I am a type II diabetic, supposedly controlled by diet, exercise and metformin and amaryl.
I write those in dark letters because I always seem to get the answers that apply to type I’s and even though I believe basically (don’t shoot me, 1’s) we are the same, I am a type II.
That said, I am scheduled to have a knee replacement in May.
It is supposedly MY decision, yet, I don’t remember saying YES, and I don’t remember saying, Please do this. I remember saying, I’ll consider it, I’ll look into it. But not once did I say YES. But I digress, and this is another question.
Right now, I have arthritis in EVERY joint in my body. YIPEE. The most painful are my knees, and they are bone on bone, or pretty close to that. HOWEVER, I have taken cortison and synvisc injections with great relief, well, enough to walk my dogs, shop at the Mall, and participate with my family in many activities. But when it hurts, it hurts! I also am working on better control of my numbers with the BS’s. They aren’t where I want them, and the A1C is not where I want it at 7.8. I am still 60 lbs from my goal weight, and want that to be more under control IF I do this surgery.
I have written letters from both my dentist and ortho who tell me that I will have to be on antibiotics for two years after even a simple cleaning at the dentist because I have a “fake” part, or transplant in my body. Now how’s that for reassurance? We have a woman in town, who had type II, she didn’t follow this plan, and for a number of various reasons, after her knee surgery, they had to remove her legs above the knee because of severe infection. Not my idea of fixing the problem — kinda overkill.
So what do I want from the people here? Well, from the people who might have had knee replacements, I don’t need to hear how wonderful you are walking, cause I got that. But what about rehab, pain, diabetic control? Tell me of your experiences about that. I’ve read most of the posts under surgery and diabetes here…interesting and informative.
Thanks again,
the only thing I know is that DB slows healing. For that reason I have elected to NOT have a highly-recommended by three docs (2 orthos and 1 rheumy) knee and shoulder replacement. My last surgeries were reconstructions of the basal thumb joints on both hands. The first one took 10 months to heal. The second one was done by a plastic surgeon and took about 8 months to heal. Normal healing time is about 8 weeks.
Everything takes longer to heal. Which means more pt, more pain, and you’ll need really good pain control meds because pain can shoot up bs numbers.
Leslie, this is the same kind of information I have been getting from diabetics who have had this surgery…although the docs tell me, to take the summer off, I am thinking and into the fall. Not being able to drive, because it is my right knee (first) as if I am going to let them do the left one… I just am not real excited. Can you tell? My non-diabetic friends are saying, they hate to see me limping (on my bad days) and I want to scream, “then don’t look at me”. They also ask if I think I am the ONLY diabetic to have a knee replaced? Well, I am the only me to have a knee replacement, and I don’t care about anyone else with this problem at the moment. I am making a healthy informed decision for myself. Sorry if I sound angry, but, at times, I get so frustrated with people who have no clue about diabetes telling me how to control my own health.
thanks for the comments and support, I needed it today and always.
I have not had knee surgery, but I have had lots of experience with people who need to have more control of their diabetes - and weight loss - before surgery. And, Cathy, I’m only trying to tell you my experience.
What happens to you when you take cortisone? How often do you test? And how do you bring that BS down? I’m wondering if you need some insulin to bring your BS under GOOD control before you have such surgery. It’s obvious that something’s keeping you from a better A1c and that metformin isn’t doing it.
If you are fully under control, and by that I mean that your BS hovers in the 95-110 region, then you will not be slow healing. But with your A1c where it is, you’re probably not going to be a fast healer. And by that I mean at least 3 months rehab and then maybe you still won’t have full function.
And the more weight you have when you go into surgery, the more stresses there are in rehab, and the longer it seems to take.
I know this doesn’t sound light hearted like many posts do. I’m sorry. Surgery like this needs hard, clear eyed preparation and the willingness to say NO until that preparation is fully done. And that preparation may mean insulin use.
Sometimes after BS comes under excellent control, the arthritis abates a bit.
Leo, thank you, my thoughts exactly. Although insulin is not an option in this case according to my team. I am thinking that getting the weight off — maybe not all 60 lbs, but the lighter I enter into surgery the better my outcome. Also with the BS’;s the lower and longer they have been in control with my program the better off I am going to be.
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My goal A1C is to have it in the 6.2 or lower range for at least two months before we head through that surgical door.
My weight because of medications taht have nothing to do with the diabetes is harder to control, but another 20 lbs would be wonderful. That said, I have to admit, I am not looking for a reason to NOT have the knee replaced, I just don’t think health wise, this is the optimum I can be to take on this short of adventure.
If you’ve been living with arthritis for a long time you’ve probably tried this, but just in case… I have beginnings of mild age-related arthritis, but I have been taking glucosamine for the past couple years and I hardly even notice any joint pain any more. I know it’s fairly expensive, but it’s not too bad if it’s not combine with condroitin or MSM, which are what seem to boost the price and don’t seem necessary, in my situation anyway.
Ellie,
When I took glucosamine, it put my blood sugar higher. I’m sure it’s great, but maybe some caution in diabetics - to test to see if its use raises BS is needed.
Your thinking is great!
If arthritis is acting up daily, you will find it is majorly affecting BS, and so it will not be easy to pull down the A1c.
Don’t let that discourage you. Work like a fiend at it.
Ellie and Leo, thanks for the suggestions. I know that at this point the pain in all joints does affect my bs’s…not a lot, but enough to make it noticeable. So, I have tried the glusosamine and chonroitin before, and it did help some…and didn’t affect my sugars at all. I suppose it’s time to add that into the mix again. The knee they want to replace is bone on bone…so don’t know how much that will affect it…we’ll see. But I will give it a try or at least suggest to my docs.