The day after Thanksgiving, often called “Black Friday,” because it is the first time all year that merchants make enough so that they are finally “in the black” (as opposed to being in debt, or ”in the red”). This is supposed to be THE biggest shopping day of the year and, of course, the start of the Christmas Season.
 
I just heard on the radio, this very morning, that one 34 year old guy was KILLED at a Wal-mart here on Greenacres Road in Long Island, when crazed shoppers stampeded through the doors (which they actually BENT) at opening, knocked the poor man onto the floor and trampled him. No joke. He was pronunced DOA at the local ER. Helluva way to start the Holidays.
 
How could this happen? Simple. People are nuts.
 
And, though I don’t KNOW this, I’ll bet that he had weak or trick knees that buckled under him, when hit with a surge of unexpected force. Poor guy was an employee of Wal-mart and couldn’t get out of the way fast enough. A pregnant woman was knocked down too, but she (and her unborn baby) are reportedly OK. I thought we were in a deep recession. Just imagine what would’ve happened had we had a record year in the GNP….
 
You know, one of the things I would tell my patients about their knee pain, during my years in practice, is that it is often not realized just how dangerous a condition it could be. Now, a torn meniscus, or an unstable knee from a chronic ACL deficiency, or a painful kneecap, from quadriceps weakness or patella maltracking, won’t kill you directly. They’re not considered life-threatening injuries or disabilities–that’s why many people put off getting active treatment. They’re not sick; they’re “broken.”  Not as high a priority, as other things going on in their lives.
 
BUT…
 
Now imagine that their knees suddenly give way at the head of a tall flight of stairs; or unexpectedly buckle on the train platform, just as the express flashes by; or crumple beneath them on a curb, causing them to fall forward into the street, right in front of speeding traffic. All of a sudden, these “benign” lesions, that all result in a sudden fall, literally become life-threatening problems.
 
And the worst thing is, that this type of knee instability may or may not be accompanied by pain. In general, people are a whole lot more likely to address something that causes them pain. This is why acute pain is said to be a survival mechanism–it tends to demand attention.
 
But when instability is intermittent, people tend to disregard the warning. They don’t realize the danger. So they put off treatment, sometimes until it’s too late.
 
The Hospital Administrator came to see me for knee pain and giving way, only a few months after I arrived in Smithtown. He snuck in late at night, so no one would see him coming to see the “new kid,” instead of one of the old “warhorses” on his hospital staff. After examining him, I determined that his only problem was weakness of his quadriceps. He could not resist me, when I pushed down on his straightened leg with my  hands. Now, THAT’S abnormal.

The thigh muscles should be stronger than my hands, stronger than ANY hands. If they’re not, then the knee is “hanging in the breeze,” with no dynamic stability. This leads to patella maltracking, which may lead to pain, and knee instability, as that joint cannot maintain a stable stance, if suddenly attacked by an abnormal force, because of muscular weakness.
 
These symptoms have led many to have knee surgery, when it really wasn’t necessary. Once you have knee pain, of course, you DO need to treat the inflammation, the pain and then, the muscular weakness. Measures for eliminating pain and inflammation are detailed in my newest program, HOW TO ELIMINATE KNEE PAIN. See it here at http://drbillsclinic.com/avoid_knee_surgery.html 
 
Once the pain has been controlled, restoring function becomes the priority. That means exercise, especially exercise to strengthen the quadiceps, such as specially modified Hindu Squats, or my personal favorite, Hack Squats, which are among the best to improve knee pain and are just part of my PAIN-FREE PROGRAM. See it here at http://drbillsclinic.com/eliminate_knee_pain.html
 
BTW, if you get the AVOID KNEE SURGERY program, you DON’T need the PAIN-FREE PROGRAM, as many (but not all) of the exercises are included in that. But you might want to get the LITTLE GREEN BOOK instead,  http://drbillsclinic.com/eliminate_knee_pain.html  to learn about your symptoms and signs, so you know what’s wrong with you.
 
And of course, keeping your weight down will help, as well. After all, if you lose a pound, that’s almost the same as having your muscles grow in strength enough to support, or lift one more pound (It’s a little more complicated than that, but you get the idea).
 
What’s that?  You say you ate too much last night,  ’cause it was Thanksgiving?  Fear not.  I understand.  And as a compassionate orthopaedic authority, who happens to love food as much as you do,  I absolve you all.  Now go and sin no more….:)
 
Til next time, my friend, be well and have a great weekend. 
 
Yours for a pain-free tomorrow,
 
Dr. Bill

P.S. For DR. BILL’S LITTLE GREEN BOOK ON ELIMINATING KNEE PAIN, a concise, but complete handbook on the root causes and the various options for treating knee pain, go to http://drbillsclinic.com/eliminate_knee_pain.html
 
P.P.S. For DR. BILL’S PAIN-FREE PROGRAM: EXERCISES TO PREVENT OR ELIMINATE KNEE PAIN, please go to
 http://drbillsclinic.com/exercise_eliminate.html
 
P.P.P.S. For the giant, comprehensive ADVANCED MASTERS’ COURSE: HOW TO ELIMINATE KNEE PAIN–ONCE & FOR ALL!, everything you need to know on causes and solutions for knee pain and the complete exercise program, too, go to http://drbillsclinic.com/advanced_masters.html
 
FREE BONUS CD with any order: THE HEALING POWER OF POSITIVE PAIN PERCEPTION
 
Copyright, 2008 by William Thomas Stillwell, MD
All rights reserved

If you happen to be one of my subscribers in another part of the globe, please indulge me in this. Every year at this time, we in the United States celebrate a day of Thanksgiving.
 
When you think about it, whether you are a religious person, or not, whether things in your life are all as you would have them be, or not, all of us have many things for which we can be thankful.
 
For myself, I’m glad I’ve had the life I have.  I’m thankful for my loving wife of 34 years, my family (including my surviving cats and my departed cats and dogs, whose companionship I treasured), my friends, my colleagues, my surgical career, and my continued health and comfort. 
 
I’m grateful that my fall (2001) didn’t kill me or paralyze me, both of which I escaped by a whisker, and I’m thankful that even if it ended my career, perhaps it opened a new door in my life, by allowing me to meet you and so many other subscribers and friends, from all corners of the world. 
 
