Arthri­tis of the knee! Deal it with courage

Woman's Era - - Short Story -

Arthri­tis is not an un­com­mon name to­day! Es­pe­cially in In­dia. where 15% of the pop­u­la­tion i. e, over 180 mil­lion peo­ple are af­fected by it and you will be sur­prised to know that this preva­lence is higher than many well­known dis­eases like di­a­betes, AIDS and can­cer. Clearly, this de­bil­i­tat­ing dis­ease has caught hold of mil­lions of peo­ple in the grip of ex­cru­ci­at­ing pain ev­ery day.

There are var­i­ous types of arthri­tis like os­teoarthri­tis, rheuma­toid arthri­tis, in­fec­tious arthri­tis, gouty, et. but the most com­mon among these is Os­teoarthri­tis i.e. the arthri­tis in knee.

It is a con­di­tion in which there is loss of the ar­tic­u­lar car­ti­lage of the fe­mur, tibia, and patella. This can be seen on xray as loss of the space be­tween the two ends of bone. Be­cause of the loss of the glid­ing sur­faces of the bone, peo­ple with arthri­tis may feel as though their knee is stiff and their mo­tion is lim­ited. Some­times peo­ple ac­tu­ally feel a catch­ing or click­ing within the knee.

Gen­er­ally, load­ing the knee joint with ac­tiv­i­ties such as walk­ing long dis­tances, stand­ing for long pe­ri­ods of time, or climb­ing stairs makes arthri­tis pain worse. When the arthri­tis be­comes se­vere, pain may oc­cur even when sit­ting or ly­ing down. The pain is usu­ally felt in the in­side part of the knee, but also may be felt in the front or back of the knee.

The arthri­tis in knee not only causes un­bear­able pain to the suf­fer­ers but is also a lead­ing cause of dis­abil­ity across the globe. Ac­com­pa­nied with ag­o­nis­ing pain and stiff­ness, it is both phys­i­cally and men­tally trau­ma­tis­ing and can bring your life to a stand­still, quite lit­er­ally.

Arthri­tis of the knee usu­ally oc­curs in peo­ple as they en­ter their 60s-70s, but this is vari­able de­pend­ing upon fac­tors such as weight, ac­tiv­ity level, etc. It can be caused be­cause of var­ied rea­sons like sim­ple wear and tear, in­flam­ma­tory dis­or­ders such as lu­pus or rheuma­toid arthri­tis, in­fec­tions, and post-trau­matic. Peo­ple who have had prior in­jury to their knee, dam­ag­ing the menis­cus or cru­ci­ate lig­a­ment may also de­velop arthri­tis. The end re­sult of all these pro­cesses is a loss of the car­ti­lage of the knee joint, lead­ing to bone rub­bing against bone.

The Treat­ment

De­pend­ing upon the sever­ity of arthri­tis and the pa­tient's age, knee arthri­tis can be man­aged in a num­ber of dif­fer­ent ways. Treat­ment may con­sist of op­er­a­tive or non-op­er­a­tive meth­ods, or a com­bi­na­tion of both.

Non-op­er­a­tive

Ini­tial treat­ment of knee arthri­tis in­cludes ac­tiv­ity mod­i­fi­ca­tion, an­tiin­flam­ma­tory med­i­ca­tion, and weight loss. Giv­ing up ac­tiv­i­ties that make the pain worse may make this con­di­tion bear­able for some peo­ple. Phys­i­cal ther­apy is also rec­om­mended to strengthen the mus­cles around the knee which fur­ther helps ab­sorb some of the shock im­parted to the joint. In­jec­tions of med­i­ca­tion in­side the knee joint may also help al­le­vi­ate the pain tem­po­rar­ily.

Fur­ther­more, walk­ing with a cane in the hand on the op­po­site side is also use­ful. A com­bi­na­tion of these non­op­er­a­tive mea­sures are ef­fec­tive in non- se­vere cases and helps ease the pain and dis­abil­ity caused by knee arthri­tis.

Op­er­a­tive

If the non-op­er­a­tive meth­ods have failed to make your con­di­tion bear­able, surgery may be the best op­tion to treat knee arthri­tis. The ex­act type of surgery de­pends upon your age, anatomy, and un­der­ly­ing con­di­tion. Some ex­am­ples of sur­gi­cal op­tions to treat arthri­tis in­clude an os­teotomy, which con­sists of cut­ting the bone to re­align the joint; and knee re­place­ment surgery.

An os­teotomy is a good al­ter­na­tive if the pa­tient is young and the arthri­tis

Dr Shekhar Agar­wal Ex­ec­u­tive Di­rec­tor & Joint Re­place­ment Sur­geon, Delhi In­sti­tute of Trauma & Or­thopaedics, Sant Para­manand Hos­pi­tal

is lim­ited to a one area of the knee joint. It al­lows the sur­geon to re­align the knee to un­load the arthritic area and place weight-bear­ing on rel­a­tively un­in­volved por­tions of the knee joint.

