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Thursday, February 28, 2013

Hip Hip Hooray!

In the middle of January I returned to the ortho doc who renewed my knees. I told him about the pain in my hip and mentioned that he had taken an x-ray of it a couple of years ago. He tested it by having my lie down and moving it this way and that and pressing here and there. He asked me questions. Then had me get another x-ray.

He showed me what the x-ray revealed: the right hip is worn out, is bone on bone. The left is still looking good. The only solution he felt made sense was a hip replacement. I was all for it.

It's funny how I've changed. Years ago I wanted nothing to do with surgery. Now I have two new knees and am looking forward to a new hip. Part of me just didn't want medical intervention. I wanted to solve it myself, and I was embarrassed at letting my body get to this place (in my case, the wearing out of these joints can easily be attributed to my heavy weight, which I carried for so many years).

Dr. W. gave me a booklet he had written, about hip replacements: the anterior approach. He has been practicing this minimally-invasive surgery for a few years now and finds that it is superior in every way to traditional hip replacement surgery. I have met some of his patients and they all say it is very easy to recover from and the pain goes away completely. The booklet has space to put all my appointments, list all my prescription meds (I still have one that I use occasionally: the Ropinirole), and other notes. So I don't have to make a folder as I did last time. The information is complete, down to "when can I drive?"  (the answer: when I feel okay enough to drive and am no longer on narcotics). A very useful booklet, which I read carefully over the next few days after my appointment.

I am scheduled for this surgery on March 26. I am excited!

It Varies

Since my juice fast, the sharp pains in my groin area have not returned. However, pain in my hip in general, the more generalized pain, has not been kind to me lately. Could be because I am trying out some new prepared foods and some have ingredients that are not helpful.

I have gone on hikes the last two Saturdays. The first Saturday I tried a new one that is on a dirt road and is two miles long. There are a couple of little hills, nothing big. Yet I found it took a lot out of me. I didn't have significant pain but my knees were tense, so I was not particularly enjoying it. I was still hurting the following Sunday all day.

The following Saturday I did one of my favorite short hikes: Stoneridge. This hike is not far from my house and involves climbing a small hill, affording views out over the city. It is a rocky dirt trail. The total distance is not long - I don't actually know how long - but it is steeper than the previous week's hike. I had a good time on this hike and did not feel any aftereffects on Sunday. I'm not sure what I learned here. It may simply be that I need to take my time, as I had to climbing those rocks. Others sail over this trail, run it. I'll never do that but maybe I'll speed up a little over time.

Tuesday, February 5, 2013

Reducing inflammation through diet

I just finished a ten-day juice fast last Saturday night. During those ten days I drank the juice of carrots, oranges, apples, kale, spinach, sweet potatoes, pears, grapes, cabbage, grapefruit, lemons, ginger, tomatoes, garlic, and there may have been one or two other fruits or vegetables. At about day 6 I noticed that the sharp pains in my groin area that had become a regular thing had disappeared. More, I found less pain in general in my hip.

I looked up the list of "safe foods" in Neal Barnard's Foods that Fight Pain. This is a list of foods that do not cause inflammation in anyone. Here is that list:

Pain-Safe Foods

Pain-safe foods virtually never contribute to arthritis or other painful conditions. These include
  • Brown rice
  • Cooked or dried fruits: cherries, cranberries, pears, prunes (but not citrus fruits, bananas, peaches or tomatoes)
  • Cooked green, yellow, and orange vegetables: artichokes, asparagus, broccoli, chard, collards, lettuce, spinach, string beans, summer or winter squash, sweet potatoes, tapioca, and taro (poi)
  • Water: plain water or carbonated forms, such as Perrier, are fine. Other beverages – even herbal teas – can be triggers.
  • Condiments: modest amounts of salt, maple syrup, and vanilla extract are usually well-tolerated.
I noticed that most of the foods I had been drinking were on this list. A few I drank are potential "triggers" - foods that, for some people, do cause inflammation. It occurred to me that these potential trigger foods are probably not triggers for me. And if so, the improvement in my pain levels may be attributed to what I was eating - drinking.

There are three parts to Barnard's plan for determining which foods cause arthritic pain in you:

1. Eat primarily the foods on the "safe list".
2. Do not eat any foods from the Major Arthritis Triggers list. Not even a tiny bit.
3. Eat other foods that are not on either list, but be sure that the great majority are from the safe list.

Avoid Major Arthritis Triggers

1. Dairy products*
2. Corn
3. Meats**
4. Wheat, oats, rye
5. Eggs
6. Citrus fruits
7. Potatoes
8. Tomatoes
9. Nuts
10. Coffee
*All dairy products should be avoided: skim or whole cow’s milk, goat’s milk, cheese, yogurt, etc.
**All meats should be avoided: beef, pork, chicken, turkey, fish, etc.
This plan is to be followed for four weeks. By that time pain should be reduced. In many persons the pain will go away sooner, but for some it takes up to four weeks to get their bodies to stop reacting. After four weeks, introduce trigger foods one at a time, eating them frequently, for two days each. Monitor the body's response. This way you find out which foods are triggers for you. Barnard advocates getting rid of meat and dairy products entirely regardless (there are many reasons).

So here I am, a few days post-juice. I intended to follow Barnard's plan but I have already slid. I have eaten oats, potatoes, tomatoes, and wheat. I feel safe in continuing to eat citrus fruits because I had so many of them while juicing. I'm feeling some hip pain today, which suggests that I may have eaten a food that is a trigger for me (or it may just mean that my hip has gone beyond much hope). I'm considering backing up, staying with the safe foods for a while, then later introducing the triggers corn, wheat, oats, rye, potatoes, tomatoes, and nuts. Oh, and coffee.

You can read more about arthritis and food at the Physician's Committee for Responsible Medicine site.