Tuesday, September 5, 2017

Weight Loss and Lymphedema Report for August, 2017

Well, I'm already five days into a new month, and setting on a dang plateau, and since y'all saw what I looked like in the pictures I put on the post before this one when I was "tryin' on clothes", I don't suppose I have to pose for you again, do I?  I just hate having my picture taken. 

I've had my haircut at the Beauty College, and not happy with it, but AM I EVER????  The problem is, I've got a dang cowlick behind my right ear and my hair never hangs right.  I guess there are worse places to have a cowlick.  My dad had several, right on the top of his head.  They don't know what to do with my cowlick at The Beauty College, but then, all the beauty shops I can afford, plus TIP at, don't do any better job.  So.  It'll grow out a little and then it'll look better.  It's just a "short bob" with the back "stacked".  These are their terms, not mine.  Unless I've outed myself again in one way or another, I'll do pictures in early October.

I lost 5.4 pounds during August.  I was shooting for 7, but I have bobbed around, up and down, up and down, since August 20, setting tight for this last week between 186.6 and 186.8 every morning.  It's a little frustrating, but it is what it is.  I don't have plans to eat any different once I'm at my goal so it makes no difference how long it takes except for the fact that it will be easier on my joints and lymphatic system to have the rest of the pounds off.  It's a lifestyle change, afterall. 

I'm continuing to go with Hubs to the workout center.  Beginning to get favorable comments from people who see me there every-other-day.  I will be glad when my knees don't look like ice-cream atop a cone.  It shows when I wear pants and is uncomfortable when I wear jeans.  So I've just been wearing jeans shorts that stop short of my knee.  Consequently, my knees have a "Farmer Tan", they are the only part of my legs that are tan, what with the shorts covering up the area upwards and the compression stocking covering up the area downwards.  I'm kind of self-conscious about the "ice-cream cone look" so I've started taking my compression stockings off and wearing my black yoga pants to work out in.  They are comfortable, a long t-shirt hides my behind, and the legs are snug enough to support the skin on my legs a little without being so tight they make my knee scream.  I tried wearing a pair of jeggings that are a size 18-20 and therefore are only tight in the legs, but that's too much pressure on the knee for right now, as the material, though stretchy, is quite a bit heavier than that of the yoga pants. 

In the previous post Comments section, I wrote a little bit about BMI (Body Mass Index), which was, most likely, thought up by some skinny MAN.  Here is the calculator I used, supposed to be "for women".

This is a chart "for women over 50"

This is a chart "for women with athletic builds"

Let's just say the last chart is a lot kinder to me than the first two are.  I didn't see much difference between the first two, in fact, so I don't know what's up with that.  I kind of expected the one for the women over 50 to be a little less, ummmmm, uncomplimentary

The reason why I bring this up at this time is that, in preparation for going to someone about my knee, I ordered a copy of my knee surgery report from two years ago, and one of the preoperative diagnoses was: Obesity, body mass index 36". (I weighed 212 at the time.)  Within the first paragraph, reference was made to the size of my thigh and a couple of other conditions being the reason why something, I suppose out-of-the-ordinary, was done during my knee surgery.  I have to admit, I was insulted and I wouldn't have been surprised to see, somewhere in the closing, "Fatty, Fatty, four-by-four, couldn't get through the bathroom floor, so she went, on the floor".  That was the mantra I endured when I was a 7th grader in school.  I've outlived most of those kids, by the way.  All this going on in the surgery report about how obese I was made me wonder if he would've done the surgery AT ALL had I shown up there at a bouncing 235, much less if I'd gone in there at 250+.  I plugged in those weights on the calculator, to see if "morbidly obese" came up, and it didn't.  So just to see where the line was, I started putting in bigger pounds and eventually got the chart up to 500 pounds before I just gave up, because it still just said "obese".  I think I might've been less insulted by the word if I HAD weighed 500 pounds but not ever going to go there just for the effect, just so you know.  But here is what I mean by doctors.  Yes, I get that being overweight, or obese (if we MUST call it that), makes it harder to get a good outcome from a lot of medical procedures.  The P.A. told me, right up front, that the surgeon didn't do the short, less-invasive incision on people "with big legs", and said the cut-off point was usually 200 pounds.  So I got the long, unsightly suture.  I sense this attitude of "You Deserve Whatever Outcome You Get", or, "Why should I try? You're obese and therefore not worth the work."  And I tend to internalize this and feel like I might've been the fattest woman this doctor has ever seen.  Yet I know that's not true because I've seen the people in the waiting room.  So is that my own insecurities showing, or are they satisfying some need in themselves in trying to make me feel like that?  Not sure.  I don't know why I should care what the hell some doctor I haven't even met thinks about my body.  And this is the interesting thing.  Perfect strangers, or maybe people we know and don't even LIKE, can say things to us or about us, look at us with disgust, or portray us in an unflattering way on the media, and we are hurt.  Or in my case, pissed off.  We know, don't we, that anger comes from hurt?  Why give these insensitive clods, these "ugly on the inside" people, even so much as the time of day?  Beats me.

