SENIOR POWER: …FOF and the bee’s knees

By Helen Rippier Wheeler,
Friday May 16, 2014 - 12:15:00 PM

Two of every 100 Americans have artificial hips or knees. 4.7 million Americans have artificial knees. They may have had arthroplasty. I’m one of them.  

Wikipedia describes total knee arthroplasty (TKA) as a common and safe procedure typically performed for relief of symptoms in patients with severe knee arthritis.  

Increase in the number of Medicare participants, expansion in the types of patients considered likely to benefit from TKA, aging population, and prevalence of conditions that predispose patients to osteoarthritis, notably obesity, have contributed to the TKA volume increase. There has also been a decrease in length of TKA hospital stay, simultaneous with increases in readmission rates and infectious complications.  

Joint replacements cost more than median annual income in 18 states, reports Napala Pratini (Huffington Post, April 23, 2014). The 18 states include California and Florida, but not Hawaii. 

Fear of falling (FOF) appears to increase with age and to be higher in women. Other elderly FOF risk factors include dizziness, self-rated health status, depression, and problems with gait and balance. Nursing home falls are a preventable cause of death and serious injury.  

TV advertising touting a “free knee brace” calls to mind Emily Dickinson (1830-1886)’s declaration: I don't profess to be profound; but I do lay claim to common sense. It’s 

nothing more than a bit of elastic with shipping and handling costs stipulated. Many products intended mainly for senior citizen consumption are advertised on TV and mentioned on doctors’ shows. Fear of falling and fear of falling again often enable these cruel frauds. 

FOF has been identified as one of the key symptoms of the post-fall syndrome. It has gained recognition as a specific health problem among older adults, even found among elderly persons who have not experienced a fall. Fall once, and you are cursed with the fear of falling again. Time seems to crawl as one goes down and lands with a painful thud. Outdoors is worst. These are things you don’t want to be reminded of, but do read "Fear of Falling," by Harley A. Rotbart (New York Times, March 5, 2013, Blog) and "That Falling Feeling," by Jane Gross (New York Times, April 2, 2013).  

Arthroscopy is a minimally invasive surgical procedure on a joint. It can be performed to evaluate or treat many orthopedic conditions including torn cartilage (the meniscus.) The advantage over traditional open surgery is that the joint does not have to be fully opened up. For knee arthroscopy two small incisions are made, one for the arthroscope itself and one for surgical instruments used in the knee cavity. It reduces recovery time and may increase the rate of success due to less tissue trauma. 

New research may provide effective nonsurgical treatment for knee osteoarthritis. Dextrose and morrhuate sodium injections (prolotherapy) for knee osteoarthritis are the subject of trials. Prolotherapy involves injecting an otherwise non-pharmacological and non-active irritant solution into the body, generally in the region of tendons or ligaments for the purpose of strengthening weakened connective tissue and alleviating musculoskeletal pain. It is also known as "proliferation therapy," "regenerative injection therapy," or "proliferative injection therapy". [“Methotrexate Decreases Pain, Improves Function in Knee OA," by Janis C. Kelly (Medscape Medical News, April 1, 2014).] 

Cataract surgery decreases the risk of falls in older patients, according to the American Association for the Advancement of Science. Vitamin D may not lower seniors’ fall risk. Blood pressure medications may raise elderly fall risk.  

Nice things do happen. While attempting to put air into one of my tires, I realized that it was beyond me…age, arthritis, fake knee blah blah… I was about to give up. A truck pulled into the space next to my car at the filling station’s watering/air hole. The driver offered to put air in the tire, and he offered to check the other three tires! The sign on his truck read Berkeley Painters. The bee’s knees phrase was first recorded in the late 18th Century, when it was used to mean something very small and insignificant. Its current meaning dates from the 1920s, when American slang expressions were coined with the meaning 'an outstanding person or thing'.  



California seniors soften languish on affordable housing wait-lists, writes Karina Cortez (New America Media, May 3, 2014). Alas, that’s not news for many seniors, but read it, nevertheless. 

"Statewide study: Marin faces 'particularly troubled' pension situation," by Nels Johnson (Marin Independent Journal [Marin County, California], May 8, 2014). 

The best states to retire in are a little surprising, writes Melanie Hicken (CNNMoney, May 5, 2014). Colorado, Utah, North Dakota and Wyoming are the top five. Bankrate's rankings equally weighted weather, cost of living, crime, quality of health care, state and local taxes and general well-being. South Dakota topped Bankrate's list for its low taxes, lack of crime and easy access to quality healthcare making it the best state for retirees. 

UK NEWS: "Courts braced for surge in cases of elderly locked up against their will," by John Bingham. "Pope Francis's envoy warns of 'horrible consequences' of Lord Falconer's Assisted Dying Bill," by John Bingham and Nick Squires. (Daily Telegraph [London], May 8, 2014).