Rotten To The Core

“When did that tree fall over?” Cody asked. He had driven down from Seattle for one of his periodic visits with Cheryl’s perpetually overloaded computer. She takes literally 1,000s of pictures at a time, and has a tenuous hold on the finer points of file management. He’s forever chaining on new hard drives, and trying to make sense of her naming schemes.

I assumed he meant the alder that had crashed down two or three years ago, the one I cut up into firewood which warmed us for two winters. “A couple of years ago?” I ventured.

“No, this one looks like it was rotten.” He guided me onto the porch, and pointed. “That one was tall and skinny; only had branches at the very top. Must have been some wind while we were gone.”

I grew a little anxious. Among the goliaths in our “back” yard stood a very thin and very tall Douglas Fir, endlessly seeking light above the maple tree which it was forever racing to the sun. I’d always worried it was too rickety to stand, that one day it would come crashing into the house, being only 25 feet away and at least three times that high.

Cody went on: “I bet it was getting rotten inside; it always looked a little sick.” He fancied himself a tree doctor, or at least diagnostician. As a boy, he’d spent a lot of time in our forest. He’s been predicting the demise of a new growth hemlock outside the glass block window for several decades now. It does sport fungal growths on its needles, but keeps getting stronger and fuller every year.

But he was right. That Doug Fir had indeed fallen over. Luckily, either the wind or its own internal tilt away from the maple had caused it to topple due south, uphill towards the sun. The deeply furrowed bark, and absence of any branches along the trunk, gave its identity away.

The base of the tree was visible. Not a root ball, pulling up great clods of earth, but rather a clean shearing, almost as if someone had cut, a few inches below the soil, the tree away from its foundation. I remembered seeing that a few days earlier, thinking it was one of the leftovers from an actual tree felling.The base looked a bit like one of those artisanal mesquite table tops, and whorls, gnarls, and knots, neatly smooth, sanded, and lacquered.

The next morning, I walked across the lawn (actually, the bed of moss which has replaced most of the grass there) to the moss-covered semi-circular concrete wall which  protects our house from the hillside above. Within its confines rise – rose – an ancient maple, and the slender fir, now supine. I struggled up the trunk of another fallen giant, resting near the wall at least since we arrived here, 35 years ago. It has shrunk a bit since then, decomposition relentlessly paring it down from three feet to 18 inches in diameter.

I was struggling, as right now I’m only able to fully use one knee. For the past three months, my right knee has been more or less swollen, depending on just how much I abuse it. A star-crossed attempt at one-upmanship in the weight room on January 8th was the first insult. In preparation for every ski season, for the past five decades, I have been grinding away at my knees with heavy weights on a squat machine, or something similar. This year, I had been slowly working my way up to 360 pounds (plus my own weight), or four 45# plates on each side. This was working well, but I had only ten more days left until I returned to the ominously barren slopes of Snowmass for another attempt at downhill glory. Sharing the small “leg room” with me was a young man, whom for some reason I felt I needed to impress. So after the 8 repetitions at 360#, I added another plate on each side, four more reps. I felt no immediate discomfort, but the next day, I noted in my training diary, “Right knee swollen.” Since I almost never add anything other than time, distance, effort, etc., this must have really impressed me. Also, my running sort of fell off the cliff. I had been going out almost every day for nearly 4 months, but I ran on the 11th (a two day rest), the 12th…and then not again until after I returned from skiing, February 3rd. I went back to daily running until leaving again for skiing, two weeks later.

While skiing in January, I did notice a little bit of strain in my right knee, when trying steep or bumpy slopes. But on March 5th, the best ski day of the year, I insisted on spending the morning chasing after Cody in the new snow, then spending the afternoon with Cheryl cruising through the chop. About 1:15 PM, we stopped for a break, and I found I could not walk up the stairs without my knee crying out in pain. I kept skiing though, going about 50% more than my usual day.

Ever since then, running has been pretty much of a non-starter, walking downstairs an adventure in agony, and the swelling giving me aches and restricted movement. I already had an MD appointment a few days after returning, which led to an MRI two weeks later. It showed, in technical terms:

“Medial meniscus degeneration is present. There is some abnormal signal within the posterior horn of the medial meniscus, but no definite extension identified to an articular surface. Therefore, this is likely related to meniscal degeneration. No definite signs of a medial meniscus tear. Medial compartment cartilage demonstrates mild grade 1/2 chondromalacia. Medial collateral ligamentous complex remains intact.

“Lateral meniscus degeneration is present. The lateral meniscus demonstrates a posterior horn, faint, inner one third, horizontal, 5 mm in length meniscal tear. Extension identified to the inferior articular surface. The lateral compartment cartilage demonstrates mild grade 1/2 chondromalacia. The lateral collateral ligamentous complex as well as the posterior, lateral corner stabilizers of the knee remain intact.

“Patellofemoral joint alignment is adequately maintained. Severe, grade 3/4 chondromalacia is present within this compartment, with a large chondral ulcer along the lateral patellar facet measuring 1.3 cm in diameter. Osseous edema is present within the lateral femoral condyle, with an epicenter at the femoral trochlear groove. This is likely related to subchondral fibrovascular reaction, from the patient’s severe chondromalacia. Also identified is a chondral rest within the lateral femoral condyle measuring 1 cm in diameter, as an incidental finding.”

Put as simply as I can, the bony undersurface of my knee cap has been worn down where it meets the femur, or upper leg bone. The cartilege which is supposed to protect those bones is pretty threadbare. My body’s chronic attempts at healing this insult to its integrity has resulted a lot of fluid showing up everywhere, particularly in the bone itself. That excess fluid fills the space between the bones, the knee joint, and pooches out in a sac behind the joint, called a Baker’s (after the men who described it) cyst.

The pain and stiffness comes from the swelling itself; further sharp pains flare up when the bone finds itself grinding out of the groove it has worn for itself over the years.

This has been a long time coming, and these findings did not erupt overnight. First, years of doing the whip (“frog”) kick as a youth swimming breast-stroke for various teams, then annual ski adventures since age 18, weight lifting most of my life, mountain biking and long cycle trips in the ‘90s, and finally 1,000 miles of running every year from 1999-2016 have taken their toll. I am slowly rotting from the inside, and need to make some decisions and changes to avoid toppling over.

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