For all of this and more I am very grateful, this Thanksgiving Day. 
 
And, as this is the beginning of the Christmas Holiday Season in our country, I want to take this opportunity to thank you, for your support, your friendship and your patronage, and to wish you and yours the Peace & Joy of The Season and many blessings for the year to come.
 
HAPPY THANKSGIVING, my friend! Be well. And don’t eat too much
 
Yours for a pain-free tomorrow,
 
Dr. Bill

P.S. For DR. BILL’S LITTLE GREEN BOOK ON ELIMINATING KNEE PAIN, a concise, but complete handbook on the root causes and the various options for treating knee pain, go to http://drbillsclinic.com/eliminate_knee_pain.html
 
P.P.S. For DR. BILL’S PAIN-FREE PROGRAM: EXERCISES TO PREVENT OR ELIMINATE KNEE PAIN, please go to
 http://drbillsclinic.com/exercise_eliminate.html
 
P.P.P.S. For the giant, comprehensive ADVANCED MASTERS’ COURSE: HOW TO ELIMINATE KNEE PAIN–ONCE & FOR ALL!, everything you need to know on causes and solutions for knee pain and the complete exercise program, too, go to
 http://drbillsclinic.com/advanced_masters.html
 
FREE BONUS CD with any order: THE HEALING POWER OF POSITIVE PAIN PERCEPTIONCopyright, 2008 by William Thomas Stillwell, MD
All rights reserved

Every so often, I get emails asking for my advice or help regarding some persistent knee pain. It’s not at all uncommon for people to have no clue what’s going on in their own knees, sometimes even if they are seeing a physician. 
 
With the increased volumes of patients necessary to generate the revenue necessary to stay in business, most physicians simply don’t have the time or the inclination to answer a lot of questions. They need to get you out, so they can move on to the next patient.
 
Recently, I had an email from a person who was referred to me by a mutual friend. He had persistent knee pain, after he had undergone arthroscopic knee surgery 15 years ago. He was understandably upset and perplexed as to why he had undergone surgery, but STILL had pain. He had expected a “cure.”
 
I mean, what if you STILL have pain after knee surgery? What then? 

Well, here was my response:
 
 
“Sorry to hear of your knee pain. Perhaps I can help you.
 
“If you had arthroscopic surgery 15 years ago, but still have knee pain, it’s likely that you ARE healed, but you have residual degenerative (arthritic) changes inside the joint. Assuming no new injuries to the internal structures, that is the most likely explanation for your persistent pain. 
 
“This is a pretty broad topic, beyond the scope of a simple email. 
 
“But I have written several healing programs for just such problems. One of these may well help you, as they have helped a number of others.
 
“I would suggest you consider my LITTLE GREEN BOOK FOR ELIMINATING KNEE PAIN, manual & CD (get it at http://drbillsclinic.com/eliminate_knee_pain.html ), which helps you identify what’s causing your pain and offers methods from across the entire treatment spectrum (conventional, alternative and complimentary), and my PAIN-FREE PROGRAM, which you can get at http://drbillsclinic.com/exercise_eliminate.html  which demonstrates the specially modified exercises I used myself (I had arthroscopic surgery, personally, a couple of years ago) and that I used on my own patients, during my years in practice. 
 
“These products are designed to compliment each other, as a set.
 
“Most recently, I wrote a new program to help people get rid of knee pain, without surgery, called (appropriately enough) HOW TO AVOID KNEE SURGERY. This program combines the best of conventional and alternative measures for short term relief of inflammation the major cause of acute pain) and specific, modified exercises for long term pain relief and restoration of function. 
 
“You can see that new program (and get it) at http://drbillsclinic.com/avoid_knee _surgery.html 
 
“I’m sure that one of these options will help you get the relief you seek, if you apply the principles I teach. Let me know how you’re doing. Good Luck!
 
“All the best,
 
“Dr. Bill Stillwell”
 
 
Well, it’s too soon to tell if he took my advice. But degenerative changes within the knee joint (usually ostearthritis) is the most common long term cause for persistent knee pain. Especially after you’ve had surgery. You see, a recent Canadian study has confirmed what an earlier clinical study had already suggested–namely, that arthroscopic surgery is NOT an effective treatment for osteoarthritis. 
 
Two groups, one which followed knee surgery with medication, physical therapy and exercise, and one which ONLY had medication, physical therapy and exercise, but NO surgery, were compared. There was NO statistically significant difference between the two groups, regarding pain and function. 
 
If there was no difference, then WHY would you have surgery, with all its attendent risks and potential complications? Right. You wouldn’t.
 
It’s too bad this man waited 15 years before getting my advice. If he had used the combined methods I teach in my new program, HOW TO AVOID KNEE SURGERY ( Get it at http://drbillsclinic.com/avoid_knee_surgery.html ), he might well have avoided years of frustration and pain.
 
So, a word to the wise…if you have knee pain, DON’T WAIT until after you’ve had surgery, which isn’t indicated anyway. Click on this link, RIGHT NOW: http://drbillsclinic.com/avoid_knee_surgery.html   and relieve your knee pain, for good!
 
Til next time, my friend, be well. Time to get a nice fat turkey ready for the feast….
 
Yours for a pain-free tomorrow,
 
Dr. Bill

P.S. For DR. BILL’S LITTLE GREEN BOOK ON ELIMINATING KNEE PAIN, a concise, but complete handbook on the root causes and the various options for treating knee pain, go to http://drbillsclinic.com/eliminate_knee_pain.html
 
P.P.S. For DR. BILL’S PAIN-FREE PROGRAM: EXERCISES TO PREVENT OR ELIMINATE KNEE PAIN, please go to
 http://drbillsclinic.com/exercise_eliminate.html
 
P.P.P.S. For the giant, comprehensive ADVANCED MASTERS’ COURSE: HOW TO ELIMINATE KNEE PAIN–ONCE & FOR ALL!, everything you need to know on causes and solutions for knee pain and the complete exercise program, too, go to
 http://drbillsclinic.com/advanced_masters.html
 
FREE BONUS CD with any order: THE HEALING POWER OF POSITIVE PAIN PERCEPTION
 
Copyright, 2008 by William Thomas Stillwell, MD
All rights reserved

It’s been said that the Internship is the fifth year of Medical School. But actually, it’s much more than that. The internship is the very first time that the fledgling physician has real patient responsibility. To be sure, his orders and prescriptions are subject to scrutiny and supervision (Thank God!). But for the first time, he or she CAN order medications and actions on his/her own volition. And for the first time, he or she is fully responsible for their consequences.
 
