I’ve always operated on the principle that
nothing is to be feared, merely understood. In a torrent of agony, with no
relief on the horizon, I decided to find out about this disease, which had
suddenly assaulted me, so before we look at the causes, let’s see what it is.
I know instantly what it isn’t. It isn’t a
pain in the arse. Well it is, but only metaphorically speaking. It can be a
pain in the neck, back, fingers, hips and knees, even the spine, the main areas
it affects, but definitely not a pain in the butt.
I came in with preconceived ideas. I knew
that Arfur was a disease of middle and old age, that it was progressive and
degenerative and that there was no cure other than joint replacement. It was a
case of management, not repair.
It just shows you how many misconceptions
can reside even in an intelligent mind. Arfur is not a disease of middle and
old age. It can strike anyone at any age.
Check the Internet, ask your doctor, see a
consultant at your local hospital and they’ll all tell you that osteoarthritis
is a degenerative condition of the body’s joints, and it hurts. For obvious
reasons I concentrated my researches specifically on arthritis of the knee.
The knee joint is composed of muscle, bone,
tendons, cartilage and a capsule called the synovium, which is like the oil
sump on an auto engine. Cartilage allows free movement of the joint, and is
lubricated by synovial fluid, i.e. fluid from the synovium, the physiological
equivalent of Duckham’s Multigrade.
In an arthritic knee, the cartilage thins
out, and roughens. In order to compensate, the bone can thicken and grow lumps
and bumps at the end called osteophytes. We all know that when you buy a new
car, you knock the rough spots off the pistons during the running-in period.
Osteophytes appear to be the reverse of that process, whereby your knee grows
fresh rough spots. The synovium, not to be outdone by glorified calcium
girders, may deliver more fluid than is necessary, and things begin to get
complicated. Push too much oil through an engine and you run the risk of
blowing the seals. Because your body has no seals, the entire area swells, and
it leaves your knee lumpy, bumpy and battered. A bit like cheap fish fingers
from Tesco.
While all this is going on the, ligaments attached
to the kneecap shrink in an effort to pull the joint back into shape, the
muscles became weaker, and this can cause the knee to give way.
The net result of all this is a knee that
is worse than useless. If it was useless, you could just limp. This, however,
is also painful, so you have to limp and grimace at the same time, and if
you’re not up to multitasking, your knee deep in the S-H-one-T.
Because I’m a sufferer, not a doctor, this
is a necessarily simplified overview of Arfur.
It cannot be cured. If you get it you’re
stuck with it, but there are surgical procedures that can help, especially with
hips and knees. Rather like the rusty, pitted body panels on a 1947 Ford
Prefect, you can have the defective pieces replaced. Unlike the body panels on
a 1947 Ford Prefect, however, you can’t buy the spares on e-bay. I know.
I checked. Mind you, at the same time, I looked for body panels to fit a 1947
Ford Prefect and I couldn’t find any of them either, so there’s hope yet.
It’s also interesting to note that
osteoarthritis of the knee is more prevalent in women than men, and it affects
Afro-Caribbean races more than Europeans.
Mar’llous, innit? Not only do I come from
completely the wrong hemisphere for this disease, but I’ve got the wrong kind
of reproductive bits, too (although, since my weight went up, I do have
bigger tits than Her Indoors).
There you have it. That’s what Arfur is.
Now let’s look at what may be causing it.
Its precise causes are unknown and can vary
from person to person. There may be a genetic disposition to developing the
disease. It may be that a sports or work injury some time in the past has sown
the seeds and over a period of time the initial wear and tear deteriorates.
Habits need to be looked at, too. All
movable joints like knees, ankles, hips, need regular, normal work in order to
keep them in tip-top condition.
It has to be said, however, that obesity
may make you one of Arfur’s major targets.
Superficially, this is quite logical. Any
mechanical bearing has a workload built into it. Exceed that load and you
produce excess wear, which means the bearing soon wears out.
However, as far as I’m concerned, blaming
obesity for Arfur is like blaming Gordon Brown for the daily traffic jam at
Spaghetti Junction. There’s a chain of logic linking the two, (a reluctance
to invest taxpayer’s money where it’s really needed) but it’s pretty
remote.
