January 5, 2010

Once released from the hospital’s RIO unit, my wife drove me home. I was set up in a spare bedroom, with a lower mattress than my usual, to make it easier to get in and out of bed.
 
Luckily, the local anesthesia was in full force, so I remained comfortable and pain-free. I checked out the dressing, but it was clean and dry, with no sign of bleeding. So far, so good. Then, I got a cold seltzer to drink. Remember, I had been NPO (nothing by mouth) since 10PM the night before surgery, and only had ice chips in recovery, so I was pretty thirsty. Hungry, too. 
 
Then, I noticed I was tired. No surprise there. Surgery is a trauma to your body, so it induces a lot of stress. After drifting in and out of sleep, I had to go to the bathroom. That’s when things started to get interesting.
 
Turns out that when you try to get out of bed, especially without any leverage, you put a lot of stress on those new sutures, just placed in the surgical repair. YEOW! Only a momentary thing, but despite the local anesthetic, I felt that! I had to figure out how I was going to do this.
 
So, I decided to try using a cane, which I had handy, left over from my last surgery, an arthroscopy of my left knee in 2005. I discovered that of I pressed down with the cane in my left hand, I was able to get up with only minimal discomfort. How about that?

Further experimentation revealed that if the came was used in my left hand while walking, it relaxed my right abdominal muscles, by reflex. Now, I’ve known for years that the use of a cane reduces the joint reaction forces across the opposite hip and knee. In fact, I make a great point of that technique, as a way to minimize joint pain, in my LITTLE GREEN BOOK FOR ELIMINATING KNEE PAIN  http://www.drbillsclinic.com/eliminate_knee_pain.html
 
But I never heard that it also relaxes the abdominal muscles on the opposite side from the cane. I don’t believe my surgeon even knows about this (but you can be sure that I’ll let him know, for his future patients). Keep this trick in mind, if you ever need to get abdominal surgery–it makes quite a difference.
 
The other thing that made a big difference in my comfort was the use of a rectangular cooler pack, stored in our freezer against emergencies, instead of a simple ice pack. The surgeon had recommended intermittent use of ice to reduce swelling, but this solid, cold cooler pack not only chilled the tissues, reducing local pain and swelling, but also acted as a buttress against any intra-abdominal pressure. When I pressed it against my surgical site, it kept the repair under pressure, so it reduced any tension on the internal sutures.
 
Between the cane and the cooler pack, I managed very well, indeed. I was completely comfortable, when at rest in bed. I only had some momentary pain, when attempting to get in and out of bed. Even walking was not bad, so long as I went slowly, using the cane in my left hand and holding the cooler pack against my lower abdomen, on my right.
 
In bed, I found by trial and error that a slightly bent fetal position, on my left side, with a pillow between my legs, made me very comfortable. Virtually no pain, at all. I still had taken no pain medication. In that position, I slipped off to sleep and slept all night long.
 
Next day, I found the same thing. Using the cane and the ice pack, I was comfortable enough that I was not in need of any analgesics, even though the local had surely worn off by then. I just took it easy, watched TV, read a bit and periodically took a nap.
 
Long and short of it is that, despite having filled a prescription for Percocet, just in case, I have not needed a single pill. Not one, to date. Just took off the dressing and the incision is healing fine. Of course, the real issue is the internal healing. And that’s the reason that I can’t take my twice daily dose of POWERHOUSE OMEGA FORMULA   http://www.favoriteformulas.com 
 
A hernia is a defect in the tough fibrous sheath across the groin, which is pierced by the spermatic cord, on its way to the testes. The descent of the testes leaves a potential weakness there, which in some people, under some conditions, leads to a tear, or rupture in that sheath. This tear allows loops of bowel (small intestines) to protrude, causing a bulge under the skin. In some cases, that loop of bowel can twist, cutting off circulation and literally dying. This is called strangulation and it’s a surgical emergency. That’s why I wanted this fixed, pronto.
 
