WHEN IS THE RIGHT TIME TO DO TKR?

This is a very common question being asked in TKR forums.  In fact, I noticed that some people joined such forums for months or years before they even schedule their TKR surgeries.  I believe that these people know  they have a problem but they wish to find out in detail before they make a decision.  Well, it's good to learn as much as possible in order to be more prepared.  However, if learning more is going to put you off, then it may not be a wise thing to do.  In such instance, I would suggest that you just learn enough to help you make a decision and make necessary preparations before the surgery.  After all, you have plenty of time to learn more during recovery which is quite a long process.

 

In my case, I have to admit that I did not know much about TKR except way after my surgery.  I was in denial for some time but I knew that I had hit rock bottom when the pain became unmanageable.  Then I went running to my OS to fix the problem.  I was told that I needed a bilateral TKR because I was already bone on bone in both knees and it had resulted in joint damage.  Without any hesitation, I immediately scheduled a surgery which was only about  a few weeks away.  At that time, I was helping my daughter to organise a charity event so I fixed the date right after the completion of the event.  I'm glad I did that as I did not have to go through the anxiety of waiting.  Though I had to move around in great pain but it was the excitement of the preparations and adrenalin from the success of the event that kept me motivated.  To be honest, I could not wait to get over with the surgery as I have endured enough.  It was only early this year that I started to join TKR forums and learnt so much from fellow TKRers. 

It's quite common to see some people who are happy to have finally scheduled their TKR surgeries but subsequently, begin to question whether they have made the right decision.  Most of the time it's because they suddenly experienced less pain in their knees and they begin to feel that their condition is not as bad as what other people are experiencing.  Actually, this is a sign of nerves and its perfectly normal.  Its also quite common to see some people who keeps questioning whether they are the right candidates for TKR because their pain is not as severe as what they see others experiencing.  Since then, I have learnt that  sometimes an x-ray can show very bad damage but the person does not experience much pain.  On the other hand, there are cases where the x-ray showed little damage but the person has extreme pain.  This is quite puzzling and  even some medical professionals find it hard to explain to their patients.  However, these people do admit that while they do not have severe pain but they walked with a limp, have bad posture,  experience pain when climbing up and down stairs, have restrictions in carrying out certain activities,  have limited range of motion etc. So the question remains when is the right time to do TKR?

I know its hard to pin point a certain time.  But some people have said that they knew its time when:-

1. they felt that enough is enough
2. they are unable to do the things they love
3. nothing works anymore
4. there is no quality in their life
5. they are merely existing and enduring life

Well, here's something that can help you to determine whether its time for you to do a TKR.  Just answer the following questions honestly:- 

1. How long can you walk and stand without pain and stiffness?
2. Are you limping when you walk?
3. Do you have a bad posture with aches and pain?
4. Are you able to climb up and down stairs normally without pain?
5. Are you able to do daily chores without restriction and pain?
6. Are you able to go shopping and holiday trips?
7. Are you able to do any exercise or play any sports?
8. Is the knee pain affecting your sleep?
9. Are you having bow legs or knock knees?

If you score poorly on the above questions, then the answer is obvious.  We do not have to just endure life.  We are supposed to have a better quality of life.  TKR is a medical miracle that allows us to gain back our life and it is one of the most highly successful surgery.  In fact, many people including myself waited too long to do TKR and as a result, suffered more damage from OA (refer post on OA still exist after TKR?).  And after finally having gone through TKR and enjoying an  active lifestyle with pain free knees, this is what most of us said  "WHY DID I WAIT SO LONG?"

GREEN SMOOTHIES & ARTHRITIS

In my earlier post on pH balance, I mentioned that its important to consume more alkaline food and water in order to have a healthy pH balance as it helps our body to function properly and prevent diseases including arthritis.  Alkaline food include most fresh fruits and green vegetables.  But how many of us actually consume lots of fruits and leafy greens in particular on a daily basis?  If I look at our diet today, I think most of us will not score well on this.   

Recently, I read a book called "The Body's Natural Instinct" by Professor Chang Jia Rui, M.D. who had researched the body's natural instincts for over 20 years.  He said that "If we all know how to improve our diets, and were willing to consume more green vegetables and drink a large amount of water, illness would automatically disappear".   He also said that "No matter what kind of illness you suffer, it is caused by one single factor, and that is acidic toxins". 

According to the US Department of Agriculture (USDA), the dietary guidelines report stated that "greater consumption of fruits and vegetables is associated with a reduced risk of stroke and perhaps other cardiovascular diseases, with a reduced risk of cancers in certain sites (oral cavity and pharynx, larynx, lung, oesophagus, stomach, and colon-rectum), and with a reduced risk of type 2 diabetes (vegetables more than fruit).  Moreover, increased consumption of fruits and vegetables may be a useful component of programs designed to achieve and sustain weight loss".

All these information really emphasises the need for us to consume more fruits and leafy greens.  Now I'm sure most of you would be asking "but how much is enough?" According to the USDA, the recommendation is 5 to 12 servings a day or 2.5 to 6.5 cups a day depending on calorie needs.  But as a general rule, the more fruits and leafy greens we consume, the better.