Then there is also joint re­place­ment surgery. Joint re­place­ments are now very com­mon with an amaz­ing suc­cess rate. The pro­ce­dure in­volves re­mov­ing a dam­aged joint and putting an ar­ti­fi­cial joint made from me­tal or plas­tic, to help it move smoothly and bring you back from the painful life to a happy, pain- free and ac­tive life­style. The surgery only takes 2 hours and a rest of a few days is rec­om­mended. In more than 90 per cent cases, peo­ple who un­dergo re­place­ment surgery do not need re­vi­sion surgery for at least 20 years.

But one must con­sult only a highly ex­pe­ri­enced sur­geon to avoid has­sle­free and easy surgery.

Dr Shekhar Agar­wal is amongst the best known knee and hip re­place­ment sur­geons in Delhi, In­dia, and is Chief Sur­geon and Head of Joint Re­place­ment Surgery at the Delhi In­sti­tute of Trauma and Or­thopaedics (DITO) at Sant Par­manand Hos­pi­tal in Delhi. With close to three decades of ex­pe­ri­ence un­der his belt, he has re­ceived sev­eral ac­co­lades and in­ter­na­tional recog­ni­tion for his ex­per­tise in knee and hip re­place­ment surgery.

He has earned a stel­lar rep­u­ta­tion for pro­vid­ing ex­em­plary pa­tient care in­clud­ing sur­gi­cal and non- sur­gi­cal pro­ce­dures with ab­so­lute pre­ci­sion, and has per­formed joint re­place­ment surgery on thou­sands of pa­tients with mirac­u­lous re­sults.

But as they say, pre­ven­tion is bet­ter than cure. Keep Arthri­tis at bay by hav­ing a healthy diet and proper in­take of vi­ta­min D, cal­cium and iron. An ex­er­cise rou­tine is a must too.

from the beau­ti­ful land­scapes Ritu re­mem­bers anec­dotes like that of a 70-year-old who was pleas­antly sur­prised to find a lady pi­lot when he came up to her. She re­calls, “‘Wow, well done!” he told her, Ba­hot Acha laga ek ladki yeh kam kar rahi hai.’ (En­joyed a girl work­ing). He was so thrilled.

Goa, where she cur­rently runs bal­loon rides through the Goa Tourism De­vel­op­ment Cor­po­ra­tion, is an­other favourite. She read­ies for an­other sea­son this Oc­to­ber on­wards.

Along with the ac­co­lades come the chal­lenges. She re­lates an in­ci­dent from Pushkar. “It was a lit­tle cloudy. We had taken off as there was no pre­dic­tion of rain. Ten min­utes into the flight and it started to rain heav­ily.”

“In the air, rain mat­ters lit­tle as once the burner is switched on, the wa­ter gets evap­o­rated. So it’s safe. But at the time of land­ing we get wet. We have to then close the en­ve­lope and the weight of the been a learn­ing ex­pe­ri­ence due to smaller spa­ces to land. In Goa, she says, the max­i­mum that she has flown has been for an hour and a half due to lack of land­ing sites. But it’s noth­ing to be wor­ried about. They are pre­pared for two hours worth of fuel for a usual 45-minute flight.

Other hin­drances are ex­posed elec­tric­ity poles and iron fencing. This is not the case abroad where the spa­ces are wider.

Her ca­reer may take her soar­ing across air spa­ces, but it is Bengaluru that she re­turns to once on land. Mother of a 13-year-old, she shut­tles be­tween work and mother­hood with equal ease. “We are like a miniIn­dia,” she chuck­les.

“My fam­ily is not in Goa. My fa­ther set­tled in Harayana, my brother who’s in the Army is posted in West Ben­gal and hus­band in Ja­sailmer.”

But they pitch in when the time comes. “We help each other. If I am work­ing, some­one has to look af­ter my son. I re­turn, and help him in his stud­ies.”

The son has al­ready shown his in­cli­na­tions to grow wings and be­come an air force pi­lot. “‘But I’ll re­turn and fly bal­loons too’ is what he says,” she tells me. He has al­ready had his first free flight at two and has joined his mother on nu­mer­ous rides.

Her son is not the only one who wants to fly like his mom. Wher­ever she’s gone girls have come up to her in ad­mi­ra­tion. They’ve taken on vol­un­teers in the past. Any­one can join her in the skies pro­vided they have the pas­sion for fly­ing and will­ing to an­swer the ex­ams to get the li­cence. “We can of­fer ba­sic train­ing and they can carry on to study fur­ther abroad.”

The best part of her job, she says, is that she’s packed up when the world wakes up – not to men­tion the great views that her job af­fords.

BALANC­ING PRO­FES­SION AND FAM­ILY

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