Friday, April 23, 2010

Next Dilemma

Toby & Toby's Dad discussed the mountain climb and are putting the dream on hold until next year, preferably a little earlier in the climbing season. A big reason why they are postponing the climb is because of knee issues. Toby's Dad has had chronic knee pain for decades and a few years ago he had his right knee rebuilt. While the right knee feels great, the left one is causing him trouble now. Consequently, he needs to make a decision on whether to get that rebuilt, as well, or try to get it to the point where he can hike and/or climb with little or no pain.

Toby, whether he likes it or not, has received this bad knee DNA and is having knee problems, as well. Toby's knee problems started in 1990 when he played college football. At that time, he ruptured his Anterior Cruciate Ligament (ACL) in his right knee and had it surgically repaired. 7 years later, he tore some Meniscus Cartilage in the same knee in a skiing accident on Mt. Hood. At the time of the skiing accident, Toby didn't know he tore the cartilage in his knee for the broken leg and teeth far outweighed the discomfort in the knee. A few months later he was playing baseball with his new students in Hokkaido when he twisted the knee and completed the tear. A few weeks later, he had his second knee surgery of his life. This was quite an experience (and a long blog post in itself) as it was Toby's first experience with Japanese hospitals and there were many difficulties. However, Toby found a knee specialist in Asahikawa who studied at The University of Chicago and was fluent in English. The doctor and Toby agreed to have a spinal anesthesia which allowed Toby to be awake/coherent during the surgery. During the procedure, the doctor tested the 1990 repaired ACL and determined it was as strong as ever. He also found the Meniscus tear and determined it could be repaired instead of being taken out. After confirming with Toby during the surgery, they decided that keeping this "cushion" between the bones was a good idea. Consequently, Toby could not ski his first winter in Hokkaido, but was looking forward to a long and healthy life with the cartilage being left in his knee.

During the house build last year, Toby re-tore that cartilage. Toby says he is glad that the only injury on the house build was his own. How did he re-tear it? He just put too much pressure on it while carrying very full, and heavy, buckets (often two at a time) of earth plaster up the scaffolding to the 2nd floor of Square One. He did this day in and day out for weeks and the knee finally said it had enough and gave him the tear. Toby didn't stop working then and not only kept working on the house, but continued to push things by skiing through the season. Of course, he went to a doctor first to find out exactly what the problem was. This time, the knee specialist informed him, after Magnetic resonance imaging (MRI), that the Meniscus cartilage was indeed re-torn and that he will probably need to have arthroscopic surgery to regain pain free use of the knee. It was already snowing in the mountains at the time of this first appointment so, naturally, Toby asked the doctor about skiing. The doctor said he could ski with pain and, in fact, doesn't need the surgery at all if the pain isn't a problem. Toby bought a brace, invested in some anti-inflammatory creams and has skied the season with the pain mostly been after he gets home or the next day. He claims it has been totally worth it, though. However, now.....he needs to make a decision. The ski season is coming to an end and the landscaping, carport and storage shed projects need to get done. Toby wants a healthy knee again and is looking at potential dates to get do the procedure. The rehabilitation of the knee after the surgery is fairly minimal, especially when compared to Toby's previous 3 surgeries (3?? Yes, Toby had another surgery to repair a ruptured Achilles Tendon back in 1993). However, Toby would prefer to do the surgery when he's not working and/or have at least a couple weeks where he can "take it easy" before doing any heavy lifting or work with the knee. The projects Toby's is contemplating around the house are not things he should do immediately after surgery. Therefore, this is the "next dilemma" and occupying Toby's mind right now as he plans the next couple months....


Norman Delaney said...

Another thing we have in common.
In November of 1990, I snapped the ACL in my right knee, right in half. It happened on a disco dance floor of all the frikkin places in the world. (a long story in and of itself. Happened the same night I met my wife.)
Anyway, I went to the Moriyama hospital and the Japanese doctor said; "If I reconstruct your ACL you may have such stiffness in your knee, that you won't be able to fully bend your leg anymore. If you are not a professional or avid athlete, I recommend that we should just repair the torn Meniscus and then put a cast on your leg for about a month."
So, that's what I did.
Since then I wonder if I made the right choice.
Even now, 20 years later, it hurts most of the time. I can be walking along and step off of a curb in such a way as to slightly twist my knee and its back to OuchVille all over again.
Knees need to be redesigned by the original maker. There must be a better way.

b.m.t. said...

Yep. A "rupture" = complete tear and that is what I did, as well. And my doctor at that time also suggested I try to live w/out an ACL. One day skiing at Colorado changed my mind. Knees can be fixed, repaired and/or replaced. They can also be protected with strong muscles on both sides. I'm looking forward to a combination of a repair and then strengthening the muscles with a lot of cycling this summer....

b.m.t. said...

p.s. You should go visit Tokuhiro Sports Clinic on 9jyo in Toyooka (right by 5 Star), Norman. He may give you some good advice and/or suggestions on what you can do for your knees. It is NEVER too late to try to get rid of that pain, brah. Tokuhiro-sensei is a very well respected knee specialist that has patients come from as far away as Sendai to see him!!!

Norman Delaney said...

Thanks for the doctor reference. I may need to go and have a consultation with him. Cycling is something I used to do a lot of but in recent years I haven't done that much. I need to get back into the saddle again.