Just finished hearing President Obama’s first offical State of the Union speech before a joint session of Congress, last night. Also listened to the Republican response by Governor Bob McDonnell of Virginia, from the Virginia State House, in Richmond. And I just finished reading some comments about the speech, left by some of our fellow citizens on MSNBC. Truly incredible (and frightening, in that these imbeciles probably vote).
 
If you ever want to feel much smarter than you probably are, just read some of what passes for political commentary by the public: Long on passion, short on facts and sense. They were in fine fettle today, I can tell you that!
 
Well, if you’re expecting me to tear The One a new one, sorry. Not my job. Instead, I will share a few of my observations on specific points that stuck out in my mind, during the speech. Make of them what you will.
 
Overall, the tone of the speech was somewhat defiant, in the face of the very obvious public message delivered in the loss of Ted Kennedy’s Senate seat (held for over 40 years) to Scott Brown, a Republican who rode independent displeasure with the Administration’s policies, especially on Health Care, to a win in last week’s special election. It was also somewhat pedagogic–he was actually lecturing and several times, sounded like he was scolding.
 
That’s the thing about this guy–he sounds perfectly reasonable when he’s delivering a speech. But then you see how he executes what he says, or IF he does. And that does not often compute with the facts. 
 
First, there he goes again…blaming Bush. It’s been a year. He knew coming in that this was the situation. I will NOT defend Bush’s record on spending; it’s indefensible. However, I will observe that quadrupling the deficit is probably NOT the most fiscally sound move that Obama could make. But his constant whining about Bush causing all this is unseemly and as often as he’s used this ploy, it’s wearing mighty thin….
 
He is taking credit for such recovery signs as are currently evident and attributing this to his Stimulus Package (even though the bulk of the money has STILL not been spent). He says now that his number one priority is JOBS and proposed a new jobs bill. Yet, he intends to impose a tax on “Big Banks,” which will further inhibit lending by said banks, which, as a result, will also inhibit small businesses from hiring new workers. 
 
But, on a positive note, he proposed eliminating capital gains taxes and tax credits for small businesses. He is still sticking by Cap and Trade legislation, even though that’s been proclaimed DOA and is deeply unpopular, based as it is on phony “climate change” assumptions.
 
On Energy, he called for new nuclear power plants, clean coal technology, biofuels, and…be still my beating heart…offshore drilling of new oil and gas reserves. Terrific. Only…does he mean it and can we believe him? That’s not cynicism. Based on past performance, that’s a reasonable question.
 
And, completely ignoring or willfully misreading the message sent by the election of Scott Brown, and the gubernatorial elections in Virginia and New Jersey, he STILL wants to pass some kind of Health Care Insurance Reform. He SAYS he thinks it’s because he hasn’t explained it enough to the American people. This, from a guy who spends more time on TV than in the Oval Office. Amazing.
 
News flash to the President: Sir, it is BECAUSE they understand it all too well that the public has rejected this monstrosity. And they don’t want it.
 
Again with the straw man argument that if you’re against this Health Care Reform plan, you’re FOR the status quo. Again with the litany of claims that you can keep your own doctor or plan (you can’t), that it will reduce costs (it can’t; it won’t), it will reduce the deficit by over one trillion over the next two decades (a mathematical impossibility) and a few true claims: it WILL cover pre- existing conditions, and prevent care from being denied when you’re sick. He never mentioned the QUALITY of care, or the possiblity of rationing, which is my biggest worry.
 
And then, the completely disingenuous claim that if anyone has a better idea, let him know. He wants to know. Please. There was virtually NO outreach to the minority party. They deliberately kept the Republicans out of the deliberations and shot down any of their more reasonable ideas, like: Buying insurance policies over state lines; Requiring coverage for pre-existing conditions; True tort reform; Medical Savings Accounts.
 
So, it’s not dead yet. Given that, my advice is that you protect yourself now, by getting in shape and staying that way. Lose weight. Watch your diet. Get started on my pharmaceutical grade fish oil  http://www.favoriteformulas.com  which will reduce your risks of heart attacks and strokes, lower blood pressure, reduce joint pain and inflammation and lower triglycerides and (with garlic)cholesterol.
 
Daily exercise is crucial and the closest thing we have to a true “Fountain of Youth.” I’d recommend my PAIN-FREE PROGRAM & DVD:  http://www.drbillsclinic.com/exercise_eliminate.html   together with a walking program, to help you control weight, reduce insulin resistance and boost immunity. It will also help to prevent or eliminate knee pain, if that’s an issue for you.
 