In the old days (when I was an intern), the only repairs sutured the edges of the tear back together and to the big oblique inguinal ligament, that runs between the “point” of the hip (anterior superior iliac spine) to the pubic bone. But that repair is under a lot of tension and ruptures can recur at a rate of around 30-40%. With a new, tension-free technique, the surgeon covers the defect with a fine mesh of polypropylene and sews that to the edges and the ligament. 
 
Eventually, fibrous tissues grow into that mesh, which acts like a scaffold, and upon maturity reconstitutes the abdominal wall, obliterating the defect and restoring integrity to the wall. The recurrence rate for this technique is only 1%. The downside is that it needs inflammation to provoke the ingrowth of the fibrous tissues. So, since fish oil is so effective at reducing inflammation, I can’t use it yet. And the rest of my joints KNOW it, too.
 
Anyway, that’s what happened next. So far, so good. I walked a bit more today and went out for the first time. So, little by little, day by day…it’s getting better. Til next time, my friend, be well. 
 
Yours for a pain-free tomorrow and your optimal health,
 
Dr. Bill
 
“The Wellness Warrior” TM
 
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 conventional and alternative treatments and exercises to relieve knee pain without surgery click on http://drbillsclinic.com/avoid_knee_surgery.html 
 
P.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, 2010 by William Thomas Stillwell, MD, FACS
All rights reserved

Bright and early Saturday morning (well, 10 AM IS early to me these days), I suited up in my green scrub suit, donned my long white coat, just like the good old days, and drove up to the Fitness Center of the Alaqua Golf & Country Club, in the community in Central Florida, where I live. 
 
The plan was to shoot the necessary footage for the new DVD edition of my PAIN-FREE PROGRAM exercises (which you can check out and purchase, if you wish, by clicking on this link:   http://drbillsclinic.com/exercise_eliminate.html )
 
I had lined up a suitable model, Jennifer Kunzig, a personal trainer, to demonstrate the exercises, with the special modifications I’ve developed to prevent or eliminate knee pain. Let’s face it. No one wants to see some middle aged guy doing these exercises, when he can look at a pretty young woman, right? She had been dieting and restricting her water intake over the last week, so her definition would look good on tape.
 
I had also retained a videographer, to produce the DVD, a great guy named Jonah Travik (Jonah–now there’s a name you just don’t hear every day). I had worked with him before, shooting the DVD version of my LITTLE GREEN BOOK FOR ELIMINATING KNEE PAIN
 http://drbillsclinic.com/eliminate_knee_pain.html  (That has yet to be edited, but I expect it to be ready early in the New Year) and he’s great to work with.
 
Finally, I had secured permission to use the Golf Club’s Fitness facilities from the owner and developer of the community, a really nice guy named John Ritenour. His kindness gave us a super venue for the shoot, not to mention very convenient for me, as I live about two minutes  down the street.
 
So all was in readiness, the cast of characters was assembled and the sun was shining brightly. We were ready to roll. I got there on time (not too hard–I WAS only two minutes away) and met Jonah. We set up the lights and planned the camera angles, while we waited for Jennifer to show up, which she did about a half hour later. This was planned–no point in having her sit around while we were setting up.
 
Finally, I placed a neat little sign on the door of the Fitness Center: QUIET PLEASE. PRIVATE VIDEO SHOOT  WITHIN. THANK YOU. This was to discourage the curious and the club members, who might otherwise enter while we were shooting.
 
But with the sign and the obvious evidence that a professional crew was engaged in a project, you would think that once we started with the “lights, camera, etcetera, etcetera…” that anyone with good sense would respect our privacy and return later, after we were done, if they felt the burning desire to work out. Just common courtesy, right?
 
I mean, if the situations were reversed and I came across a film crew working when I showed up for my exercise session, it would never even occur to me to barge into the middle of things.
 
So, you know where I’m going with this, right?
 
First, a nice middle aged woman came in and wanted to get her workout in while we were still setting up. So, she got on the treadmill, then did a few dumbbell exercises, and so on. But she never held us up, as we worked around her. And she was properly deferential and only too happy to get out when we were ready.
 
