As I have gotten older, I developed Osteoarthritis in both knees.  At first, I felt minor aches only when I did a lot of back country photography.  Backpacks full of camera gear, clothes, and food weigh a lot.  Low doses of Ibuprofen (1 200mg tablet every 12 hours during the duration of the hike) helped me get through most of the rough spots for several years.  I started eliminating bits of camera gear that I didn't use very often on a hike, my flash was first to go followed by my 400mm lens.  I changed the duration of my trips and started limiting myself to day hikes for photography.  After my 4th trip to Paria Canyon (The Wave) irritated both knees to the highest level of pain I have ever felt,  I knew I would not be doing my more adventurous trips any time soon. 

The pain increased regardless of what I did.  Large  doses of Ibuprofen are not an option for me.  I developed a stomach ulcer from having high doses of Ibuprofen (800 mg every 8 hours for almost a week) when I tore the ACL in my left knee, and never want to experience that feeling again (although Demerol was a very pleasant part of the treatment), so I wouldn't take a high dose of Ibuprofen again.   Non Steroidal Anti Inflammatory Drugs were recommended and or prescribed next.  They had no noticeable effect on my pain, but did ease the stiffness in my knees somewhat.  It seemed to be a worthwhile option, but they came with the added risk to heart attacks and since heart disease has killed direct relatives of mine, I take them sparingly.   I found that if I took them with a Tylenol capsule, I got a bit more relief and was able to sleep better. 

In order to eliminate extra drugs, I investigated Synvisc.  It seemed to be a reasonable long lasting alternative with fewer side effects to using other drugs.  I had a series of injections and after the initial pain from the injection itself was gone (about 24 hours after the shot), i found great relief.  I had greater range of motion and could actually get up from sitting on the floor without pain.  It was wonderful!  2 weeks later I went to Page, AZ and descended into Lower Antelope Canyon.  I was pain free for the entire trip. 

The painless ecstasy lasted for about a month and a half.  I noticed it was wearing off when after a day of shooting on location with lights, my knees decided to not let me sleep.  I knew I was in need of another round of injections but the earliest I would be permitted to get them was in October and this was June.  I also knew that if I wanted to be pain free for my next major vacation (a Mexican Cruise) over the Christmas holiday period, I would have to wait until December.  i  tried, but couldn't wait until December for the Synvisc.  I ended up getting it  in October.  Relief from this set was good until the 4th day of the cruise and I once again had a long wait before my next series of injections. 

This cycle seems to be repetitive, but my latest shots were of the new formulation of Synvisc.  Instead of a series of 3 injections a week apart in each knee, it is a single shot for each knee.  The most immediate thing I noticed was that a thicker needle is used.  That didn't bother me as Angelica is very good at giving the injections.  What normally is a 24 hour time frame from the injection to being pain free, was cut in half.  I awoke the next morning pain free with a minimal amount of stiffness.  I am hoping the new formula lasts longer as I am about to go to Alaska and give my knees a workout.  I have already moved my lights for a location shoot and had no discomfort.  I am hoping the good times will last through the summer.