By Andy
Related post: On the Chinese Medical System and a Rest in Shanghai
With each visit to a doctor, I increasingly feel like medicine is more guesswork than science. I’ve seen three doctors in the past two weeks, each laying blame for my knee troubles on a different part of the knee. The first doctor in Hangzhou seemed sure the problem was with my meniscus and that the anterior cruciate ligament (ACL) was perfectly fine. The second doctor, a surgeon at United Family Hospital in Shanghai, looked at my MRIs and saw slight tearing in the ACL, saying that the meniscus was a bit degenerated but would heal itself just fine. The third doctor, an orthopedic and sports medicine specialist at United Family, after looking at the MRIs and making some seriously painful jabs at my knee, said that the problem was with my patellar tendon, which is inflamed where it connects to the shin.
The latter, Dr. Chen, gave me three options: physical therapy for five weeks, a cortisone shot, or surgery. Due to communication issues, I had an extremely hard time getting him to explain to me why I would do any of these three things or what the hoped-for result would be for any given treatment. When pressed, he suggested I start with physical therapy, maybe get a cortisone shot, and do surgery as a last resort. Well, that seemed pretty reasonable. Worryingly, he also said that it looked as if my knee had developed incorrectly, with something-or-other being higher than it should be, thus making it likely that these problems wouldhttp://www.portraitofanlbx.com/wordpress/wp-admin/post-new.php continue to pop up. The consult, vague information, some anti-inflammatory patches and creams and a referral to a physical therapist set me back 1,700 yuan (nearly $250). An orthopedist friend of my mom’s suggested that the structural issue Dr. Chen was referring to was likely patella alta, where the kneecap sits too high, making for an elongated patellar tendon, which is inherently less stable.
So I got in on the earliest slot for a physical therapy session, which was this morning at 11. I met with an Indian doctor who was able to clear up some of the things the specialist had said. The goal of physical therapy would be to strengthen the quadriceps muscles to help keep the patellar tendon stable. A cortisone shot would relieve pain in the affected area and cut down inflammation so the tendon could heal, and surgery would be used to cut out the inflamed part of the tendon, again so it could heal normally. After a consult, where her timid pokes at my knee failed to illicit the same painful cringes that the specialist’s jabs had, she waved the magic ultrasound wand over my knee for a while (that thing seems about as silly as traditional Chinese medicine to me, but it’s supposed to help increase blood flow to the knee to help things heal faster). After that I got a little lesson on stretching. She didn’t seem to think my injury is particularly severe, and says that a few weeks of ultrasound, stretching and strengthening exercises will have me ready to “ease back into riding.” At 1,800 yuan ($263) for the session, I don’t know how long I can keep the ultrasound treatments up, even if my insurance actually does end up reimbursing me at some point down the road, which is of course a big unknown.
So for now I sit and wait, stretch and strengthen. At this point my plan is to give things another week, possibly getting the cortisone shot, and then heading back out on the road, building up gradually. My leg muscles have already begun to lose all the impressive definition they had acquired during the 3,000 kilometers I’ve been through so far, and knee injury or not, I’m probably not quite capable of keeping up with Evan and Alexis at this point. All four doctors did recommend the same thing, which is to raise my bike saddle to take pressure off the knees. I have already been riding with the saddle in a fairly high position, which was beginning to strain my Achilles tendons. After lowering it my knee began hurting. When I get back on the road, a major priority will be to find the sweet spot in saddle positioning that allows me to be a healthy rider. Another will be to figure out how to lose some of the weight on the bike, which currently makes the thing a hefty 60 kilos (132 pounds) without me on it.
The upside of all this is that I will get to see a few good friends who are coming into town while I am here. I’m also teaching myself more Chinese and reading more. As an aside, if any of you are like me and have been looking for a good Chinese book to read after going through most of Yu Hua’s (余华) novels, I would recommend 明朝那些事儿, which is a fairly straightforward and interesting read that comes with a healthy dose of Ming Dynasty history.
