Saving My Knees: How I Proved My Doctors Wrong and Beat Chronic Knee Pain (2 page)

The orthopedic doctor instructed me to squat from a standing position, as if I were sitting down on an invisible chair. I hesitated, knowing what would happen next. He had finished an examination of my knees that showed a normal range of motion. Now he was about to find out how bad the cartilage really was.

I lowered myself carefully. My knees made a thick, wet crunching noise as they bent. The ugly sound embarrassed me. He didn’t say anything.

A few minutes later, I was seated beside his desk, passionately telling him about my commitment to healing. He listened without comment, then bluntly delivered his opinion: “Your knees will never get better.” My best hope was to arrest their decline to avoid full-blown arthritis in a few years.

That took my breath away. “Never” sounded like a death sentence. My life had become thoroughly miserable. Every day my knees hurt. They burned so badly that I sometimes fantasized about hacking off my kneecaps with a butcher knife. I ducked social events after work, fearful of the pain from sitting or standing too long.

It was too depressing to imagine that they would never improve, no matter what I did.

After that doctor’s visit, I struggled to put the whole nightmare in perspective. Nothing had prepared me for the onset of chronic knee pain. The experience was like falling through a trap door in slow motion. Would I lose forever the active lifestyle that had come to mean so much to me? How had I arrived at this misery?

For decades, I took my good health and my body’s resiliency for granted. As a child, I was always the fortunate one who never broke a bone, pulled a muscle, or sprained an ankle. Casts were bulky white objects covered with signatures and scribblings that other kids wore.

Luck was surely on my side, considering how active I was. I grew up in a white clapboard farmhouse in rural Downeast Maine amid deep pine forests and strong, clear rivers. I enjoyed traipsing through the woods around our home. And I loved sports: everything from schoolyard kickball to winter pickup games of touch football on an ice-covered field.

The schools in Washington County, Maine, didn’t offer much in the way of athletics. The area is poor and hardscrabble; there isn’t room in pinched budgets for track and field or football programs. They did have basketball gyms though, and fans packed the bleachers even on frigid December nights.

So it wasn’t surprising which team sport I fell in love with first. Basketball seemed appropriate anyway for a gangly youngster with long arms. In shootarounds, I would sometimes imagine myself playing for the legendary Boston Celtics.

My enthusiasm for basketball eventually waned as I realized my shortcomings on the court. I stood only a few inches taller than average and lacked quickness and aggressive instincts. My modest talent usually sufficed for making the squad, but not much more.

After reaching high school, I decided to try something different. On a whim, I signed up for the cross-country team.

Distance running should have fit me well. I was a slender six-footer who possessed more endurance than speed. Also my bookish nature gave me a high tolerance for being alone. I was the kind of teenager who, on a warm summer day, would disappear with a novel by Vonnegut or Dostoyevsky and hide away under a nearby bridge, reading intently as the water swept past.

Despite that, in my mid-teens, I couldn’t get too excited about setting out on training runs on quiet, dusty roads that never seemed to end. Running long distances—basically, anything more than a mile—strikes most high school students as boring and pointless. Besides, being on the cross-country team wasn’t considered cool. We were the athletic versions of the chess club nerds.

In high school, I was a joyless runner. In college, my attitude changed completely. I was at Harvard in Cambridge, Massachusetts, majoring in government. Jogging along the broad Charles River helped relieve stress. Gradually my legs became leaner and stronger. Sometimes it felt as if I was flying over the ground, swallowing chunks of the paved riverside trail with each stride. Running became fun.

On vacations I began to clock my times on a 4.5-mile hilly loop of road in my hometown. The route swept along blueberry barrens, through stands of evergreen woods, and over a rushing river. My mother, who took up running too, entered us in local races. I was never fast enough to win, but kept improving. At the age of twenty-five, I finished a 10K in 36:34.

In my twenties, running happened to be an ideal way to keep fit. It was cheap (just the price of an occasional pair of Asics or New Balance shoes), and I could lace up and take off anywhere in the world. That proved especially convenient. In the six years after graduating from college, I lived everywhere from Switzerland and Paris to California, Kentucky, Pennsylvania, and New York City. For a while I taught high school students computer science, then got a journalism degree and became a newspaper reporter.

