Saturday, January 8, 2011

Why Is "Saving My Knees" Available Only as an Electronic Book?

Q: I have followed your blog and read your comments about beating knee pain at sites including KneeGuru, and am curious about your story. I would like to read "Saving My Knees." But why is it available only as an electronic book? Why can't I buy a paperback version? Couldn't you find a publisher? If not, why not, if this book is really any good?

Okay, that's an invented question. But it's a good one. If I had knee pain and was about to lay down a ten spot for a book that exists only in bits and bytes, that I can't carry to the park on a warm, sunny afternoon, I'd sure as heck want to know the answer.

After all, you may be thinking, here's a guy who's well-educated (I attended Harvard, then New York University for a master's degree), who is a veteran journalist working for a leading global news organization, who undertook a closely observed and unprecedented experiment to save his knees, whose extensive research into knees and cartilage is reflected in a Select Bibliography that spans three single-spaced pages -- and he can't manage to sell a book about how he beat knee pain, in a world where there are tens of millions of knee pain sufferers?

Something doesn't make sense here. Something must be wrong with this book, right?

At this point, I'm going to turn the tables and engage you, the reader, for a moment. Because when I was hurting all the time, I very badly wanted to buy a smart, sensible book written by someone who conquered knee pain. I desperately sought hope. I wanted an inspiring story to lift my spirits. And I bet you've probably looked for the same thing.

Now here's my question: How many books fitting that description have you found on the shelves of your local bookstore? Go ahead. List all the titles.

I'll give you a minute. Okay, a few minutes ... still waiting ...

I'm guessing that your list looks about the same as mine would've, four years ago. Zero. No books. Nada. We don't really need another knee book written by a medical doctor (sometimes paired with a physical therapist), full of stiff writing and photos of exercises and rather dull anatomy lessons. We've got plenty of those. But we don't have any first-person accounts that speak more personally to a knee pain sufferer: I was there, I hurt all the time too, and I beat this thing, dammit, and here's my story. So there clearly is a profitable niche, just waiting to be filled.

Now brace yourself: This niche is not going to be filled. And now I'm going to tell you exactly why.

When I began approaching literary agents with my manuscript, very excited -- I had written and extensively rewritten "Saving My Knees" and even hired four perfect strangers, for a small sum of money, to review this manuscript and make suggestions, which led to further changes and improvements -- I soon slammed hard into a brick wall. It became clear to me no agent would agree to represent my book to publishers, and no publisher would ever agree to buy it.

Why? As an agent told me bluntly, I'm not a doctor. I'm not an authority about knees who possesses a medical degree. Of course there's a rich irony here. Had my supposedly qualified doctors written a book about me several years ago, the title would have been something like, "Why Richard Bedard's Knees Won't Heal: A Look at Why Knees Afflicted by Chronic Pain, That Don't Respond to Treatment, Never Get Better." And of course that book would have been dead wrong.

I find it curious that it's not considered valid for me to write this book, even though journalists have a long history of writing about things that they're not degreed experts in. Examples could fill up pages. What makes a book about one's bad knees different? My guess is publishers would identify two main things: (1) This is a health-related book, and a different standard applies. (2) This is my personal story of how I healed, so there may be a presumption that I'm offering advice, a la a doctor.

Now when you read my book (assuming you do), you'll find the advice I do give isn't all that radical. For instance, one of my four golden rules for bad knees is "lose weight." Simple. But while the doctor wags a finger in your face and says, "Lose weight and that will help your knees," I don't wag a finger in your face. I show you -- through my experience and studies I have read -- why you need to lose weight. You can wag your own finger in your face. :)

So my not being a doctor (or physical therapist) was a big obstacle to getting this book published. But I also realized that, even if I surmounted that obstacle, another one just as big awaited me.

Let me take a moment to show you what that was. I'll do so by presenting you with the following hypothetical, that takes us on a little historical journey:

It's two hundred years ago. You're a journalist. You have asthma. You go to a doctor, describe your asthma symptoms, and he recommends a controlled bleeding from your arm into a bowl (Google "bleeding bowl" to see what I mean) to correct your breathing difficulties. You think to yourself, "Okay, I'm not a doctor. I do know that doctors often prescribe this bleeding into a bowl thing. I'll submit to whatever he thinks is best because he's the expert."

