Knee replacement turns two, and ‘Obamacare’ is still law of the land

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Still proud of myself for ‘re-purposing’ the bicycle seat that served me for 28 years as a wedding gift.

Having started with Affordable Care Act coverage when legally mandated in 2015, I’m proud to announce that the replacement knee that made me physically whole again after a dozen years as ‘a gimp’ and restored my personal confidence levels, turned two yesterday.

A physical game changer at 60, replacement was the most anticipated gift I’d ever received.

After asking my doctor if I could possibly get the surgery in December, 2017, the scheduling person said, “You’re in luck. Two cancellations means one spot has opened up. The doctor is booked on the 18th, Christmas is the 25th, and after that its a new program year. You can have surgery this Monday, but you have to tell me,” and she literally looked at her watch, “now.”

After a difficult economic 2016 as a new real estate broker, getting a knee that was totally shot at the end of 2017  fixed as a long-term negative was far from a given. In the final accounting, the numbers turned out super-doable: “Obamacare” meant my maximum out of pocket – on an insurance breakdown with a $28,700 top line was $600.  The $20 a session for physical therapy – seven weeks, twice a week – was money extremely well spent.

Thankfulness has abounded since, and I have no reason to listen to anyone knock the ACA. This past weekend I popped off an 18 mile ride without any protest or strain from “Lefty,” and while a second day of Christmas tree selling brought a minor ache, two beers watching the LSU game took care of that.

I’m a happy camper about the knee, and have said so in every survey they sent me.

Rehabbing is definitely a challenge, nothing fun

When you catch a major break like the timing and cost factors I had, you owe the Universe your very best effort in return. Whatever other exercises Amanda and Becka came up with, knowing how important a factor an ERMI was in my progress, I worked the hell out of it.

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A significant extra from having Dr. Robert McBride (OrthoCarolina) as my surgeon was getting that ERMI (Extended Range of Motion Improvement) machine as a 30 day ‘loaner.’ It’s not kidding to say, with your heel in a foot-scoop, “You pull the pneumatic lever until the bend is uncomfortable, then give it another little tug, and keep that position for ten minutes.”

After taking a break, the system calls for coming back for ten more minutes and doing that twice a day. In physical therapy for knees, they quantify your progress in range of degrees, and at least for me, clicking that lever another line or three while in the ERMI saddle and channel-surfing hit an “I got this” machismo.

I believe that *every*little*bit*more*I*do* goes directly to helping the strength and functions of my knee-quad-whatever. (What I told my PT person, Amanda, often, and strangers in grocery stores even more frequently)

Its a process, and goals help

My initial, somewhat whimsical goal for being “better” involved planting my left foot without pain and being able to hit a tree with a snowball. The last time I’d tried on a trip to NY, I literally couldn’t hit the broad side of a barn. Charlotte doesn’t get snow that often, so it was a touch of luck that a decent skim appeared in late February to help fulfill that “leveling up” affirmation.

By the end of May, with the help of regular, mostly flatter 8-10 mile bicycle rides for training, I could handle my favorite urban route, one that features a three-mile stretch with several long rises about the mid-point. Thumping a forehand up the alley in tennis as an opponent flails at its passage still hasn’t been put on the official scoreboard, but I’ve killed a nearby wall.

In a captain’s choice golf event before Memorial Day 2018, I played amazingly well off the tees, STRAIGHT drives that located well and allowed better players to shoot for higher risk options. For years that knee clicked and wobbled at exactly the point I settled into an optimal swing position, which was more than just distracting. When my balance was restored, wow! Without that constant niggling, my swing came through smoothly.

That old joke about, “Will I be able to play the piano after surgery, I never could before,” that’s what solid drives felt like.

My bike ride is a working antique, a 12-speed Miyata with gears on the up-angle from my pedals instead of in the middle of the handlebars. I bought ‘Clyde’ for $125 in 1990, refurbished it for $185 many years ago, and finally bought a more ergonomically friendly seat vs. the slab of leather (see photo at top) that lasted 28 years. Riding Clyde was a saving grace, what allowed my staying in shape because it was really the only physical thing that *didn’t* abuse the knee, and biking is an almost year-round possibility in Charlotte.

Post-replacement and therapy, I honestly never expected to become the long-distance shooting threat in hoops I sort of recall being a dozen years before, when I started needing a bracier brace. Having stopped playing even 4-on-4 games six years ago – I sure didn’t want to be the guy *anybody* can drive on and they want to guard – I just wanted to move naturally. I continued catch and shoot hoops by myself over the years, but having to WALK after misses, that didn’t really square with the inner athlete.

Not having to skip across the street so I didn’t get run over made having that knee replacement a simple decision.

This October, after declining to play the previous week, I tried “going easy” for a short game to seven, shooting 4-5 with three long shots, and an assist. I’ve been back four times since, even though my doctor says, “You’re playing basketball?” with concern in his voice. (No sweat doc, I’m playing with old, broken down guys…) I resisted for over a year, I swear I know my limitations, but running after misses because I can, is another reason for thanks.

When doing a content copy writing gig for a CBD manufacturer early last year, I did several articles about how CBD’s effect on the endocannaboid system (ECS) can help with anxiety and depression.  Other research, regarding physical activity as a good overall tool on those fronts, echoed a personal mantra, and that Forever Young Boomer inside me does seem to respond well to CBD’s “focus factor,” having both going for me is terrific.

