Can't your workplace provide reasonable accommodation for your physical condition? That might mean letting you take time during the day for physical therapy. Maybe you can get some exercise routines from a licensed physical therapist for your condition.

Aquatic therapy is also used for MS patients, so even though the regular pools' options might be restricted, you might be located in an area where MS assistant groups have their own pools. From what a relative has told me, they are warm-water pools that help relax muscles. A Web search might spot those easily for you.

Would you be interested in trying some gentle yoga while seated on a chair? DoYogaWithMe has quite a few seated yoga practice videos. To find them, under difficulty, sort by beginner and then under style, chose gentle. There's a seated lower body class by David Procyshyn that looks promising.

I used a lot of these videos for strength building and for recovery from running injuries and enjoyed them. FYI, these are free and you don't have to register at the site or anything. The videos themselves are really high quality.

Here is a link that might be useful: DoYogaWithMe

Sometimes hotels let outsiders use their pools for a small fee.

You can also get videos which might motivate you. If you have time to watch TV you can do simple exercises while you are enjoying a show.

In theory I like what suero is saying, but I would be very careful about expecting your work place to be accommodating.

If you have a lunch break, try walking as much as you are able.

Utmost, you need to get the pain under control, so I would do my best to figure out how to do this first.

Managing chronic pain without Rx meds is a process that depends on many things as I'm sure you are aware. I've lived with chronic pain almost all my long life and find meditation, aromatherapy, natural anti-inflammatory supplements, healthy diet, vitamin supplements, frequent rest, visualization, loving relationships, and sometimes just self-talk to get me thru a particular situation work reasonably well for me. At least this works better for me than trying to cope with the side effects of Rx meds. I like to be fully aware and able to drive safely whenever I want. When pain becomes unmanageable because I am seriously overdoing and pretending I am 32 instead of 72 I do take my Rx but usually at a much lower dose and usually only at bedtime.

I recommend starting by making a list of what is possible for you to do, then trying them one at a time. Everyone is different so what works for me might not for you. I avoid milk as much as possible as it causes inflammation which increases my pain. Right now I am getting over enjoying too much eggnog last week! It was delicious but not sure it was worth the extra discomfort. Also avoiding sugar and ensuring sufficient B vits in diet and supplements if necessary helps me. Doing whatever it takes to reduce stress is also beneficial.

I wish you all the best and hope you can arrange your life so you can be more comfortable and find enjoyment in it.

Aqua therapy does sound like a good option for you - providing there is a convenient facility. Regular yoga is difficult for me too even with my new knees but I have done chair yoga and aquatic yoga in the warm water pool.

I've been fortunate since one of our local hospitals just built a Wellness Center about 5 miles from my home. It's a complete gym and I have worked with a PT trainer on some of the equipment. I can utilize most of the equipment and while I can walk on the treadmill I find it just too boring. However I do use the recumbent bike, especially since it has a little TV on the front or you can hook up an iPad.

But my favorite is the aqua exercise classes, they're great for flexibility, range of motion and balance without any impact on the joints.

The Center offers 2 or 3 sessions a day, usually 2 in the am and one after work. Are there any facilities like this in your area?

Also check with your local Arthritis Foundation - in my area they offer Gentle Yoga and water therapy.

I would make an appointment with a nutritionist and have them go over your diet. Vegetarian and esp vegan are difficult diets to follow and attain complete nutrition without a lot of forethought and diligence. You may be better served by a more balanced diet with more protein and fewer carbs. You might also ask about anti-inflammatory diets.

I would also look into meditation which has had success at treating both stress and chronic pain conditions.

If you can sit, look at "sit and be fit"...there are some videos on youtube and give it a try...if they are comfortable for you, you can pursue them.

I'd also talk with your employer. If you have chronic conditions that lead to certain disabilities and/or necessary treatments, they may be required to accommodate you.

