Saving My Knees: How I Proved My Doctors Wrong and Beat Chronic Knee Pain (13 page)

If a doctor had agreed, that would have cinched things. But Dr. Chiu examined my knees again, listened to them crunch when I dropped into a squatting position, and told me they would never get better. I disagreed, saying they stood a chance of healing if I could eliminate the constant burning. Did he know of a special chair that would raise my legs and also keep them straight? I offered to pay for it out of my own pocket.

“Unfortunately there’s no good chair in the world,” he said. His matter-of-fact tone left no doubt. He couldn’t—or wouldn’t—assist me.

Finally, I pushed the company to make a decision. By staying behind a desk, I was just digging myself a deeper hole. One afternoon, an editor from London called to break the news: I should resign, then reapply after I got better.

That outcome wasn’t unexpected, but I still recall feeling a bit shocked. My mouth went dry. It was late April. Congyu and I were to be married on August 8, less than four months away. And I would be unemployed, facing a grim future if my doctors proved correct and my knees didn’t heal.

At least I had a plan. I had recently signed a new lease on my apartment, in order to stay in Hong Kong for twelve more months. That would allow Congyu and I to get married in China, near her family, and give her time to see if her fledgling startup business might take off (she and her best friend ran a consulting firm that offered management and sales training for Chinese companies). Meanwhile, in Hong Kong I would focus like a laser on saving my knees. Every day would be a knee day.

Just before leaving Bloomberg, I had a vivid, disturbing dream. I was sitting in the rear of a bus, traveling through the countryside. The bus stopped at a store and all the riders got out. I wandered over to an establishment next door and began chatting with a few locals, telling them tornado stories from a book that I’d written. Then at some moment I realized, with a feeling of panic, that I’d lost track of time. The bus, with Congyu aboard, was gone. I remember an awful feeling of abandonment.

The meaning of the dream was clear. Only one other time in my adult life had I so precipitously left a full-time job. In the early 1990s, I abruptly quit as a reporter for a small daily in southeastern Pennsylvania, packed my worldly goods in my Toyota Corolla, and relocated to Oklahoma to realize an ambition, to write a book about living in the heart of Tornado Alley.

It turned out to be a terrific educational experience, though later I vowed not to throw caution to the winds like that again. Then the situation with my knees left me no choice. This time, I was better fortified financially. Still, no matter how much you soothe yourself that everything will be all right, taking the plunge—leaving your job, your tether to financial security and social respectability—is frightening.

Later, I wondered if the anxiety permeating my missed-bus dream was actually an omen. I was about to go through the worst summer of my life.

For me, 2008 will always be the Year Of The Lost Summer. Over the course of three months, a confluence of bad luck and bad decisions caused my life to keep getting worse. By the end of August, if I had woken one morning to find hordes of locusts swarming in off the balcony, it wouldn’t have surprised me.

What should have been a summer of slow, steady gains for my ailing knees became a nightmare.

One reason everything fell apart over that wet, then sultry summer: I unwittingly had done something that proved foolish. You might say I had grabbed a snake by the tail. The snake masqueraded as a friend, but finally snapped up to bite me. This treacherous serpent was my good old buddy, the coping strategy.

For injuries that heal in a few weeks or a month or two, coping strategies are often benign. We all know what they look like and may hardly notice them. Someone leans heavily on the banister when descending stairs to take pressure off that hurt foot. Or swivels his entire upper body when looking to the side, waiting for that painful crick in his neck to go away.

A chronic injury can reveal the evil face of coping strategies. They allow us to work around a problem without fixing it. When we do that, we may start using our bodies in ways that quietly shift stress elsewhere, creating new problems.

My main coping strategy revolved around the uncomfortable act of sitting. My legs wanted to be extended and elevated. At work, I hung a sling under my desk to prop them up. That left me casting about for a solution at home. It wasn’t long before I bought my first “chondro” chair—short for “chondromalacia” of course.

I found it in Causeway Bay, the glittery shopping mecca of Hong Kong. An underground furniture store tucked off the beaten track stocked a cornucopia of chairs. One low-slung leisure model put my butt close to the ground and my knees inches higher. The geometry looked perfect. Plus the tube-metal frame was light and the price cheap, at twenty-six bucks. I had nothing to lose.

After lugging the box home, I quickly assembled the pieces and sank down into the lime-green, napped fabric. The burning in my knees lessened appreciably. So much for my doctor’s claim that no chair in the world would alleviate my symptoms! I shoved my expensive office swivel seat into a corner. For months my chondro chair was the place where I worked at my computer and played my guitar.

The chair worked so well that I sought a more upscale version for work. One Saturday I paid a visit to Hong Kong’s “furniture capital,” Ap Lei Chau. This islet hangs off the southern coast of the main island; I remember taking a long taxi ride to get there. The driver deposited me at a tall, drab building that contained an eclectic mix of furniture stores on its many floors. I picked out chondro chair number two among a display of items for boats. The attractive, sturdy deck chair had eggshell-white canvas cushions. It would have looked perfectly at home on a luxury sailboat.