You can think of Medical School as a course in vocabulary, but the Internship is the ordeal that puts it all together and applies it. It is a radical experience that actually forges the new doctor and ingrains the clinical habits that will become the hallmark of that new career, going forward. 
 
Of course, that process doesn’t happen overnight. So, take my advice–DON’T get sick, or enter a teaching hospital in July ! 
 
During my internship at the Medical College of Virginia, in early 1974, I rotated through the various services that were under the rubric of  General Surgery. That’s what a Straight Surgery Internship is–the trainee spends time on each of the different surgical sub-specialties: General, Thoracic, Cardiovascular, Plastics, Orthopaedics, etc. In this way, the intern discovers, first hand, what specialty he or she might like for further study.
 
This differs in kind from the classic Rotating Internship, in which the intern rotates through a number of different medical disciplines: Medicine, Surgery, OB-GYN, Anesthesia, Preventive Medicine, Family Medicine, etc. Since I was convinced from the beginning that I was meant to be a surgeon, I went for the Straight Surgical internship.
 
The first two months, I was disorganized, inefficient, inept, ignorant and I lived in a state of constant terror that I would kill someone, by what I was painfully aware that I DIDN’T know. I lost 20 pounds that first month, just from physical exhaustion, and the colitis of high anxiety (I DON’T recommend this as a good way to lose weight, effective though it was).
 
But gradually, I learned and as a result, calmed down. And once I did, I went straight from misery and ineptitude to overweaning self-confidence, without ever slowing down at mere competence. Such is the nature of the young and stupid. In any case, I never looked back and never again lacked for confidence.
 
Fortunately, this transformation had occurred by the end of my internship and by the time I was promoted to JAR (Junior Assistant Resident)the next year, I was convinced there wasn’t anything I couldn’t do. In a way, that’s a good thing. If you ever knew in advance what was in store for you, you’d never do it.
 
It was during that year that I rotated onto the Burn Unit. Because that’s no place for hesitation, or a lack of decisiveness–not if you want your patients to live. 
 
Two JAR’s were assigned to the Unit, which accepted badly burned patients from everywhere. In fact, we were forbidden from refusing a referral from anywhere, at any time, day or night. The helicopters would land in the middle of the night, right on Broad Street in Richmond. 
 
Here’s the thing about burn patients: you can absolutely predict, with certainty, who will live and who will die, based on a precalculated graph. 
 
This table was labeled along one side with the percentage of the body that was burned, and along the bottom with the patient’s age in years. You simply figure out how much of the body is burned, plug in the age of the patient and see where they meet on the graph. I didn’t believe this at first, but I saw it again and again. 
 
In brief, only younger people could survive massive burns, affecting over 50% of their bodies. Older people, with lesser percentages burned would still succumb to overwhelming infection, about three days out, despite I.V. antibiotics and our best efforts.
 
In a way, it was eerie. Someone who was perfectly coherent, looked like they would make it and defy the chart prediction, three days out, they crashed and died. Like I said, absolutely predictable. The only ones we could save were those with large body burns who were young enough that we could help them, with surgical debridement and aggressive use of I.V. antibiotics, to survive the inevitable infection. Not only frustrating but humbling: it gives you a real sense of your limitations, as a physician and surgeon. 
 
My partner in this enterprise was a great guy named Jim Zocco–awesomely competent and a very funny guy, as well. We alternated nights covering the Unit, calling in the other resident, if needed. But despite the grim cases we handled, when there was a lull in the action, we could have a lot of free time–a very precious commodity.
 
One day, with no patients to care for, we got into the Hubbard Tanks, large steel tubs used for whirlpool baths, to debride dead tissue from the burn patients. Thought we’d have a nice little hot tub session. So there we were, sitting in the tubs, with our drinks, when who should come in for an inspection, but the Chief of the Service, Dr. B.W. Haynes. Very straight-laced guy–not surprising, given his specialty. 
 
He just looked at us, in our tubs. We looked at him. Had us, dead to rights. And then we said, “Hey Dr. Haynes, want a drink?” That got us a ghost of a smile and he said dryly, “Don’t bother getting up for me, boys. Just be sure you scrub down those tubs when you leave.” Then he left. I thought we were dead meat. Good guy, though. Guess he remembered his own residency….
 
Well, these days, things are not so dramatic. I’m more interested in teaching you how you can avoid unnecessary knee surgery. Unlike the cases in the Burn Unit, where surgery was always necessary, but not always effective, many of the causes of knee pain can be relieved by conservative, non-surgical methods, drawn from across the entire treatment spectrum. Before you consent to a recommended surgery, try my newest healing program, HOW TO AVOID KNEE SURGERY. See how here, at   http://drbillsclinic.com/avoid_knee_surgery.html
 
Til next time, my friend, be well.
 
Yours for a pain-free tomorrow,
 
Dr. Bill
 
P.S. For DR. BILL’S LITTLE GREEN BOOK ON ELIMINATING KNEE PAIN, a concise, but complete handbook on the root causes and the various options for treating knee pain, go to http://drbillsclinic.com/eliminate_knee_pain.html
 
P.P.S. For DR. BILL’S PAIN-FREE PROGRAM: EXERCISES TO PREVENT OR ELIMINATE KNEE PAIN, please go to
 http://drbillsclinic.com/exercise_eliminate.html
 
P.P.P.S. For the giant, comprehensive ADVANCED MASTERS’ COURSE: HOW TO ELIMINATE KNEE PAIN–ONCE & FOR ALL!, everything you need to know on causes and solutions for knee pain and the complete exercise program, too, go to
 http://drbillsclinic.com/advanced_masters.html
 
FREE BONUS CD with any order: THE HEALING POWER OF POSITIVE PAIN PERCEPTION
 
Copyright, 2008 by William Thomas Stillwell, MD
All rights reserved

Back in the Dark Ages of 1969, I started Medical School like many generations of young doctors-to-be before me, with Gross Anatomy. I understand that the powers that be have demoted the importance of Anatomy in the training of medical students, teaching only that fragment of the whole necessary to have a basic understanding of whatever topic is being discussed at that time. 
 
