The compact, frail-appearing man before us with his shock of white hair conveyed to us just what a dilemma he faced.  He emphasized, with his normally quiet voice, the sudden onset of unrelenting pain.  When he had gone to see his arthritis specialist six years ago she assured him he was nowhere near being a candidate for knee surgery; he had a long way to go. 

Since that time he had gone a long way.  For one thing, he had experienced something else that was new; an emergency procedure with his heart.

And he had taken his cardiologist's warnings seriously enough, that it would be to his advantage to exercise his heart and his lungs, to take up some kind of recreational exercise that would challenge his heart in the most positive of ways.  He had already been previously convinced of the necessity to continue challenging his body physically and we saw him often in the ravine, chugging along, up hills, down into the valleys, a walking stick in each hand, propelling himself along.

Since the episode with his heart several years earlier, however, he had become committed to pushing his body in a more fierce manner, covering ground determinedly, pushing himself to ever new speeds and enlarging his walking circuit. 

His wife had admitted to him just recently that it had been a gross error on her part to succumb to the pain she experienced by lapsing into a wheelchair and remaining there.  And there, now, is where she lives out her life, with him always on duty, looking to her welfare.

He dreads ending up like that.  They are in consultation with an orthopedic surgeon to determine whether anything can possibly be done at this juncture to ameliorate her condition, for she is, as well as being fairly constantly immobilized, also in constant pain.  The surgeon hasn't held out too much hope, given her overall condition. 

And he wants to avoid a similar situation occurring for himself.

But now that he is experiencing so much pain it has become difficult to continue his walking regimen to offset the problems with his heart.  And there lies the heart of the dilemma. 

He is anguished with indecision; continue pushing himself to make his heart beat fast enough to satisfy himself that it is being adequately challenged, and suffer the unbelievable pain.  His arthritis specialist agreed he could continue the speed hiking for the damage is now done.

Bone grinding on bone.  How long he can countenance the pain is debatable.  If he forsakes the hiking he deserts his heart, and he fears that he will become completely debilitated.  Being buoyant, obtaining exercise by swimming would challenge his heart and lungs, I suggest, and bypass his knee joints, but he detests swimming.

We can but commiserate.