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

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

 When I had just arrived in Smithtown at St. John’s Episcopal Hospital, I practically lived in the ER. Initially, in fact, most of my income came from trauma–the sprains, contusions and fractures that presented to the Emergency Room. As the most junior member of my group, I was in the ER a whole lot. As one matures in practice and gets to do more and more surgery, as your practice grows, you become less and less interested in seeing anyone in the ER. 
 
The patients come in at all hours, they come in in pain, more often than not with near hysterical  families, they bring greater liability with them, and to top it all off, the injuries don’t bring very high fees and they often lack insurance (but naturally, you treat them anyway). So, with time, the ER loses its attraction to the busy surgeon. 
 
But when you’re fresh out of training and full of enthusiasm and idealism, it’s great. At first, you love the ER and the challenge that each new patient presents. And ultimately, all great practices were built on a foundation of trauma patients out of the ER.
 
Well, one day, I remember the ambulance guys (they weren’t yet known as paramedics or EMT’s in those days–that came later) carrying in some poor young woman on a stretcher. Her kneecap was completely dislocated after a collision on the soccer field. She was in agony, but was bearing the pain very well. You could see that her kneecap was stuck on the outside (lateral side) of her knee, which was rigidly held in partial flexion. She had to be carried because she couldn’t walk.
 
First order of business was to relieve her pain. FAST. And the fastest way to do that was to pop her kneecap back into its usual position. Trouble was that her leg was in painful spasm, and her kneecap was well and truly stuck in its abnormal position. Any attempt to move her knee and she screamed with pain. And by now, it was beginning to swell considerably. So all this made it difficult to reduce the dislocation (ie., pop it back into position).
 
So my first move, after introducing myself to the young woman and reassuring her that I could fix it, was to inject her knee with local anesthetic, containing epinephrine (adrenaline). This did two things: 1. it rapidly gave her relief of knee pain and 2. the epinephrine constricted torn blood vessels, to reduce swelling and bleeding. Once she was numb, I could gently straighten the knee and push the kneecap back into its groove with a muted clunk.
 
Now, here’s the thing. The first time this happens in an otherwise normal knee, the kneecap has been literally smashed to the outside of the knee, tearing the fibrous capsule (medial retinaculum) on the inside (medial side) of the joint. If this tough tissue isn’t torn, the kneecap CAN’T slip out of its normal position. So if you see a dislocated patella, it means that there is a lot of soft tissue damage that you can’t see.
 
Now here’s where options come into play. You can operate on this knee and repair the torn tissue by suturing it up. Or, you can cast or brace the knee, to hold the patella in the normal position and give the damaged tissues a chance to heal.
 
If the patient is a professional athlete, you might opt for surgery, because its a more predictable  result. But most people aren’t professional athletes. So they may well do fine with bracing in extension (with the knee out straight) for several weeks, followed by 8-12 weeks of aggressive physical therapy. This is typical of the methods I discuss in my recent healing program, HOW TO AVOID KNEE SURGERY  http://drbillsclinic.com/avoid_knee_surgery.html
 
My philosophy is, give the body a chance. In this case, if she went through with the time to allow healing, and was faithful with therapy, but STILL developed recurrent dislocations of the kneecap,  THEN you can always do the surgery. But if you win, you win BIG. So, in cases like this, it pays to be conservative and avoid knee surgery.
 
As it happens, she healed just fine. And she didn’t require surgery. She was highly motivated and did the exercises I prescribed, like those I teach at http://drbillsclinic.com/exercise_eliminate.html   So in her case, the non-operative approach was the right approach.
 
The trick is knowing when its correct to avoid surgery and when it’s really necessary. What my program teaches you is what the difference is–and why. If you have acute or chronic knee pain and you want solutions to relieve your pain, from across the entire medical spectrum, conventional, alternative and complimentary, click here NOW:
 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

Today, this morning, I plan to put out my American Flag, in honor of Veteran’s Day, across the country, and Remembrance Day in Canada, as well. This day has a significance that’s largely been forgotten by many in both countries. 
 
It was on this day in 1918 that “The Great War,” “The War To End All Wars,” what we now call “The First World War” or “WW I” was finally ended. Of course, the seeds of the SECOND World War, which would dwarf the horrors of the First, were also planted by the Treaty of Versailles, which imposed humiliating and punitive reparations on Germany. This engendered a sense of grievance among the German people that was fertile soil for the ideas of a fanatical, but gifted orator who was able to exploit this anger and discontent to forge the Third Reich and bring the world to ruin.
 
To many in this country, this is ancient history. But I was raised in a military family. My grandfather actually fought in the trenches in WW I. He was part of an elite group within the American Legion called the 40/8 or “The Forty and Eight.” This referred to 40men, being hauled in a train car by eight horses in France, during the hostilities. Both he and my father (who was a submariner during WW II) were members of the Legion and both were Past Commanders of Reveille Post. So holidays that honored the military were routine at our home.
 
Every Veteran’s Day, like every Memorial Day, we dutifully went to parades and memorial services as a family, to commemorate and honor the fallen. I remember the Grandmaster of the Parade intoning the ritual, sonorous phrases over the loudspeakers so well: “On the eleventh hour…of the eleventh day…of the eleventh month…the guns were silenced.”
 
Now, I grew up during the Vietnam Era, when, in many quarters of the country, this custom went out of fashion. But not in my house. And I still continue to honor the sacrifice of old and forgotten warriors, who purchased my right and yours to live free, with their blood. So putting up the Flag is little enough to do.
 