Like much in education today, all change is not progress…but I digress. 
 
At that time, having a sense of the whole mechanism of the human body was still considered a necessary fundamental. So Anatomy was where everything began for us.

Now, in all the Pre-Med training in High School and in College, Anatomy was always a staple subject, as a part of Biology, together with Chemistry, both Inorganic and Organic, and Mathematics (though why they thought you needed higher Math to be a physician was and is beyond my comprehension–especially Calculus). 
 
But the Anatomy studied was always that of the lower orders: frogs and earthworms in High School, dogfish (tiny sharks) in Introductory college Biology, and progression up the taxonomic scale with each succeeding course through The Fetal Pig and finally, The Cat in Mammalian Anatomy. And with each textbook, filled with anatomical minutia we were expected to memorize, there was an actual animal, preserved in formaldehyde, we were expected to dissect.
 
Sure, there were discussions and pictures and textbooks color slides and even movies (pre-video–these were 16mm films. I TOLD you these were the Dark Ages:) of human anatomy, boiled down to its essentials. But mainly, the study of animals was used to acquaint the student with the various physiological systems, which were then related to human beings.
 
But in Medical School, this was finally the real thing: the gross dissection of the human body. The cadavers were bodies from a variety of sources, from homeless people, who had died on the street, to physicians and scientists, who had willed their bodies to Medical Science, for the education of the next generation of physicians. Regardless, each was a precious gift, a key to unlocking the secrets of the human body, as a foundation to understanding its workings. And we all honored their gift and treated their remains with the utmost respect.
 
Each cadaver was preserved in formadehyde and the pungent odor permeated every square inch of the huge and brightly lit room of the lab, with dozens of stainless steel tables, each holding a body draped entirely in a long white sheet. 
 
As we trudged into the Anatomy Lab that first day, we all had on our new long white lab coats and carried our dissection manuals. We were assigned in groups to a table and a cadaver, which we would be expected to dissect, as instructed.
 
Naturally, we were nervous–anticipation was high, but for most of us, this was the first time we had seen a dead body, up close and personal. But, this was our introduction to the mysteries of the human body that we were all determined to master, our first step into the unknown, but knowable.
 
Each group had to choose two dissectors, that is, those students who would actually do the cutting, while the others watched. I naturally volunteered. I figured since I wanted to be a surgeon, I might as well get started. So, my partner and I carefully peeled back the layers, one section at a time, according to the guide and our instructors, exposing the secrets beneath. 
 
It’s harder than you think–cadavers are stiff and leather-like, and the parts are NOT color-coded like they are in the books. Everything is of a similar pale bleached tan, so unlike the color and texture of living tissues. And you have plenty of time to think about the nature of life. 
 
This inanimate body was once a living, breathing person, had a mother and a father, perhaps a family, had hopes and dreams, joys and sorrows, even as we. And yet, now, he lay here, inert, like a meat machine that someone turned off. Even as, one day, we too will lie somewhere, just like this. Can this be all that there is to us? Makes you think….
 
These anatomical fundamentals provide the necessary foundation for the understanding that emerges when you eventually experience the dissection of living flesh. It was an extraordinary experience.
 
Those students who drew back and were mostly grossed out by the whole thing, well, you just knew they were going to be the internists of the group. Some spent most of the time in the library, learning from books, instead of the cadaver. But I always learned better when I could SEE and FEEL and TOUCH, in three dimensions, with my own hands. To experience is to KNOW. 
 
For example, the first time I dissected the human knee, I SAW the fibers of the vastus medialis obliquus (VMO) muscle, inserting into the upper, inner margin of the patella, while I noticed that the other three muscles of the quadriceps were all attached to the tendon ABOVE the kneecap. So, based on this arrangement of the muscles, the VMO pulled inward on the kneecap, while the other muscles pulled outward.
 
It was only years later that I came to understand the physiological consequences of that anatomical fact, and its clinical significance. In fact, that’s the very reason that the exercises taught in my PAIN-FREE PROGAM, which you can see for yourself here at http://drbillsclinic.com/exercise_eliminate.html  concentrate so strongly on developing the VMO, in order to balance the kneecap and relieve anterior knee pain.
 
It’s also the reason that you can often relieve your knee pain if you do modified Hindu Squats, or even Straight Leg Raising. These exercises take advantage of that anatomical arrangement to relieve your pain. See how at http://drbillsclinic.com/exercie_eliminate.html
 
But this was the beginning. Years later, when I was being taught the arts of surgery, there were many times that I reflected on the lessons learned in Gross Anatomy Lab, and thought with gratitude upon that unnamed person who had granted me the gift of his body, that I might become a healer of my fellow man.  “Greater love hath no man…”
 
Til next time, my friend, be well.
 
Yours for a pain-free tomorrow,
 
Dr. Bill
 
P.S. For DR. BILL’S LITTLE GREEN BOOK ON ELIMINATING KNEE PAIN, a concise, but complete handbook on the root causes and the various options for treating knee pain, go to http://drbillsclinic.com/eliminate_knee_pain.html
 
P.P.S. For DR. BILL’S PAIN-FREE PROGRAM: EXERCISES TO PREVENT OR ELIMINATE KNEE PAIN, please go to
 http://drbillsclinic.com/exercise_eliminate.html
 
P.P.P.S. For the giant, comprehensive ADVANCED MASTERS’ COURSE: HOW TO ELIMINATE KNEE PAIN–ONCE & FOR ALL!, everything you need to know on causes and solutions for knee pain and the complete exercise program, too, go to
 http://drbillsclinic.com/advanced_masters.html
 
FREE BONUS CD with any order: THE HEALING POWER OF POSITIVE PAIN PERCEPTION
 
Copyright, 2008 by William Thomas Stillwell, MD
All rights reserved

Last night, I was on a conference call with a number of friends and information marketers from all over the world. And during the discussion, memorable advertisements of the past were referenced. Most notably they recalled the famous cartoon ads that were commonly seen in the back of comic books, as well as Popular Mechanics and other pulp books, throughout the sixties and seventies, that promoted the “Dynamic Tension” bodybuilding system of Charles Atlas.
 
