I was notified by my email account that my account was in danger of becoming completely filled and was advised to purge some of the emails that I had let accumulate. In the process of winnowing those that I still wanted to save from those that could be safely eliminated, I came across a few that I thought might be instructive for you.
 
Every so often, I get emails from some poor souls who are suffering with persistent, or progressive knee pain. They ask for help in relieving their pain and in many instances, are fearful of knee surgery. This is one such exchange, which I pass on for the lessons it entails. I have deleted any reference to the author’s origin or identity, for reasons of privacy, and some products this person was using, but otherwise the emails are as they were written. 
 
I’ll have a few comments after you read this:
 
“Dear Dr Bill
 
I came across your website and am writing to ask your advice on which of your books would help me the most (I have spent $$$$$ on lots of so-called self-help measures, like anti-inflammatories, painkillers, etc).
 
I have what surgeons call very “mobile” knee caps. It stems from being very slightly knock-kneed. About 15 years ago (when I was in my twenties), my right knee was operated on,­ after it started to track incorrectly as a result of a fall. 
 
I had a “lateral release” arthroscopy. I was advised to have another on the left knee (I never did). Today, both my knees are extremely sore and painful. I used to do yoga, but stopped two months ago, as it was too painful for my knees.
 
The last month or so, both my knees have buckled and collapsed at the same time on two separate occasions, leaving me to collapse in a heap and barely able to walk. My right knee (the one operated on) is by far the worst. It is sore, inflamed and very painful. My left knee is not so inflamed, but is also very sore and painful.
 
I swim about once a week and exercise on steps in the pool to try to build the strength up in my legs. My knee surgeon once told me we generate four times our body weight to get up the stairs! The pain in my knees prevents me from exercising more, ­even walking. When my knees collapse, I am forced to use a cane to get around for a few weeks.
 
More recently, a GP suggested getting the meniscuses in my knees trimmed so that I can walk better. Given the experiences of my last knee operation, naturally I am not inclined to have more surgery!
 
I would welcome your advice and especially advice on which of your books may help me the most.
 
And I am a vegetarian, so fish oil is out of the question.
 
Thanks for your help and I look forward to hearing from you.
 
Kind regards…”
 
Here was my response:
 
“Sorry to hear of your problems. Your story is a common one, though. Your pain is coming from chondromalacia patellae, a degenerative softening of the cartilage in back of the kneecap. This is caused by the loose (hypermobile) patellae, which in turn is due to lax ligaments and weak muscles.
 
The best value book of mine that will help you is the newest one: HOW TO AVOID KNEE SURGERY http://drbillsclinic.com/avoid_knee_surgery.html
 
That includes herbs, alternative measures, and a selection of exercises that should improve your condition, by strengthening the VMO muscle.
 
Instead of fish oil (given that you’re a vegan), try FLAX SEED OIL, as a source of omega 3 fatty acids. Other herbal anti-inflammatory measures are in the book as well. 
 
Good luck. Hope this helps.
 
Best wishes,
 
Dr. Bill”
 
Well, she took my advice and this was her follow-up email:
 
“Thank you so much for getting back to me so quickly (and in the middle of the night??) with useful information and advice.
 
I’ll definitely order the book – although I’m inclined to order the Little Green Book, as well
 (http://drbillsclinic.com/eliminate_knee_pain.html ).
 
I don’t know much about your background, but from what I’ve read so far, you truly appear to be an ethical doctor with the highest level of integrity and one that is willing to readily share his knowledge: that in itself is remarkable as well as highly reassuring.
 
This morning, I tried the leg raises you suggested in one of your articles (with one knee bent) and immediately felt the legs were stronger. 
 
Everyone else who has told me to do leg raises in the past has suggested raising both legs at the same time (which I would do for a while, but then give up because of the strain on my back). One physician suggested raising the legs with the head held up (which then puts a strain on the neck!) You are the only one who recommends bending one knee, while raising the other leg.
 
For the first time in a long time, I have confidence that – thanks to you – I can beat this problem, without knee surgery.
 
I will keep you posted of my progress and hope you won’t mind if I contact you again should I have any questions. And of course, I’d be more than happy to provide a testimonial in due course!
 
Thanks again for your help and advice.”
 
And if you have knee pain ruining your life or the life of a loved one, don’t suffer. Help me to help you. Get my new program. 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

I started my practice in orthopaedic surgery as an employee of a group practice in the summer of ’79.  While I was in my fellowship training, I truly had no idea where I was going next. I always believed that the right answer would just “show up.” I don’t know if I was just being open to the Universe, or I was just too lazy to make solid plans. But I just had no idea where I wanted to go.
 
