An X-ray of Dimitra Lavrakas' shoulder pre-surgery.
Many Alaskan seniors age from physically demanding jobs that took them to remote parts of the state, from the fishing industry, to mining and oil production, as well as tourism activities like mountain guiding and heliskiing.
But modern medicine offers relief through joint replacement. While invasive and painful depending on your pain tolerance an operation will give you years of pain-free mobility. It's a life changer.
The damage to my left knee after being catapulted off a freight sled on the way out to a whaling camp at Point Barrow saw a joint replacement 30 years later. I had a replacement after the pain interfered with walking and sleeping. And my left shoulder was replaced a couple of months ago. I feel so much better.
Worried about cost? I have a basic United health Medicare Advantage insurance plan and the knee was $59,000, but I paid only $1,200. The shoulder was $49,000 and I paid $550. Hospitals do offer payment plans making the cost reasonable over time.
I have a friend who needs a knee replacement but opted for the steroid shots.
She can no longer walk much of a distance and from afar she has the gait of Popeye the Sailor.
The shots are quite painful because the needle is guided between bone and muscle. Breathing deeply and going in your mind to your happy place is advised.
Cortisone steroid shots-well, there's a drawback. The Mayo Clinic reports "There's concern that repeated cortisone shots might damage the cartilage within a joint. So, healthcare professionals typically limit the number of cortisone shots into a joint." Mayo also cautions about the shots damaging effects on what cartilage is left.
Usually, the shot is given every six months, but in the end, it's only delaying the inevitability of a replacement. However, the push for the shots could be attributed to the insurance companies wanting a cheaper method to deal with the pain before paying for a replacement.
When offered a course of shots, from which I never did get any relief, I reminded the doctor of this side effect and asked why not just have the operation.
Also, and this is kind of cheating, when asked what level the pain is on a scale from one to 10, I always say seven because it's a level doctors seem to take seriously.
There are so many people and so few physicians that it helps to make yourself memorable to the doctor. Older people can be dismissed so easily as whining hypochondriacs.
It took me seeing three shoulder replacement surgeons to finally get one who paid attention. I leave comments if they're good and also if they are bad.
Ask your primary care physician to recommend a surgeon and make sure you tell the surgeon your doctor praised their expertise.
New treatments on the way
New joint treatments target both bone density loss (osteoporosis) and cartilage degradation (osteoarthritis).
Advances include anabolic biologic injections to rapidly build new bone and cutting-edge research into single-dose regenerative shots to reverse cartilage damage.
Bone building and anabolic agents (substances that stimulate anabolism-the metabolic process that builds complex molecules like proteins and bone tissue.
For severe osteoporosis, new treatments actively build new bone mass rather than just slowing deterioration
Romosozumab (Evenity): An FDA-approved sclerostin inhibitor that increases bone formation and decreases bone breakdown. It is typically administered as a monthly injection in a doctor's office for up to one year.
Teriparatide (Forteo) and Abaloparatide (Tymlos): Parathyroid hormone-related drugs that stimulate new bone growth, given as daily injections for up to two years.
If your joint issues lean more toward osteoarthritis (joint osteoporosis/degeneration), new therapies aim to reverse tissue damage rather than just masking pain:
Regenerative injections: Research at institutions like the University of Colorado Anschutz shows early promise for single-dose therapies designed to fill damaged cartilage "potholes" and keep joints healthy for years.
Next-Generation Joint Replacements: Minimally invasive surgical techniques mean implants can now last up to 30 years, making procedures viable and highly effective for younger patients.
Biological disease-modifying drugs
If you have an autoimmune condition (like rheumatoid arthritis) accelerating bone and joint loss, biologic DMARDs and RANKL inhibitors (like Denosumab) can stabilize bone mineral density and halt the gradual wearing away, eating away, or superficial destruction of a body's surface tissue.
What you eat makes a difference
To damp down inflammation in the body, diet changes can help and also prevent inflammation.
Fill your plate with whole, minimally processed, and whole foods like omega-3 fatty acids: Alaskans have a plentiful supply of them in salmon, sardines and chia seeds. These healthy fats block compounds linked to inflammatory responses.
Phytonutrients and antioxidants: Found in deeply colored fruits like Alaska blueberries and vegetables (leafy greens).
Healthy oils: Extra-virgin olive oil contains polyphenols, naturally occurring compounds that protect your body from cellular wear and tear.
Fiber-rich foods: Legumes, beans, and whole grains.
Minimize foods that overwork your immune system and trigger inflammatory responses.
Refined carbohydrates and sugar: Spikes in blood sugar directly cause inflammation.
Processed meats and trans fats: Often found in packaged snacks, red meats and fried foods.
Added ingredients: Prepared foods often contain hidden salts and processed oils.
I hope this helps you on your pain-free journey to better aging. I feel your pain.
