Note: At some point soon I hope to have things to blog about besides my left knee! Promise.
The surgeon looked at my x-rays and my MRI and said, “Ouch. That must hurt.”
There’s pretty much no cartilage and no meniscus left apparently. I’ve run out and there’s no growing more. I’ve got bone rubbing and grinding on bone and that hurts.
On the treatment side, things have gotten better with physio but there’s still too much pain and I can’t do lots of the things I used to love.
Hence my visit to the knee expert.
I told the doctor I’d given up soccer. I’ve also given up running and Aikido. But I don’t want to give up long hikes, bike rides, skating, skiing etc.
He tells me that I’m an easy candidate for total knee replacement given the amount of damage to my knee but he worries that I’m too young and too active.
Instead, we’re going to try to fend off knee replacement for another ten years, maybe even fifteen.
Here’s the plan:
Step 1: Try Monovisc injections
Basically it’s injecting lube into the joint. They’re $400 and it’s not covered by our provincial health plan but it is covered by my benefits. Again, I’m feeling lucky. No risk. Some people find huge relief this way. Others not so much. We’ll see. I had the first one today. Weirdly not painful but strange feeling.
Step 2: Unloading knee brace
For long walks and other activities that strain the knee, I’m getting a custom knee brace. They are supposed to work well, if you use them. Lots of people don’t. They’re clunky and not that that easy to get used to. On the upside, I don’t need to wear one at work, just walking to and from. Also, I’ll wear it on long dog hikes. Might be a great argument for commuting by bike. Again, thank you benefits.
Photo of an unloading knee brace. This is the Precision Pro brand but they all look like this. There are no “dress” versions.
Step 3: Physio, physio, physio
I’m so lucky to have good benefits.
Step 4: High Tibial Osteotomy
If all this doesn’t work, I’m also a good candidate for another surgery that falls short of knee replacement and buys me some years. It’s recommended for younger, active patients. (I like that description.)
“Osteotomy literally means “cutting of the bone.” In a knee osteotomy, either the tibia (shinbone) or femur (thighbone) is cut and then reshaped to relieve pressure on the knee joint. Knee osteotomy is used when a patient has early-stage osteoarthritis that has damaged just one side of the knee joint.”
“A high tibial osteotomy is generally considered a method of prolonging the time before a knee replacement is necessary because the benefits typically fade after eight to ten years. This procedure is typically reserved for younger patients with pain resulting from instability and malalignment. An osteotomy may also be performed in conjunction with other joint preservation procedures in order to allow for cartilage repair tissue to grow without being subjected to excessive pressure.”
And here, complete with an animation of the procedure.
In the meantime, I’m thinking strategically about saving my knees, what’s left of them, for the things that I love. No more knee damage for the sake of training. More on that thought later!
Image description: SILENCE in blue neon lights over PLEASE in green neon lights, both against a dark brick wall.
I was so envious this past weekend because a few women I know went on a silent retreat. To some, a weekend of silence might sound terrifying. But to me, it would be a welcome respite from the noise of modern life. Seriously. I can’t think of anything I appreciate more than silence. It’s so… undemanding. And warm. And calming.
Last week I #tbt’d a post about meditation. So clearly I’m craving more time to retreat into silence. It’s true that the inner world can be noisy too, when the mind churns and spins. But the more silence I am able to call into my life, the quieter the chatter in my mind becomes.
I went on my first silent retreat about 15 years ago, taking three days at a retreat centre on Lake Erie in the middle of the week. Other than the nuns and the kitchen staff, I was the only resident and I felt as if I’d hit the jackpot. They respected my desire for silence and allowed me to wander the beautiful grounds without having to interact with anyone.
For me, this is part of the restorative power of silence — not having to communicate with people. It’s not that I hate people, or even communicating. But as an introvert I get restored most when I withdraw into my own world and don’t have to interact. Silence sort of takes that to the next level because by definition, for those of us who are most used to speaking as our main means of communicating with others, being in silence interrupts that default switch.
I’ve since learned that I don’t need to go on a formal retreat to be in silence. Renald and I are really good at discerning when we need silence. Throughout our relationship, we’ve had many an occasion when one or the other of us has declared a silent morning, afternoon, or day. It provides time for meditation, inward reflection, emptying the clutter out of the mind, regrouping, and above all, taking a break from having to interact.