I considered staying in Boston, where I thought and still do think that Medicine is practiced at the very highest levels. But, I also wanted to return to New York, which was home. I just believed something would eventually turn up. I had faith that it would.
 
Meanwhile, I continued with my duties as an Aufranc Fellow at the New England Baptist Hospital. I was happy there. We were doing cutting edge clinical research on joint replacements and the treatment of their failures. It was a stimulating time to be in joint reconstruction, a revolutionary time, and I was fortunate to be standing by the side of some of the greatest orthopaedic surgeons of the day–masters of their art and acknowledged authorities in major joint reconstruction.
 
Cross fertilization of ideas and an academic environment, dedicated to the highest ideals of Medicine and Surgery, it was a heady brew for a young and idealistic surgeon, I can tell you. I had nothing but the highest regard and admiration for all my teachers, not only as physicians and surgeons, but as humanitarians and people. It was like being in a think tank, with guys who practiced the ideals of the19th century, together with the science of the 21st century. These were not only teachers, but models of how the physician should behave.
 
I admit, I bought it all–hook, line and sinker, as they say. I was prouder than I could say to be a part of it all. I was so wrapped up in the whole mystique of training at the Baptist that I rarely even thought about what comes next. 
 
Then, one day, I read something that said they had no fellowship trained joint surgeons in Southampton, Long Island. Well, it wasn’t The City, or Boston, but it WAS in New York, so what the hell… I thought I’d go see about it. Well, I first met with the Hospital Administrator in Southampton Hospital. Even then, I was aware of the area’s reputation as a playground for the rich and famous. Of course, what I DIDN’T know was that those rich and famous people didn’t stay in Southampton for their health care. They went into New York City, by and large.  It was impossibly naive, but hey, I was a kid. What did I know? 
 
Anyway, the Administrator set up a meeting with the Board of Directors for them to meet me. And then I started getting phone calls to bail out on my fellowship and start working right away. No, I wasn’t about to do that. The fellowship was a rarity in that time. I wouldn’t dream of giving that up. What were they thinking?
 
Then, came the day of the meeting, and after arranging time off from my duties, flying into New York, driving out from La Guardia in pouring rain and waiting endlessly in the anteroom, outside the meeting room, I saw the doors open and everyone leave. The Administrator came out and told me they were so busy discussing other topics, they just didn’t have time for me. I’d have to come back again.
 
“What?! Are you kidding me?” I said. Suddenly “the scales fell from my eyes,” as it were. The callous disregard for my time, the offhand disrespect, were stunning to me. It was, as they say, a rude awakening.
 
If this was how they treated me BEFORE I committed to a home, and a career in this town, I could only imagine how they would treat me AFTER I had committed.  Well, better to know NOW. So, since I was on the Island, I called Rod Turner, my professor in Boston, and asked him about the local University (SUNY at Stony Brook). A call from him to the Chairman there secured me an impromptu interview, which led to another meeting with a community pediatric orthopaedist in Smithtown, later that day.
 
He agreed to see me reluctantly, as a favor to his friend, the professor, but amazingly, we hit it off so well, that despite his earlier misgivings (and, I found out later, his promise to his friend to “get me out of town”), he offered me a job on the spot and invited me and my wife to dinner. And that was the beginning of my career…. 
 
Funny, but it seems that sometimes, it all turns on a dime. All this happened in just one day. Must have been Fate.
 
At the other end of that career, one split second, a fall, an injury and my surgical career was over. It’s ironic that someone who had such facility with the art of surgery would end up teaching people how to stay out of the operating room (to see what I mean go to http://drbillsclinic.com/avoid_knee_surgery.html )  But life is like that. “One never knows, do one?”
 
If you or your loved ones have knee pain, but want to stop the pain WITHOUT SURGERY, you need my latest program:     HOW TO AVOID KNEE SURGERY. Order it 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

Eeeeeeeeeeeeeeee! The electronic tone went off as our front door opened this morning at 8 AM, and Joe, our contractor, came in to continue the renovation job in our basement. Woke me up instantly, though the bride remained asleep. Hey, after lots of years of having to get up at the very crack of dawn, I like to sleep in, now that I’m retired. Just before awakening, I had been dreaming about Jonathan Swift’s iconic character Gulliver, standing in the sea, on a shore, bound with a host of Lilliputian lines. 
 
“Why in the world was I dreaming about that?” I wondered. 
 
Then it dawned on me, that an article in the Oct. 14th Wall Street Journal by Bret Stephens, “America Will Remain The Superpower,” referenced that character, as a metaphor for the international ramifications and implications of the recent market meltdown: “When the tide laps at Gulliver’s waistline, it usually means the Lilliputians are already ten feet under.”
 
