NEW KNEES/OLD KNEES?

My group of retired teachers stood to leave our spring get-together at Mitzi’s. Mitzi sat, planted in a chair, leg propped. Awaiting knee replacement surgery, she grimaced in pain, but called out gamely, “We’ll have our usual teacher’s retreat at my cabin but I’ll sit. You guys do all the work.” In 2008, my family’s Green Valley Lake cabin burned to the ground but teachers continued August gatherings, crowding into Mitzi’s cabin. 

Next day Mitzi emailed,  “SORRY!!! Mountain trip’s off. Can’t manage stairs up to the cabin.”

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Exiting my Saturday class, I fell into step with a lady who complimented me on a recent column, then said, “I won’t be here next week, having a knee replacement.”

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Running too fast to keep up with speedy Evie, a guy on a bike, pedaled up, “I’ve been watching you,” he said, “You’re limping. Are you thinking about a knee replacement?” He told me his doctor’s name.

Yowzers, is “knee replacement” the new appendectomy?

I count half dozen friends who’ve done one, or two, and no, none are runners.

Should I join the crowd?

Yep, it’s a “crowd.” Bostonglobe.com’s Courtney Humphries, 2012, “Do you really need a knee replacement?” says “…knee replacement surgeries are skyrocketing…attributed to many factors: growing rates of obesity, an active population of baby boomers now facing osteoarthritis, and the continuing improvement of artificial joints.” 

Dorothy Feltz-Gray at arthritis.org writes that, “People younger than 65 are the fastest-growing age group opting for total knee replacement. Overall demand for the procedure is rising as well, with numbers expected to increase.” 

Both authors caution us to think long and hard before signing-up. How to decide? Here are just three considerations.

LOOK AT YOUR AGE

Gretchen Reynolds of NY Times well.blogs, 11/13/14, in “Think Twice Before Choosing Knee Replacement, cautions the youngsters, 45-65 for whom knee replacement surgery “soared by 205% between 2000 and 2012.” Among 65 and older, the increase was only 95 percent, yet, surgical replacements were better suited for the older group because implanted materials wear out after a couple of decades—possibly necessitating a second surgery for the 45-65’ers. 

Furthermore, older people who had “really bad knees,”  benefited substantially from knee replacement surgery, gaining 20 points on a scale of improved knee function, while those with slight arthritis reported more pain and physical impairment, gaining only 2 points.

LOOK AT YOUR LIFESTYLE 

What is meant by really bad knees? Reynolds quotes, Dr. Daniel Riddle, Virginia Commonwealth professor and study author who says, “If you do not have bone-on-bone arthritis, in which all of the cushioning cartilage in the knee is gone, think about consulting a physical therapist about exercise programs that could strengthen the joint, reducing pain and disability, losing weight helps, too,” Riddle says.

By “no cartilage” in Riddle’s definition I may qualify. In 2007, an orthopedist glanced at my knee X-rays, and said, “You have no cartilage in your knees.” “End of running,” I thought. “Reading my mind, the doctor, said, “Lots of runners have no cartilage, keep running.” I went on to complete six marathons. 

So, “bone on bone” doesn't necessarily mean “really bad knees.” The deciding factor is daily serious pain. I don’t have knee pain unless I run too fast. No knee problem at my new slow rate: 12 to14-minute-miles. At the gym, I’ve given up weight machines which pain my knees, in favor of exercises learned at former physical therapy sessions. In short, I’ve altered lifestyle. 

GET EDUCATED

Globe’s Humphries offers the concept of “decision aid” to patients considering knee replacement. She quotes James Jacobsen who, like me is in early 70’s and had a “bone on bone” X-ray. His doctor recommended replacement, but handed him a pro/con video and brochure. He studied the materials: “I know right now that I’m not going to have a knee replaced until it’s absolutely necessary. If I didn’t have the [video and  brochure]  I wouldn’t [have known] how to make a decision.”

I’m not considering knee replacement. With lifestyle changes, my knee does not hurt with daily activities. 

Mitzi, waiting in line for hers, says, “Dr. X did my left knee. I can’t wait for the right. If it goes like the last one, I’ll be pain-free for next year’s cocktails at the cabin.”

https://www.bostonglobe.com/lifestyle/health-wellness/2012/10/21/you-need-new-knee/

http://well.blogs.nytimes.com/2014/11/13/think-twice-before-choosing-knee-replacement/

HAPPY GUARANTEE 

Want to feel euphoric?

Run your guts out.

Work hard, (NEVER to the point of injury.)

Complete a challenging work-out.

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Today I completed the Long Beach Half Marathon. However, for the first time in my running life I ran:

—without proper preparation due to a 17 day vacation and grandma duties

—ten days after being in serious pain due to sitting in a car for vacation-sightseeing, as well as a 15-hour return plane ride.

I sent in my $120.00 to Long Beach Marathon because I wanted a reunion with the “Saturday Runners,” a group I used to race with, completing full marathons in New York, Chicago, Portland. I’ve almost dropped out of the group due to family demands, but I’m not willing to lose contact altogether. 

Catherine, a social worker and Caroline a scientist, are the indisputable leaders. Catherine soft and wise and Caroline, tough, and exacting. 

