Saturday, November 22, 2008

Health update

Well I got back from the doctor and, not surprisingly, I need to do more physiotherapy and work harder at this. I explained to him the exercise programme I had been undergoing with my physiotherapist and then three weeks after I stopped physiotherapy I did my exercises (exercise bike) and the next day my knees were in agony. I figured I was pushing myself too much so did not exercise for the next two weeks to let the knees rest and heal. The doctor was not happy with me for that.

Apparently there are three ways I can do this: not exercise (bad), exercise but do it incorrectly (very bad), and exercise properly (good). He figures what was happening was that the exercise bike had too large of a radius on the pedals so I was either straightening my leg out completely on the bike, which is not good because it rubs the kneecap into the cartlidge, or I was bending the knee too much, which is also bad because it pushes the kneecap into the cartlidge. I need to make sure that I do neither of those things because it will make the injury a lot worse, as I discovered. But stopping exercise is also bad because the only way I will get better is if the quadricep muscles strengthen to help hold the kneecap steadier.

Then it was time for the Serious Talk. My legs are not perfectly straight and the knees bend inward a little. (I think it is genetic as I recall my father had problems with his knees as well.) This causes the bones and the knee to rub a little more against the medial cartlidge than it should, wearing down the cartlidge and causing inflammation. While this is the first time I have had this pain in my knees it was only a matter of time. The injury from the hiking and walking around during my summer vacation only highlighted the issue early, even if that hadn't happened I would have been in the same situation maybe a few years later. So the doctor said to consider this as a very early stage osteoarthrosis (i.e. arthritis). It is likely that sometime in the future I will develop arthritis in the knee joints. How long in the future depends on me, if I do not take this seriously and don't do the right exercises and strengthening then arthritis will set in early, do the right thing and it could be a long time (?decades?), if ever. But this is not a problem that will just go away, my knees will never just "feel better after a rest" and then I can go back to living the way I did before. I have got to keep up a proper exercise regimen to prevent this occurring in the future. He was even using terms like "it will help reduce the pain and discomfort and make it more manageable".

Make it more manageable!?! Arthritis!? Never go away!? *Ack*

So that was that. More physiotherapy, proper exercise, take this seriously. I also have an MRI scheduled for late December just to see how much the cartlidge is damaged.

Surprisingly I took it rather positively. I think it's because I'm one of those types of people who would rather know what was going on, even if it was not a great diagnosis, then be in discomfort and have no idea what was going on. Uncertainty makes me nervous. So having more information such as why I was in agony after exercising a few weeks back was really helpful and made me feel relieved. We had a long talk about proper exercises and other things to do. I left his office feeling fairly upbeat to be honest, which on reflection is strange considering I have a chronic long-term problem.

So that means it is time for serious changes:

1) Physiotherapy. I did six sessions before, the doctor told me that was not enough and I should be doing a lot more.

2) Exercise. Something I've always done but now the type of exercise has got to change.

Out: running, hiking/long walks, stairclimber

In: swimming, isometrics, exercise bike (proper size, might have to buy one)

Maybe: weight training (doc warned me that if I do weights it is VERY important I do that properly because if I don't it will really mess my knees up)

3) Take care in how I sit at work, I should avoid folding my legs under the chair as that bends the knees a lot.

4) Lose weight. Simple logic, the less you weigh the less stress there is on the knees.

Now I have always been on the overweight side but never obese (according to BMI). Like many people I lose weight and regain it, and so on. Unlike most people that yo-yo-ing is only in a range of 10-12kg (22-27 pounds). I think in the last 10 years I have never been out of that range. Time for that to change, and that will likely be the hardest part of this all. But I've started already -- the fridge is now full of fresh fruit and vegetables. For the last two days I have been cutting back on portions, and will tell friends and colleagues why I am dieting so that hopefully they will help stop me if I start reaching for the treats and snacks that seem to flow frequently around the workplace. Hopefully after a few months my weight will have dropped a decent amount.

And so starts a new beginning...


Karen C said...

Hello again Glen... Was very sorry to hear about those knees.
I also received the same news about 10 years ago. If you have read the e-mail I sent you, then you now know the decision I finally made after trying all other remedies. I still have my bike with the pedals set to the proper length for my legs. I only ride in the spring and fall as our Ontario summers are hot and humid.
I sure hope all this works for you. I do know weight control does help. I gained weight from lack of walking due to the pain but I think I now have that part controlled so that I can do more walking,,, hopefully around Qatar.
If I can lose about 10/15 lbs and get back to 125 or 130 lbs then maybe the pain will ease up.
I should call this Skeptic On Knees. (smile)
Anyways, only time will tell & heal.
Take care Glen.
P S I also would have voted for Obama. Palin; not sure how she got to where she is, very scarey.

Glen McKay said...

You sent an e-mail Karen? I don't think I received it.