address that equation!

I hope your knees calm down soon so you can get back on that bike!!

So, is she meaning to say that we should not try to control things we can't control, that being proactive is really an illusion?

Sometimes it sure feels that way ! After all of my big talking about strategizing and not catastrophizing I am walking a fine line today. My visit with the doc went OK. I'm talking a Humira Holiday. He doesn't feel, and neither do I, that I'm feeling enough benefit from it to take on the risks.

While in his waiting room, ironically, the link to this article came in my email http://www.medscape.com/viewarticle/822474?src=wnl_edit_tpal&uac=13774ET

It states "Forty-nine percent of patients developed ADAs, with the vast majority (90%) forming antibody titers within the first 24 weeks of therapy. The presence of ADAs significantly reduced clinical response to adalimumab therapy (correlation coefficient, -0.606) Concurrent methotrexate (MTX) therapy (n = 8) at dosages ranging from 2.5 mg to 10 mg/wk did not reduce ADA formation."

I think this may be why I am a low responder to this medication. I will continue to take methotrexate and low does prednisone for now and see if I get worse until my next visit in a month.

The water exercise class, after some rest, might be relaxing and keep me on track with a reasonable exercise plan.

That antibody build up is a real pain in the ass. I know htat's why a lot of folks continue on methotrexate along with their biologic, to try to keep the antibody count low.

As to my friend, her point is that the ego controls pretty much everything about our brain. If you think of the brain only as a machine that produces words then think about what we pay attention to, the ego has a LOT to answer for. All the "should"s about what we "ought" be doing, how well, how long, how far, etc. If, instead, we listened more carefully to our bodies we might be better off. In may case I would back off in yoga and do half a class in a modified format so as not to aggravate my elbows. But my brain delivers messages laced with pride, failure and invidious comparison to others. Instead of listening to the word noise and ego clutter I would do much better to hear my elbows going "ouch!!!". It is, in her way of thinking, the ego that clouds judgment about the correct course of action--one that shows compassion to self. The ego knows little compassion.

I believe that she would say that being proactive is a good thing, that exercise and motivation is a good thing, and that all things must be moderated by a compassionate view of self and of holistic well-being. If your body is 100% but your brain isn't you're not in balance and vice versa. The notion is to have the body and brain in sync with each other.

And, YES to aqua therapy. Best thing I did for myself. I went from cortisone injections to feeling like my old self in 3 months.

Very good advice ! And I agree, this is a pain in the ass, LITERALLY. Yesterday I told my doc that my butt hurts ! I And I aslo agree that it would be helpful to stop "shoulding" all over ourselves. :) I am going to just rest and be nice to myself and enjoy this day. I hope you have a great one too !

Well, dang it. I saw the ortho today. He did lots of x rays of my wonky knee. He said it had a "deformity"...I prefer "wonky". Anyway, I am a bit "knock kneed" and have "a knee replacement in your future". I got a cortisone shot and will attempt to coexist with it as long as I can. I want to talk to my rheumatologist about it. I had not had x rays since 2012 and there had been a lot of changes.

This ortho also said to try to exercise on the bike consistently for 30 min buy only 3 times per week, or do the water class. he feels that it is good to rest a day in between. I will attempt the gym on Friday. I really don't want to have surgery. That is the understatement of the century. I guess as crappy as I feel, I'm not miserable enough just yet. I shall search the forums for knee replacement.

The good news is that it was 86 degrees here today. Spring has sprung !

Oh mimiB I am sorry to hear it. I do everything I can to avoid surgery too. I know a lot of PsA pts have had to have this done; thee may even be a few stories on here about it. I will keep you in my thoughts and prayers<3

86 degrees!? Vermont hit 50 today and I had the front door open! Spring has sprung but we won't hit 86 here until August!

We tied a record. It's usually not this warm till the end of May !