Growing up as a toddler in a country setup near Perth, Ontario, I was a healthy and active girl who enjoyed spending time outside. I loved running around our acreage property, chasing our beloved husky, Frosty, and occasionally trying to catch a white-tale deer that often wondered on the neighboring meadow. I don’t remember much from that period and certainly don’t recall having any problems with my legs. After we moved to Ilderton, Ontario (a small community near London) at the age of 5, I became more involved in organized activities and sports. I tried almost everything that the community had to offer, soccer, ballet, karate, tennis, and even cross country running. I felt really good and satisfied about my physical abilities and the overall coordination.
Around the time that I turned 8, I noticed that something started to change. It was not a big deal but more and more often I started complaining to my parents about my knees, especially the left one. From time to time it gave me this annoying pinching ache that wasn’t sharp or disabling, but definitely noticeable. At first I tried to ignore it thinking that it might be some minor injury from my soccer game or some other activity. However, when it became more regular my parents took me to the family doctor for the first time specifically related to this issue. Sure enough, it was diagnosed as a growing pain, after all my legs were growing fast and considering my active lifestyle, surely I was trying to outrun them. And so it was, I was labeled with growing pain that slowly was growing together ‘with me’. It was becoming more and more profound and defined; nevertheless, it was repeatedly diagnosed and named the same way by various doctors and specialists.
Perhaps one useful but ‘collateral’ diagnosis that I received on the occasion of my visits to various doctors was the fact that I had slightly flat feet. This was another factor that nicely “masked” the real problem that was developing in my knees and nobody knew about. I was told to continue with my active life style, as the exercise was very important to me and far outweighed the discomforts and aches that I experienced. So I kept going, pushing more and more to get better in whatever I was doing. Soon enough I needed a whole bunch of support equipment strapped to different parts of my body, like orthotics, knee sleeves etc. I felt growing discomfort in my knees (especially the left) but was still growing so the ‘growing pain’ diagnosis was a sufficient comfort for me and especially my parents.
In 2008 when I was 13, my family moved to Vancouver just in time for me to start high school in BC. Sports, especially soccer, were my primary strategy to get to know people in a new place. More so, I thought that if I try harder, I would become more accepted and find friends more easily. At that point, the discomfort became even more evident. My running became somewhat distinct; I was trying to make longer steps and minimize bending my knees so that I could cover as much ground as possible and minimize the use of my joints. My parents felt that something was wrong and ‘growing pain’ wasn’t cutting it any more. For the first time I remember seeing them really concerned about my health. I got an appointment with a sports doctor at the UBC Orthopedic Clinic. After a series of x-rays and examinations I still did not hear any breakthrough diagnosis. The suspicion was that my knees were kind of loose and the rubbing of moving parts caused discomfort and pain. I was advised that I needed stabilization. I got a prescription for a better knee brace and physiotherapy to help me strengthen my muscles to compensate for weaker knees. I continued playing sports, mainly soccer and volleyball at that time. I also kept going back to the UBC clinic for some semi regular visits. This continued for another 4 years. Needless to say, over that time, my running became even more difficult and uncomfortable. I eventually had to give up all sports and physical activities except for soccer, which I couldn’t simply just walk away from as I had played it my entire life. Luckily, my time playing for the youth soccer league was coming to an end and in order to continue I would have to sign up for an adult team. This was not something my parents supported, as they were practically begging me to quit soccer at this point due to my knee pain. The last few games were a real struggle. My running was very stilted and I had to get off the field every 10 or 15 minutes to rest. I could hardly finish my shift and often had to ask my coach for a substitution. It was difficult to accept the fact that I had to stop playing soccer, but I felt as though I wasn’t well enough to continue.
What followed was what should have happened a few years earlier. My parents finally pressured the sports doctor hard enough to get me an MRI scan of both knees. What was previously not visible through x-rays finally became obvious. I had advanced stage Osteochondritis dissecans in my left knee, and slightly less advanced stage in my right knee. A piece of my cartilage was almost completely detached from my knee joint and a quick surgery was needed to avoid the knee locking and causing further damage. My other knee was in a less advanced stage, and although it was not entirely clear from my MRI, it may have been capable of healing on its own over time. Unfortunately, my age at this point (I was almost 18) didn’t give a good prediction for self healing of the left knee since my growing had stopped by that time. My sports physician, upon delivering the not so good diagnosis, paused for a long moment and said “this sucks”. This described my situation in that moment well, and I knew that my life would never be the same.
I was referred to a well known orthopedic surgeon, Dr. Chin from the UBC Joint Preservation Clinic. Upon my first visit, it was fairly obvious that surgery was my only option and it had to be done fast to avoid complications. The surgery was aimed at bolting the loose fragment back in place and hopefully allow for healing to take place. My operation was described as a “success.” Afterwards, I was unable to put any weight on my knee for 3 months. This meant I was essentially disabled, moving in the wheel chair, and being carried upstairs to my bedroom only once a day. After 3 months, I start walking with the help of crutches, gradually increasing the amount of weight I put on my knee. This was actually much harder than being on the wheelchair, because now I had to use my right leg very heavily, which became increasingly uncomfortable. Overall, it took me 6 long months to start walking on my own with just limited use of my crutches to ease the pressure applied to my left knee when appropriate. Unfortunately, it was not the happy ending that I hoped for.
As soon as I started walking independently, the pain returned. I noticed it was worsened by two factors. The first one was the weather. I noticed more pain in my knee when air pressures dropped, and rain was expected. Second, and much more profound, was the pain generated by prolonged walking. This pain was becoming very annoying, to the point where I returned to see Dr. Chin. After further examination, it became apparent that one of the bolts placed in my knee after the first surgery may have been sticking out and causing me pain. I was scheduled for another surgery, this time to try remove the screw. Then came the hard part, another recovery process. This time I spent 2 months in a wheelchair, followed by 2 months on crutches. Unfortunately, this didn’t bring much improvement either. Throughout all my treatments, I went through extensive physiotherapy and an endless number of consultations.
At this point in my life, I am trying to take some time to see if I can live with the limitations and discomfort associated with this condition. The alternative surgeries are much more intrusive and drastic. As much as I don’t want to go back for a third surgery, I don’t want to live the rest of my live with the limitations that I inherited as a result of this. I cannot run, or walk longer distances. I experience frequent pains and aches. Perhaps the worst symptom is the uncertainty of whether my knee will eventually get worse. Will I develop osteoarthritis? Is my right knee going to follow the same path as my left and eventually also require surgery? Will I still be able to walk when I am much older? Will I ever be able to run or hike again?
Sometimes I go back to the various stages of my life and imagine how the entire story could have unfolded differently. What if I was properly diagnosed earlier in my life and could have altered my lifestyle and relied on my body to heal itself? Perhaps the entire process would have been simpler, as it is for a large percentage of teens that are fortunate to be diagnosed early. What if I didn’t play so many sports and led a more sedimentary lifestyle? Would that have caused less damage to my knees? Was soccer what caused my problems in the long run? Doctors say that the OCD is caused by insufficient blood supply to the joints. Less stress and impact on the knees would likely mean less damage. Many questions remain unanswered, and some doctors speculate if an alternative lifestyle would have made a difference. However, my parents’ decision to continue my involvement in sports as a child was compatible with promoting a healthy lifestyle for children.