Call me nieve, or maybe a just a wishful thinker, but I figured that because I’ve had to live my entire life with such awful breathing issues that maybe I’d be spared some of the more common health ailments that people tend to get as they get older.

Who am I fooling, my entire universe revolves around my stupid lungs and my asthma. Everything I do seems to have an impact on my breathing in some way or another, why should my knees be any different.

Ok, for those of you who suffer from a chronic lung disease and have to take steroids, you might be thinking this post is about…steroid induced osteoporosis and weak joints maybe? Well, you’d be partially right, but thanks to all the walking I’ve done over the years and strong leg muscles, my knee xrays showed only mild degenerative changes. In fact, since becoming a serious fitness walker, my dexascan T-numbers have gone from a -2.5 to -0.5 currently without the need for medication.

No, I could easily blame this and all of my other health ailments on my asthma and lifelong steroid use, but in the case of my knees I definitely bare some responsibility. I have a tendency to overdo it, not only with the walking, but just about everything else in my life. I estimate that I’ve fitness walked over 13,000 miles since I began this journey back in 2005, that’s a lot of miles to put on one’s knees. Im also notorious for not allowing my body and legs enough time to adequately recover in between workouts or after long confinements in hospital beds. So yes, I’m partially to blame for my current predicament.

The culmination of all these things came to a head about 5 months ago, when I sustained a very common knee injury that afflicts people young and old, especially athletes and those who are physically active. Out of nowhere my right knee just decided to give out one day. Apparently I tore the meniscus in my right knee joint and sprained a ligament… talk about painful. Seems that having strong muscles isn’t enough. Over or under developed muscles in one part of the leg can mean an imbalance in the other parts. Over time this can take a toll or the joint and tendons. Here’s the actual MRI report for that knee.

The good news is that despite tearing both the medial and lateral meniscus, after just a few weeks of physiotherapy and lots of stretching exercises, I was able to gradually nurse my knee back into shape .Within 2 months of the initial injury I regained most of the function in that knee without the need for surgery. The pain waxes and wanes and can be pretty intense at times when it flares up, but it’s much better than it was. Still, walking hasn’t been the same since.

Not a Happy camper

Ah, but as luck would have it, 3 weeks ago as my right knee was continuing to heal, I somehow managed to injured my LEFT knee!
I had just returned home from a 2.5 mile walk, the longest distance I had done since injuring my right knee. I took a shower, walked to my bedroom and suddenly felt this clunking sensation in my knee. After taking a few more steps, I could actually hear my knee making popping and clunking sounds. Then as I took a few more steps and put weight on it, I about jumped out of my skin. Not only did that motion trigger excruciating pain, but it felt like my knee was going to give way. Whatever was going on with my LEFT knee felt totally different than what I experienced when I messed up my RIGHT knee. I’m not sure how I caused this current injury, but the timing of it suggests to me that it probably happened because I was favoring that side to protect my left knee. An imbalance if you will.

Thinking that I probably sprained something, I immediately iced it and took some anti inflammatory pain killers. The following morning the pain and clunking sounds were even worse. Because it hurt so bad when I bent or flexed it, I literally had to drag my left foot across the floor in order to move around the house. And because I was shifting my weight to my right side, my right knee was beginning to ache again as well. By the 3rd day, both of my knees hurt like hell and I could barely walk at all. Worried that this was more serious than I previously thought, I emailed the Ortho doc at UCSF sports medicine clinic who evaluated my right knee. The soonest his scheduler could get me in was another 2 weeks, so I contacted my primary care doc and she recommended that in the meantime I go to the urgent care center to get evaluated to make sure I didn’t break anything.

By this time I was so frustrated, you can probably imagine the stuff that’s going through my head. Im picturing various scenarios, like the inability to ever walk normal again without pain. That would spell the end for me. After all, fitness walking is a huge quality of life factor for me. If I didn’t get outside and walk on a regular basis, my breathing would undoubtedly suffer. I truly believe that the main reason my asthma hasn’t killed me yet, is because of my walking.
What if this injury required some sort of surgery to fix? How would that procedure affect my breathing? Doing even mild surgery carries a lot of risk for someone like me. What if the pain and limping I’m experiencing become a permanent thing, will I loose the desire to walk for fear of re-injuring myself? I was obviously was causing myself a lot stress with thoughts like these.

Anyways, 4 days later with no let up of the pain and popping of my left knee (and now my right as well), I reluctantly headed to the Urgent care center as recommended. Having been through this process just recently with my right knee, I knew that other than taking some xrays, offering me anti inflammatories and a brace, there wasn’t really a lot they could do. To my surprise though, the Urgent care doc on duty that day just happened to have a background in sports medicine. After listening to my story, manipulating and eyeballing my leg and knee, he seemed to size things up pretty quickly. He thought my symptoms were probably due to a tear or sprain of the MCL. He said depending on how severe the injury to the ligament is, it could take anywhere from 2 to 10 weeks to completely heal. He told me that in most cases, MCL injuries heal without the need for surgery. His orders were ice it when it hurts, not to walk on it and to follow up with my Orthopedic doctor.

Over the course of the next 2 weeks while waiting for that follow up appt, the pain in my left knee wasn’t getting any better and actually felt worse. Granted, I wasn’t staying off of it and resting it as much as I should have been. Call if vanity or denial, but I have this thing about using crutches, or a cane, especially in public places. It’s just not becoming to person who prides themselves on their unusual ability to walk marathon distances. The knee braces are bad enough and as soon as Im in my house I usually take them off.

On March 26th I finally saw my Ortho Doc. After evaluating my knee and symptoms his initial impression was that I tore another meniscus and probably sprained my MCL as well. He gave me steroid shot for the inflammation and pain, ordered an MRI, and another round of physical therapy. The following day I had the MRI done and the results confirmed his initial diagnosis. Here’s the MRI report for that knee.

Combination knee brace/epi-pen holder

So why is this whole knee issue such big deal for me?

Ive been blessed in beating the odds over and over again with my asthma. In the past 15 years alone, I’ve suffered dozens of severe exacerbations, most of them requiring intubation and ventilator support. Yet, Im still alive. That’s pretty much unheard of in the severe asthma spectrum, especially for a 64 year old. I think a huge part of that is due to my desire to exercise and maintain a certain level of fitness, despite the hardships of this disease. I believe that staying physically fit can help counteract the bad side effects of the disease and reduce the reliance on systemic steroids, which in the long run can makes on asthma even worse.

I like to tell people, that when you have a severe chronic lung disease such as asthma or COPD, you need to live the way you want to feel. You need to create a frame of mind for yourself that makes you feel normal. Getting out there and pushing myself hard physically through daily distance walking, even when Im not breathing well, makes me feel good about myself. It’s good for my lungs and makes me feel alive. Fitness Walking helps me tune out some of the bad stuff I have to deal with on a daily basis. Take that way from me and you’ve taken the one thing that holds me together and makes life worth living. This is why my knee issues, or ANY mobility issues for that matter are such a big deal for me.

It’s taken me a long time and a lot of patience, but yesterday I completed a 2.5 mile walk. That’s the longest distance Ive walked in a single stretch since my first knee injury happened back in Nov 2018. It could be the steroid injection in my knee I received last week that’s making the difference. (Im also having less pain.) It’ll be interesting to see how I fair after the steroids wear off in a couple of months.

Knowing what Im dealing with now and educating myself, I feel a little less anxious about the situation. The plan going forward is to treat these injuries as conservatively as possible to delay or avoid surgery all together. So that’s where things stands at the moment. I’m taking it day by day and doing everything I can do to preserve my mobility, which to me is freedom.

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