Hi Mr. Macabre,
I am so sorry for what you are going through. You wrote:
"He knows how much pain I'm in though on a daily basis..."
Now I'm not a Dr, but my knee surgeon said that once I reached the point you're at, it's time to do the replacement. I'd find another surgeon. I look for surgeons in their mid 30s to late 40s, with a good med school/residency/fellowship pedigree, great references, and with thousands of surgeries under their belt. These surgeons are young, talented, and ambitious at this point in their careers.
As for losing 30 lbs, that should be a suggestion, not something that needs to be done ahead of surgery imo. Rehab doesn't include any impact activities, in fact you won't be able to do impact activities with new knees. I understand you're a big guy, but big guys get bad knees too and should not have to live with pain.
I would not give up Mr. Macabre. Look for a new surgeon. And if you are bone-on-bone in your knees, that is, there is no cartilage left, you should get approved by insurance.
Again I am so sorry for what you are going through. It certainly sounds to me like you need replacements. Find a new doc and get approved for the replacements.
All the best to you sir. And please let me know if you find someone who can do the surgery. And I'd fight insurance as well. Bone-on-bone with arthritis is a condition that can only be relieved long-term by a TKR, as far as I know. And it sounds like the same is true for your hip(s). I had horrible pain in my groin from my arthritic hip and only a replacement fixed it.
(Also, your history of arthroscopic procedures should tell a surgeon and insurance that it's time for a total replacement, knees and hips. I had both knees scoped twice each before my TKRs. Enough.)
Joe
Thank you for your response, I really appreciate it. I've had a total of 5 surgeries on both knees, once on the right back in 2011, and 4 in total on the left. My GP knows my medical history better than any one else, and I know he sympathizes for me and thinks I need the procedures. My current orthopedist was my doctor from 2016 to early 2018. I've gone back to see him after the surgeon who did the partial retired, so he's my "new" old doctor. He did the last scope on my left knee, and removed half a dozen bone chips from my right elbow for me.
After the last arthroscopic procedure on my knee, I had to go back to see him to have my knee drained of excess fluid every 4 or 5 weeks until he basically gave up and referred me to the doctor who did the partial. No one in his office could figure out where all the fluid was coming from, and why it built up so fast. My left knee is full of excess fluid as well, but because of the partial appliance in there, they don't want to drain it for fear of an infection, so I'm in pain in that knee as well, again.
I guess I can try asking my GP for a referral to another orthopedist, it would be my 6th surgeon since 2010. I'll have to discuss it with my wife and see what she thinks, but the thought of those medical bills coming back is scary. We're having a hard time keeping our heads above water as it is, my SSDI benefit have given us a big decrease in our income. I've given some serious thought to just swearing off of medical specialists like orthopedists and neurosurgeons and just putting up with pain for the rest of my life. I'm not going to bankrupt my wife and myself, or my family with medical bills because I'm in pain, it's not fair to them.