Saving My Knees: How I Proved My Doctors Wrong and Beat Chronic Knee Pain (18 page)

Best of all, I got my life back
.

That’s not hyperbole. I still recall the moment, during my recovery, when I spontaneously began to laugh at something. The sound from my mouth seemed strange, and I suddenly realized why. For months I had been thoroughly miserable and depressed. For months I hadn’t freely laughed at anything.

Now I look to the future with optimism.

As I write these closing words, in what should be my last revision to this book, it’s now more than two years after my experiment to save my knees began. I’m cycling every week again, as intensely as ever, and my knees feel good. No, I’ll risk jinxing myself by telling the truth: they feel great.

It all starts by getting your hope back. Hope drove me forward; it was the only miracle drug I ever found during my long ordeal. This wasn’t a cheap, thin hope either, like that of a lottery player that maybe, just maybe, he holds the winning ticket against fifty-million-to-one odds. It was a hope that rested on the most solid of foundations: knowledge and experience.

August 2010

My knee journal traced the long arc of my recovery and the many highs and lows. Some entries appear below, in all their prosaic glory, with annotations in italics. They are included to show, in more detail, exactly what I was doing—and how I was constantly being proactive, thinking about my next move.

May 4, 2008
, Sunday
(Day six after leaving Bloomberg; the journey is just beginning!)

1008.6, 29.8
(Air pressure, followed by temperature in Celsius. Tracking these numbers may seem crazy, but again, it reflects my scientific-minded approach. To know how my exercise program was working, I wanted to be able to adjust for any other effects that could influence my knee scores, such as changes in weather.)

Morning: 7
(Once again, the scores are on a 1-20 scale. A “3” signals a good deal of misery; a “7” indicates moderate discomfort; a “13” stands for some discomfort that’s pretty much manageable; “18” means fleeting and only mild discomfort; “20” is for a knee that feels basically normal.)

Evening: 12

Woke up with right knee feeling a bit sore and full
(“Full” is generally code for some degree of swelling. One thing I learned early: Avoid anything that causes swelling because the joint is screaming that it can’t handle the stress. Any swelling, even mild, became one of my most-heeded “back off” signs. I would immediately reduce my exercise intensity, or even take a few easy days.)
Maybe walking in Tung Chung yesterday after Friday’s long walking is to blame. Discouraging.
(I constantly played medical Sherlock Holmes. Why am I having a bad morning? Well, what did I do yesterday? And the day before? In this case, a boat show outing with Cong the previous Friday racked up 9,552 steps (about four and three-quarter miles, though not all at once), which was followed by a day trip to Tung Chung on Saturday that involved more walking. Too much!)

End-of-day wrap: Good bounceback during day. Only one flat-stage walk, 3,415 steps, pretty short.
(Reacting to the bad morning, I reduce my walking to one and three-quarter miles.)

May 25, 2008
, Sunday
(Now I’m four weeks into my recovery program.)

1007, 29.1

Morning: 11

Evening: 8 
(This may seem confusing. Three weeks after the preceding entry, my morning score has improved, but my evening score has dropped! The lesson: don’t get too hung up on the numbers for each day. Healing bad knees is a long process. The scores really should be averaged over longer periods to be put in better perspective.)

Rain, sticky heat. Knees warm on waking
(“warm” and “hot” usually implied various degrees of inflammation)
, but that sensation went away after 10, 15 minutes of sitting. Three walks: 2,061 steps, 2,070 steps, 1,272 steps. Some crampiness in evening in both knees.
(I developed my own odd terminology to describe various knee states. “Crampiness” was a sensation I could quickly identify, though would be hard pressed to describe beyond saying it felt like the joint equivalent of muscle crampiness.)

Weekly plan and summary for week 5.
(I started doing a “plan and summary” at week’s end to put more structure into my program. Where was I at that moment? What was good about my condition, what was bad, and what was I going to try the following week? It was important to guard against the sense of just drifting along; I wanted to be moving forward purposefully.)

Plan: Still haven’t achieved goal #1, to do three daily walks of 2,000 steps.
(I was trying to build up to walking one mile, over flat, easy terrain, three times a day, without experiencing any symptoms—but I wasn’t strong enough yet.)
The plan for week five: 1. Three daily walks of about 2,000 steps each. 2. Basic stretching every day: four quad stretches each leg, one hamstring stretch each leg.
(Having healed now, I think stretching did nothing to help me. However, old habits die hard—my physical therapist believed in stretching—and so, early in my recovery, I made sure to cover all the bases. Gradually, as stretching’s ineffectiveness became clear, I phased it out.)
3. Crabwalks on Monday, Wednesday, Friday.
(I don’t talk about “crabwalks” elsewhere because I think their contribution to my healing was minimal. However, they were one of the few low-repetition exercises that my knees tolerated pretty well. How to do one? Knot a rubber resistance band (such as a Thera-Band) in a loop. Pull the loop over your ankles. Then walk with slightly bent knees side to side like a crab, back and forth, pushing outward against the band with each step. This strengthens your quads and butt muscles.)
Will continue with calf rises, 30 each morning.
(These are simple calf exercises done by standing flat-footed, then rising onto tiptoes, then dropping back to the flat-footed position, then repeating. I began doing them because my calf muscle, for no apparent reason, began aching. One thing I discovered: when your body doesn’t feel good, lots of things can go wrong!)

