giza: Giza White Mage (Default)
Cheetah pawsI've been meaning to write an LJ post for awhile about my overall health, but I've had so many things change along that front that I figured I'd let them settle down first.

First, the issue with my knees. About a year ago, I began feeling pain just below the kneecaps on both knees. I started wearing knee braces to rest the knees, and would try removing them after a few days of being pain free. But this only made the pain come back, and even worse: I would feel sharp stabbing pains in the sides of my knees. That scared me lots, because I had no idea what was wrong with my knees, and I was afraid to do anything that might aggravate them further. So I continued to wear the knee braces just in case I had something degenerative going on.

It took a few trips to the knee doctor, some MRIs, x-rays, and 2 months of physical therapy to finally get to the bottom of things. If you've ever heard a healthcare specialist say, "everything is connected", this is a classic case of that. The pain I felt under my kneecaps turned out to be patellar tendinits. Apparently the space between the bottom of my kneecap and the top of my tibia was a few millimeters too short for someone my size, which meant the tendon was shorter. This in turn predisposed me to things like that. Combine that with hitting the bicycle hard at the gym (more on that shortly), and I set myself up for issues with that tendon. And the stabbing pains in the sides of my knees? Seems I had not been working the supporting muscles on the sides of the knees, and the knee braces caused them to atrophy a little from underuse. So when I tried going off of the knee braces, I gave myself overuse injuries and a little scar tissue. Oops.

On the subject of the supporting muscles in the knees, the physical therapy I had at Zarett Rehab rocked really hard. The people there were very knowledgeable and taught me exercises such as Russian Single-leg Deadlifts to work all of the muscles in the knee, not just the patellar tendons. They also discovered some weakness in the muscles in my hips and lower back, and gave me exercises to do for those muscles as well. This should keep the muscles in my knees and feet from getting overtaxed. After several weeks of physical therapy, they then helped me wean myself off of the braces by way of having me walk longer and longer periods every day without them. At this point, I've been off the knee braces for two weeks, and have been taking walks in the evenings. It's really nice to be able to walk across town again. :-)

I said something earlier about the gym, and have come to the conclusion that gym machines are fairly evil. The problem with them, as I learned first hand, is that many machines only target a single muscle. Let's say you're using a leg extension machine. This will work the quads... and little else. This means that the supporting muscles don't get worked out, and can lead to problems down the road, especially if the quad were to get injured, causing you to limp, and causing more strain to be put on those other muscles. Muscles can start having issues one after another that quickly.

I've quit my membership at the gym, and am going to look into taking up yoga at some point. In the meantime, I'll keep doing my calisthenics 3 times a week, and walk seven days a week. I still have some discomfort in the knees and the tibialis anterior, but since it's a 100% soft tissue injury (e.g., the joints are fine), that will heal with time.

Leopard's pawThe second major issue is my feet. I began feeling this awful burning pain in them at Anthrocon last year. It limited my enjoyment of the con and was quite scary. So after the con I saw my doctor, then my pawdiatrist. Originally, it was pointed out that my feet had high arches, which meant that more load was borne by the ball of the foot and the outside of the feet. The first step to try and treat this was prescription orthotic inserts. But, the pain continued. So I was sent off to physical therapy. Unfortunately, I had an HMO at $OLDJOB, and could not choose which facility I was sent to. So while the people at the rehab facility I went to were really nice, I didn't get the best care I could. (My pawdiatrist used the word "McDonald's to describe them)

Fast forward a few months to December, when I changed jobs, and got a much better health plan. I was then sent off to Zarett for my injuries (yes, physical therapists can treat multiple injuries during the same visit, as I learned) and while it helped with the knees, it did less for the feet. Oddly enough, I discovered just a couple of weeks ago that removing my shoes while seated at my desk makes the pain and discomfort go away. Walking is fine, too. It's only standing and being seated with shoes on that cause me issues.

At this point, I've had X-rays, seen a pawdiatrist, physical therapist, neurologist, and had an ultrasound done. Yet, nobody can really tell me what's going on. The closest the physical therapist could say is that it was very likely a chronic injury spent by walking around with high arches for 30-plus years, but even he wasn't sure what the specific injury was. As he said, "Chronic injuries are frustrating for both the patients and us".

Overall, the pain in the feet is less than what it was last summer, and with things like fractures, arthritis and neuropathy all ruled out, that means I shouldn't have any serious issues going forward with my life.

TL;DR I got old, so I punched old age in the dick.
 
 
giza: Giza White Mage (Default)
I've been kinda quiet here for the last month or so, and that's because, after my workplace got a visit from the FBI(!!) a few months back, I decided that was a sign it was time to move on. I had been there for 5 years (an eternity for a software engineer) and really felt like I was outgrowing the position. I wanted to move up in my career and into a position with more responsibility. So I spent a few weeks in November quietly doing job interviews, eventually found an employer that was a good fit, received an offer, and started work for them 2 weeks ago.

