Hi,
I am 51 yers old and I weigh 200 pounds. Medication that I am on now unrelated to this has side affects of weight gain. I started out seeing my GP for knee pain in both knees. He started with x-rays and the conclusion was mild osteoarthritus and he sent me to Physical Therapy. I did pool therapy for 6 weeks and I thought that maybe this would be the answer. Nope didnt work. As time went on the pain was becoming worse. I went back to my GP and asked to see a Orthopedic Doctor that I thought would help me. I saw him and his impression of the x-rays were different. He said right away you need Partial Knee Replacement. He said that I then will have no pain. Then the bad news set in. He told me that I need to get my weight down to between 100 to 110. I could not believe it! Even in my teens I didn't weight that. And I was very active in sports. He said the the replacements would not last 5 years according to my weight. He gave me Diclofenac and said to come back in 6 months. I was very shocked.

I went home and things got worse. I fell a couple of times because my legs are getting weak and my left knee buckles out from under me. So after about 6 weeks I went back to the same Doctor I did loose 13 pounds in the meantime. He told me now you are not a canidate for by-pass surgery. WHAT! I dont want that and never expressed it. He gave me Tramadol and tylenol and sent me for and MRI and told me that he could not do anything. He said that I could go see a Doctor that specializes in Orthoscopic Surgery and he could maybe clean up the knees. So MRI done and at the new Doctor. He told me that i have too much arthritus and a torn Meniscus. He said that he was really not sure why the other Doctor sent me to him. "you need knee replacement" So he says there is nothing I can do. Well the end result was he just refered me back to the original Doctor who is not going to do anything.

The very next day I called and made an appointment with another Orthpedic Doctor that I was told on the phone he does knee surgery. I see him next week on Feb 10th. I am afraid for the outcome. I'm hoping for some sugestions on how to handle my appointment and get help.

Hello, Joni, and welcome to BoneSmart. You've come to the right place with that story! But first of all you'd posted this in the Knee FAQs which was the wrong place, so I moved it to the Knee Pre-Op forum.

Now about this issue of weight: let me tell you first that I weighed 300lbs when I had my knee done and just before I retired in 2006, I nursed a lady who'd had her knee done and she weighed 400lbs! She did just fine as did I. So what you need to do is hunt around for a surgeon who doesn't consider weight to be an issue. There are plenty around but they take some finding and it's just possible you might have to travel some to get to one.

The trouble with surgeons who make these kinds of exclusions is that they are more concerned about their working (doing TKRs in obese people is difficult) than the patient's quality of life. They also offer caveats like the implant won't last as long and/or you'll need more revisions if you're overweight. Maybe true, maybe not but it doesn't deal with the problem that whilst waiting to lose the weight, you are also going to lose the best years of your life and will never get them back.

I'd also want to make double sure that this suggestion of a partial is the right one for you as you don't want to have it and then find you need to have it converted to a total 2-3 years down the line.

So my suggestion is that you first read these
How to choose a surgeon and a prosthesis
implant longevity
Different kinds of knee replacements surgeries

and then do a search for knee surgeons using this search tool Find a surgeon on the BoneSmart main website. Ring the centres and ask if the surgeon specialises in knee surgery. You then need to make an appointment and interview him asking him the questions in How to choose a surgeon. Remember you are employing him to carry this out for you so you need to make sure you have one who does enough to qualify for the title 'knee specialist' and who will consider your quality of life before his comfort in operating on your knee. You also need to feel comfortable with him and that you can ask questions without feeling he is going to become impatient. Only then will you be armed with enough information to make a choice and decide what you want to have done.

__________________

Please post in forums; PMs and emails for personalized help are not community oriented and will not be answered. Also search the Library and other threads for information.Thanks.

LEGAL DISCLAIMER - Moderator comments on this web site are provided for informational purposes only and are not a substitute for advice from your personal physician or surgeon.

