IT'S AN UNDERSTATEMENT to say Sandi Butchkiss, a self-described fanatical walker, was shocked when she woke up one morning to find she had osteoarthritis in her knee. 'I didn't know anybody with this condition. I could have just found out I came from another planet and I wouldn't have been more surprised,' Butchkiss recalls in a thick Brooklyn accent that hasn't left her in the 17 years she's been in Hong Kong working as a food and travel writer. That was eight years ago. Now Butchkiss has self-published a book, I Had Arthritis, a 50-page volume documenting her two-year battle to overcome the condition, in which the cartilage - a natural shock-absorber that cushions the inside of joints - breaks down. The book includes a variety of supplements she took in the search for her own formula, which includes flax oil, shark cartilage and glucosamine/chontroitin tablets. It includes diagrams of the stretches that helped her build up the muscles and ligaments supporting her grinding arthritic joints. But it is intended more of an inspirational guide than a how-to book, because Butchkiss couldn't find a single inspirational story when looking for hope that her condition would not only improve but be cured. 'About eight years ago when I got arthritis it was before the Internet as we know it, so I couldn't just write down arthritis and see what it told me because it told me nothing,' Butchkiss recalls. 'And it was difficult to move about a lot. So it was a slow and painstaking thing . . . I would go to the big book stores and there was nothing on arthritis, or there was arthritis of the knuckle by doctor so and so, a term paper or something. It was ludicrous, it was awful and it was scary.' Even joining the American Arthritis Association didn't bring much joy. 'Every article, every book, every piece of literature that came my way was about learning to cope with arthritis,' Butchkiss says. 'I saw this word cope and my eyeballs crossed. It was a horrible experience, because I pictured myself coping first with a cane, then with a walker and then coping in a wheelchair. What does cope mean? I wanted to get to the bottom of this, and I can't even tell you why I thought I could cure this.' Butchkiss' arthritis started in the left knee and 10 weeks later afflicted her right knee. The woman who used to wear out leather shoes during visits to New York was reduced to shuffling in agony, taking five minutes to haul herself up from a chair, and unable to get comfortable in bed. In the first six months she visited specialists in Hong Kong, New York and Sydney but came up with nothing. A visit to an acupuncturist intensified the pain. Next came a series of discouraging encounters with a gallery of medico rogues she describes in the book as The Big Shot Non-Feeling Ortho man, The Down Under Knee Specialist, The Obnoxious Oz Torturer (a physiotherapist keen to sell her a lot of expensive equipment) and the Cortisone Squirter. She refused all four recommended treatments, including the cortisone injection and keyhole surgery called an arthroscopy, designed to remove bits of bone or cartilage that may float loosely in the joint spaces. After six fruitless, depressing and frustrating months she came across a Hong Kong physiotherapist who spoke to her and listened to her in a different way. And it seemed his bedside manner made all the difference. 'Not only did he speak to me with obvious concern and respect for my feelings and opinions, he listened attentively to the emotional description of my saga and displayed the warm, personal manner so crucial in a patient/doctor relationship. He explained exactly what was wrong and what he could and could not do to help. I felt confident and relieved almost at once.' He and his wife, also a physiotherapist, devised a series of stretches and visited her house at first to act as a 'personal trainer'. When her knees froze up completely during a long banquet she was further convinced constant movement was the cure. 'Doctors tell you to take it easy, but that's a death sentence,' she says. 'So even when I was in agonising pain I did my stretches every day.' A friend who was an orthopaedic surgeon told her as she exercised there was 'every chance' that in time her body would 'regenerate a lesser grade of tissue to replace and function much like the missing cartilage' that had broken down between her knee joints. But there was a considerable amount of trial and error involved in finding exercises that worked. As she writes in her book: 'When swimming hurt too much to endure, I switched to walking . . . and now I can swim without discomfort. When I couldn't ride on a normal two-wheeler, I worked with a small stationary pedaller . . . and now I can bike comfortably for long distances. But none of these changes happen overnight.' The essence in Butchkiss' recovery seems to rest in the tenacious attitude she claims she inherited from her 'feisty Russian grandmother'. 'Part of it is because of my nature, not to accept it,' she says. May people, she claims, are 'dilettantes' about their arthritis and simply unable to commit to the effort required to work out their own regime to beat it. She includes an arthritis-shuffling Sir Peter Ustinov in this category. When she told the film-maker how she cured herself, he responded that he was unlikely to apply the same amount of effort to help himself.