Try following my reasoning and you’ll see
what I mean. Your bog standard, chair/ settee/ bed bound couch potato isn’t
particularly active. Agreed, he does have to walk here and there , to the
lavatory, for example, or the fridge so he can stock up on goodies while he
watches the telly , but it’s hard work, so he keeps away from it like our old
man used to avoid the front door when the rent man called. In turn, the strain
on his joints is minimised. From this point of view, obesity could be way down
the list of possible causes.
Naturally somewhere on the list of suspects
is smoking. Arfur wouldn’t be a legitimate health problem if smoking didn’t
help to cause it, would it? When you think about it smoking has been blamed for
anything and everything from corns to chronic lung disease, haemorrhoids to
halitosis, so there’s no reason why Arfur should be left out. I reckon that if
the entire world gave up smoking tomorrow, half the NHS would be queuing up for
jobs on the checkouts at Tesco only to find themselves head to head with the
people who used to work on the cigarette kiosk at Tesco.
It’s not the tobacco, say the anti-smoking
gang, it’s the chemicals added to it that cause the problem. So now they’re
putting the chemical industry out of work, too, forming an even longer queue at
the Tesco Personnel offices.
‘Think back on your life,’ the doctor said
to me, ‘and although it’s taken until now to make itself known, you’ll find the
root causes in work related factors, physical habits and so on.’
I took his advice and you know, he was dead
right.
During my teens, when I was an apprentice
gas fitter, a part of my job involved bending pipes. This was necessary to make
them go round corners or jump over obstacles like brickwork or other pipes. The
job was done by inserting a spring into the pipe and bending it round your
knee. Aside from demonstrating an innate skill for twisting copper pipes into
various geometric shapes that would have had Euclid crying tears of joy into his Retsina, this
practice also gave me a beat knee. For a teenage lad, it wasn’t a major
problem. Just a bit of extra fluid on the knee. I was young and tough: I could
cope with it. But did it give Arfur the window of opportunity he’d been looking
for?
Thinking further forward, sometime around
my 18th birthday, I ran into another root cause of Arfur: unprotected sex. You
don’t have to read that twice, it does say unprotected sex.
All those romps in the fields behind the
Thorpe Hotel may have been good fun back then, but while I was riding away with
trousers round my ankles, bare arse glistening in the rain, where were my
knees? In direct contact with the damp grass, that’s where.
Think of it this way, if you buy a piece of
timber and leave it lying around the back garden for a couple of years, what
happens to it?The damp gets in.
Suppose you then lay it as part of your front room floor, what happens the moment
you put any weight on it? It snaps. The damp has rotted it from within. Well
it’s the same with your knees in the damp grass. When all is said and done,
what are your bones but upmarket wood?
This problem goes back to education. Here
in the UK, we don’t believe in sex education. When I was a lad, we were taught
the basic biological details, but quite honestly it was like reading the Haynes
manual for the 1958 Morris Minor 1000. It tells you everything about how the
thing works, but not how to drive it. Proper sex education, i.e. how to do it,
was a girl called Brenda Hardy, but even her practical classes behind the
shelter in the local park, fell short of the necessary knowledge.
Nowadays we’re a little less anal, and the
kids are coming out of school a little more clued up. Having the highest rate
of teenage pregnancy in Europe might have something to do with the change. We
teach them how to use condoms to avoid spreading all those nasty little germs
and avert all those nasty little brats growing in the girls’ bellies. For my
money it’s time we included a class on taking an overcoat or blanket with them
when they go down to the woods to play. That way we can save all those putative
men from osteoarthritis of the knees and all those wannabe women from
osteoarthritis of the spine. It would pay dividends in the long run. Think of
the money the NHS would save in 2108.
Another unsung cause of Arfur is alcohol. I
don’t mean its ability to inhibit your immune system, but its ability to
destabilise your equilibrium.
Here’s an example.Back in the mid nineties, I was at a wedding
reception in the top room of Nimble Nook Social Club. After several gallons of
ale, I needed to visit the gents downstairs. I slipped on the bottom step and
fell. Only it wasn’t the bottom step, as my sister-in-law, who picked me
up, explained. It was the top step. I came down a full flight of stone stairs
like a bouncing bomb and never missed a bleeding step. Had I been sober, I
would probably have broken several bones, but I was pissed out of my brains, as
a result of which I didn’t have a scratch on me. However, what damage did that
fall do to my left knee? It must have done some, and it was only in later years
that I felt it.
So you see, while medical science can offer
some explanations behind Arfur, it by no means covers it all. You have to look
at all the possibilities and that means examining a long life from every
conceivable angle.