He then moved on and proposed a spending freeze, of all discretionary government spending (except for the military, Medicare, Medicaid) to begin in 2011 (after first raising the spending by 24% just this year, thereby locking those increases in place). And he reiterated his proposal for increased income taxes for citizens earning over $250,000.
 
And, as a sop to his left-wing base, he called for legislation to repeal the “don’t ask, don’t tell” policy of Bill Clinton, to allow gays to serve openly in the military. All the problems we have and THIS is what he’s worried about. I feel safer now…
 
But my favorite moment was his ringing call to arms…eh…sanctions for Iran and North Korea and improved security against terrorists. The cameras then cut to Secretary of Homeland Security, Janet Napolitano, who sat there wide-eyed and looked like the Pillsbury Dough Boy. I’ll bet the mullahs are just $hitting themselves in fear….Oy!
 
He closed with an invocation of the American character: “In the end, it’s our ideals and our values that built America.” How I wish I could believe that HE believed that. But his every action belies that statement.
 
So, this speech was, in my opinion, redux, not reset. Many had predicted that he would press reset on his agenda, listen to the electorate and swing to the Center, like Bill Clinton did. But this guy is a true man of the left, not a pragmatic centrist like Clinton. He’s a true believer. So I don’t see him doing that. Instead, he’s doubling down. “I don’t quit,” he said. God help us all. 
 
The Republican response was the best in recent memory. The key points? We should restore the proper role of government and not increase taxes and litigation. Create energy jobs and lower energy prices. And, in a reference to the Christmas Crotch Bomber fiasco, we should use our dollars to defeat terrorists, not defend them. Pretty good stuff.

Well, November is coming…take solace in that. If Obama doesn’t get it now, maybe he’ll get it then. 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

Later today, I go to see my surgeon for my post-surgical office visit. The incision is clean and dry, no redness (erythema), no drainage, no swelling and it appears to be healing very well. Nice and clean, with no signs of infection.
 
Of course, it’s a bit tender still, but nothing like it was for the first few days. As a surgeon myself, I know that it’s healing well, and I’m  grateful it is. But the doctor who treats himself has a fool for a patient, or so they say. 
 
So, I will dutifully go to the surgeon and get his official evaluation and his blessing, before starting back on my POWERHOUSE OMEGA FORMULA,  http://www.favoriteformulas.com  my garlic, DR. BILL’S MAXIMUM ALLICIN FORMULA (only available for those already on my fish oil), which enhances the lipid lowering actions of the pharmaceutical grade, enteric coated fish oil, to make it a net cholesterol lowering agent, as well as lowering triglycerides.
 
Especially since this cold snap and nasty, rainy weather lately has made me feel my incision more lately, than before, I’ve really missed its natural anti-inflammatory action. Did you know that in a number of clinical studies, fish oil was found to have an equivalent effect to NSAID’s, but without their adverse side effects? It’s true. In fact, in cases of rheumatoid arthritis, fish oil use allowed some patients to reduce, or eliminate NSAID’s. 
 
And, as I’ve mentioned before, inflammation is a necessary part of this hernia repair, allowing the ingrowth of fibrous tissue into the implanted mesh. So I have had to forgo the comfort of my usual dose. But, as a result, all my joints are “talking” to me, my back is aching and of course, the incision site aches, too. So I’ll be glad to get the OK to start it up again.
 
I’ll also be glad to start some mild knee pain exercises for my aching knees, like those in my newly redone and expanded PAIN-FREE PROGRAM and full length DVD  http://www.drbillsclinic.com/exercise_eliminate.html
 
Combined with walking and isometrics, I can begin the long process of rebuilding my fitness, a step at a time. Luckily, he did a subcuticular closure, meaning there are no sutures to be removed–a long suture under the edges of the skin gives a hairline scar and a tight closure. There wasn’t even a drop of blood, when I took off the initial dressing. Good job, all in all.
 
So, I’m looking forward to a positive evaluation, now eleven days and counting, out from my surgery. This will take about six months to really mature, but this is a good beginning. Thank God! If there’s ever going to be a problem or a complication, it’s gonna happen in a doctor, guaranteed. 
 
Well, over the weekend, we had that plumber return and install a couple of new toilets for us. I went upstairs, to say hello and came up on him, kneeling on the bathroom marble floor, while setting the base of the commode. And, whaddyaknow…he was wearing KNEE PADS! Just like I told him to. 
 