In my humble opinion, when your moment comes to pull the trigger, do it. The physical therapy is going to hurt, but do it – and then do a little bit more. Happy second birthdays depend on it.

CBD oil as health care resource for Baby Boomers struck a useful chord early

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When searching for results, if you find a product that works, keep it around.

If you consider the early years of Boomers with Daniel Boone hats and hoola-hoop “fads,” CBD is more like Beatles-level important. The 70 million strong ‘Baby Boomer’ generation (1946-1964) will be overtaken by Millennials (1981-1996) soon, but Boomers accepted documentation and showed a personal willingness early to experience this non-drug and the many physical things it seemed to benefit without the buzz.

CBD oil became a health care star quickly in 2019, beginning with the passage of 2018 Farm Bill (Senate Bill 2667) just before the government shut down in December.  An essential change was redefining CBD as “all parts of the Cannabis sativa plant that do not exceed 0.3% delta-9 THC by dry weight, including “derivatives,” “extracts,” and “cannabinoids.”

Boomers are aware that Reefer Madness scare tactics and criminalized marijuana (Controlled Substances Act, 1971) use were bogus in a lot of ways, but few will deny the scary aspects of opioids like codeine, fentanyl, and hydrocodone addiction. That singular aspect makes CBD’s all-natural aspect even more appealing to those who have more liberal views on what may be good or bad for them.

With a market projected at $22 billion by 2022, Boomers can consider CBD kind of like Coca-Cola as the Real Thing.

Because they’re often caregivers, Boomers have significant first hand knowledge about upcoming senior care issues, including expensive medications with known, negative side effects. Their “Forever Young” group attitude has always valued health issues (racketball, jogging, aerobics) and their top priorities at sixty-plus years are now inflammation, pain management, and as a sleeping aid, areas where CBD has shown documented strength and results.

While it’s got a great reputation regarding arthritis inflammation, CBD is actively marketed for a plethora of medical concerns, like ADHD, multiple sclerosis, chronic pain, as a multi-vitamin, for blood pressure, hormone regulation, even PTSD. Most people don’t care whether indiscriminate use blurs previous medical boundaries, more an increased ability to control personal wellness programs being an easily followed path.

How does CBD affect the body?

In an absolute bottom line report from WHO (World Health Organization), they stated that “In humans, CBD exhibits no effects indicative of any abuse or dependence potential,” which is a positive, 180 degree alternative to the opioids addiction crisis.

While everyone knows they have a central nervous system (right?), you may not be cognizant of your endocannabinoid system (ECS), which is something that will be constantly referenced in everything you read about CBD. I’ll suggest this as a starting point to learn about its important physical regulatory roles.

Pain management, as a sleep aid, and anxiety are high priorities, and negatives like 60,000-plus deaths a year from opioids compared to essentially none to date for CBD oil is not just something you missed on the news.

Bioavailability

After a friend asked, “Whats the best way to take it?” I suggested sub-lingually, meaning under the tongue, because outside of vaping – which has taken a fairly harsh hit (sorry…) recently – that provides the greatest payoff with dosage.

Using a 25 mg capsule as a standard dose, swallowing the capsule or gummie means it has to go through the liver for processing, and only about 6% of that is “available” in the bloodstream when all is done. Vaping gets 50-60% of that 25 mg. sample (about 15 mg) into the blood stream because of the surface area the inhaled vape is exposed to in the lungs.

The mouth is a large mucous gland, and holding the tincture in there for even 30 seconds allows absorption of up to 40% (10 mg) bioavailability, even though swallowing it still means it goes through the liver.

Topicals are a simple and effective use of CBD. While very little of the rubbed on content gets absorbed into the blood system, the “magic” in the application is that its already where its needed. While a 750 mg. 4-oz. tube (ie- Recover) is mathematically 190 mgs. per ounce, “liberal application” for a knee or muscle strain is noticeably helpful without using anywhere near that amount.

Dosing is something that has to be figured out. There is no RDA (required daily allowance) for CBD, or any height-weight algorithm for mgs. There is also a caveat about CBD oil and drug interaction, specifically being a “competitive inhibitor” with the CYP450 (cytochrome) liver enzyme, which metabolizes 60-80% of the meds that Americans take.

The “dog in the manger” example works here: The CBD and CYP450 enzymes deactivate each other, so the CYP450 enzymes in your system doesn’t break down the meds and make them release the benefits they’re supposed to in a timely manner. The “dog” (CBD) can’t eat the hay in the manger, but it doesn’t let the “cow” (CYP450) get to it either.

If you’ve heard an older aunt or family friend complain about not being able to enjoy grapefruit from their tree because of an interference with medications, this is probably what they mean.

Stress relief, pain management

Doctors still don’t get much training with CBD or natural cures; in 2016, only 13 percent of U.S. medical school did any kind of training.

“Anxiety” is a consideration that ranks very high for users, and how the ECS receptors are turned on by CBD to mitigate this area is worth reading about. While there is a significant amount of anecdotal information about relief on many, many fronts, pain management may be crucial as a “Quality of Life” concern, because CBD “amps” efficacy of other meds, which when known, can help reduce dosage levels.

All the hoo-ha over infusion of CBD (not legal according to FDA), its status as a nutritional supplement, or whether Boomers are going to turn its ability to “chill” situations across a range of what historically required ‘real’ pharmaceuticals, is still in growth stage.

Like CBD’s well-known THC “brother from the sativa mother” though, if it works so nice, maybe try it twice.