Then, in my thirties, running lost its appeal. I wasn’t doing it regularly and nagging injuries started to bother me. Even though they were minor ailments such as shin splints and sore foot arches, the magic feeling of effortlessness vanished. I began to feel sluggish and plodding.

I didn’t realize it then, but my changing weight surely affected me. I went from 172 pounds in college to 185 pounds in my mid-thirties. That doesn’t seem like much of a difference, but there’s a multiplier effect at work during the act of running. For each extra pound you carry, as much as six more pounds of force are transmitted into the knee joint.

In the fall of 2000, seeking a less stressful activity, I made a fateful decision. A year earlier I’d moved to Fort Lauderdale to become an assistant business editor at the
Sun-Sentinel
newspaper. Sun-drenched Florida, where almost all the beachgoers look fit and tan, was terrific for year-round sports. I had done some cycling alone in the mid ‘90s, while living in Oklahoma and writing a book about tornadoes. So I joined a biking club.

For months I stuck out like a sore thumb. In cycling, unlike running, equipment and style matter. Riders bragged about their lightweight, fast bikes that cost up to $5,000. They debated brands of headsets, cassettes, pedals, forks, seats. Meanwhile I couldn’t even get the basics right. My socks were wrong, my helmet was too large and clunky, and my solid-blue jersey looked like a plain Jane at the ball compared with their busily and brightly patterned ones.

So I upgraded my sporting wardrobe while also learning group-cycling skills and etiquette. Organized riders travel in long “pacelines.” Only a few inches separate their wheels as they accelerate to speeds up to thirty miles an hour. The rider in front does the “pulling” by taking the brunt of the wind.

Our outings were usually courteous and orderly until we reached the designated sprint zones. Then all hell broke loose. After a few rides you became familiar with the finish lines: the speed limit sign, the highway turnoff—whatever arbitrary marker worked best at that spot. As we got closer, the speed rose and the paceline splintered.

The last hundred yards were the most intense. You had to dig down deep inside for that last bit of strength. Your legs pistoned crazily. Your thigh muscles burned. Your lungs felt raw; your heart slammed impossibly fast. For a brief moment, your heart rate monitor might even flash its maximum, confirming that you had reached your physical limit, that you couldn’t wring out one more watt of energy.

I loved it. Distance cycling was my true athletic calling, at long last. It was an aerobic, endurance sport. Anatomically, I was suited for it, with naturally large thigh muscles and a long femur, the upper leg bone that acts as a big lever with each pedal stroke. Though I didn’t possess a lot of raw talent, my body often managed to push beyond its own fatigue. Near the end of a three-hour ride in the subtropical heat, I would get out in front of the tired pack and just hammer for miles.

The group rides usually turned into punishing, extreme workouts. Still, an even more exquisite form of torture awaited me: time trials. These races pit individual riders against the clock. The best time trial series in South Florida was held out in west Palm Beach County, at a remote site where alligators slid in and out of nearby canals. For miles, all you could see were sugar cane fields, acres of swamp, and electrical transmission towers.

To gain a racing edge, I would bring aerodynamic equipment to fight air resistance and trim precious seconds. My rear wheel was a smooth disk that made a hollow whooshing sound as I brought the bicycle up to speed. My time-trial helmet looked like a backward-flowing teardrop. Rubber booties covered my shoes, to smooth out irregularities that would disrupt air flow. I even shaved my legs (a savings of five seconds on a forty-kilometer course, one online site claimed!).

Once a time trial begins, you find out why it’s known as cycling’s “race of truth.” There is no one to hide behind and no letting up until it’s over. One time, I wore my heart-rate monitor. My absolute maximum was 183 beats per minute; during the race it constantly flickered between 173 and 174. Gradually I learned how hard to push myself without burning out. It’s like an art, keeping the needle for your internal engine constantly on the edge of the red zone.

