Friday, June 15, 2018

Total Knee Replacement Scheduled

Pulled the trigger today.  I'll be undergoing a total right knee replacement (arthroplasty) in a few weeks.  

After eight months of ruling `this' out and `that' out it is conclusive: bone on bone.

The orthopedist and I had a good conversation.  If it were just pain from day to day moving around for a typical 72 yo it might be managed adequately (simple palliative treatment) with shots and stuff.  But for my purpose, i.e., an active lifestyle, it might make a difference.  Or, then again, it might not.  

It's been a lengthy sleuthing process with plenty of patience and diligence.  From initially making the working assumption that it was tendonitis to more extensive actions: medical consultations, x-rays, an MRI and second opinions.  

I've been fortunate to be the recipient of experienced opinions of many athletes and endurance cyclists (Joe Friel, Allan Duhm, Robert Baldino, to name only a few).  


The faulty knee presented in a somewhat odd manner.  On the flats I can (and have) ridden for hour after hour after hour with absolutely no discomfort.  With grades of 4% and more the discomfort went from growing ache to acute and sharp pain.  

The decision making event was the recent `24 Hours In The Canyon' competition in Amarillo, Texas (June 2 - 3).  It combined two good testing settings.  

The first was a 110 mile out and back event held in the Texas high plains.  Almost completely flat with the most challenging grade being 2%.  I  had good power, speed and endurance despite heat in the mid-90's and a steady 25 - 35 mph wind.  

The second was a 5 mile loop in the Palo Duro Canyon.  Do as many 5 mile laps in the 24 hours as you can.  This was fairly hilly, with several sections of 4 - 7% grade.  Within the very first lap the knee started to ache.  As I completed more laps (7 total) the ache grew to a sharp pain.  

Radiological evidence:
  • completely severed ACL
  • several torn meniscus (meniscii?)
  • complete absence of cartilage in some areas of the knee
  • numerous `bone spurs' (i.e., osteophytes)
  • bone on bone

Fortunately there was no swelling or damage to the ligaments, tendons or other tissue.  Excellent blood supply to the area. 

Why did this even happen?
  • family history of arthritis
  • 30 years of long distance endurance running
  • 69 years of happy bicycling
  • 72 years of living
Why isn't it worse?
  • I've not neglected my body or attempted to do foolish acts of self-destruction
  • I have never fallen for the trap of trying to `impress others'
  • I consider pain as a `friend,' i.e., my body telling me things I should listen to and act upon
  • A wise refusal to dismiss criticism or disapproval from others for refusing to `drink the cool-aid' of `too much is never enough.'  
  • I've never been a hero and I'm happy to be an observant, judicious survivor
My expectation is that I will likely be sidelined from outdoor, on the road cycling for 5 - 7 weeks.  But my rehabilitation will include disciplined and challenging indoor training on the recumbent (a recommended platform for knee surgery rehabilitation).  





I've learned a great deal and have much remaining to be learned.  Both from a `body' perspective and from an `acceptance of mortality' perspective.  The latter is the most important.

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