A very good alternative to increase the consumption of fruits and leafy greens is to make green smoothies.  Green smoothies was actually created by Victoria Boutenko in 2004.  Since 1994, she and her family were faced with numerous health problems such as obesity, juvenile diabetes, hyper thyroid, chronic fatigue, arrhythmia, chronic rheumatoid arthritis, asthma and allergies.  When medical doctors did not leave them with any chances of recovery, she began researching nutrition and even studied what wild chimpanzees ate because they share with humans 99.4% of genes and have extremely high natural immunity against aids, hepatitis C, cancer and other diseases .  She was surprised to discover that Chimpanzees ate 40% of greens and it was also observed that when they ate a fruit, they would wrap a leaf around it like a sandwich.  She became convinced that greens are the most important food for humans.  She also discovered that in order to get the nutrients, the leafy greens have to be broken down to the tiniest pieces preferably down to the molecules.  In simple words, we need to chew our greens to a creamy consistency in order to get the benefits.  And in order to digest the released minerals and vitamins, hydrochloric acid in the stomach has to be a very strong pH between 1 and 2.  This is something that is not easy to achieve and therefore, she came up with the idea of blending fruits and leafy greens into smoothies which eventually helped her and her family to fully reverse their symptoms and regain vibrant health.  However, it must be noted that she and her family are also on a 100% raw vegan diet and they do exercise regularly.

I am so glad that I started to make green smoothies for myself and my family as it is really helping us to consume a healthy amount of fruits and leafy greens  You will be surprised that it is so easy to make and very pleasant to drink because the taste of the greens is actually masked by the fruits.  You can go to Incredible Smoothies to read about all the excellent information on green smoothies and recipes.

The health benefits of consuming green smoothies indicated by Incredible Smoothies include the following:-

• Increased consumption of fruits and vegetables (particularly greens)
• Easy digestibility and Nutrient Assimilation
• Rich with chlorophyll
• Alkalising
• Antioxidants
• Increased energy
• Mental clarity and focus
• Increased fibre intake
• Clearer skin
• Natural weight loss
• Reduce cravings

We can use any leafy greens for making green smoothies.  I have tried spinach which gives the most pleasant taste for the green smoothies so its easier to start with.  Bok choy, lettuce and any other local greens can be used too.  I have also tried watercress (sai yong choy) which has a strong flavor and bitter taste but it has powerful nutrients.  Other greens which you can use (if available in your market) include kale, swiss chard, collard, dandelion, turnip, beat and parsley.  It is also best to rotate the greens in order to enjoy the variety of nutrients. The general nutrients of leafy greens include potassium, dietary fibre, folate, protein, vitamin A, C, K, calcium and iron. I also added cucumber to my smoothies as it has powerful nutrients.  According to Naturalnews, cucumber helps to control blood pressure, aids in weight loss and digestion, reduce cholesterol, promotes joint health, relives gout and arthritis pain.  It also contains a hormone which is needed by the cells of the pancreas for producing insulin which has been found to be beneficial to diabetic patients.  For arthritis, we can also add 1 teaspoon of turmeric, 1/2 teaspoon of cinnamon powder and one chunk of fresh ginger into the green smoothies as these ingredients have anti inflammatory properties and promotes blood circulation.  In fact, most leafy greens have anti inflammatory properties.

As for fruits, we can use apples, bananas, oranges, lemons, watermelon, pears, papayas, grapes, strawberry, mangoes etc.  The general nutrients of fruits include potassium, dietary fibre, protein, Vitamin A, C, calcium and iron.  However, for diabetics, it is recommended that you use more greens and choose fruits that are lower in sugar.  You can refer to WH Foods for more detailed information on the nutrients of fruits and vegetables.

The ratio for making green smoothies is 40% greens and 60% fruits but you can slowly work up to 50/50.  Sufficient water should be added.  I am using coconut water because of its excellent nutrients and sweetness.  I usually make a large batch of green smoothies and leave it in the fridge and it would be finished within a day. Each of us drinks around 2 to 3 glasses a day.  According to Victoria Boutenko, the green smoothies can be kept fresh within 2 to 3 days in the fridge probably because of the large quantities of antioxidants in the fibre.  Of course, if you can drink the green smoothies fresh from making, that would be ideal.

Now all we need is a blender to make the green smoothies.  In the picture you see below, I tried my sister's high end powerful blender to make the green smoothies.  It was excellent - very smooth.  To be honest, right now I am using a cheap blender which my husband won from a golf competition but it still works well - probably takes a little longer to blend.  But it still serve its purpose.  Maybe when it has done its time, then I will consider upgrading to a better one. 

So what are we waiting for?  Lets start making some green smoothies!  Still not convinced?  Perhaps  the picture below showing my daughter, May and nieces, Jess and Sue-Ann enjoying their green smoothies will convince you to start making those yummy and healthy green smoothies.

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