But silence need not be a big declaration either. Last weekend when I was running along the tree-lined, snow-covered lane in Haliburton, I paused to take in the silence. Whereas before I could hear the sound of my feet and my breath, when I stopped everything went quiet. When that happens, I immediately feel a sense of peace. When quiet stillness descends, I experience it as a profound moment. And that is the kind of thing I can do any time really — at my desk, at a traffic light in the car, in the woods, on the beach, on the sailboat.
Whether for ten seconds, ten minutes, an hour, or an entire morning, afternoon, day or days, an encounter with silence always restores me.
Maybe that’s why, ever since I was a young child, I’ve loved the library — it used to be a completely silent space. I have spent hours of my life in libraries, hiding out in carrels amidst the stacks, in silence among others who also remained silent (back in the days where you couldn’t bring lidded drinks in either, so you couldn’t even hear the sound of someone sipping on a latte). Again, I experience it as permission to retreat into myself with no obligation to interact, and that always regenerates my energy stores.
Walking isn’t usually my thing. Compared to riding my bike, it feels slow. But I’m injured and I’m living too close to the university to even consider riding my bike.
That’s been true on sabbaticals. I walked to work in Canberra, Australia. Under 3 km doesn’t seem worth bike shorts and special shoes and that’s the bike I had with me. Ditto Dunedin and the University of Otago. I lived just a few kilometres from campus halfway up an extremely steep hill. It would have been a fast coast to campus in the morning and walking my bike up the hill in the afternoon.
But this is my first time regularly walking to work in Canada. I don’t have a car here in Guelph so that’s not even an option.
I could do without the ice and sometimes the temperatures have been a bit much. But as all the smiling selfies attest, mostly I’m enjoying it. Look there are horses on my route to work!
In my resolution-of-sorts New Year’s post, I solemnly swore to write in about how I’ve been doing on my promises to myself. Here’s a reminder of what I wrote about my proposed weekly plans:
Go to yoga twice a week every week
Ride trainer twice a week every week (yeah I need more than that, but I am committing to this right now)
Ride outside once a week, weather permitting, or xc ski or snowshoe, different weather permitting
Do everyday movement on teaching days– e.g. park far (like, really far) away from office every time I drive to campus
Track all of this activity honestly
Reflect and write on how things unfolded, compassionately and honestly
So how’d I do this month?
When I wrote this, I had just gotten pneumonia. And I had no idea (even though everyone told me) how much pneumonia saps you of all energy. My lungs cleared quickly with antibiotics, but I was oh so tired all the time. The fatigue was so impressive to me that I even blogged about it.
The upshot of this is that I didn’t:
Go to yoga twice a week; I went a few times this month, and have just restarted at-home yoga.
Ride the trainer twice a week. I’ve ridden it once for 20 minutes. It was hard…
Ride outside at all. Oh, no. I haven’t had energy for that.
Do everyday movement more than necessary at work. I am so deconditioned that just climbing the two flights of stairs to go to classes and my office leaves me breathing heavily.
However, I’m tracking all of this. And I’m writing about it now.
In service of the compassionate/honest part: rest and non-active movement is what my body needed all month. And my body enforced that need; I simply couldn’t move much. I simply had to rest rest rest. And you know what? It’s been okay. Boring and frustrating, but okay.
My body is now ready for more movement. I’ve restarted at-home yoga, and next week will go to one or two classes. I will ride the trainer (for a short time) twice this week. And I’ll start walking more around campus.
How are you doing on any resolutions-of-sorts you made for 2018? I’d love to hear from you, and promise to listen compassionately.
You know how I can be when learning something new – I get all tangled up in helping my body move in the way my brain wants to and then I get annoyed with myself. My annoyance makes me tense and the tension makes me worse at whatever I was struggling with in the first place.
Yes, I do get on my own nerves just thinking about it.
One of the few times I have sidestepped this scenario is when I tried Zumba on the Xbox a few years ago. Instead of being frustrated when I didn’t ‘get’ it, I found myself laughing at my mistakes and then just carrying on. It was eye-opening.
Unfortunately, soon after I got into the habit of laughing at my ineptness, changes in the Xbox menu made it tricky for me to access Zumba easily. It was a tiny obstacle, but enough to deter me.
I remembered that feeling though. I am rarely casual about learning new things, and I hardly ever laugh in the process of making mistakes. I wanted to have that feeling again, in other contexts, but it didn’t happen.
Then, last spring, I was lucky enough to take a Nia dance class from my friend Elaine.