The author’s point was that the decline in value of our stock market by 25% in three months (before the surge back of yesterday)meant that the Dow had “outperformed nearly every single major foreign stock exchange (which all had losses substantially in excess of our own)” and that “America’s financial woes are nobody elses gain.” Or put another way, the news of America’s demise as a superpower is greatly exaggerated. And whatever affects us is that much worse for pretty much everyone else.
 
It was only a single line in a long article, but I guess that image made an impression on my subconscious, that showed up in the dream.

Well, as you may or may not recall, Jonathan Swift was a satirist, responsible for some pretty biting criticisms of his society at that time (my favorite was “A Modest Proposal,” which suggested that a way to deal with famine was cannibalism). And Gulliver met people both much smaller (Lilliputians) and much larger (Brobdingnagians) than himself. But I think my subconscious took the image more literally, perhaps portraying various problems and concerns I might be thinking about as those pesky lines, binding my “big self.” And in taking this form, the dream itself suggested the solutions. 
 
What’s interesting about this metaphor is that in order to break free of those entangling lines, ACTION is required. Passive acceptance of his situation will only result in further loss of freedom. It’s only Gulliver’s travails that will ultimately set him free.
 
In the same way, if you have any problem, physical, mental or spiritual, the worst thing you can do is nothing. Passive acceptance guarantees no change. You have to analyze your situation, determine what’s necssary to change it, and then you must take the necessary action to effect that change.
 
For example, if you’re crippled with arthritis, or suffering from knee pain of any cause, just sitting around won’t change your condition. You have to TAKE ACTION, like the simple, non-surgical treatments and the specialized modified exercises I teach in my newest healing program, HOW TO AVOID KNEE SURGERY, which you can see at this link:  http://drbillsclinic.com/avoid_knee_surgery.html
 
If you want to relieve your knee pain, FAST, and restore your joint stability and full function, then you need this program! Click on the link and see how:  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

When I switched on the compouter this morning in my study, I clicked on my email, as I usually do, to see what, beside spam and junk, was in the inbox. As you might imagine, I get lots of emails and referrals and requests for advice about knee pain, hip and back pain, arthritis and all the rest of it. Whenever possible, I try to help, if I can.
 
Oftentimes, that means referring the enquirer to one of my healing programs or books. Sometimes, I can give them some short term advice that may help. Of course, I’m limited by the fact that I can’t see, much less examine them, and I’m further limited by their description of their problems. 
 
Lay people know what they mean, but they often can’t express it well enough for me to understand what the problem is. We don’t share the same vocabulary when it comes to medical problems. That’s one of the most important contributions of my LITTLE GREEN BOOK (see it  at http://drbillsclinic.com/eliminate_knee_pain.html ), which translates a number of medical problems from “medicalese” into everyday plain English, so the average person can understand what we’re talking about.
 
Anyway, recently, I’ve had a number of questions from people who have already HAD surgery, usually arthroscopic surgery, but STILL have pain. As is typical in my experience, many tend to blame the doctor for screwing up the surgery. But in fact, persistent pain may be from residual arthritic changes inside the joint. And it’s now well accepted, backed up by two large studies, that arthroscopic  surgery for arthritis is pretty ineffective. So, it’s not uncommon to have persistent pain after that procedure.
 
Let me give you an example of what I mean. This is the most recent email from someone in this very situation:
 
“I have had arthroscopic surgery on both knees. My right knee is in really bad shape after surgery. I think the surgeon really must have botched it because I am in constant knee pain after being on my feet for a few hours. How will your exercises help with no meniscus left in my knee? By the way, I am 57 and the surgeon says I am too young for knee replacement. Can you help me strengthen my knees through exercising?  Thanks…”
 
And here was my reply:
 
“…Your problem is not uncommon. You may have had a torn meniscus, which the surgeon probably removed PARTIALLY (you generally try to leave some of it as a cushion, unless it is already completely shredded from degeneration).  However, most likely, he did NOT “botch it.” It’s just that you undoubtedly have ARTHRITIS in that joint, which arthroscopy CANNOT CURE. That’s the most likely source of your pain. 

“57 is NOT too young to have a total knee. But, there are a number of proven, very effective non-surgical methods that can help to relieve your pain, and restore your function, at least for a while. You may wish to get my newest healing program, HOW TO AVOID KNEE SURGERY   at http://drbillsclinic.com/avoid_knee_surgery.html
 
“Exercises help by increasing the stability and the support of the arthritic joint by increasing the mass and strength of the surrounding muscles. But they are only one method, among many others, that can delay surgery. If you have end stage arthritis, eventually you WILL come to a total knee. 
 