A knock on the door at 5:20 a.m. got me out before I gobbled my favorite pre-race food--a peanut butter sandwich. But when Caroline says, “Lets go!” we move—fast!

The dark Sunday morning yielded a nearly empty 405, so we sailed into strategic marathon parking, close to the start. 

Runners routinely use extra pre-race time to head for the port-a-potties. Happily, we were early enough to make two visits. Sadly, the potties were already out of toilet paper. I remembered too late how another runner packs a roll of toilet paper for every race. 

So without the benefit of peanut butter or toilet paper, I said bye to friends whom I was sure were faster than I, and lined up for the start. 

I like to race alone, an usual state for me. I’m gregarious. Not in races. I do not want to chat, worry about friends, or high five spectators. 

My wave of runners moved up to the starting line. The horn sounded. I started my run to the mantra, “This is easy,” and it was.  My watch read 10:45 pace. 

My race rules were:

—No reading signs or shirts. (takes energy)

—No looking at other runners. (I surge ahead when I spot a senior female. Without prep, so recently injured, I did not think I could afford a surge.) I place first in races, but gave up the idea today.

—Keep visor low and eyes down. ( Not in top shape, I don't lift my feet high enough off the ground to avoid ruts in road or sidewalk. I fall DOWN.)

For weeks before the race, I put myself to sleep visualizing each step--a clear fast race. “I’m in my dream,” I told myself, running my race at a comfortable pace. 

I popped a Shot Blok (gummy electrolytes and caffeine) into my mouth and decided to pop another every second mile. Mile 2: water, shot block, and back on the course. Repeat at Mile 4.

My strategy worked until I dropped my Shot Bloks at Mile 8. So, I fished a chocolate bar out of my fanny pack. Still running without pain, I felt continuous energy but noticed my pace slowed to 11-minute-mile. By then, I left my early mantra and adopted the strategy of rhythmic counting steps between lane lines in the road. “One-two” steps on blacktop between lines and “one” on the line. 

Momentarily sneaking a look at a a senior female, I broke my rule. Left her behind. Spotted another walking and took satisfaction, running past her. However I felt I was running at my old pace—nine minute miles. I secretly hoped to regain my 2-hour-half marathon time. 

Then the 2:20 pacers holding their prominent signs breezed past me. I did not keep up with them. 

In most of life, I am reflexively self-critical but not racing. I raced my race, keeping a steady pace, never sinking into the dreaded “used up feeling.”  “I’m doin’ it,” I told myself.

At Mile 11, I began the countdown. Shoving chocolate into my mouth, remaining spry, passing runners who bonked. 

A hot morning, I had dumped cups of water over my head and when a guy on the course gave out baggies of ice, I emptied the cubes down my shirt. 

So, all wet, I came though Mile 12 and 13. Thrilled to see "The Finish," I crossed the line as my name was announced. 

Yeah, I was glad to stop, but also elated—thirteen miles under my belt and still standing. 

Found Caroline and Catherine in the complimentary beer garden sitting with our group. My stomach wouldn’t allow me to drink beer but I celebrated. I hugged the fastidious Caroline, who recoiled. “You’re WET,” she said, “Get away from me!” Gentle Catherine was more charitable, “Get in line to get us some beer,” she told me. 

My official pace was 11:14 mile. My finish time, slowest ever by almost half hour, was 2:27:19. I got an age-group first place. No speedy 70-year-old overtook me.

Later, I read that the average female pace for the half-marathon was 12:45 and that includes everyone decades younger than I. 

I could grieve over my slowing but at nearly 73, I’m a minute and a half faster than the average lady. 

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None of the statistics or first place mattered upon completing the race. My happiness had to do with achievement. Smart runners advised me not to run, unprepared and recently injured. I wanted to join old friends for a good race and finish strong. 

Happiness.

Ten minutes ago, I paid $129.00 to run the Long Beach Half Marathon this Sunday, Oct 9, 2016. 

Crawling off the plane after 15 hours in the air just 12 days ago, I asked my husband, “Do you think I’ll ever be able to move again?

My back buckled, behind burned, knees knotted, quads quavered. Run? HA! I could neither sit nor walk without wailing.

I rolled with the Rumble Roller, splashed in the pool and jacuzzi, stretched, had my first-ever chiropractor visit. So, I’m back to abnormal, just a gimpy knee or two. 

Is it smart to run a race so soon after regaining a thin layer of fitness? No.

Have I been running in preparation for the race. No, nothing for weeks—been out of the country.

Did I get off the plane and do at least one thirteen as I’d planned, NO!

However in the last week, I’ve been back on the road, cutting work-outs in half. Today did six miles of hills, blistering 14-minute miles. At that pace I’ll do a 3-hour half marathon. I’m used to finishing under 2 hours or more recently, two hours plus 5 minutes.

So, lets see what happens.

NOTE: I committed to running this race months ago to support my friend’s niece who planned to run her first half marathon…she since decided not to do it. 

Now I’m running to support her aunt, I guess. 

Her aunt, my friend Catherine who will finish ahead, assures me she will be in the race’s beer garden waiting for me to cross the finish line. Our speedy friend Caroline will be there, too. HOPE not too long.

Hey, they have to drive me home. 

Wish me luck.