I made a mess of the movements* but I was laughing at myself. I was only getting about half of the choreography but I was having a grand time.
A rare moment when I was in sync with the rest of the class with Nia on the Rock. That’s me in the star pants in the front. My friend Krista is in the back. She’s an expert at laughing when things go awry – I’m learning to follow her example. Photo credit: Stephanie Moyst of Fannie’s Photography.
I have been trying to fit more Nia in ever since but I have only managed to make that happen in the past few weeks. Every Thursday morning, I go to class, flail around ridiculously and enjoy the hell out of it.
I can’t hear the changes in the music that tell me I should change steps. I routinely head in the wrong direction. I start too early and end too soon. As I told a friend of mine recently, I feel like I am gloriously awful at it.
I’m not putting myself down here. I’m probably not particularly bad at Nia – and the nature of Nia is that it doesn’t seem to matter how good you are anyway – I’m just celebrating the fact that I am not getting into that cycle of frustration while I learn. I am not the least bit concerned about how slowly I am learning – I am just reveling in the fun of the movements. I’m sure it helps that there are martial arts-type moves in the dances so I have a feeling of familiarity but, mostly, I’m just going with the feeling of glorious awfulness.
I LOVE being gloriously awful. I feel no pressure to get better at it – even though I am, no doubt, improving as we go along. Getting better just doesn’t seem like something I should focus on – having fun does.
Being in this space is really fun for me and it has my brain whirring – how can I bring this same feeling to other movement I am trying to learn? Can I enjoy being awful at a new pattern? Can I be gloriously awful at parts of Taekwon-Do while I learn?
I certainly intend to find out.
Are you gloriously awful at any forms of exercise? Is being awful part of the reason you enjoy it?
*Learning new moves WHILE matching them to music is a challenge, at the very least.
When I was a teenager in Edmonton, I drank not at all. I lived in the far northern suburbs (well, far north at the time), and my high school was mid-town, my university south of the river. I was the designated driver a heck of a lot of the time. My friends drank copious amounts of beer and multi-hued liquids in which I had no interest. You could find me, at parties, by the crackers and cheese.
I went abroad in the summer after my third year of university; a friend and I moved to London, England to get jobs and discover life beyond the Canadian prairie. He worked for a lawyer who took him out each afternoon for pints; I worked for a lawyer who was an utter, abusive jackass and, I think, a recovering alcoholic. Anyway, no pints for me – and that was absolutely fine. I was too poor to keep up with the rounds, anyway.
Then, late in the summer, my friend and I took the hovercraft from Dover to Calais. (Before the Chunnel! I mean, I know, right? So last century.) We had lunch in a cheap and cheerful cafe. He said: you’ve got no excuse! You don’t have to drive. We are in France – the wine is good. And cheap.
So I had a glass. It was delicious!
And so I was no longer a teetotaller.
I drank a bit but not a lot as a graduate student. My friend Clarissa and I had a regular Saturday night date to watch Sex and the City while drinking girly martinis; that was always a weekly highlight, a chance to relax and destress. I had a drink or two on Friday nights while reading Toronto Life or other books and magazines for fun; that too was a regular pleasure.
I got drunk – and I mean totally fucked up –- for the first time in my life when I was 29 years old. It was the night of the day I defended my PhD. First, the committee took me out for celebratory drinks. Then, after drinking too much too quickly out of excitement, and running only on adrenalin, I made the mistake of drinking more, and eating nothing.
Around 9pm, I started throwing up; the next two days were awful.
I didn’t drink again for a while.
There are a lot of alcohol memes on the internet. Oh my, yes there are. Always better to post a picture of a cat. (In this image, a tabby bumps its head against the corner of a white and yellow wall. Almost like it’s hungover!)
But gradually, over time, my relationship with alcohol changed. It was no longer sporadic and moderate; it became increasingly regular, and increasingly I drank too much – though never so much that I couldn’t work the next day. (Typically, I only really overindulged on the weekend, anyway.)
I had a good job but a tonne of work to do, and no partner or child to look after; I discovered that alcohol was a good short-cut to relaxation, and a helpful way to forget that I was lonely, and kind of sad. I had enough money to buy good wine and better gin. The blend of all these factors meant that, by the time I became a tenured professor, I was probably drinking two, even three, bottles of wine a week.
In 2012 I moved to England with my dog, Emma, and my then-husband. The transition was hard, as all emigration is, but alcohol played a large role in it, because, well, to be honest, British culture is saturated with drink, and drinking to excess is not nearly as stigmatized there as it is in Puritan-rooted North America. In fact, it’s normal.