But a week after the procedure, you still have asthma, just as severe. You return to the doctor. He tries another controlled bleed. You go home, find yourself still struggling with asthma, then begin to wonder, "Hmm, why are they bleeding me into a bowl? How does that really help cure my asthma?" So you do a lot of research. You run some experiments on yourself. And surprise: you find that bleeding people into a bowl doesn't seem to make much sense for treating asthma. You finally find a way to heal, sans bleeding therapy.

So you write a book, hoping to inspire other asthma sufferers who think there is no hope. You title it: "Saving My Bronchial Passages: How I Healed My Asthma and Why Bleeding People Into a Bowl Isn't Smart Medicine for Asthma Sufferers." You get your manuscript in tip-top shape, then go out to try to sell it to major publishing houses, and they ...

Shut their doors in your face.

The problem is, they would need your book to be reviewed by medical professionals. And the state-of-the-art thinking in the medical community is that bleeding people into a bowl is an appropriate treatment for asthma. And you -- just an ordinary journalist without a medical degree -- are challenging this well-entrenched medical wisdom. Forget about finding a publisher.

Two hundred years ago, that would have been the end of the story, and you would have died clutching your unpublished manuscript -- frustrated, then vindicated later by medical progress.

Today, the Internet has democratized access to information. Sure, there's a lot of bad info to wade through. But for an optimist about knowledge, and about the contagion-like property of good knowledge, as I am, it's clear that a smart book about healing knees just might take on a viral property and spread to help millions -- even if the publishing establishment rejects it.

I can be a bit of a renegade, you'll find in "Saving My Knees." But that's not really my nature. I started out as a perfect patient. I became a renegade only after doctors and physical therapists failed to help me heal. You'll see that much of the advice and information I was given -- that I had a condition called patellofemoral pain syndrome, that I should focus on strengthening my quads, that taking glucosamine would help my cartilage heal, that stretching the iliotibial band was important to get better, and so on -- was most likely wrong or useless.

Following the advice of doctors and physical therapists got me stuck in an endless rut where I never got better (and even got worse, following a physical therapist's advice!), where I was constantly frustrated and depressed. I didn't start healing until after doing a major rethink of everything. The major rethink didn't involve me staring at my navel and thinking big thoughts. I went to Knee School 101, Self-Directed Study. I pored over many clinical studies and medical textbooks -- and stumbled upon the writings of an incredible physical therapist, Doug Kelsey.

So that's my long-winded answer why you should trust a guy peddling an e-book. "Saving My Knees" is my story, certainly. I don't pretend that you need to do exactly what I did, to save your knees. But I think that I discovered a framework for healing -- and I'd be surprised if my observations don't help you in some way. Or at least give you hope -- and that may be just as important as anything for a knee pain sufferer.

9 comments:

  1. I hear ya! It is a long standing belief of mine that our bodies are made for healing. I do believe that it is possible to find a way to heal my damaged knees. BUT...

    Will this method work regardless of what kind of knee issue I have? I have never heard of patellofemoral pain syndrome, but I am hearing terms from my doctor like "bone on bone", "osteoarthritis", "inflammation", and "damaged cartalidge". What I am asking is this, "Could this method help a person with knee pain, even if that pain is not the same as you experienced?" What can I glean from your experience if my own problem is only similar with regards to anatomical location?

    I am going to purchase your book, anyway. Information is always useful, even when it might be different from my specific needs. Thanks for the encouragement you have already given, and for any further help you may be able to give!

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  2. Good question. If I were a facile snake-oil salesman, I would say, "Of course, no problem at all, you'll heal in no time after reading my wonderful book!" ;)

    The truth is, the less cartilage you have left, the harder I think it will be to heal (and it may be very hard indeed). The problem, in my opinion, is that if you've lost almost all the cartilage in your knee, most of your everday activities are already too much for your bad knee to bear.