Here is a link that might be useful: anti-inflammatory diet

Your situation certainly sounds complicated. I wonder if your health insurance company would have a case manager that could help you make the most of the services available and, therefore, use their resources the best way. Even one call to the right person, and that's the real challenge, might provide you with new resources and information you can use - other facilities with pools, PT departments that aren't 9-5, etc.

I wish you the best of luck in getting the care you need.

Your first priority needs to be you. If you don't take care of yourself, you won't be able to work or take care of anybody else.

I would encourage you to look at the elements of your job and see if there are things that can be changed to help you. It does neither you or your employer any good if you end up out on disability from pain and/or stress.

Is there any physical part about your work environment that could be changed to help you be more comfortable? Chair, desk arrangement, footrest, location, etc.

Are there any tasks that you do that can be streamlined or eliminated? Is there anything that can be delegated either entirely, or partially to someone else?

Could you do any of your work from home one or two days a week where you might be more comfortable?

Can you either come in early or work later to enable you to get the PT you need during the day? If you have PT prescribed by your doctor, I would think your employer would need to let you go. I had back surgery a couple of years ago, and I had PT prescribed by the doctor. I scheduled the PT appointments for the end of the day and came in early so I could leave early for the PT sessions. Could your work hours be changed temporarily to allow for this?

Try to do regular stretching at your desk several times a day. There are many sites that have exercises, and there are even computer programs that remind you to stretch and give you the moves to do. Or you can program a 5 minute appointment for yourself a few times a day. They are usually just simple movements, but are good to relieve stress in your neck, shoulders, and back, and a little break for your brain.

A recumbent bike might work for you, since it's non weight bearing exercise. There are a lot of exercises that can be done with the large elastic bands that help build strength, and can help with stretching if used correctly. These can be done at home either sitting or standing. I found them helpful when I was recovering from back surgery.

I hope you are able to find some solutions and get on the road to feeling better quickly.

Are you sure that there are no physical therapy offices that have night hours? I went for physical therapy several years ago and it was after work.

Check with your town recreation department or adult education for chair yoga classes or other exercise classes that you can do. These are offered at night.

I agree with the much of the advice above.

#1 thing of which you have complete control is to research and eat so as to reduce inflammation. This is a very complex thing. You will need a smart problem solver to help you. Suggest calling a rheumatology office and see if the can recommend some sources.

#2 thing is to simplify your life as much as possible. Streamline shopping, cooking, cleaning, laundry. Outsource as much as possible. Free up time and wear and tear on yourself. Order thing online instead of running errands. Wear easy to launder clothes.

#3 prioritize. What is your goal? Is your bigger objective pain management. Stress relief. Weight loss.

#4. Seek a second medical opinion. Try a differed doctor or practitioner. IMHO, nurse practitioners or PAs can have more time to find out about your chronic issues, instead of just focusing on an acute problem.

#5 ask people you know for referrals.

#6 do think creativity about how you could change your workplace time to be better for you. If you were in an accident and in pain and wanted to work, what modifications would make sense? They may make sense for you now, You are in pain, but it's chronic, not acute from an accident. But the reality you bring into the workplace is the same.

Lastly, become your own advocate. It's not selfish. It's what allows you to thrive and share your gifts and talents with others.

And, let others experience the pleasure and blessing of helping you when you need it by accepting it as offered.

Are you in a city or large 'burb? If so, I too, would bet that a few physical therapists would be willing to work in the evening. Short of placing a craigslist ad, though, I don't the best way to find one.

I know what you mean about Tuesday morning. I can't tell you how many times I have a conflict because everything is scheduled for Tuesday! But at least if you find an evening PT, pools may be available for you.

Despite it all, you sound motivated to find solutions. Good luck to you.

With ankle and knee problems my number one goal would be to lose weight. Do that and improve your fitness. Exercise is an excellent stress reducer. If you lost weight the exercise options would be greater. Right now you're letting your job kill you. It's not worth that.

Good luck. I like your attitude!!

I think you are asking a lot from yourself all at once, maybe you should break up your goals in smaller increments.
Weight loss, possibly establish an eating plan with a nutritionist, a balanced but flexible diet that you can stay on.