The new position has me working as the senior most engineer with a startup in Center City Philadelphia. In addition to actual programming, I also play the part of the sysadmin and get to be a one-man NOC. It's a big step up in responsibility, and with the corresponding pay raise I got at the new job, it's like a promotion of sorts. The company is still small, and only a month old, so I also have the chance to build something really cool as the company grows. It's the kind of challenge that attracted me to computer programming in the first place.

Yes, they're a Drupal shop, why do you ask? :-) Seriously, Drupal is a big piece of software, and I've learned even more about it in the last 2 weeks. This in turn means I do more neat things with the Drupal sites that I run. Everybody wins!

In health-related news, I finally got over to the Rothman Institute (which is like the Anthrocon of sports medicine) and got a diagnosis on my knee issues. And the diagnosis is: patellar tendinopathy, also known as chronic tendinitis. Here's my MRI:



It turns out that this wasn't brought on by exercise, but rather because the length of my patellar tendons are a few millimeters shorter than is normal. This predisposes me to issues with that tendon, and normally affects people when they get to be around my age. The rest of the knees are "perfectly healthy" according to my knee doctor, and this particular injury is treated with physical therapy. This would be different from the physical therapy I had in the spring, in terms of what muscles are exercised.

I asked the doctor if chondromalacia had anything to do with this. He explained to me that my problems were never chondromalacia. The previous issues I had were just warning signs of this. So I see more physical therapy in my future, and hopefully I can get the knees back to normal.
giza: Giza White Mage (Default)
Today I was finally able to see a knee specialist. I headed over to The Rothman Institute to see a Sports Medicine physician about my knee. Before seeing him, they actually took X-rays of my knees on site that he was able to instantly pull up on his computer when he examined me.

The good news is that he could manipulate my knees in all sorts of ways and there was no pain. That rules out lots of joint issues right there. While examining my X-rays, he actually used the software to draw measurements on the screen, superimposed over my knees. He was able to point out that the ratio of certain measurements in my knee shows the patellar tendon coming up a little short, which could be cause of this condition.

The next step is to get an MRI on my right knee (already have one on the left) and see him with both MRIs so we can get a better idea of what is going on in the soft tissue, and decide how to treat it.

He said that tendinitis in the patellar tendon is a possibility, but tendinitis usually goes away after some rest, ice, and NSAIDs. This may be the more severe tendinopathy, which would require more intensive treatment. At this point, it's unclear if surgery would be required.

I get my MRI tomorrow afternoon.

The best part about working in Center City? The knee specialist and the hospital where I'll be getting the MRI are 2 blocks from my office.
giza: Giza White Mage (Default)
I picked up my orthotic shoe inserts today. This is what they look like:

My orthotic shoe inserts My orthotic shoe inserts

For those of you who have used Spenco Polysorb insoles, that's exactly what the top of them are. They're quite padded. The underside is a carbon mesh, with a rather high arch.

Wearing them feels interesting. To quote my doctor, "it's like there is a hand pushing up on the bottom of each arch".

Getting my muscles adjusted to these will also be interesting. And I don't mean the muscles in my feet, but rather in my legs! Since these orthotics rotate my feet on the Z-axis, this means that one half of the muscles on my leg will pull more than usual, while the other half will push more than usual. I was told to wear them for an hour the first day, then increase the wearing time by an hour each day. He explained to me that if I fail to do this, the pain will send me to the Emergency Room, because wearing them for a full day before my muscles are ready would be like going to the gym for a full day.

The next step is to see my pawdiatrist again in 6 weeks. He said that there's a 98% chance that I will, and I quote, "feel like kissing him on the lips". Yes, he really said that. In the remaining 2%, some imperfection may show up in the orthotics, which means they get sent back to the manufacturer for adjustment.

The manufacturer also offers a "protection plan". For $75, I can be enrolled for 3 years, which will protect my orthotics against damage or theft (LOLWHUT?). I'll probably go for that, just for the damage angle.

What this will do to my knees remains to be seen, but there's a pretty good chance I'll see some improvement there, since my feet will now be aligned properly. If I see substantial improvement, I intend to do some traveling. Possible destinations include New York City, driving west as far as Chicago, visiting Cheetah Pizza (you guys think I'm joking? Click the link!), or flying to Las Vegas.

More news as I get it.
giza: Giza White Mage (Default)
Leopard's pawJust got back from the pawdiatrist's office about my feet, which began hurting quite bad at this year's Anthrocon and have continued to hurt since, laying me up for the last couple of weekends.

The good news: it's not neuropathy.

The bad news: it's my mom's fault.

Okay, maybe I should work my way back from that statement.