    What would I do if I were you, assuming you have very little cartilage left (I'm just guessing that's the case from what you're saying)? (1) I'd make darn sure that I was my correct weight, and not a pound heavier. (2) I would look into how I can get lots of motion with little strain on my knee -- a continuous passive motion machine or Doug Kelsey's tailgaters perhaps? (http://sportscenteraustin.blogs.com/the_view/2009/03/more-motion-and-less-load-for-osteoarthritis.html (3) If my knees were that terrible, I would look at lifestyle changes to take load off my knees for a while -- living on the first floor to avoid stairs, using crutches for a while? (4) I'd think about spending some time, if possible, at a really good physical therapy clinic, like Sports Center in Austin, Texas.

    Some thoughts. I'm not a doctor, I have no idea even what your knees look like, so of course discuss all this with a well-qualified medical professional. Good luck!

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  3. Hello Richard! (same comment on a different post.. sorry, wanted to make sure you see this! tried to e-mail you also but it failed)

    My name is Jennifer Byrne. My father has the same terrible knee problems
    that you used to suffer with. He is a fanatical cyclist and would not give
    this up for anything. However I really hate to see him in so much pain with
    his knees and it is constant.

    My mum tries to get him to see docters but be blatently refuses, saying
    they don't knot what they are doing - much the saem as your own views so I
    hear! He told me about finding information about your book online and was
    really very excited! He has a kindle but we have not been able to download
    it onto this or onto the PC, having tried many many times to do so.

    So I desided to e-mail you to see if you could help! Would you be able to
    send him a printed copy of your book if I pay you the cost of this ? Any
    help you have woudl be much appreciated!

    Thank you very much for your time,

    Jennifer
    - daughter of a very stubborn dad! :)

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  4. Well, why don't you give your book away for free? While you are busy touting the democratization of the internet. As a white, heterosexual, male, Harvard graduate, living in NYC with a wife and kid you are among the most privileged people in the world. Perhaps it is time to give something back?

    The question that started this thread may have been invented for effect. but my question is sincere. Why not put the book out for free? Perhaps it would get your experience more media coverage and catalyze more research.

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    Replies
    1. Well, I like to think this blog is "giving something back." I freely answer questions, there's no heavy-handed marketing pitch, there's no coy "for the answer to that question, you'll have to buy the book." In fact, on more than one occasion, I've told someone they don't need to buy the book -- the answers are all here on the blog. :)

      But look: I think journalism, and being a writer, is a profession, to be valued as other professions are valued. If a plumber comes and fixes the pipes under your sink, you wouldn't think of saying, "Why don't you work for free?" Yet, on the Internet, there is sometimes an ethos that all writing should be free, regardless of the labor that went into it.

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  5. Hi my name is Nick and Im 21 years old my doctor recently told my after viewing an MRI that Some of the cartilage in my left knee was damaged. I bought your ebook from Amazon and it was loaded onto kindle on my iPhone. I've had some trouble finding a way to print it. Ebooks may work for some people but I would like a physical copie for a few reasons. It seems healthier to read from paper than to read from the screen of an electronic devise, I don't wanna have to use my iPhone to read, It will be easier not only to read the text but to reread certain parts that I found helpful information in, I might be interested in highlighting sections,marking pages, writing notes or whatever. Can you send me a printable pdf version of your book? Or maybe send me a physical copy in the mail.Like I said I bought the ebook from Amazon so I'd prefer not to pay for it again but if I must I will pay ten more dollars to get a physical copy or printable pdf from you. I would realy appreciate some help thank you.

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  6. Sorry I don't have a .pdf version. But apparently a lot of other people want to do the same as you. I found a lot of websites that tell you how to convert an ebook into a .pdf. This might be a good place to start (or Google "convert Kindle book to pdf"):
    http://www.digitaltrends.com/mobile/how-to-convert-kindle-to-pdf/

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  7. Hi Richard,
    I am really keen to get a copy of your book. It appears that the book is no longer available on Amazon. Where else can I get a copy?

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    Replies
    1. It's available as an electronic version, but not hard copy. I encourage people who can't get a kindle/can't order through a local Amazon website to just look around the blog. Alternatively, Doug Kelsey has a great book here for knee pain sufferers and it even has exercises, unlike my book:
      http://dougkelsey.com/knee-arthritis-remedy/

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