For the health of it...

Ta da, this is the 100th episode of virtual buck's blog.

The death of my old pal really got me thinking and prompted this blog enter. I was thinking about my health today as I was soaking in the hot tub in the beautiful clear 15 degree sunny morn, when I noticed the band aids still on my knees, each with a dime sized spot of dried blood, from the sites of the cortisol injections. Cortisol shots into inflamed joints are famous, it seems pitchers are always getting shot up in the shoulders to enable them to finish the season, and I certainly have heard about getting the shots in the knees-- and on Friday I found out first hand what it was like. Ten cc's into each knee, with a big long needle. It did not hurt at all, but it was very weird. The pressure of the injection as the fluid engulfed the space between the knee bones was an odd sensation. But the effects of the cortisol were unexpected. At midnight I was so wide-awake I felt wired out of my mind! I lay in bed reading until 2 AM finishing the last 100 pages of John Irving's "Last Night at Twisted River" and then with the lights out, lay under my eye pillow with my ear phones in, completely awake, refractory to all attempts to lure my surging thoughts to a sleepy place. Instead I designed the patio, the koi pond, the terraced garden, the rose bed-- and then began to harvest the downed wood in the forest figuring out where to stack it, deciding to rent a splitter then stack and split.... wow, that stuff was great!

When I got up on Saturday it was as though I had new knees. I am encouraged to begin rehab. Queue Amy Winehouse-- "they tried to get me to go to rehab but I said, no, no,no.... he's tried to make me go to rehab, but I won't go, go, go..." until now. I successfully rehabbed in fall 2004 after I suffered a stress fracture in my left knee and managed to run the Denver Marathon. But last spring after skiing for four days in BC, I just haven't been the same. Now not being able to run marathons is one thing, but not being able to ski? Forget that. So, now that we've moved, and have settled into our new life in Carbondale, I decided to see if I could get some help for my arthritic meniscus eroded old knees. I had to find a doc to get my eye med Rx refilled, so I visited the Family Practice clinic at SIU med and had an all purpose visit. Nice young Doctor, first year Resident took care of my Rx and then gave me the once over. I asked about collagen injections when he observed the crepitation in my knee-- so he gave me a referral to SI orthopedic clinic. I mentioned the new mole on my shoulder and when the resident consulted with attending physician they were almost giddy to see the perfect example of basal cell carcinoma had had sprouted. Oh, nothing to worry about, the most common form of bening skin cancer, completely treatable and easily removed. So a second referal, to the SI Derm Clinic.

I was actually feeling rather poorly when I visited the doctor, as though I was coming down with a cold--which progressed to a dose of the flu over the last week of the 2009-- what a way to end a sick decade-- sick. We stayed close to home for the holidays and in the time off I was able to recuperate from the flu, and visit the Derm. Dr. Burke a recent graduate from the Derm residency at SIU and an MD from UIC, we established a great rapport and he agreed with the diagnosis-- but took a biopsy to satisfy the insurance requirement. Diagnosis confirmed so a few days after Christmas I had the growth surgically removed. I was surprised to find out how much the minor surgery took out of me, I was in a bit of pain, but more so, I felt spent by the procedure. I recovered in a day or so except for the itching stitches. So, finally, Friday, the day of my visit to the orthopedic clinic, I also got to get my stitches removed.

My visit to the orthopod started with Xrays of my knees. I had a detailed discussion with Dr Wood who then probed my knees. When I told him I had run 21 marathons he congratulated me while he cranked my clicking knee around. We looked at the Xrays and he showed me the osteo-athritic ostiophytes and how little space remained between the plates. We discussed treatment plans. His goal is to avoid or delay knee replacement. So I am scheduled for Supartz or Synvisc injections of hyaluronan-- one injection should last for about 6 months, and it is expected to prevent knee pain and give me some mobility back. But to be sure that the insurance will pay for this, first I had to have the cortisol injections, 3 months of physical therapy 3 times per week, and I have to take high dose NSAID to reduce the inflammation. Wow, they are going for it. Let's get your knees better. I had not anticipated getting injected with cortisol or the resulting phsychoactivation. Also, I hadn't expected to be plunged into a vigorous new physical therapy routine.

Perfect timing actually. As I ponder the death of my friend, who was precisely my age, my thoughts turn to my own health and longevity. The last time I saw Matt in 2002, he picked me up at the airport in KC and drove me to Lawrence for a visit. I was shocked to see the bloated 300 pound man who looked like death warmed over-- his booming voice greeted me as he remarked that I looked like a marathon runner. This when I felt fat and was in a lull in my running, but my 230 was slim by comparison,though I was approaching my all time high weight. While I was gaining control and losing weight, he continued to gain. By the time he died on New Year's Eve 2009, under the blue moon, the last full moon of the decade, he weighed over 400 pounds. Death no longer warmed over. The control I lost in the last year during the transition and then the move to Carbondale I now regain. The regimentation and time I will have to devote to rehab under the guidance of the PT at the orthopedic clinic will necessarily help me to establish a new routine. I told the doc I really missed running-- a lot, but I was enjoying bicycling and rowing. He told me that "if it was my passion, I could probably run, but it would hasten my time to knee replacement." Yikes. OK, how about walking? The Synvisc will really help with that. How about skiing? OK, I will do the rehab, limit my running and save my knees for skiing once I build myself backup to it. I guess I better be sure to wear sun screen. Losing a few pounds will help the old knees too. OK, rehab, just for the health of it.