Two days later, there I was at Bloomberg’s offices, maneuvering a cherry-wood deck chair down the twisting glass staircase to my work station. My cargo was heavy, but I had fashioned a makeshift carrying strap from an old belt. My co-workers made the expected quips. “It sure feels relaxed around here now,” one reporter said. The joshing was all good-natured. They knew I was struggling to find a way to keep working.

My chondro chairs and underdesk sling were blatant examples of coping strategies. When I told Tim about the sling, he warned me that I would develop back problems. Keeping my legs raised and straight, while bending over a keyboard, put constant pressure on my spine. I had a nagging suspicion he was right. But what else could I do?

A month before I quit Bloomberg, the back problems began. For three-quarters of a year, I had been sitting every day at a stressful job in an unnatural position. Finally my spine could no longer tolerate the strain. My back tightened and seized up while I sat. I would rise from my seat, grimacing, and walk around to try to manage the pain. The deck chair proved to be a wash: better for my knees but worse for my back. I had to abandon it.

Next came a nasty case of tendinitis. A week before leaving my job, I noticed a spot of soreness on my left inner forearm, near the elbow. The tendon had gotten sore a few times before that, while I noodled about on the guitar. My green chondro chair put me in awkward ergonomic positions, whether for strumming the instrument or typing at the computer (my wireless keyboard often balanced on my knees). Sometimes my burning joints forced me to strum songs more or less lying on my back. I contorted my body into strange positions to try to keep doing the things I loved.

Post-Bloomberg, the tendon became chronically inflamed. Then the same tendon on the right side grew tender and painful as well. It soon became clear this wasn’t a garden-variety ailment. Brushing my teeth hurt. Clapping my hands together to kill a fly hurt. Lifting headphones off my ears hurt. Carrying a bag that held no more than a foot-long Subway sandwich hurt. One night I probed the tendons and listened to them slide around. They were like hot, dry, creaky sticks. It was as if, had I moved the wrong way, they would’ve snapped like frail dowels.

So I was jobless, ready to embark on a year-long crusade dedicated to healing, and had a bad back, two bad knees and two bad forearms.

An appointment with a general physician confirmed that I had medial epicondylitis, also known as golfer’s elbow. “Medial” in this context refers to inner; the bad tendons lay near the inside knob of the elbows. He recommended physical therapy. Fortunately, my departure from Bloomberg at the end of April didn’t immediately terminate my company-sponsored health insurance. So I made the acquaintance of my third physical therapist. I’ll call her Patty.

She was a young, peppy Asian of small build who got right down to business. My first appointment, I received two kinds of treatment. Patty used ultrasound to warm the injured area and to speed healing. She also attached stick-on pads to my forearms, then turned on a machine that directed a soft flow of electrical current through the pads to relax the muscles in the area.

Patty then handed me three photocopied pages of almost a dozen exercises and stretches. Each was accompanied by a simple diagram. She skimmed down the list, one by one, as though ordering from a Chinese menu. She crossed out a few and checked others. She wrote down how many repetitions and how many sets.

What she failed to do became obvious after the exercises overstressed my left elbow, the weaker of the two, and the joint developed the bulbous swelling of bursitis. She hadn’t made any attempt to find out how strong my forearms were before blithely prescribing ten of this, fifteen of the other. One exercise involved sitting with my palms behind me and flat to the floor, then leaning back and bending, then straightening, my arms. She prescribed fifteen of these a day. But she didn’t know if I could do even one comfortably.

The inflammation continued to ravage my tendons and make them extremely weak. They even reacted badly to activities of light stress, such as typing and writing longhand. The severity and persistence of the condition alarmed me. I was no expert on tendinitis, but began to wonder if something else was going on.

So I return to a favorite theme:
Before devising a plan to heal, you need to know what’s wrong and what’s causing it to be wrong
. In this case, diagnosing medial epicondylitis seemed like the easy part. More difficult was precisely determining the cause.

The reason for nagging tendinitis isn’t always obvious, I knew from an experience in South Florida. At the time I was doing a lot of cycling, and an adductor tendon on the inside of my right thigh started to bother me. At first glance, it seemed related to my riding more than one hundred miles a week. A doctor advised doing five to fifteen minutes of adductor and hip muscle stretches before and after cycling. I followed his advice, but couldn’t shake the injury. I was baffled and annoyed. Why had this sprung up so suddenly? I had been putting in long miles on my bike for years.

Then I started doing a little detective work on my own and realized something. Not long before, I had moved my bicycle seat forward a few inches to build up my quadriceps muscles more, to make me a better sprinter. The change wasn’t much at all, but the new position altered how I used my muscles when pedaling. I remember immediately being struck by how remarkable the difference was.