We started shooting after she left and we had hit a nice, productive rhythm. We were moving right along, with me doing the talking and voice overs and Jenn doing the exercises. And just as we were hitting our stride, the door opens and in walks an elderly guy, presumably right off the golf course, walks over and turns on the T.V., and then gets on a treadmill and proceeds to begin walking on it, filling the room with the mechanical noise of its motor and the thud of his footsteps on the track. 
 
I couldn’t believe the stones on this guy. I guess he either didn’t see the sign, was oblivious to it, saw it but didn’t give a crap, or he thought that “quiet please” just meant, “don’t speak” (which he didn’t). And he DID keep the volume on the T.V. real low. 
 
Well, of course, everything we shot during this time had the rumble of the treadmill running through it. And I couldn’t throw the guy out. After all, I was a guest here, myself. But, still….
 
I was frosted at the impeturbability of this guy and his utter disdain and disregard for what we were trying to do. Maybe it’s just me, but I think he was a rude, thoughtless S.O.B., at a minimum. 
 
I let him live. But it required some considerable restraint. And the other members of the crew felt the same–we were all grinding our teeth at the nerve of this guy.
 
Finally, he finished and left. Unbelievable. One good thing about older guys–you know their workout won’t last too long. But of course, he had broken our rhythm and we had to reshoot all the footage that his treadmill sounds had screwed up. His little workout cost us at least an extra hour.  Thanks, pal.
 
Anyway, we finally got it done–a little later than I had planned, but finished. And I have to tell you, I think what we shot was great! I was really pleased. And I hope you will be too, when I unleash the final product as a set of DVD’s, sometime, early in 2009.
 
And in addition to the video, I reshot all the still photos, with professional lighting, and added a bunch of new stuff: more stretches, more exercises, the proper ways to use the stationary bike, canes, braces, taping, ACE wrapping, a real expansion of the program. It was a lot of work, but it should be great!
 
This is going to replace the current PAIN-FREE PROGRAM, so this current version is going to become a collector’s item. If you haven’t gotten yours yet, NOW’s the time, while you still can. Go to http://drbillsclinic.com/exercise_eliminate.html  and order your copy TODAY.
 
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

April 23, 2008

Here we are, Wednesday already. We get through today and we’re over the “hump day” of the week. I swear, the older I get, the faster the week seems to go. I suppose you could say the same thing about the month, and the entire year. It all seems to go by faster and faster, the older I get. You just blink, and another season is gone.

 Remember when you were a kid? I do. At that time, we got over two whole months off from school, every summer. The time seemed to stretch interminably. Even though we were having fun and playing and doing everything we wanted to do, two months seemed like a long, long time. Today, it’s gone, like you snapped your fingers, or so it seems.
 
Turns out there really is a solid scientific explanation for this subjective phenomenon. When we’re very young, the entirety of our lifetime is obviously much, much shorter. Sure, I mean we just haven’t lived that long, yet. So, every interval of time is a larger fraction of the whole span of our consciousness, at that time. As we age, the entire span of our lives is much longer, so a time interval is a correspondingly smaller fraction of the whole. Got that? Well, that’s what the psychologists say, anyway.
 
They’re probably right, but it always seem to me that time slows to a crawl right after the New Year, and continues to crawl by until Spring, around March or April. It picks up the pace a little in May June and July. But then at the end of August, it goes into an acceleration mode, picking up greater and greater speed, until it seems that I hardly turn around and  it’s already Halloween, then Thanksgiving and then
Christmas! I wonder how they explain that? Or maybe it’s just my own psychopathology….
 
Anyway, I spent my “hump day” productively, taping a teleseminar with my good friend Fred Nicklaus. Fred is a middle aged martial artist (Tae Kwon Do) who suffered through arthritis of the hip for about ten years before he finally had to undergo surgery to get a total hip replacement in 2005. Not only is he living proof that you can be fully functional after this kind of major procedure, but his story should be an inspiration for anyone who is down and depressed because they have arthritis.
 
Today, Fred is the teacher of a terrific exercise program called Combat Endurance, which was developed by a Special Forces major. Fred has a great web site at   www.combatendurancetraining.com/. He not only teaches the course, but he demonstrates the maneuvers himself on the DVD’s. Not bad for a guy with an artificial hip!
 