” But that day can be delayed in many cases–I had one patient I carried in this way for TEN YEARS,before he finally got it done. But remember, everyone is different, so you can’t predict how well these methods will work for you. Still, isn’t it worth a shot? 
 
” BTW, be sure you have your Total Knee done by a specialist in joint replacement, when the time comes. It’s a very technique dependent procedure, so a guy who’s doing a LOT of them will have better results and fewer problems and complications. Hope these  tips help. Good luck to you!…”
 
Hopefully, he’ll take my advice and click on   http://drbillsclinic.com/avoid_knee_surgery.html  He’s likely to find a highly effective combination of conventional and alternative measures and exercises that will give him FAST RELIEF from his knee pain and help him AVOID SURGERY, if that’s possible. How about you?
 
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

Soon after touching down in the Orlando International Airport last week, I realized that my local comics shop (ACME Superstore, Longwood, FL) was holding two weeks’ worth of my comics. The books come in on Wednesdays, and we had left town early on a Wednesday, returned late on the following Thursday, so they had two weeks’ worth of comics in my file. 
 
The problem with that, is that I often pick up additional titles, when I pick up the books I subscribe to. And if I let it go for more than a week, it’s hard to keep track of these. So I end up missing some items I would have liked to have. Also, they sometimes sell out of an issue I want. The point is, I like to keep current and visit the shop weekly, if I can. 

If you’re a long time subscriber, you know that I’ve been reading and collecting comics since the early sixties. In fact, as a professional artist, I actually worked in the comics industry, back in the early seventies. If you’re not a long time subscriber, you know it NOW. If you’re at all interested in seeing some of my non-medical drawings (heroic fantasy and horror) and a glimpse of “what might have been,” go get back issues of CREEPY #35  and CREEPY #37 (Warren Publications) in your local comic shop’s back issue files, or a fanzine called HOT STUF’ circa 1973.

My wife, who was mortified at my extracurricular interest, as being somehow beneath my station, would often exclaim, “A man in your position! What if your patients knew what you read in your spare time?!” 
 
With characteristic modesty, I would always reply, ”Honey, when you’re as smart as I am, you really don’t give a damn WHAT they, or anyone else, thinks!” C’mon! It’s not as if I was doing anything that was illegal or immoral (I keep those activities strictly hidden
 
Anyway, it was an off day, Friday, when I finally made it there. The owners and most of the staff were away, and only Penny, one of their sales associates (a very pretty blond and, as it happens, one of my listed testimonials on the website) was there. She got my comics from my file, and, sure enough, there were some other books I wanted, as well.
 
As I took the books to the register, to pay for them, I noticed that Penny didn’t look too happy–not like her, at all. “What’s the matter?” I asked. “Oh, my knee’s been bothering me lately. It’s feeling kind of numb,” she replied. 
 
From many long years of clinical experience, I knew to ask her what she meant by “numb.” See, my father-in-law would always say he felt “numbish,” by which HE meant a dull aching pain. To me and any other physician, “numb” means something entirely different: a decrease in sensation, usually soft touch. But had I not learned that some folks SAY that, when they really mean a deep, dull pain, we could’ve been there all day, not understanding each other.
 
Then, she said that the pain was behind her kneecap, but indicated with her hand that it was really behind the entire knee, in back of the leg. Again, a potential failure to communicate, had I not seen her point. 
 
But the kicker was that she also had pain in her buttock, right in the middle, just behind her “hip bone” (greater trochanter), above the “painful knee.” And it would radiate down the outer, posterior thigh into the knee and the upper calf. Well. Even though Penny had previously had arthroscopic knee surgery, to treat real pathology (I saw her intraoperative photographs), her problem was really one of sciatica– pinching or pressure on the sciatic nerve, probably as it emerged from the sciatic notch in the pelvis, on its way down the lower extremity.
 
Sometimes, “knee pain” isn’t from the knee at all. Other problems, in the spine, the hip joint, the pelvis, the sacroiliac joint, the abductor muscles, the trochanteric bursa, the piriformis muscle (which I suspect in Penny’s case) can give a false impression of knee pathology, even though the true cause is from a distant site. You can learn more about all the root causes of knee pain in my LITTLE GREEN BOOK; see it at  http://drbillsclinic.com/eliminate_knee_pain.html
 
By this time, we had a few of the other customers watching us, as I conducted a cursory exam and ran my makeshift “comic shop clinic.” I gave her some advice, like the alternative measures I reveal in my new healing program, HOW TO AVOID KNEE SURGERY at   http://drbillsclinic.com/avoid_knee_surgery.html   My tips included ways to rapidly reduce any local inflammation, relieve pain and stretch the offending tendon, which is placing the sciatic nerve under pressure. If she does what I told her to do, she’s  likely to be better in just a few days, without even a doctor’s visit (unless you count mine .
 