I also got my surgery report from my shoulder surgery and the doctor who did that procedure didn't say a word about my BMI and didn't feel the need, apparently, to include it in my post-operative diagnosis.  Just for the record, when I'm fat, I'm fat all over, so I'm sure my arms looked fat to him.  I don't even remember that anybody weighed me when I came in to see him but maybe they did.  I'd been down to almost 200 by about then, and had he wanted to, he could've called me obese and reported my BMI on his surgery report.  But he chose not to, because he is, by nature, a dear and kind-hearted man.

And get this: I would have to weigh 105, with a BMI of 18, before I would be considered just one toe "underweight".  I haven't weighed 105 since I was in the 4th grade.

Rant over, moving on....

So I've had some ups and downs with my surgical knee since the first of the year.  I can't say it has ever been completely comfortable since the surgery, two years ago.  And it screams at me if I try to wear something that's tight over it.  I have, in the past, reported to my knee surgeon's PA's that it tends to stiffen up at night and they always just shrugged and went on. 

When I had the work done on my shoulder, I was told not to go outside without my sling on until I was completely healed, because if I should fall and try to break my fall with my hands, I would most likely undo everything they did.  So, sure enough, I tripped and fell, couldn't catch myself, hit the wooden deck right on my replacement kneecap.  It didn't hurt all that much.  I was grateful I'd fallen on wood, and not on concrete, which was nearby.  I didn't break the skin or even so much as have a bruise.  Which is strange for me because I bruise easily.  But after I started getting treatment for lymphedema, there were occasional instances where my knee would just kind of "sieze".  I wouldn't be able to put any weight on it.  Then I'd have three or four days in which I'd have to take it easy.  I complained to my shoulder surgeon about it and he had it x-rayed and said that, although he "wasn't a knee guy", he didn't see any damage.  The first time it happened, my friends at BPR said they thought I had just twisted it when I turned to step out.  More recently, though, I've noticed it feels like a hard muscle cramp.  It has been swollen at the outside of the knee and right below the kneecap, in varying degrees, ever since.  Usually hurts and swollen behind the knee, too.  My shoulder surgeon's PA told me that most of my area of pain and swelling is where the IT Band is, and suggested some exercises.  And the therapists at BPR showed me some stuff I can do with a hard foam roller and some additional stretches.  Once I realized it was some kind of spasm, I added Magnesium tablets to my daily supplements list.  It helps smooth out cramping muscles and is supposed to improve sleep. 

The problem is that my knee had another tantrum right after I did those exercises.  And another after I had used the lymphedema pump.  So that scared me and made me wonder if I had something more serious going on. 

I was filled with dread that I might have to have what they call "a revision".  Which means they open your knee up and do whatever it is they need to do.  If you have an infection, they replace the joint with a temporary plastic one and treat you for the infection with antibiotics.  You go through the motions of healing but you know they're going to open you up to put your metal stuff back in, so there's really no point, I wouldn't think, of doing Physical Rehab till the metal stuff gets put back in.  Lots of down-time.  The knee shuts down when it's cut into, no matter how strong it was before, so you're back to square one with rehab.  I truly didn't think I'm woman enough for all this. 

I was hoping that after I got some of the fat off my knees, things would straighten out.  Because when we're fat, we're fat on the outside AND the inside.  With that new joint, I thought, maybe there just isn't room enough between my tissues and the metal.  So maybe that's irritating my tissues. 

I've seen the bones in my "good" knee begin to show more definition with recent weight loss.  But in the operative knee -- not so much.

The surgeon who did my knee has left the clinic where he was then, and has joined up with several other doctors who also left the clinic where they were.  They've moved into offices at the surgical hospital where they do their surgeries.  They own part of that hospital and say it's so they can have a say-so in how it is operated.  One thing, they keep that hospital as cold as The North Pole all the time.  They say it's because bacteria can't thrive in the cold. 

