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PMR and knee replacement for an older person

Posted , 8 users are following.

peggy_56092
peggy_56092

I am a 79 year old female who was very active and healthy a few years ago.  I don't drive so walked everywhere in my small Oregon town, took yoga twice a week, walked the dog daily, and danced every chance offered. 

September 2014, GP Dr. gave me Levofloxacin (also know by other names) for possible long term pneumonia.  I took it for two or three days and could not climb the stairs, lost control of my leg muscles.   Dr. noted that the drug seemed to trigger RA.  There was a lawsuit on this drug, which I/she was not aware of at the time.  Then I had all the bad effects of this drug including a rotator tear during a CTScan, difficulty walking, night sweats, weight loss of 20 lbs over a few months.  I lived on 800 mgs of Ibuprofen a day for pain for a year.  I was given Steroid shots to the shoulder and knees in 2015 by orthopedic surgeon.

January 2016, new GP Dr. suggested  Prednisone.   I started at 15 mgs and felt wonderful and could walk the dog again.   Months later, after blood tests and scans, July 2016, new dr. stated that I had PMR.  I reduced dosage too soon a couple of times.  5 mgs too low so I have been advised to stay at 6 mgs for a few months.

In addition to PMR, I have bursitis in my left hip and use a cane to relieve pressure while walking.  Also osteoporosis of both knees, the right one needing immediate replacement, damaged several times thru the years.  I am awaiting confirmation of a surgery date in April.  I am able to walk after the steroid shot fades by icing the knee several times a day and wrapping it up so that it will not fall apart.  I worry about my age and whether the knee will be difficult to heal because of prednisone use or the presence of PMR.

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  • Anhaga
    Anhaga peggy_56092

    Posted

    So sorry to hear about your difficulties.  Shocking that things were apparently triggered by that drug.  Do you have osteoporosis or osteoarthritis in your knees?  I've read about a number of people having joint replacements whilst on pred and I don't think anyone has had difficulty with healing.  The important thing is to be on a dose of pred which controls the PMR so that you are able to do the exercise for post op rehabilitation.  I'm sure others will be along with more expertise and experience soon, when the UK and Europe wake up.  🍀

  • Babazaga
    Babazaga peggy_56092

    Posted

    Hi Peggy,

    Good heavens you have truly been hit hard!  I'm not clear as to whether you are taking Prednisone orally and getting Prednisone shots---or are you getting shots of some other steroid?  Are you off the 800 mg of Ibuprofen? 

    • peggy_56092
      peggy_56092 Babazaga

      Posted

      I stopped taking Ibuprofen when given prednisone.   I had a steroid (kenalog?) shot in my shoulder 2015, it worked, and in 2016, two in my knees, 6 months apart; and one in my hip joint.  I orally take 6 mgs prednisone.
    • ptolemy
      ptolemy peggy_56092

      Posted

      If you are only on 6mg I am sure there will be no problem having a knee operation. I assume your surgeon knows and is OK with it.
    • peggy_56092
      peggy_56092 ptolemy

      Posted

      Yes,he is aware of the PMR and seems to think there will be no complications.  I guess I would worry about the operation even if I didn't have PMR.  I am interested in hearing from other older persons who have had knee operations.

    • ptolemy
      ptolemy peggy_56092

      Posted

      A friend of mine in his late seventies has just had a new knee. I was amazed how he sailed through it as he is quite overweight. He seems to be a new man now. I know someone who has PMR and has just had a new hip. She said that the hip operation was a walk in the park compared to PMR! 
    • Anhaga
      Anhaga peggy_56092

      Posted

      I have never met anyone who wasn't thrilled with their replacement joint!  

  • EileenH
    EileenH peggy_56092

    Posted

    I'm sure Betty on this forum won't mind me saying that she had a very successful hip replacement at about 80 (may still have been late 70s, it was a while ago) while still on pred. Nefret on this forum, who I'm pretty sure is in her 70s, has had a hip replacement last year and knee this year (I think) while on a similar dose of pred. I'm sure if they see your post they will comment with the real versions! 

    The most important thing when you have PMR is to be on enough pred to be able to do the rehab post-op. The surgeon and anaesthetist will make sure you have enough steroid during the operation - some give extra, some don't.

    And perhaps the bursitis in the hip will improve once you are walking better!

  • BettyE
    BettyE peggy_56092

    Posted

    Just to wish you best of outcomes with your knee op.  and to confirm what Eileen said about my hip replacement more than three years ago aged 81.

    By then I'd been on Pred. for more than four years and had reached a very low dose ( 1mg. ) by the time of the op. I was told on no account to try to continue reducineg and stayed on 1 until well after my follow up appointment confirmed all had gone " very well"... surgeon's words.

    Healing was no problem and I was home walking about including stairs on 1 crutch in well under 72 hours. After that it all got better and better. Best wishes.

    • peggy_56092
      peggy_56092 BettyE

      Posted

      I am so happy to hear of your recovery.  One of my worries is all the stairs I have to navigate to use the toilet, cook, etc.  I live alone with two cats and one small dog, three buildings with lots of stairs. 

      And thant you Eileen for the knowledge you have given these few months I have been on this site.

    • BettyE
      BettyE peggy_56092

      Posted

      I had my hip op at the Norfolk and Norwich University hospital via NHS and cannot praise my treatment before, during and after the op. highly enough and I do hope yours will be as good.

      There was a pre op. education session where we were told what would be happening and shown ( if we wished ) the replacement joint and how it works. The session was for both knee and hip patients. 

      There was a house visit where bathroom arrangements were assessed and loo seat risers loaned and fitted. I needed these for about five or six weeks and returned them to the hospital at my follow up visit.

      I did have my partner and my sister to help me but they were only needed for reassurance and to put my socks on for me!!

      A week or so before the op. date there were interviews with medics. including the anaesthetist and pharmacist. I think this may have been because the Pred. had raised my BP considerably but she said it would be fine and it was. I had an epidural with sedative not the tube type G.A. Didn't even have to remove my denture. This was the bit that worried me most and, given the chance, I'd have opted for staying awake but it was very skilfully handled and the next I knew I was being offered a drink of water through a straw and was soon back in the ward and having a fish supper and 'phoning home.

      We were all out of bed within a few hours. Little walk with a frame. That happened several times. The day before going home I was asked to try some stairs and to my amazement they were no problem. 

      On the subject of stairs I would definitely recommend that you arrange for hand rails on both sides. I think crutches on stairs are probably not a good idea.

      You will need to be very sure your animals can be kept away from the stairs. I've had cats and dogs all my life and, love them as we do, the interest they take in all that we do can be a bit inconvenient, even dangerous, especially when we're on crutches and even more on the stairs.

      I think if you are being discharged to an empty house they may keep you a little longer than I was but I have a friend who managed fine with visits from the district nurse for a few days.

      Best of luck.

    • peggy_56092
      peggy_56092 BettyE

      Posted

      Thank you so much, regarding the stairs.  I will probably stay a bit longer for PT, if given the opportunity.  I am beginning to feel more optimistic about the procedure. 
    • BettyE
      BettyE peggy_56092

      Posted

      Peggy, you may receive this twice; if so, apologies!

      I've sent you a PM re sheets thatI found helpful.

    • peggy_56092
      peggy_56092 BettyE

      Posted

      Again, thank you.  I will certainly update my condition as it occurs.
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