Some massage therapists can stretch you while you are on a table, you guide them as to the intensity you can stand.
I found an excellent reflexologist and the stretching and massaging of my feet and lower leg make me feel great.

As for managing your pain without meds, that is an excellent goal, is it totally realistic for you? easing into it with lower or less frequent medication might be better for you: if you have less pain, you can do more and that might be encouraging for you.

When I have less pain, I find myself in better spirits, hence I eat better and move more, so although like you I aim to take less meds, I allow myself to medicate my pain at times just so I can feel like I can accomplish more and this lightens my mood immensely.

Let us know how your new goals work out, we can all learn from that.

All great advice above especially Luckygal's.

Diet and weight are two very important components of limitations and chronic conditions. Strengthening your muscles is very important since muscles support your bones. Taking weight off will make a difference in your health physically and mentally. Many symptoms you are having may just disappear with that alone. It's up to you to do it and you really have to want it. I would WW's and stick with it. I have a friend who has lost over 100 lbs on WW. It takes time but it's worth it.

Ask your Dr. what exercises you can be doing and what you should not be doing. He does know. You may be able to do some things at home. Elastic bands can be purchased at 5 Below Stores which are great and gentle. I'm sure there are Utube videos to show you how the use them

Your on the right track with Aquatics. and I would start there since it is very gentle on joints and muscles and will strengthen your muscles.

When you start any kind of exercise program, you will have aches since you will be working muscles that have not been used and joints that are being used differently. That's not a bad thing but you may have to manage and except it at the beginning. Work through it.

Sitting for long periods of time is not good for you and can pose it own physical issues including problems with your heart. Stand and stretch ever hour or so.

Maire_cate-I belong to Virtua also.

I'm sorry you are going through this. Chronic pain and conditions just plain suck. I think given your multiple things going on, you need to consult professionals and come up with a plan that matches where you are today and where you can reasonably go. A pain management specialist would be a good place to start.

Also, a plan that is designed for your limitations and realistic goals will be easier to start. For example, like others have suggested, there are low impact things you can stop and do for five minutes every hour at work rather than start a yoga routine. In my case, the professionals I rely on have advised me against yoga and I've found myself feeling worse when I try it.

My next statement comes from a place of compassion, as I know personally what it's like to not have an option to power down.

I read a lot of what sound like excuses. For me, to marry my goal with my reality erased a lot of barriers and made me more agressive to meet my goals and find the right people to help. Your condition is real, your situation is real but might be more flexible if you had a clear path to a goal that you can obtainin a reasonable amount of time.

what a wonderful, supportive resource this forum is.

Pesky, I don't have much wisdom to add, but I love aqua exercise, and want to mention using a flotation belt, which is my favorite way to do it. With the belt, you can be completely suspended in water for very gentle aerobic exercise. I know that finding the time and space for aqua exercise is hard -- my life goal is to install a water well type pool for just this purpose.

Pesky, a thought - have you a YMCA in your area. Seattle's Y, and the Y in Longview have evening water exercise groups, I wonder if many of them do. Mother goes to the evening aquatics exercise Mon-Thurs in her city, then on Fridays she goes to the mid day group. She'll skip Saturdays because there are children present and they splash, both her hair and her hearing aids ;) If they are doing a particular exercise that isn't appropriate for her (osteoporosis and two artificial hips) she just does her own thing until they go on to something else, dogpaddles at the pool side, something on her own just so she's moving. She's 87 1/2 and twice the age of many who participate.

Please work on the weight a little when you can do that without adding stress. It's so important if you have joint issues not to carry extra weight and the loss of just a few pounds can make a difference.

Pesky,
So sorry to hear about your pain and stress. So many people don't understand the suffering caused by chronic pain.

If I were you, this is the FIRST thing I would do.