My pawdiatrist examined my x-rays and then my feet, and seemed impressed at the brain dumps I put together for him on my knee and feet issues over the past 3 months. He then went on to explain the big picture, starting with my hips. They're a little wider than they should be for someone my size, which means my knees aren't perfectly straight. This accounted for my knee issues (though the excessive cycling surely did not help, either!). From there, he pointed out that my feet also have high arches, which means that an abnormal amount of weight is being placed on the outside of the feet (where it hurts the most) as well as the balls of the feet and the heels. Age didn't help, either. My body was just too old to take the stress that I put on it at every Anthrocon, hence the problems happening this particular year.

So why are my hips abnormal in the first place? It has to do with how I grew in my mother's womb. Since I am a first born child, that means that the muscles in her uterus were tighter and caused my body to be a slightly different position as she carried me. Hence the bones of my hips forming differently.

And how to fix this? Fixing my hips (...how?) is right out, so the next best thing we can do is get orthotics to align my feet properly. That in turn will take some of the stress off of them as well as my knees. From there, it will be some months for my muscles in my knees and feet to fully adjust, since I have to undo about 33 years of mis-alignment first. (there may be more physical therapy involved) I have an appointment to get fitted for them next week, and they'll be delivered 2-3 weeks after that. They normally last a year for people who run marathons, and 3-5 years for the rest of us mortals.

As far as ongoing treatment, the doc said that foot baths and capzasin really won't do much, nor does the Piroxicam. The inserts I currently have don't hurt, but they won't completely help, either. Orthotics are pretty much the only option.

The big downside (aside from the pain) is that insurance plans generally don't cover orthotics, which means $500 out of pocket for me. But... I guess that's what my emergency fund is for. So that brings it down to a mere inconvenience.

Until I get this under control, I don't think I'll be doing much long distance travel, or even short distance travel. ConFluence (this weekend!) is right out, and so is IndyFurCon, I'm afraid, since the first one involves a 5 hour drive and the second involves stomping through a couple of airports. :-/ I'm hopeful I'm feeling better by FurFright and MFF, but we'll see. (I can still make it to DC this weekend, since that involves Amtrak, and mostly hanging out at [livejournal.com profile] davinwarter's place, as opposed to walking around a convention.)

I got plans the next couple of weekends, but I think in general if folks want to come visit on weekend (or give me a lift to local social events on weekends), I won't say no. I think the social interaction would be good for me anyway, and I can grace folks with my charming wit and witty intellect. (complete and total lies, BTW)

Oh, and being old sucks. :-P

What a day

Apr. 17th, 2007 12:31 am
giza: Giza White Mage (Default)
I had an appointment with Dr. K this morning about my knees. Since they flared up last Wednesday, they've returned close to normal, or so I thought. Upon examining them, he pointed out that there was a section of my right knee that was still swollen. He also mentioned that there are "grooves" in the bone under the kneecap, and that some people have deep grooves while some people have shallow grooves. My grooves are shallow, so this puts me more at risk for things like chondromalacia.

We discussed treatment of the condition and he said that the Aleve I was taking was a good start, but that a certain medication called "Piroxicam" works better on large joints. So I walked out with a prescription for that. Unfortunately, it's not to be mixed with alcohol, so that pretty much kills my drinking habit for the next month. It was also pointed out to me that strengthening the quadraceps will provide support to the kneecaps to keep this issue from returning.

Never one to pass up the opportunity to make a joke, when I asked about long term complications of this condition, Dr. K's answer was: "Death and decay. The same as every other medical condition." Never a dull moment with him.

Paying my bill was interesting -- when I went to pay the co-pay, I was told that my account had a $40 credit and I didn't owe anything. Hey, who am I to argue with that? When I got my prescription filled later, it was pretty much the same thing. The total due was $0.00. That's a first for me too.

Of course, the appointment this morning was made all the more interesting by the noreaster that we had going through the state. The roads were very slushy and traffic was pretty bad. What normally should have been about 20-25 minutes each way took closer to 45 minutes each way. And when I got back home, the R5 Regional Rail line was down due to electrical problems. That meant standing outside for about 15 minutes, taking a bus to the 69th Street terminal, and taking the subway into work from there. I made it into the office around... Noon or so.

Given all that went on in the morning, I was pretty tired just when I got into work. This left me being not as productive as I wanted to be. Let's hope I can do a little better tomorrow. :-P

Ouch!

Apr. 11th, 2007 07:20 pm
giza: Giza White Mage (Default)
After several months of my knees having little to no pain, I woke up this morning to my right knee being very sore. It hurt to bend, hurt to walk, stairs were agony.

Consensus among those that I spoke is that my knee probably got into a contorted position while I was asleep, or perhaps banged against the wall, and caused the injury. As of now, it's already feeling better than it was this morning, or maybe that's just the ibuprofen talking. :-)

I'm going to elevate it and ice it up when I get home tonight. I needed an excuse to play some FF7 anyway. :-) Here's hoping that it heals in a few days so I can get back into the gym.

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giza: Giza White Mage (Default)
Douglas Muth

April 2012

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