Not long after arriving in the UK, I broke my toe and had to have surgery to reset the bone; I ended up on heavy medication. I recall a work event I attended while still on the mend; our (wonderful) department secretary, Bev, met me at the door with two bottles in hand. “Red or white, love?” she asked me. I said, sorry, I can’t, heavy antibiotics. She was having none of it; I had a glass and a half.
White writing overlaid on a glass of red wine reads: “Keep calm and have a glass of wine.”
In England, there was typically at least a case of wine in our house, and at least a bottle of gin. There was usually a case or two of wine in the photocopy room at work. (Really.) Drinking each night, at home or at the pub with friends, was normal; I insisted on not drinking on “school nights”, but for me that was perhaps two or at most three days a week. Sometimes I broke that rule. I was probably drinking 10-15 glasses of wine a week at this point, plus gin martinis on the weekend.
I knew this was too much, and unhealthy; still, as I was typically not hungover in the morning, and not gaining weight, I ignored the problem. After all, most of my friends and peers drank at least two glasses of wine at parties or work events, if not more; there was literally no tangible incentive to make the change.
After I returned to Canada, the sheer force of the cultural shift meant I reduced my alcohol consumption a fair bit. Immediately I lost 5 pounds. (Alcohol is sugar, sugar, sugar.) But slowly, old habits crept back; by late last year, after a semester on sabbatical (no school nights), I was drinking 5 nights a week, and getting through at least three bottles of wine a week. It was getting expensive, I was feeling exhausted in the mornings, and I was up, well, about 5 pounds – 5 pounds I definitely did not need if I wanted to be properly ready for spring cycling season.
In early January, the man I’ve been seeing told me he wanted to cut alcohol out for the month and make some dietary changes; he was feeling as though he’d lost fitness over half a year of working too much, and he was eating too many fatty snacks mindlessly.
I decided this was an ideal opportunity for me to make some healthy changes, too.
This image shoes a heartbeat pattern with glasses of alcohol interspersed on a black background with blue graph lines. It is from an article in Everyday Health that talks about the benefits of moderate consumption, and the risks of excessive consumption.
I wanted, however, to make sustainable changes, to start doing things I knew I could keep doing for more than a month. So, instead of cutting alcohol out for 30 days and then celebrating the “milestone” on the 31st, I pledged to myself that I would cut back my drink consumption to reasonable, manageable levels, period. I would have a drink only on weekends, and I would aim to consume no more than a bottle of wine over the course of a week. I’d do this for January, and then keep doing it once it was habit.
I also pledged, along with my boyfriend, to nibble less mindlessly, and to get back on track with my weight training, which had fallen aside during my sabbatical, and during my adjustment to living in a new city. (I moved in August, to an amazing new town with outstanding open-air fitness options. Read my post on that here.)
I should emphasize here that I know I am not an alcoholic; I’ve investigated the symptoms of alcoholism, and I know that it is not necessary for me to give up alcohol completely in order to be, and to remain, healthy. I am very aware that I have, at times in my adult life, experienced a dependence on alcohol to relieve stress and dull emotional strain; but I also love nice wine and nice cocktails, and I’d like to be able to enjoy them in the future – while also feeling good, well rested, and strong the next day.
So I am the sort of person who likes to run upstairs and downstairs while carrying bags. It’s my favorite airport workout. Zoom past all the escalators. Zoom past all the people. Run to the gate. Never sit. Keep on moving. See here and here.
But now I can’t. I have a busted knee. I find out the precise flavour of busted on Monday when I meet with the knee surgeon. In the meantime, it’s all physio and all icing all of the time.
Also, no stairs. I do the stairs in my house slowly one at a time. I don’t carry things.
Definitely no running. Though I’ve been told to give pool running a try.
At work I use the elevators.
But the thing is it’s just one floor up to my office and I find myself needing to tell people why I’m taking the elevator. I’m sheepish about it. Part of that is my size. I want people to see me as the fit injured person not a fat, lazy person. For the first time in a long while I am wanting to lose weight (not just to get up hills faster and be kinder to my aging joints) because I see judgement in others’ faces.
However, the explanations about why I am taking the elevator sit uncomfortably with me. Does anyone owe strangers on an elevator an explanation? In case the answer to this rhetorical question isn’t clear, it’s NO. I even think it’s perfectly fine to be fat and to be lazy.
