Saturday, May 30, 2009

Ahh, the Downtime

So my contract is done. I have another 8 days off until my next one starts.

This is why I love travel nursing.

I have a couple of posts I'd like to make about some other experiences up there, but I am going to give it a little time and space. Small town, sensitive topic...

Finally saw the orthopedic surgeon with regards to my chronic knee pain. Three different docs (including my hero Olympic athlete sports med doc) and three different diagnoses. One thought it might be a fat pad ---which I couldn't help but think "Now I have fat knees? What's next? Cankles?"

I had decided that 'patellofemoral pain syndrome' was the fibromyalgia of knee pain and was starting to think that everything was in my head. So I just ignored it and kept running and biking, getting hopped up on ibuprofen. Vitamin I helped in the beginning but it started to feel like I was 'chasing the dragon', you know...going for that first great high you get from a drug? After a while, even if I took 2 extra strength it'd only give me GERD symptoms and crank the pain down to a dull roar (and before I hear about it I'll just say that YES I have read some studies about NSAID use with distance runners so don't bother scolding and citing).

Anyway, turns out I have (drum roll please) patellar tendinopathy, or jumper's knee. A.k.a--knee pain.

How anticlimactic.

He showed me on my xrays where you can see how the chronic inflammation at the insertion has caused a 'bone bruise' to my patella. Awesome. Apparently this type of tendinitis is slow to heal (double awesome) and the best treatment would be to go in a straight leg knee immobilizer for about 3 weeks and then no activity for 3 weeks after that. Impossible. Can't work on crutches. Maybe when I start school if it is still bugging me I'll give it a go. He also advised putting a 1/4 of a nitro patch directly over the area of pain to increase blood flow to the area--interesting...guess I am hitting the pool to get my cardio for a while. *Shudder of boredom/loathing.*

In the meantime...J and I have a climbing agenda for the next few days. Spent yesterday climbing at Squamish, really fun mellow day. I discovered that despite my weight training for the past 10 weeks, I am in fact, as weak as a kitten. A blind kitten. A newborn, blind kitten.

Found a completely dorky video of the route we did as our last climb of the day, Pixie's Corner, a fun 5.8. I do not know who that dude is but it's entertaining.

Today we're going out again and J has promised that I will get spanked. I am already looking forward to the post-climb beer....mmm...


Rogue Medic said...

Fat pad? Maybe he meant PHAT pad. It's all in the perspective.

Chasing the dragon with ibuprofen? Maybe if you stopped smoking it, it would be more effective.

Apparently this type of tendinitis is slow to heal (double awesome) and the best treatment would be to go in a straight leg knee immobilizer for about 3 weeks and then no activity for 3 weeks after that. Impossible.

There is a type of tendonitis that is not ridiculously slow to heal?

Tendinitis is an overuse injury. Any sane person would have stopped the activity long before, due to the subtle hint that is known as pain. Not people who participate in repetitive motion injury sports.

If you do not do what it takes yo get it to heal, you will end up with worse tendonitis or a tendon tear. If you think that tendinitis hurts/interferes with life, how much worse would tearing that tendon be? How much longer before you can even walk again?

How about the word impossible. You have taken care of patients who were incapable of taking a break from their work. They may even have used synonyms for impossible. It is even possible that they might have used that very word. Yet, when they became ill/injured, suddenly the impossible had to be overcome.

What is more likely to be impossible is that you will be able to heal without finding a way to dramatically decrease the stress on your knee.

A synonym for impossible is inconceivable. think of the fun everyone would have had with that word. Princess Bride quotes, hormonal humor. . .

I had tendonitis of both Achilles tendons. This was 30 years ago, so I was dumber and more indestructible. The only way I healed was to stop running for a while. My insanity level did increase. Something that plenty of people would also have described as impossible. Eventually, I healed. Eventually. It seemed like forever. The voices in my head agreed with me on that point. Yes, We did! Eventually, I could run again.

And running with an injury throws your form way off. This was before everyone had cameras in their phones. I can only take their word for it, but the 400 pounder, who came to waddle around the track, did so with more style and grace than I did. Think of the aesthetic disgrace. Oh, the humanity!

don't bother scolding and citing).Impossible. OK, I will not cite anything, but I did venture forth into the valley of the shadow of carpal tendinitis to scold you. Bad Asystole!