Have you worked for your employer for at least 12 months? Have you also worked at least 1,250 hours during that 12 month period? If so, and since you are being treated by a 'healthcare provider', you are eligible for Family Medical Leave (FMLA).

Visit the HR office, not your boss, and ask for FMLA paperwork. Take the paperwork to be completed by your physician or Physical or Occupational Therapist. IF necessary, the completed paperwork would certify to HR your need to take time off from work for treatment. Your supervisor should only be made aware of the need for time off, NOT the specific condition.

FMLA is unpaid, however most employers allow use of sick time if the employee is the one receiving treatment. Most importantly, FMLA provides legal protection of your job for various qualifying events.

Good luck to you. It all starts with just one step at a time.
~bgj

Pesky - I've been thinking about you and wondering how you're doing today. You have a lot going on and sounded rather stressed. Chronic pain can be both mentally and physically debilitating. There are a lot of great suggestions here and I hope you've found some that will work for you.

I don't know how old you are or the specifics of your insurance but if you need a knee replacement couldn't your physician appeal the insurance company's decision? Are you near an urban area? Almost all of the physical therapy centers near me are open in the evening. The one I went to for rehab after my knee replacement opened at 6 in the morning and closed at 9 at night. In the meantime there are exercises that you can do that won't aggravate your condition. Many of the exercises that the physical therapist gave me before my knee surgery utilized elastic bands and stretching.

Please take care of yourself!

Jerseygirl - We've probably passed each other at Virtua or Wegman's, we need to wear our official Garden Web hats! We've traveled in the same direction - you mentioned on funky art's Bucks County thread that you grew up in NE Philly, I used to work at the Northeast Regional Library on Cottman Ave

Pesky, let us know how you are progressing or what you may be stuck on. Sometimes talking it out helps people move in a different and better direction.

Maire- Yep, we probably have passed each other many times at Virtua and Wegman's. I remember when the NE Library was built. I went to Solis-Cohen Elementary School.

Pesky - How are things today? As others have mentioned find a nutritionist and discover a food plan (I hate using the word diet) that will address your issues. It could be something as simple as starting by cutting down on sugar and adding vitamin D to your diet which some studies have shown helps with chronic pain.

Try to find someone who is interested in YOU and your issues and who is not trying to further their own unrelated beliefs and agenda. For every knowledgeable health practitioner there are who knows how many who really don't have the proper background for dispensing advice.

I agree with you about trying to cut down on the prescriptions as much as possible.

Pesky, I have been reading along and thinking about you and am truly sorry you have come to this place in your life. I have been blessed with good health for most of my life, with a few surgeries and recoveries that set me back but no long-term pain like you have had to endure. I'm so sorry you have had to deal with this.

I know from just getting older I have to take better care of me and do more stretches. Some of them I can actually do at my desk. When I injured an ankle once, a doctor told me to try to trace the alphabet with my foot in mid-air several times a day if possible. It really helped because the muscles and ligaments were stretched in almost every possible direction. Maybe you can try this in small stages at your desk. If you can't get on the floor, there are some things you can do from a chair, just lifting your legs. The yoga in a chair someone suggested is a great idea, as was the elastic bands, and if you can do some things standing, even lifting some 1-lb weights, and bending and stretching at the waist would be good for circulation.

My DH was also having some joint problems, and he cut out all artificial sweeteners and cured/processed meats. He now uses Stevia or agave to sweeten his coffee and most of his joint pain disappeared. I'd suggest your food plan change first of all, and that would include any diet sodas and other products containing aspartame. Any other further reduction in sugar, as many have suggested, would help. I know you already know this, but you need lean protein for energy, especially if your job is often physically demanding. So just a vegan diet may not be what you need right now. Salads are great, but you can add a little chicken, beef or fish to it for variety. I even buy a whole roasted chicken and freeze some of it for later. Easy leftover meals with a little rice or salad. Keep your favorite fruits close. Anything filling is best for a snack or to keep you from grabbing something you know you shouldn't eat. Even a spoon of peanut butter on a piece of apple is better than a handful of chips. There are even frozen fruit popsicles that are pretty good desserts. Portion control and healthy eating for energy are what you need to get control of your weight. Sneak in a small square of dark chocolate or whatever gives you a smile once a week! It will make you feel better.