Even though this post isn’t from all that long ago, I wanted to repost it today because I’ve heard lots of people commenting on this dreary time of year, when the sky seems more grey than blue most days, and in our part of the Northern Hemisphere the cold makes many of us just want to pull the covers over our head in the morning and hibernate until spring.
That’s how I’ve been feeling a lot lately. Tired. A little bit miserable and off my game. Burdened even. It comes and goes. One thing that helps tremendously, seeing as I can’t actually make winter move through any more quickly, is meditation. It grounds me and helps shift my inner world even when I can’t shift my outer world.
I know it’s not for everyone, but maybe it’s something worth trying if you’ve not tried it or have been thinking of it but haven’t gotten around to it yet. Om…
I’ve posted many times about how much I love spinning classes. There’s a studio 100 metres from my home where I can quickly immerse myself into a totally focused, intense, efficient workout, the darkness and music completely lifting me out of my “real life.” Last spring, when I got back on my road bike, I felt like I hadn’t lost any strength over the winter because of my twice-weekly spinning classes.
But last Monday night, instead of pushing myself hard in the last ten minutes of a class, I found myself totally tensed up and squinching my fingers into my ears. The music was So. Loud. I felt assaulted. This was a teacher whose classes I don’t usually go to, and I had remembered why in the first three minutes of class. She was playing the music two notches above my comfort zone throughout the class, and in the final pushes, so loudly, and shouting her “encouragement” over it so incoherently, that I felt literally pushed off my bike. Without even thinking about it, I unclipped my pedals and rushed out of the room, agitatedly muttering “the music is just TOO LOUD.” The teacher smiled. She couldn’t hear me.
I was a ball of flustered irritability when I emerged into the reception area. The music was too loud even down the hall. I sputtered: “It’s just TOO LOUD, it’s HARMFUL, I couldn’t stay in there!”
NOT Cate’s feelings about music
“[That teacher] likes her music loud,” agreed the receptionist.
I got more wound up. “I’ve given her this feedback before but she doesn’t care!” (Note: I did, twice. It didn’t help). “It’s not about personal preference — it’s actually HURTING people. Aren’t you supposed to be about wellness and health?”
I was kind of wild-eyed at this point.
“We have earplugs,” the woman offered, like cautiously trying to give a soothing treat to a raging bobcat.
“You shouldn’t HAVE to have earplugs! And you can’t hear the teacher with earplugs!”
Cate is proudly old and preserving her hearing
(insert mindless, unattractive splutter here)
Realizing that I wasn’t going to have a useful conversation with the reception person, I went home and wrote an email to the owner. I did a bit of googling about dangerous decibels to back up my crossness.
Turns out that this is a really common problem, and it’s not ever-present for me because I’ve gravitated to the teachers in this studio who curate and play their music in a reasonable way, energizing without overwhelming or irreversibly harming people. According to the article linked above:
Noise-induced hearing loss (NIHL) is the leading cause of preventable hearing loss. Although you may eventually get used to the throbbing music in your Zumba class, your ears don’t. The microscopic hair cells in the inner era that transit sound to the brain become damaged and eventually die. And once they are lost, they don’t regenerate. NIHL starts innocently enough, with the loss of high frequency sounds. It is gradual and by the time you notice you have it, it is unfortunately too late for any type of prevention.
As I said in my note to the studio owner, I want to leave a spinning class feeling energized and good about my experience — not assaulted and agitated with my ears still ringing 10 minutes later.
Unlike the young woman in the reception area, the owner’s response was great. She told me she agreed, and that she’d forwarded the article I’d attached to all of the teachers. Apparently, the studio even has a warning light about sound, and she’d asked all of the teachers to start paying more attention to the warnings. She also told me that this teacher actually has hearing loss herself and therefore doesn’t always notice how loud it is (ironic, I guess?). And she credited back the credit from the class.
I’m not going to go back to that teacher’s classes — her instructions aren’t that coherent even when you can hear them. But I feel better about the studio overall, and I’ll keep going to the teachers who create an energizing but humane space.
The moral of this story is — speak up. There’s data that supports the argument for less cacophonous exercise classes. And if you draw people’s attention to the contradiction between aiming at health and wellness and permanently harming people’s hearing, teachers and studio owners may listen.
Have you ever spoken up about noise in an exercise class? What happened?
Fieldpoppy is Cate Creede, who lives, works and spins in Toronto.
