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Last week and I wrote about those vital organs, our liver and kidneys, and we were amazed to hear from so many of you who shared your various experiences that you have encountered in your lifetime. But one email really caught my eye…
As I read it, I felt that this extraordinary story should be shared as it was so inspirational.
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Hello Rosemary
I was very interested to read last Friday's newsletter. Kidneys are of great interest to me as I had a kidney transplant in 1970 and have been carefully looking after it for some 54 years. I was born with only one kidney that was damaged and it gave up working when I was just 16 years old. I was the youngest of six children in my family and proud to say all my siblings volunteered to give me a kidney. One of my brothers gave me a kidney 'as long as I took care of it' and that's just what I have done.
Unfortunately I have had many side-effects from the anti-rejection drugs I have to take. These have included needing hip and knee joint replacements, (sympathy to you and Mary for difficulties from orthopaedic surgery), skin cancers, muscle weakness and cataracts. Strangely I keep very good health otherwise even though I have been taking steroids for 54 years and have had mobility issues since I was still in my teenage years – and this has affected my weight and causes difficulty exercising. However, I have been lucky to be able to work for about 42 years of my 54 years transplanted, I have a son and two beautiful granddaughters.
Many thanks for all the interesting Newsletters that keep me up to date with all the latest news.
Janie
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I loved Janie’s positive attitude and no-nonsense approach to life. So, I contacted Janie and asked if I could reproduce it for this week’s Newsletter. She was very happy for me to do so.
Knowing nothing personally about organ transplants, I wanted to learn more about the side-effects Janie described and the various conditions she has had to endure over the years, but she emphasised that not everyone who has undertaken an organ transplant experiences what she has had to.
Janie explained that the joint replacements were due to developing ‘avascular necrosis’ so I did some research and this is what I learned:
Avascular necrosis (also known as osteonecrosis) occurs when there is a loss of blood supply to the bone, causing bone tissue to die and this can potentially lead to joint collapse. Side effects and complications include:
- Joint Pain: Pain often starts gradually and worsens over time. It may initially be felt during weight-bearing activities and later become constant.
- Limited Range of Motion: As the condition progresses, joint stiffness and reduced mobility may occur.
- Joint Collapse: Without treatment, the affected bone and joint can deteriorate, potentially leading to joint collapse and severe arthritis.
- Secondary Osteoarthritis: The loss of bone and joint structure can result in arthritis, especially in weight-bearing joints like the hip or knee.
- Increased Risk of Fractures: The weakened bone is more susceptible to fractures, which can complicate the condition.
The other conditions Janie experienced were due to the immunosuppressive drugs that she had to take to prevent her new kidney being rejected. These drugs, particularly the steroids, resulted in her to being much more vulnerable to contracting cancers such as melanoma and lymphoma, and also weakened muscles.
As we chatted, I learned that every step that Janie takes is painful because of the joint issues, so going for a 30 minute daily walk would be out of the question. I enquired what exercises she was able to do and was impressed to learn how Janie has adapted and addressed her limitations.
She has an exercise bike at home on which she exercises for 30 minutes every single day. She plays her favourite music tracks and absolutely loves it. Brilliant! An exercise bike is non-impact so perfect for Janie’s painful joints.
Asking if she is able to do any strength exercises, she explained that she invested in a private physiotherapist who set her a 20-minute strength workout designed around her capabilities and she religiously does them three times a week.
I was blown away by Janie’s positive attitude and her determination to live the best life she can – remembering those words from her donor-brother ‘as long as you take care of it!’ As I explained to Janie how impressed I was with her tremendous achievements, even more so now that she is 71, she explained quite simply ‘I do this for me’.
Janie, I think your brother must be very proud of you! Well done, indeed! You are an inspiration.
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Smoked Haddock and Potato Pie
Serves 6
Per serving: 268 calories, 1.8g fat
Prep time: 10 mins
Cook time: 50 mins
2 baby leeks, finely chopped
2 garlic cloves, crushed
2 tsps finely chopped fresh thyme
450ml skimmed milk
2 tbsps plain flour
150ml white wine
2 – 3 tsps mild course grain mustard
1 tbsp chopped fresh parsley
700g potatoes, peeled
2 tbsps fat-free Greek yogurt
700g naturally smoked haddock
vegetable stock cube
freshly ground black pepper
zest of 1 lemon plus dill to garnish
- Preheat the oven to 200°C, 400°F, Gas Mark 6.
