When my doctor told me that I could no longer run, I remained seated and calm. I even managed to laugh and joke about it.
I remained in the consultation room for a good half hour. We looked at my knee X-ray, discussed what I should and shouldn't do, went through simple exercises that I needed to do, and the medication.
After five minutes more of small talk and words of sympathy, I made arrangements for a follow up appointment and left. Despite the bad news, I carried on with work the rest of the day and then went home.
Then, as soon as I went into my room and closed the door, I dropped my bags on the floor, sat on my bed and started to sob.
I was diagnosed with osteoarthritis of both knees recently. This degenerative joint disease typically affects the elderly. However, there are circumstances where premature degeneration can occur. The chronic joint disease is disabling when the pain and the joint deformity start to affect mobility.
When I walk, I often feel pain in my knees and stiffness at the end of the day. I put cold packs on my knees when I can put my feet up and take regular pain relief medications during the flare-ups.
At times I even dread performing my prayers, as simple movements using my knees can cause agony.
I had known it all along, I guess. The symptoms did not occur overnight but happened over the years and escalated in the last six months.
I had always been active in competitive sports, since my early teenage years. When I joined the workforce, demands on my time made me change to regular exercise instead. I ran to keep fit, maintain my weight and look good. More importantly, it helped reduce my stress level.
Then the pain became more regular. I reduced the running speed on the treadmill. I started buying different shoes to find walking comfort. I started to steal few minutes of my regular ward rounds to sit down. I avoided the stairs when I could. Despite the progressive symptoms, I decided to carry on. Instead of getting medical attention, I chose to be in denial.
I had the privilege of being able to ask a fellow doctor and friend to attend to me sooner. I went through the physical examinations and investigations, and felt excited and nervous at the same time when we got positive examination findings.
I experienced fear, disappointment, anger and sadness ...just like any other patient. My doctor remained very kind and understanding.
Finally, I came to the answer that I'd already known. I just needed to hear it from someone else. Just to make it more real ...and definite.
Life goes on
It has been a couple of months now. The whole idea of lifestyle modification is not an easy concept to apply. I preach about it to my patients almost every day but now I have to do it too. I have to forget about marathons. I have to change my exercise regime. I cycle now instead of run. I jump on the cross-trainer less regularly than before. I wear my knee guard, made customised insoles to use with my shoes and watch my diet and weight.
Twice a day, I also do stretching and strengthening exercises. I take my pain relief medication when I have to, sit down when I can, and avoid the stairs most of the time.
All this is necessary to preserve my joints. I know my own disability is mild compared with my patients'. But it hits home just as hard.
The other day, an 85-year-old patient who was still standing tall despite having had a heart attack and a stroke, gave me the advice that I needed to hear.
He said: "There are a lot of things in this life that are out of our control doc, but really, life is what you make of it yourself."