and the verdict is...

Not long after I finished my previous entry, the exam room door opened again and I met Dr. J, whose real surname is Jauhiainen (try pronouncing that one, boys and girls). We shook hands and made some small talk about long-distance walking and biking, and then Dr. J got right to it, palpating the knee joint, gently pulling and rotating it in different directions, and asking all the while about where and how intense the pain was. I walked across the exam room floor at one point, did some flexion and extension exercises, and talked about how I thought the problem may have occurred. There was no MRI, X-ray, or CAT scan today, but Dr. J learned enough to diagnose the problem:

Medial collateral ligament strain.

There's no problem with the meniscus (the padding separating and cushioning the upper and lower bones of the knee), but the ligaments on the inside of my right knee have suffered some strain. The good news is that this is nothing serious; I need to continue resting the joint, icing it down, and taking ibuprofen as an anti-inflammatory.

The bad news is that, as I suspected, the problem might not be related to that fall: it may instead be the result of simple overuse. This is bad news because it means the problem may recur simply through the act of walking.

The only way around the danger, as far as I can see, is to minimize the amount of weight bearing down on the knee. There are two ways of doing this: (1) continue using chase cars to keep that pack off my back, and (2) continue losing weight. Both of these are difficult propositions; as long as I'm resting in one location and not walking long distances, the temptation will be to eat at the same rate I've been eating since the beginning of the walk. That obviously won't do, so I'm going to have to find some way to occupy myself, to distract my mind from eating.

The doc also looked at Chuck's brace and decided I needed a new one. "That one's almost shot," he said. My new brace has an enormous adjustable joint (Terminator squared) and is easily belted on by wrapping it around my knee, not sliding it up the leg like panty hose.

Because I have no insurance, I was asked for an up-front payment of $137. If the cost of the exam plus the brace goes above that amount, the clinic will mail a bill to my family's residence in Alexandria (I'll pay for it by check, of course). If the total cost proves to be less than $137, a refund will be sent to northern VA instead.

So I've got a new brace and plenty of ibuprofen; the question now is how much time to take to ice the knee down and rest. I was in Arlington for a week, and despite all the rest, my knee didn't feel all that much better. I'm hoping that an ice-down will help significantly.

We'll soon know.


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