You know, usually, I give folks good advice and more often than not, they ignore it. People often don’t respect or value what they don’t pay for. But not this guy. I told him I was proud of him. He said, “Hey, if I’m told something by a guy who knows what he’s talking about, I listen.”
 
Well, good for him. If he sticks with his new protection, he’ll be real happy a dozen years from now, when he DOESN’T have to suffer with patellofemoral arthritis. For more simple, but effective tips on preventing, or treating knee pain, try my LITTLE GREEN BOOK FOR ELIMINATING KNEE PAIN  http://www.drbillsclinic.com/eliminate_knee_pain.html
 
So that’s it for today, my friend. Talk to you soon. Til next time, be well.
 
Yours for a pain-free tomorrow,
 
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

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

Today I’m in the final countdown before my surgery tomorrow morning. I’m trying to anticipate all the things that will need doing prior to my recovery period, when I expect to be incapacitated by abdominal postop pain. 
 
Though a number of people think I’m crazy getting surgery on New Year’s Eve Day, my wife among them, my attitude is that if you recognize a problem, it’s best taken care of ASAP. Were I to wait, the damn hernia would likely just get bigger and more painful. And there’s always the chance of strangulating a loop of bowel, entrapped in the abdominal wall defect. Now, that would be a problem.
 
No, better to get it behind me, face the issue head-on and fix the damn thing. Compared to what I used to do, this is pretty straightforward stuff. But of course, no surgery is minor surgery when you’re the patient. All in all, I like being the operator better than being the operatee, if you know what I mean.
 
However, this episode gives me a chance to teach you something that I normally wouldn’t think about much. And that is ISOMETRIC EXERCISES.
 
Now, after a surgery like this, any contraction of my core muscles is going to hurt like Hell, at least for the first few days. So after the immediate period of rest, to allow postop bleeding to stop and postop swelling to recede, I have to be able to maintain and then rebuild my leg strength. 
 
This is especially true since I’m not going to be able to restart my fish oil for a while. And I feel it in every joint. There are a couple of reasons for this.
 
First, fish oil’s omega 3 fatty acids act to reduce platelet adhesiveness, or stickiness. That’s great when you want to reduce your risk of heart attack or stroke, by reducing clot formation. Not so great, when you WANT clot formation during and after surgery.
 
Then, there are the known anti-inflammatory properties of fish oil. Well, normally that’s exactly what you want. But in this surgery, inflammation is a part of the initial healing process. So, if I want a good repair, I have to suffer the lack of my POWERHOUSE OMEGA FORMULA  http://www.favoriteformulas.com  for a few weeks. But the other parts of my body, like my back and my joints can definitely feel the difference when I don’t take it. And that’s why YOU should.
 
The kind of hernia repair I’m getting is called a “tension-free” (Lichtenstein) repair, which uses a polypropylene mesh, to cover the abdominal wall defect. This mesh acts like a scaffold, to allow fibroblasts (fiber producing cells) to infiltrate it and rebuild a fibrous layer over the defect. Inflammation plays a role in initiating this process. So, I just have to grin ‘n’ bear it.
 
In the aftermath, when the abdominal wall is sore, active exercise for my knees simply wouldn’t be possible. Nor would it be wise, as it might compromise the repair, before it was strong enough to bear extra tension or intrabdominal pressure. So, what I plan to do is to use the isometric exercises that I teach in my newest edition of my PAIN-FREE PROGRAM & DVD http://www.drbillsclinic.com/exercise_eliminate.html 
 
Isometric exercise generate muscular contraction, without shortening of the muscle. That’s how they’re defined. The advantage is that I can strengthen my knee with these static postures, without putting any pressure on my sure to be sore belly and groin. 
 
The Wall Chair and the Horse Stance, derived from the martial arts, like karate and kung fu, are ideal for this purpose. And they’re safe. They’re ideal for the person just starting out, or the morbidly obese, who want to eliminate their knee pain, but lack any strength, at present. These are a great way to build a foundation of strength, for more aggressive exercises, later on. Just strike the position, and hold it for time. It’s as simple as that. 
 
So that’s what I’ll be doing, after surgery. And what YOU should be doing, if you’d like to start on the road to pain-free knees, safely and effectively. Well, my friend, that’s about it for today. This was my last lesson on eliminating knee pain for 2009. 
 