If you, or someone you know has knee pain, there are a number of effective methods to relieve it, and do it without expensive drugs or surgery. See how at:  http://drbillsclinic.com/eliminate_knee_pain.html   And if you think you need knee surgery, first try: 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

It’s hard to believe how fast time is flying. Here it is October 2nd, and the last quarter of 2008 has already begun. You know, it was a year ago yesterday that I sent my very first email to a small group of friends–my first subscribers. Well, everyone has to start somewhere, right? Things have changed quite a bit during this last year, too. I started with my LITTLE GREEN BOOK   http://drbillsclinic.com/eliminate_knee_pain.html
 
I have a number of products, including CD’s for the LGB and for my newest healing program, HOW TO AVOID KNEE SURGERY, which you can see at http://drbillsclinic.com/avoid_knee_surgery.html And, there’s also my magnum opus, HOW TO ELIMINATEKNEE PAIN–ONCE AND FOR ALL! THE ADVANCED MASTERS’ COURSE http://drbillsclinic.com/advanced_masters.html  for the last word in the entire spectrum of methods of treatment for knee pain of all kinds. This can be obtained in a single, BIG volume, or in 12 monthly installments, or Lessons–your choice. Or, if you’re just interested in the specially modified exercises that I used myself after my own knee surgery, and those I prescribed for my patients during my nearly quarter century of private practice in orthopaedic surgery, you could benefit from my PAIN-FREE PROGRAM  http://drbillsclinic.com/exercise_eliminate.html

These exercises can help get rid of knee pain, FAST, but can also PREVENT knee pain, when done as instructed. And, I’ve made some other great products available to you as well, like the human growth hormone releasing hormone analog, that when rubbed on the skin, helps to reduce inflammation, speed healing, and has anti-aging properties, as well. You can get it here: http://drbillsclinic.com/trans_d_tropin.html 

I’m grateful for all the subscribers who have joined our ranks and for the support of all those who have purchased one or more of my programs. I’ve gotten some great feedback from those who have followed my advice–none better than those who have come back to buy again. All in all, it’s been an exciting and pretty gratifying time. Just think–even though I can’t operate any more, I can still help people all over the world, through my programs, CD’s, tips and general advice. 

Let’s face it. The internet is a gusher of information: some good, some bad, some irrelevant. So much, in fact, that the average person is just swamped–people have NO frame of reference, no filter to determine what information is correct and what isn’t. What you really need is ADVICE, from someone who KNOWS. And that’s what I’ve tried to provide. 
 
So, what’s next for Dr. Bill’s Clinic? Well, I’m now working on a program for ARTHRITIS–what it is, and more important, what you can do about it: how to slow its effects, relieve pain and prevent joint damage, with my usual approach of giving you the latest measures from across the entire medical spectrum, conventional, alternative and complimentary. 

I’m also going to produce some DVD’s and digital videos, and I may provide some teleseminars, as well. So, it should be fun. I’m looking forward to it. And it starts right now….Talk to you soon, my friend. Til then, 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 Friday about nine AM, I was sitting in the Grand Ballroom of a hotel, listening with rapt attention to the speakers at an internet marketing seminar, with a number of high profile entrepreneurs. To my surprise, a number of the particpants were martial artists, and pretty well-known champions, at that. One guy, from Canada, actually did two pushups ON TWO FINGERS, just to demonstrate that it could be done. That’s TWO FINGERS of just ONE HAND, by the way. And he did it not two feet from my seat, so I can tell you, it was no trick. Wow! I couldn’t do that on my best day…and I have very strong fingers, from years of crushing bones in the OR .  This young man and his father are among the most successful martial artists in their country.
 
Another one of the speakers was a champion karateka in Tae Kwon Do and is now the President of NAPMA, National Association of Professional Martial Artists and a successful informational marketer. Man, how things have changed from the old days, when I studied Goju-Ryu karate in New York.
 
I remember entering the rickety elevator in the five story commercial building on 17th Street, just North of Union Square, in the summer of1967. The dojo was a large loft, with a polished wooden floor, on the third floor. On the fifth floor were the offices of Al Goldstein’s Screw magazine (but, of course, I never went up there). The sensei was a medium tall, very broad shouldered Hispanic guy (though no one had thought up that term, at that time) named Joe Lopez, a fourth dan (4th degree black belt) in Goju. 
 
