TITLE: A Shock to the System AUTHOR: Eugene Wallingford DATE: April 30, 2011 10:05 AM DESC: ----- BODY: I received some bad news from the doctor yesterday. It looks like my running career is over. As I wrote earlier this month, I haven't run since March 4, when I came down with the flu. As that was ending, my right knee started to hurt and swell, though I was not aware of any injury or trauma that might have caused the symptoms. In the few weeks since that entry, the pain and swelling have decreased but not disappeared. We finally had an MRI done on Thursday so that an orthopedic surgeon could examine me yesterday. The diagnosis: Osteochondritis dissecans (OCD). This is a condition in which articular cartilage in a joint and the bone to which it attaches crack or pull away from the rest of the bone. OCD occurs when the subchondral bone is deprived of blood. As near as I can tell from my reading thus far, the cause of the blood deprivation itself is less well understood. Depending on the size of the lesion and the state of the bone tissue, there are several potential reparative and restorative steps that my surgeon can take. Unfortunately, even with the best outcomes, the new tissue is more fragile than the original tissue and usually is not able to withstand high-impact activity over a long period. That's where we get to the bad news. I almost surely cannot run any more. After the doctor told me his diagnosis and showed me the MRI, he said, "You're taking this awfully well." To be honest, as the doctor and I talked about this, it felt as if we were discussing someone else. I'm not the sort of person who tends to show a lot of emotion in such situations anyway, but in this case the source of my dispassion was easy enough to see. In an instant, I was jolted from trying to get better to never getting better. On top of that jolt, it wasn't all that long ago that I went from running 30+ peaceful miles a week to not running at all. I was stunned. On the walk back to my office, my conscious and subconscious minds began to process the news, trying to make sense of it. I have had a lot of thoughts since then. My first was that there was still a small chance that the lesion wouldn't look so bad under the scope, that it could heal and that I would be back on the road soon. I chuckled when I realized that I had already entered the stage of grief, denial. That small chance does exist, but it is not a rational one on which to plan my future. The expected value of this condition is much closer to long-term problems with the knee than to "yeah, I'm running again". I chuckled because my mind was so predictable. Not being able to run is a serious lifestyle change for someone who has run 13,000 miles in the last eight years. It also means that I will have to make other changes to my lifestyle as well. My modest hope is that eventually I will still be able to take walks with my wife. In then grand scheme, I would probably miss those more than I miss the running. I'm also going to have to change my diet. As a runner, I have been able to consume a lot of calories, and it will be impossible to burn that many calories without running or other high-impact exercise. This may actually be a good thing for my health, as strange as that may sound. Burning 4000 extra calories a week covers up a multitude of eating sins. I'll have to do the right thing now. Maybe this is what people mean when they see a misfortune as an opportunity? I've had only two really sad thoughts since hearing the news. First, I wish I had know that my last run was going to be my last run. Perhaps I could have savored it a bit more. As it is, it's already receding into the fogginess of my memory. Second, I wonder what this will mean for my sense of identity. For the last decade, I have been a runner. Being a runner was part of who I was. That is probably gone now. Of course, when I put this into context, it's not all that bad. There could have been much worse diagnoses with much more dire consequences for my future. Much worse events could have happened to me or a loved one. As one of my followers on Twitter recently put it, this is a First World Problem: a relatively healthy, economically and politically secure white male won't be able to spend hours each week indulging himself in frivolous athletic activity for purely personal gain. I think I'll survive. Still, it's a shock, one that I may not get used to for a while. I'm not a runner any more. -----