I rode fast enough to place second among the men aged 35-44 in the 2005 time-trial series. My best time in the 15k (9.3 miles) was twenty-two minutes flat. That averages out to 25.4 miles an hour. Plenty of South Florida’s elite riders could top that. A few even smashed the twenty-minute barrier. But that never mattered to me because cycling meant so much more than winning a race or sprint. It was about embracing an active lifestyle that lifted me to a new level of feeling good.

It was about stumbling with wobbly legs off the bicycle after a long ride, exhausted in a wonderful way. It was about waking up each morning in my early forties with the energy of a twenty-five-year-old. It was about feeling strong and confident, taking long strides across the newsroom or bounding up a flight of stairs. It was about being healthy and not getting sick—not even a head cold—for almost five years.

My only health scare came in April of 2003. I began to experience irregular heartbeats while sitting quietly or trying to sleep at night. My heart would noticeably skip a beat, then follow with a hard beat as if to catch up. The pattern would keep repeating, affecting every eighth beat or so. The episodes would last for hours at a time over several days.

The onset of irregular heartbeats can be terrifying. Usually your heart expands and contracts silently in the background; you notice its presence only by pressing your hand against your rib cage. Odd heartbeats alert you to the possible frailty of this organ. Sometimes I found myself pounding my chest, alarmed and frustrated, as if I could manually bump it back into a proper rhythm, like a bad case of hiccups.

At the time I was cycling 140 miles a week. I would have cut back, except the abnormal heartbeats always smoothed out with aerobic activity. When my pulse cleared 130, there was never a problem. Also I never had dangerous symptoms of dizziness, faintness, or weakness. Still, not knowing what was going on unsettled me. I sought out a cardiologist.

Before the appointment, I chugged twenty ounces of caffeine-rich Mountain Dew to try to induce the strange beats. It worked. During my electrocardiogram test, they showed up perfectly. The doctor, at first surprised to see someone looking relatively young and fit, questioned me about my cycling and placed his stethoscope against my chest. “Strong heart,” he said simply. He also checked my ankles and didn’t find any swelling.

A few minutes later, after studying the EKG printout, he allayed my fears. I had nothing to worry about, he said. The unusual reading was what you might expect in an endurance athlete. All the hard exercise forced my heart to adapt and pump blood more efficiently. My resting pulse in the morning was usually forty to forty-two; the average unconditioned heart beats sixty to eighty times a minute.

Once I stopped training, the problem would probably go away, he said. He turned out to be correct.

After escaping that brush with mortality, I felt stronger than ever. I had faith in my body’s ability to recover from any kind of illness or injury. One day while cycling in a small park, I ventured onto the road’s sandy shoulder to pass a slow-moving groundskeeping vehicle. When I tried to hop back up onto the pavement, my front tire twisted. I went down hard, like a sack of cement, and cracked or bruised a rib. For days it hurt to sneeze or breathe deeply. That slowed me down on my bike, but for no more than a month.

Then came a very nasty collision on a windy fall day. I was among half a dozen cyclists sprinting on State Road A1A, the slender route that snakes down the eastern Florida coast beside the beaches. Hurricane Wilma had recently raked the neighborhood and knocked down a flashing-light warning sign for a drawbridge. I blew past everyone on the sprint and tucked my head to take a breath. I looked up to see the red-and-white safety arm for the drawbridge lowering directly in front of me.

There was no time to react. I slammed into it at twenty-five miles an hour. The arm, made out of what seemed to be heavy aluminum, caught me across the upper chest and arms. I was thrown to the ground as my bike skidded out from under me. It was a stunning, violent crash.

Without hesitating, I sprang to my feet. The drawbridge arm was dented in the shape of a rooftop profile. Supporting cables lay about on the road like strands of spaghetti.

I grabbed my bicycle and tried to straighten the handlebars. The other riders rolled up. They seemed amazed to find me upright with nothing broken, only bruises. One gave me an incredulous look and said, “That’s the most amazing thing I’ve seen.” Later it occurred to me that, had that drawbridge arm been ten inches higher, I would have been decapitated.