Friday, September 5, 2008

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.


_

6 comments:

melancholy donut said...

dr j, finnish?

anyhow, glad to hear that its not a _serious_ problem, but of course sad to hear that walking exacerbates it. you have some decisions to make certainly!

Unknown said...

In response to your comment about continue losing weight, there are two pretty good options at the hotel, remember we do have a Sauna AND Exercise Room (in fact they are in the same spot). It may be a good idea to do some light rehab exercise and use the sauna to assist with the weight issue.
Just an idea from someone that used to do sports med for wrestlers and football players (both commonly suffer MCL injuries). It would keep you in shape, rehab the knee, and help with semi-natural weight loss.

I want to see you continue with your journey, but don't want to read that you have completely blown out your knee by the time you reach Boise (or wherever you are headed next).

This is just my opinion and I am sure you know what they say about the fact that everyone has one... lol

Take care of yourself, let me know if there is anything I can help with while you are in town...
~Adam

Unknown said...

Oh yeah...I forgot to mention...we are BBQing tonight!! Give me a call if you want, I would even come pick you up if that isn't against the ideals of the journey... :-P

~Adam

Anonymous said...

"There are two ways of doing this...(2) continue losing weight."

Not being a dietician, health professional, nor Natures Masterpiece, I think your biggest clue is stated above.

For a man with such physical demands being subjected upon his large frame, this seems like the most logical choice...Captain.

Reading your food consumption preferences and schedule of not eating regulary raises us loyal reader's hands in horror.

To wit:
"...partly to do Something Big before I become too old to do so, and partly to get back into the same shape I was in back in 1990...
I feel myself wanting to pull back from the edge-- far, far back."

Your journey of discovery needs to include self discover in the ways of proper nutrition. Notice I didn't say exercise - for you definitely are geting enough of that.

Tinkaboudit.

One of your biggest fans, and tonight - biggest critic,

-Curtis S.

P.S. CHIP IN $$$ PEOPLE!!!
I have and will continue. A little goes a long way.

desertchick said...

Ouch!
Sorry to hear about the diagnosis, but glad it wasn't something much worse.

We're thinking of you.
Have a great weekend!

Anonymous said...

It is of course disappointing to hear that the knee injury is related to the walking, but not surprising. It's a tough spot you're in, but you might want to seriously consider your father's suggestion to winter in Walla Walla. I know it's early, but if you move on, the best case scenario is that the knee doesn't get any worse and you suffer the same pain throughout your journey. More likely is that the strain will gradually get worse. Like Adam, I don't want to hear about you blowing out your knee in Boise.

Heck, you could always see about getting a job at the teriyaki-jip.