Jim is suddenly faced with a major "unknown"
-- whether his running days will be over much sooner than he hoped
they would be.
The news we got this afternoon came as a shock
to both of us during a lengthy consultation with an orthopedist in
Durango about Jim's continuing knee problems since his bike accident
last November. I'll describe that in a minute.
Approaching
Molas Pass (elev. 10,910 feet) from the north on US 550
We left our campsite in Silverton about 11 AM. Cody had to stay home
because of the predicted heat in Durango (about 90 F.), which is several
thousand feet lower in elevation. It was warm in Silverton, too, but
Cody was fine inside the camper with the windows cracked and the
Fantastic Fan turned on. We have enough shade on the south and west to
keep the Cameo from getting too hot inside.
The long drive down US 550 was gorgeous with the bright blue sky,
glistening white snow on the mountain peaks, light green aspen leaves,
and dark green pines. We saw waterfalls we’ve never seen before and lots
of yellow flowers (not all of them dandelions) and blue lupines.
I took the first eight of the photos in this entry during our trip to/from Durango today
while Jim was driving. What beautiful scenery!
Snow-covered mountain peaks just beyond Molas Pass;
there are nice campsites around here.
This is a major trip -- over 60 miles one way to the doctor's
office south of Durango -- so we ran several errands while we
were out.
We dumped trash and got a NetFlix movie at the post office in Silverton.
Then we headed up, down, up, down, down, down to Durango. At the north end of
town Jim washed the truck and got a Subway
sandwich. We drove to the south end of town and ate lunch in a pretty
little city park by
the Animas River.
Lots of folks were out enjoying the warm sunshine
-- picnicking, walking, running, cycling, rafting the river but I
didn't take any pictures of them.
We still had over an
hour to kill before Jim's appointment.
We
filled two containers with gas for the generator and got diesel for the
truck (diesel prices ranged from $3.85 to $3.99/gallon in Durango), bought a
new roof vent for the camper at an RV shop across from Walmart (it cost
$20 for our little misadventure with the trees at Sam's Club Monday
night), and shopped at Walmart.
We were able to buy several other things
for the camper cheaper at Wally World than at the RV store -- new
wrap-around mats for the outdoor steps, a power strip, two more vinyl tire covers (to protect the tires
from the sun), and an extra length of hose for water.
Durango Orthopedics is in the same medical complex as
the city's hospital, where we got to spend several hours in the ER after
my serious bike wreck on South Mineral Creek Road in 2009.
Today we
arrived a little ahead of time so Jim could fill out
paperwork required of new patients. The purpose of the appointment with Dr.
Scott was to see if he can do something about Jim’s very sore knee. Our
orthopedist in Roanoke, Dr. Johnson, made the referral last week and
faxed Jim’s records, including the MRI results from last November, to
Dr. Scott.
View from Coalbank Pass, elev. 10,640
Jim also typed and printed out a chronological summary of everything that has
happened to his knee in the last seven months -- his bike
accident, meniscus surgery and recovery, continued attempts at running,
physical therapy/deep tissue massage and chiropractic adjustments while
we were in the Houston area in February and March, and a steroid
injection in late March.
Jim's knee
felt good after the steroid shot he got March 28. It began hurting a
week after the Jemez 50K race in mid-May and he wasn't able to
train like he wanted to for the Bighorn 50-miler last Saturday. He
dropped down to the 30K race but his knee hurt so much during and after
the event that he’s still limping four days later.
Dr. Scott was initially quite pessimistic about being able to help Jim.
It would have helped if we’d taken the MRI disc with us on this trip but
we didn’t think we’d need it; it's sitting in our house in
Virginia. All Dr. Scott had were written reports re: the X-rays,
MRI, surgery, and follow up visits in Roanoke, and it took a while for
him to understand the entire sequence.
He did ask Jim lots of questions and listened to his complaints, injury
history, etc. and seemed to do a thorough physical evaluation of where
the pain is located. The entire office visit lasted at least an hour,
much of it with the doctor.
Dr. Scott
ordered an X-ray of Jim's knee and was able to pull up the pictures on
the computer as soon as Jim returned to the exam room. It showed about
two-thirds of the cartilage on the inside (medial side) of his right
knee as on the left knee – he’s lost 30-40% of the cartilage that should
be there. That’s where the pain is.
Here's the kicker
--
Jim’s not bone-on-bone like I am, but the doctor very pessimistically
forecasts Jim will need a knee replacement in two to four years!! That
shocked both of us, because Dr. Johnson had indicated after the MRI done
last November that Jim has only “mild” osteoarthritis.
On the X-ray it still looks like there is plenty of “space” (cartilage)
in that knee, but X-rays don't show the whole story.
