Since April?!

I last visited the orthopedist back in April 2024. I was getting my second cortisone injection in 3 months, and I was reminded that I would not qualify for knee replacement surgery until my BMI was below 40, preferably below 35, but I was sitting around a BMI of 56 at the time. That meant I needed to lose between 90 and 115 lbs (41 to 52 kg). “All we can do until then is help you manage the pain with injections and physical therapy.” Given that I had done PT and couldn’t even last 3 months on a single injection (and they prefer not to give them that often), I was not a happy camper. 100 lbs – give or take – seemed like a nearly insurmountable number, particularly if my knee was going to hurt the whole time, which makes exercising difficult.

The second injection was very successful and lasted much longer than the first. I think it just needed more/more quickly in order to get the severe inflammation under control. But, thanks to the need to lose so much weight in order to qualify for “medically necessary” surgery, I also unexpectedly qualified for a prior authorization for Zepbound, something my doctor had been trying to get cleared since August of 2023 but was repeatedly denied. As you know, I started those injections in May 2024.

My knee was doing very well until November. It started hurting here or there, just a bit for half a day or so every week or two. Then it was at least once a week of enough pain to be bothersome, then twice a week or more. By mid-December, I was having to cancel plans to walk with my friend. I realized that I probably needed another cortisone injection, but I put it off. But when plans came up to head to Las Vegas without a rental car at the end of January, I knew that was not going to be doable without another injection.

Today, I saw my orthopedist for the first time since April. He was looking at the chart as he came in. “So it looks like you’ve lost some weight?” (That would have been easy to see, since the previous number started with a 3, and this new number started with a 2.) Yes, I have. “Wait, is this number right?” Yes, it is. “[Skeptical] You’ve lost 58 pounds?” Yep. “Since APRIL?!” Mm-hmm. “What did you do? Medication, diet, exercise?” Yes, all of that. “That’s amazing!” He was sincerely shocked. (To be honest, so am I still!)

So after checking it out and explaining why I was there, he agreed that another cortisone injection was the way to go. My BMI is still around 46, so I’m nowhere near the threshold for surgery. BUT, he did say that 6 months of relief from a cortisone injection is really good, so if that continues, he would rather just do that indefinitely, or at least until I get a lot older. (It’s funny, this is the first time in a long time that “due to your age” has meant that I’m too young for something instead of too old!) It’s not that he is refusing to do the surgery on someone my age, but they prefer for patients to be at least 50 before doing a knee replacement, preferably 60+, because the prosthetics wear out after about 20 years, and they really don’t want to have to go in there and do it again. (Neither do I!) We’ll see how the next 6 months and the next several years go. Hopefully, I can continue to lose weight, which should also continue to help my knee feel better (less pressure on it, literally), and we can easily keep the pain under control with injections for several years yet. Fingers crossed!