Dec 23: Health Update

[posted to the Wheeled Migration Yahoo Group on Dec 23, 2004]

Merry Christmas, everybody! And a happy belated solstice to those who prefer. Or vice versa, for that matter.

I'm writing with an update about my joint trouble, since many of you are on this list to learn what's involved in bike touring. Last time I wrote, I had just been to a chiropractor (recommended by a local bike shop) who said he saw no reason why I shouldn't finish my trip. However, in the two weeks since I saw him, there's been no improvement in my condition, so this morning I went to an orthopedist / sports-medicine surgeon for a second opinion. Although I'm shocked by how much money one can spend in two hours, I got some valuable information and some peace of mind. And several of you now have the opportunity to say you told me so... Merry Christmas! ;-)

1. The chiropractor had theorized that the reason my knees didn't start hurting until after I rested for 2 weeks in Oklahoma was that before then I had been doing continuous damage to the joints and not allowing them to heal. When I took two weeks off, he said, the kneecaps healed imperfectly, forming sharp points that then hurt when I resumed riding. I was relieved to see in the X-rays that this was not in fact the case. None of the X-rays showed any damage to the bones or the space between them (i.e. cartilage). That's a great relief!
2. On the other hand, the orthopedist says that whenever I feel this pain I'm doing damage to my tendons which will take a long time to heal, if it heals at all. He felt obliged to tell me that the best thing for my health would be to stop overstressing my body -- "overstress" meaning more than an hour of exercise per day! That is to say, I should stop touring. However, when he saw that I didn't throw in the towel right away, he conceded that the second best thing would be to lighten my load and reduce my daily mileage whenever possible. (It's notable that neither of the chiropractors I've seen said anything about reducing either the weight or the miles.) We talked about camping gear and various other heavy things I could consider leaving off my trailer... I was embarassed to tell him about the autoharp! Alas, that will be the first to go. :-( (Cue to Lori: you told me so!) Fortunately I have two more weeks here in which to back off on my daily miles, then work up to a sustainable day's ride. My hosts even have a stationary bike I can try.
3. When I told the chiropractors that I had lost weight on this trip, they smiled and nodded enthusiastically. When I told the orthopedist, he was dismayed. I assured him I'd gained some back in the month I've spent here in Austin, but he dragged me to a scale, and we found that even with my holiday pudge I'm 10 pounds lighter than I was when I left Minneapolis. He said this was the first time in his career he's told a patient to eat more. (Cue to Dad: you told me so!) The way he tells it, weight loss invariably affects the tendons, cartilage, and bones as well as fat and muscle, and so I should try to maintain my current weight when I leave here.
4. The orthopedist reiterated the importance of stretching (which I hadn't been doing until 2 weeks ago) but said that putting ice on my joints after exercise is optional -- rest is more important than cold. That's a relief; although my hosts here in Austin keep nice cushy cold-packs in the freezer, ice can be hard to find while camping. He was unimpressed by the supplements I got from the chiropractor -- basically gristle in a gel cap -- but didn't tell me to stop taking them. He also gave me a prescription for ibuprofen but recommended I not use it unless I feel I have to.

On the whole I'm very satisfied with the way the appointment went. The doctor was very attentive and generous with his time, and although he did recommend I give up and go home, by the end of the appointment he was parading me around the clinic as his "hero" and asking to see my photos, and he said he hopes I can complete the trip as planned. So it looks like I've got my New Year's resolutions in the form of doctor's orders: less cargo, less hurry, less pain, more food. How many people get news like that for Christmas? ;-)

I realize most of you will be accumulating more cargo this weekend, but I'll wish you all less hurry, less pain, and more food for the new year! --Ben