I felt a little uncomfortable about going back to the original surgeon, since he's left that clinic where I'm used to going and I really didn't know why he did that.  My shoulder surgeon recommended one of the other knee guys at the clinic, but when I called to get the appointment, the scheduler would not make the appointment.  She said she would have to "give him a note", asking if he would accept me as a new client, and then she'd call me back to set the appointment if he said he would.  I felt like she was treating me like a small child that was about to have a tantrum, and that actually made me WANT to have one.  But I didn't.  She never called back.

So I got an appointment with my original surgeon but it's not till late October.  Ordinarily I'd think this was a sign the doctor doesn't think it's an emergency thing, and that's good.  But hell, I know there usually isn't much communication between the appointment scheduler and the doctor.  It seems like, when people complain that their doctor's after-care sucks, it's not because of the doctor, it's that you are in the hands of people who are just in there doing their jobs, and you are just a face in the crowd to them.  It's not like they lay awake nights worrying about anybody.  The woman who scheduled my appointment seemed to care.  She was nice.  Polite.  Helpful.  She said she'd put me on the list of people to call when someone cancels an appointment that's earlier than the one they have.  I didn't have the nerve to ask how many cancellations they usually have or even how many were ahead of me on that list.  When I worked for Dr. Grisham, if somebody called and had what sounded like a bad situation, we'd wait between exam rooms and catch the doctor on the way through, and he'd find a way to work them in, somehow.  Usually that very day.  I suppose I could probably get seen earlier if I hadn't asked specifically to be seen by the doctor.  I didn't know until just recently that if you don't ask to see the doctor, you get seen by the PA.  But this doctor never saw me except for a brief moment out in the hall.  Oh, and during surgery, at which time I was just a knee in the sling and probably not even with my face visible to him.  Anyway, I HOPE that was him doing the cutting on me.  I was out cold and anybody could've been there in his place, for all I knew.  Even Rosemary's Baby. 

I'd been in contact with the surgeon's registered nurse before they moved.  When they moved all their contact numbers and email addresses changed.  So when I got my appointment, I asked for the RN's email address, and then sent her an email.  I wanted to know if it would save time to anticipate what tests the surgeon might want to run, and get them done before my October appointment, so as to save some time.  Well, that turned out to be a blessing that I happened to think of doing that.  The RN was really nice and she showed concern for me.  She talked to the P.A.'s since the surgeon was out of town that week.  And they decided I should have some bloodwork done, because that's normally the first thing the doctor does.  These particular tests show if there is infection in the bloodstream.  She said if the test came back positive, she'd work me in sooner.  So I had that done and it came back negative.  This is very good news but I knew it didn't mean I won't have to have surgery.  They'll have to go in if it turns out there's something wrong with the joint.

The blood test was done, and the good news is that there is no infection.  The next test would be an MRI, I can't have it locally because the implant requires a special machine that they have at the surgeon's hospital where the orthopedic surgeon has his clinic.  It's because there's metal inside my knee.  Knee surgery is such a barbaric thing.  I've wondered why they can't just make cartilage pads out of silicone, and go in there and insert them.  Or even something in liquid form that they could spray on the joint arthroscopically.  I mean, they can go in there with an arthroscope and scrape all the cartilage OFF your joint, why couldn't they do the reverse?  Seems like it'd be easier.  And not so hard on the patient. 

The surgeon finally came back in off vacation, and the RN had a conversation with him.  I had to OK the transmission of the knee x-ray, that the shoulder surgeon took, to them.  It's only one view, and usually they take a front view and a side.  The RN sent me an exercise sheet, and said he thinks my hamstring(s?) might be too tight.  There are all kinds of hamstring exercises on YouTube.  Some of them are things I wouldn't want to do in front of someone, especially in those bitty shorts those girls wear.  There are a lot of creepy guys that view exercise videos and they make nasty remarks in the Comments, too.  Like they're proud of being a creep.  Sheesh.  But OMG, a lot of those hamstring exercises have titles that include the words, "Grow Your Booty".  This is a part of my body that DOES NOT need to "grow".  And no, I would never have my "Booty-Mass" increased just because some guy likes "lots of junk in the trunk".  There's already enough of THAT, thank you very much.  You have a fight and he leaves, and you're left with a dang big butt no one else really likes.  Not even you.  Why, you'd be reminded of that guy every time you turned around.  Heh.