A second problem is the torn meniscus and subsequent surgery. With less
of the meniscus “donut” to cushion the joint, the load/weight on the
knee isn’t distributed evenly. Jim’s mechanics are different and the
head of the femur is more stressed. That could be part of his pain;
an MRI can help confirm that suspicion.
A third problem is a probable medial collateral ligament (MCL) strain or
sprain. Jim may have gotten that at the Jemez race, with its rocky,
uneven footing. It’s not related to the meniscus but is located over it.
Dr. Scott says it should heal with rest and a brace.
A fourth potential problem is further tearing of the meniscus. Only an
MRI can determine that, and it will be hard for Dr. Scott to know if
it’s the same tear Jim had in November, or subsequent damage, without
seeing the first MRI. We will try to get a copy of it sent out here from
Dr. Johnson's office.
NOW WHAT?
This is Dr. Scott’s list of treatments:
-
rest and observe the knee (no running, but didn’t say how long);
-
brace on knee to allow MCL to heal faster (it allows flexion but not
sideways torque);
-
MRI (we pretty much had to beg for that; it seems reasonable
to me that a current scan will show further damage to the knee in the
last seven months);
-
cortisone shot (he does not recommend that because it just
covers up the problems and doesn’t address them);
-
may need another look through arthroscope if the above solutions
don’t help.
We'll proceed with the first three
this week.
Jim was fitted for the knee brace today and will wear it for
several weeks to allow the MCL to heal, if that's part of the problem.
The nylon fabric brace wraps around his knee and snugs up with Velcro.
There is a cut-out for the front of his knee to allow more flexion.
I took the next two photos later in the summer while Jim was wearing the
brace cycling:
An
MRI is scheduled in the same office on Friday afternoon. Dr. Scott will
call with results and Jim may or may not need to return to his office
before we leave the area.
WHAT A DOWNER!
Jim’s pretty bummed, of course. This may well end his ultra running
career, at least if he wants to postpone knee replacements as long as
possible.
Dr. Scott advised that cartilage loss is faster once it starts to go
-- after an injury, with aging, or both in Jim's case --
and the stress of running on pavement or trails exacerbates the
loss even more.
It's the same message
I've gotten from Dr. Johnson in Roanoke about my Granny Knees.
And also like
Dr. Johnson, Dr. Scott recommends cycling instead of running. We didn’t ask
about Jim's prognosis for long-distance hiking/walking yet.
As you can imagine, we had a somber drive back home through the
mountains.
I can empathize and sympathize with Jim. I know how much
he is hurting both physically and psychologically. Two years ago I had
to face the fact that I can't/shouldn't run any more because of a lack
of cartilage in my knees but I had more warning than Jim did because my
problem is caused by osteoarthritis and not an injury.
Running addicts like us don't ever want to hear that we might soon have
to quit doing one of the things we most enjoy in life. Hearing it so
bluntly and unexpectedly is tough. We hope Jim recovers well and the
doctor's assessment is wrong.
BACK AT HOME
When we got back to Silverton late this afternoon we treated ourselves to
an early supper at the Brown
Bear restaurant, one of the few restaurants we've visited over the years
in Silverton. We simply don't eat out much.
We were disappointed to find that the price of our favorite entrée
(chicken breast, rice or potato, hot veggie, salad bar, and yummy
homemade wheat bread) has gone up $2 from last year but it’s still a
pretty good deal and the food is tasty. We’ll probably not eat there as
many times as we did when the price was lower.
Jim immersed himself
in the movie "True Grit" in the evening and I worked at my computer. You
can bet our thoughts kept going back to what we heard in Dr. Scott's
office earlier in the day.
Cody-pup did fine while we were gone. He was jumping up and down like a
ping pong ball while I was outside getting his supper. A couple driving
out of the campground saw him and stopped. The man observed that Cody
must be pretty hungry. I laughed and said yes, his supper is four
hours late!
They were amused to watch Cody inhale his food like he always does, even
when it isn't served late.
Campers have a fire going right next to the
overflowing creek this evening;
the main channel is to the left, out of sight in
this picture.
I walked Cody over to the creek about 8 PM. Yikes! It’s even higher than
it was last evening. On this relatively hot day, a bunch of snow in the
nearby mountains melted. It should be interesting to watch the creek the
next two weeks -- from the safety of our "high and dry" campsite.
Next entry:
let's go see what South Mineral Creek Road and the Ice Lake Trail look
like . . .
Happy trails,
Sue
"Runtrails & Company" - Sue Norwood, Jim O'Neil,
and Cody the Ultra Lab
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© 2011 Sue Norwood and Jim O'Neil