Administrator is an orthopaedic nurse of 50+ years experience in joint replacement.
Left arthroscopic menisectomy 4th October 09
RTKR 17th March 09
Right arthroscopy June 06

Hi, Joni,

I'm new here, and I'm mostly just lurking and reading, but I had to reply to you. My OS told me for several years that I needed to be older and thinner before TKR. I weigh right at 300 pounds and thought I'd never be any thinner or out of pain. Trying to exercise caused great pain; the great pain made me depressed; the depression made me eat; the weight gain made my knees hurt more; and on and on and on. I had made my mind up that I would seek another opinion, but I went in to my OS about a year ago for Synvisc. At that time, he told me that he had recently done a BTKR on a woman who weighed over 400 pounds. He said that after seeing her practically crawl into his office that he could no longer stand by the "you're too heavy" caveat. He did her surgery, and she did phenomenally well. He told me then that when I was ready, he would do the surgery. Well, I'm ready now, and so is he. He even said, "I can't wait to see how new knees will turn your life around."

If your OS can't see how incredibly constricted your life has become because of the pain and lack of mobility, find another one who will help you. I'm glad that mine has had his eyes opened (I really do like him and think he is a good surgeon), but I was fully prepared to go elsewhere when the time was right.

Hoping you get good news soon!

Gwen

Dear Josephine,

Thank you Thank you so much for your words of encourgement. I have hope that I can find someone who understands me. This is such a great help. I wish I would have found this web site sooner. The tears are flowing with the hope of finding the right Doctor. I could probably go on and on but I better stop. I will read everything you suggested.

Thank you again


Gwyneth,

I know what you are talking about with the depression. Not being able to do your normal activities is so frustrating. Sounds like you have a great doctor. Good luck with your surgery. I will be anxious to know how well things go for you.

Hope to hear from you soon!

Joni

Joni...bless your heart! I weighed 230 and was 45 years old last July when I had my BTKR. Not once did my OS say anything about my age or weight! Now that it is over I am able to get back to exercising and the weight is coming off. I am down to 201 now and still going. I feel like I have my life back and I;m able to do so much more now. I am happy all the time. It's an amazing feeling. My OS said that I should expect the new knees to last at least 20 years as long as I take care of myself and use the new knees! So I am wishing you the best. Hope everything goes your way!

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Cindy BTKR 7/20/09
Cupcake Queen

Cindy,
Thank you so much. I am starting to feel that there is help out there. I am looking forward to being able to do everyday things that I can't do now. Even going grocery shopping sounds good. And I hate to grocery shop!

Hi Joni,
My Ortho surgeon said, "so many doctors worry about the patient being heavy, what about them having a quality of life!" That was what sold me on him immediately! I weigh over 300 lbs now and I used to be an athlete also. Depression and pain have sidelined me but having BTKR will give me a quality of life that I have not had in a long time. I wish you well; you deserve to be treated with respect and dignity, and if that doctor isn't giving it to you, find one that will!

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Sonja Dachshunds (Myra & Brandy)
LTKR 3-4-10 RTKR 5-27-10
RTKR Revision due to MRSA 6-22-10

Sonja,
You know what I am going to say to this new Doctor on Wednesday. Just what you quoted regarding quality of life. That will be perfect!
Thank you!
I hope everything goes well for you

Joni...Sonja has said well.

I too am over 300 pounds. My surgery went well, my healing went well and my rehabilitation has gone well. My OS explained that his concern was mostly healing....that heavy people have a tougher time healing. (I understand that...it makes sense). But he also understood that my quality of life was aweful..and I had a lot of living left to do!!

I am having L knee replacement on Tuesday. I have promised a friend that I will dance with him this year.

If your doc gives you grief....find one that is more compassionate and understanding.

Good luck
Barb

__________________
Barb
R Total Knee: 4/14/09
L Total Knee: 2/9/10

Oh-ho! All us big gals coming out of the woodwork now!

__________________

Please post in forums; PMs and emails for personalized help are not community oriented and will not be answered. Also search the Library and other threads for information.Thanks.