My wish for you, as we enter a new year and a new decade, is one of peace, happiness, health and prosperity. Have a Happy and Healthy New Year, my friend. All the best, as always. Talk to you again in 2010.
 
Yours for a pain-free tomorrow and optimal health,
 
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 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, 2009 by William Thomas Stillwell, MD, FACS
All rights reserved

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

Some of the types of arthritis, and other related conditions, which are associated with inflammation 

    * rheumatoid arthritis                                                                              

    * gout
    * tendinitis
    * bursitis
    * polymyalgia rheumatica

What is Arthritis?

Arthritis actually means joint (arthr) inflammation (itis). Arthritis can be used to define a group of more than 100 rheumatic diseases and other conditions that can cause pain, stiffness and swelling in the joints or any part of your body. Additionally, it can damage the joint cartilage which can lead to joint weakness, instability and visible deformities that can interfere and, in severe cases, limit a person’s ability to perform most basic daily tasks such as walking, climbing stairs, using a computer keyboard, washing dishes or brushing your teeth. Arthritis can affect anyone regardless of age and most commonly affects joints in the knees, hips, hands and spine. If left undiagnosed and not treated properly, arthritis can cause irreversible damage to the joints, bones, organs, and skin, not to mention dramatically impair your quality of life.

Arthritis-related conditions primarily affect the muscles and the bones but are also considered to be systemic, affecting the whole body. Arthritis can cause damage to any bodily organ or system, including the lungs, kidneys, blood vessels, skin and even the heart. The Arthritis Foundation cites two independent studies (Brigham and Women’s Hospital in Boston and at the Mayo Clinic in Rochester, Minnesota) both of which prove that the widespread inflammation in rheumatoid arthritis is linked to heart disease and an increased risk of early death.

No one really knows the exact cause of arthritis but there are certain risk factors to keep in mind:

    * Genetics – likely to contribute to risk but no one knows how much.
    * Age – the older you are the more at risk you become.
    * Weight – maintaining a healthy weight will ease the load on the joints.
    * Previous Injury – major injuries are likely to contribute to risk.
    * Occupational Hazards – repetitive, high demand jobs increase risk.
    * Certain Sports – high level, high demand sports can contribute to arthritis (however, general exercise is always a plus)
    * Illness or infection – an infection in the joint or gout can lead to arthritis.

What we do know is that when you have arthritis your immune system goes into over-drive and causes the joints to swell and become inflamed. Therefore, treating the inflammation becomes key in managing the pain and discomfort associated with this condition.

Sadly enough, the Arthritis Foundation reports that half of those Americans with arthritis don’t believe anything can be done to help ease their pain. You may be in that situation yourself, having thrown your hands up in frustration and simply decided to live with your pain. The good news is that by reducing the inflammation you can significantly ease the painful symptoms associated with arthritis.

Here are a few ways to reduce your inflammation:

    * Exercise – less weight equals less stress on joints
    * Diet – Eat plenty of vegetables, fruits and whole-grain products; limit sugar, salt and fat (especially saturated fat found in animal products)
    * Rest – a good balance between rest and activity is the key to joint health
    * Over-the-counter and prescription medications – while these may provide temporary relief by masking the pain they do not always get to  the root of the problem – inflammation. They can also have serious side effects, especially with long-term use.
    * Natural anti-inflammatory supplements – probably the most promising natural approach to reducing inflammation in a long while. We recommend looking for supplements containing systemic enzymes and all-natural herbal ingredients.

By taking these simple steps to reducing inflammation you will be well on your way to managing your arthritis pain and it devastating effects on your mind and body. Everyone should strive to achieve a healthy and active lifestyle for optimal health and wellbeing.

Try some 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

Bear in mind that once you’ve entered the joint through those tiny arthroscopic portals (mini-incisions), there’s almost no limit to what you can do in there. And the postop morbidity (pain, swelling, stiffness, disablity, etc.) is pretty much the same, regardless of how much you do inside the knee, UNLESS you cut, drill, abrade, puncture, or otherwise violate the bones. 
 
If you DO get into the bones, you automatically increase postop bleeding, pain and swelling–which makes sense, right? Otherwise, however much you do, the postop limitations are a function of those tiny portal incisions. That’s the great advantage of arthroscopy and why it’s been a transformative concept in modern surgery, that’s made outpatient surgery possible.
 