With all the 7th, 8th, and 9th dans floating around today, 4th dan doesn’t sound like much, but I can tell you, Goju was a Japanese style, and pretty conservative about promoting people. Joe had come out of the old Peter Urban dojo in New york and he was widely respected by all the martial artists, of all schools, for his unbelievable strength and tremendous punching power. Even the Chinese respected him and actually taught him Gung Fu. Today, that’s no big deal, but in those days, they wouldn’t teach “white guys.” So he was the real deal. Solid and traditional–Nothing inflated, or puffed up about him.
 
Goju only had four belt ranks, too: white, green, brown and black. None of the multicolor constellation you often see with the Korean styles. Pretty conservative, all around. And our sensei absolutely idolized the Grand Master of the style, Gogan “The Cat” Yamaguchi.
 
“Cat” Yamaguchi was a really impressive guy, too: Short man, with long flowing black hair past his shoulders, who wore traditional black Japanese robes all the time. By the time I got involved in Goju, he had become a Shinto priest, with great emphasis on the “internal” or meditative aspects of the art. But when he was young, by all accounts, he was a real street fighter. He was one of the original students of Chojun Miyagi, the Okinawan founder of Goju, and he represented a direct lineage to the roots of modern karate. So everyone in the dojo, from the sensei on down, was greatly honored to follow in the footsteps of the “Cat.”
 
One of the things I admired most about the style was its Chinese influence and its emphasis on flowing, circular motions, very unlike the linear forms seen in Shotokan style, another Japanese form. But, some of these circular movements, especially round house kicks, if not done correctly, would result in knee pain, and occasionally, torn menisci, or injured ligaments, that could result in knee surgery–and they didn’t have arthroscopy in those days.
 
Of course at that time, I didn’t know what I know today. I knew barely enough anatomy to be dangerous. And as for exercises, I was into weights, like everyone else and the basic exercises taught at the dojo, some of which could actually cause knee injuries. But who knew? Had I known then what I know now, I could have helped a number of my fellow students avoid pain and disability, with the exercises I teach today in my new healing program, HOW TO AVOID KNEE SURGERY, which you can see at  http://drbillsclinic.com/avoid_knee_surgery.html
 
Whether you’re a fledgling karate student like I was in 1967, or a champion mixed martial arts fighter, an aging Boomer, or an aspiring young athlete, if you have knee pain, or would like to be sure you avoid it, try the measures I reveal in HOW TO AVOID KNEE SURGERY http://drbillsclinic.com/avoid_knee_surgery.html   I thnk you’ll be glad you did. 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

This summer, there’s been an outbreak of ticks all over our county, here in sunny Florida. Since my poor old dog, Kelly is the only pet that goes outside to take care of her business, she’s a  potential vector for bringing the damn little blood suckers into the house. I’ve had the entire yard sprayed three times now, the interior of the house sprayed, the dog given a flea and tick bath twice at the vets and sprayed her feet and belly with Frontline spray every time she goes out. And still I occasionally see one creeping around. It’s like they’re super bugs or something–really hard to kill. And I’ve heard from my landscaper that it’s the same all over, but no one knows why.  First year since we’ve been in Florida that this has been a problem. Maybe it’s the relatively mild winter we had (yes, we do get a brief winter, occasionally with freezing temperatures at night. But it only lasts for about 4-5 weeks, or so). One more thing about Florida they don’t tell you in those brochures….

But this reminded me of a story I thought I’d share with you.

A number of years ago, there was this one hard luck patient who needed to have his hip replaced. So we did the usual pre-op work-up and scheduled him for the O.R. The first time he showed up, one of his lab results was out of the normal range and Anesthesia (quite correctly)refused to anesthetize him. Of course, I agreed–better to be safe. So we corrected the electrolyte problem and rescheduled him.

Next time, his blood pressure was too high, despite his medications. Again, he was scrubbed and rescheduled. Finally, the third time, everything looked OK, he showed up in the OR and we got him anesthetized (combination  anesthesia: epidural and a light general). We then rolled him over on his side, in what we call the “lateral decubitus position,” and the nurses began to prep him.

As I usually did, I came in to inspect the prep and noted that there was one area where they hadn’t shaved the hair away. And, of course, it was right over the area  where I needed to make my incision.

So I said, “Hey. There’s a spot you missed.”

“Well, there’s a mole or skin tag there and I don’t want to cut him,” the nurse replied.

“Alright,” I said, “give it here and I’ll do it.”

And with that, I took the razor and I looked closer at the skin tag or mole. It was flesh colored, no hair on it, looked like a typical fleshy skin tag, in an odd place. So, just to see where its base was, in preparation for carefully shaving around it, I flicked it with a finger…

And suddenly,  LEGS CAME OUT!