LEGAL DISCLAIMER - Moderator comments on this web site are provided for informational purposes only and are not a substitute for advice from your personal physician or surgeon.

Administrator is an orthopaedic nurse of 50+ years experience in joint replacement.
Left arthroscopic menisectomy 4th October 09
RTKR 17th March 09
Right arthroscopy June 06

Josephine,
YOU KNOW IT!!!!!

I weigh 190 and I am 5' 10" and I am overweight! First Dr. told me to lose it! I lost her and found a new Doctor!

__________________
Helen

BTKR 8-25-09

Joni, I hope by now you are starting to feel a little better about your situation. You'll find the right surgeon....just keep looking. They are out there and will be willing to help you get your life back. In the meantime, keep posting to let us know how you're getting along. We care about you!!!

__________________
RTKR - February 29, 2008

LEGAL DISCLAIMER - Moderator comments on this web site are provided for informational purposes only and are not a substitute for advice from your personal physician or surgeon.

Jamie,
Thank you so much. I am nervous and excited about my Appointment with the new doctor on wednesday, i am trying to get prepaired.
Joni

Joni...you said you hate going grocery shopping....well I used to but now I look for any excuse to go grocery shopping or any kind of shopping. I can walk now and I love it. With all this snow it's easier for me to take my daily walk inside the stores....good excuse to shop...too cold to walk outside...plus dangerous..LOL

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Cindy BTKR 7/20/09
Cupcake Queen

Cindy
Thanks for that, i do want to walk thru stores,
I am seeing a new doctor tomorrow and i can't tell you how nervous i am. i don't know if he will listen to me. i am trying to think of everything i want to say, but i get so intimidated. well i will make a list tonight.

That's right - write them down and you'll feel more empowered. But remember that if he won't offer you the courtesy of being patient with your questions, he might be the same if you have concerns after the op. If he's too non-compliant, find yourself another chap.

__________________

Please post in forums; PMs and emails for personalized help are not community oriented and will not be answered. Also search the Library and other threads for information.Thanks.

LEGAL DISCLAIMER - Moderator comments on this web site are provided for informational purposes only and are not a substitute for advice from your personal physician or surgeon.

Administrator is an orthopaedic nurse of 50+ years experience in joint replacement.
Left arthroscopic menisectomy 4th October 09
RTKR 17th March 09
Right arthroscopy June 06

will do. I'll let you know how it goes.

Yeah! My Doctors appointment went great! His nurse was very kind, then his PA came in and asked questions of me, how I was feeling and verified some of my complaints. I was armed with x-rays and MRI. He took my information.

Then the Doctor came in and smiled, introduced himself and we began the conversation. he went into detail showing my x-rays and said that he didn't need the MRI to see what was going on. He explained to me that yes if I was not heavy a partial implant could be used. He said in his experience that the pressure of such a small implant could lead to not a very good outcome. It could break my bone. He did say that he would only do a Full Knee Replacement.

Because I do have some arthritis on the outside of my knee, and I would have total support. It is longer recovery and has more risks. He said that it is a big decision to make. He was very kind and offered without me asking, telling me his speciality is knees and how many partials and how many total knee replacements he has done. I took my daughter to be the note taker.

He left the room for a moment and I started to cry because finally someone cared. When he came back he was so worried that I was crying. I tried to tell him that I felt so good that he listened to me and I do have options and dont have to live like this. So in his opinion I have the option of loosing the weight and having a partial knee replacement or ending up anyways with a full replacement. Of course if I weighed less the surgery and recovery would be easier.

He said that he would do one knee at a time starting with my left. He asked me to really think about the surgery and talk with my family. All I have to do is call his office and say I'm ready. And if you can believe this, one of the last things he said was "It's your quality of life that you are considering" So he gave me a packet of papers for me to go over about what it is like in his words to have knee replacement surgery. I feel a little silly but I came right home and had my daughter scan them and e-mail to my Mother for her to look at. I am very happy right now.

Sounds to me that this OS has been reading this forum !

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Ellen
RPKR 3/19/09