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Not the best timing

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2012 was going to be a year when I did more section hiking than in previous years. The simple fact is that I can not continue to hike a mere 100 miles or so on the AT each year -- which has been my average over the last five years or so -- and have any hope of completing all 2100 miles. At age 58, the math and physiology are pretty simple. Thus, Shuttle and I looked forward to a significant increase in both (1) backpacking treks in the manner of
and (2) assisted hiking along the lines of

After my warm-up hike of
I felt I was ready.

The problem is, my statement in that latter blog -- "I feel good that I had no significant body aches or angina during the walk" -- was quite premature. The simple fact is that I DID have some pain in my right knee, on the inside part. I ascribed it to the combination of holding down the gas pedal while driving, followed by some hiking. I had felt stiffness in this area before -- can't say if it was weeks, months, or even years -- but never to the point that it was a bother to walk. This time was different.

When I did some hiking on the Horse Shoe Trail a couple weeks later, the pain in the exact same place was unmistakable and impossible to ignore for a hiker. I mentioned the pain to my primary care doctor during my bi-annual checkup, and he did a little twisting and stretching of the knee.
"Does that hurt?"
"Does that hurt?"
"I guess THAT hurts?"

The doc wrote a prescription to see an orthopedic specialist with the notation, "Torn MCL(?)"
Having followed sports injuries for decades, I knew "torn MCL" was not good.

Okay, I need to see an orthopedic specialist. As I do not typically have access to a car, I wanted a trustworthy doctor that I could get to via a minimal amount of mass transit. After a couple of hours of online searching, I found a doc whose office is right on a nearby bus route, and who has been doing orthopedic surgery for decades. I had no trouble getting an appointment within a few days.

As is typical for meeting a new doctor, I spent more time filling out paper-work as I did with the doctor. Although many people would be bothered by a doctor who spent no time getting to know their patients on a personal level, that's actually the type of health care professional I prefer. I described my symptoms, and he even guessed one before I said it. Specifically, that driving a car causes the most pain. He did a little bit of twisting, predicting the exact results even before he started. He thus concluded that the initial guess of torn MCL was correct. In medical billing terminology it's called a '713.3' . The ortho-doc also noted that he couldn't say how badly the miniscus was torn without an MRI of the knee. He thus gave me a referral for this procedure.

The hospital with which he is affiliated has this device, and (apparently) the hospital is familiar with these problems. When I called to make an appointment, the conversation went:
"What type of MRI do you need?"
"I don't know -- the doctor just said to get an MRI on my right knee."
"What's written on the prescription?"
"I know this is stereotypical, but I'm having a problem reading it. The only thing I can see clearly is 713.3"
"Oh, a torn miniscus. We know what to do."

I was surprised to be able to get an appointment on a Saturday, which worked just fine. I wasn't happy with the parking arrangements for this hospital, but I was able to work around them. Amongst the problems I had was having to park in the back of the place and then walk all the way to the front. When you're getting a procedure because it hurts to walk, this is not an optimal arrangement!

I actually learned about the physics of MRI when I was in college 35 years ago, so I understood that the procedure uses very strong magnets. I guess I shouldn't have been surprised by the questions prior to the procedure -- "Have you ever received a gunshot wound?" -- but I was amazed at the number of things they have to watch out for.

The technician was quite helpful with a procedure that requires that you remain almost completely still for about thirty minutes. I was prepared for that, I was NOT prepared for the incredible noise level of the machine. It was like being in a boiler factory, with all sorts of bizarre noises all around me. I should also mention that this procedure can be VERY un-nerving for those with claustrophobia. There were five sets of picture-taking, each taking about four minutes, and I was out in about thirty minutes.

The technician gave me a compact disk with the complete set of photos. I looked at them as soon as I got home, but, as far as being anything I could understand, they may as well have been driving directions written in Chinese.

The orthopedic doctor phoned early in the week and stated that the MRI's confirmed the initial diagnosis.
"Can you live with the pain?", he asked; and I noted (quite truthfully) that I could work around it IF I was going to sit around my house for the rest of my life. Then I noted that I had plans to do hundreds of miles of hiking this year and in the years to come. We thus agreed that out-patient, arthroscopic surgery would be my only option. My knee would have to be immobilized for 48 hours after the surgery, followed by a few weeks of physical therapy. He felt confident I could make a full enough recovery to permit continued hiking.

The surgery is now scheduled for early morning May 9th. There will be the usual pre-surgery work, but I expect nothing to be problematic.
The last time I had surgery was an appendectomy in 1970, so this is a experience I don't have a lot of experience with. I hope it will be another 42 years before I'm put under the knife.

Details will follow as they occur.
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