Holy crap! It was a fat TICK embedded in this guy’s thigh, alive and so positioned that you couldn’t see it when the patient was on his back (he was a heavy guy and the flesh of his thigh neatly covered it, until he was rolled over). So we had to scrub his surgery, yet again!The risk of infection, especially with an implant, was far too high to proceed.

I removed the arachnid (not an insect: ticks have eight legs, like spiders, not six) with surgical forceps and stuck it in a specimen jar of formalin (a preservative).  Anything removed from a human body has to go to Pathology, once you’re in the OR. And an Operating Note has to be dictated. The official operation was “Removal of Foreign Body.” Probably very entertaining for the Medical Transcriptionists who typed these things up for the record, too. A variation on what they usually say: “The third time’s the TICK!”

Imagine the surprise of the patient and his family when I told them about this one! Without doubt, this was my very weirdest case. They were good sports though, and understood why we didn’t see it ahead of time. Hell! They hadn’t seen it either.

After the little bite wound healed, we finally got him done, without any complications at all. I guess he used up all the bad luck in his previous attempts to get into the OR. And he ended up doing great! Now admittedly, (and thankfully) this was a pretty rare set of circumstances. But if you ever needed yet another reason to stay out of the OR…J

And speaking of staying out of the OR, if you have knee pain and want to get relief, but WITHOUT SURGERY, click the link below to see my most recent healing program, HOW TO AVOID KNEE SURGERY  http://drbillsclinic.com/avoid_knee_surgery.html

Til next time, my friend, be well (and stay out of the tall grass…).

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

For the past week or so, I’ve been trying to relieve your fears about surgery. Hey, you never know. One day you might NEED one of these procedures, and it would be a shame if you were terrified, due to misperceptions, misinformation, distortions and urban myths. It’s also a good idea to know just what your options are, so you can make an informed decision, should that day ever come.
 
So, I’ve attempted to give you the straight dope, tell you exactly what’s done, in each of the most common surgical procedures for the knee. As I’ve said before, when you KNOW the finite dimensions and the finite duration of an experience you fear, it helps a lot to put it in perspective, help you face it and help you handle it. 

Today, to round this all out, is the ultimate option: ARTHROPLASTY, more commonly called joint replacement. Though the term actually means “creation of a joint,” it’s come to be identified with joint replacment, and is now virtually synonymous. This was initially TOTAL knee replacement, but today, through many technical advancements, it encompasses PARTIAL or UNICOMPARTMENTAL joint replacement, as well. These options are explained in great detail, though in layman’s language, in my LITTLE GREEN BOOK at http://drbillsclinic.com/eliminate_knee_pain.html
 
This is really a misnomer, though. Unlike a total hip replacement, a total knee DOES NOT replace the entire joint, nor does it remove the bony segments of the joint. Instead, only the SURFACES are replaced with man-made shells of polished metal, articulating on very tough plastic. Technically, the operation is a joint resurfacing arthroplasty. If there’s severe arthritis on only one side of the joint, then only that side has its surfaces replaced. The so-called UNI (unicondylar knee replacement) can be done through a very small incision, sometimes even on an outpatient basis. The trick is for the surgeon to balance the ligaments and align the knee properly, so the kneecap tracks properly.
 
Small power saws are used, with special saw guides and alignment tools, to cut thin slivers off the ends of the bones, the femur and the tibia. This removes the arthritic surfaces and “opens up” the spongy (cancellous) bone, for acrylic cement intrusion, which holds the implants in place on the respective bones. The properly sized implants are then selected and implanted. 
 
A total knee replacement, like the name implies, resurfaces all three compartments, medial lateral and patellofemoral. It’s done for more extensive, or end stage disease, in two or all three compartments. It needs a larger incision, generally involves somewhat more pain, swelling and potential bleeding. It has a greater potential to develop adhesions, and limited motion, after surgery.
 
In both cases, weight bearing is initially limited by pain, and the use of crutches or a walker. Motion is started right away. Pain is controlled with medications, and physical therapy and rehabilitation are essential. Many of the exercises used are those I teach in my PAIN-FREE PROGRAM, at   http://drbillsclinic.com/exercise_eliminate.html
 
But here’s the thing. Although the success rate, in the right hands, is very good with joint replacement, you NEVER do this without the right indications. The truth is, nothing made by man is as good as what God gave you. Man-made parts can wear out, can get loose, even get infected…and there’s always the chance of a technical problem or human error, even in the best of hands. 
 