After deducing that my seat might be at fault, I slid it back to a normal position. After some weeks, the tendinitis faded away.

Still, that battle with sore tendons was nothing compared with what I suffered in Hong Kong. During the summer of 2008, my forearms would ache, a deep, dull sensation that felt ten times worse than sharp pain. Sometimes nausea swept over me and I fought the urge to throw up. By itself, even a chondro chair that caused me to adopt terrible ergonomic positions couldn’t cause a condition that extreme, I thought.

Then, while idling away another evening at home, I decided to watch the old Hitchcock classic
Notorious
on DVD. The Ingrid Bergman character is a spy who’s been found out. Instead of being exposed, she’s surreptitiously given small doses of a poison that keep her weak and bedridden. After the movie ended, something clicked in my head. Could anything in my environment be “poisoning” me and contributing to my problem?

Medications couldn’t be to blame, it seemed. I didn’t take any. Upon further reflection, I realized that wasn’t quite true: there was the Rogaine.

It was kind of silly, my attempt in middle age to grow back some hair that genetics had robbed me of. The product hadn’t done much either, from a casual inspection of my pate. There might be a dozen or so hairs that Rogaine could take credit for. I rubbed it onto my scalp once daily, just before going to bed.

Then I thought about the symptoms of my tendinitis: they were always worse in the morning and improved as the day progressed.

Curious, I went online and did a search on “minoxidil,” the active ingredient in the hair-restoration product. A few clicks brought me to a Web page about the drug, maintained by the University of Maryland Medical Center, a well-known teaching hospital. Among the listed side effects: tendinitis. Elsewhere I learned about the maker of Rogaine’s own clinical trials. Patients suffered a number of adverse reactions. These included tendinitis.

That the Rogaine might be involved in my epicondylitis spurred me to action. I wasted no time tossing it out. After that, the worst episodes of pain went away.

Even so, the tendons were already badly damaged. Chronic inflammation had swept through them like a forest fire that crackles through a stand of trees on a dry summer day, leaving behind charred remains. They continued to be sore and weak all summer long.

At least my medical mystery was solved. Or was it? As I struggled with multiple health problems, a disquieting thought crossed my mind. What if everything happened to be connected? It didn’t take long to pinpoint a common denominator: joints. Knees . . . tendons . . . spine.

My research branched off in an unpleasant direction. I began to look at autoimmune diseases, such as rheumatoid arthritis and reactive arthritis. The former seemed the bleakest. In rheumatoid arthritis, for reasons unclear, your immune system attacks your joints. It’s as though the troops designed to protect your body get confused and go beserk, trying to destroy the very organism they are supposed to defend. Joints swell. Cartilage breaks down. Bone erodes. This form of arthritis usually strikes between the ages of thirty-five and fifty.

During a long-distance phone call, my father urged me to have a blood test. The symmetry of my joint pain matched well the classic pattern of rheumatoid arthritis. I wondered whether other perplexing symptoms might fit too. My knees suffered from what seemed like an unusual amount of inflammation. Also, while I was under emotional stress, the burning sensation would worsen or even appear out of nowhere. Was that significant? Or simply a reflection of how weak my knees were?

The possibility of having rheumatoid arthritis scared me a lot. If my own body was sabotaging my attempts to heal, I feared becoming an impotent bystander, forced to helplessly watch a terrible process beyond my control. Nonetheless, I wanted to settle the matter and so arranged to see a rheumatologist.

After making the appointment, I began to have second thoughts. Many of my symptoms didn’t line up with those of rheumatoid arthritis. My joints were painful, but not swollen. I didn’t have morning stiffness. I didn’t feel fatigued or feverish.

From the outset, the rheumatologist who examined me seemed doubtful as well. He checked the strength of my hands and their mobility and found them to be perfectly normal. He didn’t see any evidence of rheumatoid arthritis, though he ordered an X-ray of my hands and a blood test to be more certain.

My next visit, he shared the results with a shrug. The thin finger bones of my hand looked fine, according to the X-ray images. The blood test didn’t spot anything strange in measurements of two markers of inflammation. My sedimentation rate, or the speed at which red blood cells settle out in a test tube, was reported to be within a normal range. If there was inflammation, the cells would clump together and fall out faster. The other marker, the level of C-reactive protein in my blood, came in low—a very good finding.

More hopeful news followed when the bursitis lump on my left elbow was drained. A lab test was negative for the presence of bacteria. The swelling didn’t appear to be related to any kind of infection.

I heaved a huge sigh of relief after getting all the good test results. I had dodged a nasty bullet. I would have celebrated, except my arms were still almost useless. The aching tendons became sore easily. They made it impossible for me to do many of the activities that I had planned for those twelve months away from the workplace, such as learning Photoshop and doing some composing on my guitar. Odd as it sounds for someone living in an international city, I started to worry about going stir crazy.