You know, the ones that show the iconic “97 pound weakling,” Mac, who is humiliated in front of his girlfriend on the beach, when he gets sand kicked in his face by a bully. Mac then sends away for the Charles Atlas Dynamic Tension Course, becomes a he-man and punches out the bully at their next encounter. 
 
This little illustrated vignette is considered by many marketers to be one of THE most effective and successful ad campaigns ever run. And of course the “97 pound weakling” has become part of our national culture, recognized even by people who have never seen the original ads.
 
This reference has a special meaning for me, because I’m one of the few guys around who actually met Charles Atlas, later in his life. Of course, when I met him, he was Mr. Siciliano to me.
 
I worked as a delivery boy for an Italian fruit store to earn money after school, in Bay Ridge, Brooklyn, in the mid-sixties. I pedalled this enormously heavy bicycle up and down the hills of Bay Ridge (so-called because of the hills), delivering the fruits and vegetables carried in its basket to my boss’ customers. It gave me some spending money and a pair of rock hard thighs, from the hours of pedalling.
 
Well, one day, my boss Mr. Scotto, an old world Italian, who made his own wine in the basement of the store, told me to take an order of fresh oranges to an apartment house on 88th Street and Shore Road in Bay Ridge, just down the street from Fort Hamilton High School (where I would one day go). He told me that this guy I was delivering to was Charles Atlas. Yeah, sure. I thought he was pulling my leg….
 
So off I went. I found the apartment, noted the name “Siciliano” on the door and rang the doorbell. And who should open the door, but HIM. He was much older than his photographs, but unmistakable. He had a full head of white hair and a rather large head. He was still a big handsome guy, with mile-wide shoulders and a very pleasant, affable manner. Holy crap! I couldn’t believe it! Old man Scotto had been telling me the truth.
 
On my right was a life-sized mural, painted on the wall next to the door, of him, as a nude young man, posed like a classical Greek statue, clothed only in a strategically placed fold of a royal purple robe. I just stared at him, probably with my mouth open. “You…you’re really him…” I said.
 
He just smiled and then, Atlas shrugged. “Well, I was a young man then,” he said quietly, with a gentle smile, referring to his painting. Then he gave me a tip, advised me to live a clean life, drink plenty of fresh orange juice and exercise. Then, he sent me on my way. I never saw him again. But I did meet him. How cool was that?
 
I later looked up everything I could about him. Born in 1893 in Calabria, Italy, as Angelo Siciliano. He emigrated to the USA with his father in 1903 and took the name Charles. At age 15, he was attacked on the streets of Brooklyn, where he grew up. The following year, he actually did have a bully kick sand in his face at Coney Island beach. He decided to do something about it.
 
During a visit to the Brooklyn Museum, he became aware that the muscles on the Greek and Roman statues were a product of exercise. After flirting with free weights and pulley exercises, but being disappointed with his results, he became inspired by a lion he saw at the Prospect Park Zoo. He theorized that the heavily muscled cat developed its muscles by pitting one muscle against the next. He developed a system of isometrics based on that idea and literally transformed himself into the paragon that the world came to know as Charles Atlas.
 
He was originally nicknamed Atlas by his friends, after the classical Greek statues, and took the name legally in 1922. He won the title of “Wold’s Most Perfectly Developed Man” in 1921 and 1922. He started a small mail order business to sell his exercise system that didn’t do much until he partnered with Charles Roman, an advertising man, in 1929. 
 
It was his new partner that wrote the famous ad and created the term, “Dynamic Tension” to describe the Atlas System. This system was not only a series of exercises (some of which are similar to those I teach today in my PAIN-FREE PROGRAM, which you can see at http://drbillsclinic.com/exercise_eliminate.html ) but also advice on diet, health, grooming and correct behavior. 
 
Through Roman’s efforts the business thrived, despite the Great Depression, and Charles Atlas became the iconic figure of physical male perfection that we know and remember today.
 
Charles Atlas died from heart failure (for which he had a family history) at age 80, in Long Beach after a jog on the beach, December 23, 1972. But his legacy lives on. And, as a young man, I was lucky enough to meet him. Only once, but I remember….
 
Til next time my friend, be well. And have a great weekend.
 
Yours for a pain-free tomorrow,
 
Dr. Bill
 
P.S. For DR. BILL’S LITTLE GREEN BOOK ON ELIMINATING KNEE PAIN, a concise, but complete handbook on the root causes and the various options for treating knee pain, go to http://drbillsclinic.com/eliminate_knee_pain.html
 
P.P.S. For DR. BILL’S PAIN-FREE PROGRAM: EXERCISES TO PREVENT OR ELIMINATE KNEE PAIN, please go to  http://drbillsclinic.com/exercise_eliminate.html
 
P.P.P.S. For the giant, comprehensive ADVANCED MASTERS’ COURSE: HOW TO ELIMINATE KNEE PAIN–ONCE & FOR ALL!, everything you need to know on causes and solutions for knee pain and the complete exercise program, too, go to
http://drbillsclinic.com/advanced_masters.html
 
FREE BONUS CD with any order: THE HEALING POWER OF POSITIVE PAIN PERCEPTION
 
Copyright, 2008 by William Thomas Stillwell, MD
All rights reserved

It’s early morning in my Southampton study, and as I look outside the window at the beautiful stone waterfall my wife had built (which she still has running, despite freezing temperatures), I reflect on the really nice time our family had yesterday. My wife had arranged this for her Dad, his wife and a family friend, as well as the two of us, as a treat to open the Holidays. 
 
So this past morning, we got up early and drove to the Jitney station. Although I have always loved going into The City, we have taken to travelling in on a giant bus, The Hampton Jitney.
 