So you need to be SURE that if TKR or a UNI is recommended, it’s NECESSARY. And if you can get relief from ANY more conservative methods, conventional, alternative, or complementary, provided you don’t have a lot of bone loss in the joint or severe deformity, then it’s an UNNECESSARY SURGERY and should be delayed, or avoided. And it was to help you do just that, that I wrote my new healing program, HOW TO AVOID KNEE SURGERY   http://drbillsclinic.com/avoid_knee_surgery.html
 
Well, I hope that this series on knee surgeries has been informative for you and that I accomplished my goal: to tell you exactly what goes on in the O.R., give you some perspective and relieve your anxiety and fears about surgery. If you NEED surgery, by all means, accept the risks and get the benefits.  Odds are, you’ll do great. But if you’re not sure, or if all non-surgical measures have NOT been exhausted, then there’s at least the possibility that you may be headed for an UNNECESSARY SURGERY.
 
In that case, get my program and be prepared. Don’t guess, when you can KNOW. Click on the link and get HOW TO AVOID KNEE SURGERY today, right NOW, at   http://drbillsclinic.com/avoid_knee_surgery.html   to relieve your pain, restore your function and do it WITHOUT SURGERY.
 
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

The last time, we discussed what’s really involved in arthroscopic knee surgery. My thesis is that you’re far less likley to be afraid of necessary, needed surgical procedures, if you understand what’s actually done. Otherwise, your imagination creates a lot of nightmares that are much more intimidating than the real thing–by far!
 
Although the procedure I described was for treating a painful, degenerative kneecap, the same basic techniques are utilized when dealing with torn menisci, loose bodies, inflamed synovium and even ACL ruptures and tibial plateau fractures. The specifics are different for each type of pathology, but the basic approach is the same.
 
Let’s look at torn menisci first, for today. As I point out in the section on menisci in my LITTLE GREEN BOOK FOR ELIMINATING KNEE PAIN    http://drbillsclinic.com/eliminate_knee_pain.html   these cushions have no blood supply, except for the peripheral 25-30%. So many tears on the inside of the knee simply won’t heal. Therefore, treatment is basically removing the loose, torn fragment. 

After inserting the arthroscope into the joint, as we discussed yesterday, and identifying the loose torn piece of the meniscus, the surgeon uses small nippers, called “basket forceps” to nibble away the offending fragment. The little pieces of the meniscus float around inside the joint, until they’re sucked out by a power shaver (basically a tube with a rotating blade, attached to suction).  This shaver is also used to cut away overgrown and/or inflamed synovium (joint lining membrane), or shredded, fragmented articular cartilage (a process called debridement, or “house cleaning”).
 
Loose bodies, usually fragments of bone coated with cartilage, which have “fallen out” of the articular surface by disease, have been grown inside the synovial membrane, or have been “knocked out” of the joint surfaces by trauma, are removed by long grasping forceps. These are basically “grabbers” that the surgeon uses to capture the loose body and extract it. If it’s too big to pass through the arthroscopic portal (the little incision used to introduce the scope into the knee), either the incision can be enlarged, or the loose body can be broken up into smaller pieces and remove them, one by one.
 
Anyway, as you can see, you can do lots of different things through the arthroscope, but since nearly all the stuff inside the knee is devoid of nerves (or blood), the minimal disability is about the same, no matter WHAT you do inside. And THAT’S what the arthroscopic revolution is all about. And that’s why the pain is so minimal and recovery so rapid after this type of surgery. Pain and disability are functions of the size of the incisions and the amount of internal bleeding.  Minimal incisons, minimal disability. Simple, no? Pretty cool, too. It’s really transformed surgery!
 
Now, you know the worst of it. Not so scarey, is it? But that doesn’t mean you want to have surgery if it isn’t really necessary. That’s the key: you don’t want to be irrationally afraid of surgery, because there ARE times it’s needed. But you DO want to AVOID the UNNECESSARY surgery. This is a common sense, rational approach and the same one I used for lo those many years in practice, which resulted in my treating over 90% of my patients, WITHOUT SURGERY.
 
If you want to give your body the chance to heal naturally, if you want to stay OUT of the operating room, if you want to improve the odds of conservative treatment working, or use alternative methods to relieve your pain, then you need my newest healing program, HOW TO AVOID KNEE SURGERY, which you can see at   http://drbillsclinic.com/avoid_knee_surgery.html
 
Now, I had planned to continue with a description of joint replacement — what it is and what it isn’t–with the same idea: you will be less afraid if you understand what it really is. But I have a special treat for you instead. My friend, Fred Nicklaus, a veteran of 30 years in the martial arts and a guy who has HAD a hip replacement himself, is going to have a special offer on his Combat Endurance course, a proven method to give you a core of steel. But more about that tomorrow…
 
Meanwhile, if you have knee pain and you’re keen to stay out of the O.R., try HOW TO AVOID KNEE SURGERY 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