All these procedures are described in much greater detail, including the conditions that require them, in my LITTLE GREEN BOOK FOR ELIMINATING KNEE PAIN,  available now as a book and an audio CD, too, at  http://drbillsclinic.com/eliminate_knee_pain.html
But for now, let’s look at a few other conditions for which arthroscopic surgery is often recommended, how they are treated surgically and whether other options and NON-surgical treatments are available.
 
First up is SYNOVITIS, an inflammation of the lining of the joint (any joint that has freely moving parts, not just the knee). I alluded to this with a brief remark, last Wednesday. When the lining of the joint gets irritated, it gets bigger, actually grows, often in an irregular way, resulting in flaps, shelves, clumps and masses, that can flop around inside the joint, occasionally getting trapped between the moving parts. This entrapment causes pain, and further swelling and inflammation. The irritated membrane produces lots of joint fluid, resulting in “water on the knee,” as well as pain.
 
The arthrocopic removal, or resection, of this diseased membrane is executed with an electronic motorized shaver. This is a stainless steel tube, with a small window at its end. The window encloses a rotating (or reciprocating) blade, that nips off small morsels of synovium, which are then sucked out by a vacuum pump and collected in a trap, for pathological study. Using this technique, you can systematically resect almost ALL the lining, as in cases of Rheumatoid Arthritis, or Bacterial Infection, where you want to rapidly “debulk” the mass of diseased membrane. But guess what? A new membrane grows back very rapidly, hopefully in an uninflamed, relatively normal state.
 
DEBRIDEMENT is a French term, meaning “house cleaning,” and it’s pronounced “De-BREED-mont,” not de-BRIDE-mont. I had an Australian professor once, who use to say “Da BRIDE is whut walk down de aisle wit’ de groom. Gentlemen, it’s deBREEDmont.” This refers to shaving off loose shreds of degenerative cartilage from the articular surfaces, to smooth them out. It’s important to remember that you can only REMOVE tissue; you can’t put anything back. 
 
Normally, the shaver is used to do this and it’s combined with synovectomy and LAVAGE, essentially washing out the joint with irrigation fluid. This is controversial in the treatment of arthritis, but if you’re there for other reasons, you might as well “clean house.” Today, you can also do this with radiofrequency probes and lasers, too.
 
And, as I also mentioned last Wednesday, LOOSE BODIES and FOREIGN BODIES can be grasped by forceps and extracted through the arthroscopic portals.
 
Areas of bare bone, if they’re small enough, can be treated through the scope to restore some kind of cartilage covering, but as I mentioned above, the morbidity and pain is greater once you penetrate the bone surface. Arthroscopic awls are sharp, pointed steel spikes that are used to put multiple shallow punctures into the bone, a procedure called MICROFRACTURE. Another way to do the same thing is to use a high speed burr to “sand” the surface and stimulate bleeding. This is called ABRASION CHONDROPLASTY. Both these techniques result in blood clot, which is changed into fibrocartilage over the bare area.
 
An alternative is to restore actual hyaline cartilage, in one of two ways: CHONDROCYTE TRANSPLANTATION, in
which cells initially harvested from non-articular parts of the knee are cultured, then reimplanted to grow new cartilage; and OATS (Osteochonral Articular Transplanation ) which transposes plugs of bone, with its articular cartilage attached, into drill holes in the bare area. Pretty cool stuff, no?
 
And, really, NOT so scarey, now that you KNOW what’s involved, right? Whatever it is in your life, if you KNOW what you have to deal with, you can DO it, if you have to.
 
But, there are many times that you DON’T need any of these techniques. Those are the times that surgery ISN’T warranted, because conservative methods will work to relieve your pain and restore your function just fine, thank you very much. If you want to AVOID An
UNNECESSARY SURGERY, then you need my newest healing program, HOW TO AVOID KNEE SURGERY. Get it here, at
 http://drbillsclinic.com/avoid_knee_surgery.html
 
Next up, osteotomies and realignment surgeries. Talk to you tomorrow, my friend. Meanwhile, 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 would explain the phenomenon of melting polar ice caps, rising seas (which, given Al Gore’s time line, should have swallowed several coastal cities by now) et al, which are a product of extrapolated computer models. Same problem: if the assumptions on which the models are based are faulty (ie. warming, such as it is, is the product of man made activity, greenhouse gases and the like), the results are, too. This is why the polar ice caps of Mars are also observed to be receding, absent ANY man-made activity (so far as we know). And it explains why our polar ice is now INCREASING, contrary to the predicted findings of the models.
 
