Pauls Knee (ii)

My bad knee continues to be a problem. It's been five weeks since my fall and I've been getting treatment every week. The swelling has now gone down to leave a large lump on the top of my tibia. The lump is egg shaped and gives a little if you press it. I'm told this is a haematoma, a blood blister that formed on top of the bone when it was bruised in my fall. The lump is no longer very painful and I'm told it will go away in time.

 

The knee joint itself is the most painful: it still feels weak and I get stabbing pains with certain movements, especially when walking. I've been wearing a support bandage a lot of the time. The physiotherapist now believes that I have torn a cartilage. I'm booked to have a scan on my knee which will tell for sure.

 

You have two pieces of cartilage in each knee. They are crescent shaped and look a little like the segments of an orange, thicker on the outside of the knee and thinner on the inside. The cartilages fit between your tibia and femur, working as shock absorbers. A sudden impact on your knee, particularly with a twisting movement, can damage them.

 

The outer edge of the cartilage has a blood supply and thus can repair a small tear. So I've been doing plenty of hot compresses on my knee to help stimulate this. The inner surface of the cartilage doesn't repair. It's possible to have surgery to repair large tears of the cartilage and for damaged pieces to be removed. But, especially given my recent experience, I don't want to go down that road.

 

As driving is a little painful, I'm leading a fairly enclosed life. At home with my injury I surf the internet and watch plenty of TV, which has driven me to fix the drip on the kitchen tap and other minor tasks around the house that I had been putting off. I don't seem to be in the mood for writing very often. It's pretty frustrating, this is the longest interruption to the active life that I've been enjoying over the past three years. And of course I'm very worried about what the scan will show.

 

 

Americano and Caramel Square

I've become a connoisseur of independent coffee shops. My usual is an americano and a caramel square. I've tried plenty of different places.

You sit and wait with anticipation: the coffee machine growls and hisses, a teaspoon clatters onto the saucer and a plate is loaded with your pastry. But so often the outcome is disappointment: coffee insipid or brackish, caramel square thin and tasting like sugary cardboard.

 

I end up returning again and again to the few places that provide consistent high quality: strong flavourful coffee and a delicious caramel square (smooth shortbread, caramel and chocolate in good proportion). My favourite independent coffee shops are:

 

Grounded Café, Monaghan St, Newry. On the corner near the Canal Court Hotel. A café with a youthful vibe, always busy but the quality never lapses. Great coffee and the best caramel squares I've tasted.

 

Green Bean Café, Townsend St, Banbridge. Just off the main street, behind Supervalue. A peaceful place, rarely full but always high quality. Fantastic bespoke coffee (they ask you how strong you want your americano) and great caramel squares.

I've tried independent coffee shops across much of Co Down and South Belfast. These two stand out as the best. Are there any others of note that I've missed?

Paul's Knee

Home sweet home is a dangerous place. Three million of us visit A & E every year because of an accident in the home. I'm afraid to say I've joined this unhappy band.

I don't recall exactly what happened. One moment I was stepping out from my front door to collect something from the car, the next I was lying on the gravel outside with a terrible pain in my knee. I guess I must have tripped on the steps down to the driveway.

Many accidents must happen just like this. You are in a well known place doing something routine, and your attention lapses momentarily. It's the sort of thing you find yourself doing pretty often, thankfully without unpleasant consequences most of the time.

On this occasion the top of my shin bone (tibia) took most of the impact of my fall, pushing it upwards and across into my knee joint. I've been told that I've sprained two knee ligaments (patellar tendon, lateral collateral ligament) and bruised the cartilage. It could all have been a lot worse, had the impact been an inch or so higher it would have hit the side of the kneecap itself.

I've had a couple of ultrasound treatments and one of electrical stimulation, where a pad is placed either side of the knee and electric current passed through. It's a very odd feeling, intense pins and needles, like you're attached to a farmer's electric fence for a couple of minutes.

During the good weather it's been tough having to sit quietly at home and give my knee hot and cold compresses. Thankfully I've also had the distractions of Wimbledon, the World Cup and the Tour de France. All being well, in another couple of weeks my knee could be back to normal.