QUINCY -- Nadine O'Brien's dream job cost her two knees and three years of pain.
Arthritis set in after 30 years of walking mail routes on uneven sidewalks and porch stairs. Still, that pain never stifled her smile or her good attitude as she delivered mail to her customers. She enjoys bringing them Christmas presents in December. She passes out post-holiday credit card bills as cheerfully as she can in January.
O'Brien, 52, considers the regulars on her route an extended part of her family. Those patrons -- and her eagerness to work -- have encouraged her as she's recovered from a double-knee replacement.
"I didn't want to do college," O'Brien said. "I wanted to stay active and meet people, but little did I know it was going to take such a toll on my body after 30 years."
Arthritis is the most common cause of disability in the United States, according to the Centers for Disease Control and Prevention. Arthritis causes pain, aching, stiffness and swelling near joints.
David Bingham, an orthopedic surgeon at Quincy Medical Group and O'Brien's doctor, said few arthritis patients seek knee replacements in their early 50s.
"Her knees were at least 20 years older than she was," Bingham said.
Knee replacements last 10 to 15 years, and having this surgery at a young age increases the likelihood of another such surgery later. He prefers to do replacements in people who will have the new knees for the rest of their lives.
"But you get people that are young and active, or would be, but their knees and hips are just killing them," Bingham said. "My attitude with that is (to) get them new knees and get them their lives back."
The disease has limited the activities of more than 21 million American adults.
O'Brien refuses to be limited. She plans to work another 10 years if her knees let her.
"Too many retire," she said. "They sit down. They gain weight. They get tired, and then they die. I don't want to even talk about that."
Bingham said new standards at Blessing Health System and Quincy Medical Group have allowed patients, such as O'Brien, to heal faster and experience less pain. Bingham has implemented more aggressive measures of pain control both before and after surgery. Post surgery, the patient's various specialists, nurses and home care team collectively visit to ensure all doctors are aware of any potential issues.
In the six weeks since her knee replacements, she's traded her usual Zumba classes and bowling league for therapy with athletic trainer Adam Lee. Lee said few patients progress as quickly in recovery as O'Brien. In a recent therapy session, her legs pushed double the weight they did just a few days before. Lee anticipated O'Brien may return to her route a mere 10 weeks after surgery.
"It's really easy to make progress when you have someone who works that hard," he said. "It's having patients like Nadine that remind me why I do what I do."
O'Brien talked with Lee as she pushed the weights. Her social, uplifting attitude served her as well in therapy as it had in her career. Eventually, the conversation distracted her from the exercise. She'd completed more than double what Lee had asked of her. At night, she continues on her own with leg lifts and short walks.
She looks forward to reclaiming her customers, her social life and her quality of life. As the arthritis set in and her knees rubbed bone on bone, it limited her level of activity. Pain medicine kept her moving during the day, but each night after work, her tired body slumped into the recliner. She's ready to start living again.
"Any day in the last year is more painful than anything Adam has put me through," O'Brien said. "I know I'm going to get through this and things are going to be better. Before this, I knew I was just going downhill."