And yes, try to find that place for aquatic workouts that can help you work around your schedule. Maybe you can work something out with your employer to come in later a couple of times a week so you could do it early in the mornings? I do hope you can get the help you need in this regard. I think any exercise is a 'mental break' any of us need from the daily stress of life away from home or office.

Let us hear from you again. This is such a supportive group.

You are all sooo wonderful! Thank you for your great words of wisdom. I finally saw a dr today and I really liked this one-she was very progressive and agreed that I know what's going on in my body-so she's got me started on some antibiotics (infection due to the lymphedma-AGAIN). I'm going to see if she's accepting patients and if so, request to have her be my PCP.

I did some checking into chair yoga-I think that might help a bit-and I'm going to ask my boss if I can work 4/10's so I have a day during the week to handle some of those stressors that I can't fit in during the week-errands, personal phone calls, etc.

The nature of my job is that it's not predictable-I can't always tell when I'll be called to the field and because I work with so many partners outside my agency, I need to be flexible with my time. When I have field days I could be out 12 hours! Other days I'll be in meetings for hours or desk bound reviewing projects-it's not an 8-5 desk job! But they do make accomodations-and if I don't think I can do the hike down to the bottom of a ravine, I just don't do it! It's more myself being unable to accept my physical limitations.

I'm going to look into other aquatic options. I might even see if I can get my doctor to write me a prescription for a swim spa-then I can deduct that from taxes! LoL. But at a minimum I'll try to chair yoga for now.

I spoke with my husband about changing our eating habits and we agreed to start with baby steps. We both know that right now, until at least after Christmas, it's not something we are up to tackling-he's got customers coming by almost every day bringing homemade holiday goodies (he gives them away, but they're still a temptation). But we're making strides in deciding WHAT we will eat and who will make it when...so it's going to be a partnership there.

I think it's just going to be a matter of takig charge and stop whining! Mostly, tho, it's getting my mind into the fact that I have a disabling condition exacerbated by multiple traumas to my body. It's just hard, emotionally to go from being a super active, athletic, strong person to being one with chronic pain and limited mobility. But with the kind words I have received here-I think I can move on and start to look into the new phase of my life.

I have to say, thanks to you all, I AM going to push to get my knee looked at again. I really need that fixed-if they can't replace it yet, at least they can figure out exactly why I have the pain I have.

If you haven't tried it, I highly recommend a tablespoon of high lignan flax seed oil daily. I suffered chronic aches and pains for years and the only thing that helped me was the flax seed oil...you need the lignans and you need to buy it refrigerated and keep it refrigerated. Stir it really well to get all the brown stuff mixed in...that's what you're looking for. It's like a great lubricant for all the joints in the body.

Also, I know it's gross, but highly effective...leeches have been shown to be very good at alleviating knee pain. And it's painless. It's up to you whether it's too gross relative to the time, pain, length of recovery and cost of surgery as the alternative.

Here is a link that might be useful: knee pain and leeches

Yay, Pesky! Sounds like you are taking control, and that's the first step. I hope you'll post often to let us know how it's going.

I have a friend who has just finished acupuncture school (3 years of study). She's studying for her Board exams now and I can't wait to try it when she is certified. We have talked a lot about it (she's my massage therapist), so I know she has seen people with pain issues helped with acupuncture too.

Pesky - if for some reason you can't get your knee replaced now has your doctor recommended injections into the knee? Have you had an arthroscopy done to determine if some of the pain might be caused by detritus within the knee? Have you tried Capsaicin cream - it's a topical pain ointment.

I can only tell you my experiences and hope it helps. I tore the cartilage in my knee when I was in my 20's. I had a nasty wipe-out while water skiing. Hitting water at a high speed is like hitting concrete. They removed the torn meniscus and told me I'd develop arthritis later. I assumed it would be much later - like in my 70's.