I haven't heard from the registered nurse since the x-rays were supposed to have been received and then viewed.  So I'm doing my exercises, hoping they'll solve my problem and that by the time my October appointment rolls around, I won't even need to be seen.  The RN called a prescription in for me that's a muscle relaxant.  She told me the name of the drug and I looked it up.  Tizanidine.  I'm scared to death to take it.  I think I'm just better off dealing with the muscle spasms in my knee the same way I do when I have them in my back.  Rest.  Heat.  A glass of wine.  Then, when the spasm stops, ice.

Just for good measure, I'm also back doing the IT Band exercises as well.  The reason why is that, certain ways I move, I feel a twinge in my backside, right where the girls at BPR showed me was where the IT Band connects to the hip.  I do so love my friends at BPR.  And I really suspect that the "educated guess" that the orthopedic shoulder guy's P.A. offered me, out of the goodness of her heart and concern for my general well-being, might have been spot-on, considering she's the only one that has actually seen me.  It's funny, I didn't like her at all at first.  I found her "aggressive".  But she grew on me and I ended up really feeling true affection for her.  Of course if I do both kinds of exercises and get better, we'll never know whether it was the hamstrings OR the IT Band.  So we will not know where the credit goes.  Not that I will care.  I just want my knee to stop swelling and hurting. 

Since my knee doesn't like anything tight across it, it doesn't like the pressing down that my lymphedema pump does, AT ALL, so I've been unzipping the boot on the left leg down to below the kneecap and then icing after.  That seems to help.  I've been wondering if the knee implant acts as a dam, causing lymphatic fluids to collect there.  Hopefully it's just because the tissues are swollen and therefore more sensitive.  If the problem remains, then that will be one of the questions to ask in late October.  Since I have asked specifically to be seen by the doctor, I'll be pissed if I get a P.A. again. 

I don't really think it's the hamstrings because I have already been doing exercises similar to the ones on the sheet I was sent, using the weight machines, even.  So if that's what's wrong, that should have already fixed it.  But once these doctors say what they think is wrong, they don't like to be challenged by the mere person who lives in that body.  Even though we do not have the education and experience the doctor has, we HAVE lived in our bodies and know how things are supposed to feel.  If you tell them what you think is wrong they just throw all that away, because, what the hell do YOU know, anyway.  I mean, I even told the registered nurse about the weight machines I use at the workout center AND about the lymphedema diagnosis AND that I use a lymphedema pump regularly, and didn't see any comments about it in the reply I received. 

At least it's something to know I do not have infection in my knee.  And so I will be rocking along with things as they are, now till late October.  In the night, before I fall asleep, I worry about what I will do if I have some kind of event before then, as an emergency situation doesn't really lend itself to an hour's drive to Tulsa.  It's not like I'll want to have emergency orthopedic surgery here.  But I must not start "borrowing trouble".  Lord, will you hold me in Your hands, and make me feel safe?  Amen.  Then God says, "You gave your troubles to Me.  Now let go of them."  OK, God.  Got it.

I have not started any of those exercises from the "Pain Free For Life" book and website I wrote about in the post previous to this.  She says none of her exercises should be painful to do, and if they are, not to do them.  So, if I can do them without pain, I may.

I'm trying a few things to break this plateau I'm on.  One thing we tried today was going to the workout center verrrry early.  Before breakfast.  They say if you exercise on an empty stomach, you burn stored fat.  I liked being there.  I didn't have to compete for a machine.  I didn't have to dodge runners on the track.  I could actually see getting addicted to this, which is saying something, since I was a sloth in another life.

I've cut out dairy as I've been told dairy makes the body produce mucous, which is hard for the lymphatic system to filter out.  This is harder than cutting out sugar was.  I miss dairy almost as much as I would miss bread.  Not supposed to have too much protein, either, they say, as we Americans typically eat 'way too much protein and the lymphatic system has to filter all that.  I should lose weight easily, since there's just not much left I can eat!  And seriously, when it comes to weight loss, we've all been told SOOOO many conflicting things, it's just impossible to sort it all out.  I'll be feeling my way along this month, trying to strike a happy balance and report what happened to you next month. 

That's where things stand now.  Till then, stay well, safe, and happy.  Love your friends and family.  Most of all, look in that mirror and have compassion and love for that dear person that peers back out at you.  Hugs xoxoxo

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