People who are fully invested in the whole global warming enterprise are aware of these disturbing variations in the real world from the computer models. That’s why you now hear more about “climate change,” than global warming these days. Here’s a clue: the climate is ALWAYS changing–that’s what it does. And all climate is a function of the activity level of the SUN, the source of all energy on earth. The amazing thing is not that climate varies now and again, but that the narrow range necessary to preserve life on our little planet is remarkably constant.
 
So while the meteorologists and weathermen appear to be fey on Fay, I’m going to look out my window, onto the real world, and see what the weather’s doing. Still cloudy, still no rain, mildly breezy here in Orlando. But the radio says twisters were noted in Southern Florida. Which way will it go? They have NO IDEA, though they have plenty of predictions. Ah well, let’s hope it misses us. We’ll soon know…
 
Speaking of the crappy weather of the Hurricane Season, ever notice that your joints ache when it’s about to rain? Or that you feel sleepy when it’s cloudy and damp? Well, that’s a function of specialized nerve endings in the tissues around your joints that respond to a fall in barometric pressure (baroreceptors). Any inflammation, as from synovitis, arthritis, a chronic sprain or strain, a recent fracture (even if healed) aches with damp weather.
 
You can ease those aches and pains with some local heat applications and the various anti-inflammatory measures I teach in my newest program, HOW TO AVOID KNEE SURGERY    http://drbillsclinic.com/avoid_knee_surgery.html
Using measures from across the medical spectrum, you can relieve pain, reduce inflammation and restore function in your painful knee–without surgery. 

Til next time, my friend, stay dry, stay safe, and 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 actually had an instructor tell me, “Hey Stillwell, you ain’t even HUMAN til July,” meaning NEXT July. The attitude of the attending physicians & surgeons was “I did it; now YOU do it.” And the surgeons were, by far, the worst. 
 
Quite insane, actually, but the feeling was that if they could train you to automatically do the right things, in the right order, without thought (you were much too tired for rational thought), then you would learn “reflexes” that were always correct. That actually was correct, but it’s still NUTS! To this day, I still do things by rote that were “burned” into me during those formative years of training.
 
Anyway, there I was, in a zombie-like state, terrified that I would kill someone, by action or inaction, in a state of constant anxiety. I was literally afraid to go to the bathroom, for fear I’d miss a page. I had to have all my patients seen and examined, notes written, bloods
drawn, x-rays collected and be IN the O.R. by 7:30 AM, so surgery could begin at 8:00 sharp. I was a mess. 

Then, one day, I noticed that my bloods (patients’ lab work) were being drawn for me. I was a little puzzled by this, but I “never looked a gift horse in the mouth,” as the saying goes. And, truth be told, I was so burned out from exhaustion that I accepted this, without really caring why. This went on for a couple of weeks, until one day on the ward, a beautiful little girl, with butt-length, reddish chestnut hair asked for
my help in drawing the blood of a quadruple amputee.
 
Now, when no limbs are available from which you can draw a blood sample, your main option is what we call a “femoral stick” — a puncture of the femoral vein in the groin. Technicians were supposed to ask a physician to do this, because there is a certain amount of danger in doing this technique, where you could hit the artery, by mistake. Sure, get the zombified intern to do a delicate procedure–brilliant!
 
Well anyway, the patient, a very cheerful older black man, who had been injured in the war, was up for it. He looked back and forth between this young lady and me and finally laughed and laughed. “Hey doc, that vampire gonna GET you,” he said, laughing at me.
“What are you talking about?” I replied. He laughed even harder. “YOU’LL find out…heh-heh-heh,” he said. With that, I got the sample, gave it to the young woman, who I found out later was FAR better at femoral sticks than I was (rules be damned). 

And the rest, as they say, is history. The young woman became my wife. I never saw it coming. I never had a chance. That guy sure knew what he was talking about. And that’s why I have a soft spot in my heart for vampires, to this day, which I always think of whenever blood work is needed.
 
Getting periodic blood work on yourself is a good idea, at least yearly. And some special tests, like the CRP (C-reactive protein test) can be helpful in diagnosing inflammation, while Rhematoid Factor can be diagnostic in Rheumatoid Arthritis. I teach about these tests, and others in my Little Green Book, which you can get at   http://drbillsclinic.com/eliminate_knee_pain.html
If you have knee pain, or know someone who does, you can’t do better for a concise but comprehensive review of the diseases that cause it and the methods to treat it.
 
Til next time, my friend, be well.
 
Yours for a pain-free tomorrow,
 
Dr. Bill
 

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