My Trick Knee

Will the medical clearance process never end? Peace Corps bureaucracy has been getting me down for the past few months. I've been worried recently that an issue with my knee that didn't go away might actually be big enough to prevent me from leaving for Malawi in September. After I announced my trip to the world, started learning the language, and looked into practicalities like term life insurance and mosquito netting! Sure, it was my fault for not getting my knee looked at immediately - but that problem came after a pretty tough bike race, so I expected to have SOME recovery time anyway. Just not 4 months of it. The real road block was being "put on hold" after I fessed up to the folks in the PC medical office that I couldn't ride a bike without some very real pain. That's one of the basic requirements (along with being able to lift 50 pounds) - can't really get around without, since public transpo is spotty and motorcycles are death traps. PC even goes so far as to prohibit any volunteer from driving any kind of motorized, 2-wheeled vehicle.. but their mortality statistics have gone way down, so their motivation seems valid.

Back to my knee:
After a visit to the orthopedist, I can now breathe a sigh of relief that my knee probably is not going to require surgery now, or in the next 3 years, so I am probably OK to ride a bike. I found it fascinating to learn about the different tissues in the knee joint. My injury is a small tear in my lateral to medial meniscus - basically a flat piece of spongy stuff between where my upper and lower leg bones rub up against each other. Check it out in the picture here:

Funny thing was I stopped doing almost everything for the past 3 months: very few biking trips (and none that were at all strenuous), no walking down or up steps on the metro, no walking to work -- and the damn thing still gets sore! Here's why, though:
The cartilage tissue in the meniscus has very little blood supply. What blood it does get comes to the outer rim, so if your tear happens to be there, your tissue can self-heal OK.. but when your tear is in the middle like mine, there's no circulation to bring in new cells to fill in the damaged cellular matrix (essentially a gel of cells and proteins). Unfortunately, with a tear as small as mine, arthroscopic surgery (non-invasive) is unlikely to actually *find* anything so there's little to be done by that method. More interesting info here.

That means it's physical therapy to strengthen the surrounding muscles and connectors so I can support my poor meniscus. Funny enough, I've probably stressed my meniscus more by laying off the physical activity and letting the muscles take too much of a rest. Ah well, medicine balls and stretchy bands, here I come!

The last detail to take care of is to send a form to PC on monday so they'll take my medical hold off so I can enter the "staging" stage - where I get my diplomatic passport, make flight arrangements, and start the process of making my way over to the continent!