Well that was naive. By the time I was 40 I had stiff knees which progressively deteriorated. I went from an active outdoorsy individual to a more sedentary one which led to a gradual weight gain. I had an arthroscopy done which flushed out the joint removing small tidbits of cartilage and even tiny bone chips. It significantly improved my knees and lessened the pain.

However it wasn't going to alter the inevitable course of osteoarthritis. Around age 50 I had Synvisc (made from the comb of a chicken) injections into my knees. It's a gel like substance that helps lubricate and cushion your knee. It's usually effective for 6 months or longer and is about 50% effective if you still have some cartilage. It's relatively painless, I only felt a little pressure as they injected it and I went about 3 or 4 years before having it done again.

By that time it was bone on bone so the injections really didn't do much. My surgeon told me that I could have knee replacement at any time. I managed to postpone it ten years - but by that time it was extremely difficult to walk up stairs, get in and out of a car, walk the dog, stand to make dinner, the pain even woke me up at night. I had both done at the same time three years ago and I'm thrilled with the results.

I certainly don't know what coverage your insurance provides and perhaps they'll want you to try anti-inflammatory (NSAID) medicines first or the hyaluronan injections. NSAIDs should not be taken long term so that's only a temporary help. Some have received pain relief from acupuncture too.

But if it's determined that a knee replacement is the only solution then I don't think it can be denied merely due to your age ( you are in the US right? My girlfriend in CA did have to wait due to age). When I had mine done I went to a specialty hospital in NYC and I saw patients of all ages attending the pre-op knee replacement class - children, seniors and my favorite - a pro basketball player.

I do hope you get some relief.

Pesky,
You have received great advice. I wanted to offer one more alternative - pilates. I have hip problems and pilates makes life bearable. I take two to three classes a week and it makes it possible to sit twelve hours straight at my desk. I try to take breaks and stretch but it is not always possible. The reformer uses resistance to stretch your body. I am not very flexible but pilates has made yoga easier for me. It is expensive in my area but I gave up other things to make it possible. I would love to swim but water makes me itch so it is not a great option for me.
Good luck on your journey to better health!
Homepro01

maire-cate-THANK YOU for your advice! That sounds just like what is going on with my knee-I wiped it out years ago (several tmes) and I think that if they did something arthroscopically they could clean out a bunch of junk and make it feel better, for at least a little while!

I feel a 180 turn around now that I'm on day 2 of the antibiotics. My swelling has gone down considerably and I've got loads more energy than I had. Tonight I got a massage and asked to concentrate on my feet & lower legs-so they feel a lot better too-get some more of that fluid moving out and once it's moving, I can move a little better.

I didn't realize how run down I was until now-gosh it's no wonder I was so whiney! It's pretty amazing how my body reacts to infection-even mild infection can just tear me down. But today was a good day and tomorrow will be even better. Going to look into Pilates too-I need some good stretching out!

You might consider looking for a massage therapist that does what is called Isolated Active Stretching. The exercises are done slowly and not held as long as many of the PT ones and each part of the muscle is worked seperately. When I had frozen shoulders, I got more relief from these than from the ones the PT had me doing. There are some videos online that are done by Aaron Mattes, I think. He is the one who trained the gal I went to.

Aquatic exercises are helpful but the one part of your body that you need to strengthen is your core. Much of the strength you use to move, lift, even walk uses your core muscles. So even if you can't do a full set of floor exercises, try some modified ones.
One that our Senior Fitness gal uses is this one. Lean back in a chair, holding the sides of the seat with your hands so you don't slip. Stretch your legs out , with toes up, heels on the floor. Try to lift your legs up using your stomach muscles. If all you can do to start with is an inch, then do it. Periodically throughout the day, try to do it 2 or 3 times. As you can, increase the height you lift your legs and/or the number you do at a time. Make sure not to use your back muscles but your stomach. You will be able to feel what you are using.