The advantages are pretty substantial: you sit in comfort, without the tension and stress that are inescapable when driving yourself. Here, someone else does the driving and deposits you right outside your destination. And when your entertainment is over, they pick you up, drive you back and drop you off where you left your car. I’m telling you, you can’t beat it.
 
You can’t put a premium on the lack of tension brought about by having someone else drive you. As many times as I’ve driven into the City for some very nice times, there was always that wearing tension from trying to keep other drivers on the LIE (Long Island Expressway) from running into you, at high speed. As good a time as you may have had, you lose the glow real fast when you have to drive home yourself. Take it from me, this is a whole lot better. Very civilized.
 
Anyway, for this trip, the plan was to get into The City by noon and have lunch at a nice little French Restaurant on 28th Street and Lexington Avenue, La Petite L’Auberge. The bus let us out right in front of the restaurant at the appointed time. And another benefit–no worries about trying to find a parking space!
 
Let me tell you, it was terrific! The cuisine was Country French and, although our lunch was included in the theatre package, I understand from our guide that their prices are very reasonable–especially for a French restaurant. And more amazing still, they gave us a goodly amount of food.
 
We had a choice of three appetizers, three entrees, and three desserts. The food was wonderful. And the service was very pleasant, friendly and efficient, with none of the stereotypical hauteur that one sometimes sees in such places. If you’re ever in New York City, I highly recommend this establishment. I think you’ll be very pleased.
 
After a leisurely two hours, we all piled back into the bus for a ride to the Marquis Theatre on 46th Street. The play was the musical “White Christmas” (not Winter Wonderland, as I mistakenly reported yesterday–hey, my wife got the tickets. I just go where I’m told!) featuring Irving Berlin evergreens like “White Christmas,” “Happy Holidays,” etc.
 
Although I’d naturally heard the songs over the years (they’ve long ago become part of our cultural lexicon), I had no idea what the story of the play was about. So, it turned out to be a pleasant surprise for me.
 
It was set in the post WW II America of 1954 and concerned the efforts of a couple of soldiers, who had become famous and successful Broadway song and dance men, who attempt to produce a Broadway musical in a Vermont Inn’s barn, for the benefit of their old commanding General, who is now the owner of this failing Country Inn. Along the way, they both discover true love and the real meaning of Christmas. Corny? Maybe. But real traditional Americana and a thoroughly enjoyable family show. 
 
I really enjoyed it and my father-in-law, who is a real part of that WW II generation, was in his element. He loves those old songs and those synchronized dance numbers. He was a pretty good dancer himself, in his day.
 
These days, however, he’s been slowed down by arthritis in his back and his knees. So, sadly, his dancing days are over. I know for a fact that he had arthritis in his knees years ago, because I operated on him back in the early eighties and saw he had arthritis back then. Of course, I tried to advise him to do the exercises I teach in my PAIN-FREE PROGRAM (see it here, at http://drbillsclinic.com/exercise_eliminate.html),  but you can’t do a thing with him! He does what he wants. So now, it is what it is. But after all, he IS 84+.
 
But IF I could’ve gotten to him years ago, and IF I could’ve given him the advice I have to give, now in my newest healing program, HOW TO AVOID KNEE SURGERY http://drbillsclinic.com/avoid_knee_surgery.html  and IF he had actually followed that advice, then maybe he’d be in better shape today. 
 
The point is, there ARE things you can do to alter your destiny. You CAN prevent knee pain, you CAN  slow the progress of arthritis and you CAN, in many cases, avoid unnecessary knee surgery. To see how, go to http://drbillsclinic.com/avoid_knee_surgery.html 
 
Until you do, if you have knee pain when walking, you can keep yourself from falling and minimize your pain by using a CANE, when you walk. Stubborn as my father-in-law is, even he does that, now. You should, too.
 
Well, that’s it for today. Only a week to go til Thanksgiving–can you believe it? Til next time, my friend, be well.
 
Yours for a pain-free tomorrow,
 
Dr. Bill
 
P.S. For DR. BILL’S LITTLE GREEN BOOK ON ELIMINATING KNEE PAIN, a concise, but complete handbook on the root causes and the various options for treating knee pain, go to http://drbillsclinic.com/eliminate_knee_pain.html
 
P.P.S. For DR. BILL’S PAIN-FREE PROGRAM: EXERCISES TO PREVENT OR ELIMINATE KNEE PAIN, please go to  http://drbillsclinic.com/exercise_eliminate.html
 
P.P.P.S. For the giant, comprehensive ADVANCED MASTERS’ COURSE: HOW TO ELIMINATE KNEE PAIN–ONCE & FOR ALL!, everything you need to know on causes and solutions for knee pain and the complete exercise program, too, go to
http://drbillsclinic.com/advanced_masters.html
 
FREE BONUS CD with any order: THE HEALING POWER OF POSITIVE PAIN PERCEPTION
 
Copyright, 2008 by William Thomas Stillwell, MD
All rights reserved

 I’m back in Southampton, having flown in yesterday. So this past morning, we drove to the airport to pick up my father-in-law and his wife. We thought it might be nice to gather at the new house for Thanksgiving and to see in the new Christmas Season. 
 
And to be honest, there’s something bizarre about having Thanksgiving and the Christmas Holidays in 70-80 degree temperatures in Florida, when you’ve grown up associating them with the cooler weather of Fall in the Temperate Zone. You know, the whole “chestnuts roasting on an open fire” thing rings truer when “Jack Frost is nipping at your nose.” When it’s perrenial summer, not so much.

So, to prepare for the Season, my wife got us tickets to Winter Wonderland in New York for later this afternoon. True, the Rockerfeller Center Christmas Tree won’t be lit yet; the official Christmas Tree Lighting Ceremony won’t be for a couple of weeks– I think it’s December 4th. But all the other Lights and Christmas Decorations will be up and well worth seeing. 
 
So, I was prepared for cooler weather and looking forward to it. But last night, my wife and I went out shopping, and man, it was COLD! Late last night, it was down into the twenties. I guess I’ve been in Florida too long. I was looking forward to the cooler weather but here I am, freezing in Southampton!
 