One of the points we discussed in the teleseminar was the number of non-surgical things you can do to “buy time,” before you need surgery.  I teach these methods with respect to the knee in my LITTLE GREEN BOOK    http://drbillsclinic.com/eliminate_knee_pain.html
but the principles apply to ANY joint that has pain, whether from injury or arthritis.
 
One of the key methods is the use of an ambulatory aid, like a cane, when you have a sore joint.  When used in conjunction with OTC anti-inflammatory medications, like Aleve, local heat and exercises,  like all those taught in my PAIN-FREE PROGRAM
 http://drbillsclinic.com/exercise_eliminate.html    ambulatory aids help to markedly reduce forces on the joints (especially the hip, knee & ankle) and help to relieve pain, sometimes dramatically. 

Fred actually climbed Mt. Kilamanjaro, AFTER his hip replacement (do you believe this guy?), but he used two walking sticks to help him during the climb and he’s a great example of how that extra support can be a tremendous help. That’s just one of the tips we talked about in our discussion. This teleseminar will be available in the near future, on my web site.  Keep on the lookout for it.
 
Well, I think I’ll spend the rest of today working on my newest book: HOW TO AVOID KNEE SURGERY. I hope to have it finished and available for you by next month. This will give you all the insider secrets I’ve learned from my years in practice, all the conservative tricks
for getting rid of your pain and staying OUT of the operating room. This is your first early warning about this terrific new product. I’m really proud of it and I think it’s going to help a whole lot of people. So, watch for it next month. 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

My wife picked me up at the airport the other day, after my flight to New York. It was good to see her.  Especially since I had worn a green polo shirt, in honor of St. Patrick’s Day and it was COLD outside the airport, if you’re used to Florida temperatures. Once inside the nice, warm car, with the butt warmers on, I settled in for the road trip to Southampton.
 
While we were catching up on events, I noticed that she was squirming in her seat. I asked what was the matter and she said “My butt is sore.” Turns out that she’s noticed this just the past few days,  just about the time that her new car was delivered and she started driving it. Hmmmmm…. 

Well, further questioning revealed that what was actually sore was her right greater trochanter.  It just seems like her butt to her because the trochanters, the hard bony lumps at the outer upper part of the thighs, that lay people often refer to as their “hips,” actually roll backwards, toward your butt, when you sit. To make matters worse, and what was probably the cause the onset of this pain, the new seats have a deep “bucket” profile, moreso than the car she’s been driving, til now.
 
So the side walls of the bucket seat press in on the trochanters, which roll backwards, right into the “bucket.” This extra pressure rubs the bursa, a sac of fluid that normally lies over the prominence of each trochanter to allow gliding of the soft
tissues over the bones. This extra pressure causes inflammation, a bursitis. Once started, the bursitis is worsened by any additonal pressure or friction.
 
If you develop trochanteric bursitis, for whatever reason, there are things you can do to relieve your symptoms. First, avoid that activity that’s aggravating the symptoms. In this case, a pillow or gel pad in the seat can cushion the trochanters and raise the level of the seat, to eliminate the sidewall contours of the bucket seats and the pressure they apply. Next, rest and sleep with the legs apart, to relax the soft tissues over the bony prominences. Often the best way to do this is to place two or three pillows between the knees. Finally, you need to reduce the inflammation, by using OTC medications, Advil or Aleve, applying local heat, and using the various alternative measures. Although it’s directed primarily at the knee, a complete discussion of all the methods to eliminate inflammation is described in greater detail in my LITTLE GREEN BOOK. See what I mean at   http://drbillsclinic.com/eliminate_knee_pain.html
 
Oh yeah. One more thing–while you’ve got pain, use a cane in the opposite hand. This will reduce the pull of the hip abductor muscles on the tender greater trochanter and allow it to heal more readily. I’ve not only treated many people, besides my wife, for this condition, but I’ve had it myself, as well. So I can tell you, first hand, that these measures work.  If you ever suffer from this problem, they’ll work for you, too. 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