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Warning: Quitting Smoking Can Be Hazardous To Your Knees

If the Surgeon General had my best interests in mind, he would have issued a warning: quitting smoking can be hazardous to your knees. I quit smoking, and in the process, ruined one of my knees. I am in absolute agony.



A few months ago, I decided to quit smoking. It wasn't easy, but it could have been a lot worse. I used the nicotine patch, it went well but I gained about 10 pounds. Then due to some stressful events, I caved in and started smoking again. I went through all the trials of quitting and had nothing to show for it except the extra pounds.
So I decided to get more serious about quitting. I figured that the only way to succeed would be to exercise to avoid the weight gain. I went on the patch again, but this time it was absolutely horrible. One of the rare side-effects of using the patch is insomnia, sometimes I couldn't sleep for days on end. I finally got a prescription for some sleeping pills, they helped a little, but not enough. I was absolutely frazzled. But finally I got through it, and I could begin an exercise routine.
Back when I was a teenager, the new rage in exercise was Ken Cooper's Aerobics, and I followed it religiously. I had a racing bicycle and I used to ride 20 miles each way to high school from my house out in the country. I had great motivation to do the program and document it, I was allowed to skip Phys Ed classes, so I didn't have to mix with the jocks or the obnoxious Phys Ed teacher. I got in really good shape, the best shape of my life. I had occasional thoughts of becoming a bicycle racer, way back when Lance Armstrong was in diapers, and nobody ever heard of the sport. I finally gave up bicycling when I moved to Los Angeles where cars and bikes do not mix. This was vividly proven when a neighbor swiped my bike and was hit by a car, turning my beautiful racing bike into a pretzel.
The distinctive feature of the Aerobics program is that it progresses very slowly since it was designed for sedentary middle-aged men who were completely out of shape and on the verge of a heart attack. You are supposed to progress very slowly so you don't have a heart attack or injure yourself from over-exercise. When I was a teenager, I wondered how anyone could get so out of shape that they could only safely walk 15 minutes a day. But now that I am a sedentary middle-aged man, I completely understand. It doesn't happen intentionally, it creeps up on you slowly without you even noticing it.
I decided to start with a low-impact swimming program, since I live across the street from my city's indoor pool. I got in about 4 weeks of swimming, then suddenly school started and the local swim teams started monopolizing the pool, I could never get in to do laps. So much for that idea.
I decided to do it the hard way, running. Running gives you the most benefit in the shortest duration, but it is hard on your legs and ankles (especially if you're 6ft2in and 250lbs like me). I am not built for running, so I took all possible precautions. I got some really great running shoes, and expensive custom orthotics. I tested them out and the new technology was really great, it wasn't nearly as stressful on my legs as I expected.
The classic Aerobics running program starts with a slow 12 week progression of slow walking at increasing distances before you even start to jog, let alone start running. I started in early autumn, it looked like I had just enough time to get up to running speed before winter set in. I wanted to get up to speed before the coldest weather set in, so I could keep warm from my own body heat. But I got a late start, I spent a few more weeks on the patch than I expected, so now winter was here and I had to go out walking in temperatures as low as -10F. That was no fun at all, but I suppose it was better than exercising in sweltering summer temperatures.
Of course I didn't think I was in as bad a shape as the Aerobics program expected, so I pushed harder than the routine suggested. When it said I should walk 1 mile every other day, I did 2 miles. Then I increased to 6 days a week instead of 3 days a week. I was pushing hard, but I seemed to be making good progress. I exercised for 6 weeks before I lost a single pound, then suddenly I lost 4 pounds in one week. The program was starting to work, even if my legs were taking a beating. I was really motivated, I got an iPod and walked along to tunes by The Donnas, there is nothing quite so motivational as being taunted by teenage girls. I kicked it up a notch from 15 minute walking miles to 13 minute miles with 2 minutes of light jogging per mile. Then one day I was out walking in a straight line, in the home stretch, and my right knee began aching. It seemed only mildly painful, so I figured I'd take the next day off.
I woke up the next day and I could barely stand up, my knee was so painful. I didn't think I injured it, I was just going in a straight line, I didn't torque or twist it, I didn't fall, so I figured it was just a strain and it would go away after a few days. But it didn't. The New Year's holiday was approaching, I figured if it didn't heal after a week, I'd go to the doctor. I spent a week in agonizing pain, and then went in to the ER on Jan 2, figuring the doctors would be back from the holidays (I forgot that Jan 2 was a Monday and a holiday, oops). They took some wonderful X-Rays of my knee and declared the bone structure was in perfect shape, no fractures, no arthritis, not even any signs of wear and tear. But an X-Ray can't see the ligaments and cartilage, and the orthopedics clinic was still closed for the holidays. I made an appointment, which is still a whole week away. They gave me a stupid splint to immobilize my whole leg, and prescribed 3x the normal dosage of ibuprofen, which is almost 90% of a toxic dosage. It's not doing much for the pain, but I can tell when it wears off so it must be doing something. I was kind of hoping for better meds.
I decided to backtrack and see where I went wrong. I used the original Cooper Aerobics program, the same book I used as a kid. It calculates each activity by "Aerobics Points" and you need to do a minimum of 30 points per week to improve your fitness. You start out doing 5 points and work your way up to 30 points over several months. I looked around Dr. Cooper's website, and found out that they had recalculated the entire point system. I thought I was doing the recommended 20 points a week, but I was already doing 30 points. Oops. No wonder I got injured.
Now I have a setback of at least a couple weeks, maybe even months. Worst case I might need knee surgery, best case I need to rest for several weeks. I can't even get in to see the doctor for another week. Now I'm back to where I started from, and probably worse.
If I have to start over from square one, I'm going to do things right this time. I should have gotten a stationary bicycle with a built-in heart rate monitor. I looked at some used models before I began, but decent bikes start around $700. Besides, I want to move back to California in a month or two, and that would just be another expensive bulky item to move. So once I get relocated, I'm going to get a stationary bike, and I can get my aerobics points without pounding my feet on the pavement.

Comments

Charles, I hear you on the insomnia side effect. I used the gum to quit smoking a while back and it really threw my sleep schedule off for a couple of weeks. Even exercising didn't help - it made me tired but not sleepy.

I quit smoking 6 mths ago. I have gain 11 pounds. I increased my cardio and work outs. Actually cut back on calories, a first for me. Still can not get this 11 pounds off. My entire life Ive weighed 135 to 140.

[I sympathize with your problem. When I started working out after quitting smoking, my weight continued to go up for a while. My doctor said I was replacing fat with lean muscle mass, so it was a good thing. It may take a while, but you will lose the fat and get into great shape, eventually. Keep at it. --Charles]

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