Given that background, it seems strange that I didn’t serve in the military myself. But there are many ways to serve your country and your fellow man (and woman, for the P.C. crowd . Mine was to continue my education and go on to medical school, internship,  residency, fellowship and ultimately, the practice of orthopaedic surgery for nearly a quarter century. I learned to save lives and defend patients from disease. Not the same thing, but a good thing, I think. We each do what we can.
 
After my back injury and the resulting disability, that career was over. But thanks to my books and CD’s and other healing programs, I can still help my fellow man (and woman) in ways that matter. In fact, the tips and advice I give out frequently, in this forum alone, help to relieve pain for many thousands more people than I could have possibly treated, during my years of practice.
 
For example, have you ever noticed that your aching joints tend to hurt you more, after a large steak dinner? Well, red meat is a great source of an Omega 6 fatty acid, arachadonic acid. And this type of fatty acid is a precursor of a number of inflammatory chemicals, like prostaglandins, that stimulate pain nerves and worsen knee pain. So, rather than take a drug to decrease these chemicals, just avoid red meat and see the difference. It’s simple, but it works.
 
For many other conventional and alternative ways to relieve knee pain (and other kinds of pain, too–they all share a common pathway), and restore function to your aching joints, and do it without surgery, see my newest healing program, HOW TO AVOID KNEE SURGERY at  http://drbillsclinic.com/avoid_knee_surgery.html
 
So enjoy the day, my friend, and remember those veterans who’ve paid the price of freedom for us all.  Til next time, 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

So this morning in my study, I was going over a number of health related blogs, reviewing them for any potential for commentary and teaching points. A number were pretty good, most often involving the back injuries one sees in sports or exercises or stretches for general fitness or specific injuries. A few had to do with joint replacements of the hip and knee, which happened to be my specialty in practice. 
 
But then, I read one that was incredible. Not good incredible, as in ‘Wow! How amazing!” but incredible as in, “I can’t believe they have this thing out there on the web!” It concerned ACL injuries and rehabilitation and it was so full of factual errors and frank mythology that I couldn’t believe it.
 
I wanted to tactfully reply, correct the most obvious misconceptions, hopefully without insulting the author, or hurting his feelings. It wasn’t a scam, or a deliberate attempt to misrepresent facts for some nefarious purpose. It was obvious that the author was sincere. He was just wrong.
 
For example, one guy said that an ACL rupture wasn’t painful. In fact, it’s one of the most painful and disabling injuries you can suffer. What he meant was that a CHRONIC ACL disruption is painless–the damage has already been done. But the resulting instability, the “wobbly knee” that results from absence of the ACL, CAN indeed cause pain, from secondary tears of the menisci, synovitis, and arthritis.
 
Further, there ARE some people with an ACL injury who DON’T require surgery. This fact is almost entirely ignored in these articles. Specific exercises, especially leg curls and calf exercises, can often compensate for people who make low demands on their injuredknee. The point is, there are options that can be offered.
 
Unfortunately, it was a major pain to reply. First, you have to register in order to reply. Then, the registry doesn’t accept the information and erased all the info I had just input. Finally, I just gave up in disgust. Too bad. Some people are going to read that blog and accept what it says uncritically. As a result, they’ll absorb information that’s just incorrect. And who knows what the consequences will be?
 
Funny thing is, people will believe almost anything they read on the net, even though it’s well known that there’s no filter. That’s one of the internet’s chief charms. But it’s also one of its chief problems, when you really have a need to know the facts about a topic. Without a bit of comparative research on your own, there’s often no way to tell what’s fact and what’s fiction.
 
You may read it on a website, but “it ain’t necessarily so.” But the written word has power to persuade, whether it’s accurate or not. So, especially in seeking medical information, it’s best to go with a trusted source. Hey, that’s one of the major reasons for the existence of Dr. Bill’s Clinic. I’m here to try to provide some guidance and practical advice, based on my nearly quarter century in clinical practice in orthopaedic surgery. That’s why I wrote my healing programs: to help those of you with knee pain, grinding, instability, arthritis, water on the knee, deformities, and any other problems with a variety of treatments, conventional, alternative, and complimentary, from across the entire medical spectrum.
 
DR. BILL’S LITTLE GREEN BOOK FOR ELIMINATING KNEE PAIN is a concise, but complete guide to all the root causes of knee pain and the treatments that I know from experience, professional and personal, do work. You can get your own copy, including an audio CD, at  http://drbillsclinic.com/eliminate_knee_pain.html
 
But, just so you know, the LGB does NOT include the recommended knee exercises. Those are given in a separate companion manual: DR. BILL’S PAIN-FREE PROGRAM, a selection of exercises and stretches that helps to prevent or eliminate knee pain–once & for all! You can get it here, at this link:   http://drbillsclinic.com/exercise_eliminate.html
 
Most recently, based on what people seemed to want, I created my newest healing program, HOW TO AVOID KNEE SURGERY, in both written and audio CD formats. This is a blend of the former two programs, and in addition, adds a great deal of new material, especially on herbs and nutriceuticals and other alternative treatments to help you avoid the unnecessary knee surgery, or at least delay the most invasive procedures, like total knee replacement, in the case of end stage disease, like arthritis. 
 
If you’ve been thinking about having surgery, but would like to delay or avoid it, you can get it here: http://drbillsclinic.com/avoid_knee_surgery.html
 
So, above all, don’t believe everything you read. DO your due dilligence before you accept whatever is out there on the net. The right advice can make a big difference in your life, but you need to be sure of the facts, before you act.
 
Well, that’s it for today. 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