- Preheat a non-stick saucepan. Add the leeks, garlic and thyme, stirring well. Reduce the heat and add 3 tbsps of milk. Sprinkle the flour over, then stir it in quickly to form a roux. Cook for 1 minute to allow the flour to ‘cook out’, then gradually mix in the remaining milk.
- Add the wine, mustard and parsley bringing the sauce to a gentle simmer. Simmer for 10 minutes, stirring occasionally.
- Meanwhile, boil the potatoes in a saucepan with a vegetable stock cube until well cooked. Drain and mash well until smooth, adding the Greek yogurt and seasoning well with plenty of black pepper.
- Skin the fish by pulling the skin from the thickest part in the direction towards the tail – it should come away quite easily.
- Cut the fish into chunks, checking it for bones, and place in the bottom of an ovenproof dish. Cover with the sauce.
- Using a fork, smooth the potatoes on top. Bake in the oven for 30 – 40 minutes until golden.
- Just before serving, garnish with lemon zest and a little chopped dill
Chef's Tip: Try to buy naturally smoked fish, which is pale yellow in colour. The bright yellow fish often sold in supermarkets has been dipped into a coloured chemical flavoured dye to give a smoked flavour.
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Don't forget, you can download and print a copy of all our recipes if you click on the image to go to the recipe's page on the website.
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Fun, Facts & Fitness from Mary Morris MSc.
This week I am focussing on those joints of the body that are most likely to present us with problems as we age – the hips and knees.
Along with feet which I will discuss another week, these are the joints that are more likely to become arthritic due to the fact that they take a heavy load over the years and are therefore more at risk of excessive wear and tear. Osteoarthritis is the most common condition associated with ageing and it can affect any joint, but is more likely to affect those that take the most weight.
The smooth and slippery cartilage that covers the ends of the bones, helping them to move freely, gets rougher and thinner until it eventually gets worn away completely, leaving us with bone on bone – very painful!
What makes arthritis worse?
- Being overweight. It is really important that if we are starting to experience problems with our hips and knees that we are not too heavy. It is pretty obvious that excess weight will put a lot of extra pressure on the joints and increase the rate of wear and tear.
- Lifestyle Choices. This is particularly related to keeping moving so the joints don’t become 'stiff'. If you have always been rather sedentary then now is the time to take up some appropriate exercise that suits your ailing joints! On the other hand, be careful if you have always been an avid exerciser, participating in heavy-duty training. It may be that now you need to moderate the intensity with more low-impact and mobility exercises, putting less pressure on your joints.
- Diet. It will be no surprise to learn that the best diet to follow is the Mediterranean one. A study published in the Journal of Nutrition, Health and Ageing in 2017 found that those who followed this diet for 16 weeks had decreased levels of inflammatory protein in their blood and gained significant improvements in their hip and knee mobility, compared to those who did not. Who would have thought our diet could have such a profound impact on our joints?
- Genetics. Sadly, our mum and dad will have had a great influence here. There is a hereditary gene that leaves us pre-disposed to arthritis. This is definitely something I inherited as my grandparents and parents all suffered severe arthritis – thankfully, we can have our joints replaced today. Previous generations were not so fortunate.
- Past Injury. If we suffer a serious injury to a joint then arthritis may set in earlier than it otherwise would have done.
- Age-related muscle loss. This is called sarcopenia and there is a strong link between the loss of muscle and more pressure on the joints. When the muscle size decreases then the joints are tasked with taking the strain. Keep up with those strength workouts!
THE HIPS
By comparison with the very shallow ball and socket shoulder joint, the hip joint is set deep in the pelvis and has the reputation of being very stable, but as previously alluded to, it has to take a lot of wear and tear over many years. And if we have been very sporty, particularly with contact sports, then we may have experienced rapid wear and tear, so that in older age we need to have them replaced. Hip replacement is a very successful operation these days and is far less of a problem than having a knee replaced. I say that from personal experience!
I had my hip resurfaced at the age of 54, so exactly 20 years ago, and I have to say it has served me extremely well and I do not have much trouble with it. However, many women suffered severe problems with this type of partial hip replacement remedy and today it is no longer performed on females due to the size of our hips being smaller than a male and also the angle of the pelvis (a female pelvis is at much more of an angle than a male). Now, a full total replacement is the only option for women.
Andy Murray had a re-surface because he is still very active in his sport and it was a better choice than a full hip replacement. ‘Resurfacing’ is unlike a total replacement as it retains more of the bone and the surfaces are metal on metal. It affords a quicker recovery too.