Well, hopefully, it will warm up a little later. Brrrrrrrrrrr! This part of New York I didn’t miss.
 
Funny thing about cold weather is that, like damp weather, it can make your joints ache when you have any degenerative joint disease. Among the things that can make you feel better and provide a little relief are supplements and joint wraps.
 
I’ve mentioned before that if you improve the balance of Omega 3 Fatty Acids in your diet, by avoiding red meat, saturated fats and other sources of Omega 6 Fatty Acids and then taking fish oil and other sources of Omega 3′s, you can reduce inflammation and therefore, relieve joint pain.
 
You can also keep your joints warm, too. Ways to do this range from simple elastic or neoprene knee sleeves, to far infrared capturing KENKO wraps and magnetic knee wraps that generate  internal heat within the joint tissues (both are available from your nearest NIKKEN distributor). 

These and a number of other methods for relieving knee pain are described in greater detail in my newest healing program, HOW TO AVOID KNEE SURGERY. See it at http://drbillsclinic.com/avoid_knee_surgery.html 
 
In addition, I list a number of other methods, from across the entire health care spectrum, to relieve knee pain and restore knee function–conventional, alternative and complimentary. And I include a Baker’s dozen of the most effective exercises to prevent and eliminate knee pain, for long term relief. See them at   http://drbillsclinic.com/avoid_knee_surgery.html
 
Gotta go! Til next time, my friend, be well. And stay warm….
 
Yours for a pain-free tomorrow,
 
Dr. Bill
 
P.S. For DR. BILL’S LITTLE GREEN BOOK ON ELIMINATING KNEE PAIN, a concise, but complete handbook on the root causes and the various options for treating knee pain, go to http://drbillsclinic.com/eliminate_knee_pain.html
 
P.P.S. For DR. BILL’S PAIN-FREE PROGRAM: EXERCISES TO PREVENT OR ELIMINATE KNEE PAIN, please go to   http://drbillsclinic.com/exercise_eliminate.html
 
P.P.P.S. For the giant, comprehensive ADVANCED MASTERS’ COURSE: HOW TO ELIMINATE KNEE PAIN–ONCE & FOR ALL!, everything you need to know on causes and solutions for knee pain and the complete exercise program, too, go to http://drbillsclinic.com/advanced_masters.html
 
FREE BONUS CD with any order: THE HEALING POWER OF POSITIVE PAIN PERCEPTION
 
Copyright, 2008 by William Thomas Stillwell, MD
All rights reserved

When I was first building my joint replacement practice in Long Island in the early eighties, I focused on doing the most difficult revison procedures. Just so you know, a revision is a re-do operation of a prior joint replacement that failed, for whatever reason. What else you need to know is that these surgical procedures are at least four to five times the magnitude of an initial “virgin” joint replacement. 
 
The biggest revisions I’ve ever done have involved an entire body transfusion. That means transfusing the entire volume contained in a human body, over 12 units of packed red cells, together with platelets (that help to stop bleeding by forming “white clots”), FFP, or fresh frozen plasma (which contains clotting factors, to allow the bleeding surfaces to clot and stop intraoperative and postop bleeding), and additional fluids, containing electrolytes (charged ions, like sodium, potassium, chloride, etc. that let the heart beat and the nerves work, among other things).

Many times, the loosening of the initial implants results from resorption of the surrounding bone, a process called osteolysis. This occurs as a biological reaction to extremely tiny wear particles of polyethylene, from the plastic parts of a joint replacement–kind of like “brake dust” that accumulates on your car wheels from the wear of your brake pads. This often leaves weak or missing bone, which has to be replaced with bone graft, large pieces and ground up fragments of banked human bone, harvested from donors who have died. 
 
In addition, removing bone cement from the inside of the bones is time consuming, tedious and takes its own toll in damaging and removing native bone stock. Fashioning and fitting these bone grafts to reconstruct the patient’s bones is often the reason for long operative times in the OR. It ain’t easy.
 
And of course, these monster surgeries are fraught with potential complications and much higher risks than the virgin cases. So a failed joint replacement is not a small matter, but a pretty big deal to fix.
 
The longest total hip revision I ever performed took 15 hours, though most were in the three to six hour range. In other words, these are enormous surgeries, on a par with the biggest open heart surgery or excising and grafting an aortic aneurysm, in terms of magnitude and metabolic stress on the patient.
 
And for all these reasons, many surgeons who are comfortable doing primary (virgin) joint replacements are not so thrilled to do revisions. They often feel, many times quite correctly, that they’re out of their depth, way over their heads. 
 
So why in the world would I WANT to attract these cases?
 
My reasoning was multifactorial. I was the only one in the region really trained to do revisions. Most guys wanted someone to clean up their messes, and if I developed the reputation of being an expert in revisions, it would be a great indirect advertisement that I was an ideal choice for doing the simple, “virgin” total joints, too.
 
The problem was that most surgeons wanted to ship their disasters out of town, by referring the case to a big kahuna in The City, so they wouldn’t be embarrassed by the failure of their surgery and wouldn’t be tacitly admitting that someone else in town might be a better surgeon. So I had to attract these cases by going to the patients directly, by word of mouth. And once I got them, I had to handle these cases very diplomatically, so as not to embarrass the prior surgeon.
 
Even in the OR, where my pal and assistant Steve and I would scrub and come swaggering into the room to save the day, like “The Pros From Dover” in the movie M.A.S.H., we were careful not to badmouth the prior surgeon. After all, the failure was often NOT the fault of the surgeon, but caused by factors outside his control.
 
I always felt the guy did his best and “there, but for the Grace of God go I.” Other hotshot surgeons of my acquaintance were not so sanguine or understated in this regard. But I’ve always believed that the Universe has a way of punishing that sort of arrogance, eventually. In any case, my behavior did not go unnoticed.
 
Gradually, the other surgeons in town (and in the entire region) grew to trust that I wouldn’t throw them under the bus to the patient and family. I enjoyed the repuation of a gentleman, as well as an expert in this field. So they began to send me their grief, I would ask them to scrub with me, so they would become part of the solution, maintain their contact with the patient and family, and be able to bask in reflected glory, when the new surgery restored the patient and relieved the pain, which fortunately was most of the time.
 
