Arthritis, Part Three by John Post, MD

Supper time at the old triathletes home

 

Making it to Kona    (written on the Big Island)

 

“And another one’s gone, and another one’s gone, and another one bites the dust, heh heh.”  You know who sang these words.  But, earlier in his career, singer Farrokh Bulsara (you now know him as Freddie Mercury) was going nowhere in a band called Sour Milk Sea.  He took a look at his past, present and unpromising future, and made the changes he felt were required to reach the top.  I guess the question is…are you willing to make the sacrifices Freddie made to get here?  But first, answer these three questions:  1) Do I have  reasonable chance to qualify or do I just impress myself when I tell others “I’m training for Kona?”  2) Will my personal/professional life suffer too greatly if I take on this goal?  Does my spouse/significant other agree with this biased assessment?  3) Is it worth it in the end and what will have been the cost – how many irretrievable kids soccer games will I have missed?  (The 70.3 distance is to some the perfect race.  It takes a fair amount of training – but not your life – to finish respectably, you’re not walking death the next day…or two. Also, it’s easy to keep the family involved without dipping into the college savings account for airfare.)  Food for thought.

 

Parts one and two of this arthritis thread have covered the general pathophysiology of the degenerative process, anatomical findings and PAIN. When it comes to procedure specifics, arthroscopy was reviewed, microfracture, and bone/cartilage transplants (OATS).  I reviewed joint replacement in triathletes and the host of issues that diagnosis and operation bring forth. 

I actually spent a good bit of time on the phone recently with an experienced triathlon coach scheduled for knee replacement surgery in January.  This is a man who already knows the triathlon game and who’s done a great deal of research on artificial joints.  The main point I tried to get across to him was that regardless of TV ads or the skill of his surgeon, he will not have the same knee when all is said and done.  He may get a terrific result, but he’ll notice at least small differences in joint function.  His choices of athletic activity may have to take this joint into account on some level.  Good luck, Coach!

So, this leaves us with conservative care. You don’t immediately (if ever) want an operation and would like to take steps to diminish or eliminate pain while maintaining function. There are many volumes devoted to care of the arthritic patient, even an entire medical subspecialty – Rheumatology – so I’ll just touch on a few things. As with most medical issues, an accurate diagnosis is an essential starting point. Does your arthritis affect only the joints or perhaps other body parts? An educated patient has the best chance to retard progression of the disease while maintaining the highest quality of life. Learn what you can about the problem and be your own best advocate. Some would say this could be true of any illness or injury and I’d tend to agree.

This may be accomplished through a host of options including weight loss, life style modification, changes in activity choices, joint protection, medications or injections, etc. Trying to balance the seemingly opposite goals of doing well in one’s age group in a race as opposed to getting a damaged joint to last as far into the future as possible can be a challenge. In short, just like the triathlon coach facing knee replacement, do your research, ask your physician the right questions, and take charge of your own body. You are a triathlete after all!