Summary:

Good: Crunch got a little lower.
(That is, my knees sounded less crunchy.)
Able to sit for a few hours at a stretch in a normal chair.
(This sounds trivial, but it represented a real victory! It meant that, for a little while, I could sit with my knees bent like a normal person’s, without pain or discomfort.)
Knees felt better during the day in the apartment and while doing walkarounds.
(“Walkarounds” was my shorthand for the periodic “dosed” motion I got walking around my apartment. Every fifteen minutes or so, my wind-up timer would ring, prompting me to get up and move around, taking about seventy steps each time.)

Bad: Got severe cramp in right calf one morning. Also bad that I’m not able to build up distance yet. Will be patient for another week at least.

June 28, 2008
, Saturday
(Two months have passed.)

1005.7, 28.4

Morning: 14

Evening: 14

Knees a touch warm and full when I woke up. Why? Can think of only three reasons: 1. Walked too fast yesterday. 2. Did almost 10,000 steps Thursday. 3. Cleaned yesterday, including a lot of standing, and briefly was kneeling on knees. Of the three, I think #3 is most likely. Bad sign last night: had some burning while standing and brushing teeth—been a while since I had that symptom. One other interesting possibility: have been wearing old sneakers a lot in past couple of days because of heavy rain. Been wearing them since Wednesday. It’s possible that my feet land differently and that stresses cartilage differently. Will switch back to running shoes today.
(This entry is notable because I’m playing detective at full intensity here, trying to figure out why I woke up a bit off. The larger point: if you want to win back your knee health, you have to pay much more attention to the joints to figure out what they like and don’t like, and how fast they can be nudged along in an exercise program. You have to stop being a passive owner of your knees and take an active interest in their welfare, all the time.)

Cut back on walking: 2,558 steps at noon and 3,020 steps at 6 p.m. Trying to let knees bounce back. Knees felt raw in the morning, but came back in afternoon.

September 28, 2008
, Sunday
(Five months in! The problem is, summer has been uneven, with a number of setbacks, so I want to try something new . . . which fails, as can be seen by the dropoff in my scores over the course of the day.)

Morning: 16

Evening: 10

Sunny, warm. Air pressure about 1008. Walks of 2,100 and 2,640 steps. Ten minutes of cycling in morning. Knees a little stiff at night.
(This signaled that my knees couldn’t tolerate cycling that well yet.)

November 20, 2008
, Thursday
(I’m closing in on the seven-month mark and am starting to do some vigorous walking, but challenges remain.)

Morning: 15

Evening: 14

Air pressure about 1023. Still dry, very cool. About 1,000 steps to plaza in morning, then 4,620 steps on monastery trail.
(This was the up-and-down path that allowed me to do some climbing, though at this point, I’m mostly traversing the flat stretches of the trail.)
Ended trail hike early because of right knee soreness.
(Here I’m reacting in an early, pre-emptive way, and not for the first time. I could have continued the hike with a little soreness, but the next morning I would’ve suffered a little, pushing me backwards in my attempt to heal.)
Knees bounced back over rest of the day though.

January 21, 2009
, Wednesday
(Almost nine months have passed and I’m definitely feeling better, but I have to guard against overconfidence.)

1016.9, 24.5

Morning: 18

Evening: 18

Warm, sunny. 10,218 steps on monastery trail. Some left kneecap tingling during hike; will monitor.
(I was always alert to unusual sensations from my knees and tried to categorize each. Was the sensation benign? A harbinger of trouble lurking? A sign to take the intensity down a notch?)

February 1, 2009
, Sunday
(I’ve entered month ten of my recovery and this day stood out as a particularly good one. A rare 19!)

1020.2, 20.3

Morning: 18

Evening: 19

Cloudy, cool. 1020 air pressure. 7,881 steps on flat stage. Knees really good at night.
(I began alternating walks on flat and hilly courses, so as not to push myself hard on consecutive days. Also, whenever I went more than four or five thousand steps, I sat down and rested for ten minutes at the midway point to let my knees recover a little. This is important though: my knees weren’t hurting and telling me to take a break; I began doing this simply because it made sense to me.)

March 9, 2009
, Saturday
(By now, month eleven, the nice thing is that there are many positive things showing up in my journal—many reasons to celebrate.)

1016.9, 18.8

Morning: 17

Evening: 18

Cool, overcast. 10,145 steps on monastery trail, with a little walk around Discovery Bay mixed in. Note: knees very good on trail going up and down, no twinges at all for first time ever. Also knees generally very, very good over the last three days—good sitting, walking. Is it cool weather or?
(Again, I’m considering what other factors may be influencing how I feel.)

April 5, 2008, Sunday
(I’m in month twelve, generally feeling strong enough to try things—such as riding my bike again.)

1014.6, 26.5

Morning: 18

Evening: 17

Sunny, warm. 30 minutes cycling, 6,609 steps on flat stage. (Because of the cycling, I cut back on my walking this day. Getting back on my Litespeed felt good! I still didn’t feel ready to ride regularly. On June 1, after returning to the United States, I began going out on the bike every couple of days. I did only forty minutes at first, spinning the pedals a lot, pushing them fast but not too hard. Rehabbing bad knees is all about patience!)

In writing this book, I consulted a wide variety of sources, from blogs to textbooks to leading medical journals. Instead of cluttering the main text with footnotes, or even notations for endnotes, I decided to include a select bibliography at the end. For readers wishing to delve more deeply into the subjects discussed on the preceding pages, below are some of my sources.

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