The point of all this is that surgery is NOT without risks. And these risks are magnified and multiplied when an initial surgery fails and needs to be revised. So, it follows that you should NEVER undergo an UNNECESSARY SURGERY. 
 
If you have knee pain, for example, you may be able to relieve your pain and restore your function, by using the methods I’ve outlined in my newest healing program, HOW TO AVOID KNEE SURGERY. See how here at  http://drbillsclinic.com/avoid_knee_surgery.html 
 
Til next time, my friend, be well.
 
Yours for a pain-free tomorrow,
 
Dr. Bill

P.S. For DR. BILL’S LITTLE GREEN BOOK ON ELIMINATING KNEE PAIN, a concise, but complete handbook on the root causes and the various options for treating knee pain, go to http://drbillsclinic.com/eliminate_knee_pain.html
 
P.P.S. For DR. BILL’S PAIN-FREE PROGRAM: EXERCISES TO PREVENT OR ELIMINATE KNEE PAIN, please go to   http://drbillsclinic.com/exercise_eliminate.html
 
P.P.P.S. For the giant, comprehensive ADVANCED MASTERS’ COURSE: HOW TO ELIMINATE KNEE PAIN–ONCE & FOR ALL!, everything you need to know on causes and solutions for knee pain and the complete exercise program, too, go to
 http://drbillsclinic.com/advanced_masters.html
 
FREE BONUS CD with any order: THE HEALING POWER OF POSITIVE PAIN PERCEPTION
 
Copyright, 2008 by William Thomas Stillwell, MD
All rights reserved

Later this morning, I have to break down and clear out all the furniture and other crap that has accumulated around and in front of my bookcases. These are the same bookcases I had in my medical office when I was in practice. They’ve “seen” a lot. I got them originally back in the mid- eighties, when I first set up my “satellite” office, with the rheumatologists.

You see, when I was first in practice, I had a “baby face.” I looked younger than my stated age, as we say in the trade. Now, considering that I was the only fellowship trained orthopaedic joint surgeon on Long Island at that time, I was trained and hot to do some major reconstructive surgery. But when little old ladies who needed their hips replaced came in, I could almost “hear” them thinking: “Right, kid! Where’s your father?” And who could blame them?
 
So I figured that I needed to reassure them, with visual cues, that I was competent and worthy of their trust. After all, they were being asked to put their lives in my hands. And that commitment requires a leap of faith. So I set about getting them to “believe.” I couldn’t do much about my face, so I had to find a way to instill confidence, without saying anything that could be interpreted as empty bluster or boasting. 

Nonverbal cues, as the shrinks call them, are very effective for this purpose. So I had real engraved stationery and business cards made–not cheap thermographed cards, that mimic engraving, but the real thing, on Crane’s Crest linen paper, no less. The difference is subtle, but those who recognize the difference KNOW and those who don’t still FEEL the weight of the paper stock. Either way, it goes right to their subconscious and screams QUALITY, albeit quietly, in an understated way.
 
Then, I got a real antique oak partner’s desk, circa 1865, large, long and supported by smooth turned columns on each corner. I bought real leather furniture, brown tufted wing chairs for the patients to sit on and an even larger cordovan leather wing chair for myself, all sitting on plush wine colored carpeting. 
 
There was mahogany chair rail all around the room, and there was a set of richly polished cherry bookcases, some open, some with windowed doors, backlit with subtle lighting. The very same bookcases I still have. 
 
The overall effect was more like a lawyer’s office than a physician’s. But it stated, without saying so, that this was an office of substance, of permanence, of quality and traditional values. In short, it projected an aura of gravitas and competence that compensated for my youthful appearance. And you know, it worked. And once I showed what I could do, the issue of my relatively tender years never came up again….
 
Well, time has had its way with my face, like everyone else. But I still love my bookcases and have them filled with leatherbound volumes, novels as well as medical texts, these days. They still make a nice backdrop for an office, or a video set. So, I’m going to use them as a backdrop for my next major production.
 
I have a video producer coming over and we’re about to shoot my very first video DVD. As you may know, I’ve written a number of books and produced a few audio CD’s to teach you about the various problems that can result in knee pain and the various options you have to relieve that pain, especially those options that allow you to stay out of the operating room and avoid knee surgery. These topics are well covered in my LITTLE GREEN BOOK FOR ELIMINATING KNEE PAIN   http://drbillsclinic.com/eliminate_knee_pain.html
 
But now, I’ll have the opportunity to SHOW you what I’m talking about. I can SHOW you the bones, show you where the ligaments attach, show you what torn menisci look like, and what actually happens in surgery, from videos taken during actual procedures. There isn’t anything like this for lay people on the market. So, I’m pretty excited about it. I hope when it’s released that you’ll like it and find it useful, as well.  I guess we’ll see….
 
Well, have a great weekend and I’ll talk to you next week, with some new tips and things you can do for yourself, to prevent or eliminate knee pain. Til next time, my friend, be well.
 
Yours for a pain-free tomorrow,
 
Dr. Bill
 
P.S. For DR. BILL’S LITTLE GREEN BOOK ON ELIMINATING KNEE PAIN, a concise, but complete handbook on the root causes and the various options for treating knee pain, go to http://drbillsclinic.com/eliminate_knee_pain.html
 
P.P.S. For DR. BILL’S PAIN-FREE PROGRAM: EXERCISES TO PREVENT OR ELIMINATE KNEE PAIN, please go to  http://drbillsclinic.com/exercise_eliminate.html
 
P.P.P.S. For the giant, comprehensive ADVANCED MASTERS’ COURSE: HOW TO ELIMINATE KNEE PAIN–ONCE & FOR ALL!, everything you need to know on causes and solutions for knee pain and the complete exercise program, too, go to
 http://drbillsclinic.com/advanced_masters.html
 
FREE BONUS CD with any order: THE HEALING POWER OF POSITIVE PAIN PERCEPTION
 
Copyright, 2008 by William Thomas Stillwell, MD
All rights reserved