Liana said...

Mmmm.... Pixie Corner. I love that climb.

I thought the guy was going to climb the whole thing hands free. Now that would have been a feat (with his feet).

PS Found you via Old MD Girl. Nice blog!

Keet said...

EBSCO, you must take care of your joints... I started writing this rant about ruling the old-folks home with an iron cane, but it started to be offensive to multiple groups so i'm just going to say: get thee to the pool. My rotator cuff is F'ed and my osteo has me going to the pool, and its really helping. What isn't helping is playing softball and volleyball every week. Ah, we do what we can.
We'll go swimming in the sea when you're here.
Can't wait.

Albinoblackbear said...

RM--*She holds up hands* Ok, you got me! Yes, the MRI's of the torn patellar tendons really made me shudder and I officially scratched running off the list of activities.

Jerry is getting tired of hearing my dialogue when runners go by,"humph, must be nice being able to run...they probably don't even CARE that they can go on a run on this beautiful day...they probably don't even thank their knees at the end of it!!!"

Yes. I look like a woman with wooden legs already when I walk so clearly I need a time out...'graceful' has never been an adjective used to describe anything I do.

Liana--Thanks! Yeah, I thought it was funny that he chose the crux to start filming! But I guess on TR there is no crux--just more work for the belay! hahaha I can say that because I am a top-roping tramp. Glad you like the blog. I took a boo over at your site yesterday and was highly entertained as well. Edith Cavell is my favorite mountain of all time. When I lived in Jasper my bedroom window had a view of it and it is always my favorite part of the landscape when I travel through there now. If I only ever climb one mountain, it'll be that one.

Oh Keet--I am sure your rant was hilarious! Since when did you have a filter?! one who could get offended reads this blog...hey--the other thing that probably isn't helping your joints is the 4 pre-game vodka coolers :P

Yes. I am off to a pool. As soon as I get me a granny-bathing suit. And yes...we'll dip in the ocean somewhere along the way...or maybe the river Shannon...

Bostonian in NY said...

Knee pain sucks. I have a decent history of PFP/PF bursitis ("knee fat pad") that flares up when I get up over 20mi/wk and lazy with stretching...stupid biomechanically retarded body.

Access that Canadian health care system you pay half your paycheck into and get some PT going. Nothing like some U/S massage, electronic stim and a masochistic, biomechanically gifted individual screaming at you while you do stupidly hard exercises three times a week to fix those weak quads/hips and tight hammies.

Blind newborn kitten weakness...hilarious!

Albinoblackbear said...

BINY--dude I WISH physio was convered! Not by my BC medical services plan (54$ a month)...Ok it is not ALL milk and honey here in the land of socialized medicine.

Just saw my usual doc for a Rx refill of BCP and she asked about said knee (noted that I saw colleague with regards to same) and the first thing she asked was "are you running DOWN more hills than usual??"

Er...why yes. Hence major flare up over past 3 weeks running hills in Northern BC. The first (and only) doc to ask about what TYPE of running I was doing. Note to self, not all sports are created equal as are not all sports injuries.

Interesting--so this fat pad thing is real...hmm...I just thought it was some weird South African diagnosis...

Yes...I will get me to a pool and a sadistic physio.


P.S Don't talk smak about my lower extremities there could bounce a quarter off these quads!!! ;) Ok maybe not a quarter but a super bouncy rubber ball of sorts perhaps...

Albinoblackbear said...

and by "convered" I mean "covered".

Rogue Medic said...

Running down hills leads to eccentric contraction. This is not named for me, but is a way of exercising that can be very productive, but also much more strenuous on the muscles (and everything connected, like those funny things that connect muscles to bones) than concentric contractions. This is something that is a healthy part of your workout, but only occasionally. Not every run. More intense exercise requires more rest. Not that I have ever had a problem with overdoing things.

Rogue Medic said...

I thought you used convered rather gracefully.

Albinoblackbear said... MD had the same eccentric chat with me...which I found interesting. See I thought I was being all clever by working on my downhill running and building up my quad strength. Wow did that ever backfire.

Yeah, it backfired right into a black Speedo and goggles today.


I thought I heard someone scream "oh the humanity!!!" when I was in the change room. Then I realised it was me screaming.