Two Exercises for the Hips
- Stand upright with both hands on the back of a chair or edge of a worktop. Slowly lift and lower alternate straight legs behind you, maintaining an upright posture throughout. This is designed to strengthen the muscles (gluteus maximus) at the back of the hip. Do 10 lifts, under control, with each leg.
- Still holding on to the back of a chair or worktop, lift left leg outwards away from the body as high as you can while keeping your trunk upright. Hold it out for 2 seconds then return. Do 10 then repeat with other leg.
THE KNEES
Knee problems develop over many years. They can give us some pain and discomfort and then settle down again and that can go on for a very long time. There will then be a point when we know we need to get them investigated to be told whether they are ready for surgery. Initially we may be offered an arthroscopy which simply cleans out any debris in the joint that may be causing us the pain. Another option is to have a steroid injection in the joint which again, for some, works for a period of time allowing for the knee to settle down again. Some find these options useful and others may find they didn’t help.
Rosemary had an arthroscopy five years before she had a partial knee replacement last year. As the name suggests, this involved only having part of her knee replaced. Alternatively, like myself, it may be necessary to have what is called a ‘total knee replacement’.
My personal experience of knee surgery is that it is far more challenging than the hip. It is a more complex hinge joint that is more difficult for the surgeon to replace, mainly due to the need for precise alignment. The recovery also takes longer and requires a total commitment to doing physiotherapy to get the best outcome.
One of my walkers told me of a lady who had her knee replacement at the same time as mine and she is still using two sticks to get around, whereas I am back to walking with my groups (not as fast yet, but getting there). She was slightly older than me, so that can make a difference, and probably not as fit as I was before surgery, but I believe that the big difference comes from how much we put into our exercising before surgery as well as after, to afford the best outcome.
Two Exercises for the Knees
- Sitting upright on the edge of a chair and feet flat on the floor, straighten one leg fully out and raise it parallel to the floor. Pull your toes towards you and hold for 2 seconds before bending and lowering again. Do 5 on each leg before changing legs and repeat another set. Build up to a 5 second hold if possible.
- Step ups. Using the bottom step of a set of stairs, step up on the right leg, follow with the left and step down again with the right, followed by the left. Repeat leading with the right leg 5 times then change to lead with the left leg.
Nuffield Health Joint Pain Programme
Recently, I came across this and it may interest you if you find you are beginning to suffer with your joints and would like to join a programme specifically designed to help. This is run by Nuffield Health – a UK health charity and not-for-profit organisation – who have set up a six-month programme to help people relieve joint pain and go on to lead a more independent life. It begins with a 12-week lifestyle advice and exercise session, led by a rehabilitation specialist. It sounds too good to be true as it costs you nothing but it also sounds incredibly useful. Go to www.nuffieldhealth.com to find out if there is a course running in your area.
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This Week's Fitness Challenge
- Be committed to your Strength training this week. If you are to protect your joints in the long term, it is a no-brainer! Choose 3 whole body programmes.
- Walking regularly is excellent exercise for the knees and hips. Go for your 30-minute daily walk and walking uphill pushes them even more.
- Regular stretching maintains your range-of-movement in your joints so follow a stretch programme 3 times this week.
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Did you know... 
The Kidney is the most commonly transplanted organ in the human body with nearly 3000 transplants a year in the UK. The first successful transplant in the UK took place in 1960 and there are now 24 specialist kidney transplant centres in hospitals across the country.
Liver transplants are less common with around 800 per year taking place in 7 operating centres and rarer still, there are around 150 heart transplants occuring each year.
 In addition to these three well known transplant operations there is now a large number of things that you can usefully donate either before or after your death including blood, tissue and stem cells.
Every day thousands of people’s lives are saved or improved thanks to the generosity of donors but there are still many more patients awaiting treatment due to lack of supplies.
If you would like to know more look at the NHS Blood and Transplant website at www.nhsbt.nhs.uk
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And finally...
Learning more about how our body works and what are our likely weak spots as we grow older is both interesting and helpful insofar as we can work hard to prevent problems whilst we still can. Then, if they do present us with an issue that needs addressing in later years, we can hopefully embrace the remedial action necessary and achieve the very best outcome.
Thank you, Janie, for being amazing. Let’s all embrace this attitude and make the same effort as Janie, saying her magic words to ourselves – ‘I am doing this for me!’
Let’s all have a great week!
With love and best wishes,
Rosemary Conley CBE DL
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LIVE LONGER | LIVE HEALTHIER | LIVE HAPPIER
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