accessibility · aging · disability · injury · motivation

An apology: A thing Sam thinks she needs to stop saying…

My life has changed a lot since we started the blog and the fitness challenge. There are things I say when we’re promoting the book that now strike me as wrong or at least not as simple as that, or maybe even naive.

Things feel a lot more complicated since osteoarthritis and advanced cartilage degradation made me a candidate for knee replacement.

It’s hard to get a more nuanced message across when you’ve just got four minutes on television so I’ve been sticking with the simple story but the truth is I know it’s not so simple. I’m not staking out a position here or defending a claim other than than claim that things are messier than I thought. I do know the blog can handle more complexities than the media buzz around the book can take. So you blog readers get the messier story.

Maybe after the book promotion I have to stop saying “if you don’t love it, don’t do it.” There are a lot of things in life that I do but I don’t love. These days a lot of exercise feels to me to fall into that category. Knee physio can be tedious and sometimes painful. And I do it most days. There’s no way to love it. You watch Netflix to distract. You give yourself rewards for finishing. I need to do it but there’s little joy in it.

Instead, I take pride in my grit and determination, in my resolve.

See When exercise isn’t fun.

Why am I doing it? Not love of the thing itself that’s for sure. Partly to be sure it’s instrumentally justified in terms of continuing to do things I love. Canoe camping, hiking, biking. I want to keep these things in my life.

But it’s also instrumentally justified in terms of basic movements, like walking to campus, between meetings, getting in and out of chairs.

To suggest that we approach all exercise from this “loving it” perspective comes from an incredible place of privilege. I had that privilege. I don’t anymore and I’m sorry if I sounded insufferable, naive, and smug.

I saw it again today, by the way, in an online body positive fitness community of which I’m part. Someone offered the advice to another community member to do whatever brings joy to your heart. And the thing is I too reject the imperative that we all have to do joyless exercise to tame or unruly, overweight bodies to keep them in line. I also know though that life is complicated.

Just as Tracy rejects body positivity as just one more demand, I’m coming to feel that way about “if you don’t love it, don’t do it.” No one loves knee physio. It’s okay not to like it and to do it anyway.

It’s okay to be angry and sad and roll your eyes at people who say they just don’t feel like running this morning. You don’t get to yell at them that at least they can run and tell them to just go do it because you can never run again. Just say it in your head. That’s what I do.

It’s okay to think, “I’m tough and I’ve got this” instead of I’m doing this because I love it . Because that’s what’s true: I’m tough and I’ve got this.

Maybe that’s true for you too. I’m sorry for saying you have to love exercise. You don’t. Right now, a lot of the time, I don’t. And that’s okay too.

disability · fitness · injury

When exercise isn’t fun: Sometimes it’s boring and repetitive, painful, and not the least bit joyful

My new physiotherapist tells me that I’m tough. She also says I’m determined.

That’s the kind of praise I need these days.

Because contrary to our usual message, I’m not exercising these days because it’s fun or joyful or at all social. I’m doing a lot of boring, repetitive, sometimes painful exercises, mostly by myself, in order to regain basic knee function so I can do things like climb stairs and get out of chairs without grimacing. I’m also making time for it when I am super busy and when the exercising part doesn’t feel like a reward at the end of a long day. It’s more like punishment.

So when Tracy wrote yesterday that “our number one piece of advice for anyone is to find activities that you enjoy” I admit that I kind of flinched. Because my life isn’t like that right now. Right now I am doing a lot of physio. My knee hurts. I’m resolute and determined to get back on my bike even though I’ll never run or play soccer again. Aikido? Maybe. I’ve got hope for cycling. We’ll see. I’m in mourning a bit for my former self!

In my Facebook memories newsfeed a happy photo came through of the Run for Retina 9 years ago. It’s me and cousin Tara doing the 5 km. Look at our smiles! Look how happy we are!

tara

I’m not sure why I am telling you all this, except to find company and to reassure those of you, who like me, who are in pain, that you are also not alone.

I do exercises to support my knee function to my pain tolerance and then it’s all ice and ibuprofen after. I’ve missing the Fowler Kennedy game ready ice and compression thingie. I want one for home!

Yesterday, I was balancing and marching and doing squats on a bosu ball. See here for how that helps.

So contrary to our usual message of “if you don’t love it, don’t do it,” this is me saying, it’s not always fun or joyful or social and sometimes you need grit and determination and you do it anyway. That’s part of my character, a big part of who I am.

What was Tracy’s message last week, life on life’s terms? Something like that.

aging · injury · Uncategorized

Sam’s left knee: An update

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.

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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.”

See here.

“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 result for knees
WebMD’s diagram of knee anatomy